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Stuff: Compulsive Hoarding and the Meaning of Things

by Gail Steketee, Randy Frost

Published: 2011-01-04
Paperback : 304 pages

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Introduction

What possesses someone to save every scrap of paper that’s ever come into his home? What compulsions drive a woman like Irene, whose hoarding cost her her marriage? Or Ralph, whose imagined uses for castoff items like leaky old buckets almost lost him his house? Or Jerry and Alvin, wealthy twin bachelors who filled up matching luxury apartments with countless pieces of fine art, not even leaving themselves room to sleep?

Randy Frost and Gail Steketee were the first to study hoarding when they began their work a decade ago; they expected to find a few sufferers but ended up treating hundreds of patients and fielding thousands of calls from the families of others. Now they explore the compulsion through a series of compelling case studies in the vein of Oliver Sacks.With vivid portraits that show us the traits by which you can identify a hoarder—piles on sofas and beds that make the furniture useless, houses that can be navigated only by following small paths called goat trails, vast piles of paper that the hoarders “churn” but never discard, even collections of animals and garbage—Frost and Steketee explain the causes and outline the often ineffective treatments for the disorder.They also illuminate the pull that possessions exert on all of us. Whether we’re savers, collectors, or compulsive cleaners, none of us is free of the impulses that drive hoarders to the extremes in which they live.

For the six million sufferers, their relatives and friends, and all the rest of us with complicated relationships to our things, Stuff answers the question of what happens when our stuff starts to own us.

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What possesses someone to save every scrap of paper that's ever come into his home? What compulsions drive a woman like Irene, whose hoarding cost her her marriage? Or Ralph, whose imagined uses for castoff items like leaky old buckets almost lost him his house? Or Jerry and Alvin, wealthy twin bachelors who filled up matching luxury apartments with countless pieces of fine art, not even leaving themselves room to sleep?

Randy Frost and Gail Steketee were the first to study hoarding when they began their work a decade ago; they expected to find a few sufferers but ended up treating hundreds of patients and fielding thousands of calls from the families of others. Now they explore the compulsion through a series of compelling case studies in the vein of Oliver Sacks.With vivid portraits that show us the traits by which you can identify a hoarder--piles on sofas and beds that make the furniture useless, houses that can be navigated only by following small paths called goat trails, vast piles of paper that the hoarders "churn" but never discard, even collections of animals and garbage--Frost and Steketee explain the causes and outline the often ineffective treatments for the disorder.They also illuminate the pull that possessions exert on all of us. Whether we're savers, collectors, or compulsive cleaners, none of us is free of the impulses that drive hoarders to the extremes in which they live.

A Q&A with Randy O. Frost and Gail Steketee, Authors of Stuff: Compulsive Hoarding and the Meaning of Things

Q: What is hoarding, and how does it differ from collecting?

A: Two behaviors characterize hoarding: acquiring too many possessions and difficulty in getting rid of them when they are no longer useful or needed. When these behaviors lead to the kind of clutter and disorganization that disrupts or threatens a person's health or safety, or they lead to significant distress, then hoarding becomes a disorder. Simply collecting or owning lots of things does not qualify as hoarding.

A major feature of hoarding is the large amount of disorganized clutter that creates chaos in the home. Rooms can no longer be used as they were intended, moving around the house is difficult, exits are blocked, and life inside the home becomes dysfunctional. Collectors typically keep their possessions well organized, and each item differs from other items to form an interesting and often valuable collection. Further, an important purpose of collecting is to display the special items so that others can appreciate them. People who hoard are seldom able to accomplish such goals.

Q: What kinds of things do hoarders typically save?

A: While it may appear that people who hoard save only trash or things of no real value, in fact most people who hoard save almost everything. Often this includes things that were purchased but never removed from their original wrappers. The most frequent items saved are clothes and newspapers. Other commonly hoarded items include containers, junk mail, books, and craft items.

Q: What factors contribute to the development of hoarding?

A: People who hoard often have deficits in the way they process information. For example, they are often highly distractible and show symptoms of attention deficit hyperactivity disorder. These symptoms make is difficult for them to concentrate on a task without being diverted by other things.

Most of us live our lives categorically. We put our possessions into categories and use those organizing systems to store and retrieve them easily. But categorization is difficult for people who hoard. Their lives seem to be organized visually and spatially. The electricity bill might go on the five-foot-high pile of papers in the living room, to keep it in sight as a reminder to pay the bill. Hoarders try to keep life organized by remembering where that bill is located. When they need to find it, they search their memory for the place it was last seen. Instead of relying on a system of categories, where one only has to remember where the entire group of objects is located, each object seems to have its own category. This makes finding things very difficult once a critical mass of possessions has been accumulated.

Q: Do all people who hoard save things for the same reason?

A: No, but there are some general themes. The most frequent motive for hoarding is to avoid wasting things that might have value. Often people who hoard believe that an object may still be usable or of interest or value to someone. Considering whether to discard it leads them to feel guilty about wasting it. "If I save it," reasons the hoarder, "I might not ever need it, but at least I am prepared in case I do."

