Saturday, December 19, 2009
'Hoarders' Psychologist Suzanne Chabaud on Why People Hoard and How to Spot the Disorder
If you've ever seen A&E's compulsively addictive reality series 'Hoarders,' you're probably already familiar with Dr. Suzanne Chabaud, a clinical psychologist who helps chronic hoarders part with their prized possessions -- even if those possessions are, as the show's opening credits tell us, "worthless, unsanitary or hazardous."
Chabaud, who has counseled more than 400 people with OCD (including hoarders), gave us her insights into why it's nearly impossible for family members to help, and some warning signs on how to tell if your neighbor -- or possibly even your child -- might be a hoarder. She also answers the question: Why is dealing with the problem a lot more complicated than just helping somebody clean their house?
How did you end up working with hoarders?
I'm also a developmental psychologist with an emphasis on cognition. OCD interests me so much because it is related to how people think and the connection between thoughts and emotions. Normally hoarding is considered under the broad umbrella of OCD. At some point, there may be an attempt to separate out some types of hoarding, at least hoarding without OCD as opposed to hoarding with OCD.
Why do people hoard?
Sometimes after an early trauma in their lives, they start surrounding themselves with objects to create an artificial sense of safety. And, ironically, they end up putting themselves into a threatened condition.
Why is it so hard to treat a hoarder?
The ones who admit there's a problem are easier to treat. The people whose hoarding is part of an obsession -- where hoarding is one of the rituals that they have to manage the fear that results from the obsession -- those people have a great deal of difficulty letting go of particular objects. For example, if one had the idea that all their mail had a contaminant on it, then they may wrap up all those items and keep them in their house so they wouldn't contaminate anyone else.
At what point does someone graduate from being a "pack rat" to being a hoarder?
Hoarding tends to have a very early onset, maybe even earlier than general OCD. There are terms that make it more socially acceptable: "She's just a compulsive shopper" or "He's a pack rat." People may collect things for years and it doesn't really come to people's attention until it becomes disgusting or causes a problem with everyday living. When it gets to that point, family members realize it's beyond normal social behavior. It's a progressive disorder, so for instance, when a person is a child, they might want every type of a certain doll, which might be considered cute. Or to save every ticket to every concert or every little memento from school. As they become older, it progresses into a severe problem that can impair their health and safety.
I'm also a developmental psychologist with an emphasis on cognition. OCD interests me so much because it is related to how people think and the connection between thoughts and emotions. Normally hoarding is considered under the broad umbrella of OCD. At some point, there may be an attempt to separate out some types of hoarding, at least hoarding without OCD as opposed to hoarding with OCD.
Why do people hoard?
Sometimes after an early trauma in their lives, they start surrounding themselves with objects to create an artificial sense of safety. And, ironically, they end up putting themselves into a threatened condition.
Why is it so hard to treat a hoarder?
The ones who admit there's a problem are easier to treat. The people whose hoarding is part of an obsession -- where hoarding is one of the rituals that they have to manage the fear that results from the obsession -- those people have a great deal of difficulty letting go of particular objects. For example, if one had the idea that all their mail had a contaminant on it, then they may wrap up all those items and keep them in their house so they wouldn't contaminate anyone else.
At what point does someone graduate from being a "pack rat" to being a hoarder?
Hoarding tends to have a very early onset, maybe even earlier than general OCD. There are terms that make it more socially acceptable: "She's just a compulsive shopper" or "He's a pack rat." People may collect things for years and it doesn't really come to people's attention until it becomes disgusting or causes a problem with everyday living. When it gets to that point, family members realize it's beyond normal social behavior. It's a progressive disorder, so for instance, when a person is a child, they might want every type of a certain doll, which might be considered cute. Or to save every ticket to every concert or every little memento from school. As they become older, it progresses into a severe problem that can impair their health and safety.
How can a hoarding situation get so out of control that a person is living in their own feces?
At some point hoarders lose the ability to organize their possessions. They get overwhelmed and have an increasing difficulty making decisions. There's an internal immobilization that occurs, sometimes in combination with depression. Their life feels out of control and they surrender to the disorder, which means that nothing leaves, nothing goes out, but objects still come into the home. They become more and more isolated and more and more immune to the squalor that surrounds them. They, in fact, will not perceive certain smells, they won't perceive the filth, or the things that could hurt them. They'll live in a house with animal feces and dead animals and not sense that it's something that's noxious. The less they move in and out of the house, the more they acclimate to those foul conditions.
Why does it usually backfire when a family member tries to help out?
