All or Nothing

Perfectionism.  The word conjures up images of spotless houses, immaculate clothing and everything done just so.  But there is a darker side to perfectionism.  Many people who would consider themselves perfectionists live in conditions just the opposite of those I just described.  Their homes are cluttered and dirty, their clothing is worn and poorly fitting and most people who look at their lifestyle would consider it slovenly.

But, strange as it may sound, it is perfectionism that leads them to be this way.  This is due to their "all or nothing" way of viewing the world.  They might decide that today is the day they are going to finally get the kitchen pantry organized.  They remove the first item, a can of soup bought a few weeks ago on sale.  But the perfectionist in them can't help but notice the sale sticker on the can and spend 10 minutes carefully removing the sticker so the can looks neat.  After an hour of this they find they've barely made a dent in half the first shelf and give up.

Instead of seeing the value in having things better than they are now, they only see that there is no way they can make everything perfect.  Their natural predisposition towards avoidance kicks in and they end up doing nothing at all as their homes and belongings fall into increasingly worse repair. 

They may occasionally go on a marathon cleaning binge, making one room in the house look absolutely perfect after several hours of cleaning, but there is no way they can maintain that level of effort on a long term basis.  Things eventually return to the status quo. 

I recently read a story written by some anonymous internet fellow that I believe can be very useful if the all or nothing perfectionist can put it into action.  This is the principle of GRADUAL, CONSISTENT and MORE.  The saying goes:

   "Be gradual, be consistent and always do more."

In other words, instead of massive, exhausting cleaning binges, start with something small.  In fact, begin with something tiny.  Maybe today you only take out the trash.  You're starting out gradually with something that only takes a couple of minutes, so it should be fairly easy to do tomorrow.  So that's what you do:  tomorrow you take out the trash again, if it needs it.  On day three you do the same, and so on.  After a few days, you add in something new, like washing the dishes.  Is the house perfect at this point?  Definitely not.  There are still huge mounds of clutter and unusable rooms buried under your thousands of possessions.  But the dishes are clean and the trash has been taken out, so your house is that much better than it was yesterday.

You're now being gradual by starting small, consistent by doing it every day and always doing more by adding a new activity every few days or weeks.  If we can overcome our avoidance tendencies and our desire to make things perfect right now, we can use the principle of gradual, consistent and more to make massive changes in the cleanliness of our homes and the quality of our lives.

A&E's Hoarders visits Canyon, Tx

A&E's hit show Hoarders filmed an episode here in Canyon, Tx in February of 2012.  In it they told the story of a local woman named Jan, her daughter and the hoarding that is causing so much trouble in their lives.  Below is a link to the episode as well as a text description and transcript.  Caution-  Some of the imagery in this video is disturbing:

http://fullepisode.info/hoarders-season-5-episode-8-deejan/

Description & Transcript

We see a shotgun shack nestled up against the rail line’s fence as a train rumbles past; we’re south of Amarillo in a small town with few resources. Jan lives here. She has pretty nails and a sad face as she tells us that she makes jewelry and plays on the Internet.

She doesn’t leave her bedroom much. As the camera pulls out, we see why. It’s a tiny place, maybe less than 800 square feet, and every room is caked with feces and garbage. “I’m not very good at taking care of myself.” The front of the stove is unrecognizable due to the amount of feces and cat spray that is caked on the appliance. A long-haired Tuxedo cat perches on the edge of a counter, darting away as the camera comes near.

“My kitchen is the worst room. It’s just a mountain of cat crap.” Jan’s lip trembles as she tells the camera about her house. She’s clearly ashamed and seems to have tunneled into herself for years in order to just survive the day-to-day of living in squalor. She doesn’t want to talk about her bathroom.

Jan has no running water, yet she continues to use the commode. When the camera panned across the small space, I had to pause the screen, trying to figure out what I was seeing. Rising out of the toilet is a huge, black, bulbous…thing. It’s a foot and change higher than the toilet seat. Jan is still defecating in the toilet. This was the first time I had to stop and walk away. Not just because I’m disgusted by it, but… How sick and broken does a person have to be to walk into a room with their eyes closed and use the toilet, pretending that they’re not doing what they’re doing? (This is how Jan has managed to continue this behavior.)

