At some point in the last 19 years, Brenda McDonald just stopped inviting people over to her house.
Drawers were overflowing. Closet doors wouldn’t close. There were piles and boxes everywhere of flyers. Magazines. Papers. Stuff.
She’d always been a collector. When she was a kid, if she went to a fair with her parents, she’d grab all the available pamphlets and keep them.
It turned into full-on hoarding sometime after her first child was born, when she couldn’t bear to part with any piece of artwork, or any photo, or any item of clothing, no matter how useless or full of holes it was.
“You have boxes here and overfilled dresser drawers there, and you try to hide the clutter, but it doesn’t mean it’s not there,” she said. “You try to push it into corners where no one sees it, but it’s there.”
McDonald is one of the roughly 14 people who take the annual hoarding course at St. Joseph’s Healthcare Hamilton’s Anxiety Treatment and Research Centre, where they learn to get their houses in order again.
While it’s usually not the extreme cases seen on TV where people sit among garbage piled to the roof, many people come to the program with problems with landlords and bylaw enforcement officers, or with the realization that their collecting is out of control, said Karen Rowa, the psychologist and hoarding expert who runs the program.
McDonald lives in Waterloo and works at the University of Waterloo. She was on a list of willing participants for research trials. She signed up to participate in a research project and the researcher told her about the St. Joseph’s program.
McDonald has five children, and for years, she couldn’t part with any item they gave her.
“If it was a stick that they said was a person, I kept it,” she said.
She kept boxes and boxes of her kids’ artwork. She became obsessed with photographing their activities. Every photo was developed, sometimes multiple times.
Greeting cards and kids' artwork
The hardest items to discard, she said, are the ones with emotional meaning. The thought of parting with an item connected to her kids or a lost loved one was unbearable.
“A lot of hoarding is tied up with emotions. So-and-so died and gave me this. Someone gave me this card and the message is so special,” she said.
An air hockey table sat in the living room, but instead of being for air hockey, it became storage. Surfaces and couches became catch basins for clutter. McDonald’s family could still use all the rooms of the house, but that’s not always the case with hoarders, Rowa said.
“For some of people, it gets to the point where they’ve lost rooms in their house, including bathrooms and kitchens,” said Rowa, who acted as an expert in a season one episode of Hoarding: Buried Alive. “That’s a huge problem because obviously, if you can’t have a functioning kitchen, it has a huge impact on your day-to-day life.”
“At a minimum, people we see here at the clinic have acknowledged this causes them significant distress, whether it be anxiety or guilt or shame or embarrassment. They can’t do something in their house that they want to do.”
Learning to cope with the anxiety
Group therapy is a big part of the course. Another part is exposure therapy – exposing the hoarder to objects and asking him or her to make a decision, then “sitting with the anxiety until it’s a little more tolerable,” Rowa said.
At some point during the course, the hoarder leaves an object with Rowa’s team to see how much they miss it. In many cases, they don’t.
Hoarding is a complex mental health issue, and it impacts as much as eight per cent of the population. Hoarding often starts sometime during childhood and worsens as a person ages, Rowa said.
Hoarders tend to be environmentalists — they want to reuse rather than buy new. They have trouble making decisions. They are also creative, Rowa said. They look at objects and see possibilities for reuse, but it gets out of hand.
Stressful situations such as the death of a parent or a traumatic break up don’t cause hoarding, but they can worsen it, Rowa said. So can a loss such as a flood or a fire.
Throwing out a little every day
“All of those sorts of things seem to be a big trigger for a hoarding problem to go from manageable to not manageable.”
Hoarders may also feel stress more deeply than the average person, Rowa said. Her team is studying how hoarders physically react to stress to see if it differs from non-hoarders.
McDonald has found ways to deal. She cleans and throws out a little bit every day rather than waiting for it to be a monumental task that she never starts. And she invites people to her house now.
With therapeutic help, her mindset is changing. Instead of buying books, she rents then from the library. In the case of her children’s artwork, she had her children choose a few pieces for her to keep and display. She threw out the rest.
“It’s a lifelong process,” she said. “There are always going to be times where I think ‘I should keep it. Maybe I will use it. It would look nice there.’ Would, could, should. Then you catch yourself.”
Common traits of hoarders
Hoarders often have difficulty paying attention. At Rowa’s clinic, they see elevated rates of attention problems, including Attention Deficit Disorder. “They have a hard time staying on tasks and thinking things through,” she says.
Hoarders tend to be creative people — sometimes more creative than average, Rowa says. For this reason, they see possibility in every object, so they save it. But they lack follow-through.
Hoarders are often perfectionists to such a degree that they don’t even start something for fear of not doing it right. “Their standards are so high that they never meet them, so they almost go the opposite way and don’t even start trying to organize or make decisions.”
Emotional stress such as grief or a break up
Stressors such as losing a parent don’t cause hoarding, Rowa says. The tendency already exists. But the traumatic incident can worsen it, particularly when it comes to discarding items with a tie to the lost loved one.
Concern for the environment
Many hoarders are keenly aware of the environment and want to reuse things rather than throw them out, Rowa says.