I get to play two games while I work: Jenga and Tetris. If you know the games, skip to the third paragraph down!
In the game Jenga, rectangular wooden blocks are placed three across with another set of three stacked on top of the first crosswise. Continuing this pattern, a tower is built that is 18 levels high. The challenge is to remove a block from the stack and place it on top without the tower falling. The trick is to touch the blocks slightly to find one that is not load bearing and can be removed without consequence.
In the electronic game Tetris, a patterned series of blocks fall from the top of the screen and must be placed by moving it right or left and rotating it in such a way that they form complete rows of blocks, which then disappear after every space on the row has been filled. When the screen is filled with uncompleted rows, the game ends.
I liken much of my work to these two games. Either we are trying to remove items from a “tower” and relocate them safely, or we are taking diverse items and trying to place them compactly into a defined space. Especially when working in a cluttered home, I remember and teach the basics of these games as we remove items from a pile without creating an avalanche and find a space to place it.
With a hoarded house in mind, I offer the following pointers about how to play Decluttering Jenga and Organizing Tetris.
When I began working in hoarded homes, my goal was to start from the top of a pile and work down to the floor or table or sofa beneath the accumulated things. However, two dynamics became obvious after doing this a few times: chronology and accessibility.
First, chronology: we’re dealing with cubic feet that have archaeological layers and the items on top are the things most frequently or recently used. When starting from the top of the stack and working our way down, the least used things become most accessible and the most used items hidden. We can’t always shift things to the side while we remove the less used items because there simply isn’t room. How do we maintain daily use of important items while removing the bulk of things which can be more easily considered for discarding?
I offer a few tips:
1. Plan the movement of items to safe and open spaces for discarding and saving. Allow at least 4 hours of uninterrupted time to:
a. set up tables and shelves for sorting,
b. remove and review items,
c. organize and return items to storage or usability.
Be prepared to remove discarded items at the end of that day. If possible, work outside, but otherwise, find stable places inside to work. For instance, an origami shelf can be unfolded in a tight space. Four shelves quadruple your surface space.
2. When possible, target large items for removal and work your way toward them. For instance, if there is an unused fitness machine, work a path toward it. When removed, you will have opened functional space. (Of course, you have potentially lost a clothing rack!!!) When you remove a sofa, you’ve hit the motherload!
Second, accessibility: we need to use all available space to increase movement. This means choosing function over aesthetics until a hoarded home is under control. For instance, the use of a big shelving unit allows more organization and containment than a smaller, more “homey” shelf. The bulkier shelf usually looks better than the current piles, and they make the space safer from avalanches. Another way to make space is to use the walls. Do you have pictures that you want to hang? Hang them now and you can get used to seeing them on a wall, even if not on the perfect wall. They are also protected from damage. Find your birth certificate or car title? Put it in a Ziploc bag and tack it on the wall.
Sometimes people can have both unusual amounts of things and increased safety in their space. For instance, imagine that you have an enormous, much-loved wardrobe of clothes, shoes and accessories, hanging across every doorway, draping across sofas, and filling half of your bed. At the same time, you have a spare bedroom that is partially filled with things of less importance. My recommendation is that you organize the entire room as a closet for clothes and accessories, including a portion for storage of other things. When things are accessible it becomes easier to make good decisions about long-term value. Take one full wall and turn it into the ultimate place for your clothes and accessories. Don’t think 12-inch-deep shelves either – think 20 inch– large enough to hold handbags or hats two deep. Use this stepladder to easily reach.
Discarding for change is challenging because of the nature of hoarding disorder. One trick to discarding for change is to get to the things that have been lost over time and have been functionally replaced with other things. This entails making our most used things easily and safely accessible, but moved so we can get to the items buried. Significantly, the first expectation of this excavation is to compare items for better decisions about discarding.
While moving and arranging things without the expectation of discarding, we gradually notice the relative difference between things and learn to ask multi-layered questions the deeper we go. By the time we get to the seventh hammer and we have put the first six together, it can seem absurd to keep seven. Discarding from the bottom of the stack doesn’t work well with gravity, but it does work with emotional and psychological thinking, well-being, and decision-making.
Hoarding disorder makes discarding tremendously difficult, but with conscious understanding, good therapy and a realistic game plan, life inside the house can steadily improve. Find emotional “Jenga” blocks that can be removed and watch things begin to fall into a “Tetris” row that disappears before your eyes!
All the best,
Susan Gardner is a Certified Professional Organizer in Chronic Disorganization, CPO-CD®, MDiv in Nashville, TN and owner of Clearing the Way Home.
One of the major reasons that hoarding disorder is one of the most complicated mental health issues to treat is that is a co-occurring disorder, which means that it is almost always (92% of the time, in fact) shows up alongside another mental health diagnosis- like major depressive disorder or generalized anxiety disorder. The idea of co-occurring disorders helps guide the way we think about the behavior of people who are affected by them. We understand that the symptoms of one psychiatric disorder are highly intertwined with symptoms of the other.
The term co-occurring disorder (or dual or comorbid disorder) is typically used in the field of substance abuse treatment, referring to the idea that people who abuse substances like alcohol or drugs are likely to be struggling with another diagnosable mental health condition as well. For instance, if someone is struggling with alcoholism that is co-occurring with generalized anxiety disorder, we may explain that some of the behavior of abusing alcohol may be exacerbated, or made worse, when life gets particularly stressful and anxiety increases. From there, the outcomes of excessive alcohol use can create additional stress in a person’s life, which can further increase anxiety, thus increasing alcohol use. It’s a slippery slope.
Things are similar with hoarding disorder. By applying an understanding of co-occurring disorders, we can start to make sense about why efforts to address the symptoms of hoarding (like difficulty parting with items or excessively acquiring things) seem so difficult for the person struggling with them. For instance, if a person has co-morbid diagnoses of hoarding disorder and major depressive disorder, that person may really struggle with motivation to work on discarding items or struggle with paying attention and decision-making about their possessions. While symptoms of hoarding disorder do include having a difficult time parting with items, they do not include a lack of motivation, inattentiveness, or indecision. However, all three of those are symptoms of depression. In this case, the person’s depressive symptoms are making the symptoms of hoarding disorder even more challenging to manage.
There are a lot of diagnoses that can co-occur with hoarding disorder- in fact, almost any of them can. The most common ones are mood disorders (like depressive or bi-polar disorders) or anxiety disorders. Obsessive compulsive disorder (OCD) is a common co-morbid condition, as is attention deficit hyperactivity disorder (ADHD). We also see a fair amount of other types of diagnoses alongside hoarding disorder, including post-traumatic stress disorder (PTSD) or other types of organic brain illnesses, like dementia or schizophrenia. When symptoms of any of these other types of mental health diagnoses show up, it can make managing symptoms associated with hoarding to be a very difficult task.
As mental health professionals, we can use strategies developed for other co-occurring disorders in our effort to support our clients. By prioritizing treatment interventions that help reduce the most significant symptoms first, we can then work more easily on addressing the direct symptoms related to hoarding. For instance, if a client has a diagnosis of an anxiety disorder and is actively experiencing panic attacks, it would benefit the clinician to first work with the client on improving emotional regulation skills and distress tolerance prior to focusing attention on decision-making and discarding items.
By recognizing hoarding disorder as a co-occurring condition, we can help better understand the challenges people who hoard face and work with them to develop more effective approaches to treatment.