A Person I Care About Hoards

Over the last few weeks I have received many calls from people looking for help for a relative or friend who hoards. In addition to help cleaning out their loved one’s home, the callers are often looking for some way to process what is happening in their loved ones’ lives.  I thought it would useful to write a bit about these calls to help others who find themselves in this situation.

 From the perspective of the callers, the clutter is worthless and the piles are fire hazards. They wonder how their loved ones can live this way. They think that throwing out the clutter is the answer – but why don’t their loved ones see that?

The loved ones who are hoarding have a different perspective. Their collections are useful, interesting and valuable. The problem is not the stuff. The problem is other people feel they have the right to tell them what to do with their stuff.  

The situations are painful, frustrating, and scary – for both the callers and their loved ones. However, I can only address the needs of the person who calls me; it would be unethical and deleterious for me to work in a home without the homeowner’s prior knowledge and consent.  It is news that rarely surprises the caller, but typically is met with resignation.  There is hope if the caller is willing to do some work on his own.

1)   Acknowledge what you are feeling and get support for you.  Isolation often accompanies hoarding, not only for the person who is hoarding, but also for his relatives and friends. Hoarding is not a “water cooler” topic. But there are other people in similar situations who understand what you are going through, and that can be comforting.  The website Children of Hoarders is a very good resource. If you are in the St. Louis area, the St. Louis Behavioral Medicine Institute provides support for family and friends.

2)   Maintain your cool and be respectful of the person who is hoarding. Each of you has different perspectives. Suspend the temptation to declare a “right” and a “wrong” in this situation because it will lead you to a dead end. The likelihood of progress is far greater if you can act with empathy.  Understandably, this may be hard to do.  What you feel is legitimate and that is why I start with getting support for what you are going through.

3)   Educate yourself.  The International OCD Foundation’ s website contains a wealth of information and it has an excellent infographic that you can download. The Institute for Challenging Disorganization has a variety of informational downloads.  The books Digging Out by Michael A. Tompkins Ph.D and Tamara L. Hartl, Ph.D. and Buried in Treasures by David F. Tolin, Ph.D., Randy O. Frost, Ph.D. and Gail Steketee, Ph.D. are excellent resources.

4)   Prepare for the long-term. Hoarding behaviors do not go away in a week, a month or a year. This may be a life-long struggle.

5)   Turn the conversation from throwing things away to making the environment safer and more comfortable your loved one.  If you focus on throwing things away, then you are discounting your loved one’s perspective that his things are valuable. Can you agree not to block the door or to keep items off of the stove?  Agree upon a goal together. You might consider these small steps. But it can be a big step for your loved one to agree to partner with you to take action.

Your loved one may not be ready to work with you. You cannot rush the process.  There may be some emotional groundwork that needs to be worked on first, which is why it’s important to get support for what you are experiencing.

The temptation may be go into the loved one’s home and clean it out. Not only will your loved one continue to acquire items to fill his home, but in all likelihood you will seriously damage your relationship with him.  Please take a step back, take a deep breath and proceed with care and respect for both of you. You are not alone.

Stop Clutter From Stealing Your Life

I recently read the new edition of Stop Clutter From Stealing Your Life: Discover Why You Clutter and How You Can Stop by Mike Nelson. Nelson’s book offers explanations for why people clutter and strategies to stop cluttering. While Nelson did a lot of research for his book, what distinguishes it from many other books on organizing is his account of his efforts to declutter. It is his experience that gives this book a very genuine and hopeful quality.

Nelson is very open in his book about his history as a clutterer. He describes how he collected vast and varied items that filled his spaces yet did nothing to fill the emotional holes in his life. “Clutter is the symptom. Recognizing and changing the reason for our cluttering are the solutions.”

Types of clutterers are identified early in the book along with specific emotional and practical solutions for each type. Nelson distinguishes hoarding from cluttering.; although cluttering and hoarding share many symptoms and pain. Contrary to what the popular media seems to depict, hoarding is not common and effects a small percentage of the population.

