By Mary Kearl
You've read the headlines: After being reported missing for seven years, woman is found dead in her house, lost among the clutter. Woman suffocates and dies under collapsed piles of clothes. Male trash hoarder dies in labyrinth of garbage tunnels.
Some articles call them hoarders, others call them packrats. These stories seem extreme and isolated. But according to new research from the University of Michigan Health System, hoarding presents a real danger, not only for those who do it but also for their neighbors -- creating fire hazards, as well as unsanitary, unsafe conditions. In addition, hoarders face the real prospect of becoming buried under an avalanche of trash. Researchers note that treating hoarding is difficult because people who suffer from it don't see it as a problem. According to the Obsessive-Compulsive Foundation (OCF), an estimated 700,000 to 1.4 million people in the United States are believed to have compulsive hoarding syndrome, a sub-condition of obsessive-compulsive disorder (OCD). The OCF defines hoarding as "the acquisition of, and inability to discard, worthless items even though they appear (to others) to have no value ... [Hoarders] have symptoms of indecisiveness, procrastination, and avoidance ..."
In the gallery below, Jeff Szymanski, Ph.D., executive director of the OCF, explains the differences between packrats and obsessive hoarders and just why someone may become a hoarder. Plus, read an excerpt that details how hoarding has affected two people first-hand -- and their families.
The excerpt below is reprinted with permission by New Harbinger Publications, Inc. from "Overcoming Compulsive Hoarding: Why You Save & How You Can Stop" by Fugen Neziroglu, Ph.D., Jerome Bubrick, Ph.D., Jose A. Yaryua-Tobias, M.D.
Bill had recently retired from his job as an airline consultant, had been married for over 20 years, and was respected by his peers and clients. No one had ever questioned why Bill always preferred to meet clients or friends at restaurants instead of having them over for dinner. Nor did they ever think twice about why his daughter always went over to friends' houses rather than having playdates at home. There was always an excuse as to why the blinds were closed or why the windows were never opened.
Bill came to treatment reluctantly. His wife had told him that she would leave him unless he got treatment for his hoarding. He reported that his house was almost unbearable to live in anymore, but he felt too overwhelmed by the clutter to begin to make any changes. His previous attempts to clean up were unsuccessful, and he became very angry when others would try to help him throw things away.
Bill stated that if you looked hard enough in his living room, you could see the sofa, loveseat, and chair underneath the heaps of papers, plastic bags, and cardboard boxes that were stacked at eye level. Next to the sofa there was a snowblower and underneath the coffee table was a full-size car tire. He had desk drawers filled to capacity with rubber bands, batteries, and paper clips "just in case" he needed them in the future.
The kitchen was not very different. The six-person table was completely overrun by papers, plastic bags, and cardboard boxes. In fact, this was the only place in the entire house that could seat more than one person at a time. Family meals at the dinner table did not exist. Nor was there space for the family to retire to the living room and watch television together.
Bill discussed his extreme difficulty in discarding anything that was sent to the house. The previous year, he was able to cancel five of his 15 magazine subscriptions, which cut down the number of magazines coming into the house. However, the remaining 10 subscriptions, most of which came once a week for over seven years, had dominated both floor and countertop space, rendering the stovetop completely useless. The primary method of cooking was the microwave, but you had to step over boxes and crates to get there safely.
Bill had severe asthma and had no idea how much his symptoms had been exacerbated by the dirt, mold, and fungus that flourished in his house. Before Bill got treatment, he had not vacuumed or dusted anything in over four years. The shower stall in the bathroom had not been cleaned in years and was covered with a black mold that was very dangerous, as people invariably slipped on it. Following the treatment, his asthma was significantly better.
Next: Gloria's Story of Hoarding
Print this article.
You've read the headlines: After being reported missing for seven years, woman is found dead in her house, lost among the clutter. Woman suffocates and dies under collapsed piles of clothes. Male trash hoarder dies in labyrinth of garbage tunnels.
Some articles call them hoarders, others call them packrats. These stories seem extreme and isolated. But according to new research from the University of Michigan Health System, hoarding presents a real danger, not only for those who do it but also for their neighbors -- creating fire hazards, as well as unsanitary, unsafe conditions. In addition, hoarders face the real prospect of becoming buried under an avalanche of trash. Researchers note that treating hoarding is difficult because people who suffer from it don't see it as a problem. According to the Obsessive-Compulsive Foundation (OCF), an estimated 700,000 to 1.4 million people in the United States are believed to have compulsive hoarding syndrome, a sub-condition of obsessive-compulsive disorder (OCD). The OCF defines hoarding as "the acquisition of, and inability to discard, worthless items even though they appear (to others) to have no value ... [Hoarders] have symptoms of indecisiveness, procrastination, and avoidance ..."
