What’s “hoarding”? Well, the DSM-V includes hoarding in its section on obsessive compulsive disorders. There’s OCD, which is a pattern of behavior and inner experience, and there’s OCPD (Obsessive-Compulsive Personality Disorder), which includes that pattern, but also extends to deep-seated and pervasive concerns with order, regularity, and tight control. You exert unnecessary and excessive control over variables you can actually affect, like neatness or punctuality, but your opportunities to do so are often subject to other variables beyond your reach, like the weather, traffic, or other people’s actions. This brings plenty of episodes of frustration, when highly charged efforts at maintaining order get interfered with by unpleasant surprises from outside. The irony is that someone suffering from OCD or OCPD is exercising what can look like a heightened personal mastery over their immediate environment, but it’s actually a type of helplessness: they cannot control their relentless need for control.  

OCD tends to start in childhood, but like most personality disorders, OCPD usually (not always) shows up a bit later, in adolescence or early adulthood. Hoarders typically don’t have OCPD. They don’t care much about order; their environments tend to be chaotic, and they often hold onto broken or incomplete items without repairing or maintaining what they insist might someday come in handy. Their problem is classified next to OCD because it’s a maladaptive behavior pattern they can’t regulate, with a thinking style that’s distorted to legitimize it. Of course, this fits addiction, too (so does disordered eating), and compulsivity is part of addiction—especially behavioral addictions that aren’t drug use, like shopping, sex, or gambling. Psychological diagnosis and “nosology” (the part of our science that divides human troubles into discreet categories) are not entirely scientific, and plenty of books (here’s a favorite) rightly criticize the Diagnostic and Statistical Manual of Mental Disorders for the limitations of its ever-changing categories (a more nuanced and humane approach has produced the Psychodynamic Diagnostic Manual, or PDM, by Vittorio Lingiardi and Nancy McWilliams). We do need some way of talking about what ails people; imprecision is inevitable; and imprecise terms are far better than none.  

Like many ailments, hoarding occurs on a spectrum of severity. It can be a light nuisance, a serious problem that impinges on one’s life-possibilities, or a severe mental affliction with potentially dire implications for physical health. Like some other conditions, it’s a distorted version of some natural and necessary mental functions. In the deeply ancient world, long before civilization, people generally kept almost nothing, or only what they could carry. When the Paleolithic (“Old Stone Age”) became the Neolithic (“New Stone Age”), the first settlements were established where people lived for an entire season, or even year-round, storing food and artifacts. Evolutionary psychology of this sort can easily jump to mistaken conclusions, but it seems likely that somewhere along the line it became adaptive to try and hang onto stuff that might be useful later on. A temperament that disposed people to a more retentive attitude became partly heritable—despite the fact that it could also cause trouble, like plenty of other genetic traits. Even if OCD were entirely DNA-based, which it isn’t, activating it would still require a releasement mechanism in the form of a lived experience. Such mechanisms are usually traumas of one kind or another, having to do with some kind of scarcity: food insecurity, inadequate love and affection, episodes of being robbed or cheated—all these can make someone err “on the safe side” by keeping too much stuff.  

Obsessions are a cognitive thing, with affective (i.e., emotional) dimensions, manifest as intrusive repetitive thoughts, preoccupation with certain themes or figures, or recurring words that take up too much mental space for no good reason. Compulsions are behavioral; often they’re involuntary rituals, involving repetitive counting, arranging objects in spatial patterns, or “checking” again and again that one really did lock the door or turn off the stove, far beyond the point where you’ve already secured that important information. There’s usually some misery in it, along with efforts to conceal the problem. Hoarders rarely have people over to visit, because shame is usually involved—unless the person is oblivious to other people’s judgments, or to their own disorder, two features of more severe presentations. If you suspect you may be hoarding, it’s likely a good thing that you’ve got the perspicacity to be concerned.  

It’s a lot easier to deal with hoarding when it’s got other meanings to it besides the traumatic, maladaptive ones. If you’re a collector—of art, musical instruments, rare handmade tools, antiquities, autographs—you may manage to sublimate the underlying anxiety into a life-enhancing fascination with some aspect of culture that speaks to you. A “philatelist” collects stamps, a “numismatist,” coins. Book collectors may be captive to their enormous holdings, and being only human, they don’t have the necessary centuries to read every book they own—but come on, it’s the cumulative wisdom of the world on those shelves, not, say, a hundred pairs of shoes (ok, I’m a bit of a bibliomaniac myself). Then again, hearing a balanced, articulate shoe collector hold forth about his or her favorite specimens might be interesting enough to earn a guest’s instant respect. There’s something cool about a passion that builds expertise and a refined capacity to appreciate the larger meaning, history, and design of what appeals to you, however esoteric it might be. But there are limits. 

