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

Perhaps you were raised in a household with a chronically and deeply inculcated ethic of self-effacement. Perhaps people quoted to you that vexing line of scripture, Proverbs 16:18: “Pride goeth before destruction, and an haughty spirit before a fall.” Maybe that was a gendered experience, in which girls and women were raised to people-please, as if their maternal function were the only legitimate contribution they could make to the world. Or maybe it was a message for men and boys, that male people must be regarded as toxic opportunistic jerks, until and unless they establish their own goodness through people-pleasing.   

It’s true that people-pleasing and self-effacement are much better than the opposite extreme—where narcissists act as if the world owed them everything they could ever want, going through life exploiting others by deception, cheating, and entitlement. But there is a vast, wholesome, fertile middle-ground between these extremes.  

The culture of masochistic self-effacement—particularly common in the American Midwest, but not rare elsewhere—involves an extremely important error about human nature. When you withdraw into yourself like a turtle in its shell, giving up your claim to social space, resources, and dignity, other people in general do not actually benefit. Unprincipled characters may avail themselves of your services without reciprocating; such opportunists do not generally deserve what you’re giving them. Warmer folks might welcome your generosity and actually repay you in kind, but this is actual mutual goodness—not people-pleasing. Those who have the self-confidence to meet their own needs are going to do so with or without your self-sacrifice. And those who lack that confidence may be cowed by your example and feel shamed into emulating it (especially if you are their parent).  

Here are a few analogies, since the same principle applies in many other domains. Watching an anxious, apologetic musician perform is exhausting, whereas watching a confident and relaxed performer is energizing. When a singer is tense, tentative, inhibited, and nervous, the audience is drained by the performance and waits for it to end. When the singer is calm, expansive, centered, and open, the voice fills the whole space; the improvisation is playful and fluid; and the audience is captivated in delight.

Sociality tends to work the same way. The other people around you will benefit more from your loving self-acceptance than from your self-loathing. They are more likely to flourish if you flourish, than if you sulk, stagnate, or persecute yourself.  It is not anti-social to love yourself. It is pro-social to love yourself.  

As a brilliant Chinese political philosopher, Jiwei Ci,  once observed: “In a world of perfect altruists [who only promote their neighbors’ interests, not their own], no one has any interests for his neighbor to promote.”  

This same principle also applies to dating, where there are two major ways of being beautiful. One way is to absorb the standards of beauty that are tendered to you by the media and by your peers, and shape yourself to match those ideals as closely as possible. Some people will stop at nothing in pursuit of such external notions of aesthetic self-presentation, even at great personal expense, not all of it financial. Some will even inject their own faces with botulism toxin (“Botox”)—often at such youthful ages that there are not yet any wrinkles for the procedure to erase. The price is bigger than it seems, since the deactivation of facial muscles can make the human countenance less expressive, with serious possible consequences for emotional intimacy. Other forms of body modification have their risks, too. Fasting can have health benefits, or spiritual aspects, but starving oneself in pursuit of weight loss can constitute dangerous (even fatal) disordered eating. Working out in the gym can be a great enhancer of physical and emotional health, a rewarding and challenging part of self-care, and a venue for camaraderie. But it can also be the site of an “adonis complex,” where people toil for a missing self-respect that they associate with a highly muscular physique (this is a struggle often met with in some forms of Gay men’s culture).  

Most people benefit from some moderate degree of participation in shared ideals of attractiveness, maintaining their appearance as part of the pleasure of self-care—without overdoing it, or falling prey to excessive anxiety about how they look. At that point, the other approach to beauty takes over: sheer genuine confidence. So long as I have met this basic standard of self-care, my confidence that I am beautiful—even if my beauty is unconventional—has a benign influence on the way other people perceive me. Whatever my age, gender, sexual orientation, or social position might be, my comfort within my own skin, my genuine belief that, odd or not, I am cute as hell—is itself part of the way observers see me. The visual dimension of my self-image is part of my charisma; it is self-fulfilling.  

I’ve discussed musical performance and physical attractiveness as examples of the broader issue I raised at the beginning: my belief in myself is better for me—and for others—than my self-doubt. Put another way, other people will benefit more from my achievement of loving self-acceptance than they will from my continued self-denial and people-pleasing.

This applies to many more arenas than the few I’ve discussed here. For example, one of the best books I’ve read on sex is Male Sexuality: Why Women Don’t Understand It and Men Don’t Either, by psychoanalyst Michael Bader. He spells out the way that sex between men and women can go poorly if both people are entirely focused on the other person’s pleasure. Of course, it can also go poorly if they’re exclusively concerned with their own pleasure, but that problem is much more obvious, and much easier to discuss. Some generous attention to the other person is, of course, important, since sexual giving is both gratifying in its own right, and ethically salient—but so is some degree of embodied raw desire for stimulating experience of one’s own, without distraction, judgment, guilt, or ambivalence. When you share what’s yours, you’re sharing what’s yours.