In the gallery below, Jeff Szymanski, Ph.D., executive director of the OCF, explains the differences between packrats and obsessive hoarders and just why someone may become a hoarder. Plus, read an excerpt that details how hoarding has affected two people first-hand -- and their families.
Collecting Clutter
By Mary Kearl
AOL Health: Can you explain the difference between a packrat and an obsessive hoarder?
Szymanski: The difference between a packrat and a hoarder is functioning. A packrat has a cluttered house, a filled garage. There is disarray in some rooms of the house. A hoarder is spending money on lockers or additional storage space, has a hard time getting around the house and is filling up the car with possessions because they've run out of room in the house. There is a continuum in degrees of difference among hoarders.
Courtesy of Fairfax County
AOL Health: Would you say that packrats have a mental health condition the way obsessive hoarders do?
Szymanski: Packrats aren't necessarily keeping people out of their house because of their clutter. People who are packrats say, "I just don't have the time to go through this and get rid of it." There is avoidance -- they recognize that it's a problem, but they ignore it. Hoarders, they love all their stuff, and they have no plans to get rid of it. Packrats don't really need any treatment -- it's more of a preference -- they just like to have a lot of stuff, but it doesn't affect their lives. Hoarders say, "I am unable to socialize, unable to get to my job. I'm not living my life in the way that I'd like to."
Courtesy of Fairfax County
AOL Health: Are people born compulsive hoarders, or do they become them?
Szymanski: We do think there is probably some difference in how their brain works, with how they organize information. Hoarders report that when they walk into a room, they have to respond to all sorts of different inputs at once, [because they see] value in everything, so their attention is drawn to everything at once. They want to attend to everything so it has its proper time. They see things in a vacuum, where everything has equal value. Their wedding ring is a recyclable bottle is a sleeping bag from 1943 is anything.
To get them to acknowledge that there is a difference, you set up "pro" and "con" lists. Hoarders end up living in these houses that are fire hazards. They're no longer able to use parts of their houses in the way they are intended. So you do this kind of pro and con analysis by rank, ordering these things. Ask, "What's the value of being able to eat at your dining room table again?" Or say, "A coffee cup can't really be as valuable as your wedding ring." You say to them, "Although this is important, it may be less important than something else." You have to go through this process of how important something is in the overall scheme of things.
Pictured: Office of the Fire Marshall, Fairfax County, Virginia, at the house of a hoarder.
Courtesy of Fairfax County
AOL Health: Do hoarders tend to collect different things, or are there commonalities among hoarders?
Szymanski: Probably the most common things are newspapers, magazines, books, clothing, receipts, bills, and we're seeing a lot of people getting caught up in having lots and lots of e-mails and junk mail in their in-boxes.
AOL Health: So there's hoarding in the virtual world too?
Szymanski: Exactly.
AOL Health: Do people ever go back and read the newspapers or magazines they've saved?
Szymanski: What they typically say is, "I'm going to put this magazine aside and go through rest of the mail." Then maybe two weeks later, they'll come to the magazine and say, "Oh, I want to read that; let me put it aside." It's called churning. They pick things up and say, "This is valuable," then they put it down and put it aside. Eventually, they'll have 200 magazines that they're behind on reading. They would spend three hours reading through one magazine making sure they didn't miss anything important. How can you do that if you're behind 200 magazines?
Courtesy of Fairfax County
AOL Health: Can you describe the treatment?
Szymanski: Treatment typically involves going into their houses. It's going to be hard to de-hoard someone's house from an office -- you can have them bring boxes into your office. The first thing that you do is to sit down and talk with them: "Are you living your life the way you want to?" It's about building some motivation to see that the hoarding is really a problem. In some ways they might not have thought about this. And then it is just about looking at what are the kinds of things they collect. Then going into their homes, seeing how bad it is. Are beds filled with things, bathrooms filled with things, tables filed with things -- is it pervasive or just some areas of the house? Then start with one area, maybe the office, [focusing on] the desk in the office. Then go through a system of deciding what to keep and what to discard. You want to start with just a very specific area. You might say, "There are a lot of bills here. Let's go back and figure out how many years back you want to keep things for." You might tell them how long the average person keeps things for. Once you get them on board with that, you say, "Let's set up a folder system. Let's get them into a filing cabinet." It's about making choices, encouraging them to get rid of things, setting up guidelines, and then putting things where they belong. Suggesting, "When you go through your mail, get your bills, pay them and then put them in these folders." It sounds like a complicated process, which is why you go with one thing at a time. A cardinal rule when you're helping hoarders is that you never really touch their stuff.
