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How Compulsive Hoarding Affects Familiesby Fugen Neziroglu, Ph.D, ABBP, Jill Slavin, Ph.D., Katharine Donnelly, M.A.
Great Neck, NY
Living with a person who hoards is very stressful. Unlike people with certain other OC Related Disorders, such as Obsessive Compulsive Disorder (OCD) and Body Dysmorphic Disorder (BDD), hoarding directly affects others in the home. While OCD and BDD affects family members emotionally and at times, physically, the effect is generally indirect. In other words, family members of most OCD related disorders may be able to avoid the symptoms of the disorder. For example, if a young girl is a compulsive hand washer due to contamination, and spends much time in a specific bathroom, her parents and siblings are able to use the other bathrooms in the home with no more than an inconvenience. With hoarding, all of the bathrooms in the home may not work or are so cluttered that it is impossible to reach the shower, toilet or sink. Thus, hygiene may become a problem. In addition, utility problems in the home are often unaddressed due to shame that the person who hoards may feel when having a handyman come in to fix the problem. Below, we will address many of the direct effects of hoarding on the person who hoards and the family members living with him/her in the home. We will also explore the emotional impact that hoarding may have on the wellbeing of extended family members, or family members who no longer live in the home.
For those family members who live with a person who hoards, such as a wife, husband, child, or dependent parent, it is impossible to live in the clutter and not have physical and emotional trauma. Not only the clutter, but the person who hoard’s need to control all items and areas of the home causes extreme friction and tension. Those with hoarding often attach an emotional, instrumental, or aesthetic value to items. Instrumental value is also referred to as the “just in case” phenomenon. They keep the item “just in case” they may need it at a later time. Ironically, when the person who hoards may need that item, they may be unable to find or access it due to the clutter.
A primary area of contention is that clutter often results in a loss of once usable living space, even in shared areas (e.g. kitchen, living room, etc.). Usable living space refers to furniture, appliances, countertops, etc., being used as they were intended. For example, families are often unable to use their kitchens to cook food and may, therefore, be dependent on ordering take-out daily. This may lead to more financial strain and obesity, because they are spending more money and taking in more calories than they would if they were able to make their own meals. Financial strain also results from excessive shopping and the need to get more storage facilities (chests, lockers, garages, sheds, etc.). It can lead to debt; purchases are often not discussed; credit cards may be “maxed out”, and money therefore cannot be allocated to purchases that other family members may need or want. Often, the rationale for this extra storage is to regain some usable living space. Ironically, at the beginning these facilities are useful but if hoarding behaviors are not addressed, it is likely that usable living space will once again become overrun with even more clutter.
Not only do people who hoard often claim parts of the home that are for other family members, but the control of how that space is used or what items should be thrown away is often up to them. Family members aren’t allowed to make decisions, which leads to feelings that family members are living in someone else’s home, causing discomfort and disrespect. They no longer have the ability to decide the way in which they live and their power is stripped from them. They feel vulnerable and unstable. Essentially, family members are forced to live in chaos. Family members may get so frustrated with clutter that they will attempt to clean or organize without the person who hoards knowing, which always results in more arguments and fights. In addition, behaviors may get worse due to this “deception.” Those who hoard may feel violated and lose trust in family members. The lack of trust may make them more paranoid and protective of their items. This often leads to an increase in checking behaviors (e.g. check the garbage cans to make sure something important was not thrown out).
Children of those who hoard often cannot avoid living in the clutter, which affects their social lives. Children are often too embarrassed to have friends come over, or are not allowed to, due to their parent's embarrassment. This may lead to isolation, helplessness, and resentment. Spouses often consider divorce or separation because of the hoarding and may also worry about responsibilities to the children that are not being met. The children feel torn between the parent who hoards, and the parent who does not. Children tend to be very secretive about the hoarding problem, but feel depressed and angry due to the sacrifices that they are expected to make on account of compulsive hoarding. If the non-hoarding parent decides to ask for a divorce, a custody battle may ensue. Often, pictures of the home are taken to court to convince the court that the home environment is not suitable for bringing up a child. The individual who hoards is not only embarrassed but feels much resentment, interfering with the ability to bring up the child jointly. Further legal issues may arise should a neighbor become aware of the home situation and call child protective services (CPS). If this happens, an investigation may ensue. This may result in the removal of the children from the home unless one of the parents makes other living arrangements. Whether the child lives in clutter or is removed from the home, the end result is devastating, and the effect of these events often serves to increase the person’s hoarding, as a source of comfort.
