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Stuff: Compulsive Hoarding and the Meaning of Things

Stuff: Compulsive Hoarding and the Meaning of Things

Amazon.com Review

Product Description What possesses someone to save every scrap of paper that's ever come into his home? What compulsions drive a woman like Irene, whose hoarding cost her her marriage? Or Ralph, whose imagined uses for castoff items like leaky old buckets almost lost him his house? Or Jerry and Alvin, wealthy twin bachelors who filled up matching luxury apartments with countless pieces of fine art, not even leaving themselves room to sleep? Randy Frost and Gail Steketee were the first to study hoarding when they began their work a decade ago; they expected to find a few sufferers but ended up treating hundreds of patients and fielding thousands of calls from the families of others. Now they explore the compulsion through a series of compelling case studies in the vein of Oliver Sacks.With vivid portraits that show us the traits by which you can identify a hoarder--piles on sofas and beds that make the furniture useless, houses that can be navigated only by following small paths called goat trails, vast piles of paper that the hoarders "churn" but never discard, even collections of animals and garbage--Frost and Steketee explain the causes and outline the often ineffective treatments for the disorder.They also illuminate the pull that possessions exert on all of us. Whether we're savers, collectors, or compulsive cleaners, none of us is free of the impulses that drive hoarders to the extremes in which they live. For the six million sufferers, their relatives and friends, and all the rest of us with complicated relationships to our things, Stuff answers the question of what happens when our stuff starts to own us.

A Q&A with Randy O. Frost and Gail Steketee, Authors of Stuff: and the Meaning of Things