As is said on every airline flight, and metaphorically repeated in myriad therapy sessions: put on your own oxygen mask first, because that’s the necessary preparation that makes it possible to help anyone else. If you do not start off by loving yourself (and it’s never too late for that), but instead regard yourself as a despicable sinner who must find ways to prove his or her own decency, then how do I know whether your kindness to me is a genuine gift, or just another impersonal effort to demonstrate that you’re a worthy human being? We generally prefer to receive kindness from people whose motive is not to escape hell (in this world or the next), nor to win entry into post-mortem paradise. We prefer to receive kindness as an authentic expression of somebody’s good nature, or, if we know each other well, as a communication about their feelings for us—not as a mere byproduct of their own secret wrestling match with a tyrannical conscience. Love yourself, and your love for others will mean more to them, not less.

Two thousand years ago, the great Rabbi Hillel said this unforgotten thing: “If I am not for myself, who will be for me? If I am only for myself, what am I? And if not now, when?”

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

Preoccupied with freedom, we can miss out on the full possession of whatever it is we have already chosen, or might choose now.

Keeping open as many future choices as possible is a great way to wind up with nothing.

Married men can cheat themselves out of a lot of wellbeing and self-respect by over-associating masculinity with novel erotic adventure, with an unrevised ideal of “fun,” with youth and its open horizon. It makes them underestimate how much wellbeing and self-respect can be had by freely choosing to love the person they have already chosen. Resentment blocks this process, so it’s an important early step in therapy to check for resentment. If there isn’t much of it there to obstruct the flow of feelings, then the man may be relatively free to make a new use of his freedom: namely, choosing afresh the same person he chose in the past, but this time making the choice as the more mature fellow he has become in the meantime. Suppose I first made the commitment when I was 27, and now I’m 41. My forty-one year old self has (and needs, and deserves) his own chance to make the choice on his own terms, for current reasons: to stay or to go.

Why stay? The fact that you promised to stay should be one reason, but it can’t be the only reason, or the promise is a prison. It is your exercise of your own liberty that liberates you, but it’s a common mistake to suppose that only a break-up would be an exercise of free will, an action, a difference-making choice. There are at least two other choices. One is to stagnate, to resent and to sulk, to withhold affection and sex and boycott the marriage without changing or ending it: choosing not to choose. Such a marriage is kept just-good-enough to be tolerable, but no better and no worse. The third choice is to opt for renewal and flourishing, despite uncertainty about just how best to go about it, and just what you can reasonably hope for by trying.

The goal is to open your heart. There is a better life waiting, though from where you now stand it may be invisible to you. Inside an attempt at an enduring monogamous commitment, a couple builds a small relational micro-culture in their home, that defines the norms of what they can expect from each other. How much verbal affection? How much sex? How much gift-giving, and on what occasions? Is it ok to yell? To use demeaning language, and call it “just a joke”? How much emotional safety is it reasonable to require? How much information about plans and spending and schedules is supposed to be shared in advance, to make the other feel included and facilitate collaborative problem-solving? How much of my time and attention should I expect to share with this person, and is it acceptable for one or both of us to be staring into a cell phone during that time?

The answers to all of those questions can be changed, but it takes deliberate effort. The ends will illuminate the means for achieving them. To find out what you need to do to improve things, envision the kind of relationship you actually want—the one that’s good enough that you could freely decide to stick with it despite your spouse’s limitations, and yours. Some of those aren’t going to change, but what might well change is how much that stuff actually matters to you. If she really can’t sing, she might sing anyway, but not well. If your husband has poor proprioception so that he never knows where his elbows and knees are, that’s unlikely to go away. Rarely does a person start to move like a gazelle who never resembled one before. People can learn to manage their A.D.D., but some of it may be intractable, and the chronically late person might never be consistently on time.

But what empowers us to look past those foibles is the much larger, more important open field of shared loving trust, joy, kindness, humor, help, reminiscence, learning, encouragement, celebration, and sex. Besides all those good things, the experience of shared suffering—getting through difficulty together—is a big contributor to bonded intimacy. And compared with the sum of these, a few human faults might not amount to much. I was going to add, “the signal-to-noise ratio is what matters,” but that metaphor won’t do, because exercising your freedom to improve your marriage doesn’t just make the music of love more clearly audible, it also makes it better music.

All of this assumes that becoming more invested and relationally ambitious is going to be appreciated and, at least somewhat, matched. If it’s not, and you’ve spent the past six months being more thoughtful than before, more firmly-but-gently assertive, more decisive-but-cooperative, more affectionate, more vulnerable, and more present—but your wife or husband has not changed at all, nor acknowledged it, nor made some similar changes to validate and reinforce yours, then you have to consider new options. Couple’s therapy can be a way to figure out how to stay together, or whether to stay together, or how to break up. It can be used to improve a good marriage or a bad one. It can also be a way of finding out whether the thing can be saved or not; if not, you can leave with the confidence that you tried your best. Or it can be a venue for discovering in greater detail just how to go about consistently making each other happier, perhaps even happier than you had thought possible.

With or without the help of a therapist, people in committed relationships who find themselves preoccupied with freedom will benefit from remembering that freedom is useless unless you make use of it. That can be done in ways that are immediately easy to observe, but some of the most consequential and wise uses of freedom are inward shifts that can bring to bloom enormous changes in due course. Among the best of these is the free decision to open the faucet in your chest from which love can flow when you dare to allow it.

For those whose marriages are dormant but good enough, and potentially very good indeed, it’s well to take a leaf from Homer’s Odyssey and reflect: you may find yourself sometimes fantasizing about Circe and Calypso, and that’s fine. But Penelope is the truth.

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.

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.