Stuff (30 page)

The kitchen formed part of Helen's territory, but in Paul's forages, he frequently acquired discarded vegetables and produce from grocery stores. Some of the produce rotted in the yard and prompted a lawsuit from their neighbors. Some of it he brought into the kitchen. Retrieved at the point of spoilage, the rotting food sickened Helen but didn't seem to bother Paul. For some reason, Helen didn't feel that she could throw it out. Somehow it transcended their rules of engagement.

Another battle was waged over sex. The bedroom was his domain. To sleep there, she had to move part of the hoard off the bed. She took the offensive and refused to have sex with him until he cleared the hoard from the bedroom. He refused. They had reached a stalemate. Her use of sex as a weapon in the war had failed. He argued that she was ruining the family and forcing him to seek the comfort of prostitutes.

Helen stayed in the battle, refusing to surrender or to quit the marriage. Finally, after many years, something changed. Paul declared that he was through collecting and that he was going to get rid of much of what he had accumulated. Helen described the turnaround as nothing short of amazing. In the months preceding this change, Helen had taken to reading articles about hoarding to Paul. He enjoyed being read to and was attentive, providing critiques of the research. After she read portions of a draft of our treatment manual to him, he stopped collecting. When I met him a few years later, he told me why. His rationale had always been that someday he would need and use the things he collected. But it finally dawned on him that at his age, this was terribly unlikely. As another of our clients on her way to overcoming hoarding once remarked, "You can't hook up a U-Haul to a hearse." Helen attributed Paul's sudden change to pressure from the city and his friends, as well as her threat to leave him at the end of the year if nothing changed.

When I last spoke with them, the situation was much improved, but their perceptions of the extent of the remaining problem differed substantially. Helen's account of the condition of their home indicated that using the refrigerator, eating at the table, finding important papers, and sleeping in their bed were still difficult because of the hoarding. Paul thought that none of these things was a problem. Helen also described parts of their home as extreme fire hazards and very unsanitary. Paul considered their home safe and clean. His perceptions of the value of objects also differed substantially from Helen's and from most people's. One day a visitor asked him why he washed and hung out to dry so many rags and why he never used them. The questions enraged him. He couldn't understand how someone could describe his used clothes and bits of cloth as "rags." In his mind, he would never have picked up or kept something that was just a rag.

Helen and Paul came to a fragile truce in their marital war. Skirmishes still occurred on a regular basis, and whether they would be able to keep the peace remained to be seen.

If she ever owned it, it's hers; if she wished she owned it, it's hers; if in the future she might own it, it's hers; if it belongs to anyone she loves and who loves her, it's hers.

—Amy's mother

Many people who see hoarding cases—psychologists, psychiatrists, social workers, housing and health department officials—insist that it is a disorder of older people. Most people who get in trouble with the health or fire departments because of their hoarding are middle-aged or older. A survey of the existing research might lead to the same conclusion. The participants in our studies, for example, have ranged from ages eighteen to ninety, with an average age of just over fifty. But our studies of people who suffer from hoarding problems indicate that hoarding begins early in life. Although few published case studies of hoarding in children exist, some of our colleagues have described the symptoms in their child clients. Aureen Wagner, a clinical child psychologist at the University of Rochester and author of
Up and Down the Worry Hill: A Children's Book about Obsessive-Compulsive Disorder and Its Treatment,
told me about an unusual case: a six-year-old girl who collected nearly everything she found—crumbs from a restaurant, pencil shavings at school, empty juice cartons, whatever came her way. When her parents were remodeling their home and workers removed the drywall from her room, she threw a fit. On another occasion, she was with her parents at Wal-Mart when some mud dropped off her shoe. An alert store clerk happened by and scooped it up. The little girl fell apart in the store, demanding to get her mud back. "But it's mine!" was the only explanation she could give.