I know people want to be grossed out and entertained by this show, believe me. But how can you see this, see the woman who looks as fragile as spun glass and not realize that something is wrong with her? How can we shovel popcorn in our mouths and just wait for the next freak show? That’s not what this show is about – it’s about recognizing that many people just can’t do for themselves, that they need others to step in and help. How they got there, and how they can change their behaviors.

But those people need to have the tools to help, of course.

Georgia is Jan’s quiet daughter. Pam, Jan’s sister, finally explained to her that she was raising “the stinky kid.” Georgia would leave the house and douse herself in perfume and air freshener, hoping that no one would realize what she was living in. Finally able to leave, she has been in college for some time.

Jan is staying with her now, as the city was called and her home was deemed uninhabitable. And this is when we realize that her home isn’t the building we’ve seen from the outside, but that it’s a duplex. I would imagine that the other side isn’t currently being rented out. How could it be?

Jan, while never a shining example of housekeeping, did function normally until her father died in the early 90s. She took steps to get counseling and medication for her depression, and as soon as she started making positive strides, her husband informed her that he’d impregnated another woman, was in love, and would be divorcing Jan immediately in order to marry the other woman. She had a nervous breakdown, during which her mother suffered a stroke and died.

When Georgia was able to leave the small house (where up to 20 cats lived at one point, we’re told) this seemed to push Jan even further. She gave up. She felt she had no worth, and so why bother? Georgia still feels guilt for leaving her mother in that mess, but what choice did she have as a child?

Jan can barely speak as her face crumbles, her voice breaks, and she tells us how ashamed of herself she is.

Dr. Zasio arrives with a smile and a hand on her arm. When they open the home, however, Dr. Zasio says slowly, “Oh…dear,” as she sees the caked feces everywhere. She immediately puts on a face mask. (Ammonia is incredibly unhealthy, not to mention the danger of fecal matter.)

Jan shakes and says quietly, “When I realized I was going to be alone for the rest of my life I just thought, ‘Well, what the fuck?’ You know?”

Dr. Zasio asks her if she doesn’t believe she deserves anything better than this? “I suppose,” she mumbles.

“This feels like punishment to me, Jan!” She holds Jan’s shoulder, bending down to look her in the eye and try and communicate with her, but Jan realizes that the next step is to show the doctor the bathroom and she just can’t bring herself to do it.

Dr. Zasio goes on her own, and later she tells the camera, “This is one of the most horrific images I’ve seen in my life.” She gently guides Jan to the doorway, needing her to see it, to stop pretending it’s not there. “You’re punishing yourself. This is some kind of torture.” Jan can’t bring herself to open her eyes.

Before they clean up, the doctor insists that Pam and Georgia see how bad things have gotten – no one can turn a blind eye to this anymore; it would be unconscionable. Dorothy Breininger is on site at this point and guides the family in.

Pam, her soft-spoken older sister, says, “I never dreamed it was this bad. I’m sorry.” She cries, trying to reach out to Jan, who is curling in on herself in her shame. “I’m so sorry I didn’t help more.” But…what could Pam have done? This is a situation where professionals were clearly needed. And if Jan wasn’t willing to accept help, Pam could bring all the doctors and so forth in that she wanted; it wouldn’t have done any good.

Georgia starts sobbing, holding her mom. This was her home. It was never great, but it was never this.

The Get Junk crews start carting things out: soaked and damaged card tables, boxes that have been chewed on. Jan stands outside saying, “Good-bye!” with glee. Her sister and daughter are inside, however, working. She’s not participating. Dorothy acts on that quickly, telling her that she needs to participate, regardless of how ashamed she is; she must deal with things.

Dr. Zasio adds, “It’s your responsibility to take care of this situation, okay? Go back in.”

Jan, eyes wide, murmurs, “Okay.”

