well either, as objects stacked there are constantly in danger of toppling off and braining someone.
The beds are a minor disaster area too, as a toe or two is repeatedly stubbed due to the protruding objects stored under the beds. Mealtimes are reduced to eating with plate in hand because the table is covered with bottles, books, newspapers and dabbas.
So one fi ne day, after a lot of cajoling, a little embarrassment and a great degree of reluctance, you decide to declutter.
C OVER C OVER S T OR Y S TO R Y
S
TILL wondering whether you should start off the New Year with a thorough cleaning of your home? For the past four to fi ve weeks (or is it months?), you, your family and perhaps visitors to your home have noticed that many of your cupboards and drawers are stuffed to capacity and they need a fi rm heave and strong latch to keep them closed. The top of the cupboards are not faring veryClutterer, Collector or Hoarder?
When the assigned day dawns, you set to work and in no time at all, the fl oor of your home is spread out with objects that ultimately land in three piles – junk to be discarded, objects to be kept and a pile of
‘maybes’.
This is where things get interesting.
If you are not a hoarder, the pile of junk rises steadily and before you can say
‘junkyard-guy’, the guy is out of the door with a sizable chunk of junk and you
U
JWALAK
ARMARKARCompulsive
hoarding is
a disorder
that should
be taken
seriously
and calls for
psychological
and medical
treatment.
have some cash in hand. This scenario means that you are just an overworked, frazzled person without time, stomach or patience for decluttering, i.e. you are just a clutterer. You may stop reading this article because none of what comes ahead applies to you.
If you are a ‘collector’, you will be proud of what you have accumulated
and display or catalogue it systematically, even selling or bartering the objects, when you deem necessary.
But if you are a hoarder, chances are the selection process is somewhat like this: the kitschy green lamp with purple tassels which has not worked for the past ten years; the pen-stand made of ice-cream sticks by your kid when she was fi ve; the tight nylon trousers which you have not worn since 1994; the teapot with the broken handle (handle preserved inside the pot) – all these will be consigned to the ‘keep it’ pile.
You say to yourself, “All I need is to get the lamp working/hit the gym and wait for fashions to change to wear the nylon pants”, and so on.
You will make excuses to keep the heap of newspapers, bunches of plastic fl owers and old bottles no one remembers or needs, the toys your kids picked up free with burger meals ten years back and a hundred odds and ends that you are sure will be needed some day.
At the end of a few hours, all that is left in the throw-away pile is one rusty chair, an old umbrella with holes in the fabric and some moth-eaten magazines,
basically stuff which even your junk-guy refuses to touch. (You think that the chair will fare well with a little oiling and the umbrella can be used for an astronomy lesson on a rainy day and back they go in the keep-it pile!)
If this is a regular happening in your home, then chances are that you are a hoarder – someone whose clutter is a big part of their lives. You are attached to the clutter, will make up ‘reasons’ to keep objects that are never used, but the clutter is not yet taking over your space and your life. Things pile up around you, but you still attempt to declutter your home at regular intervals and occasionally, do clear up small parts of it.
The fi rst stage is distressing to the people around the hoarder, but beyond being aesthetically displeasing, does not really affect anyone.
Progressing or Not?
If the hoarding is progressing, space such as tables, chairs, beds and couches are taken up by the collected objects. They are so covered by stacks of clutter that they cannot be used for the purpose for which they are meant. So chairs cannot be sat upon and beds cannot be slept in.
C OVER S
TORYThere is very little usable space left for the occupants. Kitchen counters are occupied by bottles, containers, food and the refrigerator is close to overfl owing. There is very little space left for movement, and also, a risk of injury.
The owners of these objects seem immune to the problems caused by the large number of objects. Indeed, they are psychologically attached to them and resist their removal.
One would think that small living spaces would discourage hoarding.
But on a visit to a home in Mumbai, the owners proudly mentioned that they had calendars dating back from 25 years and every greeting card ever received among other ‘collectibles’, and also every craft project ever made by their son, all crammed into the 250-square-foot home.
There was a narrow space to move between the stacks and one had to sit on the edge of a bed because the rest of the bed was piled high with old clothes.
S YMPTOMS OF C OMPULSIVE
H OARDING
• Saving broken,
irreparable or useless things
• Buying excessive quantities of goods
• Saving excessive quantities of printed matter
• Purchasing large
amounts of useful items and storing them away for future use, but never using them
• Having diffi culty
discarding anything due to fear of accidentally throwing out something important.