Q:
What is hoarding, and how does it differ from collecting? A: Two behaviors characterize hoarding: acquiring too many possessions and difficulty in getting rid of them when they are no longer useful or needed. When these behaviors lead to the kind of clutter and disorganization that disrupts or threatens a person's health or safety, or they lead to significant distress, then hoarding becomes a disorder. Simply collecting or owning lots of things does not qualify as hoarding. A major feature of hoarding is the large amount of disorganized clutter that creates chaos in the home. Rooms can no longer be used as they were intended, moving around the house is difficult, exits are blocked, and life inside the home becomes dysfunctional. Collectors typically keep their possessions well organized, and each item differs from other items to form an interesting and often valuable collection. Further, an important purpose of collecting is to display the special items so that others can appreciate them. People who hoard are seldom able to accomplish such goals. Q: What kinds of things do hoarders typically save? A: While it may appear that people who hoard save only trash or things of no real value, in fact most people who hoard save almost everything. Often this includes things that were purchased but never removed from their original wrappers. The most frequent items saved are clothes and newspapers. Other commonly hoarded items include containers, junk mail, books, and craft items. Q: What factors contribute to the development of hoarding? A: People who hoard often have deficits in the way they process information. For example, they are often highly distractible and show symptoms of attention deficit hyperactivity disorder. These symptoms make is difficult for them to concentrate on a task without being diverted by other things. Most of us live our lives categorically. We put our possessions into categories and use those organizing systems to store and retrieve them easily. But categorization is difficult for people who hoard. Their lives seem to be organized visually and spatially. The electricity bill might go on the five-foot-high pile of papers in the living room, to keep it in sight as a reminder to pay the bill. Hoarders try to keep life organized by remembering where that bill is located. When they need to find it, they search their memory for the place it was last seen. Instead of relying on a system of categories, where one only has to remember where the entire group of objects is located, each object seems to have its own category. This makes finding things very difficult once a critical mass of possessions has been accumulated. Q: Do all people who hoard save things for the same reason? A: No, but there are some general themes. The most frequent motive for hoarding is to avoid wasting things that might have value. Often people who hoard believe that an object may still be usable or of interest or value to someone. Considering whether to discard it leads them to feel guilty about wasting it. "If I save it," reasons the hoarder, "I might not ever need it, but at least I am prepared in case I do." The second most frequent motive for saving is a fear of losing important information. Many themselves as information junkies who save newspapers, magazines, brochures, and other information-laden papers. They keep stacks of newspapers and magazines so that when they have time, they will be able to read and digest all the useful information they imagine to be there. Each newspaper contains a wealth of opportunities, and discarding it means losing those opportunities. For such people, having the information near at hand seems crucial, whereas knowing that the information also exists on the Internet or in a library does little to help them get rid of their out-of-date papers. Hoarders are often intelligent and curious people for whom the physical presence of information is almost an addiction. A third motive for saving is that the object has emotional meaning. This takes many forms, including the sentimental association of things with important persons, places, or events, something most people experience as well, just not to the same degree as hoarders. Another frequent form of emotional attachment concerns the incorporation of the item as part of the hoarder's identity--getting rid of it feels like losing part of one's self. Finally, some people hoard because they appreciate the aesthetic appeal of objects, especially their shape, color, and texture. Many people who hoard describe themselves as artists or craftspeople who save things to further their art. In fact, many are very creative with their hands. Unfortunately, however, having too many supplies gets in the way of living, and the art projects never get done. Q: Why can't people who hoard control their urges to acquire and save things? A: Understanding this requires knowing what happens at the moment the person decides to acquire or save something. At the time of acquisition, people who hoard often experience a sort of high or euphoric sensation during which their thoughts center on how wonderful it would be to own the object in front of them. These thoughts are so pleasant that they dominate thinking, crowding out information that might curb the urge to acquire. For instance, hoarders may forget that they don't have the money or the room for the item, or that they already have three or four of the same item. When faced with the prospect of discarding, hoarders have different thoughts from other people. All their thoughts center on what they will lose (for example, opportunity, information, identity) or how bad they will feel (distress, guilt), while none of the thoughts focus on the benefits of discarding. Saving the item, or putting off the decision, allows them to escape this unpleasant experience. In this way people become conditioned to hoard. Q: How much truth is there to the common assumption that hoarding is a response to deprivation? A: Although some their hoarding to having lived through a period of extreme deprivation, our research has failed to find a link between material deprivation early in life and later . We do suspect there is a connection between hoarding and traumatic experiences, or chaotic or disruptive living situations, earlier in life. Q: Hoarding has been considered to be a subtype of obsessive-compulsive disorder (OCD), but there are some crucial differences, aren’t there? A: Yes. Only about 20 percent of people with hoarding problems report any significant OCD symptoms, like checking or cleaning rituals. There are other crucial differences. In OCD, obsessions are experienced as intrusive and unwanted, and the symptoms are always accompanied by distress. But in hoarding, owning things often produces pleasant feelings of safety and comfort, and acquiring can even produce euphoric feelings. In fact, the distress we see in hoarding comes from the byproduct of the acquiring and saving--the clutter--or from thinking about discarding things. There also appear to be differences in the brains of people with hoarding problems compared to those who suffer from OCD. For these reasons, many scientists who study hoarding have recommended that it be classified as a distinct disorder separate from OCD. Q: Is it true that depression is a common affliction among hoarders? A: In our research we find that over 50 percent of people with hoarding problems are clinically depressed. However, the depression does not seem to cause the hoarding, although it might be a result of hoarding, especially when the clutter interferes with people's ability to function and they feel embarrassed and ashamed. (Randy O. Frost photo © Judith Roberge)
(Gail Steketee photo © Kalman Zabarsky, BU Photography)