When there’s no unifying theme to the possessions, when they’re not in good shape, when their owner can’t find anything, and the space is cluttered to the point that the room is hard to cross without knocking things over, when dust is a major issue, when acquiring and retaining things has crowded-out self care, sociality, and financial prudence—and above all, when there is no joy in having all this stuff, well, that’s obsessive-compulsive hoarding disorder.  

Aristotle recommended “the golden mean,” the sweet spot between the extremes: “nothing in excess.” It may seem odd that people who endure opposite insults like “neat freak” and “slob” will find their problems listed on the same pages, but remember the horseshoe metaphor? The extremes have more in common with each other, than with the center. Dante put the Spendthrifts and the Misers in the same circle of the Inferno, where they taunted each other forever, shouting “Why hoard?” and “Why squander?” That’s also the soundtrack of the hoarding experience whenever it’s time to try and escape it: the first question is your exasperation at all the junk you’re living with, but as soon as you pick up any single item of it and try to throw it away, the second question kicks in.  

Let’s linger on that a moment. You’ve just picked up one of your hoarded objects… an extra audio speaker, a bundle of obsolete cords, a chipped tureen, the wrong-sized pair of old new shoes you never got around to listing on eBay. You’re holding it in your hands. The pleasure of keeping it is only a very brief moment of relief at not having to part with it. But the pleasure of removing it lasts, because you keep noticing the cleared space you freed-up by releasing it. Suppose you hang onto a belt sander for eight years because you might have a carpentry project one day. Then you get fed up, or you’re given an ultimatum by a lover or a landlord, and finally manage to fetch $40 for it on Craigslist. A week later, your favorite aunt Facetimes you out of the blue, about the wooden stairs at her place—how they keep giving her splinters, and they need “a coat of varnish or something.” Waves of self-reproach come flooding in from your inner tyrant: How could I let myself give up that sanding machine, after keeping it for eight years! Now I need it! I knew this would happen. The people who urged me to get rid of it were wrong! Now I’ll have to spend a hundred dollars to buy another one! 

Persuasive as that mighty voice may seem, it doesn’t know the whole truth. And the part it does know, isn’t helping you. Sure, you could buy a new sander, but you’ve just learned that the need for this tool arises about once per decade. And for under $40 per day, you could rent one and be rid of it when the job is finished. Look around the living room, the garage, the storage unit. Of all the objects you see, what percentage of them have suddenly come in handy the way the belt sander just did? Wrapping paper will get reactivated on holidays, and candles are a good hedge for a possible blackout. But the extra speakers, the orphaned USB cables, the chipped tureen? Almost no foreseeable scenario will turn their lost importance back on again, and what you see when you look at them is stagnation, anxiety, and reluctance to govern your own affairs without excessive fear of being caught without a tureen, just in case a soccer team drops by with five gallons of soup in a bucket. Giving up that belt sander was a victory. It turned out you could’ve saved some money by keeping it, after all. But there would have been value in getting rid of it years ago, to enjoy the freedom of choice, and the decluttered living space, its absence would afford you.  There are hidden costs to hanging onto things you don’t need now, even if there’s a chance (and there’s always a chance) you might need them in the future.

Suppose you do throw out some usable item, and some years go by. Then the phone call comes, announcing a sudden occasion to make use of what you sold, or gave away, or threw out so long ago. Suppose there’s no option to rent a new one, and no cheap replacement waiting for you on some website or a thrift shop. If you want to do the project, you’ve got to spend $50 that you could’ve kept if you’d only continued hoarding the thing. Well, consider the $50 a small fee you pay for those years of being unencumbered by the thing.  

We know some of the neural correlates of Hoarding Disorder, and there are medications that can be useful components of treatment. While there’s currently no 100% effective psychopharma for it, HD often occurs with depression, so any successful treatment for that mood issue can alleviate HD, sometimes significantly.  

If you believe you may have a milder degree of trouble with hoarding, it may help to watch some of the documentaries and reality TV shows that have been made about cases much worse than what you’re contending with. That can make unpleasant viewing, but it can jolt you into firmer resolve to make some changes.  

An excellent psychodynamic treatment approach for OCD in general is George Weinberg’s book, Invisible Masters.  

Some cultural resources that may help anybody who needs them include Swedish “death cleaning,” which builds on the truism that “you can’t take it with you,” and Japanese housekeeping, which emphasizes an elegant minimalism.  

If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Licensed in NY, NJ, TX, and CA. www.drjameyhecht.com

Patients sometimes say things like this: “If psychotherapy is largely a process of cultivating self-love, where is it supposed to come from? I don’t feel like I love myself. I can hardly stand myself. Where do I begin?”

Well, anyone who is alive to ask this question has survived, because at some point in the critical period of their infancy they, too, were loved. And babies love their caregivers, because love works as a circuit, a between-ness, like the glue between two surfaces. The love feels good because it works: my caregiver is loving me and I’m receiving it, and when I love her back, I experience my own goodness in the delight she takes in my smiles, my sounds, my touch, my presence.

