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Illustration by Kelly Doren Clutter Busters Deconstructing our acquisitive human nature By Bill Strubbe THE RED T-SHIRT I usually wore on the job read: "Obey Me." Though I once did facetiously return to a particularly recalcitrant client's house with a cat-o'-nine-tails, the whips and paddles in my arsenal were more figurative than literal. That clients had dialed up Clutter Busters was a sure indication that they'd already traversed some crucial inner line of demarcation to acknowledge that they were helpless helpless: in the face of their amassed junk and in need of a "professional organizer" to help deconstruct their chaos. Milder cases simply needed assistance in cleaning out the garage or rearranging their home office. Others were truly desperate. One client shoved a dresser in front of a bursting closet; another rented a parking space because his garage was a tinderbox crammed with newspapers; another's husband had given her the ultimatum--her stuff or him. It wasn't until about four months into my moonlighting career that it belatedly dawned on me that these worst-case scenarios were not just lazy stuff-sluts, but that something beyond the pale of run-of-the-mill human behavior was at play here. I should have been forewarned when the caller asked if I had a pickup truck. Still unsuspecting, when the door opened, I was nearly bowled over by the stench. Recovering from momentary shock, I resisted the urge to pronounce in my best Bette Davis voice, "What a dump"--which it was, literally. Unless you've actually entered a horror house like this, you'll deem my account more fiction than fact. The five rooms were accessible via narrow trails blazed through waist-high garbage. The bed had long ago disappeared under a drift of clothes, books, newspapers, and unimaginable things. In the kitchen, filthy dishes and pots and pans encrusted with blackened crud were heaped everywhere. I shuddered as something small and furry disappeared under a pile of boxes. And the bathroom . . . well, I'll spare you. Ever optimistic, the man, perched on a corner of the couch--the only uncluttered surface--asked, "Can you do it by Friday? My landlord is going to evict me unless it's all out." When I asked how he planned to pay me, he replied matter-of-factly, "I thought there might be some things here that you'd want in trade." Incredulously, as I scanned the room, daftly thinking I might have overlooked a valuable antique or piece of artwork, I realized that all of this stuff was of value to him. My irritation quickly waned in the face of this belated revelation. I wished him good luck and left; I couldn't wait to get home and shower. Initially, I found them rather pitiful, these crucibles of chaos couched in a myriad of inane rationalizations. But I was being paid--rather well, in fact--so I'd mask my disdain and feign sympathy while the more extreme hoarders dismantled their armor of junk, shielding what I imagined were grievously wounded souls. The kinks in the psyches behind this passion to amass intrigued me, made me ponder the origins of the acquisitive nature of human beings. PEOPLE OFTEN wonder what grants me the credentials to be a professional organizer and turn a stranger's house upside down and inside out. Certainly no college course offers Mess Management 101, but it does help that I'm big, somewhat intimidating, and naturally bossy. That my decidedly recessive shopping gene manifests an aversion to malls and department stores adds to my résumé. Perhaps because I've moved enough times to embody the axiom that a rolling stone gathers no moss, I've garnered a modicum of authority to encourage/cajole others to winnow their possessions down to the essentials. But who among us doesn't collect something or another? Growing up, I had a penchant for psychedelic Fillmore Auditorium and Avalon Ballroom posters. My sister collected spoons; my mother, native California Indian artifacts; a friend, dead insects entombed in Elmer's glue. Even the dearly departed aren't exempt--though it's highly unlikely they give a damn. The Egyptians established an entire culture around catering to the needs of the dead. In China, thousands of terra-cotta soldiers and horses march into eternity with an emperor. Apparently acquisitiveness is imbedded in our human genes. But the boundary between collecting as hobby and hoarding as illness becomes obscured when a neighbor's collection of 1,455 snails--cuff links, jewelry, ceramics, dishes, carpets, etc.