Clutter is just the start for local hoarders

The Virginian-Pilot
By Nora Firestone
Correspondent

Margie Gummo fingered the holes in her 45-year-old sweater. She was finally giving in to her daughter's repeated request to discard it. Gummo hates to waste anything - always has.

"It still keeps me warm," she said, admittedly embarrassed by the irrationality.

The path from the front door to the spare bedroom of her Virginia Beach home, where she sat trying to make sense of it all, remained clear. But she shar ed the couch with crumpled blankets and various displaced items. Other surfaces harbored more papers, books, clothing and "stuff" than she could manage.

Throughout the house things inhabited the spaces where people once communed. Gummo had succumbed to debilitating anxiety and depression, initially extensions of a lifelong struggle with obsessive-compulsive disorder and compounded in 1999 by three significant losses: the death of her father, separation from her husband and relinquishment of the couple's planned "dream home."

"It was a lot to deal with," she recalled.

Fresh tears reflected the ongoing impact of past trauma. She's since lacked the mental, physical and emotional energy needed to keep up with the material stuff of daily life.

Gummo's standard for keeping up would be considered unreasonable by most. Her untreated OCD had always been an internal slave driver, undermining her judgment with a constant and negative critique of everything she did and thought.

The house was "never clean enough" while her children were growing up.

She'd vacuum constantly, scrub the same surfaces repeatedly and agonize for hours over things being misaligned or "out of balance," she said.

The house appeared meticulously clean, but at a grave and concealed cost. Gummo battled relentless self-badgering. Time she spent tending to objects meant time away from nurturing relationships.

Everybody suffered, whether or not they understood the dynamics or foresaw the impact.



Facing the problem

With an understanding of the history, the irony computes.

Gummo's surroundings have spiraled from overly controlled to out of control, yet the two remain poles of the same tense coil.

She recalled her son's perspective: "He left for college in 2000 and 'came back to a disaster,' " Gummo said. "The hoarding had started. "

Her dining room, family room and kitchen no longer function as purposed. Today, they warehouse knee-high stacks of unread newspapers, neat piles and boxes of things she's compelled to save, and bags of items that she'd like to donate - once she finds the "right" recipients. All along this spiral are the lines between reasonable and unreasonable actions, drawn with the marker of irrational thought.

Gummo, 62, has no problem discarding newspapers and magazines after she's read them cover to cover. Until they've been used up, they're "still useful," she said. Discarding them prematurely "feels wasteful," she said. Receipts for minor purchases made in the '90s should be OK to throw away, she thinks, but might she need one someday? Regardless, they're paper, with which she has difficulty parting.

"It's ingrained in me. I don't want to waste anything," she explained. "It's part of hoarding. But how many paper clips or rubber bands do I really need?"

Gummo's embarrassed, ashamed. She knows better, she said. People view compulsive hoarding as laziness or a lack of willpower.

"They say, 'You can get rid of stuff if you wanted to,' " she noted. "Easy to say, hard to do. The hoarder has to be in control of throwing things out, or at least give permission for someone else to do it."

Daughter Melissa Gummo, 23, feels frustration when she'd rather feel a bond.

The recent college graduate moved back home temporarily but can't have friends over because she's embarrassed. She eats out or from the freezer's lot of microwaveable meals "because the kitchen's a mess," she said. Years of environmental dysfunction have left her feeling unprepared for the future.

Even away at college, she felt socially impaired, she said.

"I'd never learned how to entertain in my own place," she said.

Melissa doesn't accept her mother's claim that hoarding is a disorder. She believes it's a choice.

"I think it's something that's all in (her) head, because everybody can have OCD tendencies" and not everyone hoards, she said.



Understanding the hoarder

"It's all in the head" is a common misconception by observers, said Lisa Zocco, a Norfolk-based licensed clinical psychologist who specializes in treating people with anxiety disorders and OCD, many of whom also hoard.

"People don't realize how disabling (hoarding) can be," Zocco said. "It's not a willpower issue. It's not about just throwing out the items; there's a whole way of thinking and behaving associated with how things are discarded."

