A lot of people ask me about hoarding, and do I watch Hoarders (I do, religiously), and recently a few people have asked me if I’ve read Stuff: Compulsive Hoarding and the Meaning of Things. I can now report that I have read it, and it was very interesting.
I should probably preface this entire piece by saying that I am not in any sense clinically trained and I have no educational or professional background in psychology aside from AP psych in high school and 2 college courses to complete my science requirement. Just so you know.
I don’t know that I agree with the idea that all hoarders are sick, or that they are all sick in the same way. Most psychologists seem to lump compulsive hoarding in with OCD and anxiety disorders. I see a few problems with this. One is the success of exposure therapy in treating OCD symptoms. There has been great progress in guiding people with OCD to face their fears, allowing them to progress into more and more anxiety-producing situations until their fear or compulsion is conquered. Yet with the treatment of hoarders, the conventional wisdom is that this type of treatment will not work. It’s generally agreed that a forced cleanout will cause additional stress, possible breakdown, and ultimately lead to the hoarder re-filling their home with stuff, possibly to a greater degree than before. So I find it a bit odd that we can treat fears and compulsions with exposure therapy – except this one. That, to me, says that hoarding is somehow different.
The second issue is that the hoarders I have read about and seen on TV are not all the same. If you watch Intervention, or The Biggest Loser, or any show about different people overcoming a common challenge, there is a common thread between them. In some sense, these people share the same story. With hoarders, that doesn’t seem to be the case. Some show hoarding behavior from the time they are young. Some can point to a life event – usually some sort of loss – as a trigger. Some hoard items indiscriminately while others hoard specific categories of items with a specific purpose. Some are very outgoing and social and some are very lonely and closed-off. Some hoarders seem completely incapable of making decisions. Some are much much cleaner than others. There’s no common story. I don’t think these people have a common illness. I think some have OCD or anxiety disorders. Some have a disorder that makes decision-making difficult. Some have paranoia or control issues. Some are traumatized. Some are depressed. These are all very different mental problems – they just happen to be expressing them in similar ways.
And yes, I do think some of them are just lazy. I think that by the time your situation is bad enough to merit inclusion on a television show you’ve probably progressed beyond lazy to overwhelmed and scared and desperate and probably depressed, but in some cases I do think it starts out as sheer laziness.
There are still a few things that I don’t understand about hoarders. I don’t understand why, if their possessions are so precious, they don’t treat them well. They don’t store things properly, they bury their treasures under mounds of stuff, they let things rot or mold or break. A hoarder with dozens of carefully arranged curios of figurines makes sense to me. A hoarder with half-crushed boxes of mixed items that they can’t easily access does not. This goes double for animal hoarders.
I don’t understand why the people on TV – especially the doctors, who I would assume are mandatory reporters – don’t call child and animal welfare services more often. There was one episode of Hoarders where they did call child services, and it was a big deal. The thing was, it was not by any stretch the worst house with children in it that was featured on the show. Why did they call then and not other times? (Sub-question, goes to mental illness: Why was the parents’ response to this to try and stop the show rather than to change the situation so that the home was fit for the children? Their solution was to let things stay as they were, i.e. unfit for the childrens’ well-being (a point they agreed with!), and let their children continue to live in that environment, rather than change the situation so that their children had a safe home. That’s a huge mis-prioritization that I see over and over with hoarding stories. People know how bad the situation is – they know that child services, adult services, animal services, and the housing inspector are threatening to make the worst happen, but they still don’t act to change their situation. They misplace their anger at the government agency. They choose the unhealthy situation over the healthy solution. It’s a lack of ability to prioritize and make decisions and see the big picture.)
I also don’t understand the filth. Not all hoarders are filthy, but a good number are. Sometimes it’s a function of the hoard – mold that can’t be seen or treated, dust that can’t be reached, floors that can’t be vacuumed. But often times, there is a mess on top of this. Animals that are not cleaned up after, ash trays that are not emptied, garbage – that the hoarder knows and agrees is garbage – not removed from the house on trash day. What gives? What is it about hoarding that makes you unable to wipe up a spill or empty a litter box? I don’t understand that.
So that’s kind of my high-level thoughts on the whole hoarding phenomenon. I could probably write more on it, but at some point I have to get back to my day job.
