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

We often want to help people with their regrets, by telling them: “If you could have done any better, you would have. The reason you didn’t, is that you were constrained by your trauma background, your history.”

They reply that this is a slippery slope; that if they allow themselves the solace of explaining their bad choices by invoking their past history, they might recklessly let themselves off the hook for all kinds of error—laziness, impulsivity, greed—in the present and the future.

But it is not a slippery slope, so long as we locate the determinism in the past, where it belongs, and the freedom in the present, where we need it. Both the past and the present are constrained by the effects of the remote past I call my childhood. But the past of my young adulthood is already fixed, whereas the present is still relatively fluid, with room for choice and decision.

What is the precise extent of today’s freedom? How far can I hope to excel my previous performances? How free am I this morning, to do better than before? The only way to find out is to do the best I can now do, and learn about the flaws in today’s efforts only in hindsight, later on. Only tomorrow’s perspective will reveal the hidden limits of today’s freedom. I can best reach those limits—I can make optimal use of today’s undefined opportunities—by living as if I were entirely free of the constraints my origins impose on me. I am now 55. For my twenties, therefore, this process is now complete, so I’m now free to conclude that at 25 I indeed did the very best I could do—even though some of my choices that year were relatively disastrous. Had I been more free, I would have done better.

This is not a moral framework; the goal is to understand, not to excuse. Understanding will give me the breathing room to choose how to handle the moral dimension of my past conduct, prioritizing compassion over punishment, wisdom over bitterness, edification over regret.

Every child experiences some particular mixture of three things: getting the good stuff (love), not getting the good stuff (neglect), and getting the bad stuff (misuse, or worse: abuse). The particular mixture supplied by a particular childhood has consequences—exerts constraints on our freedom of thought and action—for the whole lifetime. But those constraints can loosen and fade with experience, especially with enough good experience. At no point am I ever in a position to assess exactly how much my early years are still shaping my current actions and perceptions right now.

So: today, I will do the best I can, as if I were no longer limited by the consequences of my origins. Tomorrow will show me why I got as far today as I did, achieving no more and no less than my level of maturation could permit. The psychotherapy that helps me understand the tragedies of my young adulthood also equips me to improve my future, not only because it helps me learn from experience, but because it explains why I suffered from the particular ignorance that I did.

Today’s ignorance will be tomorrow’s knowledge. As I contemplate the ways I fell short in the past, the more compassion I can muster for my youthful self, the less regret I must endure today. From present contemplation of my past mistakes, I must learn both prudence in dealing with the outside world, and mercy in dealing with myself.

Of course my history limits my choices. But exactly how much? I don’t know, and that’s a good thing. Our ignorance of the precise nature and extent of our constraints is part of our freedom. And just as a temperate optimism can enhance my odds of success in the world outside, my inner life will likely go better if I let myself assume I have achieved more growth and healing than I can readily prove. “With every mistake,” wrote the Beatles, “we must surely be learning.” In the absence of an impossible certainty, we are better off trusting in the human spirit’s innate powers of development.

One way to have that experience, to grasp for that faith, is to “see” your elderly future self kindly smiling down on you from the future. You might as well… look.

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.

If Winter comes, can Spring be far behind? – Shelley

Seasonal affective disorder (or S.A.D.), also known as the winter blues, affects “0.5 to 3 percent of individuals in the general population,” according to MedlinePlus. But it also “affects 10 to 20 percent of people with major depressive disorder, and about 25 percent of people with bipolar disorder.” So if you’re already suffering with a mood disorder, the shorter days and colder weather may be making it worse. There is, of course, a subtype of S.A.D. that’s less severe but more common. Things seem flat, cold, and remote, instead of enlivened and eventful.

From mid-February, it may feel like Spring is a long way off, regardless of what the Groundhog says. But Daylight Savings Time begins on March 12th this year, rain or shine, cold or mild. That’s less than a month away. Hang in there! And if you’re struggling with your mood, call for an appointment today, at 917-873-0292.

Whatever your age, you are also all the ages you’ve been before. Part of your psyche is an infant, because past selves remain as parts of an increasingly complex self-system. Younger parts of self, with unhealed wounds and unmet needs, can interfere with adult life, until they get the necessary loving care from the most adult parts of self.

Now, without an awareness that the self has parts, we are likely to feel crazy the moment our feelings do not agree with one another. I want to eat the cake, but I also want to be in a caloric deficit. I want to keep playing in the snow, but I also want to go inside and warm up. Knowing it's impossible to do both, I might well feel crazy whenever a pair of incompatible desires assails me. 

Unless, of course, I have an understanding of the self as a dynamic composite, in which case it all makes sense. A more ancient version of this same fact can be found in the distinction between monotheism, and the polytheism it replaced. If there are many Gods, as Plato pointed out in his Euthyphro, their desires can be in conflict with one another. But the God of a monotheist cannot do this, for lack of any opposing competitor. In the work of making sense of a dangerous world, each had its advantages. And it was Plato who first discovered (or at least, first mentioned) the inner child, in the Phaedo. But I digress. Let’s return to the self. 

Think of a moment when your behavior seemed to you to be immature for your age, or otherwise irrational--procrastination, for example. What tasks are you avoiding? Part of you wants to complete these tasks and enjoy the sense of accomplishment and relief that comes from a job well done --but part of you prefers to keep deferring the inevitable. When you catch yourself engaged in this pattern, perhaps you are harsh and punitive with yourself. Perhaps both the avoidance and the punishment feel somewhat alien—-as if you were not quite in charge of either of those inner and outer goings-on.

Where, then, do they come from? Whenever anything just doesn't fit with the present reality, we can ask ourselves what it might fit with from the past. The mind doesn't randomly generate errors, so much as it displaces significant, meaningful things from one context to another, where their meaning is far less evident. 

Perhaps the part of self who is responsible for procrastinating is an overwhelmed five or six year-old kid who is genuinely frightened of adult tasks, and concerned that completing them would result in abandonment. That is, if he shows he can take care of himself, nobody will ever take care of him again—so he procrastinates, instead. Or rather, he forces you to procrastinate. The purpose of his boycott is to make sure that he, the inner child, gets the loving attention he needs, as a matter of (what feels like) life and death.

Perhaps the part of self who is responsible for the punitive attack on the procrastinating, needy child is an embarrassed, rageful adolescent. The inner teenager is, after all, disgusted and repulsed by the frank, naive, primitive neediness of the defenseless child. The teenager’s whole existence is about escaping from childhood, parting company with it, and often marshaling a bitter contempt for it in order to bear the terror and loss of saying farewell to childhood forever. This explains the savagery of the “super-ego” when it punishes that lost little kid for the sin of imposing inconvenient delays on the whole (inner) family.

The inner adult, the most adult self, is the part who is best able to nurture, respect, protect, and educate all the younger parts of self whose difficult states of mind sometimes rise to the fore and feel intractable. Instead, your most mature self, the parts of your personality that are most intact and best developed, can be encouraged and equipped by psychotherapy to re-parent the rest yourself. Freud taught long ago that each of us is all the ages we have ever been. Like ancient Rome, the psyche is a many-layered thing, in which deeper levels from long ago persist beneath contemporary layers with more life and less history. Conversely, being young involves more strength and less wisdom, so that the middle-age we so long dreaded becomes a domain of awareness, rather than mere lost youth.