Stuff (4 page)

As we learned more about her and her home, Irene's contamination fears became more apparent. On the counter next to the kitchen stove was a relatively neat pile of newspapers, magazines, and mail, grown into a leaning tower that threatened to cascade onto the burners. This, Irene explained, was her "clean" stuff. No one could touch it, nor could it come into contact with anything else in the room, because everything else was "dirty" (contaminated). She kept her purse next to the stack and took it out only if she felt clean. If she didn't feel clean, she covered her purse with plastic wrap before she picked it up so that she wouldn't contaminate it.

The dining room was clearly the worst room in the house. Every surface was covered. The piles of clothes, containers, books, and newspapers climbed above my head. One skinny path led from the kitchen along the side of the room to the door of the TV room. Another path, even narrower, ran along the adjacent wall to the front hallway. Again, the array of things was impressive: magazines, baskets, clothes, papers, boxes, even three or four books about organizing. But still Irene had a strategy to separate the clean from the dirty. On the dining room table were layers of items separated by blankets or towels. Irene explained that the towels and blankets were clean and that laying them over dirty objects protected the clean ones on top.

Soon it became clear that Irene had different degrees of clean. Some objects had to be kept apart from all the others because they were "pure" and uncontaminated. The pure state was only nominal, however. In fact, making things clean often resulted in their deterioration. Once when we were helping her clear a pile of papers from her couch, an envelope from the clean pile fell onto the floor, rendering it contaminated. Irene stopped her work and rushed the envelope to the kitchen, where she ran it under the faucet. She carried the soggy letter back to the couch and propped it up to dry on top of the pile. The letter had already begun to dissolve into the envelope.

As Irene walked us through the house that first day, she pointed out the piles of things that were clean and the piles that were dirty. This distinction was hard to grasp because everything in her house had a thick layer of dust, but gradually we gathered that everything on the floor was dirty and most things on the furniture were clean. We were dirty. Touching me or shaking my hand, or even hugging her children, left Irene dirty. Some days she strived to maintain a clean state, and some days she decided to be dirty. If she was dirty, she avoided touching anything in the house that was clean. Of course, she preferred to stay clean, but getting dirty allowed her to carry on a relatively normal life. In fact, her dirty state was what most of us consider normal.

Irene developed unusual ways to clean herself when she became contaminated. She always kept a Wash'n Dri towelette tucked into her blouse, even when she was dirty. When something got contaminated, she pulled out the towelette and wiped the item off, thereby decontaminating it, as she had done when I'd touched the chair in the dining room. Caught without a towelette, she would put her fingers in her mouth to decontaminate them, as if she were licking off sticky food. Putting her fingers in her mouth looked like a normal behavior, as did wiping something with a wet cloth. I wouldn't have noticed except that she reacted the moment I touched the chair. Only by watching closely could I tell that these behaviors were compulsions, designed to prevent the ill effects of contamination. But exactly what these effects were was unclear.

For many people with OCD, obsessive fears and compulsive actions are tied to feeling responsible for some sort of harm that might possibly befall them or others. But Irene's cleaning behavior was not exactly a fear of dirt or germs. She was not worried about getting ill or making others ill. She was, however, plagued by intense feelings of discomfort if certain things were not clean, including herself, but her clean was different from everyone else's. She described it as a "pure" state, a way of being separate from everything, a state of perfection—pristine and unpolluted. She created her own world—a comfortable and safe one. Such desires play prominent roles in hoarding, as we would find out later.

Frank Tallis, a British psychologist, has suggested that this type of washing compulsion is attributable to perfectionism rather than to a fear of harm. Indeed, our research has shown that most people who hoard are perfectionists and that the perfectionism plays a major role in their hoarding. Irene often spoke of having a place that was truly hers and things no one else could touch, as if yearning to achieve some type of ideal state. She longed for a place of retreat when she was stressed, a place where she was clean and secure, undisturbed by outside concerns. She had several such safe havens in her home where no one, including her children, was allowed. Her bedroom was one of them. Here she collected her most cherished possessions and kept them solely to herself. Her "treasure books" were there—books that had special meaning because she had once enjoyed reading them or she simply liked the way they looked. Magazines with pictures she liked were part of the hoard, as well as other things she wanted to keep her children from contaminating.

Despite the complications it created, Irene's cleaning compulsion was not as serious as her hoarding. She could function quite effectively despite her contamination fears by dabbing at dirty objects with her towelette whenever she felt she must. She seldom had to thoroughly wash contaminated items. Her rituals did not, as is sometimes the case, take up enormous amounts of time, and she could go for long periods in a dirty state. The biggest problem her cleaning compulsion created was the effort required to maintain the distinction between clean and dirty objects.

Irene's TV room, where she and her children spent most of their time, was just off the dining room. One chair was completely clear; no other sitting space was apparent. Videotapes were scattered about—hundreds of them. Most of them were recordings of TV specials Irene had taped so that she wouldn't lose the information they presented, but none of the tapes were labeled. She lamented that there were so many, but she had no plans to reduce her collection. On one side of the room was what appeared to be a couch, completely engulfed in papers. In fact, all that was visible was a pile of papers four feet high, extending about five feet out from the wall and running the length of the couch. A coffee table was also submerged beneath the pile. One small corner of the couch, about six inches wide, was clear. This was Irene's sorting spot. She reported that she sat there for at least three hours every day trying to sort through her papers, but the pile was growing steadily despite her efforts. We asked her if she would show us how she worked.

