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Stuff: Compulsive Hoarding and the Meaning of Things (original 2010; edition 2010)

by Randy O. Frost, Gail Steketee

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7325812,784 (3.85)77
Member:kaulsu
Title:Stuff: Compulsive Hoarding and the Meaning of Things
Authors:Randy O. Frost
Other authors:Gail Steketee
Info:Houghton Mifflin Harcourt (2010), Edition: 1, Hardcover, 304 pages
Collections:Your library
Rating:****1/2
Tags:OCD, hoarding, kindle, 2012

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Stuff : compulsive hoarding and the meaning of things by Randy O. Frost (2010)

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As an outside observer of a hoard, it can often be difficult to imagine what leads a person to believe trash is treasure. But of course it’s more complicated than someone just being unable to recognize trash. After all…one man’s trash is another man’s treasure. The authors attack this head-on by first giving a true definition to what counts as hoarding and then talking about various causes and possible presentations of the disorder. So what counts as hoarding? Basically, it counts as hoarding if the collection of items interferes with the person’s health or happiness or the health or happiness of others nearby. The complicated gray area of course is that the sufferer may not realize that the hoard is interfering with their happiness and health. That is the point of conflict for many loved ones of people who hoard.

After establishing and defining what hoarding disorder is and is not, the authors continue on to analyze the behavior and mind of someone suffering from hoarding. Fascinatingly, hoarding shares commonalities with many other mental illnesses, seeming to a certain extent to defy categorization, although the DSM 5 currently lists it among “Obsessive Compulsive and Related Disorders.” Are you shocked? Did you think that OCD always means cleanliness? The fact is that is often not what OCD means. It’s a misunderstanding spurred on by popular culture. OCD is an obsession. It can be with cleaning and germs but it can also be with anything. It also often features repetitive behaviors. If you think about it, you can see what hoarding has in common with this. People who hoard become obsessed with the idea of not losing something important, of collecting everything relevant to a certain idea, of not wasting things. They also can come to establish repetitive behaviors such as maybe always buying a newspaper from a certain store on the way home from work. Another similarity with OCD is that hoarders often are perfectionists. Part of why their homes become cluttered is they are obsessed with only doing a perfect job of cleaning up or of fixing something or using some item for a project, and they become paralyzed with the fear that they can’t do it good enough, so they never start.

The authors also talk about how hoarding has commonalities with Impulse-Control Disorders, such as gambling and compulsive buying. Similarly, many hoarders show symptoms of ADD. They often do much better cleaning up if there is simply someone there to help them maintain focus, rather than being easily distracted.

Hoarding is also often a result of trauma. People suffer a trauma and essentially attempt to build a protective space around themselves by hoarding. Many hoarders also report a childhood devoid of warmth and support, so even if they were not traumatized, it is still likely that they had a cold, distant childhood. In contrast to PTSD, the majority of hoarders (nearly 60%) meet the criteria for major depression, and it is posited that this depression could be in response to the hoarding itself.

The authors then talk about what may be going on in the heads of people who hoard. People don’t do things completely irrationally. There are reasons for it. There are multiple possibilities for hoarding of what may be going on. No single aspect has been determined yet. Essentially, though, hoarders are often people who are perfectionists who tend to perform rituals and struggle with impulse control. They may compulsively shop and/or gamble in addition to hoarding. They often had cold, distant childhoods and/or suffered a trauma (or traumas). They tend to come at life from a basis of fear and feel safer in tight, closed spaces, and their fear is heightened by removal of things, rather than appearance of new things. At some point, they started avoiding distress, and this distress avoidance became a self-fulfilling cycle. They also frequently struggle with knowing who they are internally, rather looking outward to possessions for identity signals. In addition to these compulsions and fears, hoarders also often see things differently or in more detail than non-hoarders, and they also struggle to focus or concentrate, making cleaning up even more difficult for them.

