Mental illness falls along the great continuum of human variation; the question is where. Listen to hoarders like Bonnie and Bob and the others who let me into their lives, and you hear the reasons they give for keeping stuff, and the sorrow they feel when asked to discard it, that are strikingly similar to those of everyone else who feels attached to their college physics textbook (that class changed my life), their mother’s wedding ring, their child’s christening gown. The only difference is that the latter feel this attachment to only selected things. Hoarders’ hearts embrace multitudes.
Bonnie Grabowski, with whose story I began this chapter, epitomizes the hoarder whose inability to part with stuff results from the deep sentimental attachment she feels to it, whether because it is all she has left of her husband and her dreams, or because it ties her to an earlier time in her life, when her children were young, when it felt like there was still a chance and time enough for the then-unhappiness to give way to something better. One of Frost’s clients was unable to throw out anything that connected her to her past. As he was helping her declutter one day, she found an old ATM envelope in the pile of junk on her couch. With his encouragement, she managed the immense accomplishment (for a hoarder) of dropping it into the recycling box—and immediately began to cry. It felt like she was “losing that day of her life,” Frost recalls her explaining. If she threw out too much, she said, there would be “nothing left of me.”
Because many hoarders see sentimental value everywhere, the old DSM’s description of hoarding as “the inability to discard worn-out or worthless objects even when they have no sentimental value” (my italics) was off-base. To a hoarder, the most worthless-seeming junk can have immense sentimental value; every scrap and ort is a piece of their lives, and yanking one out threatens to make the rest fall apart. We all feel something like that, if not for an ATM receipt then for the Playbill from the show at which we shook hands with Adlai Stevenson (my parents) or the baseball scorecard from the last game a now-deceased parent took us to (my cousin) or the dress we wore on the first date we had with a now spouse (singer-turned-fashion-designer Victoria Beckham, who in 2014 told the British magazine Stylist that she has never parted with the suede minidress she wore in 1997 when she first went out with soccer great David Beckham, whom she married in 1999). The difference between that and hoarding is one of degree, not kind. Frost calls it a “special ability to see uniqueness and value where others don’t.” If you followed the old editions of the DSM to the letter, Bonnie and millions like her would not be classified as hoarders; the possessions in the floor-to-ceiling piles have deep sentimental value.
The tendency of many hoarders to imbue their acquisitions with deep emotional significance lies at the extreme of a continuum where we all find ourselves. In a bud vase on my étagère is a desiccated flower from my mother’s funeral. Beside it are half a dozen pieces of confetti from the millennial New Year’s Eve in Times Square: I had to work on January 1, 2000, and as I walked along the morning-empty streets from Grand Central Terminal to the Newsweek office at Columbus Circle, I picked them up, thinking, In fifty years it will be so cool to touch these and know they fell from the most famous New Year’s Eve site on the most notable New Year’s Eve in modern history. In my son Daniel’s room are photographs of him with his soccer teams, the cheap trophies he got for Little League, the yellowing “Way to Go!” certificates from Miss Mango for “excellent behavior” in first grade. (I hasten to add that Daniel’s room is neat as a pin now that he lives on the other side of the country, but these mementos are still there.) Are these signs of a mental disorder?
Although I mercilessly cull old clothing, papers, and even books (donating them to the local library), I keep these things, and a few others, because they connect me to people and times I will never see again. They are little tiles in the mosaic of personal identity. Our stuff expands that identity, deepens the meaning of our lives, provides security, and attaches us to our own past as well as to a world beyond ourselves.
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I. The New York Times described the impending auction of Dershowitz’s trove on Feb. 19, 2016.
II. Researchers often use waiting lists for their control groups because people who try to enroll in a Buried in Treasures workshop are thought to be similar to those who actually participate in their motivation, severity of hoarding, and other traits.
CHAPTER NINE
Compulsive Acquiring, or I’ll Take Two
The human animal is a beast that dies, and if he’s got money he buys and buys and buys and I think the reason he buys everything he can buy is that in the back of his mind he has the crazy hope that one of his purchases will be life everlasting!
