When I was growing up, in a world without television-- not to mention video games and cell phones-- books were very important to me. There was radio too, of course; and I spent dinner hours bent over the radio set, listening to Superman and other such programs that lasted, if memory serves me right, fifteen minutes. To be continued the next day at the same time. Once a week, later in the evenings, there was the Lone Ranger, the Green Hornet and the Shadow. The most popular show of all during the thirties and forties was Jack Benny; and I still think those programs were funnier than anything I have seen or heard since. But most of the time, there was nothing worth listening to on the radio. (Besides, my father, who was sort of nervous, did not like me fiddling with the dial. He thought too much turning back and forth was likely to break the knob.)
We had only two books: one was a single volume of an encyclopedia, the letter A, I think. (I wrote about this in “Superpowers.”) The other was a slim volume written, I was told, by a distant ancestor. It was a description of a method of shorthand which he had devised and which had fallen into disuse, if it ever was used. Still, there was magic in those strange squiggles. I read other books, of course, borrowed from the public library; but I envied my friends who had walls covered with books.
When the time came, I wrote books of my own. There is a certain satisfaction in holding in your hand a book that you have written, even if you have reason to think it will not be widely read. I displayed one copy of each of my books in my living room, placed amongst a growing number of other books. Growing and growing. In time they covered the walls of that room and spilled into other rooms and hallways. But I felt pleased looking at them. Books are the repository of all the world’s knowledge. They are sacred. And they feel good too, wrapped in leather, even in paperback.
In various places I was able to buy used books very cheaply. I only bought books that I planned on reading; but there were a great many of those books. So, I collected more and more books. Then, an odd thing happened. I found when I went looking for a particular book to read, I could not find it. It was lost in a mélange of other books. When I brought home still another one, I had to make sure it was not put away anywhere, because putting it away was like throwing it away. It became invisible. But that is what happened over and over again. Something had to be done.
I put together those books that I had already read and that were not likely to be read by anyone else in the family. Because books were special, I brought them to the hospital or to other charities where someone else could buy them. And have them. But the books continued to proliferate. Finally, I made a rule: no matter how interesting the book promised to be, if I had not read it within three years of buying it, I would give it away. This was hard because I thought that someday when I had enough time I would really want to read those books. I did not always live up to my rule. But the books were, in an odd way, getting in the way of my reading them. Sometimes I would start one, and it would disappear into the morass of all the others.
There came a time when I began to feel surrounded and burdened by all these books. They seemed then to me less precious. No matter how sacred they were, a particular copy of a book—just one among thousands—came to seem to me not worth even giving away. They were taking up space. I began to throw them away!
I have reached a sort of equilibrium now. The books sneak into the house somehow and settle into piles until I am moved one day to throw out a bunch--with misgivings, it is true, but I am stern with myself. (My wife also is stern with me.)
What I am describing, of course, is a kind of hoarding. A hoarding of books. Some people are afflicted with this particular condition to the point where they steal books from the collections of others. They cannot exhibit the books; and they are not likely even to read them. Just having them provides satisfaction. This fixation preoccupies them and dominates their lives.
The urge to collect things is common. It is only one step away from hoarding. The hoarder finds it painful, literally, to throw out anything that could be of use at some time in the future--not just literature, but telephone books, and railroad schedules, and magazines, and newspapers. Conceivably, these things can be useful, they think. It seems a shame to throw out anything than can be useful at some time in the future. But collecting things, not just the garbage that hoarders think might be useful, but truly useful things, like books, gets in the way of enjoying life. I have seen patients slowly pack a room from ceiling to floor and then close off that room, and then pack up another room until it too cannot be entered, and progress in this manner until the entire home becomes unlivable. And then start anew in another apartment or home and do the same thing all over again.
Hoarders are likely to accumulate anything that comes into the house. I remember a man who was dying in a hospital, who knew he was dying, yet prevailed on his sister to take home the plastic knives and forks that came with his meals. Everything seems like it can be useful somehow in the years to come. I have seen rooms opened up after a hoarder died which had in it rolls of dollar bills, small whiskey bottles saved from airplane flights, dildos (more than one in a single room) and packages which were delivered twenty years before and which were still unwrapped. I cannot think of anything I could find in such a room that would surprise me.
Hoarders know very well that they have an illness. They understand that marriages—including their own marriage—can break up because a spouse cannot tolerate forever living in clutter, trying to wind a careful path between all sorts of things, trying to struggle along a path from the bed to the bathroom and then onto another narrow path to the outside door. Yet, they will risk suffering that loss rather than stop hoarding.
Hoarding is very difficult to treat. I try to establish a rapport and trust which will allow me to come to a patient’s home and collaborate with that person in making decisions about what to throw out. But although hoarders know their judgment is flawed, they have trouble deferring to the judgment of others. I try to start with paper records that they know—or should know—cannot possibly be important, such as bank records from fifteen years ago or high school report cards. Still, not infrequently, patients rummage through the garbage after I have left to retrieve something.
It is important for the patients’ families, and therapists too, to understand that the act of throwing something away—even the thought of throwing something away—is painful, even physically painful, to hoarders, so painful sometimes that the patient will leave treatment rather than subject himself/herself to such torment. But some patients do get better. I remember a woman who was always in conflict with the health department because of the danger to the community that her dilapidated and disorganized house had become. (When we started finally to throw out things, she was afraid the sanitation department would refuse to remove such a great volume of material. Indeed, when we had filled fifty or sixty garbage bags, I sort of wondered about it, myself.) She never entirely cleaned up that house; but when she moved into another apartment the following year, she gave no further evidence of hoarding and did not hoard over the remaining three years of her life!
There are two ideas that a therapist would like to convey to a hoarder:
1. It is okay to throw out something that can be useful in the future. It is okay to throw out something and then have to buy something just like it later on. Being without something you need for a time is not terrible. The extra expense is not terrible since it is very infrequent that something has to be repurchased.
It has been said that we do not own possessions, they own us. They take up time and space. There is a price to be paid for owning anything: taking cars to the garage, bringing a diamond bracelet to a safe deposit box and going back to take it out again from time to time, having so many pairs of shoes that it takes time to decide which ones to wear—and they, too, like my books can be so many that they get in the way of finding the ones you want. Convincing hoarders that it is better to live a spare life is difficult, and is a hard sell for many others too.
- Empty space is valuable. I try to figure out how much a square yard of empty space is worth, given the cost of the apartment or house. And how much is it worth to be able to walk from here to there in a straight line? Some hoarders live in what amounts to solitary confinement because they cannot move out of a small, not so comfortable, space. And what price should be put on living among ugly surroundings? It is cheaper to live like a normal person.
In the end, treatment resembles the treatment of obsessive-compulsive disorder, which some clinicians think is related to hoarding. It is to help the affected person tolerate the very bad feelings of confronting an upsetting circumstance, in the case of hoarding, the act of throwing something out. As in the treatment of OCD, some patients will quit treatment rather than undergo such distress.
These matters are familiar to anyone who works with this condition; but I think one element of the disorder is often overlooked. Even though I have an exaggerated fondness for books, I still get a kind of satisfaction—it seems sometimes like a perverse satisfaction—in clearing them away, in making a clean space. I think many people have such a feeling, whether they are doing spring cleaning, or organizing the garage--not so much, maybe, that they go out of their way to accomplish these chores; but I think the good feeling is real. I do not think hoarders ever have such a feeling.(c) Fredric Neuman 2013 Follow Dr. Neuman's blog at fredricneumanmd.com/blog