The authors conclude by discussing both how to treat hoarding and effects on family members and loved ones (as well as on communities). The authors stress repeatedly that forced clean-ups are the absolute worst possible solution or treatment option. A forced clean-up just fulfills the person’s fear that people are out to get them, and simply makes them cling on to their possessions even more aggressively. It also can make them more depressed. Since their identity is wrapped up in their possessions, getting rid of them by force can cause emotional trauma akin to someone chopping off your hair by force. I was stunned to learn that there have been cases of people who hoard committing suicide after a forced clean-up. The authors strongly advocate for the much slower, but with more long-term positive results, method of going through the hoard with the person slowly and basically teaching them new ways to think about both their possessions and their identity. They also state that it’s easier to treat compulsive buying and gambling than hoarding, so when possible treat that first to prevent the arrival of new items into the hoard. It is a long, difficult treatment plan to go through a hoard slowly, and sometimes it may be necessary to remove the person from the home for safety but then to return with them repeatedly to work on cleaning out the hoard.

So much of hoarding is stigmatized. To a certain extent this is understandable. It often isn’t seen by the public until it has reached a public health crisis level or in situations where animal hoarders are keeping their hoards in deplorable conditions. Often loved ones of those who hoard feel trapped and frustrated by the hoarding. They feel as if the loved one loves their stuff more than them. These are complex issues and professional help is required to address them. I honestly don’t think this is a situation that is easily handled one family at a time. A family member must be well-informed and patient and empathetic enough to wait through the long treatment process. Often that family member is the child of the hoarder and therefore a minor with no power, which makes the issue even more complex. This is definitely a situation in which public health education campaigns on things like early warning signs of hoarding tendencies and ways to seek help could be extremely helpful long-term. I do believe the authors could have taken things one step further at the end of the book to this connection to public health, rather than mostly focusing on individual therapy. They do mention less consumerism would be helpful, but that simply is not much of an observation. It is a small complaint, but I do feel that this interdisciplinary leap is important.

Overall, this was a fascinating, enlightening book. The authors have conducted extensive scientific research for years, and they do an awesome job of writing this information at the consumer level, as well as humanizing it by bringing in real cases with clients who they render in a three-dimensional fashion. I know I for one will never be able to stomach watching forced clean-ups on the tv show “Hoarders” again. Recommended to really everyone. Anyone could potentially know someone who struggles with hoarding, whether now or in the future, and the book is very readable.

Check out my full review, featuring quotes and more in-depth discussion. (Link will be live February 24, 2016). ( )
  gaialover | Feb 18, 2016 |
As an accumulator of books, I sometimes wonder where one draws the line between clutter and hoarding. This book was informative and thought-provoking. The authors specialize in researching and treating hoarding and obsessive-compulsive disorders, so are very knowledgable about the subject. The first few chapters look at why people acquire stuff, why they become attached to it, and why they can't get rid of it. The ownership themes of utility, security, and sense of self are explored. Then there are chapters on animal hoarding (cat ladies), garbage hoarding and public health services, genetics, children of hoarders, and children who hoard. The last chapter provides resources for people who need help. Each chapter focuses on different case studies. One of my favourite things about the authors is that they present the people in the case studies with great respect, never belittling or judging them. The reader is able to build empathy with the subjects.

The one limitation that I see to their research is that their subjects are mostly self-identified hoarders, who have some awareness that their situation is unusual. This means that most of their conclusions are drawn from a particular subset of hoarders, who tend to be quite intelligent and articulate. That limitation is understandable, given that you can't study people who don't come forward.

Personally, I found the book reassuring. My acquisition and possession behaviours don't approach hoarding behaviour. I may buy a lot of books, but I also get rid of a lot. If I ever do slip over the edge into hoarding, following some trauma or change in my brain's chemical balance (and it probably wouldn't take much), I'm pretty sure I would be an information hoarder. The type with newspapers, magazines, and books, books, books piled from floor to ceiling all over the house. I would have a strong fear of losing knowledge.

I liked this book a lot, but will try to resist the temptation to buy my own copy—that would be too ironic. I recommend it to anyone who has a connection to a hoarder, who wonders if their own collections are getting out of control, or who enjoys Oliver Sacks-style medical narratives.

