When I asked how he would feel if he were to throw away those two pieces, he said, "It would be just as bad as when it broke, and it would feel that way for a long time." This was another refrain we'd heard before. When I pressed him some more, he said, "Maybe a glass blower can use them for another piece." Finally, he said that he would get rid of them in a month or so, when he got over the loss of the vase. When I visited four years later, the pieces were still there.
Memory: Things Speak Out
Although many hoarders avoid spending time in their homes and feel depressed when they notice the clutter, paradoxically they retain an intense attraction to individual items in the hoard. Alvin told me that he visited his penthouse apartment for a short time nearly every day to get away from his business and to enjoy his things. He didn't organize or try to cull when he was there; he just enjoyed being amid his treasures. I accompanied him on one of his walks through the apartment. He scanned the room with his eyes and said, "Most people would look at this and see a mess. Really, it's layered and complex." When his gaze fixed on something, he inspected it, and the effect was intoxicating. He spotted an Orrefors crystal goblet and launched into a description of the Ariel versus the Grail technique used by the designers, but it was really the shape and contour of each piece that excited him. His eyes found another treasure. "Here, let me show you this, Dr. Frost." He picked up a bronze elephant with a man sitting inside a basket atop it. He recounted how he had found this piece in an antique store more than a decade before, but the detail with which he described the store and the purchase made it sound like yesterday.
"But wait, Doctor, look at this." He pointed to a stained-glass panel with a wall lamp in it. "This came from my parents' house. There are still eight of them there on the wall and working. I saw one like this go at Sotheby's for over four thousand dollars."
"Wait, here, look at this, Doctor!" His voice rose with excitement as he found a ring. The ring, he thought, was from western India. It was huge, almost the size of a walnut, with a large sapphire in the center, a Buddha on each side of the stone, and elephants around the edges—silver with gold inlay.
One of the many clothes racks in the apartment had fallen over and caused a shift in the landscape, burying his box of prized rings. Alvin's ring collection numbered more than five hundred. Each had a story, and each was personal, from his father's moonstone ring to the signature ring he had bought one night at an upscale restaurant. He'd seen it on the finger of the man standing at the urinal next to his in the restroom and offered him three times what it was worth. Alvin appreciated the artistry of each of his rings, but more than that, his rings recorded his life. They were his way of organizing and remembering events. They provided a vividness not available from simple recall. I asked why he had a Hula-Hoop in his room. He'd bought it on a recent trip. "In my mind, it's like a reel that can put that movie back on."
But it wasn't as simple as needing things to aid his memory. It was more like the things allowed him to reexperience a past event. He described a recent experience of losing a folder containing his notes from an event he'd organized. For the life of him, he couldn't remember anything about the event—who had been there or what had happened. When he found the folder, his memory returned. He said, "I didn't even have to look through the folder. I remembered it all. Memories associated with things are vivid. The things are like holograms."
"But wait, Doctor, look at this!" Again his voice rose as he spotted a nineteenth-century Russian icon hanging haphazardly on a nail next to the doorjamb. It was a masterful piece, and I could see his appreciation as he carefully caressed the wooden backing and the inlay. "There must be a dozen more of these around here somewhere," he said.
"But wait, Doctor." Now he rushed from thing to thing. I expected another valuable artifact as he reached across the cluttered top of a nineteenth-century French dresser. Instead, he picked up a pair of green plastic dime-store glasses. He handled and admired them with the same reverence as he had the icon. They were, he recounted, from an "Emerald City" party he had once organized.
"When I walk in here," he said, "it's like walking into the past. Here, let me show you." He opened a drawer and pulled out a stack of business cards. "I collect these. I must have over twenty-five thousand of them. I can tell you something about each of these people—mostly where I met them and what we were doing. Being handed a card forms a physical connection to them and to that past. There is a physicality to my memory. I have to have the physical connection."
The way Alvin's memories were tied to objects is reminiscent of sympathetic magic, in which someone sees a physical object as forming a connection with the original owner or event, much like Jerry Seinfeld's shirt did for my student (see chapter 2). Once Alvin was at a dinner with the former governor of Puerto Rico. The governor gave a speech that Alvin admired, and Alvin asked if he could have the governor's notes for the speech. At some point during the meal, the waiter picked up the notes and threw them away. The governor promised to e-mail a copy to Alvin, but Alvin insisted on the original. He spent more than an hour going through the kitchen garbage looking for the notes. He said that the original notes carried the "physical memory" of the dinner, and he had to have them.
Many of the things Alvin collected connected him to people he did not even know. He showed me a ring he had bought years before at a flea market. It was engraved with the words "To my daughter." The affection from parent to daughter struck Alvin as beautiful, and he had to have the ring. He described such things as "footprints to the soul of the former owner."
We spent nearly an hour looking through Alvin's stuff. By the time we left, his hands were blackened with dust from the treasures he'd caressed. Possessions connected him to his past and the pasts of others. They had a meaning far beyond their physical existence. "It's like a language," Alvin said. "The things speak out."
