Wednesday, January 03, 2007

The Empty Nest


I know that this may be very difficult to understand for people who are not familiar with OCD hoarding, but I guess that's one reason why the associated behaviors qualify as symptoms of a disorder -- they do not make sense; they are not rational behaviors. In this case, a person with more than adequate financial resources, with far above average intelligence, with a high degree of social functioning outside of the home, seems utterly incapable of distinguishing between "important" things and "trash" -- leading eventually to living conditions of abject squalor. Attempts by others to help to clean up or at least to manage the clutter can be traumatic, with the hoarder refusing to allow the removal of almost anything that most people would regard as trash, insisting that things will somehow get "squared away" eventually.

Many health care professionals advocate taking a slow, non-judgmental, low-pressure approach to resolving such cases. While they are almost certainly correct that different methods may be too traumatic or may prove unsuccessful at providing permanent solutions, I believe that other factors should also be weighed when considering treatment or assistance strategies:

  • What is the impact of "go-slow" approaches on other family members, particularly on juveniles who are raised in squalor?
  • Even if there is significant relapse after more aggressive intervention, what happens when a "go-slow" approach fails to generate adequate progress before the hoarder becomes elderly or infirm, when the likelihood of progress is dramatically reduced and the likelihood of injury drastically heightened? (See The Hallway for the result of "too much patience".)

I am not saying that a "go-slow" approach is necessarily wrong; indeed, it probably should be the first thing to try. However, it must be balanced against the impact of hoarding on the entire family and the prospects for the long-term safety and well-being of the hoarder.

6 comments:

  1. Kudos for speaking up! I think hearing your voice makes the videos more real, especially for people who spend their whole lives in denial.

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  2. In our experience there is no "go slow" with a hoarder. They are seemingly attached to all their stuff to the extent that asking them to do something about it is more than they can, or are willing, to do. The situation seems to almost always come to a head...with the hoarder being forced to do something.

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  3. Hi nashbabe,

    I definitely agree that there is no "go slow" with a severe hoarder. As we both have seen from the experiences discussed on the COH group, an acute crisis seems to be required in almost every case before the situation changes.

    On the other hand, before the crisis hits, I think that many, if not most of us COHs, go through a period where we have to try the "go slow" approach first before we are ready to admit to ourselves that more direct, aggressive action, including seeking outside help, is required.

    In other words, it's not about the hoarder, it's about us: how we cope with the problem and how we find ourselves moved to intervene (or perhaps to walk away).

    Thanks for making me think about this more clearly: if a "cure" for the hoarder's irrational behavior seems to be out of reach in the vast majority of cases, the most productive approach may be to explore the processes by which COHs and others who are affected by the problem can be empowered to take appropriate action. Depending on the circumstances, that may mean intervention or it may include walking away from the situation without feeling overwhelmed by guilt.

    How can a COH get to that point of clarity as quickly as possible? I've been a COH for 40 years, and I've been aware of the nature of hoarding as a mental illness for more than ten years, and I'm still not sure I've reached a point of clarity!

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  4. How aboutmy case? My sister's house got so bad she finally moved her family in with our mother for relief, and of course now my mother's house-once immaculate- loooks more/more like my sister''s. Neither can confront the problem rationaly. Mom makes excuses for Sis saying it's not that bad.. I live far off and have no say or control.-have had to walk away...

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  5. I am tired of hearing about the "go -slow" and absolutely, under no circumstance do a clean out for them! It's o.k. to take drugs and alcohol away from an addict and force a rehab. Why not a hoarder? It's just a different addiction. Anyone can see that the hoard can be dangerous to them (as well as others), so why advocate going slow. I have another question that is a bit unrelated... do your parents know about this blog?

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  6. Hi Jamie,

    Thanks for the comment. There are definitely aspects of hoarding that seem similar to addiction. If I were a psychology researcher, I'd probably be very interested in investigating that potential connection.

    As for my mom, she does not know about this blog. My dad passed away more than a decade ago, but my sister knows about this blog, and I've showed her my videos, as well as videos that other people have put on the net. It's been helpful (yet also a little sad) to know that other people are struggling with the same issues.

    -HS

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