There are very intense emotions with letting go of and moving objects around, and so when someone comes in, the hoarder sees it as a violation not only of their personal space but of themselves. The person who hoards becomes so anxious about people getting rid of their things that they will suffer extreme emotional distress. If someone, even a family member, tries to get rid of the objects, the hoarder goes bonkers. They will feel really violated.
Family members get so worried about their relatives that they will go get a Dumpster and just do a clean haul, but without addressing the illness or condition in an appropriate way. Cleaning out a hoarder's space without their permission just exacerbates their anxiety and causes all kinds of anger, fear and even profound grief.
Why can't a hoarder just ask for help?
You often see a decrease in self-esteem, and a decrease in their ability to manage anything in their lives, which leads to increasing isolation because they're embarrassed to have people discover their problem. They may have a life outside of the home, but don't bring people inside their home because of the environment. When they're at home, they go into their own bedrooms or an isolated place and just stay there and don't really function very much until it's time to leave the house again. The sad thing about this condition is that once it has progressed to a very severe state, there's such tremendous fear and discomfort associated with the relinquishment of objects in their life, that they will go into a state of anxiety or panic.
At some point hoarders lose the ability to organize their possessions. They get overwhelmed and have an increasing difficulty making decisions. There's an internal immobilization that occurs, sometimes in combination with depression. Their life feels out of control and they surrender to the disorder, which means that nothing leaves, nothing goes out, but objects still come into the home. They become more and more isolated and more and more immune to the squalor that surrounds them. They, in fact, will not perceive certain smells, they won't perceive the filth, or the things that could hurt them. They'll live in a house with animal feces and dead animals and not sense that it's something that's noxious. The less they move in and out of the house, the more they acclimate to those foul conditions.
Why does it usually backfire when a family member tries to help out?
There are very intense emotions with letting go of and moving objects around, and so when someone comes in, the hoarder sees it as a violation not only of their personal space but of themselves. The person who hoards becomes so anxious about people getting rid of their things that they will suffer extreme emotional distress. If someone, even a family member, tries to get rid of the objects, the hoarder goes bonkers. They will feel really violated.
Family members get so worried about their relatives that they will go get a Dumpster and just do a clean haul, but without addressing the illness or condition in an appropriate way. Cleaning out a hoarder's space without their permission just exacerbates their anxiety and causes all kinds of anger, fear and even profound grief.
Why can't a hoarder just ask for help?
You often see a decrease in self-esteem, and a decrease in their ability to manage anything in their lives, which leads to increasing isolation because they're embarrassed to have people discover their problem. They may have a life outside of the home, but don't bring people inside their home because of the environment. When they're at home, they go into their own bedrooms or an isolated place and just stay there and don't really function very much until it's time to leave the house again. The sad thing about this condition is that once it has progressed to a very severe state, there's such tremendous fear and discomfort associated with the relinquishment of objects in their life, that they will go into a state of anxiety or panic.
What about those hoarders who don't live alone, who maybe even have children?
A lot of hoarders feel worthless, so they think, "Why would anyone want to feel close to me?" So we see the spouse becoming more and more estranged and spending more and more time away from the home, because it feels so uncomfortable. If the hoarder has young children, they will often bring them into the one safe place in the house, which might be the mother's own living space. Naturally as children become older, they become less tolerant of that. Often, the child may leave or become the caretaker who takes over some of the functioning that the mom or father is unable to do because they have symptoms of depression, low self-esteem, and are overwhelmed.
A lot of hoarders feel worthless, so they think, "Why would anyone want to feel close to me?" So we see the spouse becoming more and more estranged and spending more and more time away from the home, because it feels so uncomfortable. If the hoarder has young children, they will often bring them into the one safe place in the house, which might be the mother's own living space. Naturally as children become older, they become less tolerant of that. Often, the child may leave or become the caretaker who takes over some of the functioning that the mom or father is unable to do because they have symptoms of depression, low self-esteem, and are overwhelmed.
What's normal behavior in collecting things vs. hoarding, say, in children?
The important thing is to not rush in and clean their room or to say, "You need to stop doing that." If you approach it with anger or with codependency, where you take over as the parent, you're not going to be helping them at all. You need to approach it sensitively, help them understand how there could be a problem.One thing a parent can do is to help the child differentiate between very important things to save versus not as important things to save. Profoundly impaired people who hoard do have an inability to evaluate and to make decisions. So help your child with those processes and do it in a non-threatening and supportive way.
Is hoarding hereditary?
