Nestled in a modest white colonial home in Maine, Roberta Josephine age 53, lives a very lonely life. She has raised two marvelous boys to adulthood, Shon age 30 and Gauge age 33. Roberta has been married once but presently lives alone. Her belongings have pushed her entire family away. She suffers from what is thought to be a subtype of Obsessive-Compulsive Disorder(OCD) known as Hoarding.
It is unclear what specifically causes hoarding, Psychologists are not even sure if it fits under the OCD umbrella or is appropriately labeled, this is yet to be determined. There are several reasons that hoarding may not fit the OCD category. Unlike most people with OCD, hoarders do not usually seek help unless necessary. Also, people with a hoarding problem most likely have cognitive issues(the ability to categorize and decision making skills), and the treatment is not the same for OCD patients as it is with hoarding. Research has also shown that most hoarders do not display many of the common deifying symptoms of OCD, but often display some symptoms of ADHD or Attention Deficit Hyperactivity Disorder(Down with).
Therefore you just might see Hoarding renamed in the next version of the American Psychiatric Association’s Diagnostic and Statistical Manual or DSM(Hoarding OCD/Anxiety). Some Psychologists believe that upbringing as well as some genetic links trigger the compulsive behavior, along with any traumatic life event(Hoarding).
Roberta‘s home is a four bedroom, two bath, two story house with no room. There are piles on top of piles of newspapers, bottles, rotten foods, boxes, furniture, and clothes. The smell is atrocious, and there are small rodents boring through the walls to get to the rotten piles of trash. There are things in that house that have long been forgotten, and impose a serious health hazard for Roberta. You can no longer see the floors, or most of the walls, and you can touch the ceilings on your pass through the house. The path is like scaling a mountain just waiting for an avalanche caused by one wrong step, it could be deadly. Roberta has a strong attachment to these material objects even though most of them are garbage. She continually addes to the piles daily and simply can not help herself.
How is it possible to live in such disarray?
The condition known as Hoarding is defined as the continual excessive acquiring of possessions, even if the items are worthless, unsanitary, and hazardous. This condition interferes with the basic activities of daily life; family, hygiene, sleeping ,cooking and mobility(Hoarding).
Like Roberta, most hoarders do not know or admit to having a problem. According to an article by the MFMER or the Mayo Foundation for Medical Education and Research, the symptoms of Hoarding usually include: living spaces that are extremely cluttered
Inability to throw out or recycle items
Keeping many stacks of old newspapers, magazines or junk mail Moving items from pile to pile, without actually throwing anything out Acquiring a lot of unneeded or useless items, including trash, even foods Difficulty performing activities of daily life, including putting chores off and trouble making decisions about items No or little organization of items
Neglect of responsibility of home upkeep
Excessive attachment to items, discomfort and anxiety letting other people touch or borrow possessions Lonely, little or no social interactions including family(Hoarding)
Although Roberta suffers from nearly all of these symptoms she is in denial, most of her family does not even know the severity of her growing condition. She has created isolation so that no one can pass judgment on her living conditions. She is unable to find the shower or sink to bath under such a mess. Roberta uses baby wipes to clean herself. She no longer sleeps in her bed because there is simply no room, instead she lays a blanket on the floor in front of the door and sleeps there. The loss of her husband, exaggerated her “pack rat” self into more of an obsession with collecting things, any things, to replace the interaction she once had from her family. After several attempts to help their mother both Shon and Gauge moved out years ago due to fear, and disgust of their mother’s condition. Seemed the boys could not continue to live in such an unorganized mess.
There are many levels of hoarding, level one being just past the “pack rat” stage, all the way to level five which is the worst and most extreme. The National Study Group of Chronic Disorganization also known as the NSGCD have named the classification the NSGCD clutter hoarding scale(Wikipedia). This scale has four sub-categories’ which helps define the severity of the clutter and hoarding potential at each level. “Structure and zoning
Pets and rodents
Sanitation and cleanliness”
“Level I hoarder
Household is considered standard. Elevated “pack rat” if you will. No special knowledge in working with the Chronically Disorganized is necessary to fix the problem. Level 1 hoarding can be seen as someone overlooking a pile of newspapers, recyclables or pizza boxes gathering in the corner.
Level II hoarder
Household requires professional organizers or related professionals to have additional knowledge and understanding of Chronic Disorganization. The clutter is more than just overlooking a few piles here or there.
Level III hoarder
Household may require professional services. Including those of professional organizer and related professional waste removal. Professional organizers and related professionals working with Level III households should have significant training in Chronic Disorganization and have developed a helpful community network of resources, especially mental health providers. Assemble a team.
Level IV hoarder
Household needs the help of a professional organizer and a coordinated team of service providers. Psychological, medical issues or financial hardships are generally involved. Resources will be necessary to bring a household to a functional level. These services may include pest control services, “crime scene cleaners”, financial counseling and licensed contractors and handy persons.
