Stuff (5 page)

Thanks to our close observation of Irene, the first piece of our theory for understanding hoarding was taking shape. Hoarding appeared to result, at least in part, from deficits in processing information. Making decisions about whether to keep and how to organize objects requires categorization skills, confidence in one's ability to remember, and sustained attention. To maintain order, one also needs the ability to efficiently assess the value or utility of an object. These mental processes seemed particularly challenging for Irene. As we shall see later, these dysfunctions may reflect problems with how the brain operates in people who hoard.

After Irene gave me the tour of her home, she asked, "How did I get this way?" It completely baffled her that her home was nearly unlivable. "I know I am smart and capable, so why can't I manage my stuff? I see other people doing it. Why can't I?" I had no answer for her.

When we began studying hoarding, we were told by other mental health experts that it was a response to deprivation. Living through a period of deprivation, such as the Great Depression of the 1930s or the Holocaust, might cause people to stock up on whatever they can find to prevent such an experience from occurring in the future. Indeed, in our first study of hoarding, we found that many people described much of what they collected as "just in case" items. But when we asked our hoarding research participants if they had ever experienced periods of deprivation, by and large they said no. In fact, many of them grew up quite wealthy and never faced any shortage of food, money, or luxuries. Irene's experience was typical: She grew up in a middle-class family. Her father was a high school accreditor, and her mother taught typing and shorthand at the local high school. They had enough money and never experienced any material deprivation.

Irene could not remember exactly when her hoarding began. She remembered saving her schoolwork from elementary school, much of which she still had. But when she was young, her room was not cluttered, and she had little trouble managing the things she owned.

Her father traveled a lot for his job. She remembered being spellbound by his descriptions of the places he visited and the things he saw, and his stories left her with a lifelong interest in travel. Although she traveled very little herself, travel sections of newspapers and travel brochures could be found throughout her house. They were among the most difficult things for her to discard. Perhaps they represented a bond with her father that she cherished. The rest of her relationship with him was not so warm.

Outside of his travel stories, Irene remembered him as distant and cold. Irene recalled her father's terrible temper when she was growing up. Although he never hit her, she remembered being afraid of him. That dynamic continued into her adulthood. One day she showed me a letter he had written to her several years earlier. It was formal and criticized the way she cared for her house. "You have failed in your obligation to properly maintain the house and grounds," he complained. He had helped them buy the house but now threatened to cut her off if things didn't improve.

On another occasion, not long after she got married, Irene went looking for a pair of gray wool slacks some friends had given to her husband. She recalled putting them in a box in the barn behind her house with some of her many "lists," but the box was nowhere to be found. Her father had been in the barn, so she asked if he had moved it. He admitted to having thrown the slacks away, trying to secretly rid his daughter of stuff. Irene drove to the town dump and spent several hours searching through the trash. She never found the slacks.

More recently, she saw her father tear up and throw away some of her late mother's handwritten lesson plans. Irene was incensed that he would do this and rescued them. The shredded papers now rested in her living room. After her mother died, Irene stopped receiving birthday or holiday cards from her father, though she knew that he wrote to other people. Perhaps he feared contributing to her clutter, or perhaps out of frustration he'd lost interest in communicating with her, so different were they in their views of the world. We have often wondered whether cold and distant parenting may be a contributing factor in the development of hoarding. In several recent studies, people with hoarding problems recalled disconnected relationships with their parents, particularly their fathers.

In contrast, Irene was extremely close to her mother. Whenever she faced a crisis, she turned to her mother for advice and comfort. She came to value anything connected with her mother, especially after her death.

Irene's earliest memories were of a very happy childhood, filled with lots of children and activities. She walked to school with the neighborhood kids. They all gathered together after school and on weekends, and there was always someone around to play with. When she was in the second grade, however, her family moved to the suburbs. With only one other child in the new neighborhood, Irene felt isolated and alone. She rode the bus to school by herself and found the bus driver loud and menacing. He frequently yelled at the kids. She was frightened of him and avoided speaking to anyone on the bus. Her teacher seemed no better. Irene was so scared, she seldom spoke in class and began to dread going to school. "I was scared all the time," she told me. "It was horrible."

Under these conditions, she began to devise strategies to manage her emotions. She recalled getting wrapped up in objects as a child. "Things were fun, interesting, and different," she said. "They were removed from emotional life—soothing. All my fears were gone." She elaborated: "Things were less complex than people, less moody. People either leave or hurt you." Ironically, it was her things that eventually caused her husband to leave.

Fear still permeated Irene's life nearly fifty years later. During one of our sessions, she admitted, "Every day, I wake up in fear," although she couldn't articulate exactly what she was afraid of. She coped with her fear by surrounding herself with things, just as she had as a child. One day she told me, "You know, yesterday, without thinking about it, I sat down and built a little fortress around myself. It felt nice, comfortable." She made a number of such comments during the time we worked together.

Around the age of seven or eight, Irene began ordering and arranging her possessions in peculiar ways. She arranged her books and papers so they were perpendicular and perfectly aligned with the edge of the desk. At first this compulsion was mild and did not interfere with her life. But over time the feeling got stronger, and she began to spend hours arranging and rearranging things. She had trouble getting her homework done, doing her chores, and even getting ready for school on time. If she was prevented from doing her arranging or interrupted in the middle, she felt uncomfortable and anxious. This was the first hint for Irene of problems related to possessions, and it is consistent with research finding symmetry obsessions and arranging compulsions in children who also have hoarding problems. Since symmetry, arranging, and hoarding all have to do with physical objects, the connection may suggest a deeper problem with how people interact with the physical world or separate themselves from it. Luckily for Irene, the symmetry obsessions and arranging compulsions eventually disappeared.