—Big Daddy, in Cat on a Hot Tin Roof
THERE IS NO HOARDING WITHOUT acquiring, and in twenty-first-century America acquiring has become the national pastime. At a December 2006 news conference, President George W. Bush cast it as Americans’ patriotic duty: “I encourage you all to go shopping more.” For many of us, shopping, at least beyond what’s needed to provide the necessities of life, can be an exciting, joyful, carefree indulgence, a splurge and a treat, a reward for a job well done or compensation meant to tip the balance of fair and unfair, just and unjust (My boss lit into me at today’s meeting; I deserve a new pair of sandals). Like virtually every behavior people engage in to an extreme, excessive acquiring—shopping, shoplifting, or picking up free stuff—can spring from any of the three forces described in the Introduction: impulses in which we are seized by an irresistible urge, a pleasure-seeking drive akin to an addiction, or a need to dispel an unbearable anxiety that builds and builds until it feels like it will crush us. We’re interested in the last version, of excessive acquiring as a compulsive behavior that people engage in to quiet anxiety.
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On Jenny’s way to meet me on a spring afternoon in Manhattan, the universe spoke to her: peeking out of a bag balanced atop a garbage can in front of an Upper West Side brownstone was a beautiful comforter. The week before, Jenny had vowed to other members of Nathan Blech’s Meetup hoarding group that she would resist bringing into her apartment anything that she didn’t absolutely, positively need.
Need, of course, is subjective.
The comforter seemed to be in pristine condition, and as Jenny remembered her vow she felt as if an angel and a temptress were lobbing mortars at one another from her two shoulders. The angel beseeched her not to take something that would only add to clutter so horrendous that the only places Jenny could move in her apartment were along its goat paths, around the computer desk, and on her bed, which she managed to keep clear. The temptress whispered that “this is a once in a lifetime deal.” Her rational mind knew this wasn’t so, of course; Manhattan is full of perfectly usable discards, so this was hardly a rarity. In any case, she didn’t need another comforter. She briefly considered walking away empty-handed, but a toxic blend of insecurity and anxiety filled her chest. “If the universe put it there,” she remembered thinking, “I should take it.”
An actress who took mostly bit parts separated by weeks and sometimes months of no parts at all, Jenny never made much money. When she was growing up, her family struggled financially. She was taught to eat everything on her plate; “waste not, want not,” was the household mantra, she said. Now, when something went on sale, she bought it. Actually, not exactly “it.” She regularly bought eight or ten cans of her favorite tuna, she told me. But wait, I said; lots of people do things like that; maybe you’re not really so unusual, let alone a compulsive acquirer. Jenny took a deep breath. And told me about the washing machines.
The one in her apartment broke a few years ago, and Jenny couldn’t afford to fix or replace it. But as she was walking along the sidewalk one day, contemplating a future of Laundromats, she saw a washing machine at the curb. It was the same make and model as hers. She paid a neighborhood kid to haul it to her fifth-floor walk-up, then dismantled both it and her broken one (Jenny has been mechanically handy for year
s: as a hoarder, she can’t have repairmen in her apartment). What was wrong with one was fine with the other, and vice versa, she discovered. It was as if one was yin to the other’s yang. She cannibalized the found machine to repair the broken one.
No wonder she rejects the idea that it’s a symptom of mental pathology to pick up “junk” on the street. Walking the sidewalks of New York, she said, “I just see things. Something will be behind a hydrant, or behind a pile of garbage, and I’ll just know instinctively that it’s . . . interesting. People like me, we see the potential in things that others don’t. I know a hamper is not a living, breathing thing. But it deserves a chance, you know?” Even toilets do. She found a quite usable one on the sidewalk and disassembled it, making several trips to lug home the pieces. It was just what she needed to repair the cracked commode in her apartment. “That just doesn’t wash with me, therapists saying it’s crazy to think some piece of junk will be useful,” she said.
