The Secret Lives of Hoarders: True Stories of Tackling Extreme Clutter (9 page)

According to Dr. Chabaud, researchers are still debating about whether hoarding is an impulse disorder, a compulsion, or an addiction. While one may casually use the term “shopaholic” to describe people like Kurt and Marcie, a true “addiction” would indicate that the addict goes through
physical
withdrawal symptoms if he or she tries to stop the behavior. Anecdotally, I don't see this happening with hoarders. To me their behavior looks more like a compulsion, which is a behavior that feels so good that a person does it to excess. I do see serious hoarding compulsions that have a lot in common with addictions like alcoholism and drug addiction, and I'm not a psychologist, so I tend to use the word “addiction” to describe hoarding, even though it may truly be more of a compulsion.

Hoarders who shop, or who go “Dumpster diving,” definitely do it because it feels good. These hoarders get a primal rush from the “hunt and gather” experience. This rush helps them avoid the reality of what is truly going on in their lives. Rescuing a broken television set from someone's alleyway trash pile is a thrill. These hoarders don't stop to think about whether or not they have the time to fix that TV, along with the dozens of other broken appliances they have gathered.

For collectors, the excitement of finding a long-sought, rare Michael Jackson album on vinyl is all about scoring. They're never going to play it. But they feel powerful and happy when they buy it. The hoarder feels like a success because he or she just got a valuable item. There's a level of excitement that releases adrenaline in the brain, and when that adrenaline high fades, the hoarder goes back for more. That's when it begins to look like an addiction, because the hoarder's happiness is linked to the item, not to any sense of self-worth.

Animal hoarders have a similar thing going on, with the constant love they get from their pets. Anytime an animal hoarder feels down, there's a cat right there to share some affection, which can quickly become a substitute for human relationships. Receiving love endorphin hits all day is a happy way for anyone to live. Hoarders get to feel that exciting rush every time they go shopping, go Dumpster diving, or reach for one of three dozen affectionate dogs. Especially when the rest of a hoarder's life isn't going well, it's easy to see how this behavior could become an addiction.

Some experts argue that addicts never change their personalities; they just substitute healthy addictions for unhealthy ones. So a smoker might give up cigarettes and turn instead to the exercise addiction of running marathons. I see this sometimes with hoarders, and I encourage the replacement behavior if it seems positive.

For example, as we cleaned Kurt's house, it became clear that it needed major repairs. The bathrooms had extensive water damage and needed to be redone, the kitchen needed new cabinets and appliances, and the whole downstairs required new walls and flooring. I encouraged Kurt to channel his shopping energy into the remodel. He threw himself into choosing appliances and researching subcontractors. This work kept him focused on making positive decisions. Suddenly, Kurt's shopping had purpose. Luckily, when the remodel was over, Kurt became very involved in his church's upcoming remodel. Although Kurt hasn't had counseling to deal with the real issues behind his hoarding, he has successfully rechanneled that energy into more positive behavior.

I have done this in my own life. I replaced my gambling addiction with work. Some may say I'm just as addicted to cleaning as I was to gambling, and they might be right. For me it worked to substitute a positive addiction for something negative. I haven't gambled since 1999, and I've refocused my life to revolve around my family and my work. I'm not saying that's scientifically or psychologically correct, but for me it worked.

Roxanne, the hoarder who saved all of her daughter's items, showed all the classic signs of depression. She didn't make eye contact or smile when she spoke in a colorless monotone. She wore the same clothes for several weeks in a row, even when they were covered with food stains. Her dirty brown hair was pulled into a messy ponytail, and she admitted that she didn't wash herself regularly. Roxanne ate a lot of fast food, and she was overweight.

When Roxanne opened a package of food, she tossed the wrapper on the floor with a “why bother” attitude. She had basically given up—some days, she just stayed in bed.

Depression is a crippling illness, erasing a person's desire and ability to make daily life decisions. Someone who is depressed usually knows what to do in order to get better but can't muster the energy to actually do it. To a depressed person, even a small job like getting out of bed or taking a shower can look overwhelmingly hopeless and impossible.

A depressed person withdraws from normal life in the same way that a hoarder does. Depression is marked by decreasing interest in organization, self-care, and interaction with the outside world, which are all traits I see often in advanced hoarders.

Depressed people seem to be perpetually sad, angry, or anxious. Eventually, if the disease isn't treated, depressed people can become so frustrated and worn down by their negative outlook that they become suicidal. I've seen this in hoarders too, and it should be taken seriously.