The biohazard team arrives to dispose of the toilet. They suit up, tape off, and put on their rebreathers. They have to chop away at the black mountain in the toilet before they’re able to break it down, bag it, tape that, and cart it out of the house.

The family is called outside so they can be addressed by a member of the team. Something has just gone wrong. [Here's your warning from me.] “While we were doing our clean out, we noticed there was [sic] cats hiding in the bathroom. One of them was hiding behind the toilet. And it ran out, came over here–” He points to the sidewalk outside. “–laid down and died.”

The women all move to where he pointed as Jan sighs sadly, “Oh, Randy!” And my beef with the editorial staff is that they showed the poor cat lying in the street. And also as Jan held it, cradling him. For several minutes. I have a hard time enduring images where innocent victims (animals, children, the infirm, the mentally challenged) are helpless or hurt. Or in this case, still warm after dying. Maybe I’m just too sensitive. I had to leave the room to pull myself together, I’ll tell you that much.

Dorothy stands behind them wiping away tears as well. She and the biohazard team try and explain that years of ammonia and filth led to this, not the ammonia released as the toilet was removed, as Jan is trying to tell herself. She has to take responsibility for this. She stands still, holding her deceased cat, stroking his head as they try and explain this to her. It’s a lot to take in.

The Got Junk crew picks up the pace, essentially pulling everything out of the house. Nothing is staying, nothing. They find more cats hiding, corral them into a box, and call the SPCA, who immediately come out and rescue them, sending them off for health care.

The less chaotic the interior of the house is, the more Georgia seems to find her voice. She angrily tells her mom, “You made me feel like this was my fault because I didn’t clean the litter box [for my cat],” when there were other animals in the house. Georgia felt like the mess was her fault for years.

Jan blinks, shocked by this. “I didn’t mean to make you feel responsible for all of them…”

“But you did!” Georgia shouts. “You did!”

Jan is being bombarded with truth and the realization that her actions affected others, but it’s actually sinking in. She apologizes profusely to her daughter, who takes it at face value. They’re sweet, quiet women and I get the impression that they just want to find some sort of happiness. It’s nice to see people willing to work for it. Jan knows she’s made it rough on her daughter. “I’m sorry, darling. It’s been a lot to ask.”

Everyone notes that Jan is now “wildly committed” to the process. After getting most of the rooms shoveled free, Dr. Zasio loads her up in a van and takes her off to an undisclosed location while Dorothy engineers some magic back at the house. Dorothy has a crew come in behind the Got Junk crew to do a biohazard scrub down – ceiling to floor, everything sanitized – with a second team behind them to repaint and decorate the house.

All in all, five tons of garbage are toted out of this tiny little building. Five tons. I’m telling you, that apartment couldn’t have been larger than 800 square feet. It’s like a clown car of garbage, I don’t know how there could have been that much inside.

Jan, meanwhile, is at a salon getting her hair properly cleaned, cut, and styled. Dr. Zasio wants her to remember that she has worth, that she’s worthy of something as simple as being clean. With freshly done makeup and a new hairdo, they drive her back to the house where she’s shocked to see new (albeit simple) furniture, curtains, and a few rugs. The bathroom has a new toilet, pretty candles and tchotchkes. She’s overcome, crying harder the farther into her house she goes, completely grateful and humbled by the effort put into “little ol’ me.”

She openly weeps, saying “It’s so pretty!” She’s finally decided that she’s worthy of something decent. “I can live again, I can be a person again.”

Aftercare: She is working with both an organizer and a therapist. Some of the cats that were taken from her home have been adopted out to forever homes.

What is Hoarding?

A view inside the Collyer Bros. brownstone, featuring
a very old organ and a long-defunct gas light era chandelier.