Pictured: Member of the Fairfax County Hoarding Task Force
Courtesy of Fairfax County
AOL Health: Is there medication people can take in conjunction with this therapy?
Szymanski: What the de-hoarding process does is provides a hoarder with decision-making skills and organization skills, but it can also provide coping skills and stress-management skills and replacement activities. People who hoard may also be compulsive shoppers, so you can find other things for them to take pleasure and value in. Some of it might be that they just might be socially anxious -- since they've been away from human contact for so long. We had one patient at McLean who was overwhelmed by all the interaction, since he'd been isolated so long. You can provide social skills training to get them out to socialize more. For someone who is a hoarder, medication will help them access these forms of therapy better. They may go off the medication in the future at the recommendation of their psychiatrist to see what happens.
Courtesy of Melissa Korn
Szymanski: Most often a family member or loved one encourages it. On average the hoarders are not seeing it themselves. Typically there is a lot of conflict. Family members think that going in and throwing out people's stuff, while they're out of town or in the hospital, or cleaning out the entire house [is the way to solve the problem]. Instead, people come back feeling very, very angry and end up filling the house all over again. They have to want to solve the problem on their own. There was a judge in Cincinnati overseeing a case where a hoarder's house was being condemned. When the hoarder agreed to seek treatment, the judge said we'll stay the eviction. This is happening over and over again where people's houses are being condemned and taken away from them.
Courtesy of Melissa Korn
AOL Health: So is there a "cure" for hoarding?
Szymanski: It's an ongoing thing, which is the case for OCD in general. If you've learned something and you've been doing it for a long time -- the analogy I like to use is, if someone was a smoker for 20 years and now hasn't smoked in 20 years, do they still get cravings for cigarettes? The impulse doesn't go away.
Courtesy of Melissa Korn
AOL Health: How are people's family and social lives affected by hoarding?
Szymanski: They don't like people going through their things, so they tend to not have people over. Because they get so preoccupied with their stuff, they tend to not go out. If you're living with them, they're always encroaching on your space. So there are lots of disagreements. If they're living alone, family members might begin to worry that their living conditions are unsafe.
Courtesy of Fairfax County
The excerpt below is reprinted with permission by New Harbinger Publications, Inc. from "Overcoming Compulsive Hoarding: Why You Save & How You Can Stop" by Fugen Neziroglu, Ph.D., Jerome Bubrick, Ph.D., Jose A. Yaryua-Tobias, M.D.
Bill had recently retired from his job as an airline consultant, had been married for over 20 years, and was respected by his peers and clients. No one had ever questioned why Bill always preferred to meet clients or friends at restaurants instead of having them over for dinner. Nor did they ever think twice about why his daughter always went over to friends' houses rather than having playdates at home. There was always an excuse as to why the blinds were closed or why the windows were never opened.
Bill came to treatment reluctantly. His wife had told him that she would leave him unless he got treatment for his hoarding. He reported that his house was almost unbearable to live in anymore, but he felt too overwhelmed by the clutter to begin to make any changes. His previous attempts to clean up were unsuccessful, and he became very angry when others would try to help him throw things away.
Bill stated that if you looked hard enough in his living room, you could see the sofa, loveseat, and chair underneath the heaps of papers, plastic bags, and cardboard boxes that were stacked at eye level. Next to the sofa there was a snowblower and underneath the coffee table was a full-size car tire. He had desk drawers filled to capacity with rubber bands, batteries, and paper clips "just in case" he needed them in the future.
The kitchen was not very different. The six-person table was completely overrun by papers, plastic bags, and cardboard boxes. In fact, this was the only place in the entire house that could seat more than one person at a time. Family meals at the dinner table did not exist. Nor was there space for the family to retire to the living room and watch television together.
Bill discussed his extreme difficulty in discarding anything that was sent to the house. The previous year, he was able to cancel five of his 15 magazine subscriptions, which cut down the number of magazines coming into the house. However, the remaining 10 subscriptions, most of which came once a week for over seven years, had dominated both floor and countertop space, rendering the stovetop completely useless. The primary method of cooking was the microwave, but you had to step over boxes and crates to get there safely.
Bill had severe asthma and had no idea how much his symptoms had been exacerbated by the dirt, mold, and fungus that flourished in his house. Before Bill got treatment, he had not vacuumed or dusted anything in over four years. The shower stall in the bathroom had not been cleaned in years and was covered with a black mold that was very dangerous, as people invariably slipped on it. Following the treatment, his asthma was significantly better.
Next: Gloria's Story of Hoarding
Print this article.