Yes, I think that they're finding more and more that there could be a hereditary factor. We now know that OCD does have a genetic component and the category of those hoarders with hoarding obsessions and compulsions, those seem to have the strongest genetic link. Now this is not all hoarders, but with those who have the very obsessive-compulsive hoarding, there's a strong incidence of it also occurring in siblings.
Is it also learned from living with another hoarder?
I think they controlled that in these studies. Some of it is learned behavior, but I think we're going to find more and more that there is a genetic component to it. You may have OCD running in the family and some of those people may have hoarding. That's all being studied right now. It's a very hot research topic. If you live in an environment with a hoarder, you definitely become desensitized. You don't have the same sense of order that another person would have. We learn organization and how to make decisions through our parents. Because a person lives in an environment like that, you'll see other kinds of emotional and psychological problems that evolve. They may be acquiring some of the behaviors, or just say, "What's the use? It doesn't really matter whether I pick up my things or not."
What's the success rate, if any, for hoarders who've received professional help?
There are people who get treatment and who maintain it, but that is not common. We need to further refine our treatment approach. Hoarders in general do not seek therapy, they feel forced into therapy, so when the treatment providers who help them maintain their healthier situation bail out, then they're more likely to return to that sense of safety that they get from old ways and old habits. Long-term follow-up is very important, especially early in the game. If you have it occurring in older people at a very progressed stage, they tend to be more isolated and they go right back to where they were. They don't have the skill base to implement a lifestyle change. Part of the maintenance is continuing to give the emotional support they need as well as addressing the new skills that they're learning in thinking how to evaluate, how to prioritize, how to deal with the fear that occurs after they make a choice.
What kind of follow-up do the people who appear on 'Hoarders' get?
I'm not allowed to say the amount of money, but it's significant, enough for most clients to have a solid year of follow-up sessions. I've gotten e-mails from clients asking, "How do I keep my house clean?" They've forgotten those skills and what they have to do to maintain a clean house. In the first week after a cleaning, I'll say, "Just don't go open up all those boxes just yet, let's go through interior spaces and make some space and go from there." If you don't do that, the contents will go on the floor or on the counters or tables.
Since so many of these cases result in neglect of children or animals, or become a public health hazard, what can we, as a community, do to help hoarders?
Sometimes hoarders will camouflage, so the outside doesn't look as bad as what's inside, but we can look for certain things: not putting out any garbage, not paying their utility bills and, in very progressed cases, not using electricity or water, because they can't get service people into the house. People that provide services should recognize the red flags. It might be a mail delivery person who sees a big pile of unopened mail sitting outside the door or neighbors who see the house in darkness at night. It's a matter of public education to not see it as way to report a person, but to help them get them the treatment that they needed. If law enforcement and providers of utilities and neighbors start viewing this as a serious mental condition, then maybe they can intervene in a more compassionate way and get people the help and longtime maintenance and monitoring that they need.
I think they controlled that in these studies. Some of it is learned behavior, but I think we're going to find more and more that there is a genetic component to it. You may have OCD running in the family and some of those people may have hoarding. That's all being studied right now. It's a very hot research topic. If you live in an environment with a hoarder, you definitely become desensitized. You don't have the same sense of order that another person would have. We learn organization and how to make decisions through our parents. Because a person lives in an environment like that, you'll see other kinds of emotional and psychological problems that evolve. They may be acquiring some of the behaviors, or just say, "What's the use? It doesn't really matter whether I pick up my things or not."
What's the success rate, if any, for hoarders who've received professional help?
There are people who get treatment and who maintain it, but that is not common. We need to further refine our treatment approach. Hoarders in general do not seek therapy, they feel forced into therapy, so when the treatment providers who help them maintain their healthier situation bail out, then they're more likely to return to that sense of safety that they get from old ways and old habits. Long-term follow-up is very important, especially early in the game. If you have it occurring in older people at a very progressed stage, they tend to be more isolated and they go right back to where they were. They don't have the skill base to implement a lifestyle change. Part of the maintenance is continuing to give the emotional support they need as well as addressing the new skills that they're learning in thinking how to evaluate, how to prioritize, how to deal with the fear that occurs after they make a choice.
What kind of follow-up do the people who appear on 'Hoarders' get?
I'm not allowed to say the amount of money, but it's significant, enough for most clients to have a solid year of follow-up sessions. I've gotten e-mails from clients asking, "How do I keep my house clean?" They've forgotten those skills and what they have to do to maintain a clean house. In the first week after a cleaning, I'll say, "Just don't go open up all those boxes just yet, let's go through interior spaces and make some space and go from there." If you don't do that, the contents will go on the floor or on the counters or tables.