Alvin's experiences with his possessions were far richer in detail and complexity than they are for most people. Each of his treasures contained a vast amount of information, and seeing an item conjured up all of it. It was easy for him to get lost in the memories stored in each thing or in the stories they contained about others. But these objects also had a physical presence—they had shape, color, and contour—and these characteristics were as captivating to Alvin as the memories. Alvin's excitement at showing me his treasures reminded me of Irene's bag of bottle caps. His appreciation of the physical attributes of each thing was remarkable. His attention to every physical feature of an object expanded its value and meaning. As Alvin once said to me, "Visual art bounces my electrons." We have noticed an inordinate number of hoarders who describe themselves as artists. This might be because hoarders are more intelligent or creative than the rest of us, their worlds filled with an appreciation of the physical world that most of us lack. This part of hoarding is a kind of giftedness, a special talent for seeing beauty, utility, and meaning in things.
But along with this gift comes a curse. Alvin's complaint that his mind was "a tree with too many branches" may prove to be the most accurate description of the worst part of hoarding—an overabundance of information paired with an inability to organize it. Disorganization makes what would otherwise be a gift into a seriously problematic, dangerous, and sometimes deadly affliction. Maybe hoarding is creativity run amok.
Brain Circuits
Irene had struggled with hoarding for more than thirty years by the time I met her. She complained about her seeming inability to control it: "I was born this way, and I'll probably die this way. I see too many options [for things]. I can't control it. My brain needs to be rewired!" Brain circuitry may indeed be involved in the development of hoarding.
In the fall of 1848, Phineas Gage, the foreman of a Vermont railroad construction crew, set gunpowder in a hole in a rock he wanted to clear. He packed sand on top of the powder with a tamping rod, a three-foot-long iron bar that tapered from one and a quarter inches in diameter down to one-quarter inch at the tip. As he tamped, the powde
r accidentally exploded, launching the tamping rod through Gage's skull. It entered just under his left eye, exited through the top of his head, and landed twenty-five yards away. Miraculously, he survived and lived nearly a dozen more years. Changes in his behavior after the accident made Phineas Gage the first and most celebrated neuroscience case study.
Among many changes in his behavior, Gage developed a "great fondness" for souvenirs. Although little has been recorded about Gage's apparent hoarding, other cases of hoarding following damage to the frontal lobes of the brain have been reported since then. Researchers at the University of Iowa have taken the next step in localizing this effect. They compared brain-damaged patients who began abnormally collecting things following their injuries to brain-damaged patients who did not collect. All of the abnormal collectors had damage in the middle of the front portion of the frontal lobes, while the non-collecting patients' damage was scattered throughout the brain. The prefrontal region of the brain is responsible for goal-directed behavior, planning, organization, and decision making—all activities that represent challenges for people who hoard.
Brain scan studies have added additional information about what is happening in the brains of people who hoard. Sanjaya Saxena found lower metabolism (an indication of the level of activity in that portion of the brain) among hoarders in regions of the brain roughly corresponding to those identified in the University of Iowa study. In particular, hoarders had lower metabolic rates in the anterior cingulate cortex, one region responsible for motivation, focused attention, error detection, and decision making.
Saxena's study examined people's brains while they were at rest, or at least not engaged in a task. Subsequent studies have examined what is happening in the brain when hoarders try to make decisions about discarding possessions. Our colleague Dave Tolin at Hartford Hospital in Hartford, Connecticut, devised one such ingenious experiment. Hoarding patients and a control group who didn't hoard brought their junk mail to the lab. Their brains were scanned while they watched a monitor showing the experimenter picking up their mail and holding it over a shredder. The subjects were then asked to decide whether the experimenter should shred or save the item. In contrast to what happened when their brains were at rest, hoarders had significantly more activity in areas such as the anterior cingulate cortex than control subjects did when trying to make the decision.
Because these areas of the brain are responsible for many of the functions with which hoarders have difficulty, these studies support the idea that something may have gone wrong there. Perhaps Alvin's tree did have too many branches. Although it may seem easy to conclude that hoarding occurs because of dysfunction in these areas of the brain, the science doesn't yet allow us to do so. What happens in the brain seems to match what hoarders experience, but that doesn't mean brain dysfunction caused it. The function and even the structure of the brain can change as a result of experience.
Even if hoarding is inherited or driven by problems in the wiring of the brain, people with hoarding problems do seem to be able to learn to control them. I spent several hours working with each of the twins sorting and discarding. Progress was slow, but both were able to sort and discard, and it appeared to me that with effort, they could both learn to control their hoarding. It seemed that these men needed someone they trusted to sit with them while they went through their possessions. Perhaps having someone else there kept their attention focused on the task at hand. My attempts to get them to do this work on their own failed, as had Betty's efforts with Ralph (see chapter 7).