Irene began by picking out a newspaper clipping from the pile. It concerned drug use among teenagers and the importance of communication between parents and teens on this issue. The clipping was several months old. She said she intended to give it to her daughter as a way of initiating a conversation about drug use. However, since her daughter was away at school, she would have to wait until she got home. She said she would put it "here, on top of the pile, so I can see it and remember where it is." She then picked up a mailing from the telephone company offering a deal on long distance. She said she needed to read it to tell whether she could get a better price on her long-distance plan. She put it on top of the pile so that she could see it and wouldn't forget it.

She followed a similar logic with the third item, which also went on top of the pile. This process continued with a dozen more objects. The clipping about drug use was soon buried. For each item, she articulated a reason to save it and a justification for why it should go on top of the pile. Most of her reasons had to do with the intention to use the object. Her rationale was that if she put it away in a file or anywhere else, she would lose it and never find it again. The result of all this effort was that the papers in the pile got shuffled and those on the bottom moved to the top, but nothing was actually thrown away or moved to a more suitable location. We have seen this process so often among people who hoard that we have come to call it "churning."

The churning we saw in Irene's TV room was driven in part by something we'd found in our earlier studies of hoarding—a problem with making decisions. With each item Irene picked up, she failed to figure out which features were important and which were not, in the same way that she struggled to distinguish important from unimportant objects. Moreover, she thought of features and uses most of us wouldn't. When she picked up a cap to a pen, she reasoned that the cap could be used as a piece in a board game.

She couldn't throw it out until we had talked through whether this was a reasonable and important purpose for the object. The same problem arose with a piece of junk mail from a mortgage company. She couldn't get rid of it until she figured out what was really important (or unimportant) about it. Sometimes she could decide to throw things away, but the effort it took was enormous. Often the effort was simply too much, and things went back on the pile.

As with other hoarders, her indecisiveness was not limited to possessions. One day her daughter, Julia, asked for some money to go to the mall with a friend to buy some shoes. Irene pulled a wad of cash from her purse and started to hand it to her daughter. As the money was about to change hands, she wondered aloud if it would be enough. She took the money back and pulled out her credit cards, but now she wasn't sure whether to give Julia the MasterCard or Diners Club card. "Which should I give you?" she asked. Before Julia answered, she said, "I don't know, maybe I should give you both," and she handed both of them to her. "No," she said, "I might need one to get groceries." She took both of them back and handed Julia the MasterCard, but again took it back, adding, "I'll probably need the MasterCard for the groceries." She gave Julia the Diners Club card, but just a second later she said, "Is Diners Club accepted everywhere?" Before Julia could respond, she took back the card and said, angrily, "Oh, just take this one," and handed Julia the MasterCard, obviously frustrated and flustered by the process. Her indecision seemed to stem from a flood of ideas about what might happen if she chose one action over another.

Irene's churning revealed another facet of her disorder besides her trouble with decisions: she wanted to keep objects in sight in order to remember them. When we toured her bedroom, this became even clearer. Stacked on her dresser, all the way to the ceiling, were clothes—while her dresser drawers were empty. When I asked about this, she replied, "If I put my clothes in the drawers, I won't be able to see them, and I'll forget I have them." On another occasion, she was going through pamphlets advertising various home care products. She remarked, "I want to remember these things. If I throw them out, I'll never remember them. I have such a terrible memory."

Irene frequently complained about her poor memory. This contradicted our observations of her elaborate stories about so many of the objects she found in her hoard. She remembered details about where and when she got things, whom she was with, and even what she was wearing that day. It wasn't that she had a poor memory; she just didn't trust it. Her organizing style may have played a role here as she tried to remember exactly where things were in space. With thousands of objects in her home, this was an impossible task. She was asking too much of her memory, and not surprisingly, she lacked confidence in her recall. We got a further sense of this one day as she was trying to get rid of a pile of newspapers she'd already read. She said she wasn't comfortable discarding them because she couldn't remember the articles she'd read in them. Saving them would be a good substitute for her memory. Her belief that she
should
remember all this information, much of it unimportant for her daily life, led her to save the newspapers. It also explained why she felt that her memory was poor.

Another apparent problem had to do with the ability to categorize, to group like objects together. Most of us live our lives categorically—at least the part of our lives dealing with objects. Tools are kept in the toolbox; bills to be paid are kept in a special place in the office area and then filed after payment; kitchen utensils go in a drawer. But Irene organized her world visually and spatially, not by category. When I asked her where her electric bill was, she said, "It's on the left side of the pile about a foot down. I remember seeing it at that spot last week, and I think I've piled about that much stuff on top of it." Many of us do this on a smaller scale. I have faculty colleagues whose offices are populated by piles of paper, and although they get a bit nervous that I'll label them hoarders, most actually know what each pile contains and can readily find what they need. Others, who are less sure of the content, remain confident that their piles have only low-priority, unimportant stuff. In short, they are unconcerned about their memories.

Although a visual/spatial organizing scheme might work on a modest scale, it's not an efficient way to deal with a large volume of possessions. In fact, Irene frequently did lose things in the piles and found herself buying replacements for items she knew she had but couldn't locate. After we set up a filing system for her important papers, she reported being able to find things much more easily. But because she couldn't see the papers, she felt uncomfortable, as if she had lost them. This dependence on the visual connection with objects is a common trait among hoarders.

As Irene worked her way through the pile on her couch, something else struck me. She often picked up an item from the pile, looked at it for a second, and caught sight of something else. She then picked up the new item, putting down the first one. This happened often enough that it seemed like a pattern. She simply couldn't keep her attention on things that posed a decision-making challenge or seemed boring. She preferred to focus on objects that had positive connotations or evoked a story. As she drifted into an anecdote, she lost track of the sorting she was supposed to be doing. Not maintaining our attention while performing tedious tasks is certainly common, but it seemed to be especially pronounced in Irene's case.