Clearing out the clutter in our heads

TIME OUT: Hoarding can be a sign of mental illness, writes MARIE MURRAY

TIME OUT:Hoarding can be a sign of mental illness, writes MARIE MURRAY

THE ROOM is rank. Faded newspapers block the doorway. Dirty cups clutter surfaces. There are containers of congealed contents. The bed is unmade.

The occupant of the room sits in a stained chair, wearing a collection of garments. The air is stale. The decay, dankness, the sealed windows and a person among the rubbish, apparently unperturbed by the surroundings, reveal another example of Diogenes syndrome, a condition of hoarding behaviours and serious self-neglect and isolation.

The problem with accumulating objects, hoarding them, being unable to discard anything and feeling threatened, anxious or even aggressive if others try to do so, is often associated with older age or with physical helplessness. It is more complex than that and may have its origins decades before it arrives in the extreme situation of enforced entry by neighbours, relations, friends or social services to intervene on behalf of the sufferer.

There are parents of some teenagers reading this who will protest that they know this condition. As they survey the daily detritus of teenagers’ rooms they have excellent evidence of early-onset Diogenes. They can confirm that accumulation of food, cups, clothes and general rubbish is not the province of the old but equally manifests itself in the young. They have experienced the anger at intrusion, resistance to assistance and the recalcitrant nature of the condition. Even when there are regular parental forays and clearouts, the space returns to comfortable chaos.

Nor, if truth be told, is excessive acquisitiveness confined to young and old. Reality TV has exploited the topic with voyeuristic quasi- psychological programmes where teams of cleaners enter people’s homes to declutter, clean and convert the mess into pristine minimalism. When tidiness becomes television fodder we must be in trouble, yet there is something oddly intriguing about participating in people’s private lives. It reassures those who are ordinarily untidy that their comparative condition is fine.

As we identify more and more psychological conditions, one may ask if we have not run amok with categorising every human behaviour and eccentricity along a continuum that makes them abnormal or pathological at every juncture.

After all, excessive cleanliness is equally regarded as pathological, and falls into anal-retentive or obsessive-compulsive categories. Can clutter seriously be a psychological condition? The answer is yes, when it gets out of control.

The problem with hoarding is that there is validity to keeping some objects because they are beautiful, have sentimental value or practical utility. Generations reared on “waste not, want not” and “saving for a rainy day” could not be expected to chuck everything out the moment that its usefulness was over. There was sensible retention of objects that might serve again.

But behind the rationale, there is a reality to Diogenes and general pathological acquisitiveness. They have been linked to distressing indecisiveness, to planning and organisation issues, to difficulties in categorising information and to forms of dementia and brain injury.

People who hoard may believe objects are more trustworthy than people, and fear neediness which may arise from early infant emotional or physical deprivation.

Also identified as relevant is loss of a parent or partner, loss of physical contact with people and the losses associated with institutional experience which makes individual ownership and possessions more important than they would otherwise be.

On a positive note, whatever the origin, extent or the entrenchment of hoarding, it can be resolved successfully therapeutically when underlying anxieties are addressed. It’s a mental spring clean that works.

Clinical psychologist Marie Murray's weekly radio slot, Mindtime, is on Drivetimewith Mary Wilson on Wednesdays on RTÉ Radio One