Belanger, Michael A.

Dr. Rebecca Johns

ISS 4935

25 April 2012

When Living is No Life

The light is dim as you enter the room after receiving no answer from repeated knocking. The lack of light is due to aluminum foil and newsprint taped to the windows. The thick humidity envelopes you, carrying with it an overpowering sickly sweet odor that assails you as your eyes adjust to the darkness. Even though you have donned coveralls, you can feel and taste the smells, and wish a face mask was at hand. Being part of a social welfare assistance team, you arrived early to help with an elderly recluse, but you did not expect this. There is no furniture to be seen, except for the odd table corner jutting out from a growth of boxes draped with clothing in a myriad of colors. While maneuvering through a narrow trail that literally snakes back to a hallway passage and perhaps other rooms, the piles become higher and more menacing. Folded, crumbled and torn are the newspapers, envelopes, wrapping paper, and roaches. Roaches everywhere with little ones scurrying away at the slightest nudge of an item. The walls appear discolored, when seen, and any interest in knowing the actual source of the smudges has rapidly vanished. You begin to think that you should not be in here. “Wait for the team” the leader said, but curiosity at the new and unseen wins out. Moving towards another room, you turn sideways, because the passage of paper stacks is so narrow, and in doing so see a bright red box sticking out of a sea of gray papers above your head. As you reach up and give a tug, a rush of newspaper starts to spill over you, faster than one could imagine. Dust swells up as the spill causes towers to tumble, and with hands over your head you feel the tracing of paper and debris across your face and neck as papers, cardboard, and all else closes around your legs, pinning you in place. A sensation on your face feel like windblown threads and you hope it really is bits of paper…you wish you had the mask on.You remember the cautionary cliché aboutwhat curiositydid to the cat …and hope the team is timely.

Hoarders and hoarding. Reading the spectacular stories of people killed by their junk can make one wonder how a situation can become so extreme. If you watch a cable television hoarding show and cringe at the mess wondering how someone can wander around in front of a camera and say everything is fine, you are not alone. It is always “someone else”, yet we may all have a family member, or friend, who “collects” or just plain hoards. How do they get there, and how do they get out? I hesitated to pick this topic for one embarrassingly good reason: I am a hoarder. So read on, try to resist the urge to scratch and pay no heed to the wisps across your neck.

Hoarding is the extreme accumulation of things, to the point where the mess can ruin your life. In this paper, I shall compare the impact of hoarding on the hoarder and his or her family. It is no easy task, for no one has ever wanted to be labeled a hoarder, and the practice is not a new phenomenon. Throughout history, humans have held their possessions in great regard, often using the accumulation of items as a show of power or prosperity. The ownership of things tends to define people in many ways. The more things someone owns, has in the past marked their place in the community, just as their physical appearance did. Merchants, political figures, and those born into wealth generally did not have to labor and were, well, fat. The manner of things defined people in the past: the swords, armor and mounts of a warrior king, or the wealth and servants of an Egyptian Pharaoh. They all sought to insure that they would have such things in the afterlife. Archeological excavations discovered how simple soldiers or farmers were buried with their implements; to an entire army of life-size soldiers, in the hundreds, are set in place to guard a Chinese Emperor who is laid to rest with his horses and servants, who were likely hesitant to join their master (Peers). In spite of the common saying “you can’t take it with you,” many have tried, and many still try to keep it all with them.

Though not yet officially described as such, hoarding is psychological disorder, the results of which are seen in the accumulation of all manner of things. Hoarding is defined in broad terms as the acquisition, collecting and saving of items, usually of little or no value. These possessions can fill up rooms and clutter up homes to the point that the houseloses its usefulness. Hoarding may be a corollary of other disorders, such as schizophrenia or major depression. Other symptoms of hoarding may include:

  • Unable to discard possessions.

  • A disproportionate sense of anxiety when trying to discard things.

  • A great inability to put possessions in any sense of order.

  • Avoidance in makingdecisions that relate to the clutter.

  • An excessive attachment to possessions.

  • Anxiety issues like shame at the mess, or feeling out of control.

  • Fear of others handling their things.

  • Obsessing over decisions, or second guessing on what has been done (i.e. checking trash for an item “accidentally thrown out.”)

  • A marked impairment in the ability to function in the daily life: little or no social contacts, family interactions, and distress caused by the hoarding.

(Grisham, 46. Tolin, Challenges451-452).

Hoarding is a behavioral disorder that goes beyond the scope of one who collects, for collectors take pride in the items they have garnered. These items are usually of a narrow scope, such as coins, stamps, automobilelicense plates of the United States, or the equipment worn by soldiers at specific points and places in time. Collections are well organized, maintained and usually proudly displayed. On the other hand, a hoarder has to have things often for no reason other than to fulfill the need to acquire. There is a feeling of safety in being amongst possessions, or having things that may be needed in the future.

