Coming Clean

Hoarding is a genuine disorder, and its many sufferers require therapy
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Illustration by James Gulliver Hancock

When Elizabeth Nelson was in high school, a boy flirtatiously informed her that he planned to drop in on her at home when she didn’t expect it.

What should have been a fun prospect was, instead, a major problem. Nelson’s mother was a hoarder, and their home in suburban Chicago was overflowing with “stuff.”

“The thought of him at my doorstep terrified me,” says Nelson, who now lives in Ann Arbor.

That type of anxiety-inducing experience is typical of the stress and fear felt by family members of hoarders. A mental disorder, hoarding makes sufferers loath to discard items. Left untreated, hoarders can accumulate so many things over time that the lack of space created by encroaching belongings forces family members from their homes.

Every spring, the media abound with well-intentioned tips for shedding domestic clutter. For hoarders, however, the word clutter doesn’t begin to describe the accumulated mountains of old receipts, bags, and outdated clothing. And no amount of friendly advice will induce them to get rid of it.

“We’re trying to look at unconscious emotional drives like attachment and comfort to explain hoarding,” says Stephanie Preston, an assistant professor in the department of psychology at the University of Michigan, who studies hoarding behavior in animals and humans. “This drive to acquire things is not very susceptible to logic. It just feels bad, really bad, to them to lose this stuff.”

Hoarding is classified as an obsessive-compulsive disorder (OCD), but hoarders rarely respond to OCD medication, and clinical research on hoarding is limited. Hoarders are more likely to be women, and more likely to be older. Some simply can’t throw things away, while others are driven to accumulate — buying 10 of a given item that’s on sale, for example.

It’s unclear what percentage of the population hoards, but there are indications that the disorder is widespread. In April, My Mother’s Garden, a documentary film made by Cynthia Lester, the daughter of a hoarder, aired on television after making the rounds of film festivals. It had already been shown in Ann Arbor, where a special screening at the Michigan Theater drew an estimated 1,000 people on a weeknight. In Washtenaw County, the housing bureau has created a hoarding task force because so many evictions are hoarding-related.

Oprah Winfrey, Dr. Phil, and other talk-show personalities have also spotlighted the disorder. Nelson — spokeswoman for Children of Hoarders, a Web-based organization (childrenofhoarders.com) — provides resources and support and often consults with producers preparing programming on hoarding. Too often, she says, such shows approach the problem as though it were easily fixable by showcasing a hoarder who’s ready to get help.

“Every time you hold up as an example someone who’s dealing with the problem, you’re holding up someone who is totally atypical,” Nelson says. “I see someone totally unlike my mother and solutions that are totally unavailable to me.”

In 2006, Nelson and her siblings, now all grown, had had enough. Their father, who was having prostate problems, was forced to use handheld urinals for months because their mother’s stuff blocked access to the bathroom.

“That was the turning point,” Nelson says. She and her siblings lured their parents out of town to stay with Nelson’s sister while the three others cleaned out the house, a “surgical procedure” designed to discard only what they believed their mother wouldn’t miss. When their mother returned, they told her she needed help and got her to agree to see a therapist and to accept a twice-weekly cleaning service.

Since then, Nelson says, her mother has “weaseled her way out of” the cleaning service and remains angry that her children cleaned her house. But Nelson says the family had no other way to remedy the situation. Their case, she says, highlights how difficult it is to change a hoarder’s behavior.

Hoarders affect the domestic behavior of their offspring, as well. “Many [children of hoarders] have very orderly houses; some are obsessively neat,” Nelson says. “Then there are people like me. I learned no skills for maintaining a house. My house is messy. Toys are strewn around. I have clutter blindness, but I don’t see it because it’s functional.”

Experts say most hoarders are very resistant to changing their ways. “Saving things and having things at hand that one thinks are of value is intrinsically rewarding,” says Jim Abelson, director of the anxiety disorders program at the University of Michigan. “It seems as if the importance of having their things overrides their ability to perceive the negative consequences that follow.”

Hoarders who do seek help fall into two basic categories, Abelson says. In the first group are those who, like Nelson’s mother, have faced external pressure, either from landlords, health officials, or family members. The other group includes those who decide on their own to seek help. The second group is more rare, but more likely to succeed with treatment.

“I remember one case in which an elderly man came in facing some health crisis, and he was thinking appropriately about the legacy he was going to leave his children and grandchildren,” Abelson says. “He said, ‘Do I want them to remember me and the mess I left them that’s going to take them six months to sort out? Or do I want them to remember me as a loving father and grandfather?’ ”

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