Because of its visibility and popularity in our modern culture, we hear the word HOARDER thrown around a lot these days. But hoarding or, more correctly stated, Hoarding Disorder actually has a clinical definition in much the same way as Post Traumatic Stress Disorder, Dissociative Identity Disorder and all the other disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

In the previous version of the Manual, the DSM-IV, Hoarding Disorder was actually listed as a subset of Obsessive Compulsive Disorder (OCD). It was only in the most recent version, the DSM-5, that Hoarding Disorder was separated into its own disorder. This newest version was published in May of 2013. Despite the newness of the study of Hoarding Disorder, it is certainly not a new problem as the sad case of the Collyer Brothers in the 1940s illustrates.

According to the DSM-5, to reach the level of a Hoarding Disorder diagnosis, a person must do more than simply have a lot of junk lying around. The manual set out five main criteria that must be met in order for the behavior to be severe enough to be considered a disorder. They are:

1. Persistent difficulty discarding or parting with personal possessions, even those of apparently useless or limited value, due to strong urges to save items, distress, and/or indecision associated with discarding 

2. The symptoms result in the accumulation of a large number of possessions that fill up and clutter the active living areas of the home, workplace, or other personal surroundings (e.g., office, vehicle, yard) and prevent normal use of the space. If all living areas are uncluttered, it is only because of others’ efforts (e.g., family members, authorities) to keep these areas free of possessions. 

3. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment for self and others). 

4. The hoarding symptoms are not due to a general medical condition such as a brain injury. 

5. The hoarding symptoms are not restricted to the symptoms of another mental disorder (e.g., hoarding due to obsessions in Obsessive-Compulsive Disorder, lack of motivation in Major Depressive Disorder, delusions in Schizophrenia or another Psychotic Disorder, cognitive deficits in Dementia, restricted interests in Autistic Disorder, food storing in Prader-Willi Syndrome).

The main feature of Hoarding Disorder, collecting large amounts of stuff, is widely known. More important to the diagnosis is criterion three. The symptoms must cause "clinically significant distress or impairment in social, occupational or other important areas of functioning." It is not enough to simply have a messy house. The level of mess must cause distress or impairment to the normal functioning of your life.  Jerome C. Wakefield's "harmful dysfunction" theory stated that in order to be considered abnormal a behavior or mental state must violate social norms in such a way as to be detrimental to the health and well being of the individual.  Despite their criticisms of Wakefield's work, Scott Lilienfeld and Lori Marino both agreed with this aspect of his theory.

There may be some difficulty in diagnosis of this disorder due to criteria four and five in the list above. There are several other mental disorders that may manifest themselves with similar symptoms of a messy home or the desire to collect lots of items. Those similar disorders must first be ruled out before a definite diagnosis of Hoarding Disorder can be made.

The main take away from this post is that hoarding is a complex disorder. Sufferers can hoard all sorts of items ranging from garbage to animals to objects of great value. What is important is the effect these things have on their owner's quality of life. If the potential hoarder, due to his or her hoard, has lost friends and family, lives in an unsafe environment, is unable to make use of the home's normal facilities like a kitchen or bathroom, has lost a job or is in danger of being evicted then there is a good possibility Hoarding Disorder is the problem.

Introduction

A typical scene in a modern hoarder's home.

Chances are, you either know someone or you are someone with too much stuff.

Maybe your garage has shelves stuffed to overflowing with tools, camping gear, tubs of extra clothes, you name it.  Or maybe your mom or your sister has a collection of tchotchkes that long ago overflowed her curio cabinet and has spread like a bad weed around her house.  Maybe your uncle still has the shoes he wore to his prom in 1968, and has added another three or four dozen pairs to his collection since then.  But at what point does this overabundance of stuff become abnormal?  Are the people in these examples hoarders?

The popularity of television shows like Hoarding: Buried Alive and Hoarders means that, even if you don't personally know anyone with these tendencies, there is a good chance you have seen people suffering with this problem in great detail.

The purpose of this blog is to provide education and resources for hoarders, people who fear they might be hoarders, the family and friends of hoarders and those who are just curious about this debilitating disorder.

Please know that whatever your connection may be to hoarding, there are resources out there available to help in whatever way you may need.  This is a blog that truly understands that all that stuff you have can be so much more than just junk.