By some estimates, more than 90 perc ent of c hildren have a collection of something: rocks, dolls, bottle caps, action figures. But the story of Alvin and Jerry in chapter 10, who recalled an unbreakable attachment to sticks they found on walks, and stories like this six-year-old's seem extreme. When does normal collecting behavior in childhood turn into hoarding? Perhaps the best way to make the distinction between hoarding and normal collecting is to determine whether the behavior creates a problem for the family. Ted Plimpton, a colleague of ours and a child psychologist specializing in OCD, became interested in the topic of hoarding in children late in his career. He had seen very few such cases but admitted that he had never asked his OCD kids or their parents about it. When he did, he found he had several hoarding cases in his practice. Apparently, hoarding was not the most troublesome problem for these kids, so it hadn't come up in therapy. Still, it was serious enough for the parents to take steps to deal with it. Several of these parents agreed to tell us about their children who hoarded. We describe four of these cases here based on descriptions by one or both parents. Work such as this may lead to more and earlier diagnoses of hoarding problems in children, for whom treatment may be more effective than it is for adults, whose habits have had years to solidify.

For the first five years of her life, Amy lived with an abusive and neglectful mother who suffered from a host of problems, including alcohol and drug addiction, OCD, and AIDS. Both Amy and her younger sister were in and out of foster placements until they landed at the home of Krystal and her husband. Krystal's household contained a mixture of foster, adopted, and biological children, many suffering from various disorders, including Asperger's syndrome, attention deficit hyperactivity disorder (ADHD), Tourette's syndrome, and OCD. Amy and her younger sister arrived as foster children and were adopted by Krystal and her husband within two years. Krystal was a very bright and capable woman who seemed undaunted by the problems in her brood. She spoke of them all lovingly, without minimizing the significance of the problems they faced. At the time I interviewed Krystal, Amy was twenty-two, had just finished college, and was living with several roommates and working in New York City.

Krystal and her husband noticed Amy's hoarding immediately. Even at age five, she saved every paper from school regardless of its importance. Both Amy and her sister hoarded food, hiding it under their beds. At first Krystal attributed this to the girls having been neglected and suspected that in the past they had needed to hoard food to keep from starving. She kept telling herself, "If I can just feed them enough, they will realize there will always be food there." Amy's sister's hoarding gradually stopped, but Amy's grew worse. Krystal worried that the food would attract mice and insects and that if Amy ate the rotten food, she would get sick. She finally decided to make Amy keep the food in a box so that it would be sanitary. Her approach paid off, and food hoarding became less of a problem, but Amy's other hoarding behaviors escalated.

Like many moms, Krystal hung school papers on the refrigerator. In a houseful of children, these papers needed to come down regularly to accommodate the newest ones. It didn't take long before Krystal realized that Amy's refrigerator displays, as well as all her other papers, never left the house. Amy collected homework, notes passed in class, handouts, and magazines under her bed and in her closet—stacks and stacks of them—until by the fifth grade, they had become unmanageable. Krystal made Amy get rid of them, prompting an angry outburst.

Despite the struggles, Amy settled into her new family and community. She was a remarkable child: beautiful, dramatic, engaging, and extraordinarily bright. After three weeks of kindergarten, the teachers suggested that she move on to the first grade. She could already read fluently, and her math skills were at the second-grade level. But she was a challenge for the teachers, too. Easily bored, she was also loud, abrasive, messy, and disruptive. Krystal suspected that this was another reason the kindergarten teachers wanted to bump her up to first grade.

Amy developed a wide circle of friends, and when she went to friends' houses, they and their parents would give her things, especially if she hinted or asked. "She was such a sweet, charming, and beautiful child, how could you not?" Krystal observed. There seemed to be little logic to what she brought home. It might be a movie they already owned or clothes she didn't need. At first her friends and their parents were generous toward this interesting little girl. After a while, however, her behavior became more annoying than interesting. Krystal began receiving embarrassing phone calls: "Amy appears to have gone home with our daughter's shirt, her sneakers, and her doll." She didn't steal; she borrowed or begged these items. She couldn't seem to leave anyone's home without something. Often the item was on loan, but Amy seldom returned these things to their rightful owners.