--takes up every square inch of house space; or when Aunt Nell must rent a storage unit to house her collection of books, most of which she's never read and never will. My first encounter with pathological hoarding was at a relative's. Her living room's most impressive feature--besides the hideous stench--was the endless stacks of newspapers and magazines covering floors, tables, couches, and chairs. When I asked why, she explained that she planned--someday--to clip out interesting articles for a folder. She added that the newspapers kept the cats--she had dozens of them--from climbing up and peeing on the chairs, except for the one unobstructed armchair in the corner, whence arose the stink. My subsequent experience with hoarding occurred in Israel, where I lived on a kibbutz. While taking afternoon tea at an elderly couple's house, I went to retrieve sugar in the kitchen. I opened the cupboard and was startled to see enough provender and supplies--distributed free on the kibbutz every week--to last half a lifetime. I snooped into other cupboards, and it was the same: top to bottom with soap, toothpaste, shampoo, vanilla packets, baking powder, raisins, nuts, powdered tahini, Osem soups, matches, toilet paper, matzos, Shabbat candles, etc. Later, I learned that they had both survived World War II. Though they now live in a relatively safe place, their psyches, forever scarred by lack and deprivation, have made manifest in cupboards and closets the corollary "I shall not want" to their pledge of "Never again." AS A COUNTY mental health worker in California, Jane Walberg encountered numerous intractable hoarders and related this story about a former resistance fighter in World War II. "Inside her front door was a dead cat being eaten by creatures," Walberg recalls. "To get from one room to another you had to crawl on your stomach over mountains of garbage that reached almost to the ceiling. Her husband, who drank heavily, moved out to the garage, then moved back into the house. "He died, and two weeks later they found his body buried in all that stuff." At first glance, to a novice like me, hoarding seemed to be engendered by a scarcity mentality anchored in some past trauma--the Holocaust, the Depression, or unpleasant familial experience. Formerly, behavioral scientists believed that excessively rigid childhood family relationships played a role in obsessive-compulsive disorders, or OCDs. But it appears that hoarding, like an increasing number of aberrant behaviors, is not the roguish choice of a free will, but is in the sway of some molecular imbalance, a fluke of chemistry. When asked what I wanted to be when I grew up, it's not as if I replied, "Oh, maybe a fireman, a doctor, or a professional organizer." My Clutter Buster career didn't coalesce until decades later, after I tackled--and perversely enjoyed--organizing a friend's immense basement, consolidating all like items, such as light bulbs, paint cans, Christmas decorations, tools, and pink tulle, in one place. Friends joked that maybe I could earn money from this new "skill." Later, I discovered in the Yellow Pages six listings under professional organizers and then bumped into an old friend exploring the same line of work. He invited me to attend a meeting of the local chapter of NAPO, the National Association of Professional Organizers. Seventy people attended--all women except for four men--and, as you might well imagine, the meeting itself was very organized. With about 1,600 members nationwide and an annual national convention, the association demonstrated that professional organizers are in a booming business. Encouraged, I placed a few ads in local rags and made a go of it. Then, by word of mouth, business took off. The general plan of attack was this: one pile for the garbage bin; one for the Goodwill (if you hadn't worn/used/tasted it within a year, it was out); one for items to give to friends; the rest to keep. Negotiations were allowed--though I usually prevailed--and when a stalemate was reached, there was the "Maybe Box" for the terminally indecisive. The operative words here were "Obey Me," and my clients usually did. Though I'd kid around to try and make it fun, I was one strict mother (fucker) superior, and occasionally I made people cry. Over time, as I learned more about hoarding, my harsh judgments--perhaps backlash to my own closeted acquisitive inclinations (occasionally I kept for myself choice items being tossed)--were mitigated with a modicum of compassion. Hoarders are not just bums; they truly cannot help themselves. "A hoarder perceives a great need for a particular piece of junk," explains Sanjaya Saxena, M.D., assistant professor in UCLA's department of psychiatry and director of its Obsessive-Compulsive Research Program. "A plastic McDonald's cup may be junk to anyone else, but a hoarder may inexplicably express some sentimental attachment to it, or [not] want to throw it away because there might be something valuable inside (money, jewelry, lotto tickets)." "They always have come up with some reason or future need for it," explains John Gillette, M.D., staff psychiatrist with Community Mental Health and Older Adult Services in Santa