Since so many of these cases result in neglect of children or animals, or become a public health hazard, what can we, as a community, do to help hoarders?
Sometimes hoarders will camouflage, so the outside doesn't look as bad as what's inside, but we can look for certain things: not putting out any garbage, not paying their utility bills and, in very progressed cases, not using electricity or water, because they can't get service people into the house. People that provide services should recognize the red flags. It might be a mail delivery person who sees a big pile of unopened mail sitting outside the door or neighbors who see the house in darkness at night. It's a matter of public education to not see it as way to report a person, but to help them get them the treatment that they needed. If law enforcement and providers of utilities and neighbors start viewing this as a serious mental condition, then maybe they can intervene in a more compassionate way and get people the help and longtime maintenance and monitoring that they need.
From what we see on 'Hoarders,' it seems that this disease is more prevalent among people with limited incomes.
You can live in a mansion and be a hoarder. Rich people may be better able to obscure their disorder than poor people, they may have servants to keep the outside of the property looking good, so they can get away with it for longer periods, or the things that they hoard are not as gross.
If I know someone who's a hoarder, what should I do?
The best resource is the OCD Foundation. It's a marvelous group that has therapists listed by state.
Rihanna Topless In GQ: "I Finally Get To Let Go" (NSFW PHOTOS)
Rihanna poses topless in the January issue of GQ magazine, strategically covering herself while she talks about moving on after her split from Chris Brown.
"It's relieving," she told the magazine of talking to the press about her violent encounter with Brown early this year, "because it was built up for so long, and all these thoughts and emotions have been running through my mind for the past eight months. And now it's like I finally get to let go and move on."
"I wanted people to move on with me," she continues, "'cause the last big thing they know about me is That Night. And I don't want that to be what people define me as."
Come on now tell me she is crying or acting out for attention. To do such a thing after being through such an experience of abuse I really think she should have photo'd classy instead of trashy! What kind of message is she sending out to young women and others who have been abused or experienced date violence?
Demi Moore: I'm 47, How Am I Supposed To Look? (PHOTO)
Demi Moore can't win. Her recent W cover was widely regarded as a Photoshop disaster, though she maintained it was her real body. Now she's getting flack for an unretouched photo--for looking old.
On Wednesday Demi shared an outtake from a Santa Monica photoshoot for Harper's Bazaar.
"Had the priviledge of working with a giraffe yesterday he was beautiful gentle and so amazing!" she tweeted along with the picture below. Some responses were unforgiving:
"sorrydemi that your self esteem is so low you can't admit to a little Photoshopping. And Ghost sucked," one follower wrote.
"sorry but you look old. specially your neck & cheecks at the second shot.." added another.
"I'm 47 how am I supposed to look?" Demi responded.
Demi and Ashton have long been consumed with cultivating their Twitter presence. A couple of weeks ago they planned dinner and sex over Twitter from different rooms in their house, and then there was that butt picture.
Courtney Love Topless & Sheer For Dazed and Confused (NSFW PHOTOS)
Does this make her week better or worse?
Courtney Love lost custody of daughter Frances Bean Cobain this week, and the 17-year-old also got a restraining order out keeping her mom away.
Meanwhile Love's spread in Dazed and Confused magazine is out, and in it the rocker poses in sheer clothes and behind a sheer cloth for a feature called "Nobody's Fool."
Wayans Brothers SUED For Stealing Book Idea
A former assistant to the Wayans Brothers has sued the comedy team for unspecified damages, saying they snatched his "You know you're a Golddigger ..." book and published it as their own.
Jared Edwards of Los Angeles filed the lawsuit in federal court in Manhattan on Thursday against Keenen Ivory Wayans, Shawn Wayans, Marlon Wayans and St. Martin's Press.
The lawsuit said Edwards worked as an assistant for a decade beginning in 1995.
It said in 2005 he wrote jokes about women who seek wealth and status through romance.
He said the brothers rejected his book, but in May published their own: "101 Ways to Know You're a Golddigger.'
St. Martin's Press did not immediately return a call for comment.
Desperate Housewives - Upcoming Spoilers
- The plane crash will leave one of the husbands paralyzed and wheelchair-bound. He is said to become a tyrant around the house. My money is on Orson.
- A second husband will require medical help. Wouldn't it be time for Tom to get some important medical attention since both Mike and Carlos have suffered a lot in the past?
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