Hoarding is considered a medical disorder, Zocco said, and is most often accompanied by medical and/or mental issues, including physical illness or disability, anxiety disorders, depression, brain injury or dementia.

People who hoard "tend to have difficulty processing information or making decisions, and many are lonely and socially isolated," she said. Some don't see it as a problem. Studies suggest a familial, or maybe genetic, component, as well.

Kit Anderson, a certified professional organizer in chronic disorganization and president of the National Study Group on Chronic Disorganization, a nonprofit organization, coined the term "overwhelm paralysis" to describe the shift to compulsive hoarding.

"They finally get to the point where the brain says, 'I'm not going there,' " she said. "There's a real paralysis that sets in, and it's very, very real - and it becomes impossible."

The study group examines "why people are disorganized and what special techniques and approaches are needed for them to be successful," Anderson said. It provides training and certification, based on the latest research by leading authorities, to professional organizers.

The group defines compulsive hoarding according to three characteristics outlined by experts Randy O. Frost and Tamara Hartl, Ph.D., "The accumulation and failure to discard a large number of possessions that appear to most people to be useless or of limited value; extensive clutter in living spaces that precludes activities for which the rooms were designed; and significant distress or impairment in functioning caused by the hoarding."

A free "hoarding scale," available at www.nsgcd.org, can help people determine the difference between common clutter/collecting and hoarding, and how problematic the behavior might be.

Gummo hoards the most commonly saved items: papers, clothing, boxes and bags. She does not save kitchen and bathroom trash or old food, and she does wash her dishes and clothes.

"I don't think I'd ever become a far out, full-fledged hoarder, because I know too much about the condition," she said.

Help and hope

Early warning signs of compulsive hoarding may include compulsive acquiring that impedes into or affects daily functioning, excessive storage in outside units or even digital medium, difficulty throwing out things that others wouldn't keep, avoidance and financial difficulties.

Hoarding can begin with simple procrastination or attention deficit disorder, said Nancy Watson of Virginia Beach, a certified professional organizer in chronic disorganization and founder of Harmony at Home Organizing.

In its early stages hoarding can often be managed with the assistance of a professional organizer trained in chronic disorganization. More serious cases, marked by potential health and safety hazards, often require medical- and mental-health assessment and treatment by a mental-health professional, Watson said.

Hazards can include the presence of pests, unsanitary conditions, blocked passageways, unusable appliances and home systems, structural overburden and fire-safety violations.

Cognitive behavioral therapy and exposure and response prevention - the gradual exposure to the anxiety-provoking condition and support in resisting the usual response - are the recommended treatment approaches, Zocco said. Medication can alleviate some of the related distress.

But a client must be willing to accept help, Watson said. Family members shouldn't overstep boundaries by clearing out the home or criticizing.

"It's a very sensitive issue, because the hoarding has to do with an inappropriate relationship with stuff," she said. "They don't trust people, so they invest and engage with stuff because it's 'safe.' "

The hoarder's boundaries, pace and "rules" must be respected within an established, trust-based rapport, she cautioned.

"It's an ongoing process," added Mary Frances Ballard of Orderly Places, a Newport News-based professional organizer with National Study Group on Chronic Disorganization training. "It takes time to establish that rapport and to train them in the process of letting go and what to keep and how to keep it.

"It's most helpful when they let it go and know that it's going to a higher use," Ballard explained.

Keys to success for hoarders include motivation, the assistance of experienced professionals and "love, support and understanding from loved ones," Zocco said.

Gummo said she feels good about recent achievements: letting go of her 45-year-old sweater, cleaning out a closet and raking leaves outside. She's learned to make short, manageable to-do lists, to praise herself for progress and to avoid some predictable pitfalls.

She has cancelled all magazine subscriptions. If she goes away she has undelivered newspapers credited to her account rather than held for her return.

But it's a daily struggle.

"I know I'm not alone in this, yet I feel like I'm alone," Gummo said. "I don't want to be criticized, I want to be understood. I want to overcome this."