With the advent of reality television series like "Hoarders" and "Hoarding: Buried Alive," public attention has become sharply focused on a form of compulsive behavior that can, if left untreated, jeopardize not only a person's livelihood and financial standing, but also their interpersonal relationships and even their health.
In the past, a house being taken over by clutter -- pile after pile of newspapers stretching up to the ceiling, stacks of books squeezed into every available nook and cranny, empty Cool Whip containers and jelly jars taking up most of the kitchen cupboard and counter space -- was often dismissed as lazy housekeeping or eccentricity.
More and more, however, compulsive hoarding is being recognized for what it is: a mental disorder that can become a serious illness if allowed to continue unchecked.
This past Thursday, a group of roughly 180 human services social workers, home health care and mental health professionals gathered in the conference center at Minnesota State Community & Technical College in Detroit Lakes to learn more about the disorder and its recommended methods of treatment.
Dr. Renae Reinardy, a nationally known clinician who specializes in treating compulsive hoarders, was the presenter for the full-day training session.
Reinardy has often appeared on the A & E television series "Hoarders," as well as on "Dateline NBC."
As Reinardy discussed on Thursday, the line between compulsive hoarding and collecting things as a hobby can often be a little blurred.
"What's the difference between collecting and hoarding? I don't know (where the line is)," Reinardy said.
But when it gets to the level where a person can't use their kitchen because there's no available counter space, or get into certain rooms of the house because their possessions are piled up to the ceiling -- then it's a problem, she added.
The familiar adage, "one man's junk is another man's treasure," can be taken to startling extremes with compulsive hoarders -- who are so averse to the idea of throwing anything away that they have even been known to save rotting food, feces (both animal and human) and other items most people would identify as garbage without a second thought.
The reasons for hoarding are complex, Reinardy said. It's a disorder that crosses barriers of gender, race and socioeconomic status -- in fact, many hoarders are highly intelligent, wealthy and successful in their careers.
It can start as a positive trait -- i.e., artists seeing the creative potential for making art out of discarded and broken items, or an environmentally conscious person wanting to reuse or recycle as much as they can.
As the disorder progresses, however, it can cause increasing social isolation, as the hoarder grows reluctant to allow friends and relatives into their home.
"They feel so much shame and guilt," Reinardy said, noting that hoarders often experience self-esteem issues.
If they have possessions piled up in their car, for instance, they may even park their vehicle blocks away from their destination, then walk the remaining distance so that no one will identify the vehicle as belonging to them.
There's also an aspect of perfectionism to hoarding, Reinardy noted.
"They can't tolerate the feeling of making a mistake," she said -- so hoarders become paralyzed with an inability to make even the simplest decisions with regard to what to keep, and what to throw away.
In the same vein, hoarders often put unrealistic expectations upon themselves with regard to organization.
"It's all or nothing," Reinardy said. "They either want things organized perfectly, or not at all."
Some of the contributing factors include "information processing deficits" -- i.e., a lack of decision-making and organizational skills, poor memory, or a lack of confidence in any or all of these areas.
So how does one go about solving the problem?
Ideally, Reinardy said, it would be a gradual process, whereby the hoarder could be trained to deal with their own mess, in their own time.
What she prefers is to take a more gradual approach, and encourage her clients to take small steps toward improvement, maybe by going through one box, or one room at a time.
"They feel like they're losing part of their identity," Reinardy said. "They think the regret (of losing something they value) will last forever."
But by letting go of one item at a time, Reinardy said, her clients learn that the emotional fallout of letting go is temporary.
"They see it's not going to be as catastrophic as it feels to make these decisions," she said.
It's also important to set realistic goals for change, Reinardy added. "You need to build them up ... set realistic goals, and recognize when they've achieved them."