A messy secret

You’ve seen them on TV: people housed amid piles of paper and sundries, accumulated over years if not decades, stacked so high and deep that there’s scarcely room to move. Shows such as Hoarders and Hoarders: Buried Alive have brought them into our living rooms.

The behavior may seem a curiosity, an uncommon phenomenon. It’s not. Chances are, you know someone who exhibits hoarding behavior, or someone related. Research suggests at least 19 million Americans, or 6 percent of the population, are so-called hoarders—and that figure may be low because of the secrecy and shame associated with the condition.

Dr. Patrick Arbore knows this firsthand. He’s a program director with the Institute on Aging who speaks nationwide about hoarding behaviors—including Monday in Chico (see infobox)—and grew up with a hoarder, his father.

“This life is very difficult, and it’s really sad when [producers] use it as entertainment and people find these hoarders kind of freakish,” he said by phone from his Bay Area office. “That’s what I worry about with these television shows; it reduces this serious syndrome … and it’s very heartbreaking to see that.”

Sarah Frohock, too, understands the underlying pain. She’s a licensed clinical social worker with a private practice in Chico. She’s worked in the field in Butte County since 1997.

Around five years ago, Frohock received specialized training in hoarding behavior sponsored by the then-active Butte County Hoarding Task Force. (That group has since disbanded.) She’d had several clients over the years, plus she’d “seen it on a personal level” with a family member.

Typically, the client seeks counseling for an underlying issue that spawned the behavior—anxiety being the most common; also depression—but not hoarding. The therapist discovers this later.

“When people come to your office, you have no idea what their house looks like,” Frohock said by phone. “You often won’t find out [about their hoarding] because they don’t disclose it. There’s a lot of shame, there’s embarrassment, so they don’t share it.”

Once trust develops, she continued, the person may feel comfortable enough to reveal the secret.

The accumulation weighs heavily on not just the hoarder but on loved ones, too, who often feel the same embarrassment and shame along with a need to stem the tide.

Arbore grew up on a dairy farm in western Pennsylvania. His mother insisted that his father keep his stuff out of the house, so it spread outside. She died 10 years before he did. Two weeks after her funeral, the house had begun to fill, to the shock of Arbore’s brothers.

Arbore gears his talks for a general audience and professionals alike, he said, “because I think it’s good for community members to see that practitioners are also interested in learning.” He estimates he’s come to Butte County 15 times to speak on various subjects related to aging, in partnership with the Passages elder care agency. At the Institute on Aging, Arbore founded both the Friendship Line (a confidential “warm line” for people in crisis) and the Center for Elderly Suicide Prevention.

When speaking about hoarding, Arbore aims to inform people not just about the symptoms but also the triggers.

“What they’re doing is hiding,” he explained, citing the research of psychologist Randy Frost, author of several books on the subject. “They are using stuff as a way of coping with past trauma, and the trauma event—or, usually, events—happened when they were young.

“Those traumatic events of childhood wind up feeding into this obsessive acquisition of stuff.”

Family and friends who think they’re “helping” by cleaning the person’s home actually wind up causing upset and anxiety, he explained, by removing the “stuff protective of my wounds, filling holes in my soul.”

“They can’t see the difference between ‘treasure’ and ‘trash,’” Arbore added. “I say to people, like I will say on the 29th in Chico, that we need to work with them, which is not that easy a task. There is no quick fix for it.”

Frohock equated hoarding to addiction, similar to a pattern in drug and alcohol abuse. People may struggle interminably until a “moment of clarity” causes “a breakthrough in their denial system.”

“People have a big capacity for denial,” she continued, “and it can be pretty easy to explain away things for folks who have a lot of practice at that.”

A group intervention—much like on the TV series Intervention, where loved ones confront addicts—can yield a moment of clarity and begin the healing. But Frohock cautions that “every situation is different. Alcoholics talk about hitting rock bottom; for some, that could be their family getting together and letting them know they’re seeing a problem. For others, it could be someone letting them know their children or their pets can’t be there because it’s not safe.

“Different people have different motivations and different things that turn that switch for them.”

The helpers’ motivations matter, too.

“There’s something about this enormous amount of stuff that some people who don’t have this issue just can’t tolerate,” Arbore said, “and they usually get very angry at the person who hoards and clutters. Not everyone can really be of support and help in a compassionate way because of that.”

The trauma and anxiety associated with the hoarding behavior “is why I think it takes a special kind of individual—whether it’s a practitioner or a family member or friend or [clergy]—to really be able to create a trusting, caring relationship with these individuals,” Arbore added. “Normal, healthy people might be messy, but they’re not going to be hoarders or clutterers.”

As a first step in helping, Frohock recommended assessing the person’s physical welfare. Is there a health concern with how he/she is living?

“Address that,” she said. “Go from there.”

Arbore said his institute’s Friendship Line (800-971-0016) is open to callers statewide. He also advised, “Be aware of young people in your lives…. No one is born a hoarder.”