Understanding clutter and hoarding
Some people are extremely tidy, while others tend to accumulate a bit of clutter. Some people live in dirt and don’t seem to notice. Then there is the hoarder, whose possessions accumulate until his home is a fire and health hazard.
What goes through the minds of very messy people? I think they can be separated into two types: those who are disorganized and those who have psychological disorders. The first group includes people who have trouble keeping things tidy.
They may have some spatial organization issues and just don’t know how to deal with all the papers and objects that make up their home life. They feel overwhelmed by everything, and when they give up in despair, the batteries start to build up.
These people know they have a problem, but they cannot find the solution on their own. What they need is a lot of support and some simple systems to fall back on. Organizational consultants are people who have a knack for finding the right place to put everything and can help those who suffer from clutter and clutter to have a more orderly and less chaotic home life.
When even this doesn’t help, it’s because the person’s problems are more serious, perhaps they suffer from ADD (Attention Deficit Disorder) and they just can’t cope with trying to keep all their stuff organized. These people need a lot more support, maybe even medication, to be able to manage all their papers and possessions.
A more severe form of disorder belongs to those people who do not clean. We’ve all seen them on reality shows about dirty houses. These are the people who never change their sheets or kitchen sponge; who rarely, if ever, empty kitty litter, dust, sweep, mop, or even scrub a surface. Your kitchen and bathroom are petri dishes in which pestilences and pests grow and yet persist in their ways.
Chronic non-cleaners live in an unpleasant, smelly, and unsanitary environment, but they don’t seem overly bothered by this, which in itself is a sign of a serious problem. Many of these individuals have a mental disorder that allows them to create clutter and then live in it without worry. They may be able to function adequately in other areas of their life, but their psychological problems are demonstrated by the literal dirty secret of their filthy home.
A milder form of this problem is those people who let their dishes accumulate in the sink for a week, don’t do laundry for a month, sweep their floors only occasionally, and dust rarely. They wouldn’t qualify for the TV shows, but the level of clutter and dirt in their homes is unacceptable for a normally clean and tidy person.
These people suffer from low self-esteem, passivity and inertia. They are overwhelmed by life and feel powerless to have any control over things. They have basically given up and their mess is just a sign of the problem. They could benefit from supportive psychotherapy.
Finally, there are the hoarders. These people have an extreme disorder. His overwhelming anxiety and inner chaos is expressed through the need to accumulate as many things as possible and the inability to throw anything away, be it old clothes, wrapping paper, newspapers, or even your trash.
When I was in pre-med, I ended up sharing a house with a 27-year-old woman, let’s call her Jenny, who had a form of this problem. She was, on the surface, an attractive, well-groomed young woman from a good middle-class family. It was only by living with her that her problem was revealed. Her first clue was that she locked her bedroom door and hid the key.
The only time I got to see his room, I was shocked. There were so many things piled up on the floor that I had to walk through them to get to the other side of the room. He invited me in only because he was in a panic: he had lost something in the two-foot-high piles and he needed my help to find it.
Every week Jenny went grocery shopping and came home with enough food to feed a family of six. She was a small person, and yet she bought a dozen grapefruits, ten pounds of potatoes, two quarts of milk, and three loaves of bread for her own consumption. She made herself a big dinner every night and then she obediently put the leftovers in a plastic container that she never looked at again.
I would go through the fridge and pantry every week, throwing out mushy grapefruit, stale leftovers (container and all), potatoes with long green sprouts, curdled milk, and moldy bread. At the time I wondered if I missed his family, but then I realized that I just had to accumulate things. This was further demonstrated by his compulsive shopping sprees; the evidence of which lay piled on his bedroom floor in the form of handbags, scarves, belts, sweaters, jewelry, and assorted shopping bags.
Jenny had filled the room across the hall with her bedroom excess. One day I came home to find her sitting in the hallway, surrounded by bags and boxes and lots of things. She had emptied the room, hoping to sort through the years’ possessions and throw away what she could. She sat there, paralyzed, for several hours and finally gave up and put everything back in the guest room.
At the time, I thought she was weird. She was a bit uptight and had some strange habits like stacking all the cutlery in the utensil drawer without sorting the various forks etc. in each tray slot. I didn’t realize her problem had a name. It is actually a form of OCD, Obsessive-Compulsive Disorder. There are many manifestations, and compulsive hoarding is particularly challenging.
Jenny started dating Harold and decided to hide her problem from him. On the few occasions that she came to visit, they stayed in the living room. In the course of their entire relationship, Harold was never able to see her bedroom. I wondered at that moment what it must be like to be intimate with someone and keep such a big secret from them.
I moved out at the end of the year and never saw Jenny again. We got along as roommates, but her problem made it impossible for us to be close. I thought about her from time to time, and once I was a psych resident, I realized how instructive it was to be face to face with someone who was described in my textbooks. There’s nothing like seeing it first hand to see how concerned these people are. And it turns out that his was a mild case. The most serious patients cannot contain the disorder and the problem takes over their lives.
It is clear that, except for those who have organizational problems, people who live with extreme clutter or hoard it actually show signs of significant mental disorder. Unless these problems are recognized for what they are and treated by trained mental health professionals, people who live in extremely disorganized, messy or dirty environments will have no chance of making significant changes towards cleanliness and order.
(C) Marcia Sirota MD, 2010