Cruz. " 'I'm saving it for my grandchildren,' or 'I love literature and am going to read that book someday.' They know enough to put you off with a logical excuse." IN OCD's extreme form, even bodily excrement is not exempt from being saved. An elderly woman and her grown son used the guest bedroom as their lavatory. Another wouldn't flush her excrement down the toilet, saving it and her urine instead in Tupperware. One man shat in his socks, then returned them to the drawer. Scavengers, pack rats, and junkaholics are lay terms, but the clinical appellation for their disorder is obsessive-compulsive hoarding--defined as "the acquisition of and failure to discard possessions which appear to be useless or of limited value," a relatively new frontier in psychotherapy circles. Although hoarding behavior may manifest in people suffering from psychosis, brain damage, or dementia, most severe hoarding appears to be a subtype of OCD and is usually coupled with other OCD behavior such as compulsive counting, hand washing, checking (making sure the stove is off), and organizing (never mind!) Studies carried out by an expert in the field, Randy Frost, Ph.D., and a National Institute of Mental Health survey, both estimate that between 2 and 3 percent of the population suffers from OCD--creating around $8 billion annually in social and economic losses, with about 15 percent to 30 percent of those OCD sufferers experiencing hoarding as their primary symptom. "OCD hoarding is an extremely confounding disorder, difficult to treat, and in severe cases life threatening," explains Dr. Gillette, who has worked with the elderly for more than 25 years. "Outdated food spoils, accumulated food and feces breed health problems, little critters move in, and stacked newspapers and magazines become fire hazards." Indeed, a friend's mother's house which was crammed from basement to attic with garbage, burned to the ground last year. In one study of children who suffered from OCD, 20 to 70 percent of first-degree relatives also exhibited significant signs of OCD. It is now widely believed that hoarding, like other OCDs, has a strong genetic component and often runs in families, as in Barbara's. Both of Barbara's parents were hoarders, and as a child she collected rocks, shells, leaves, and flowers pressed in books, and assorted insects kept in jars for show-and-tell. She particularly treasured books--"I go into a trance when I look at books," she says. Now, at 62, Barbara has walls lined with tomes. Her collection--estimated at 50,000 editions--rivals the stock of nearby bookstores. Her formidable stash also includes LPs, videos, audiocassettes, computer stuff, tools, craft materials, odd pieces of fabric, beads, shoes, hats, gloves, scarves, purses, tote bags, cat paraphernalia, radios by the dozen, mirrors, beer steins and liquor glasses, ashtrays, exercise gear she never used (she's "exercise intolerant"), baskets, and advertising art like "Absolut Vodka" and "Got Milk." All this booty is stashed in her 12-by-16-foot single-wide mobile home, which she has humorously dubbed her "Pack Rat Aversion Therapy Center." A narrow "goat trail" necessitates scooting sideways from the front door, down the hall, and into the kitchen, which she can barely use. She fears that "the floors may cave in under the load" and that the Health Department or the manager of the complex will evict her. The medically prescribed Paxil that Barbara takes daily has helped combat her depression and anxiety, but hasn't stemmed her hoarding. She carts off or gives away as much as possible to charities or friends, but the more she takes out, the more comes in. "I go to thrift shops to donate and can't resist looking," she explains. "Recently I was going to give myself five minutes in the Goodwill, but saw a familiar face and stayed two hours. It's my favorite place to socialize." INDECISIVENESS and procrastination, along with magical thinking and repetitive rituals to stave off anxiety and panic attacks, are often symptomatic of OCD behaviors. "I often pray and sometimes even believe that I will go to sleep and wake up and this will all be a bad dream," Barbara says, petting one of her cats. "Sometimes I feel so overwhelmed that I just scream inwardly or sit and cry. If I pray when I go to sleep that I won't wake up, then I worry about what will happen to my cats." As with Barbara, early signs of hoarding generally manifest in adolescence, gradually intensifying in later years. Many victims lead otherwise normal lives and may feel a sense of embarrassment or shame about their hoarding, while others are unable to acknowledge that their behavior is peculiar. Their preoccupation with hoarding will eventually come to exclude work, family, and friends. "Whereas most people with OCD are aware that their behavior is out of control, OCD hoarders usually lack