Jerry tried hiring a professional organizer, but he got frustrated by someone else making decisions about his stuff. I tried on several occasions to find a therapist for Alvin and Jerry, but no one seemed good enough for them. They continued as best they could. It was easier for Alvin, who had his business and spent much of his time away from his apartment. For Jerry the situation was more troubling. His stuff had become his life, and although it gave him some degree of pleasure, worrying about it took a huge toll.
Alvin and Jerry's story is a remarkable one. The similarity in their hoarding behaviors, the early onset, and the fact that their mother also hoarded suggests that their hoarding was heavily influenced by genetics. But nurture may also have been at work, as they grew up in a cluttered home with a mother who taught them her ways. At this point, geneticists are betting that hoarding has at least some significant genetic cause, but exactly what is inherited is not clear. One possibility is that hoarders inherit deficits or different ways of processing information. Perhaps they inherit an intense perceptual sensitivity to visual details, such as the shapes and colors of Irene's bottle caps. These visual details (overlooked by the rest of us) give objects special meaning and value to them. Or perhaps they inherit a tendency for the brain to store and retrieve memories differently. If visual cues (i.e., objects) are necessary for hoarders' retrieval of memories, then getting rid of those cues is the same as losing their memories. Whatever is inherited, it is likely that some kind of emotional vulnerability must accompany this tendency in order for full-blown hoarding to develop.
11. A PACK RAT IN THE FAMILY
It was my BIG SECRET. I always had to make up something to keep my friends from coming over.
—Ashley
Growing Up in a Mess
Ashley panicked as soon as she walked into the apartment. It was worse than ever. The pathways through the mountains of stuff were narrower than she remembered. The piles were higher, and the closed-off feeling struck her sooner than ever before. "It felt horrible—unnatural," she told me later. I can't do this anymore, she thought. She had just gotten away a few weeks earlier—to college and a room that was hers to control. No more walking on eggshells. No more worrying that she might touch or move the wrong thing. She could relax and look after only herself. As she looked around her mother's apartment, she realized that she no longer considered this home.
Children who grow up in a hoarded home are dramatically affected. Their childhoods are markedly different from those of their peers, and their adult lives can be shaped by the experience. Ashley was one such case. She started her sophomore year at Smith College troubled by a variety of things, not least of all worry about her mother. She made an appointment with the college's counseling service and began to talk about her mother's eccentricities for the first time. She was shocked when her therapist recognized her mother's behavior and surprised to find that it had a name: hoarding. Her therapist told her about the work we were doing in studying hoarding. She called me immediately after the session.
Ashley was the kind of student professors love: bright, thoughtful, responsible, and curious. She was quite open with me about her mother's difficulties and about what it was like growing up with them. Eager to learn more about hoarding, she worked in my research lab during her senior year. Not surprisingly, her research project was on the effects of growing up in a hoarded home. Ashley reviewed interviews with more than forty children of hoarders who described their experiences growing up. The information she gathered formed the backdrop for our subsequent studies on the topic.
When I first met her, Ashley was at once relieved and saddened that her mother's condition was a subject of study. Knowing that it was identifiable meant that there was hope that something could be done, but her mother had needed that hope years before. When Ashley's father left, partly because of her mother's hoarding, her mother became extremely depressed. "Just knowing it had a name," Ashley said, "would have protected her and given her some self-respect—knowing that she wasn't a freak of nature." Ashley also thought that if they could have named her mother's condition, she might have been able to discuss it with her mother. As it was, Ashley's attempts to do so always ended in frustration and anger.
She first noticed that there was something "wrong" with her home when she was very young and needed a babysitter when her parents were going out. The entire weekend before the event, Ashley and her parents cleaned like demons. Since her mother would not allow anything
to be discarded, most of the stuff was relocated to a studio apartment they kept primarily for storage. Ashley remembered trip after trip to the apartment and a mad rush to the finish. Afterward, the stuff came back.
Major chaos accompanied any planned visitor, so very few visitors ever crossed their threshold. Ashley took these episodes in stride, but her father was frustrated and resentful. He took her aside after one such event and said, "You don't have to live this way when you get older." Ashley wasn't sure whether he feared that she would inherit this behavior and was warning her, or he was apologizing for what she had to endure.
With her house too messy for play dates, Ashley went to her friends' homes. "I liked that," she said. "Their houses were clean." But she always held back a little even around close friends. There was a part of her life that she couldn't share. She felt funny when her friends asked, "Why can't we play at your house?" She made up clever excuses to hide the truth. She didn't think of it as lying exactly—more like protecting. Her parents needed a shield—from what, she wasn't sure, but she knew from the way they behaved when visitors were expected that their home was something to hide. This was, she told me, the worst part of it. She called it her BIG SECRET, and she felt obliged to keep it. What's more, she had no words to describe the situation at home. "It's hard to talk about something when you don't know what it is," she said. "I knew things weren't normal, but I acted as though they were." While at camp one summer, she confided her secret to a new friend. She wanted some sympathy and understanding, but instead got what she characterized as "morbid interest—like I had just described a cool bird I'd seen at the zoo." She shut herself off and didn't try again for some time.
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