New Reason, New Thinking

For the last three years I have been working with people who have become overwhelmed by their possessions in their homes. This has been some of the most interesting, challenging and thought provoking work I have ever done. It is also an area that, I think, highlights all of the issues that challenge us in helping people who feel overwhelmed, for whatever reason.

The people I meet, who either they or somebody else has said that they have a problem with clutter in their homes mostly have one thing in common and this is not, as most people would assume, having a lot of clutter in their home! What they have in common is that they nearly all say to me “I have watched those hoarding programmes on the TV, and that is not me!” They are terrified of what they see on their screens, and the very thought of that process happening to them triggers many more overwhelming feelings.  My experience is that they are of course always 100% right, and this is the key issue. The people that are on the screen are not them.

There is always, of course, a reality that centres on people’s relationships with possessions. Not always quantity, but the things that the person has become overwhelmed by. Being overwhelmed for some can be related to the sheer quantity of the possessions, and the dilemma that comes from fitting them all into their home. Overwhelm is however more often related to feelings of shame, embarrassment, guilt, frustration, anger and a profound loss of self-esteem and sense of self-worth. Feelings that relate to issues that have happened in their lives, issues that are then reflected in their homes or with specific feelings towards their things.

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The person’s story is always unique and there are always life issues, traumas and events that then relate to what is happening with their belongings.  The people are unique, their situations unique and a failure to understand and respond to people and situations as being unique is always failing to see them. To call them hoarders or suffering from a disorder is therefore alienating and reducing them to broad classifications that therefore do not require a narrative.

When I meet professionals from a range of services they may tell me that they have a “hoarder” on their caseload, or that there is a problem with “hoarders”. I am told by experts in the field of “hoarding” that the fact that the DSM V (Diagnostic Statistical Manual 5) has recognised Compulsive Hoarding Disorder in its own right is a good thing as treatment can now be anticipated to follow. I am told that this is a chronic problem affecting up to as many as 5% of the population and that “hoarders” lack insight and are hard to engage, therefore making this specialist work.

Having met many people now who would be talked about in this way, I wonder what their response to this might be, or any of us for that matter.

Please imagine someone comes to your home having received a referral as they are concerned with the state of your home. Imagine that they look around your home and ask you about your relationship with your possessions and then diagnose you with a Compulsive Hoarding Disorder. Much like the response from the TV shows you may (I know I would) either tell them (or believe) that they are wrong and that whilst you know things weren’t great that was not the problem. The professional may then tell you, or perhaps they would imply, that you therefore lack insight. Again, as is common and something I think I would do, is ask them to leave or perhaps never let them back in the house. If this should happen they can then confirm to themselves, and those around them, that “hoarders” are difficult, lack insight and are hard to engage! This is a professional set up that I have experienced many times throughout my career, most notably when working with people referred to Assertive Outreach as “hard to engage”. The people I met were not hard to engage if you had time to listen, understand and attempt to help in a meaningful way. However, if you ignore them and try to impose yourself and your opinions on them they resisted. So for people overwhelmed with their possessions in their homes, a familiar process has taken place that distorts what is really going on because the system lacks the ability, or the insight, to look only at the person, their unique situation and the relationship that they have with that person. A common irony is that this response often comes from professionals and services that promote themselves as “person centred”. It appears that this approach is so often conditional upon the person accepting the opinion of the worker first!


Listen, understand and attempt to help in a meaningful way. However, if you ignore them and try to impose yourself and your opinions on them they will resist.


 

What I see is people trying desperately hard to survive the many difficulties that they are experiencing now, or which are legacies of events in their and their families’ lives. What is so often the case for the people I meet, as with people who are distressed by hearing voices and people who injure themselves or many of the other manifestations of distress, is that these crucial survival strategies get attacked or medicalised, and that professionals are less interested in what has happened and more concerned with fixing the immediate concerns that may be distressing others. I do understand the argument and the feelings that make people want to classify others, and I understand that people will see someone overwhelmed by their possessions and think that the possessions are the problem. I know that people will meet people distressed by voices and will want to take the voices away, I can see that when someone you care about is injuring themselves you will want this to stop. Likewise, I can see that profound sadness and crippling worries and fears are tremendously difficult and we would all wish for this suffering to be gone. However, what I also see when I meet people experiencing all of these, is that the suffering is a related to what has happened to them, who they are, how they see their world and what resources they have to overcome what is happening. That the belongings, the voices, the injury, sadness and worry are understandable responses and often desperate and successful attempts to survive. That the feelings that people have, whilst painful and difficult, are often the perfect response considering what is happening or has happened. That rather than anything being wrong with the person, everything about the way they feel is right given the circumstances.

So perhaps if we can acknowledge that these are natural human responses and not symptoms of a disorder, we can just accept and support people, and not as we do now and call them names, then try to get them to accept the names that we use and then reserving labels such as lacking insight and hard to engage for those who dare to disagree.

If we can employ our natural human skills of love, compassion and empathy, if we listen, if we are curious, if we accept people and their stories as truly unique, complex and inspiring, if we can marvel at people’s resilience, if we can truly accept difference and tolerate uncertainty, then maybe we can strip away the disorders, we can change the language of emotions to words that unite us as human beings, and perhaps then we can equip us all to be more helpful to ourselves and to others. Perhaps then we can see through the clutter, in whatever form it takes, and see a person.

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