Now I'll go and get rid of a bunch of my nonfiction books. ( )
  SylviaC | Jan 3, 2016 |
This was a fascinating description of hoarding from one of the few psychologists studying the phenomenon in depth. I'm a little uncomfortable with pathologizing some of these behaviors, and I'm not sure how culturally-bound some of this stuff is, but this book gave me a lot to think about and has definitely helped me reconsider my relationship to my stuff. ( )
  jen.e.moore | Dec 15, 2015 |
Fascinating study of several hoarders, some of whom are trying to dig out from under their clutter. Gave me a bit of empathy for my spouse, and made me grateful that he only hoards in the garage and the shed instead of the whole house. ( )
  kivarson | Nov 12, 2015 |
When you think "hoarding," often it's one definition that floats into your mind. Stuff pushes that stereotype and examples many different levels and types of hoarding and equally as many reasons for the behavior. The author attaches a personal story, a real person, to each type/reason for hoarding. The author focuses less on the therapies or assistance available for people in such conditions. ( )
  Sovranty | Nov 5, 2015 |
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Author nameRoleType of authorWork?Status
Frost, Randy O.primary authorall editionsconfirmed
Steketee, Gailmain authorall editionsconfirmed
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On Friday morning, March 21, 1947, the police in Harlem received a call.
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Brain scan studies have added additional information about what is happening in the brains of people who hoard. ..In particular hoarders had lower metabolic rates in the anterior cingulate cortex, one region responsible for motivation, focused attention, error detection & decision making.
Objects in a hoard may appear to be without value to an observer, but someone with a hoarding problem would hardly describe them as worthless.
When hoarding causes distress or impairs one's ability to perform basic functions, it has crossed the line into pathology.
Little thought is given to the cost of keeping things or the benefit of getting rid of them.
Disorganization makes what would otherwise be a gift into a seriously problematic, dangerous, and sometimes deadly affliction.
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Book description
What possesses someone to save every scrap of paper thats ever come into his home? What compulsions drive a woman like Irene, whose hoarding cost her her marriage? Or Ralph, whose imagined uses for castoff items like leaky old buckets almost lost him his house?

Randy Frost and Gail Steketee were the first to study hoarding when they began their work a decade ago; they expected to find a few sufferers but ended up treating hundreds of patients and fielding thousands of calls from the families of others. Now they explore the compulsion through a series of compelling case studies in the vein of Oliver Sacks.

With vivid portraits that show us the traits by which you can identify a hoarder - piles on sofas and beds that make the furniture useless, houses that can be navigated only by following small paths called goat trails, vast piles of paper that the hoarders churn but never discard, even collections of animals and garbage - Frost and Steketee illuminate the pull that possessions exert on all of us.

Whether we're savers, collectors, or compulsive cleaners, very few of us are in fact free of the impulses that drive hoarders to the extremes in which they live. For all of us with complicated relationships to our things, Stuff answers the question of what happens when our stuff starts to own us.

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Amazon.com Amazon.com Review (ISBN 015101423X, Hardcover)

Product Description
What possesses someone to save every scrap of paper that's ever come into his home? What compulsions drive a woman like Irene, whose hoarding cost her her marriage? Or Ralph, whose imagined uses for castoff items like leaky old buckets almost lost him his house? Or Jerry and Alvin, wealthy twin bachelors who filled up matching luxury apartments with countless pieces of fine art, not even leaving themselves room to sleep?

Randy Frost and Gail Steketee were the first to study hoarding when they began their work a decade ago; they expected to find a few sufferers but ended up treating hundreds of patients and fielding thousands of calls from the families of others. Now they explore the compulsion through a series of compelling case studies in the vein of Oliver Sacks.With vivid portraits that show us the traits by which you can identify a hoarder--piles on sofas and beds that make the furniture useless, houses that can be navigated only by following small paths called goat trails, vast piles of paper that the hoarders "churn" but never discard, even collections of animals and garbage--Frost and Steketee explain the causes and outline the often ineffective treatments for the disorder.They also illuminate the pull that possessions exert on all of us. Whether we're savers, collectors, or compulsive cleaners, none of us is free of the impulses that drive hoarders to the extremes in which they live.