There is a dollar store near Jenny’s apartment, and one recent afternoon she passed it by. At first. But then she thought, Oh, there’s no harm in checking out the new arrivals. Seeing canine diapers, she told herself she had enough for her seventeen-year-old dog, but then her brain demanded: Do you know where they are? The only way to quiet the anxiety was to toss a package into her shopping cart. Then she noticed vinyl tablecloths, which she regularly cut up to make doggie mats. The universe spoke to her again: the shelf was piled with plaids, whose Mondrian-like geometry make them ideal for cutting, with the straight lines and right angles for her scissors to follow. Again the angel and the temptress argued, but every time the “don’t buy it” angel seemed to be winning Jenny felt an anxiety so gripping she compared it to when a severe allergic reaction constricts your throat. “I’m talking to myself, trying to rationalize why I don’t need more diapers or tablecloths, and the next thing I know the world goes black and I feel powerless,” she told me. Stacks of tablecloths went home with her.
During summer pilgrimages to her mother’s rural home, she discovered an acquirers’ mecca: outlet malls. “I would get thousands of dollars’ worth of stuff for just a few hundred dollars, and UPS it back to New York,” she told me. “It was unbelievable. I would spend entire days shopping until I was exhausted. Clothes, housewares, home furnishings, kitchen stuff, canned food, dry stuff like cereal and candy.”
Even now she doesn’t regret it, or at least not all of it. “One year I shipped home twenty-five tubes of anchovy paste: they were $2.99 in New York but only a quarter there!” She paused. “I still have some of that anchovy paste. And that was ten years ago.” The frugality impulse was so strong that when she tried to resist, the throat-closing anxiety felt like a signal from her unconscious telling her to give in. Compulsively shopping “is just comforting,” she said. “It’s like building a wall or a fortress like the ones I made in kindergarten. I don’t want to be this way but I can’t overcome the compulsion.” As we said good-bye and Jenny picked up the plastic bag with her found comforter, she wanted to tell me one more thing. Whoever put it out had also piled sheets, blankets, and the like outside the brownstone. “I left as much as I took,” she told me—proudly or defensively. It was hard to tell.
Oniomania
In a 2006 study of 2,513 U.S. adults, psychiatrists at Stanford University found that 5.8 percent exhibited compulsive buying behavior, based on a screening questionnaire called the Compulsive Buying Scale. Compulsive buyers tended to be younger, Lorrin Koran and his colleagues reported in the American Journal of Psychiatry, and despite age-old stereotypes men were as likely to shop compulsively as women. More recent surveys have found a similar prevalence: a 2008 study in the Journal of Consumer Research estimated that 9 percent of Americans are compulsive buyers.
Excessive buying exemplifies the dilemma I described earlier: what looks like the same behavior can be a manifestation of impulsivity, an addiction, or a compulsion. “The behavior can be the same, but different people arrive at it by very different avenues,” Susanne Ahmari, a clinical psychiatrist and neuroscientist, said when I visited her at Columbia University (she later moved to the University of Pittsburgh). “One behavior may stem from anxiety and another seemingly identical behavior will come from depression or mania or even just boredom.” For other people, said April Benson, a psychotherapist who has made her name studying and treating overshopping, “it’s closer to an impulse-control disorder: they get an urge to have something and they can’t stop themselves from acting on it.”
That was how psychiatrists in the early twentieth century viewed compulsive buying. The first scholarly reference to compulsive shopping came in a 1902 medical book, Obsessions and Compulsions, coauthored by a neurologist in Bordeaux, who treated a man who had manie des achats—mad shopping. It caught on: German psychiatrist Emil Kraepelin, considered the founder of modern scientific psychiatry, wrote about “compulsive buying disorder” and “buying mania” in his influential textbooks. Swiss psychiatrist Paul Eugen Bleuler (1857–1939), who is best known for coining the terms schizophrenia and autism, discussed it in his 1930 textbook, called compulsive buying oniomania (from the Greek onios, meaning “for sale”) and described it as a “reactive impulse” or “impulsive insanity” much like kleptomania. He cited Kraepelin’s discussion of “oniomaniacs in whom even buying is compulsive and leads to senseless contraction of debts with continuous delay of payment until a catastrophe clears the situation a little.”