Clutter Image Rating Photos used by Randy Frost and Gail Steketee, Authors of Stuff
(Click on images to enlarge and learn more)
In our work on hoarding, we've found that people have very different ideas about what it means to have a cluttered home. For some, a small pile of things in the corner of an otherwise well-ordered room constitutes serious clutter. For others, only when the narrow pathways make it hard to get through a room does the clutter register. To make sure we get an accurate sense of a clutter problem, we created a series of pictures of rooms in various stages of clutter--from completely clutter-free to very severely cluttered. People can just pick out the picture in each sequence that comes closest to the clutter in their own living room. This requires some degree of judgment because no two homes look exactly alike, and clutter can be higher in some parts of the room than in others. Still, this rating system works pretty well as a measure of clutter. In general, clutter that reaches the level of picture #4 or higher impinges enough on people's lives that we would encourage them to get help for their hoarding problem.
Randy Frost & Gail Steketee (photos © Oxford University Press) 1. No evidence of a hoarding problem. 2. Beginnings of a problem with clutter. A subclinical hoarding problem. 3. A mild hoarding problem if the room looks this way most of the time. 4. A moderate hoarding problem 5. A serious hoarding problem. 6. A very serious hoarding problem. 7. A severe hoarding problem with substantial impairment. 8. A very severe hoarding problem. 9. Extreme hoarding.

From Publishers Weekly

Amassing stuff is normal in our materialistic culture, but for millions it reaches unhealthy levels, according to the authors of this eye-opening study of the causes of hoarding, its meaning for the hoarder, and its impact on their families. Frost, a professor of psychology at Smith College, and Steketee, dean of the social work school at Brown, gather much anecdotal material from conversations with extreme hoarders and find that for such people, intense emotional meaning is attached to so many of their possessions… even trash. For some, this meaning inheres in animals: one interviewee has 200 cats. The effects of hoarding on the hoarder's spouse, parents, and children can be severe, the authors find. Frost and Steketee write with real sympathy and appreciation for hoarders, and their research indicates an absence of warmth, acceptance, and support during many hoarders' early years. They even speculate that a hoarder's attention to the details of objects may indicate a special form of creativity and appreciation for the aesthetics of everyday things. This succinct, illuminating book will prove helpful to hoarders, their families, and mental health professionals who work with them. (Apr. 20)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

From Bookmarks Magazine

The individual accounts of hoarders in
Stuff are a parade of stifled lives, failed marriages, estranged , personal agony, notes the families
Wall Street Journal. It's almost the stuff of fiction: indeed, E. L. Doctorow recently fictionalized the lives of mid 20th-century hoarders in his novel
Homer and Langley (*** Nov/Dec 2009). If Frost and Steketee don't completely answer the question of why hoarders hoard, they identify some psychological commonalities, such as clinical depression (though the causality evokes the classic chicken-and-egg question). Nonetheless, they compassionately lay bare the lives of those affected by the illness, and their stories offer fascinating, observant, and well-researched insight into "how we form and justify our own attachments to objects"--for better or, in this case, for worse (
New York Times Book Review).

From Booklist

Fans of the A&E series Hoarders will be the ideal (but not the only) audience for this very intriguing book. The authors approach the subject, which they have studied for more than 10 years, from an analytic point of view. What makes people believe they shouldn’t throw anything away? What causes otherwise ordinary men and women to fill their lives, and their homes, with detritus because they are unable to differentiate between useful items and waste? How is it possible for someone to live in a house full of trash and simply not know it is there (a phenomenon the authors call “clutter blindness”)? Hoarding isn’t new—Dante wrote about hoarders, and so did Dickens—and most readers will recognize some aspects of themselves in the people the authors discuss. We may not be hoarders exactly, but the authors make us take a closer look at our own lives, wondering (for example) about that very fine line that divides a collector from a hoarder. Fascinating stuff that could generate some off-the-book-pages interest. --David Pitt

Review

"Pioneering researchers offer a superb overview of a complex disorder that interferes with the lives of more than six-million Americans. . . .  Writing with authority and compassion, the authors tell the stories of diverse men and women who acquire and accumulate possessions to the point where their apartments or homes are dangerously cluttered with mounds of newspapers, clothing and other objects. . . . An absorbing, gripping, important report." --Kirkus (starred)

About the Author

DR. GAIL STEKETEE is a professor and acting dean at Boston University in the school of social work.

