Our non-acquiring trips work in part because a therapist is available to help talk people through their urges and place them in context. Since therapists can't accompany people everywhere they go, we ask our clients to create a list of acquisition questions to carry with them. These are simple, commonsense considerations such as "Do I have anything like it already?" or "Do I have a place to keep it?" Janet found these questions particularly helpful. They seemed to work nearly as well as having her therapist present, although they will work only if they are used. On one occasion, I overheard a member of one of our treatment groups tell another member, "I went shopping last week, but I didn't bring my questions because I knew if I did, I wouldn't buy anything."
Our research indicates that most people who undergo this treatment learn to control their acquiring more easily than they manage to get rid of their clutter. For some the effect is financially rewarding. Janet, for instance, paid off her credit card debt and ended treatment with more than $10,000 in the bank. By the end of her treatment, Janet could look through clothes racks and walk away without buying. Whereas controlling acquisition is pretty straightforward, changing the meaning of one's possessions and ridding one's home of hoarded clutter is far more difficult.
4. BUNKERS AND COCOONS: Playing It Safe
I had such a terrible week that I just wanted to come home and gather my treasures around me.
—Irene
Chris lived in a small bungalow on the edge of Berkeley, California. Overgrown trees and shrubs hid her house from the street. Potted plants covered most of her porch. She had an eye for Persian rugs and hung them from ceiling to floor along her hallway. There were eight or nine of them on top of one another, narrowing the hallway by at least a foot and giving her home a cavelike feel. Goat paths threaded through the waist-high piles of books, clothes, magazines, and other stuff filling the house—certainly enough clutter to impair her quality of life. She told us her refrigerator had broken recently, but she couldn't remove it through the maze of stuff, nor could she get the new one in. So the new refrigerator ended up in the basement, adding one more inconvenience to her already complicated life. Like so many of the people we've met, she was very intelligent. It was clear that she had read most of the hundreds of books that were strewn throughout her home. Chris was a nurse who had found me through an online hoarding support group, and we corresponded for quite a while before we met. Though she was a great resource for others, she had trouble controlling her own passion for collecting.
"I have pioneered a method of spotting hoarder houses from the street," she wrote to me once. "I just drive slow and look for front yards that look like mine, a jungle of hundreds of plants. Porches are often full too." She offered to make a study of it, taking pictures and sneaking by when a door or window opened to get confirmation. "I estimate the incidence of H-C [hoarding and cluttering] homes at about one household per block here in Berkeley," she claimed. Chris knew her neighborhood and the characters who lived in it. She accompanied us on a "hoarding tour of Berkeley" (see chapter 13), and she pointed out homes occupied by people she knew or suspected were afflicted with hoarding. "Like mine, complex and jungly" was how she described them. Pruning trees and shrubs was clearly a low priority. Permanently drawn shades pressed against the windows; apparently unsteady piles of stuff had fallen against them inside. Old and dented buckets, broken lawn mowers, paint containers, and piles of wood littered the yards, which were often obscured by tall grass and weeds.
Many of these homes needed repair and painting, but there is some variability on this point among hoarders. One of our most severe hoarding clients lived in a home whose exterior could be featured in House & Garden magazine, but whose interior was a horror. Our research has shown that only about half of identified hoarders live in dilapidated homes, so I guessed we were probably seeing only half of the hoarding population of Berkeley.
The darkness of the houses we drove by struck me: they were practically caves. To me they seemed dreary and menacing, but I came to understand that many hoarders, like Chris, view their homes very differently. It's possible that people who hoard prefer small, enclosed personal spaces—almost the opposite of claustro phobia. Perhaps they close in their living spaces to achieve a cocoon-like feeling of comfort and safety. I remembered how Irene, after a stressful day, wanted to come home and "gather my treasures around me." Irene's "treasures" helped her feel safe; when threatened, she wanted to surround herself with them. Investigators who study fear make a distinction between events that signal threat and events that signal safety. We commonly think of fear as occurring in the presence of threat signals. But fear can be activated by the absence or removal of safety signals as well. For many hoarders, the thought of losing possessions fills them with fear.