My goodness is twofold, without any distinction being drawn: I am worthy of the Mother’s love, and my love for her is good. Therefore: I am good. I love myself. Trauma interferes with the benefits of that good foundational experience—but not completely, since you are still here, even though you’re also in pain. The task at hand is to reawaken those early, primitive good feelings and make them sustainable.

First, who do you love? It need not be a human person, but it must be a person in your eyes: a dog, a cat—a bear or an elephant if you know anyone who is an actual member of those species—or your nephew, grandmother, partner, friend—anybody you love. It could be a figure from religion or the arts, so long as admiration is not the main thing, but love. And if there is nobody in your life, bring to mind your feelings on seeing a baby or an elderly person, your spontaneous compassion for children in distress, even kids you don’t know.

If you can think of someone for whom you feel love, think of your feelings for this person. Feel the feelings. Notice that they arise naturally, without structure or measurement or transaction. Notice that they are not based on achievements, or talents, or cost/benefit calculations. As the philosopher Kant taught in the 18th Century, persons are ends in themselves, not means to an end. Adults love the baby because-the-baby.

An infant is too young to have accomplished anything cultural, and it’s too early to tell whether there are any significant talents present or not—thank goodness. That way, these extrinsic grounds for esteem can’t interfere with the fundamentally non-rational flow of love between caregivers and babies that is absolutely necessary for the survival of individuals, and of the species. As we therapists never tire of mentioning, babies tend to die if they aren’t loved-over-time by at least one individual caretaker, whatever other love, food, and shelter they do receive. If you’re still here, somebody loved you. That means you have some experience of the thing you’re looking for.

Thinking of a person you love brings up feelings of care, protectiveness, belonging, warmth, similarity, compassion, and esteem. You need to get yourself onto the list of beings who deserve this good stuff from you. Then you need to get yourself up to the top of that list. The fundamental reason to love yourself is because it is your right and role, your dharma, your vocation as a living organism on this planet. But if that currently feels too foreign and far-off, be motivated by altruism. Some depressed people only hate themselves, while others hate everybody; right now, I’m addressing the first group. Love yourself because the oxygen mask on your own face will keep you capable of giving oxygen to somebody else, instead of collapsing for lack of it.

After some time spent trying to love yourself so you can help other people, your motives may ripen and expand to include genuine, intrinsic self-love. Meantime, Nietzsche wrote, “The self-despiser nevertheless esteems himself—as a self-despiser.” In other words, if the only thing you can approve of about yourself is that you have sufficiently high standards by which to condemn yourself, well, those high standards are an esteemable form of investment in the Good, so start from there, and build out. Are you using the high standards as guides to improvement, or as a blunt instrument for self-punishment? If switching from punishment to guidance is hard, there is some internal cruelty in the mix, and you may currently be addicted to that cruelty.

Well, how would you feel and act if the person you love was being treated the way you treat yourself? You would intervene protectively; you would make emotional contact, to make sure the person was ok; and you would help your beloved to defend against attacks. Do that for yourself, as a matter of ordinary responsibility, like washing your hands after you use the bathroom, or like offering a glass of water to somebody who obviously needs it. Decency. If you can’t be kind to yourself, start with being polite to yourself, and work your way up to lovingkindness.

Elsewhere on this blog I’ve written about the inner exercise you can do to get better and stronger at self-love. It is an imaginal exercise, something you do with your imagination. What’s “imaginary” is a mental representation of something physical, compared to which the representation is relatively unreal—it is “merely imaginary.” But working to heal your inner child is itself a mental (both emotional and intellectual, both affective and cognitive) job. The problem, the solution, and the work of applying it are all psychic, not material. They all share the same form of realness, namely psychic reality. Inner actions are actions indeed, just as much as taking out the garbage, changing a tire, or dressing a flesh-wound is taking an action. A better analogy would be practicing with a musical instrument, because each session of practice—with all its frustrations and small glimmers of triumph—improves the prospects for progress the next time. Like therapy.

 If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Sessions are available in-office in Park Slope, Brooklyn, and remotely in NY, NJ, TX, and CA.

We were all born innocent and beautiful. Then we had a childhood, in which the people who raised us gave us some combination of three things: love (getting the good stuff), neglect (not getting the good stuff), and abuse (getting the bad stuff). When a kid gets neglect and/or abuse from a parent, the psychological process involved is something like this. The person who is supposed to take care of him with nurturance and protection is giving him pain instead. Why? Because the parent is a bad parent. He or she may be a good person, but too damaged by their own untreated trauma to provide good parenting.  If the child realizes this, he will be forced to see that his parent will never meet his needs for consistent nurturance and protection, since they aren’t capable of it. That’s despair, and no kid can tolerate that, because the younger you are, the more your very survival is at risk if your parent is bad. Babies can actually die from lack of love, even if they get all their physical needs met (food, cleanliness, protection from heat and cold, etc.). The name for that is marasmus, or “failure to thrive.” To avoid such life-threatening despair, the child uses the only available defense, despite the terrible price it will cost him. He keeps the parent good, by taking their badness into himself: he must be the bad one, so that the parent can still—in his mind—remain good.