The second most frequent motive for saving is a fear of losing important information. Many hoarders describe themselves as information junkies who save newspapers, magazines, brochures, and other information-laden papers. They keep stacks of newspapers and magazines so that when they have time, they will be able to read and digest all the useful information they imagine to be there. Each newspaper contains a wealth of opportunities, and discarding it means losing those opportunities. For such people, having the information near at hand seems crucial, whereas knowing that the information also exists on the Internet or in a library does little to help them get rid of their out-of-date papers. Hoarders are often intelligent and curious people for whom the physical presence of information is almost an addiction.

A third motive for saving is that the object has emotional meaning. This takes many forms, including the sentimental association of things with important persons, places, or events, something most people experience as well, just not to the same degree as hoarders. Another frequent form of emotional attachment concerns the incorporation of the item as part of the hoarder's identity--getting rid of it feels like losing part of one's self.

Finally, some people hoard because they appreciate the aesthetic appeal of objects, especially their shape, color, and texture. Many people who hoard describe themselves as artists or craftspeople who save things to further their art. In fact, many are very creative with their hands. Unfortunately, however, having too many supplies gets in the way of living, and the art projects never get done.

Q: Why can't people who hoard control their urges to acquire and save things?

A: Understanding this requires knowing what happens at the moment the person decides to acquire or save something. At the time of acquisition, people who hoard often experience a sort of high or euphoric sensation during which their thoughts center on how wonderful it would be to own the object in front of them. These thoughts are so pleasant that they dominate thinking, crowding out information that might curb the urge to acquire. For instance, hoarders may forget that they don't have the money or the room for the item, or that they already have three or four of the same item.

When faced with the prospect of discarding, hoarders have different thoughts from other people. All their thoughts center on what they will lose (for example, opportunity, information, identity) or how bad they will feel (distress, guilt), while none of the thoughts focus on the benefits of discarding. Saving the item, or putting off the decision, allows them to escape this unpleasant experience. In this way people become conditioned to hoard.

Q: How much truth is there to the common assumption that hoarding is a response to deprivation?

A: Although some people attribute their hoarding to having lived through a period of extreme deprivation, our research has failed to find a link between material deprivation early in life and later hoarding behavior. We do suspect there is a connection between hoarding and traumatic experiences, or chaotic or disruptive living situations, earlier in life.

Q: Hoarding has been considered to be a subtype of obsessive-compulsive disorder (OCD), but there are some crucial differences, arenâ??t there?

A: Yes. Only about 20 percent of people with hoarding problems report any significant OCD symptoms, like checking or cleaning rituals. There are other crucial differences. In OCD, obsessions are experienced as intrusive and unwanted, and the symptoms are always accompanied by distress. But in hoarding, owning things often produces pleasant feelings of safety and comfort, and acquiring can even produce euphoric feelings. In fact, the distress we see in hoarding comes from the byproduct of the acquiring and saving--the clutter--or from thinking about discarding things. There also appear to be differences in the brains of people with hoarding problems compared to those who suffer from OCD. For these reasons, many scientists who study hoarding have recommended that it be classified as a distinct disorder separate from OCD.

Q: Is it true that depression is a common affliction among hoarders?

A: In our research we find that over 50 percent of people with hoarding problems are clinically depressed. However, the depression does not seem to cause the hoarding, although it might be a result of hoarding, especially when the clutter interferes with people's ability to function and they feel embarrassed and ashamed.

(Randy O. Frost photo Â© Judith Roberge)
(Gail Steketee photo Â© Kalman Zabarsky, BU Photography)

Clutter Image Rating Photos used by Randy Frost and Gail Steketee, Authors of Stuff
(Click on images to enlarge and learn more)

In our work on hoarding, we've found that people have very different ideas about what it means to have a cluttered home. For some, a small pile of things in the corner of an otherwise well-ordered room constitutes serious clutter. For others, only when the narrow pathways make it hard to get through a room does the clutter register. To make sure we get an accurate sense of a clutter problem, we created a series of pictures of rooms in various stages of clutter--from completely clutter-free to very severely cluttered. People can just pick out the picture in each sequence that comes closest to the clutter in their own living room. This requires some degree of judgment because no two homes look exactly alike, and clutter can be higher in some parts of the room than in others. Still, this rating system works pretty well as a measure of clutter. In general, clutter that reaches the level of picture #4 or higher impinges enough on people's lives that we would encourage them to get help for their hoarding problem.
â??Randy Frost & Gail Steketee (photos Â© Oxford University Press)


1. No evidence of a hoarding problem.	2. Beginnings of a problem with clutter. A subclinical hoarding problem.	3. A mild hoarding problem if the room looks this way most of the time.	4. A moderate hoarding problem


5. A serious hoarding problem.	6. A very serious hoarding problem.	7. A severe hoarding problem with substantial impairment.	8. A very severe hoarding problem.	9. Extreme hoarding.