In many yards, we saw cars and trucks given over to storage. The truck beds, back seats, and even driver's seats were full of newspapers, clothing, and other overflow from the homes. Rusty charcoal grills, usually in multiples, peppered lawns, as did containers of various sorts, barrels, beat-up trash cans, and planting pots. The stuff the containers held looked disorganized and chaotic and had obviously been untouched for years. As we passed block after block, every street seemed to have two or three cocoon-like houses. It reminded me of the surprise I felt at the large number of phone calls we got when we placed our first ad looking for pack rats. Is it possible that so many of us have lost control of our stuff? Were all these houses just containers for the things that make us feel safe?
Walling off the Danger
Bernadette was a large, light-skinned black woman, attractive and stylishly clad when she first came to therapy. Her personality filled the room when she wasn't depressed. She dressed very well on some days, with matching shoes, purse, and scarf; she favored pink and patent leather. On other days, she dressed to match her depression, throwing on whatever she found in front of her—even pajamas with snow boots. She had been a schoolteacher for many years until the birth of her daughter when she was forty-four. Shortly thereafter, she and her husband adopted a little boy. Her daughter and son were now five and three, respectively. Her husband was a committed preacher, busy taking care of his flock in a largely African American community. Bernadette's and the children's lives revolved around her husband's church as well. She assisted her husband as a deacon, attended a Bible study group, and joined her fellow churchgoers to pray whenever anyone needed help. Now she was the one in need. Bernadette and her family lived amid mounds of clothes, shoes, kids' drawings, pet projects, and assorted everyday family paraphernalia. After years of struggle and conflict with her husband over her hoarding, which had taken over their three-story, fourteen-room Victorian home, she finally decided to seek treatment for her problem.
By then, her home was nearly uninhabitable. The entry hallway and first-floor landing were full of children's clothing and toys, shoes, decorations for various holidays, books, Sunday school papers, and lesson plans from her teaching years. Just as we've seen in so many homes, ineffective efforts to organize were evident in the innumerable empty plastic bins and lids stacked elsewhere. The living room and adjacent dining area were waist-high with clutter of a similar sort—lots of clothes and shoes, plus place mats and table decorations, random papers, and assorted knickknacks. The stairwell contained more plastic containers and covers, cascades of newspapers and magazines, and more clothes and shoes. The bedrooms ranged from waist- to ceiling-high mountains of mostly clothes and shoes. The children could still sleep in their beds, but barely.
Most of what filled Bernadette's home came from her daily shopping sprees. She was devoted to her kids and insisted that they should have the things she never had. She tried to be frugal, shopping primarily at discount stores, because the family had very little money. Nonetheless, her buying so taxed their finances that the electricity had been shut off for nonpayment, and the family was facing bankruptcy. To cope with the loss of electricity, they stretched extension cords up the cluttered stairwell from the single working
outlet in the basement. Although this provided them with light, it increased the risk of fire in a home from which escape would have been difficult.
Child and Family Services had been inquiring about the conditions in the home, and the loss of her children was a possibility if Bernadette could not learn to stem the tide of clothing and toys. Still she shopped. Her husband was angry. The chaos at home prevented his finding important papers or inviting anyone from the church to their home, and it kept their kids from having friends over to play. He wanted to know how she had let this happen and why she kept bringing new stuff home.
From our earliest studies of hoarding, we've noticed a connection between possessions and security. Violations of ownership lead to extreme feelings of vulnerability. When describing their reactions to someone else discarding one of their belongings, a number of our clients have said, "It feels like I've been raped." It is possible that in some people, hoarding might develop as a response to severe trauma. Compared to people who do not suffer from hoarding problems, clutterers report a greater variety of traumatic events (an average of six versus three), as well as a greater frequency (an average of fourteen versus five) of such events. The types of trauma most often experienced by hoarders include having had something taken by threat or force, being forced into sexual activity, and being physically assaulted. Traumatic events often cause people to reach for things. A survey of survivors of the World Trade Center attack in 2001 found that nearly half spent time gathering possessions before evacuating, even as the building shook beneath them. * Hoarding may be an extreme version of this phenomenon in response to trauma.