Amy's childhood was otherwise remarkably normal and active, with tennis, soccer, prom, and boyfriends. The charming and attractive child grew into a strikingly beautiful young woman. "She could be Miss America," said Krystal. "Her features are perfect. Her teeth are perfect. Her dimples are perfect. Her hair is perfect." No matter how she dressed, she caught the eye of every person in the room.

But her "collecting" habits belied her personal charm. When something left the public domain and entered Amy's bedroom, it became hers. A family DVD in the den was hers as soon as it crossed her threshold. When a friend asked her to return a sweater, Amy felt insulted. "How dare they? They're accusing me of stealing!"

"But, hon, you've had it for seven months. It looks like stealing," Krystal would reason.

"I'm a nice person. I don't steal things!"

When she was in her sophomore year, a friend's mother called Krystal and demanded that Amy return an expensive camera she had borrowed. Amy was livid. She couldn't understand how the woman would have the nerve to call Krystal. In fact, Krystal found four digital cameras in her room, only one of which belonged to Amy. She knew to expect more angry phone calls.

Family members' personal stuff migrated to Amy's room as well: clothes, jewelry, hair clips, and more. Sometimes she talked family members out of them, and sometimes she just took them. Mostly they were small items, but sometimes she took expensive things, such as her father's binoculars. Krystal recalled a time when they had just taken in a new foster child, a young girl who had been neglected and came with only the clothes she was wearing. Within a few hours, Amy was wearing the child's sweatshirt. "But it's a cool shirt, and she didn't mind," Amy explained. Never had Krystal been so angry with her. "How could she take the only shirt off this child's back?"

Retrieving things from Amy's room required a confrontation. Typically, Amy ended up angry and hurt, and the fight became about the insult to her rather than the missing item. When Krystal suspected that Amy had added her tape recorder to the treasure trove in Amy's room, she avoided trying to get it back because she didn't want to spark an argument.

Discussions with Amy about taking things frustrated Krystal. "Amy, if it doesn't belong to you, and you don't have permission, it's stealing. That's the long and short of it."

"But it's not stealing if it's your family," Amy would insist.

Confrontations about the number of things she acquired were equally frustrating. "Just how many pairs of nail clippers do you need?"

"Well, I don't know, but I can never find them."

Amy just didn't have the same understanding of ownership that most people did. Krystal described Amy's philosophy to me this way: "If she ever owned it, it's hers; if she wished she owned it, it's hers; if in the future she might own it, it's hers; if it belongs to anyone she loves and who loves her, it's hers."

Amy's recognition of her hoarding fluctuated. If she was in a good place, she could acknowledge that her life was more difficult because of the hoarding. But if she was in a bad place, she would say, "It's nobody's business but my own." At those times, even the criticism of friends and the anger of family members didn't have an impact.

Amy shared a room with her biological sister. Both girls suffered from OCD but couldn't have been more different in their symptoms: her sister had symmetry obsessions and ordering compulsions, while Amy feared contamination and germs. Krystal knew that Amy didn't like to be dirty, but she didn't realize it was a problem until Amy was about fourteen. On a trip to the mall, Amy stopped at the door. With a baby in her arms, Krystal couldn't open it and motioned for Amy to do so. Amy said, "I gotta wait until someone else goes in."

"Why?" Krystal asked.

"I'm wearing short sleeves!"

"And?"

"I can't touch the doorknob!"

Krystal realized then that she had never seen Amy touch a doorknob in the nine years she'd known her. Although Amy managed this problem better as she got older, she still wore long sleeves to the mall so that she could pull them down and not have to touch the door.

Amy's side of her bedroom was a sea of stuff, chaotic and disorganized. In contrast, her sister's side was picture perfect and clutter-free. She spent a great deal of time lining things up just so. Like Debra (see chapter 5) and Alvin and Jerry, she knew the instant she entered the room whether any of her things had been touched or moved. If she found that a hairbrush on her dresser had been moved even a little, she exploded. Amy didn't want anyone to touch her things either, but she left her stuff in such disarray that she wouldn't have noticed. The line down the middle of their room made the space look like a before-and-after shot. The sisters struggled constantly with these conflicting demons.