ANSWER YES or NO. Each yes is one point.
1.) Has anyone close to you commented on the volume, number, quan ty of objects in your home, repeatedly?
2.) Do you constantly make excuses to postpone “going through your stuff ” and
“clearing” some of it?
3.) Do you remember similar episodes within your own family while you were growing up?
4.) Do you remember the last me you disposed of any of your belongings to the raddiwala (junkyard-man)? Is the period more than a year or maybe, even, two?
5.) Does the thought or sugges on of removing your belongings make you feel uneasy, agitated or even angry?
6.) If you have family or guests over, do you need to shuffl e around belongings on your furniture to have space for them to sit, eat, sleep or rest comfortably?
7.) Have you been repeatedly injured / hurt by a falling or protruding object within your own home?
8.) Do you avoid invi ng friends, guests, repairmen, etc. into your home?
9.) Are you avoiding social interac on by even closing your windows and drawing your curtains?
10.) If you open your refrigerator now, will the majority of cooked food in it be more than ten days old?
If your score is three, you are a Grade 1 hoarder.
If your score is four to six, you have proceeded to Grade 2.
If your score is above six, you are a Grade 3 hoarder.
Hoarders who are in the fi rst two grades can help themselves if they wish to.
They need to improve their decision- making skills in the following areas:
1. Go over your belongings and keep those you absolutely need on a daily basis close at hand. Make a list if that helps.
2. Next, decide what are the objects that you need at least once a year (winterwear, Diwali decora ons, etc.
R ECOGNIZING AND T ACKLING H OARDING
for example). Keep these organized in a separate cupboard.
3. Mementoes, photographs, keepsakes can be displayed in a systema c manner, and the rest can go into storage. Decide what you need to absolutely look at every day, and put the rest in a labeled box in an a c.
4. If you have large collec on of books, sports memorabilia, or old clothes consider dona ng them to some place or cause which is worthy. Give joy to someone with your kindness.
5. Try moving the stuff to another room or to the garage (if you are lucky to have one) as an intermediary measure and see if it distresses you. Review your decision a er a month.
6. Newspapers, old bo les, freebies, old calendars, catalogues could go to the raddiwala, if you are comfortable.
Reason with yourself in a logical manner.
If they were not used, read or enjoyed in all this me that they were stacked in your home, then they certainly will not be soon.
7. Be clear about the reason you are keeping any object. Does it have a specifi c func on? When did you last use it? Do you envisage using it again? If the answer is no, then it is me to let go of the object.
8. DO NOT fi ll up this fresh space with new objects. Before leaving home, make a list of what you need and s ck to it.
Grade 3 hoarders need special help:
• Psychologists agree that the hoarder must fi rst accept and acknowledge that he/she has a disorder that needs help.
• A bond of trust needs to be built in which the hoarder realizes that his objects, belongings and property will not be disturbed or removed by others in his absence.
• The support system of family, friends, neighbors, social worker should refrain from referring to the objects ‘junk’, trash or ‘garbage ’ – that is, being judgmental or arguing with them about clearing their objects.
• Treatment by a psychologist.
More often, the refusal of the hoarder to recognize the problem can lead to friction with other family members. The pathological attachment to the objects which are largely unused and a stubborn refusal to declutter can become a bone of contention. Hoarders have an inability to perceive their objects as another person would, that is, basically as junk. Moreover, they actively refuse help from others to clear their things, becoming distressed and anxious if asked to do so. They also lack the decision-making ability required to organize or get rid of their collection on their own. But the hoarders at this stage still have a social interaction with others and are not reclusive.
If it is true that one man’s junk is another man’s treasure, then it is equally true that a man’s home is his castle and one cannot interfere with the unique décor of a castle without the owners’
permission.
Having said that, hoarding at times progresses to a stage where hoarders are in danger of posing health hazards to themselves, their families and neighbors.
Extreme?
Extreme cases of hoarding can take up bizarre forms. Rotting food and piled objects are sometimes interspersed with excessive number of house-pets who may leave urine and feces in the house which are not cleaned. Sometimes dead and injured pets have been found under the objects.
Subconsciously, the hoarder realizes that the objects in their home are a source
Psychology
Psychologists believe that a purely hoarding disorder is often a result of some psychological trauma or major depression following a personal loss.