After the brief mentions by Kraepelin and Bleuler, for most of the twentieth century psychiatry showed little interest in compulsive buying. The phenomenon didn’t even make it into the 1987 DSM, though it merited a few lines in the 2004 edition as an “impulse-control disorder not otherwise specified.” The DSM-5 of 2013 booted it out again. Researchers who studied consumer behavior paid some attention to compulsive buying, but for psychologists and psychiatrists “it basically just disappeared from the textbooks until the 1990s,” said Donald Black, a psychiatrist at the University of Iowa and one of the country’s leading experts on the behavior. “It was like no one thought about it.”
Beginning in the 1990s, however, psychiatrists and others began reporting case histories of people who felt compelled to hit the mall—twenty cases in one study, twenty-four in another, and forty-six in a third. And that was when researchers began to realize they were dealing with a phenomenology of several distinct ontologies.
For some excessive shoppers, the behavior is a consequence not of a spur-of-the-moment impulse, as per Kraepelin and Bleuler, but of a buildup of emotions: depression, anxiety, boredom, and anger were the most common, Black concluded from the scientific literature as well as his own patients. “Euphoria or relief from negative emotions were the most common consequence,” he found. If the payoff is relief, it’s a compulsion, as I’ll discuss below; if the payoff is euphoria, the behavior resembles an intensely pleasurable addiction. In that case, “there’s an anticipatory element—they think about it, the excitement builds, and then they make the purchase,” said Black. “People have described feelings similar to withdrawal if they can’t shop. They experience mild dysphoria, irritability, even jitteriness.” Between one-fifth and one-half of people (depending on the study) who buy to excess also have a substance abuse disorder, suggesting that these are the ones who are most likely to have the addictive version of excessive shopping, feeling a mood-boosting hedonic hit from whipping out the credit card again and again and draping those lovely shopping bags over their arms. Without that regular hedonic hit, the overshopper is as bereft and down as a gambling addict without her fix, and so has to shop and shop and shop again to maintain the thrill and the (temporary) high.
Closely related to shopping as a quest for a hedonic hit is shopping as a form of self-medication for boredom or depression, in which acquiring one more pretty thing assuages those and other painful emotions: I don’t have a date for Thursday night, but I have an amazing new pair of stilettos. Loneliness, anger, and feeling inadequate, rejected, fr
ustrated, and hurt can all trigger a shopping binge. “Most of the people I treat say it distracts them from whatever pain or distress they feel,” said Terrence Shulman. Although the loneliness, anger, or hurt almost never have anything to do with shopping, shopping “acts like a soothing agent,” he said, especially for people who feel “I’m not enough unless I have enough.” A 2013 poll commissioned by “The Huffington Post” found that 40 percent of women and 19 percent of men said they shop as a way to cope with stress.
When overshopping is a true compulsion, in contrast, it brings little more than temporary relief from anxiety. Just as hoarders derive little joy from their stuff, instead offering it up like a sacrifice to placate the gods of anxiety, so compulsive shoppers experience anxiety and distress until they acquire and only relief when they do. “There is a rising anxiety that can be relieved only by going out and buying,” April Benson said. “You feel driven to do something you don’t necessarily want to do.” Between 40 percent and 80 percent have an additional anxiety disorder. That’s where we find the true compulsive shopper like Jenny. She did not impulsively scrounge the discarded comforter or get a lifetime supply of anchovy paste, and she derived no great pleasure from her acquisitions. Instead, she listened long and hard to what her feelings were telling her, and what they were telling her was You feel that? You feel your throat closing up and your heart racing? That’s your unconscious telling you that if you don’t take this you will keep feeling as if you are waiting for word of whether the person you love most in the world survived the crash of the plane he was on.
“The anxiety that drives the compulsive shopper could be anxiety about anything,” Benson said. “It could be a fear of ‘missing out’ on something, like what everyone else is wearing, or missing out on the July sale at Nordstrom.” The anxiety often involves self-esteem or feelings of worthlessness. If I’m able to bring home another bag of outfits from H&M, I can’t really be poor, can I? Or it can arise from the thought of not buying. One woman whom psychologist Randy Frost tried to help was watching a shopping channel one day when a group of puppets was featured, he recalled. When no one bid on them, the woman began to fret that the puppets’ feelings would be hurt if they “thought” no one wanted them. She bought half a dozen to make them feel wanted and relieve her own anxiety about their sadness.
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