Level V hoarder
Professional organizers should not venture directly into working solo with this type of household. The Level V household may be under the care of a conservator or be an inherited estate of a mentally ill individual. Assistance is needed through the use of a multi-task team. These members may include social services and psychological/mental health representative (not applicable if inherited estate), conservator/trustee, building and zoning, fire and safety, landlord, legal aid and/or legal representatives. A written strategy needs to be outlined and contractual agreements made before proceeding(Wikipedia).”
Hoarders generally cling to one big event (or several small ones) that causes a breakdown or change in their lives. Often along with the obsessive-compulsion side of this disorder comes acute anxiety, depression, loneliness and fear. Anxiety of losing their belongings, as well as not being able to throw them out. Studies at the Mayo Clinic have shown that as strange as it seems most level five hoarders are considered perfectionists’ due to their extreme need make a decision about every possession(Hoarding).
Do I keep it?
Do I throw it out?
Having to make these decisions usually causes distress, and in turn the hoarder just keeps everything. This eliminates having to make those crucial decisions. The depression side comes from the loneliness, isolation mostly, but often the sheer thought of not knowing what to do
The Buried Secrets causes fear.
For some hoarders they come to a crossroads, to “make it stop“, often prompted by concerned family members or authorities(TLC Hoarding: Buried Alive). TLC channel is airing a show that steps inside lives of hoarders all over the U.S., it is called Buried Alive. The show airs on Sunday nights at nine o’clock. This educational show has many cases of this illness, and all that is involved with it. In these cases the people are at the point of getting help, whether it is being forced by law or implemented by family the show explains in detail the course of treatment. TLC uses professional organizers with health professionals to try and make a difference in these homes, and families.
Hoarding imposes threats beyond the mental side of things. It becomes physical, the fact that your entire house be filled with “stuff” could cause a fire, trap you in during fire, rot walls and floors, create an avalanche effect with a simple miss step, and in doing so cause bodily harm. Not to mention house rodents or other small animals, effect air quality(mold and other inhalants), and just create an overall toxic environment(TLC, Buried Alive).
In some cases the smell alone has indicated there is a problem. Authorities are often called by neighbors or concerned family members, and changes are then forced on the hoarder. Or they may be subject to fines and/or jail time. In severe unfortunate cases children are removed from the house by child services, and animal control removes any pets that could be in potential danger. More times than not hoarding violates town, and city codes(inside and outside the home), possibly becoming uninhabitable or condemned(Wikipedia).
How to fix this giant mess that is consuming my once normal life? Roberta has finally got to that spot, her sons have taken a stand. Shon and Gauge demanded that she get well, be involved in their lives, and in her grandchildren’s lives. The only way that can happen is by making a major change in her environment. They have offered to help organize, pay for waste removal, hire professionals, and to be supportive of her condition. That’s when treatment began.
The process of “fixing” compulsive hoarding is a long one. It includes many professionals, an organizer, a Psychologist, a Physician and the support of your family(Wikipedia). Treatment of hoarding is often a challenge that has many levels of success. For one thing, many people who hoard do not recognize the negative impact of hoarding on their lives. They simply do not see what it is doing to their families or their homes. Most hoarders don’t believe they need treatment. This is especially true if their belongings or pets offer comfort or value. Treatment of hoarding is also difficult due to the lack of research and results on the disorder(Hoarding).
Which treatment is best?
Depending on the symptoms it could include drug therapy, a therapist or other mental health provider who has experience in specifically treating hoarding. While therapy can be intense and take a lot of time; sometimes many months, or even years depending on the individual. All the hard work and understanding pays off in the long run, the amount of success is life changing to many who suffer from hoarding. The most common treatment is psychotherapy paired with medications for depression and anxiety. This pair seems to be the most sufficient(Hoarding).
Through therapy Roberta can begin to understand why she collects an abundance of unnecessary things. Why she feels such an attachment to those objects, and discovers how to make a definite decision to let got of them when it is time. While working with an organizer, and her sons she is able to begin the process of sorting through her self made mess. Over several months the clutter begins to disappear. It is a long, long road and a lifestyle change to achieve full recovery. Will determination, and her family by her side, Roberta realizes all that she had been missing was a relationship with the ones she loves, and those possessions that were so dear to her are of no real value.
“Compulsive Hoarding.” Wikipedia, the Free Encyclopedia. Web. 09 Dec. 2010. .
“Down with Hoarding – in Praise of My Gorgeous New Garbage Bin « Julie Lomoe’s Musings Mysterioso.” Julie Lomoe’s Musings Mysterioso. Web. 09 Dec. 2010.
“Hoarding: Buried Alive : TLC.” TLC : Family, Home, Style, Cooking. Web. 09 Dec. 2010. .
“Hoarding: Lifestyle and Home Remedies – MayoClinic.com.” Mayo Clinic Medical Information and Tools for Healthy Living – MayoClinic.com. Web. 09 Dec. 2010. .
“Hoarding OCD | Anxiety and OCD Exposed.” Psych Central Blogs. Web. 09 Dec. 2010. .