Friday, November 13, 2015

Hoarding, Mess, and Barry Yourgrau

I want to think that everyone has a closetful of plastic bags.
Barry Yourgrau's MESS, required hoarder reading


The city of Evanston banned plastic grocery bags, the ones we see caught in the branches of trees, if we look up. The good news is that we can now choose between a bag made out of tougher paper (they still break) or new sturdy, shiny plastic bags that talk.
Recycle!

We're supposed to bring them back to the store to use them next time.

This never happens. They remain in the trunks of our cars because who can remember to shlep something out of the trunk of the car to shop? But the thought of reusing things is nice.

Chinese gift bags

The cynic in me thinks of an Iranian relative somewhere on the family tree who made his fortune many years ago in the shopping bag business. Smart guy.

On a recent vacation, I found the shopping bags in China so crisp, new, and easy on the eye that throwing them away proved challenging. I paused before giving gifts to relatives. A voice inside whispering,  
Keep the bag.
It shouldn't hurt to throw things away, but the illustrated panda and the fortune-cookie script in Chinese-- priceless. Such things keep memories fresh, like photographs, but not being much of a pack rat, seeing the bag is wrinkled, it is history.

Similarly, had there been two panda bags, only one would have made it to  the closet with the good bags in the first place. (closet not shown).

Let's get serious and take a look at the features of Hoarding Disorder to determine what is pathological, what is not. Because lately, a lot of people are nagging other people to get rid of perfectly good stuff. 

Hoarding Disorder (F42) DSM 5 (not word for word but close, page 247)

A) Persistent difficulty discarding or parting with possessions, regardless of their actual value.
B) The difficulty is due  to a perceived need to save the items and to distress associated with discarding them. 
C) The difficulty discarding possessions results in an accumulation that congests and clutters living areas and substantially compromises their intended use. 
D) The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment).
E) The hoarding is not caused by another medical condition, such as a brain injury, or cerebrovascular disease)
F) The hoarding is not better explained by the symptoms of another mental disorder.
We're to specify if there is excessive acquisition, and if insight into the condition is either good, fair, poor, or delusional. 80-90 percent of this clinical population fit excessive, most with hoarding spending habits. But many of us hoard freebies, like gift bags. Few steal. 

The word persistent refers to a life long condition, not having acquired an inheritance (a garage full of incredible stuff). Most hoarders believe in the value of their possessions. Many are simply sentimental fools. There are combinations.

Also a feature of Obsessive Compulsive Disorder, holding onto possessions is a way to defend against intense contagion fear. Keeping something serves to protect others from the perceived biological contagious quality of the item. Hence there might be rancid, putrid, moldy things among the possessions of those worst afflicted.

Animal hoarders probably fit in there with obsessive compulsive personalities.

Someone with this disorder might feel defective, incomplete. Surrounded by things fills us up.

It is also a familial disorder, fifty percent see it in other family members. That said, a traumatic event might precipitate safety in hoarding.

It is not an easy problem, not for the person who has it, not for family members.

We think that because the thought of discarding acquisitions causes distress, that hoarding behavior is intentional, even when it is dysfunctional to the degree that there is no room to move, a narrow snake path left, maybe, for a visitor to find the bathroom (although visitors tend not to be welcome). Piles of newspapers or National Geographics decorate beds, take the place of mattresses. This would be where back issues of Psychology Today, the ones we'll never get around to reading, might go. A hoarder will frequently sleep in a chair rather than chuck items on the bed.

It could be because as humans we're members of the animal kingdom. Take hamsters. Once while house-sitting the dog and a family hamster, the hamster escaped! He had been planning it for weeks, for sure, but when we found him, had an excellent stash of candy and dog hair that he couldn't possibly have acquired on such a short vacation. He had priors.

This nest could have meaning, could be what hoarders are up to.

Barry Yourgrau, in his beautiful memoir, MESS, describes his struggle to get rid of his clutter. The fear of losing the love of his life, who insists he make her dinner in his apartment, motivates him to change.

Forget that the writing is so strong, which it is, and that you will learn new words, like flaneur. In an effort to clean up his act, Mr. Yourgrau tries different methodologies,a multivariate approach. Family therapists don't believe in any one size fits all cures to life's obstacles, and because people with hoarding disorder in particular tend to be indecisive, trying everything is the way to go.

Barry's scientific approach:

(1) He studies up on famous hoarders and visits them to learn more about himself, You don't have to be a journalist or hunt any of these people down, it is all in his book, makes for an interesting who-done-it. People with this diagnosis can be exceedingly private.

(2) He attends Clutterers Anonymous meetings, reinforcing the therapy adage that we are only as sick as our secrets. Hearing what other people are doing, feeling, hating about themselves is the great normalizer. Plus the stories are compelling and true.

(3) He hires professional declutterers to help him get rid of things, a very brave and painful process. But love is a great motivator, and losing the love of your life, a person who will take you to far away places to buy shiny new things and an endless buffet of bags, is not something you want to do. Lose your clutter, find yourself.

(4) Which is the process of therapy, too. Barry goes through a few therapists before finding the right one. Finding a therapist is like finding a 12-Step meeting you like; try six before you give up. He shares the experience, the ah ha moments, only briefly touching upon being a twin. Being a twin, imho, can account for much of the psychodynamics of the disorder.
Maybe Barry Yourgrau was blue. MESS




Twins tell me that they are particularly cautious, even zealous about their belongings. They are forced, even in utero, to share! The competition for resources never really stops, either. Whatever the other has, even as an adult, can seem better than what you have. And nobody talks about it because it is like talking trash (no hoarding pun intended) about yourself. Even arguing with one's twin can be like arguing with oneself. What you do get is a color, and you are glad for that. You are the one in the orange.

So the author has that going for him, along with the fact that he moved so much during childhood, and moving is associated with hoarding, so much interruption, so much down-sizing. A person wants to hang onto their things, especially if they seem ephemeral, which goes along with never throwing anything away, even when you can replace them at will, as an adult.

The excuse, one of the many, is that everything might be useful one day. We have our comfort stashes, old medications,paint cans with an inch of paint or less. Add your example here.

Well maybe not all of us. The spouse of a Marine, a career service guy, once told me that she couldn't bring home a new blouse unless she gave away an old one. A Marine might have a watch collection, however.

What is the difference then, between a hoarder and a collector? If Mr. Yourgrau acquired only specific things and organized them systematically, even if there were a lot of them, he would be a collector. So there is that out.

But if your basement is really one big train set, you might reconsider the whole idea, make room for a ping pong table, just to stretch your identity.

And if the plastic bags are everywhere, just toss them.

therapydoc.




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