Adult children often have a very strained relationship with their hoarding parent. As adult children move out of the home, they may become estranged from their hoarding relative due to disagreements about how hoarding should be handled. Adult children may also blame the parent for the condition in which they were forced to live as a child. As these children marry and have children of their own, they are most likely resistant to ever bringing their children over to their parent’s home. They are embarrassed and would not like their children to model the hoarding behaviors they see. Therefore, grandparents may be isolated from their grandchildren as hoarding may be seen as a bad influence. Not only does this create distance in the family, but the person who hoards becomes even more isolated. Adult children often copy or oppose the behavior that they witnessed as a child. Either hoarding behaviors are learned and repeated, despite living separately, or the adult child, embarrassed and disgusted at how they lived, keep next to nothing. For example, if a daughter has observed her mother’s hoarding early in life, and then moves out, she may be more likely to develop her own hoarding problem as a result of watching her mother. In addition, if a divorce resulted due to the hoarding, adult children may blame the break up of their family on the person who hoarded. They may have been taken away from their parent, causing feelings of abandonment, as though inanimate objects meant more to their parents than they did. This causes significant psychological distress and often impacts their future relationship behaviors.
Not only do the affected family members suffer the physical and emotional effects of hoarding, but so does the person who hoards. For example, the person who hoards may resent loved ones who offer advice, but little help. Those who live alone may resent family members that stay away. Extended family members may feel shame related to the hoarding problem in the family and will keep the person who hoards from the rest of the family.
An area that needs more research is how hoarding may prevent individuals from marrying and having families. If a person struggling with hoarding is single, how are they able to date if they are unable to bring the person over to their home? Also, finding a partner who will tolerate the hoarding for the long-term context may be difficult. Prospective partners would be making a conscious decision to approve of the sacrifices associated with this lifestyle. Further, efforts to avoid possible rejection may completely prevent the person who hoards from pursuing romantic relationships, leading to more isolation. Besides potential romantic partners, even family members are not often invited over, due to shame and a lack of space to entertain. The person who hoards can meet family members/friends outside of the home, at others’ homes, or restaurants, but the secrecy associated with hoarding and the refusal to invite significant others to his/her home, often leads to strained relations.
According to Grisham, Steketee, and Frost (2008), those who hoard often have poor insight and display a disorganized, tangential, or detached style of interaction, having difficulty with perspective-taking. They have problems relating to both others’ and their own emotions, but an excessive attachment to possessions, making it difficult to maintain interpersonal relationships. This possible social impairment may also be due to a high association with Personality (Axis II) disorders. In fact, they may be making up for poor social skills by attaching to possessions instead of people.
The above concerns typically result in frustration, resentment, and conflict in a family.
However, hoarding can also affect the safety and health of those living in the home. For instance, individuals who hoard and their families often have headaches, breathing problems (asthma, etc.), and allergies, due to living conditions in the home. As clutter develops and stays, it becomes impossible to remove accumulated dust from spaces that are most affected because people are not able to vacuum or dust their homes, sometimes for years. Additionally, spilled liquids, such as, soda, juice, and water are often not cleaned up causing mildew, fungus or unwanted pests. Health-related effects of hoarding reach all members of the household, not merely the person who hoards.
