Transcription:

Scott Webb: Many of us like to collect things, but when our collections and our stuff in general begins to impede our living spaces and affect our lives, collecting may have evolved into hoarding. And when things reach that level, we may need professional help to address the clutter in our homes and the root causes of our inability to discard things.

And joining me today to help us understand hoarding and how she helps folks to eliminate clutter is Lynn Faust. She's the program manager of ClearPath, a community partner of Emerson Health that helps people with organization needs.

This is the Health Works here podcast from Emerson Health. I'm Scott Webb. So Lynn, thanks so much for joining me. We were just speaking a little bit about hoarding and the different types of people who hoard and why they might hoard, and it's a really fascinating topic. So just as we jump into this here, what is hoarding?

Lynn Faust: Hoarding is a very common mental health issue that affects about 5% of the population. What it really involves is a difficulty with discarding items. So collections get out of hand and the resulting clutter overflows into the active areas of a home, creating a hazardous condition.

Scott Webb: Yeah, and how do you know when it's become a problem? Or how can you tell if hoarding is an issue?

Lynn Faust: Well, you really have to ask yourself if your stuff is impacting your life in a negative way. Is it harming your safety? Is it harming your relationships with the other people that live in the house, or is it keeping people out of your house? Are you able to use your home as it's intended to be used? Use the kitchen as a kitchen. Use the living room as a living room. Are you able to sleep in your bed? We have plenty of people on our caseload that their collections have gotten out of control, so they have very little living space left to them.

Scott Webb: When we think about people who do hoard, is there sort of a profile you can give us? Are they a certain age, living arrangement, gender? Or can really anyone, can their stuff and their clutter just get out of control eventually?

Lynn Faust: Well, it could really be anyone. But there's a common thread among them, that about 70% of the people who have a hoarding issue had a trauma in their background and usually that trauma happened before age 20. This is a disorder mostly of older people, but it can affect younger people. And it especially affects combat veterans, people who grew up in the foster care system, people who were abused when they were a child or an adolescent. They are prime candidates for hoarding later in life.

Scott Webb: Can you help us to make those connections? Like what is the connection between that? So people who've experienced these traumas, as you say, often before age 20, how or why does it lead to these mental health issues or hoarding issues?

Lynn Faust: Yeah, what the psychologists tell me is that many of the traumas happen between age eight and about age 12. And the trauma that happens to a child at that age means that the child is out of control. Something's happening to them that they cannot control. And they're a little bit too old to go running back to their parents crying about it, but they're too young to cope with the trauma themselves. So what they do is they develop another way to gain control of the world.

Some people that have traumas, they may later in life hoard. They may develop eating disorders. They may have other disorders due to the trauma. They may have multiple disorders because of the trauma. But trauma does definitely run through most of the people that we work with who have hoarding disorder.

Scott Webb: What are some of the ways that you help people who are hoarding?

Lynn Faust: First of all, we have to determine whether or not a person has hoarding disorder. There's a definition that was created in the DSM-5 in 2013 about what the criteria are for hoarding. And, first of all, the person has to have difficulty discarding or parting with possessions. The definition of the disorder doesn't say anything about accumulating, only with discarding or parting with possessions. There needs to be distress associated with discarding items. The clutter has to be in active living areas of the home, such that it compromises the intended use of the home. And so the people that we work with, we do assessments and test people to see if they have hoarding disorder to start with, because just simply having a collection doesn't mean that you have hoarding disorder. We will test them by trying to take something away in their home that they've been collecting and to see if it causes distress. For many of the people, it causes so much distress that they have to sit down. They may sweat profusely, but they definitely become much more anxious when we suggest that they discard something.

And the best way to intervene for people that need help with hoarding is first of all, give them some education about what it is. Most of the folks that we work with, they don't understand why they can't get rid of things. People ask me constantly, "Why don't they just clean it up? Why don't they just throw it out?" And honestly, the people that have hoarding disorder, they ask themselves the same question. The fact is they don't have insight into why they hoard. They may have no idea that they were traumatized earlier in life. But what we can do is we can offer workshops usually in a group setting to help them understand what's going on. We are incredibly fortunate in Massachusetts to have some of the world's experts in hoarding disorder, because there's a number of professors who spent a lot of time working on a hoarding disorder. One is from Smith College and one is from BU. And they wrote a book together called Buried in Treasures.

And Buried in Treasures is made into a workshop, that my organization and other organizations run the workshops, run for 15 weeks for 90 minutes in a session. And during these workshops, people can really start to understand what hoarding is, how it affects them, how it affects other people in their lives. And they can develop some skills for learning how to part with items, which is really important. After they're in a workshop, we sometimes work with them in their home as they're practicing getting rid of things. And so, there's a whole emerging very young profession of clutter coaches who help people who are trying to discard some of their collections in their home and make their home safer.

Scott Webb: Important to know that hoarding is a disorder and really to understand that it sounds like it's sort of a symptom, right? A sign or a symptom of something much deeper. A mental health wound or scar or something, you know? So yes, obviously dealing with the clutter, dealing with these collections and things, the stuff as it begins to sort of take over people's homes and lives, but then probably really ultimately trying to address those things from childhood that led to the hoarding in the first place, right?

Lynn Faust: Right. And so clinicians who deal with trauma are instrumental in our work. We often refer someone who attends our workshops into clinical psychological therapy to identify and deal with traumas that may have happened decades before. By dealing with the original trauma, they can move on a bit more easily in many cases. We ourselves do not treat the trauma.

We help to impart skills to the person that's struggling with the clutter. We are very careful not to retraumatize the person by cleaning their homes up for them or cleaning their homes up too quickly. This is a disorder of control. So if you take the control away from the person who has hoarding and clean up the home for them, you can retraumatize them to the point that the hoarding gets worse instead of better. So imagine how many people, very well meaning families, have had their parent or grandparent in the hospital and they said, "Wow, I'm going to do a favor for them. Their house is such a mess. I'm going to clean the house up so that when they come out of the hospital, they'll have a great brand new spank and clean house." Well, what happens is that the person with hoarding comes to their home and they don't recognize it anymore. They're suddenly out of control of their environment and they may have an anxiety attack or a heart attack because they're just so upset that their home is not the way they left it and someone trespassed and touched their things and discarded things that they were so attached to.

Scott Webb: This is such a fascinating conversation. As we wrap up here, Lynn, what else would you want the community to know about hoarding?

Lynn Faust: I really want people to realize that this is a mental disorder. And as with any other mental disorder, you can't judge or punish someone for their mental health. Cleanouts are harmful for people with hoarding. And what they need is professional help. And families can learn how to be a help and not to harm their loved ones. And we're always happy to help people.

Scott Webb: Well, certainly with this topic, it does seem like education is key and I definitely have learned a lot from you today and I'm sure listeners have as well. So getting that education, getting the word out there that, you know, hoarding is a disorder, it's a mental health condition, but help is available. Thanks so much, Lynn. You stay well.

Lynn Faust: Oh, you're very welcome. I'm so glad to be here today.

Scott Webb: Visit emersonhealth.org/mentalhealthresources for information and support. And thanks for listening to Emerson's Health Works Here podcast. I'm Scott Webb. And make sure to catch the next episode by subscribing to the Health Works Here Podcast on Apple, Google, Spotify, or wherever podcasts can be heard.