Beach identifies hoarders, helps them overcome compulsion
The Virginian Pilot
By Susan E. White
May 29, 2007

Marin County Task Force on Hoarding
"More to hoarding than just clutter"
Oakland Tribune,  May 14, 2007  
by Paul Liberatore

Grabbing hoarding by the horns
(Orange County, CA)
By FRANK MICKADEIT
October 25, 2006

Hoarder's Eviction Didn't Violate Rights, Judge Rules
Arlington, VA-By Brigid Schulte
Washington Post Staff Writer
Thursday, July 27, 2006
(See similar story-abcnews.com)

Fighting to Remain Engulfed in Junk
As Task Forces Move In, Hoarders Strike Back in Court
By Brigid Schulte
Washington Post Staff Writer
Sunday, June 18, 2006

Arlington is defending the actions
of its Hoarding Task Force, a group charged with removing stockpiles of materials from apartments and homes that present dangers to residents.
by David Francis, The Examiner,
July 26, 2006

Stockpiling Run Rampant
(Fairfax, VA)
By Timothy Dwyer
Washington Post
Thursday, December 8, 2005

Social Workers Hope to
Coordinate Treatment of Hoarders
By Cameron W. Barr
Washington Post Staff Writer
Thursday, June 16, 2005

Task Force (NY) Seeks to Help Compulsive Hoarders
NPR:by Margot Adler
Morning Edition, January 22, 2004

So Much Clutter, So Little Room:
Examining the Roots of Hoarding
New York Times
By NINA BERNSTEIN
Published: December 31, 2003

Task Force Tries to Save Those Who Save Too Much
By HEATH FOSTER
SEATTLE POST-INTELLIGENCER
REPORTER, October 30, 2002

University of Kansas School of
Social Welfare Office of
Aging and Long Term Care Report, 2007: ...
Second, we communicated with key informants from hoarding task forces around the country to identify innovative protocols and state or local codes that have shown to be effective in assisting older adults who hoard to maintain community tenure.

NYC Task Force on Hoarding 1-19-04, Transcript

This is an edited transcript of Dr. Randy Frost's talk at the New York City Task Force's conference, When Hoarding Causes Suffering - Working Together to Address a Multifaceted Problem. The conference, held on January 19, 2004, was sponsored by Weill Medical College of Cornell University, Cardozo Bet Tzedek Legal Services of Cardozo School of Law, and The New York City Task Force on Hoarding and Older Adults.

"Good Morning. It is a pleasure to be here. What you see here is an illustration from Dante's Inferno. I do not know how many of you have studied this at school or may be classical scholars, but the storyline is that Dante had a dream one night that he saw a beautiful hillside. And he dreamed he just had to climb this hillside to get to the top, which was like a paradise. He started to climb the hill but his journey was interrupted by a monster who told him that before he climbed to the top of the hill, he first had to descend through the nine circles of hell, down to the pit, and back again. Only then could he ascend to the top. His guide on this journey was the ancient poet Virgil. When Dante and Virgil entered the 4th circle of hell, they saw two armies of people at war with each other, rolling huge stones with their chests, crashing about. One army would shout "Why do you hoard" and the other army would shout back "Why do you waste"?

Virgil told them that these were the hoarders and wasters in life. They had spent so much time worrying about their wealth and possessions "that they lost the light of God and were forever doomed to this joint punishment. These heavy stones represent the possessions they tried so hard to possess in life. I am not suggesting this is the fate that awaits people who suffer from hoarding problems but rather the hell in which they live on earth.

What I would like to do in the next few minutes is to tell you what this hell is like in order to understand something about the nature of this phenomenon.

Hoarding can be associated with a variety of dangers. This is a picture of a house, not unlike most hoarding housing. Large volumes of combustible materials can be a fire hazard, a danger not only for residents but also for their neighbors. Blocked egresses can cause death or other kinds of injuries. Unsteady stacks of heavy materials can crush or trap people, as was the case a few weeks ago with the gentleman in the Bronx who was crushed under his possessions.

Severe hoarding cases often involve structural problems. Accumulation of newspapers, boxes and other heavy materials can stress joists and beams, causing floors to sag, crack, or even collapse.

Mobility is an issue in homes that are filled with clutter. As you can see, trying to get up or down the stairs alongside stored materials could be dangerous if emergency personnel had to get into
this apartment to rescue someone. Clutter also increases the risk of tripping and falling, especially for the elderly.

Accumulation of trash, food, and animal waste can cause disease, vermin and/or insect infestation, not to mention violation of laws and health ordinances. Use of appliances can be either completely
impossible or very dangerous and are often associated with this problem.

To Top

Hoarding of animals can cause all these conditions, plus the suffering of animals.

Hoarding of animals is often associated with starvation, disease, accumulation of feces, and the decomposing remains of deceased animals. Dr. LaFarge is going to talk about this more in detail later on today.

There is a considerable cost in terms of cleaning up these materials. In a small town near where I live, the Department of Health spent approximately 75% of the town's budget clearing out one person's home. Eighteen months later the home was back the way it was before.

In addition to the health and safety costs of the individual and the community, there is also a psychological cost to living in this kind of environment. This is a picture of a woman that was featured on an episode of 20/20 several years ago. Everyday, she and her nine-year- old son sit in this living room where they watch TV, among other things. You can imagine what the nature of that life is like, especially for the little boy.

When we talk about compulsive hoarding, we use a definition that is three-fold. The first part of the definition talks about the behavior itself:

The acquisition and failure to discard possessions that appear to be useless or of limited value. This describes the behavior that many of us engage in. It is not really a problem, maybe an eccentricity, unless we see the other two features of the definition. Living spaces so cluttered that using the room as intended is impossible. The third defining feature is significant distress or impairment in the ability to function.