Of course, not every case of hoarding stems from trauma. But in some cases, the connection is undeniable. One study showed that hoarders who experienced traumatic events had more severe hoarding problems than those who were not exposed to trauma. One unexpected finding in this study was that clutter, rather than difficulty discarding or excessive acquisition, was associated with trauma. For some hoarders, such as Irene and Bernadette, clutter helps them feel protected within their homes. In cases where a traumatic experience precedes the onset of hoarding, perhaps the trauma triggers a nesting instinct to protect the person from further harm.
Bernadette had coped with adversity most of her life. As a child, she saw more than her share of violence, both in her rough neighborhood and within her own family. Her father was a pathological liar and petty criminal, in and out of prison from the time she was born. Her mother criticized her mercilessly, demanding perfection of the sensitive young girl but spending little time attending to her needs. After her parents divorced when Bernadette was small, she and her siblings rotated among relatives. She formed the strongest bond with her great-aunt, the most stable figure in the large extended family.
When Bernadette was ten, she was sexually abused by her stepfather. The experience left her with doubts about her own basic safety and self-worth. As a teenager, she sought comfort in drugs and casual sex. About the time she went off to college, she began to shop. She bought mostly multiples of things, such as boxes of tampons, to avoid having to borrow them from others. But her excesses left her more than $10,000 in debt. Some "messy piles," as she described them, grew in her room, but at that point she had little trouble getting rid of things.
By her mid-twenties, Bernadette had found strength and solace in religion. She devoted herself to God and pulled her life together. She remembered the moment that God spoke to her, and she vowed to give up sex for God—to remain celibate until marriage. In the wake of her newfound faith, she encountered little difficulty with shopping or hoarding.
That changed when she was thirty. By that time, she was working as a teacher and had her own home. Late one night, a man broke into her second-floor bedroom by climbing up the rain gutter. He raped her at knifepoint. This horrifying assault—an unpredictable and uncontrollable event—was especially damaging to Bernadette, already cursed with a fragile sense of security from her earlier abuse. She found little help in her community. When she approached the minister of her church, he was too busy to talk to her and seemed to imply that she'd done something to invite the rape. She felt angry that God had seemingly abandoned her, and at the same time she felt ashamed, as if perhaps she had done something wrong.
Bernadette's family helped her pull down the gutter, but that wasn't enough to make her feel safe. She moved to a different room and locked the windows, but she couldn't shake the feeling of vulnerability and grew depressed. The world was not a safe place for her, and perhaps, she thought, she didn't deserve to be safe. A life of happiness must be reserved for those more worthy.
Despite her disillusionment, Bernadette did not abandon her religious beliefs. She shut out all thoughts about the rape and got on with her life. She fulfilled her Christian responsibilities as best she could but found little comfort in them. She did, however, return to one activity that pleased her—shopping. She loved buying clothes. She bought more and more things, which she put in the now unused bedroom where the rape had occurred. Soon the room was full, and her things spilled out into the hallway and eventually down the stairs. The rest of the house began to fill up as well.
Almost ten years after the rape, Bernadette met and married the pastor of a nearby congregation, and he moved into her house. Their first few years were happy, and although their home was cluttered, it was still manageable. At age forty-two, Bernadette experienced another disaster. She had a miscarriage, but her body would not discharge the fetus. She was devastated. Three weeks later, she finally acceded to her midwife's insistence that the dead fetus be removed medically. Afterward, her shopping and saving grew worse, and the clutter took over her home. She soon became pregnant again and this time gave birth to a daughter. A year later, she and her husband adopted a son. Despite her improved fortune, Bernadette could not escape the effects of her earlier traumas. She felt guilty and depressed much of the time, convinced that something was fundamentally wrong with her.