Facing one’s emotions is essential for the effects of decluttering to be long lasting.  It will take time but making progress always does. Nelson offers several tools to help develop a less cluttered life. Journaling, identifying and working with one’s learning style, and understanding one’s personality are among them.

The bumpy road of change does not happen overnight. But for those undertake the challenge there are rewards: greater self-esteem, inner strength, greater satisfaction and a less cluttered life. If you feel as though you are trapped by your clutter, read this book. If someone in your life is trapped by clutter, read this book. Mike Nelson does a very good job in showing you how you can make the changes you need to set yourself free.

Hoarding

Once again the subject of hoarding has captivated the public’s attention. Every week the A&E show “Hoarders” spotlights the clean up of two different cases of extreme hoarding with the assistance of a professional organizer and a crew. Despite the unpleasantness of the deep clutter, rodents, insects and squalor our attention is held by the need to know why someone lives this way. What is clear from watching the program is the intensity and magnitude of emotional pain caused by hoarding for both the hoarder and his family.

No one willingly chooses to hoard. Psychological and emotional factors underlie hoarding behavior. Mental health workers have traditionally considered hoarding as a sub-type of Obsessive Compulsive Disorder; however, recent research seems to indicate that hoarding is a feature of many psychiatric disorders. While the research on hoarding has been fruitful, there is still a lot that is unknown.
The show’s opening displays the statistic that three million people in the United States are hoarders; however, the exact number is unknown. I have seen estimates as low as two million and as high as 20% of the population – about 61,528,000 people. Shame, embarrassment and fear contribute to the social isolation of hoarders and the difficulty in identifying them.

People who suffer with extreme hoarding behavior are adept at hiding. Friends, family, repairmen, utility workers – anyone wanting entry - are typically barred from the house. Such isolation can lead to further degeneration of behavior and of the home. In the most extreme cases, doors and windows blocked by clutter trap the occupants from escaping during a fire.

It is important to point out that hoarding, like many behaviors, follows a continuum. The National Study Group on Chronic Disorganization (www.nsgcd.org) created the Clutter Hoarding Scale that is used to objectively describe clutter in place. The scale uses four factors to assess the level of clutter on a scale from one to five. The examined factors look at the integrity of the home’s structure, the pets and vermin present, household functions and cleanliness. Most lay people would describe a Level I home as messy and a Level V home as uninhabitable.

If someone you know and love hoards it is important to seek help. There are several organizations that provide information and forums. Children of Hoarders (www.childrenofhoarders.com), Messies Anonymous (www.messiesanonymous.com), and Squalor Survivors (www.squalorsurvivors.com) are very good websites to visit. When speaking to someone about his hoarding use neutral and supportive language. Sometimes good-meaning friends and family decide to do a surprise cleanup of the cluttered house. Such gestures are usually not a good idea. How would you feel if a group of people came into your home and threw out things without your knowledge or permission? Respect and dignity are always important and appropriate when dealing with anyone, and provide the foundation for taking the first steps towards recovery from hoarding.

Help for Hoarders

There has been an increase in awareness among professional communities and the public that Compulsive Hoarding is a more common problem then once thought. A frequently cited estimate places the number of Americans suffering with hoarding between one and two million. However, it is suspected that this estimate is too low. Hoarders exist all over the world. They come from every economic and educational background. Your neighbor, your aunt, or your best friend could be a hoarder.

According to David F. Tolin, Ph.D., Randy O. Frost, Ph.D. and Gail Steketee , Ph.D. (2007) there are three major characteristics of hoarding:
1) Acquiring, saving, and great difficulty discarding items that seem to be useless or have limited value;
2) Enough clutter so that living spaces cannot be used as intended;
3) Significant stress or impairment of everyday activities caused by the clutter.

