Suffocated by Stuff: Hoarders

The A&E show Hoarders often makes its mark on Monday nights in much the same way any day’s popular topic boasts its presence: It’ll be trending on Twitter.

Follow the #hoarders trending topic and you’ll see paroxysms of disgust, a smattering of sympathy and promises of a renewed commitment to cleanliness by teenage dirty clothes-pilers nationwide.

But often buried in the discussion online and onscreen are the intricacies of a condition with counterintuitive ties to a disorder typically associated with strict cleanliness.

The San Diego Hoarding Collaborative, the International OCD Foundation and the daughter of a Twitter-trending Hoarders subject are digging deeper into hoarding—its causes, effects and sufferers—to generate a more nuanced understanding of what prompts some people to hold on to so much stuff.

“The key thing is it’s a psychiatric disorder or a mental (illness),” said UC San Diego professor Dr. Catherine Ayers, who helped launch the local collaborative of public safety officials as a resource about hoarding in San Diego County. “It’s not something people are doing on purpose.”

Ayers, who spoke about the collaborative at the International OCD Foundation’s annual conference in San Diego recently, is only a couple of months into a federally funded study on hoarding among seniors 60 and older—a demographic encompassing many of Ramona’s residents. People in this age group are particularly prone to packing their homes with possessions, and hoarding, Ayers said, only “gets worse with age” in the absence of treatment.

An estimated 3 to 5 percent of the general population are hoarders, with an increasing awareness of the condition through shows like Hoarders causing many more to think they, too, have more than just a messy home, Ayers said.

The line between hoarding and a normal attachment to childhood toys or an acceptable level of disorganization is the effect these behaviors have on everyday life, Ayers said.

“That line is distress and impairment” such as an inability to go to work and social functions, or a significant emotional reluctance to get rid of things, Ayers said.

Therapy must be part of any hoarding treatment, or the items are likely to pile right back up, Ayers said.

On Hoarders, individuals work with an expert who guides them through the cleanup, and therapists are on-hand and available afterward to help them better understand the condition.

While some individuals see major improvements post-show—such as Ceci Garrett’s mother, Judi, who became infamous for the mounds of soiled diapers in her home during season two—other hoarders see the show as exploitative and damaging.

Both Ceci Garrett and the expert who worked with her mother on the show—Matt Paxton, who owns Clutter Cleaner and wrote The Secret Lives of Hoarders—manned a booth at the OCD conference, fielding questions and outbursts from attendees.

The positive-negative feedback from conference attendees was about 50-50, Paxton said, adding he is used to getting a mixed response. A woman once blamed him for her divorce, Paxton said.

Garrett, who said she had a strained relationship with her mother before the show, said she has also been lashed out at by viewers who blamed her for her mother's state. Garrett, like many children of hoarders, said she was frustrated by the situation and had given her mother an ultimatum: Clean up or you can't see your grandchildren.

Such ultimatums are not unusual, but typically aren’t helpful, Ayers said. When seniors hoard, the impact often stretches to their children, who feel frustrated, disgusted, embarrassed and confused about how things got so bad, Ayers said. Some, like Ceci, try to spur change through ultimatums, but when these demands don’t kick the cleaning and de-cluttering into high gear, often grown children feel their parents are choosing the “stuff” over them.

Ayers said the hoarders don’t see it that way; rather, they often don’t know how to detach from their belongings. Some studies have shown compromised executive—or decision-making—functioning in the brains of hoarders, Ayers said.

This can be difficult for family members, especially children who may have grown up with the stuff coming in between them and their parents, to understand. And sometimes, shows like Hoarders (TLC has a similar show called Buried Alive) don’t help others understand, either.

Hoarding is not yet officially recognized as a distinct disorder in the industry-standard DSM-IV manual, but is typically considered to be related to obsessive compulsive disorder. Many people think of OCD simply as a preoccupation with hand washing, but perfectionism, strict adherence to religious standards and intrusive thoughts about danger or improper behaviors are part of the disorder, too. 

When it comes to hoarding, the tie to OCD may be both in the compulsion to buy things (many hoarders have rooms full of new, unused clothes, etc.) and the obsession with perfection, researchers say. For example, a germaphobic perfectionist’s home can devolve into that of a trash-collecting hoarder as a symbol of all-or-nothing thinking: If it can’t be perfect, it shouldn’t be done at all.

But not all hoarders have OCD. A combination of genetic and environmental factors can lead to hoarding, such as trauma and other mental illnesses, Ayers said. Researchers are still trying to figure out how other mental illnesses may cause hoarding or relate to hoarding.

In the meantime, through the San Diego Hoarding Collaborative and the personal outreach of people like Ceci Garrett, many are trying to help those who hoard get to a clutter-free life.

Garrett and Paxton said the key for adult children whose parents may be hoarders is to be present and patient. Most of the time, it’s family and friends who first realize the hoarder needs help, Paxton said, and they will need to tread carefully.

In his book, The Secret Lives of Hoarders, Paxton discusses how loved ones with certain personality types—the negative child or sibling—may need to stay away from cleanups to avoid hindering the project.

Garrett, whose mother, Judi, now lives in an assisted-living facility after her home was condemned, said she has learned to get along better with her mother, though they aren’t best friends. A&E recently aired an update show on the mother and daughter, showing a smiling Judi with her grandchildren at her new home.

Garrett said it’s important for adult children to realize they can’t change who their parents are, but they can learn to work with each other toward healing their relationship.

Ayers pointed to the International OCD Foundation’s hoarding section for tips on talking with family members. Several dozen slots also remain open in Ayers’ free Treatment of Late Life Compulsive Hoarding research project on hoarders who are 60 and older, which is funded by the Department of Veterans Affairs. Participants must be willing and able to come to the VA building at 3350 La Jolla Village Dr., La Jolla. Interested individuals or family members can call Ayers at 858-552-8585, ext. 2976.