Extra clutter may cause other safety issues. It is common to have so much clutter that paths need to be built through the clutter in order to get through the home. These paths may become blocked by fallen or new clutter, which can result in people tripping, slipping and falling. Not only is this an impact on those that are physically able, but may impose an even greater threat for a dependent parent that is living in the home and that may lack mobility. The parent may not be able to get around the home, being isolated in one or two rooms, and may be unable to help him/herself if clutter tumbles onto them. In addition, clutter may interfere with a speedy departure from the home and cause a significant fire hazard. Furthermore, if clutter blocks entryways or access to fire extinguishers, members of the household will not be able to take action, should a fire start. Hoarded materials also increase a building’s fire load (amount of combustible materials contained within the building relative to the size of the structure). Also, during a fire, burning materials may fall, creating a trapping hazard. This is dangerous and can interfere with firefighters being able to save the people from the home. Furthermore, toxic fumes that come from the flammable materials may create further health problems for all those who are exposed.
Floors may also not be able to hold the weight of excessive clutter. People with hoarding often acquire written materials, including newspapers and magazines. Although a single newspaper or magazine may weigh very little, hundreds or thousands of them can weigh several hundred pounds. Other items that are saved include clothing, boxes, extra appliances (extra televisions, stereos, etc.) and even heavy machinery. The combined weight of all the clutter plus the potential water damage from spilled liquids, broken and/or clogged pipes and appliances put a tremendous amount of pressure on floorboards and can cause them to decay. There are even more dangers in homes that have pets. Sometimes cats are not able to find or enter litter boxes, or dogs are unable to "hold it" long enough for owners to get through clutter. Both situations cause the animals to urinate or defecate inside the home, sometimes unknown to the family. This, combined with the mildew and possible fungus from spilled liquids, often decays floorboards, and attracts rats, cockroaches and other pests. Certainly, health and safety concerns with clutter can have a big impact on families.
Despite the negative effects of living in clutter, the person who hoards is usually very reluctant to seek treatment. However, there are effective treatments. These suggestions for family members may convince their loved one who hoards to enter treatment:
- Tell your family member that a therapist is not going to go into the house and start throwing things out. They are not going to take control of their things. Well-trained therapists will work side-by-side with your loved ones. If the person who hoards does not want the therapist to go into the house at first, that is okay. It is a very gradual process.
- If your family member refuses to go for an initial appointment, it is suggested you go to the therapist several times on your own to learn how to get him or her into treatment.
- If resistance increases, family members should be told to form an empathic united front, confronting their loved one in a systematic, deliberate manner, following the recommendations and oversight of an experienced clinician. Intervention strategies are frequently used by family members in order to communicate to their loved one the seriousness of his/her problematic behaviors.
- Once your loved one agrees to seek therapy, it is important that the therapist talks about the ease and convenience of therapy. Those who hoard tend to be very secretive about their hoarding behaviors and may not think that it is a big problem. Because of this, they may avoid visitors and gloss over problem behaviors when they talk to their therapist. Therefore, building trust early is very important.
10 Early Signs that Your Loved One May Have a Hoarding ProblemMichael A. Tompkins, Ph.D.
San Francisco Bay Area Center for Cognitive Therapy
The signs of someone with a significant
hoarding problem are obvious. Floorboards rot and sag under the weight of tons of paper and garbage. Food containers litter the home and the smells of rotting food and mildew permeate the air. Every nook and cranny is filled with stuff and what paths there are in the home are carpeted with layer upon layer of damp, dark, and dirty paper, bags, and other litter. However, a significant hoarding problem does not usually happen overnight. It slowly blooms and grows over many years. Here are ten warning signs that your loved one may have a burgeoning hoarding problem.
- Your loved one keeps parts of the home off-limits and the curtains always drawn. People with a hoarding problem often try to hide it. They may close off areas of their home or try to keep others out of their home altogether. They may fear that if you see the state of their home or certain rooms, you will demand they clean the mess, or they may fear that you will touch or remove their possessions without their permission. People will go to great lengths to keep you out of their space. They may tell you that you cannot enter a room because it contains unwrapped gifts they do not want you to see. Other people keep the curtains closed so that others cannot see inside their homes. If your loved one tells you that parts of his home are off-limits, or is overly concerned about others seeing inside his home, this may indicate a hoarding problem.