During those early school years, Irene began to gain weight and had struggled with her weight ever since. At one point in high school, her eating habits became rigid and unusual. In retrospect, she thought that she may have been anorexic at the time. Now she believed that her weight and hoarding were connected: "My body and my house are kind of the same thing. I take things into them for solace." We've had a number of other hoarding clients who believed that their weight problems were related to their hoarding, and in one study we found that people with hoarding problems had higher than average body mass indexes.

When Irene was nine years old, her grandparents moved in with the family. They were elderly immigrants from Europe, and their grooming habits were at odds with Irene's. They seldom bathed or used deodorant, and they seemed to Irene to leave an odor wherever they went. She would not sit in a chair that one of her grandparents had recently used; it disgusted her. Before long, she stopped sitting in any chair her grandparents had once occupied. Still, there was no cleaning compulsion, just a sense of disgust. In all likelihood, this was a precursor of her contamination fears.

Objects seemed to have a special significance for Irene as a child. Although she was not deprived, she had relatively few toys and cherished the ones she had. She recalled never taking a number of them out of the package, perhaps foreshadowing her tendency to value mere possession over use of an object. She remembered one treasure, a cylindrical paisley pocketbook with a mirror on top, that her parents threw away when she was about ten. By this time, they had become annoyed with the number of things she was saving and occasionally took matters into their own hands. Perhaps this shaped her response, years later, to a friend who agreed to help her clean up but was dismissed for throwing away a gum wrapper. Irene developed elaborate strategies to foil those who insisted that she get rid of her stuff. When her husband threw out her piles of newspapers, she sneaked them back into the house by using them to line the bottoms of boxes she brought in to help her organize.

Even losses that were not emotional were troubling, particularly the loss of a potential opportunity. I got a sense of this one day as we excavated in Irene's TV room. She came across a piece of paper with a telephone number written on it. Judging from its depth in the pile and the fact that it was yellowing, it had been there for quite some time, possibly years. Clearly, she had written it in haste on whatever she could find. As was the case for most of the information in the pile from which it came, she had not taken the time to identify it or put it in a phone or address book—it was just a number on a piece of paper. When she picked it up, she exclaimed, "Oh, a phone number! I'll put it here on the pile where I can see it and deal with it later."

"Why do you think it is worth keeping that number?" I asked. She said, "Well, I made an effort to write it down, so clearly it was important to me. And it will just take a minute to call and find out what it is. I don't want to do it now, though, because it will interrupt us." She hadn't made the call in all the years the paper had sat in the pile. Whether making the call would have helped her make a decision about keeping the number is uncertain. Perhaps the idea of a potential opportunity that the number provided was better than the reality provided by making the call.

In high school, Irene's behavioral oddities became more rigid and extreme. She felt compelled to do things in a certain way, particularly her schoolwork. Irene was an exceptional student, but at some cost. She insisted on using a #3 pencil sharpened to a very fine point so that she could write precisely. She printed everything in very tiny letters, and the formation of the letters had to be perfect. If she did not form a letter just right, she would start over and rewrite the entire page.

In college, her room was not cluttered, though she remembers having lots of stuff packed in boxes. But other peculiarities caused her considerable discomfort. She recalled feeling tormented when other students came into her room and sat on her bed. It reminded her of her grandparents sitting on chairs and leaving an odor. Still, this torment was private. By all outward appearances, she was functioning extremely well. She had friends and was getting straight A's. As her senior year progressed, however, her tightly controlled world began to unravel.

Irene majored in art history and decided to write a senior thesis on Iranian art and architecture. As she collected and read book after book on the subject, she began to see connections everywhere. One obscure fact led to another, and when she saw these connections, she felt compelled to pursue them. To keep track of it all, she kept copious notes on each book she read. Sometimes her notes approached the length of the book itself. She felt the need to collect information until she had a "complete" picture before sitting down to write. For the perfectionist Irene, anything less than perfect meant disgrace. As the end of the term approached, she had written very little, and for the first time in her life, she faced the prospect of failure. Still, she couldn't quite see how to limit her material, and she went on collecting.

When she realized that she didn't have time to complete her thesis, she became suicidal. It began as a thought that gave her some respite from her terror about the upcoming deadline. Soon she found herself thinking about how to kill herself every day. Instead of writing, she made plans to drive her car into a nearby lake. Death seemed like a better alternative than failure. In the end, she put all her notes and the few pages of her thesis she had been able to squeak out in a manila envelope and gave them to her professor with an explanation of her problem. He took pity on her and gave her a C–, her only grade below an A in college.

She had struggled with depression since then, though she had never again been suicidal. Irene's depression impeded her ability to deal with her clutter. During her depressive episodes, no sorting or discarding occurred, and one of the few things that made her feel better, shopping, only added to the problem. Depression is a common affliction among hoarders. In fact, nearly 60 percent of the participants in our research meet diagnostic criteria for major depression—much of which results from the hoarding itself. People draw conclusions about their worth and competence based on their inability to control their living space, and not being able to entertain people in their homes isolates them and limits their social lives.

On my first visit to Irene's house, she said something unusual. When I asked her if she would agree to be studied while we tried to help her manage her stuff, she said, "Why would you want to waste your time on someone like me?" When I asked her more about what she meant, it became clear that her low opinion of herself reflected ambivalence or uncertainty rather than pure low self-esteem. When she was at work, talking to other people, or shopping, she did not have the same feelings. But when she was at home, her unworthiness was more apparent to her, mostly when she focused on the clutter. When she focused on individual items, however, her possessions seemed more comforting than threatening. The irony that her hoard could be comforting and tormenting at the same time was clear to her.