Traits associated with hoarding are anxiety, indecisiveness, dementia and depression. Other associated factors are alcohol dependence.
It is often closely associated with obsessive-compulsive disorder and for a long time, was thought to be part of OCD. The American Journal of Psychiatry published a combined study and study review in 2004, which concluded that people affected by compulsive hoarding differ from people affected by OCD in several important respects. For example, persons with OCD-based hoarding will be aware, and perhaps repulsed, about their own behavior and will also not have a real attachment to the objects of their hoarding.
The treatment of the two disorders also differs. The International Hoarding Foundation has, however, clarifi ed that some persons who have hoarding traits might still merit a diagnosis of OCD. As recently as 2013, the DSM (Diagnostic and Statistical Manual of Mental Disorders)- of amused interest, disgust, contempt, but
is helpless to do anything about it. Over a period of time, the hoarder resists the entry of visitors, maintenance-men and cleaning staff into his/her home. Curtains are drawn and the hoarder becomes a recluse.
Persons at this stage are in danger of having severe infections, malnourishment and injury, besides being a source of worry to neighbors.
In Western countries, especially, in the U.S.A., there have been instances where fi refi ghters and paramedics who have been called in by neighbors, have been unable to enter homes due to the ceiling- high stacks of objects. There are cases, where home owners have been buried beneath their own clutter and unable to call for help. Television shows, such as
‘Oprah’, have dedicated entire episodes to this condition and it is recognized as a
‘psychopathological’ disturbance.
Anatomy and Pathology
The cingulate area of the brain is the part which is on the medial part of the cerebral cortex. The anterior cingulate is specially involved in decision making and problem solving and posterior cingulate is responsible for memory and spatial orientation. Hoarders show decreased activity in this part of the brain, indicating to researchers that brain pathology is responsible for this behavior.
Thus, underlying autism, mental retardation, brain injury due to trauma, neurosurgery, etc. can sometimes cause Compulsive Hoarding behavior. But this may not be the only cause.
Problem is commoner than
we think and normally it is
not perceived as one. But
if someone around us is
showing signs of being a
hoarder, maybe it is time to
gently remind them.
C OVER S
TORYSystematic decluttering is done preferably by the person affected. The hoarder has to see his compulsion to hoard as an illness, view the objects he has ‘collected’ as a hazard to normal life and seek help.
According to Dr. Ajita Nayak, Professor of Psychiatry, K.E.M. Hospital, Mumbai, this disorder is treated with a combination of anti-depressants and cognitive behavioral therapy, the latter helping the person to understand the reasons for hoarding, and gradually reducing the objects that have been hoarded, without being distressed.
Cognitive behavioral therapy also improves decision-making, organization and teaches relaxation techniques.
Enrolment in Support Groups also results in improvement in rational thinking and preventing a relapse.
This problem is commoner than we think and normally it is not perceived as one. But if someone around us is showing signs of being a hoarder, maybe it is time to gently remind them that they need help.
Dr. Ujwala Karmarkar is a Consultant Anaesthesiologist at the Dhanvantari Hospital
& Rahaeja Hospital, Mumbai. Address: 111- A, Aradhana, G.D. Ambekar Marg, Next to Spring-mills, Dadar, Mumbai-400028; Email:
ujwalaskarmarkar@yahoo.co.in 5th edition, recognized this disorder as
a distinct one, separate from a larger obsessive compulsive neurosis (as was previously thought).
Prevalence
Prevalence is 2-5% in adults, although early childhood traits may be seen which may manifest fully in adulthood.
It is more obvious in the elderly, perhaps because they have been
collecting for a long time. Similarly, people who live alone are more prone to this disorder.
It is believed that hoarding may be partly hereditary and many hoarders have a family member with the same problem.
Treatment
Forcible removal of clutter is no solution and can only lead to renewed hoarding.
At times, the hoarders get extremely distressed and violent during the removal of hoarded items. Building more cupboards for storage does not really help and only leads to renewed collecting.
Stop saying to yourself, “All I need is to get the lamp working/hit the gym and wait for fashions to change to wear the nylon pants”, and so on.
You will make excuses to keep the heap of newspapers, bunches of plastic fl owers and old bottles no one remembers or needs, the toys your kids picked up free with burger meals ten years back and a hundred odds and ends that you are sure will be needed some day.
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