Stuff (2 page)

In 1942, the bank foreclosed on their house for failure to pay a mortgage note of $6,700. No payments of any kind had been made on the mortgage for eleven years, since shortly after Susie Collyer's death. Because it now legally owned the house, the bank was ordered by the health department to make repairs to the crumbling façade. When the workmen arrived, Langley appeared and ordered them off. A few months later, the bank and city officials appeared at the house to take possession of the property and evict the brothers. They broke down the door with hatchets, but a solid wall of papers stopped their progress. A large crowd gathered, as it always did when things happened at the "Ghost House." The bank officials decided to enter through a second-floor window. After three hours of work, they were only two feet into the house. The sounds of the excavation finally alerted Langley, who demanded to see his lawyer. John McMullen had been the brothers' lawyer for some time and knew of their peculiarities. He was quite frail and elderly; nonetheless, he crawled up the fire ladder and through a tunnel in the parlor to find Langley hiding behind a piano. When McMullen told him that the only way they could avoid eviction was to pay the $6,700, Langley handed him a wad of cash, borrowed a pen, and signed the papers saving his house.

In the fall of 1942, a rumor began spreading through the neighborhood that Homer was dead. It finally reached Sergeant Collins of the 123rd Street Station, who knew the brothers well. The sergeant went to the Collyer house and persuaded Langley to allow him inside to verify that Homer was alive. It took them thirty minutes to traverse the sea of possessions and avoid the booby traps. Finally, they emerged into a small, dark clearing. When Collins turned on his flashlight, he saw Homer, a gaunt figure sitting on a cot and covered by an old overcoat. Homer spoke, "I am Homer L. Collyer, lawyer. I am not dead. I am paralyzed and blind." That was the last time Homer spoke to anyone other than Langley. The next day, Langley lodged a complaint with the police about the incident.

THE COLLYER BROTHERS'
house was demolished in July 1947. The salvaged belongings were sold at auction but netted less than $2,000. The lot on which the house stood was sold in 1951, and in 1965 a small park was fashioned there. Parks commissioner Henry Stern named it the Collyer Brothers Park. In 2002, the Harlem Fifth Avenue Block Association took on the challenge of increasing the use of the park. The first order of business, they decided, was to change its name. The president of the association argued that the Collyers "did nothing positive in the area, they're not a positive image." She wanted the name changed to Reading Tree Park. The board turned down her request. Parks commissioner Adrian Benepe commented, "Sometimes history is written by accident. Not all history is pretty, but it's history nonetheless—and many New York children were admonished by their parents to clean their room 'or else you'll end up like the Collyer brothers.'"

The Collyer brothers' behavior was bizarre and mysterious, but not unusual. It is now known as hoarding, and it is remarkably common. Although few cases are as severe as the Collyers', for a surprising number of people the attachments they form to the things in their lives interfere with their ability to live. Since we began our research on hoarding, we've received thousands of e-mails, letters, and phone calls from relatives and friends of hoarders, public officials grappling with the public health and safety aspects of hoarding, and hoarders themselves. When we speak to professional audiences including psychiatrists, psychologists, social workers, and other human service workers about hoarding, as we often do, we usually ask for a show of hands in response to the following question: "How many of you know personally of a case of significant hoarding—yourself, a family member, a friend, or someone who is not one of your professional clients?" Over and over again, at least two-thirds of the people in the room raise their hands. All are a bit shocked by the numbers. Afterward, many come up to admit that the topic attracted them because they have begun to realize they have a problem that is out of control and not going away soon.

Chances are you know someone with a hoarding problem. Recent studies of hoarding put the prevalence rate at somewhere between 2 and 5 percent of the population. That means that six million to fifteen million Americans suffer from hoarding that causes them distress or interferes with their ability to live. You may have noticed some of the signs but have never thought of it as hoarding. As you meet the people in this book, you will begin to see hoarding where you did not recognize it before. And while hoarding stories like the Collyers' may sound unusual, the attachments to objects among people who hoard are not much different from the attachments all of us form to our things. You will undoubtedly recognize some of your own feelings about your stuff in these pages, even if you do not have a hoarding problem.