This defense solves the terrifying problem of being stuck with a bad parent. But it does so at the expense of the child’s self-respect, and he grows up believing that he is bad to the core. After all, only a bad child would get bad treatment from a parent who was fair and just. If the parent is good, and yet she treats him badly, it must be because he himself is bad: he must deserve the bad treatment. Believing this, he grows up with a heart full of toxic shame. Guilt is pain about something you have done, but shame is pain about what you are. Some kids misbehave—lying, stealing, hurting themselves or others, abusing drugs, failing at school, having sex too early and unsafely—in order to verify that they are indeed the bad one. If they are going to get neglect and/or abuse no matter what they do, then doing bad things will at least mean that they really do deserve the pain they get, and that feels less unjust. This story accounts for the fact that, when troubled adolescents do get asked why they behave so badly, they often have no idea.

Such a kid typically hates her parents and appears to be in a battle with them. Her destructive behavior is seen as a means of revenge against the parents, and in a way, that’s just what it is. It can also be a protest against a deeply felt though poorly understood sense of having been wronged. It can also be an effort to attract the parent’s attention so that neglect will be replaced by punishment (since, unlike neglect, punishment at least requires the parent to acknowledge the kid’s existence). And in an environment of authoritarian bullying, parental commands backed by force, and unexplained rules, a kid may become destructive in order to preserve her integrity. I may be a bad person, he thinks, but at least I’m my own person.

Now that you’re an adult, the old defense has worn out its usefulness. It costs far more than it’s worth. When you hear the question—what’s wrong with me?—the answer is nothing, because it’s the wrong question. The right question is, What happened to me?

There are several reasons why being kind to yourself might feel terrifying (at first). It requires admitting that the good parents you yearned for are never coming, because here you are, doing for yourself what they should have done. It reminds you of what you should’ve gotten from the people who were supposed to nurture and protect you. The better you treat yourself, the greater the contrast between what you got and what you now realize you deserved. And if you grew up believing that kindness was weakness, that kind men were feminine, that kind people were naïve and lucky and full of shit, then you have to admit you were wrong.

Feelings of worthlessness/self-hate are messages from a wounded child part of you. Don’t buy into what he says. You know things he does not know. Turn toward him, and in your mind’s eye (your imagination), pick him up and dry those tears and speak to that kid with soothing words of love. Tell your inner lonely little child: I love you… I got you… we’re ok… come with me. Talking to parts of yourself that way is not crazy, it is a survival skill.

When you hear intrusive negative thoughts, use your mind/your intellect/your inner observer. Say, oh, look, part of my mind is attacking me right now… isn’t that interesting. Say to that inner attacker: Oh, you again. Yes, I know what you think. But I know something you don’t know. Say to that inner attacker, Yes, I know you think you’re making some kind of contribution, but aggression is not the kind of help I need right now. When you hear intrusive negative thoughts, connect them with what you know about your history. Oh! This is an echo of other people’s shit that got thrown at me in the past. I do not have to hang onto it.

Your inner attacker is an internalized parent, a copy of the one(s) who gave you some amount of neglect and/or abuse. Your parent(s) may have grown old and harmless by now, but those aged parents aren’t inside you. What is inside you is a figure made of the young, strong, crazy people they were when you were a kid. You can’t get rid of that inner bully or kill him/her off. S/he has a place at the table. But not the head of the table. The inner bully needs a seat in the car, but not the driver’s seat. Get that person into a passenger seat so you can steer your life.

When you start to love yourself, it will soon become clear that the love that you have inside—which is yours to give, when and where you want to—is very high-quality, and it’s going to get even more valuable as you grow. It’s the good stuff. It is worth a lot. You can be a source of the good stuff, giving as well as receiving. When you’re accustomed to feeling like a vacant cave of darkness, a black hole from which not even light can escape, it’s strange to think you might turn into a star that radiates light instead. But it happens.

For Further Reading:

The Drama of the Gifted Child, Alice Miller

The Forgiving Self, Robert Karen

Healing the Shame That Binds You, John Bradshaw

Radical Acceptance, Tara Brach

Slings and Arrows: Narcissistic Injury and Its Treatment, Jerome David Levin

If this post resonates with you, consider booking an appointment with me at 917-873-0292, or email Jamey@drjameyhecht.com. Sessions are available in-office in Park Slope, Brooklyn, and remotely in NY, NJ, TX, and CA.