All human beings have needs, and the urge to fulfill them is set deep in the subconscious mind. The discussion regarding hoarding currently surrounds the epidemiology of the disorder, and treatment strategies. It was considered to be a practice of stubborn, stingy and methodical individuals by founder of the discipline of psychoanalysis, Sigmund Freud, in1908, and thus evolving through time, to be closely interpreted as an obvious adjunct of Obsessive Compulsive Disorders (OCD) in the present day (Grisham, Barlow 46). The hoarding of things is thought to be linked to primitive survival instincts, and is reflected in animals as well. These primitive needs have been highlighted in the field of the social sciences, by psychologist Abraham Maslow, who wrote a paper entitled “A Theory of Human Motivation” in 1943. In it he described a pyramid or hierarchy of needs; five levels which must be met in seriatim before the person is complete. A person starts with the physical (wants of food, sleep, water), precedes those of safety (shelter, protection), then to the social (being with like people, being accepted), and up to the point of self-realization. The lower levels of this hierarchy point out the primal instincts of humans. Like animals, humans will gather things they consider necessary. In humans, however, the need can be illusory. Like animals that store necessities, humans will prepare for future, but certain changes occur in some people that cause them to obsessively accumulate things, like nest building animals. They will go out and find things that only they find a need or use for, broken or whole, and return to “fill the nest” building what Dr. Stephen Kellett of the Department of Clinical Psychology, Keresforth Center, in Barnsley, UK, calls a “security site.” He draws comparisons in his writings as to how humans with hoarding disorders can operate at very basic levels of understanding and without clarity when confronted with the reality of their surroundings and how their lives plod on as if on a treadmill of continual acquisition, regardless of the consequences (Kellet, 425). A hoarder can bring thingsinto the home, sit and examine the new acquisitions, find some peace in handling them and leave them where they are placed. In this way a new layer is added to the mess. Sometimes the instinct is so ingrained that the hoarder will react adversely to any aid given in cleaning out their domicile, to the point of reverting back to the role of scavenger and refilling the recently cleaned home (Stuff, 185).

Hoarding has long been listed as a type of Obsessive Compulsive Disorder (OCD) or Obsessive Compulsive Personality Disorder (OCPD), orObsessive Compulsive Hoarding Disorder (OCHD) although some professionals believe it should have a specific definition rather than being an adjunct of other disorders. Those with OCD have behaviors that can be repetitive, like scratching, touching, checking/rechecking, cleaning/re-cleaning, and urges to throw things away. Someone throwing away items is somewhat of the antithesis of a hoarder. Jessie Stoll is so obsessed with not becoming like her hoarding mother that she cleans her home in such a compulsive manner that she has thrown out important items in the process, like her college diploma (Cenicola). Information drawn from psychiatric studies on hoarding show that hoarders can suffer the typical OCD/OCPD traits while OCD types will not always have hoarding as a symptom (Tolin, Challenges). Most research that is conducted leads the researchers in the field to come to the conclusion that compulsive hoarding should be named CompulsiveHoarding (CH). The Diagnostic and Statistical Manual (DSM IV, a guidebook for mental health professionals), lists hoarding under the criteria for OCD, but Dr. David Tolin has presented research and a proposed criteria needed to classify hoarding as a distinct disorder for review and judgment of the board assembling the contents of the next volume of the DSM (Tolin, Challenges, 452). Facets of hoarding that have caused it to be considered an adjunct of OCD are similar to those implied by Freud: perfectionism, obsessive cleaning, a fear of infection, a fear of loss, a lack of organizational skills, poor social skills, an inability to make decisions of any magnitude, and self-delusion. It is the rigid path of definition that has kept hoarding from being described as a separate disorder. The works of Tolin, Frost and Tompkins illustrate that while hoarding can be identified with other disorders, it also can a problem of its own.

The hoarder often faces greater health problems than otherindividuals. The television shows on hoarding give the greatest possible exposure to the inside of a hoarder’s home, often the very worst of conditions. Althoughanimal hoarders are not included in this paper, they can be found to live in much worse living conditions than covered herein. For a person coming in, the smell is unbearable, but the smell is the only thing for which the hoarder cannot be held responsible for not noticing. One can easily discover this when in constant contact with bad odors, the sense of smell is gradually inured to them. When in the Army, we would often spend up to two weeks in the mountains and hills of North Carolina conducting training. With little recourse but to use only what you can carry, changes of clothes were minimal, and re-use was constant. The smells went unnoticed until a good shower on return. Gathering your laundry at that point reminded you of how inured the nose becomes to odor for long periods, so the fact that a hoarder cannot necessarily smell the mess they live in is possibly the only truth they can claim. In a normal home, however, clothing is washed with regularity and put away. When clothes, paper, and articles of all sorts become packed in on the floors, in closets and rooms, bacteria can form in the void, and spread without hindrance. Molds form in damp places, and especially in climatessubject to high humidity, as in Florida. Mold is a serious problem, with respiratory complications coming from breathing the air in a home that has airborne mold spores drifting in it. This usually accompanies a serious lack of personal hygiene. Dr. Frost describes this as the Diogenes syndrome, which is named after a Greek philosopher noted for not only wandering the world with a lantern in search of an honest man, but also for very bad hygiene. In many case it is found in elderly hoarders, but is not restricted to certain age groups (Stuff, 176-179).