This is another situation where it's not clear which comes first—depression or hoarding. Dr. Chabaud says that depression in someone who is genetically predisposed may be triggered by a traumatic event. That same event can also trigger hoarding behavior, and the two disorders can develop simultaneously.

Ironically, I've noticed that hoarders who are depressed usually don't fight a cleanup. They just lack the initiative to make the push and get it done themselves, and they generally accept help. However, under these circumstances, it is even more important to understand that the cleanup on its own will not solve the problem. Unless the underlying issues are resolved, the hoarding will come back. Depression isn't just an annoyance; it can lead to a seriously life-threatening situation.

Ben, the “pizza man” who also hoarded vintage airplane parts, was shy and uncomfortable around people. He avoided group settings because they made him anxious. Ben seemed to have an issue that Dr. Chabaud says is sometimes linked with hoarding—social phobia.

Hoarders who have a social disorder connect more with the world of objects than with people. Their possessions become their friends. Those possessions won't threaten them with pressing questions or awkward social moments. Hoarders can control their relationship with these items more than they can control relationships with friends or family members.

This disorder, Dr. Chabaud says, isn't necessarily a symptom of hoarding, or a cause. Like depression, social phobia can show up in hoarders, but it's not clear which disorder came first, or if one triggered the other.

One of the keys to success on a hoarder cleanup is to get the hoarder back into the world and involved in outside activities and a social life. For that reason, any social disorder needs to be treated as part of a hoarder's recovery therapy.

Rick, the retired professor with a house full of paper, was showing signs of dementia when the cleanup began. He was very forgetful, often standing in the living room hunched over in confusion and asking the same question over and over. Sometimes he didn't recognize an item he had in his hand, or remember why he was holding it. His sister commented that the problem had been worsening over the past year.

He had focused on information hoarding during a lifetime as a professor, but his forgetfulness had exacerbated the problem. He would pick up something, intending to use it or throw it away, and then forget why he was holding it. Confused, he would just set it down again on a growing pile.

A study published in the
American Journal of Geriatric Psychiatry
found that 23 percent of patients with dementia also showed hoarding behavior. As the population ages, dementia—and hoarding—will increasingly become severe problems, which need to be addressed in tandem. When a hoarder isn't even able to have a coherent conversation about the issue, interventions are essential if the hoarder is living in conditions that are physically dangerous or unhealthy.

Aside from the emotional toll that hoarding takes, it can make conditions physically unsafe for the hoarder. Piles can fall over and germs can cause illness. A cluttered house can hide serious structural damage. An elderly hoarder can have trouble getting around, and if there are medical issues, it's sometimes impossible for emergency medical teams to even get into the house to respond.

As we have discussed, hoarding is—and often disguises—a severe mental problem, as hoarders tend to be isolated, cutting themselves off, socially and emotionally, even when they crave human interaction. If a hoarder also has a related mental disorder, that often goes untreated.

Hoarding affects more than just a hoarder. Children growing up in a hoarder house don't learn to set limits on their possessions and sometimes on their behavior. I've seen those bad habits spill over into work attitudes and financial management, so that a child of a hoarder struggles to follow rules on the job or stick to a budget. Children of hoarders talk about the emotional trauma of feeling like their hoarder parent chose hoarding over his or her children. And some of them grow up to become hoarders themselves.

Hoarders also make a big financial mess that someone else often has to clean up. Hoarders who spend money on their acquisitions usually end up broke and dependent on family members, or the government, for assistance. When a late-stage hoarder is forced to clean up, it's often the county that's paying the bill. Social workers, building inspectors, and animal protection services are all paid for with tax dollars, so even people who aren't directly affected by hoarding are increasingly paying the price for it.

And last but not least, hoarders leave behind a legacy that causes a lifetime of pain. When a hoarder passes on and leaves a cluttered house, family members have to deal with it at a time when they are already raw and under tremendous stress, leaving the family unable to go through the natural phases of grief.

Too many families wait until the hoarding gets seriously out of hand before they start really pushing to fix the problem. Watching for the early warning signs is critical, and understanding the types and stages of hoarding outlined in Chapter 1 will make everyone's job much easier. Addressing hoarding sooner rather than later has tremendous shortand long-term benefits, potentially breaking the cycle of hoarding that causes so much grief. Since many of the mental situations associated with hoarding are serious and could be life-threatening, I advise my clients to consult with a therapist. This is important not only to deal with hoarding, but to improve the hoarder's quality of life in other related or unrelated areas.