Excerpt. © Reprinted by permission. All rights reserved.

PILES UPON PILES
The Story of Hoarding
I attach meaning to things that don’t need it.
—Irene
I spotted Irene’s home immediately. Despite its commanding view of the countryside from atop a hill, it was dark and gloomy. Overgrown trees and bushes hid much of the house from the street. The paint was peeling, and the fence needed mending. A car parked in the driveway was packed with papers and clothes. I had brought along my student assistant, Tamara Hartl, and as we walked toward the house, we could see boxes, newspapers, clothes, and an assortment of unidentifiable objects pressed against the windows.
 We knocked on the front door but got no answer. We found a side door and knocked. Something stirred inside the house. Behind us, a door to the garage opened, and out stepped Irene, slightly overweight and rumpled, with straight brown hair and a friendly smile. She introduced herself with a nervous laugh and invited us in: “You can’t get in that way. You’ll have to come through the garage.” A sea of boxes, bags, ski poles, tools, everything imaginable—all in a jumble, chest-high—covered the entire length and width of the garage. Along the wall was a narrow pathway to the only door to her house that was not blocked by debris.
 The foreboding exterior of the house belied Irene’s personality. She was friendly, bright, and engaging and very curious about our research. Like others we’ve interviewed, she was tormented by her situation and demoralized by her inability to do anything about it. Though happy to see us, she worried that she was wasting our time, since her problems were of “no consequence to anyone but me.”
 In Irene I’d found an extraordinarily articulate and insightful subject. I agreed to work with her as she tried to clear her home. In exchange, she agreed to describe everything she felt and thought during the process and not to filter out any reactions, positive or negative.
 Irene lived about ninety miles from my college in Northampton, Massachusetts, which meant a long drive for each visit with her (forty-five visits over eighteen months). Each visit lasted about two hours. Tamara accompanied me on most of the trips. On our way to Irene’s home, we’d review what we had learned the week before, and on the way back we’d discuss the visit as Tamara made notes on a laptop. By the last of our sessions with Irene, we had generated a theory for hoarding—a framework for future research and a major breakthrough in understanding the phenomenon.
 Some theorists have posited that people with hoarding tendencies form attachments to possessions instead of people. Erich Fromm claimed that a “hoarding orientation” leads to social withdrawal. Hoarders, he suggested, are remote and suspicious, preferring the company of objects to that of people. Indeed, for some people prone to acute social discomfort, possessions can be stable and comfortable companions. Irene, however, defied this categorization. She had a wide circle of friends, some of whom I met in the course of my work with her. They displayed a great deal of affection for her, and she for them. She had a quick wit and a well-developed sense of humor. It was easy to see why people liked her. She laughed readily and was often amused by the ironies of her plight. One day, as she pondered why she had saved a newspaper ad for new tires, she fell into gales of laughter when she noticed the headline: SAVE THIS AD. She was also quick to shed tears when she encountered something sentimental, such as a picture drawn by her son when he was a toddler.
 With Irene as a model, the classic definition of hoarding as a socially isolating syndrome appeared to be flawed. One of Irene’s favorite things, she said, was to make connections between people with mutual interests. She would frequently give me the names of people she thought would click with me. She planned to give many of the things she saved to friends and acquaintances for whom they seemed suited. Unfortunately, her gift of seeing these connections was a factor in her keeping virtually everything she acquired.
 Irene was intelligent and well educated. She seemed to know something about almost every subject and displayed curiosity and a wide range of interests. She had a story to tell about each possession—most of them remarkably detailed and engaging. For instance, one day she found a piece of paper with a name and phone number on it among the pile of things on her kitchen table and excitedly recounted its history: “This is a young girl I met at a store about a year ago. She’s Hawaiian and had such wonderful stories about Hawaii that I thought Julia [Irene’s daughter] would like to write to her. They are about the same age. She was such an interesting person, I was sure Julia would enjoy getting to know her.”
 Her face lit up at the prospect of making this connection.