- You and your loved one talk endlessly about the stuff. A telling sign that a loved one may have a hoarding problem is that you and your loved one talk at great length about the stuff. At first, conversations are gentle and supportive. You might offer suggestions or advice. You might offer to come over on a Saturday to help clear out just a few things. Over the years, however, the conversations become louder and more demanding as pleas turn to threats. You may have threatened to call the authorities and your loved one, in return, may have threatened never to speak to you again. Simply put, if you and your loved one are talking a lot about the stuff, he or she may have a hoarding problem.
- De-cluttering even a small area is a major job that would take more than a few hours or days. Even a relatively small amount of clutter can pose an organizational nightmare to a person with a hoarding problem. An inability to sort possessions efficiently may distinguish the person with a hoarding problem from someone who is only prone to some disorganization and clutter. That is, if a person without hoarding difficulties intentionally carves out three hours to sit down in front of her piles of stuff, she can usually sort and organize these possessions with some level of efficiency. Conversely, the person who hoards likely cannot because he falls into the trap of considering the many and endless ways he can sort, organize, or store an item. Before you know it, the process overwhelms him and he stops. For this reason, hoarding problems that may look small soon mushroom out of control as the years go on.
- Your loved one often fails to pay bills. Your loved one may have bill collectors hounding him because he has missed payments on his house or credit card even though he has the money to pay these bills. When you call your loved one, you may discover that the telephone company has disconnected the phone again or that she is living without power or heat. Your loved one may not be able to locate bills other important notices or documents because of the clutter in the home.
- Your loved one is in debt because of compulsive shopping. Another warning sign that your loved one may have a hoarding problem is that she spends more money than she has. People who hoard may not admit that they buy things they do not need, in part, because they see it quite differently. They will tell you, and not blink an eye, that it is always good to have extra presents on hand for unexpected guests or last minute celebrations. You may see packages that she has never opened. You may find that your loved one has filled the pantry and closets with many more supplies than she can ever use or that she has filled her freezer with expired or old food that she will not permit you to discard.
- Your loved one has trouble finding things and resists storing things out of sight. Because of the quantity of stuff, your loved one may have trouble finding things. She may complain that she has misplaced her purse or cell phone again. She may arrive late to appointments because she could not find her calendar or the note you sent her about when and where you were to meet. Adding to the problem, people who hoard insist on keeping their things in sight, usually in stacks from floor to ceiling, or littered over most horizontal surfaces. People who hoard are comforted when their possessions are in sight, and may resist your pleas that she store things in closets, filing cabinets, or in sealed boxes.
- Your loved one puts off repairs to her home. You may wonder why your loved one complains about the leaky faucet or broken toilet but will not permit you to repair it. She may tell you that the broken toilet is not that bad or that she welcomes the help but wants to clean up the house first before you or the plumber comes by. Over the years, you may watch as the roof caves or weeds choke the front and back yards and still your loved one tells you that things are not that bad.
- Your loved one insists she meet you at your home or at the event. People who hoard often feel uncomfortable with people in their homes. They may fear that you will discover the extent of the hoarding problem or perhaps they are just tired of the endless arguments with you about the stuff. You may wonder why your loved one is eager to meet with you but only if she can meet you at your home or at the event; and, why she always rejects your offers to pick her up or drop her off at her home.
- Your loved one's garage is overflowing and he rents one or more storage units. Overflowing closets and garages may be an early sign of a hoarding problem. Furthermore, your loved one may have multiple storage units in the back and front yards or has asked you to store things for him in your garage or storage areas. Your loved one may pay rent on several storage units and always seems to be on the lookout for more storage.
- Your loved one will not let you touch or borrow his possessions. When you do visit your loved one, you may have felt hurt when he refused to loan you a saw, a book, or even yesterday’s newspaper. Your loved one may have barked at you when you picked up something of his or when you moved some papers aside to sit down on the sofa. You may have learned to keep your hands in your pockets when you visit and to stand rather than sit in his home.