This is the home of a 53-year old woman who suffers from compulsive hoarding. She contacted me some time ago after her husband left her because of the clutter. She has three children. I will talk briefly about each of these pictures, as they are the beginning of what I will talk about in respect to this phenomenon. That can we learn by looking at these pictures? This is a kitchen that is reasonably full, certainly not the worst case, but probably a moderate level of hoarding. As you can see, every surface is covered. They only have space in the corner for one person to eat, and they have to move things around to do so.

Cooking is somewhat of a problem. She still cooks, and her stove is still working, but you can see the pile of papers beside the stove. This is not a particularly safe situation. The entire area underneath the table and the chairs is full. There is no ability to move the chairs around. There is only a very small area of available floor space in the kitchen.

This is her dining room. You can see that the nature of things change somewhat but you still see a random mix of clothing, books, containers and so on. One of the things I want to you notice is the
narrow one-foot pathway that runs on the left side of the table and along the back.

This path, which is sometimes referred to as a "goat path", is the only way she can get through the room.

This is another picture of the room. As you can see, this room contains the two exit doors to the house and they are both blocked. There is no way she could get out of these doors if she had to, as there is too much stuff blocking the exit.

I would like to discuss the three major manifestations of hoarding, which we have just seen in these pictures.

The first one is acquisition; materials have to come into the house in some way. We want to understand something about the way this material comes in.

The second manifestation is saving. We can think about saving as a behavior of keeping things or an inability to throw things away. At this point, we may want to think about it both ways until we
understand it better.

The third manifestation is the level of clutter and disorganization. This problem exceeds the problem of volume. It really doesn't matter how much stuff a person has.

We want to take a look at these three features to understand the phenomenon of hoarding.

I want to start with acquisition. This is the upstairs hallway of the woman's house we just toured, filled with a sea of bags. In these bags are gifts, purchased over the course of a decade. She had every intention of giving them away, but has not been able to do so, and here they have sat for over a decade.

This is very characteristic of the problem. We see compulsive buying as a significant part of compulsive hoarding. This woman also has great difficulty in walking by a newsstand. Once she sees the magazines and newspapers she thinks to herself: "Somewhere in all that information is a piece of information that could change my life. How could I walk away and lose that opportunity." It is such a powerful thought for her that the only way she can manage it is to cross the street and look the other way. So you can see that the power of this phenomenon is remarkable.

The second feature that we see is the compulsive acquisition of free things, for example, newspapers and handouts. I do a lot of speaking at organizations such as Messies Anonymous and I tend not to bring handouts as they are gone by the front row.

The woman whose home we just toured had made an arrangement with her local post office to save undelivered magazines and newspapers and every week she would go and collect them.

We also see people who will collect things out of dumpsters, off the street and so on. Again, it is this powerful compulsion to acquire things.

This picture shows you what a living room looks like when you have a hoarding problem. There is a lot of stuff, but if you were to organize it and put it along the edges of the room, you could make this room, although somewhat full, at least functional. However, she can't do that. There is something about this problem that is giving her difficulty in organizing rooms.

To Top

Why do these people save things? Are their reasons different than ours? Understanding their reasons can help us develop treatments. Our research indicates that they save things for exactly the same reasons we all save things. The difference seems to be that people who suffer from compulsive hoarding apply these reasons to a wider variety of things.

There are three types of such reasons:

Sentimental saving refers to the attachment of emotional value to a physical object. It is, in a sense, a way of extending our identity to incorporate objects. "This is a part of me, of who I am." One day, we were going through this client's possessions, helping her make decisions about what to throw out. She came upon an empty ATM envelope, and on the envelope was written how she had spent the money. It was nothing remarkable.This ATM envelope that she had not looked at in five years held the emotions associated with that day. The envelope was a sentimental object. Many of us keep sentimental objects; however, we typically do not keep ATM envelopes like this one. "Go to the grocery store, go to the drug store," and so forth. She said: "I can throw this away" and as she put it in the throwaway pile she immediately started crying. She said: "If I throw this away, I'll lose this day, it will be gone from me and I won't be able to remember it."

Instrumental saving refers to saving things because we need them, or because we can imagine a use for them. The woman whose home we just toured saved the inside cardboard of toilet paper rolls - the cardboard you have left over at the end. She saved them in the space between her refrigerator and the cupboard; there were hundreds there. I asked her what she was saving them for. She said: "Well, I'm saving them for my son's art teacher because they will be great to use in art projects." Now she was not an art teacher, she never met her son's art teacher, and had not asked him if he needed these things. But once she had imagined a use for these paper rolls, she felt a sense of responsibility for keeping them and turning them into a useful possession.

The following is a good example of intrinsic saving. The same woman came to me one day with a clear plastic bag filled with bottle caps. She said: "Look at these bottle caps. Aren't they beautiful? Look at their shapes and colors." I asked her what she would be wasting if she threw them away. She said that she would be wasting the color and the shape of the bottle caps. This is a kind of funny aesthetic because when you look at her house, it is certainly not aesthetically pleasing. But when she looks at her individual possessions, some sense of aesthetics leads her to save them.

So far, we've talked about the acquisition of possessions and the inability to discard them. But if this were all there was to this problem, it would be easy to fix. The real problem with hoarding is that the possessions interfere with the ability to live. It doesn't really matter how many possessions we buy, own, or keep, as long as they don't interfere with our ability to function. What we see in hoarding is a serious problem with the organization of and control over possessions.

When we look at these pictures we see are a couple of different features. We see random piles of things, worthless items paired with items that are quite valuable – piled in the center of the room. While we were working with this client, we were sorting a pile of newspapers, helping her to throw them away. However, she had to go through each one, carefully detailing it before she could throw it away. Finally, we got her to the point where she was ready to throw away a whole newspaper without lookin