 “But Julia wasn’t interested. I thought about writing her myself, but I never did. Still, I don’t want to get rid of the contact. Julia might change her mind.”
 I have met few people who are as interested in the world around them as Irene, though I later learned that this attribute is fairly common in people with hoarding problems. As she talked, I could see the way each of her things was connected to her and how they formed the fabric of her life. The advertisement for the tires led to a story about her car, which led to a story about her daughter wanting to drive, and so on. A piece of the hoarding puzzle seemed to be falling into place. Instead of replacing people with possessions, Irene was using possessions to make connections between people and to the world at large.
 As we were soon to learn, the hoarding phenomenon is composed of a number of discrete factors, some well hidden and unexpected. But the most obvious factor was the simple problem of accumulation: from a scrap of paper with an unidentified and long-forgotten phone number on it to a broken vase purchased at a tag sale, Irene had great difficulty getting rid of things. The value she assigned to objects and the reasons she had for saving them were many and varied. Irene’s beliefs about what should be saved seemed isolated from everything going on around her. She was truly baffled that her son and daughter didn’t share her penchant for keeping things. One day, as she went through the mound on her kitchen table, she found instructions for one of her son’s toys. “I’ll put it here in this pile of your stuff, Eric,” she told him when he got home from school. Eric immediately picked up the instructions, walked to the wastebasket, and threw them away. She stopped what she was doing, looking surprised. Eric saw her and responded angrily, “I don’t need it. I know how it works.” She didn’t say anything. A few minutes later, she found a bookmark. “Oh, this has all the book award people on it. Do you want it, Eric? I’ll put it in your pile.”
 “No,” he responded before she’d finished her sentence.
 “Don’t you even want to look at it?” she asked incredulously.
 A few minutes after that, she found an old birthday card someone had sent Eric. She put it on top of the pile of things she was saving for him without saying anything. Almost as if on cue, he walked by, picked it up, and threw it out. Irene stared at him in disbelief. She simply could not comprehend his lack of interest in things she considered full of significance.
 The sense of emotional attachment that Irene felt for her possessions has been shared with us over and over by people seeking help with their hoarding problems. These sentiments are really not that different from what most of us feel about keepsakes or souvenirs—the abnormality lies not in the nature of the attachments, but in their intensity and extremely broad scope. I find many articles of interest in the newspaper, but their value to me is reduced when piles of newspapers begin to impinge on my living space and overwhelm my ability to read what I have collected. For Irene, the value of these things seemed unaffected by the trouble they caused.
 Hoarding involves not only difficulty with getting rid of things but also excessive acquisition of them. Irene’s upstairs hallway contained hundreds of shopping bags filled with what she described as gifts for other people. Whenever she saw something that she thought might make a great gift, she purchased it, even though she had no particular recipient in mind. The items were all still in their original wrappings. Many people shop ahead to have gifts on hand when the need arises, but Irene and many like her cannot control their urge to buy when they see something they fancy. In addition to buying excessively, Irene collected things that could be had for free. She had an agreement with the postmaster of her town: he placed any newspapers or magazines that were undeliverable in a box, and on Saturday morning he put the box in the foyer of the post office, where Irene picked it up. Her home was stuffed with these free newspapers and magazines.
The Tour: “Homogenized” Clutter
On our first visit, Irene gave us a tour of her house. Hustling through each room, she held her arms up in front of her bent at the wrists with her hands drooping down, like a surgeon who had just scrubbed for an operation. Her small steps propelled her deftly through the maze in each room. She insisted that we not touch anything, and she watched us carefully as we negotiated the space. It was hard to avoid touching things in some places because there was so little room to move; the stacks rose to the ceiling. Several things struck me about her hoard. She saved pretty typical stuff, the sorts of things we’d seen in other homes: stacks of newspapers going back years, newspaper clippings of interesting articles, thousands of books, mountains of clothes, con...

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