For the six million sufferers, their relatives and friends, and all the rest of us with complicated relationships to our things, Stuff answers the question of what happens when our stuff starts to own us.

A Q&A with Randy O. Frost and Gail Steketee, Authors of Stuff: Compulsive Hoarding and the Meaning of Things

Q: What is hoarding, and how does it differ from collecting?

A: Two behaviors characterize hoarding: acquiring too many possessions and difficulty in getting rid of them when they are no longer useful or needed. When these behaviors lead to the kind of clutter and disorganization that disrupts or threatens a person's health or safety, or they lead to significant distress, then hoarding becomes a disorder. Simply collecting or owning lots of things does not qualify as hoarding.

A major feature of hoarding is the large amount of disorganized clutter that creates chaos in the home. Rooms can no longer be used as they were intended, moving around the house is difficult, exits are blocked, and life inside the home becomes dysfunctional. Collectors typically keep their possessions well organized, and each item differs from other items to form an interesting and often valuable collection. Further, an important purpose of collecting is to display the special items so that others can appreciate them. People who hoard are seldom able to accomplish such goals.

Q: What kinds of things do hoarders typically save?

A: While it may appear that people who hoard save only trash or things of no real value, in fact most people who hoard save almost everything. Often this includes things that were purchased but never removed from their original wrappers. The most frequent items saved are clothes and newspapers. Other commonly hoarded items include containers, junk mail, books, and craft items.

Q: What factors contribute to the development of hoarding?

A: People who hoard often have deficits in the way they process information. For example, they are often highly distractible and show symptoms of attention deficit hyperactivity disorder. These symptoms make is difficult for them to concentrate on a task without being diverted by other things.

Most of us live our lives categorically. We put our possessions into categories and use those organizing systems to store and retrieve them easily. But categorization is difficult for people who hoard. Their lives seem to be organized visually and spatially. The electricity bill might go on the five-foot-high pile of papers in the living room, to keep it in sight as a reminder to pay the bill. Hoarders try to keep life organized by remembering where that bill is located. When they need to find it, they search their memory for the place it was last seen. Instead of relying on a system of categories, where one only has to remember where the entire group of objects is located, each object seems to have its own category. This makes finding things very difficult once a critical mass of possessions has been accumulated.

Q: Do all people who hoard save things for the same reason?

A: No, but there are some general themes. The most frequent motive for hoarding is to avoid wasting things that might have value. Often people who hoard believe that an object may still be usable or of interest or value to someone. Considering whether to discard it leads them to feel guilty about wasting it. "If I save it," reasons the hoarder, "I might not ever need it, but at least I am prepared in case I do."

The second most frequent motive for saving is a fear of losing important information. Many hoarders describe themselves as information junkies who save newspapers, magazines, brochures, and other information-laden papers. They keep stacks of newspapers and magazines so that when they have time, they will be able to read and digest all the useful information they imagine to be there. Each newspaper contains a wealth of opportunities, and discarding it means losing those opportunities. For such people, having the information near at hand seems crucial, whereas knowing that the information also exists on the Internet or in a library does little to help them get rid of their out-of-date papers. Hoarders are often intelligent and curious people for whom the physical presence of information is almost an addiction.

A third motive for saving is that the object has emotional meaning. This takes many forms, including the sentimental association of things with important persons, places, or events, something most people experience as well, just not to the same degree as hoarders. Another frequent form of emotional attachment concerns the incorporation of the item as part of the hoarder's identity--getting rid of it feels like losing part of one's self.

Finally, some people hoard because they appreciate the aesthetic appeal of objects, especially their shape, color, and texture. Many people who hoard describe themselves as artists or craftspeople who save things to further their art. In fact, many are very creative with their hands. Unfortunately, however, having too many supplies gets in the way of living, and the art projects never get done.

Q: Why can't people who hoard control their urges to acquire and save things?