Frequently a hoarder may deny or minimize the hoarding problem, much to the exasperation of a loved one. The family and friends of a hoarder may watch aghast as a hoarder continues to add to an already dangerously cluttered house. Well-meaning family and friends might go so far as to clear out the clutter for the hoarder. Their actions are understandable. Hoarders may live in dangerous situations brought on by their hoarding behavior: clutter stacked precariously, unhygienic conditions, structural damage to the living quarters, and obstructed exits. But instead of thanks and relief, the hoarder’s response to their efforts is a bewildering mix of anger and anxiety. Worse, the hoarder may rebound with more clutter than was present before the cleanup.

Why can’t the hoarder just stop collecting and start disposing of the clutter? According to mental health professionals the explanation may lay neurobiology. Compulsive Hoarding is considered part of a psychiatric disorder. But, recently disagreement has risen among professionals as to how to classify Compulsive Hoarding behaviors. Traditionally Compulsive Hoarding has been considered a form of obsessive-compulsive disorder (OCD). Some professionals are rethinking this classification because there are aspects of hoarding that do not seem to fit into the characteristics of OCD. Depression, social anxiety disorder and attention-deficit/hyperactivity disorder are often associated with hoarding. Regardless of how Compulsive Hoarding is classified the question remains: how to treat it?

Seeking the help of a counselor can be the first step toward recovery. Be sure that the counselor is knowledgeable about Compulsive Hoarding – not every counselor is. Some studies indicate that traditional talk therapy is not effective in treating hoarding. But preliminary studies have demonstrated success with Cognitive Behavioral Therapy (CBT). CBT focuses on changing the faulty thoughts associated with Compulsive Hoarding while simultaneously modifying the hoarding behaviors, which should lead to a change in how a person feels.

Medications may provide some relief for the depression or anxiety that sometimes exists with hoarding; however, in some cases medications are ineffective. Although any physician can prescribe medications Tolin, Frost, and Steketee recommend the hoarder consult a psychiatrist or advanced practice nurse who is an expert in psychiatric medications.

Professional organizers who have special training and expertise in dealing with Compulsive Hoarding can provide hands-on assistance, support and can work collaboratively with a counselor; however, they are not a substitute for a counselor.

The Internet may provide resources in finding help for Compulsive Hoarding.

The National Study Group on Chronic Disorganization (www.nsgcd.org) and the National Association of Professional Organizers (www.napo.net) can help you find professional organizers who specialize in Compulsive Hoarding.

Squalor Survivors (www.squalorsurvivors.com) has stories of those who are dealing with hoarding either personally or within the family. You can also find information on Compulsive Hoarding and resources.

Children of Hoarders (www.childrenofhoarders.com) is a website for the adult children of hoarders. You will find support, information and additional resources there.

The Obsessive Compulsive Foundation’s website on Compulsive Hoarding (www.ocfoundation.org/hoarding) provides information and assistance to those dealing with hoarding.

St. Louis Behavioral Medicine Institute (www.slbmi.com) has professional counselors who understand Compulsive Hoarding.

There are several good books on the subject of hoarding which you may find useful. In 2007 Tolin, Frost and Steketee published Buried in Treasures: Help for Compulsive Acquiring, Saving, and Hoarding. David F. Tolin, Ph.D., Randy O. Frost, Ph.D and Gail Steketee, Ph.D. have published many excellent books on the subject of hoarding previously. The Messies Manual by Sandra Felton has provided help for many people. Overcoming Compulsive Hoarding: Why You Save and How You Can Stop by Fugen Neziroglu, Ph.D., Jerome Bubrick, Ph.D., and Jose A. Yaryura-Tobias, Ph.D. is another highly regarded book on the subject.

Dealing with Compulsive Hoarding may feel lonely and overwhelming. The good news is that it is treatable. Whether you personally are dealing with Compulsive Hoarding or are involved in a relationship affected by it, there is hope.