The Collyers' story may have been front-page news in the 1940s, but the intense media interest did not carry over to the psychiatric community. Until we began our research, the scientific literature contained few studies and scant mention of hoarding. I (Randy Frost) began that research almost by accident. In the early 1990s, I was teaching a senior seminar at Smith College on obsessive-compulsive disorder (OCD), as I had for many years. OCD has become a relatively high-profile disorder, experienced by an estimated six million people in the United States, perhaps most famously by the late industrialist Howard Hughes, and depicted in movies such as
As Good as It Gets
and the TV show
Monk.
In this particular class, I had an unusually inquisitive student named Rachel Gross. Early in the semester, Rachel asked why there were so many studies on contamination fears and compulsive cleaning and checking rituals, but virtually none on hoarding. She brought up a famous hoarding case that had fascinated her since her childhood—that of the Collyer brothers.

Rachel's question evolved into a term paper, a summer project, and then a senior honors thesis. As part of the research, I suggested placing an ad in the local newspaper looking for "pack rats" or "chronic savers." Hoping to get a few responses, we were amazed to receive more than one hundred calls—so many, in fact, that we launched two separate studies. We visited the homes of several of our volunteers and discovered a wide range of clutter, some relatively mild and some quite severe. Our research culminated in the 1993 publication of the first systematic study of hoarding in the journal
Behaviour Research and Therapy.
The findings from these studies helped shape much of the research to come. The chronic savers we studied were highly perfectionistic and indecisive, having trouble processing information quickly enough to feel comfortable making decisions. They acquired things wherever they went, and every day they carried lots of things with them—"just in case" items they couldn't be without. Surprisingly, they were not alone in their peculiar behavior; most had family members who hoarded as well.

Rachel went on to graduate school to study public health, heading in a new direction. I developed an enduring fascination with this neglected subset of what many consider obsessive-compulsive behavior, and with the people who can't part with the objects they've so avidly gathered.

Up to this time, my research had focused on OCD and the trait of perfectionism. As part of that work, I came to know Dr. Gail Steketee, a well-established scholar of OCD at Boston University. We were already collaborating on several OCD projects when hoarding began to capture my interest. Her reaction mirrored my early response to Rachel's queries: hoarding seemed to be a narrow, fringe aspect of OCD and a dubious area of research. Why study something so rare and esoteric—who would care? But gradually, as I had before her, Gail came to appreciate that hoarding was a substantial and intriguing phenomenon, far more widespread and problematic from a public health perspective than she or I had ever imagined. In our collaboration for this book, I've done the bulk of the fieldwork, investigating and interviewing cases. Hence, the interviews and cases herein are mainly mine, recounted in the first person. The conceptual work, however, has been fully collaborative, and both of us have spoken to and seen more people who compulsively hoard than we could possibly recount. We have experienced awe, the excitement of discovery, and empathy for those caught in the web of hoarding.

In the past decade, we've learned that hoarding seems to be such a marginal affliction in part because it's carried on largely in secret: we think of it as an "underground" psychopathology, occurring most often behind closed doors. Hoarders tend to be ashamed of their disorder and unwelcoming to those who would interfere with their activities. Yet hoarding is far from rare, and Collyer-like cases appear with regularity, so that references to the Collyer brothers can be found in emergency services and legal arenas. Even now in New York City, firefighters talk about a "Collyer house." In New York City housing law, tenants who fill their apartments with clutter and fail to maintain sanitary conditions are called "Collyer tenants." Collyer tenancy in New York and many other cities across the country has become a significant problem.

Most cases of hoarding are not life threatening, and for those who can afford lots of space or help to manage a hoard, collecting may never reach a crisis level. Most with this problem, however, are left depressed and discouraged by the overwhelming effects hoarding has on their lives. For them, hoarding is certainly pathological. In our work, and indeed in most mental health research, distress and dysfunction are the determining factors as to whether hoarding constitutes a disorder in a particular case. If clutter prevents the person from using his or her living space, and if acquiring and saving cause substantial distress or interference in everyday living, the hoarding is pathological. But exactly what kind of pathology is not clear.

