Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Thursday, April 21, 2016

Hoarding Disorder

"I don't see it as courage [to tackle hoarding]. I saw it more as desperation. I was so afraid of people finding out that I wanted to stop it before I lost control. Hoarding is an illusion of control. You believe you're the one who is controlling what you get rid of and what you collect. But in actuality, it controls you."
"It's a source of high anxiety for me. When I go into a [remediative] phase of cleaning, I can go for days without sleeping. We [she and her therapist/clutter coach] would pick things up and I would describe my feeling about getting rid of it or putting it away and that would help. I would shake, cry, have dry heaves. It was pretty intense."
Josie (last name withheld) Ottawa

"In the States, most of their intervention is based on enforcement. People are found out and then the enforcement agencies intervene. Easily, 70 percent of my referrals are self-referrals -- that's almost unheard of in the States."
"It [her hoarding counselling service] is not about cleaning up. It's not about getting rid of things. It's about getting that person to change their relationship to those things. That's when the cleaning up happens naturally. ... If you just throw out and they haven't come to terms with letting go, then you've just created a void and they will fill it."
Elaine Birchall, Ottawa therapist, "clutter coach", expert on hoarding
Elaine Birchall is an Ottawa psychologist who treats hoarding disorder. She is seen in a client's home in this 2010 file photo. Ashley Fraser / The Ottawa Citizen

"That inability to process information carefully and quickly contributes to the hoarding problem. People can't distinguish important from unimportant features. So they have difficulty deciding whether to keep it or discard it, and once they decide to keep it, they have difficulty organizing it, so it all ends up in the middle of the room."
"There's nothing here that is not the case with all of us. Our possessions are magical. They have an essence that goes beyond their physical characteristics. Like that favourite ticket stub from a concert. It's the same phenomena, but with these people, it just extends to more things."
Randy Frost, professor of psychology, Smith College, Massachusetts

This 2015 file photo shows an apartment in New York City surrounded by hoarded newspapers, clothes, books and other items.
This 2015 file photo shows an apartment in New York City surrounded by hoarded newspapers, clothes, books and other items. (Jack Sherratt/Associated Press)

The diagnostic-helpful handbook that psychologists depend on titled the Diagnostic and Statistical Manual of Mental Disorders lists hoarding as a condition that afflicts an estimated two to six percent of any population. A year-long study that took place in Ottawa by Montfort Renaissance and Options Bytown released the results of their investigation into the prevalence of hoarding in the hope that it could be better understood, its motivation and result, and the potential for intervention.

Hoarding can be dangerous. When living spaces are crammed full of objects accidents can occur. Fires can also occur and with so much combustible materials packed into tight spaces such fires can be difficult to control. Jamming all manner of objects from newspapers to bags of durable goods into a living space can also create an obvious hygiene problem leading to the risk of disease and illness. People who hoard know their habit is abnormal and they tend to be ashamed, and become isolated from society.

Moreover, if and when a landlord discovers that a tenant has packed rented space with a plethora of objects making that space both unlivable and potentially dangerous, eviction can follow, and from there homelessness. Hoarding is a pathology where people think of objects that most people will have discarded or feel to be unnecessary or redundant to their needs, as vital to their existence. Hoarders experience great difficulty in objectively considering the absurdity of owning multiple objects with the same function.

Hoarders are very often people who have suffered some kind of trauma in their lives. Hoarding takes their minds away from their pain and gives them something to look forward to. Possessing useless objects that clutter a living area beyond reason, offers a peculiar kind of comfort to hoarders. Depression and anxiety disorder may lead to placing great value on useless objects with little-to-no inherent value, collected in impossible-to-control quantities.

At one time hoarding was considered to reflect a type of obsessive compulsive disorder, but it has now been listed on its own in the reference manual. It was, in fact, an unknown or unrecognized phenomena until 1947 when police discovered a horror story in a three-storey mansion in Harlem. When they entered the building it was to discover that it was packed floor to ceiling with all manner of detritus. And among that junk was the bodies of the two owners of the mansion.

In this March 25, 1947 file photo, Lt. Ed Stanley, left, and Deputy inspector Tom Boylan of the New York City Police point to piled up boxes in the home of the city's legendary hoarders, the brothers Homer and Langley Collyer, who were found dead amid more than 100 tons of possessions in their Harlem brownstone in New York.
Police detectives examine the mansion of brothers Homer and Langley Collyer in this 1947 photo. The Collyer brothers hoard was a sensation at the time, one of the first cases of hoarding to hit the media. Anthony Camerano / AP

The Ottawa study reached the conclusion that forced cleanouts of "hoarder houses" rarely solve the problem. In fact, it seems to exacerbate the need of hoarders to continue collecting secretively and the problem becomes more difficult to deal with in its aftermath.

"Cleanouts aren't very effective. They are usually very traumatic for the person receiving the cleanout, and they have an almost 100 percent recidivism rate. The person gets very, very traumatized. We find that after three to six months the person is hoarding once again and the problem is worse than it used to be", explained Stephanie Yamin, a psychology professor at St.Paul University who researched the two-year pilot project on hoarding.

The study tracked fifteen people with the hoarding disorder, among them two men, the balance women, all with an average age of 53. Although officially hoarding is said to affect 5.3 percent of the population, researchers feel the actual incidence is higher. It is considered a "hidden disorder", isolating those who are impacted by it, through shame and embarrassment.

People with depression, schizophrenia, fetal alcohol spectrum disorder and developmental delays seem most vulnerable to the pathology. And among those studied, 75 percent had other members of their families who also were affected with hoarding disorder.

"We made a tool kit that's made for the people who work one-on-one with clients. They can use it to help make their environment a better place to live in, with less clutter and less risk around fire, infestations or public health issues. Most of our partners have clients who are struggling with these issues", explained Lise Girard, director of Montfort Renaissance.

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