The Providence Journal / tom murphy

Charlene Darnell would love to see her family living in a pristine home.

“A big showcase house,” the cheery 43-year-old nurse said, “with room to display stuff.”

But Darnell knows the truth.

She says she is a “clutter-aholic,” a pack rat of such magnitude that even the suggestion of tossing away anything brings on a near panic attack.

“It’s almost like it hurts,” she says.

The result is a tiny Olathe, Kan., home that is, by her own admission, a colossal mess. It looks as if someone ripped off her roof and spilled the contents of 10 other houses inside.

Rumpled mountains of laundry make hallways and bedrooms impassable. Piles of papers, bills, pots, pans and plastic containers — poised to tumble in an avalanche of kitchenware — cover every inch of her counters.

Seven cars (one of her husband Bob’s compulsions) cram their short driveway and two-car garage. Most, such as a white ’63 Thunderbird, haven’t worked in decades.

“I’m no help,” he says.

Pull open the garage doors and one faces a near-solid wall of stuff. Furniture. Broken electronics. A rusted pedal car that Darnell unearthed when she was five months pregnant. A hotplate retrieved from the neighbor’s trash. Darnell thinks she might one day use it.

“I hate to give something away that I might use,” she confessed in an e-mail. “I collect things, save things, pile things up. ... My house is horribly messy. ... My car is full of things. ... I still have a bag full of items from my job I quit four or five years ago.”

Darnell stood recently on the steps above her living room watching as her 8-year-old son, Wesley, kicks and trips over toys heaped upon the carpet. Even broken toys are kept.

“When I was a kid, I used to hear about people who lived this way,” Darnell said. “I never thought I’d be one.”

Psychologists say Darnell is hardly unique. Rather she fits the psychological profile of as many as 2 million people in the United States known as “compulsive hoarders,” a group researchers are studying with increased interest.

Physician Sanjaya Saxena, director of Obsessive Compulsive Disorders Program at the University of California-San Diego, has been discovering differences in compulsive hoarders using brain-mapping techniques. He said hoarding is extraordinarily common.

“Every time we solicit for a study or give a talk on this, people come out of the woodwork,” he said.

Collecting stuff certainly is part of human nature. It’s part of evolutionary biology and the survival instinct, like squirrels stashing food. The behavior can be seen in the way kids collect toys or shells or rocks, often refusing to throw or give them away.

But in this instance, the difference between a behavior that is normal and one that is pathological is a matter of degree.

“This is not just a problem of being a bit messy or saving a few too many things,” said Randy Frost of Smith College in Northampton, Mass., a leading researcher on hoarding.

“Hoarding involves the acquisition of, and difficulty discarding, possessions that result in so much clutter that the person has great difficulty functioning. Many of our cases can’t use their kitchen, living room; sometimes they can’t sleep on their bed, and sometimes they can’t use their bathroom because of the volume of clutter.”

Consider Terry Lipp.

The 44-year-old field technician lives with his girlfriend, Samantha Turner, 43, on 18 acres in Edwardsville, Kan. They’ve lived there less than a year after their old property was bought as part of a plan to build a new giant water park in western Wyandotte County, Kan.

But it looks as if they have lived there 50 years.

The barn is filled with broken machinery, water heaters, sinks, tires, wood, cinderblocks, old tool handles, a life preserver, rusted milk cans, rusting scaffolding, wagon wheels, metal stripping, busted lampshades, ladders, glassware.

Nearly every stall of their five-car garage is jammed to the rafters with furniture, mostly from ancestors, Lipp said. He even has the nail-strewn wood from his old bulldozed house in Kansas City, Kan., piled out back because he didn’t want to get rid of the lumber.

Moving all the stuff, Turner said, cost $35,000.

“Ain’t no junk there,” Lipp says, laughing. “That’s my good stuff.”

To him it’s valuable, stuff to use one day.

Turner thinks it’s wacky because even if it does have value, she said, Lipp never does anything with it other than keep it.

“It doesn’t bother him; it bothers me,” she said. “He still has all these old clothes from high school. He says they are collector’s T-shirts.”

Psychologist David Tolin, director of the Anxiety Disorders Center at the Institute for Living in Hartford, Conn., says the medical understanding of hoarding is weak. “The major questions could fill a book,” he said.

The belief that hoarding arises mostly in people who experienced the Great Depression or have known poverty or deprivation are untrue, he said. Hoarding is seen in people who are rich and poor.

Treatments are similarly behind. At the University of California-San Diego, brain scans have shown compulsive hoarders to possess lower metabolic activity in a deep brain structure known as the dorsal anterior cingulate gyrus. The structure is involved in focusing attention and decision-making, and the abnormality may explain some of the clutter, disorganization and anxiety over getting rid of things.

Prozac-related medications used to combat depression help some compulsive hoarders, as depression and compulsive hoarding seem to be linked in some patients.

Medications used for Alzheimer’s (Aricept) or attention deficit hyperactivity disorder (Ritalin) also may help.

Recent studies show that cognitive behavioral therapy, in which therapists help change people’s beliefs about their possessions, is proving useful. But it’s hard.

Darnell knows this. She would like to have a clean house and have space to put stuff.

“It’s embarrassing to live this way,” she said. “It’s a problem.”3 ways to spot a hoarder:

• They acquire, or fail to discard, numerous possessions that appear to be useless or of limited value.

• Their car or living spaces are so cluttered they can’t be used for their intended purpose.

• Hoarders imbue the stuff with importance beyond its value or an inflated sense of its utility. DEFINING THE COMPULSION TO HOARD

Barely a decade ago, most researchers considered compulsive hoarding a sub-symptom of other disorders such as obsessive compulsive disorder or — because a lot of hoarders find themselves compelled to shop — an impulse-control disorder. More and more, scientists are also coming to think of compulsive hoarding as a unique syndrome of its own.

Compulsive hoarders are defined by three characteristics:

They acquire, or fail to discard, numerous possessions that appear to be useless or of limited value. That includes stuff that most people would toss away, or even free stuff such as newspapers or advertisements.

“Instead of saving one set of screw drivers they don’t use often, they might save 50,” physician Sanjaya Saxena said.

Their car or living spaces are so cluttered they can’t be used for their intended purpose. Often the home is so disorganized it no longer functions like it should. Maybe there’s limited space to cook, sit, sleep, study or even walk. At worst, the place is hazardous or a health risk.

“A surprising number of people have been evicted from their homes or had their children removed from their homes because of clutter,” said psychologist David Tolin, director of the Anxiety Disorders Center at the Institute for Living in Hartford, Conn.

Tolin, who with Randy Frost of Smith College and Gail Steketee of Boston University, is a co-author of the book, Buried in Treasures: Help for Compulsive Acquiring, Saving and Hoarding. “You name the item, and someone out there is hoarding it. There are some cases of people hoarding rotten food. There is an entirely different set of people who hoard animals, like someone who has 80 cats.”

Hoarders invariably imbue the stuff with importance beyond its value or an inflated sense of its utility. They fill their car or house with mail reluctant to toss it away because there might be a check in there or a letter of import. They don’t toss out even broken electronics because they might one day use a part, which they never do. Or else they look at objects with deep sentimental attachment.

“The beliefs people with hoarding problems have are much the same that you and I have about the things we save,” researcher Frost said. “We might need it some day, it has sentimental meaning, or we just like it. The problem is that these meanings get assigned to everything, so nothing can be thrown away.”

http://www.projo.com/health/content/lb_compulsive_hoarders_photos_06-01-08_6V7V26_v26.17746c0.html