A: Understanding this requires knowing what happens at the moment the person decides to acquire or save something. At the time of acquisition, people who hoard often experience a sort of high or euphoric sensation during which their thoughts center on how wonderful it would be to own the object in front of them. These thoughts are so pleasant that they dominate thinking, crowding out information that might curb the urge to acquire. For instance, hoarders may forget that they don't have the money or the room for the item, or that they already have three or four of the same item.

When faced with the prospect of discarding, hoarders have different thoughts from other people. All their thoughts center on what they will lose (for example, opportunity, information, identity) or how bad they will feel (distress, guilt), while none of the thoughts focus on the benefits of discarding. Saving the item, or putting off the decision, allows them to escape this unpleasant experience. In this way people become conditioned to hoard.

Q: How much truth is there to the common assumption that hoarding is a response to deprivation?

A: Although some people attribute their hoarding to having lived through a period of extreme deprivation, our research has failed to find a link between material deprivation early in life and later hoarding behavior. We do suspect there is a connection between hoarding and traumatic experiences, or chaotic or disruptive living situations, earlier in life.

Q: Hoarding has been considered to be a subtype of obsessive-compulsive disorder (OCD), but there are some crucial differences, aren’t there?

A: Yes. Only about 20 percent of people with hoarding problems report any significant OCD symptoms, like checking or cleaning rituals. There are other crucial differences. In OCD, obsessions are experienced as intrusive and unwanted, and the symptoms are always accompanied by distress. But in hoarding, owning things often produces pleasant feelings of safety and comfort, and acquiring can even produce euphoric feelings. In fact, the distress we see in hoarding comes from the byproduct of the acquiring and saving--the clutter--or from thinking about discarding things. There also appear to be differences in the brains of people with hoarding problems compared to those who suffer from OCD. For these reasons, many scientists who study hoarding have recommended that it be classified as a distinct disorder separate from OCD.

Q: Is it true that depression is a common affliction among hoarders?

A: In our research we find that over 50 percent of people with hoarding problems are clinically depressed. However, the depression does not seem to cause the hoarding, although it might be a result of hoarding, especially when the clutter interferes with people's ability to function and they feel embarrassed and ashamed.

(Randy O. Frost photo © Judith Roberge)
(Gail Steketee photo © Kalman Zabarsky, BU Photography)



Clutter Image Rating Photos used by Randy Frost and Gail Steketee, Authors of Stuff
(Click on images to enlarge and learn more)

In our work on hoarding, we've found that people have very different ideas about what it means to have a cluttered home. For some, a small pile of things in the corner of an otherwise well-ordered room constitutes serious clutter. For others, only when the narrow pathways make it hard to get through a room does the clutter register. To make sure we get an accurate sense of a clutter problem, we created a series of pictures of rooms in various stages of clutter--from completely clutter-free to very severely cluttered. People can just pick out the picture in each sequence that comes closest to the clutter in their own living room. This requires some degree of judgment because no two homes look exactly alike, and clutter can be higher in some parts of the room than in others. Still, this rating system works pretty well as a measure of clutter. In general, clutter that reaches the level of picture #4 or higher impinges enough on people's lives that we would encourage them to get help for their hoarding problem.
Randy Frost & Gail Steketee (photos © Oxford University Press)

1. No evidence of a hoarding problem. 2. Beginnings of a problem with clutter. A subclinical hoarding problem. 3. A mild hoarding problem if the room looks this way most of the time. 4. A moderate hoarding problem

5. A serious hoarding problem. 6. A very serious hoarding problem. 7. A severe hoarding problem with substantial impairment. 8. A very severe hoarding problem. 9. Extreme hoarding.

(retrieved from Amazon Thu, 12 Mar 2015 18:17:29 -0400)

(see all 3 descriptions)

With vivid portraits that show us the traits by which you can identify a hoarder, Frost and Steketee explain the causes and outline the often ineffective treatments for the disorder while illuminating the pull that possessions exert on all of us.

(summary from another edition)

» see all 2 descriptions

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