In time, the great accumulation of debris and decomposition of damp paper products, forgotten foodstuffs, and animal fecal matter will attract rodents, insects, and other carriers of disease. Such can be found in the story of Daniel and Edith, in the book Stuff, by Dr. Frost, which gives gruesome detail of entering a filthy home. Daniel is the hoarder and they have a condominium filled with more than just things, but filth and debris, with roaches literally everywhere. Dr. Frost and his team of volunteers come to help remove debris and Daniel continually talks with the crew about what should and should not be disposed of and why. This would have been enough of a peaceful distraction for the crew, but violence erupts in the form of Daniel’s son, Tim. He storms in screamingand hitting Daniel for letting some of his things be touched and moved. Police are called as the argument spills onto the street, where the son tears open trash bags looking for a jacket, showering roaches on passersby, and the police. Needless to say, Tim is arrested, and sadly, within a week Daniel has collected new refuse to replace what was removed. (Stuff, 173-187).

Another health threat to a hoarder can also be found in the mess. This is the physical threat of accidental falls. In a hoarder’s home, the debris, stuff, and junk can take up most all of the living space. Stacks form in corners, on tables and counters, moving like an out of control organism to fill the house. As it is stacked, it forms trails, much like the small pathways of worn down grass in the underbrush that marks the passage of small animals, called “game trails” by hunters. In the world of hoarding literature they are called “goat trails.”(Frost, Stuff) Through rooms and up stairways these paths snake through a house. When crossed by obstacles such as boxes, the hoarder is constantly shifting weight from one foot to the other, pivoting in place, high stepping to get over something, ducking low, and often crossing an item and turning at the same time. Awkward stress and pressure is put on knees, ankles and hips, in a junkyard steeple chase that one takes to just walk through the house. I have twisted my knee more than once going through my house and never considered it a problem. However, as nimble as I might imagine myself, nothing would help if I were to fall and knock down towers of boxes and create the type of accident that opened this paper. It actually happened to Patrice Moore in New York City, a hoarder who piled all sorts of mail in his tiny one room apartment. When the tumult came, he was enclosed upright in junk and debris for two days until he was heard by other residents (Duenwald). Not only heavy things but sharp or pointed objects can lay unseen and cause injury if tread upon, walked into, or into a hand searching the mess. When the hoarding spreads out of doors, the yard can become a literal minefield of right angled harm and knee breaking holes.

It can come to a point that the hoarding becomes injurious not only to the hoarder and associates, but also the dwelling place. I have been called upon to clean rental houses that became hoarding domains. Trash piled everywhere, unusable sinks, catlitter in drawers, human waste overfilling a non-functioning commode, all things which have had to be cleaned up, often by myself. Long-term accumulation of debris can affect the home, causing structural failure, and rendering it unlivable. One recent viewing of the television show Hoarding gave the story of a man in Cincinnati who had lived in a home with so much debris and without power. Because of the lack of light he did not go in the basement. After a harsh winter’s cold caused a water pipe to burst, the basement was flooded, and that support beams for the house were cracked, rendering the house unlivable and thus condemned by the city. His daughter had not lived with him for many years, and approached the producers of the show with his problem. Though not having lived there because of her parents divorcing, she doubted she would have stayed, even if she had been given the choice.

Some children see the growing problem and move away from it. Michelle, 45, has two brothers and a mother who are hoarders. Things were not that way as a child, but she had some friends whose mother was obsessed with cleaning and vacuuming, and the clean streak stayed with her. Michelle will call herself OCD in a humorous manner, but has seen the way in which family members have fallen into the patterns of hoarding. She will not allow it to happen to her (Michelle, 2012). Jessie Sholl wrote on her experiences with a hoarding mother and possibly feels that there is a genetic component (Cenicola). According to Dr. Kiara Timpano, this may be the case. Dr. Timpano, oftheUniversity of Miami, has researched the link of hoarding as a matter of genetic predisposition. She has identified the Brain Derived Neurotropic Factor (BDNF), a recently identified member of the family of neurotrophins, protein cells that control the life span of neurons complex cells that relay messages from the brain to the body. For instance, a certain cell controls the release of messages that reinforce behaviors, good or bad. If that cell is allowed to die, some behaviors will continue while others may cease (Timpano). Her work opens greater discussions on the probability of the BDNF gene having some input into the causes of hoarding, andoffers proof that hoarding is genetic, making it distinct from OCD and necessitating its own distinct disorder category.