that insight or don't think that it's that unusual," says Dr. Saxena. "Inevitably it's a family member or friend who brings them in for therapy, and they're unusually difficult to treat." As hoarders age, they face an escalating series of stress factors--loss of control over children, retirement, death of a spouse, impending illnesses, diminished ability to care for themselves, etc., and hoarding is the imaginary line of defense in the face of inevitable loss of control. As the baby-boomer generation grays, it's likely that society can expect an increase in hoarding, especially dementia-related. "The average age for those with hoarding problems is about 50, and many are older," says Gail Steketee, professor at the Boston University School of Social work. "There's a growing concern on the part of elder service workers about hoarding and how to manage its potential consequences, such as fire, risk of falling, inability to find medications, etc." ONCE A HOARDER crosses the hurdle of seeking help, the physician must determine the actual underlying cause. Successful treatment for OCD hoarding, which generally reduces symptoms only 50 to 80 percent, includes therapeutic, environmental, and psychopharmacological aproaches. Therapeutic behavioral treatment for OCD hoarding involves five steps: helping hoarders understand how out of control and damaging their behavior is; cognitive restructuring, helping hoarders identify their thoughts and beliefs about hoarding, and challenging these attitudes by employing particular techniques; improving their organizational and decision-making skills; teaching hoarders how to tolerate the fears while "excavating" their space and becoming habituated to the anxiety; and enabling them to maintain their space--canceling subscriptions and credit cards, no stopping for yard sales or malls. The first line of medications to combat OCDs and OCD hoarding is serotonin reuptake inhibitors, or SRIs, such as Paxil and Zoloft, commonly used as antidepressants. "For some unknown reason, hoarders often don't respond to SRIs, which tells us this may be a unique neurological subtype," explains Dr. Saxena, heading a three-year UCLA study. "There's a likelihood that OCD hoarders exhibit unique patterns of brain abnormalities, different from those of other OCDs, which will enable us to direct our research into other drugs." Words of hope for those whose cluttered lives have become a living hell. Since most of my Clutter Buster clients had money to spare, I couldn't help wondering whether hoarding was perhaps more prevalent among the wealthy, a symptom of a creeping cultural emptiness. But then we've all seen street people shoving shopping carts bulging with God knows what. Maybe the difference is that the rich possess the means to acquire their stuff with credit cards at Bed, Bath, and Beyond or Macy's, while the street lady gathers hers by hand from gutters and dumpsters. I WONDERED if people in India, Albania, or Sierra Leone suffer from OCD hoarding to the same degree as Westerners do. The few cross-cultural studies (one in particular done in Egypt, and others currently under way in Italy and Australia) show that hoarding does, indeed, cross cultural, ethnic, gender, and economic boundaries. "It seems that economics doesn't have much to do with acquisition or saving, though those with money may save more expensive items than those with little money, who might collect free or inexpensive items," explains Dr. Steketee. Dr. Saxena conjectures that hoarding lacks natural control systems and is an evolutionary adaptive behavior gone awry. Hoarders, who simply cannot control themselves, have taken our pathological national pastime of acquisitiveness, magnified it a thousandfold, and reflected back to us the void of our rampant materialism. Perhaps, for the spiritually deprived, amassing stuff keeps their minds on a permanent detour. One 56-year-old hoarder shared the following: "There is not a moment that loop tape of inner dialogue isn't playing, even in my dreams: 'Another day, the same mess. Why can't I be organized like other people? I'm not a stingy person--how did I become a hoarder?' "In all these boxes are my fulfilled and unfulfilled dreams, my memories of people, my attempts at having a life, my good intentions. "It wounds my childish id to admit that these things--all this flimsy evidence that I have even existed--matter to no one else but me. "Mere ashes in the winds of time." Years ago I was impressed enough with an anonymous poem I came across to write it down: "The more I have, the more I want. The more I want, the less I have. The less I have, the less I want. The less I want, the more I have." A simple formula for a happier life. Bill Strubbe, a freelance writer and photographer, lives in a yurt on a hillside in Occidental. [ Sonoma County | MetroActive Central | Archives ]