She continued her shopping sprees. Buying lifted her spirits for a few hours, but then the disappointment and depression set in again. She tried establishing rules for acquiring, but she couldn't stick to them. The urge to buy had become too hard to resist. When she was shopping, her world felt safer and things seemed clearer to her. Her goal was to look "classy," and she prided herself on her taste in clothes, choosing brilliant colors and styles that looked good on her. She felt important when she dressed well. Soon she was able to wear only a fraction of the cartloads of clothing she bought, and so she then turned to her children's needs. She justified her purchases as a means to ensure that her children wanted for nothing, and her old habit of buying in multiples returned.
She described the typical shopping trip: "I'm out looking for white shirts for my son—he's hard to fit because he's a big boy. And there I am at Wal-Mart, and lo and behold, there are the white shirts in his size. So I start thinking about how many to buy. 'Course he'll mess up the shirts, so I gotta have at least five, and they are a really good price. It's a hard item to find, so I buy six of them, and I find sneakers for him, too."
Getting rid of her purchases, or for that matter anything in the house, was next to impossible. Bernadette spent little time organizing or sorting and wouldn't allow her husband or children to discard anything without her approval. Whenever she tried to get rid of something herself, she felt vaguely uneasy and afraid. Understandably, her husband was becoming frustrated, but his criticism of her excess strengthened her conviction that she was bad, inadequate, a failure. Her only respite from these feelings seemed to be shopping. Like Janet in chapter 3, Bernadette was caught in a vicious cycle.
Bernadette self-medicated with things the way other trauma survivors self-medicate with drugs or alcohol—but the cure was getting worse than the disease. Still, the pain she was treating was very real, and her methods had an immediate effect. Despite the high frequency of traumatic events in the lives of people who hoard, relatively few of them develop posttraumatic stress disorder (PTS
D). Whereas other anxiety disorders and depression are often accompanied by PTSD, in a 2006 study we found that it afflicted only 6 percent of compulsive hoarders. A low frequency of PTSD among people with a high frequency of severe traumatic events suggests that something is operating to limit the development of PTSD. Perhaps hoarding actually helps prevent the development of PTSD following a trauma.
To understand the reasons for hoarding, it's often necessary to examine what's going on in the lives of individuals at the time the hoarding develops. In our study of the onset of hoarding, we asked hoarders to describe their lives at around the time they first noticed the hoarding. More than half remembered some kind of important event, either positive or negative, many times associated with a loss or death. The hoarding problems of those who remembered such an event, like Bernadette, began later than the hoarding of those who did not identify a particular trauma. It appears that for some, a stressful life event precipitates hoarding, while for others hoarding begins early and continues on a steadily worsening course.
We knew that the common wisdom of hoarding being a response to deprivation was not the whole story. As we've already discussed, plenty of hoarders have lived comfortable lives. But deprivation is not always material, and emotional deprivation also can be devastating. To examine the relationship between emotional deprivation and hoarding, we compared people with hoarding problems to people with OCD and people without either problem (our control group), based on the nature of their attachments and recollections of their early family life. Both the hoarding group and the OCD group experienced more tenuous attachments to people than did the control group. They endorsed statements such as "I have always been 'hot and cold' with other people" and "I've not been sure how others feel about me" more frequently. We found no difference between hoarders and people with OCD, however, indicating that poor attachments may be a consequence of having significant emotional problems rather than anything specific about hoarding. On the second measure, recollections of early family life, people with hoarding problems were much less likely to report having been reared in a warm and supportive family than people in either of the other two groups. Hoarders were less likely to endorse statements such as "My childhood featured a constant sense of support" and "My family was always accepting of me." Perhaps the comfort provided by possessions developed during a childhood filled with inadequate protection.
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