Hoarding has been widely considered to be a subtype of OCD, occurring among one-third of the people diagnosed with that disorder. Interestingly, when we flip it around and study only those who complain of hoarding, only just under one-quarter of them report having OCD symptoms. Recent findings have begun to challenge the view that hoarding is a part of OCD and suggest that hoarding may be a disorder all its own, quite separate from OCD, though sharing some of its characteristics. Classic OCD symptoms are associated with anxiety. The sequence begins with an unwanted intrusive thought (e.g., "My hands are contaminated from touching the doorknob"), followed by a compulsive behavior designed to relieve the distress created by the intrusive thought (e.g., extensive hand washing or cleaning). Positive emotions are not part of this OCD picture; compulsive behavior is driven by the need to reduce distress or discomfort. In hoarding, however, we frequently see
positive
emotions propelling acquisition and saving. We see negative emotions in hoarding as well—anxiety, guilt, shame, regret—but these arise almost exclusively from attempts to get rid of possessions and to avoid acquiring new ones.

Other evidence suggests crucial differences between hoarders and people with classic OCD. The genetic linkage studies show a different pattern of heritability for OCD than for hoarding. Likewise, brain scans reveal a different pattern of cerebral activation for hoarders. Hoarders don't seem to respond to the same treatments as people with classic OCD symptoms, and they show more severe family and social disability, as well as less insight into the nature of the problem.

In fact, the mixture of pleasure and pain hoarding provides distinguishes it from all of the anxiety and mood disorders. In many ways, hoarding looks like an impulse control disorder (ICD). ICDs are characterized by the inability to resist an urge or impulse even though the behavior is dangerous or harmful. In fact, compulsive buying, a major component of hoarding, is considered to be an ICD, as is kleptomania. Because pathological gambling, like compulsive buying, is classified as an ICD, we wondered whether it, too, would be related to hoarding. To find out, we put an ad in the newspaper looking for people with gambling problems. We found that people with serious gambling problems reported problems with clutter, excessive buying, and difficulty discarding things at much higher rates than people without gambling problems. What may unite these disorders, besides a lack of impulse control, is a psychology of opportunity. One gambler from our study described his experience to me: "Seeing the scratch tickets over the counter at the convenience store leads me to think,
One of those tickets is surely a winner, maybe a million-dollar winner. How can I walk away when the opportunity is there?
" Our hoarders have said similar things about items they've wanted to acquire.

Although the acquisitive features of hoarding look like an ICD, the difficulty discarding and the disorganization do not. The emotional reactions to discarding are more reminiscent of anxiety disorders and depression. At present, there is a growing consensus that hoarding should be included as a separate disorder in the next version of the
Diagnostic and Statistical Manual of Mental Disorders.
Intensive study and decisions about this plan will take place over the next few years.

The boundaries between normal and abnormal blur when it comes to hoarding. We all become attached to our possessions and save things other people wouldn't. So we all share some of the hoarding orientation. The passion of a collector, the procrastination of someone who hasn't taken the time to put things away, the sentimentality of one who saves reminders of important personal events—all these are part of the hoarding story. How, when, and why do these otherwise commonplace and normal experiences develop into hoarding? What compels these compulsive collectors to create unlivable conditions for themselves and often for others? Why do they go too far? This is what we seek to explain in this book.

About fifteen years ago, I received a desperate phone call from a woman named Irene. She'd found me by contacting the Obsessive Compulsive Foundation (OCF) and asking for someone who might help her with her hoarding problem. (In recent years, the OCF has experienced a dramatic increase in requests for information about hoarding.) When she learned that I was researching the problem, she literally begged to be included in our study. Irene was fifty-three and had just separated from her husband. She had two children, a thirteen-year-old daughter who was away at boarding school and a nine-year-old son who lived at home. Irene worked part-time as a sales associate for a real estate company. She had lived in her house for more than twenty years. Her husband, an engineer, had been after her for years to get rid of the clutter, which waxed and waned but never went away. Finally, he told her to clean it up or he would leave. She couldn't, so he did. Now she was worried that she would lose her children in the upcoming divorce.