Authors: Gail Steketee
Daniel arrived about thirty minutes after the cleaning crew started working. He was fifty, with a medium build and lots of energy. He complained about the crew starting without him and insisted that it was his job to direct the cleaning. Susan intervened. She told Daniel that the place was unlivable and asked how it had gotten that way. Daniel appeared offended, but he also seemed to enjoy the prospect of an argument. He objected to her depiction of the apartment as unlivable and suggested that she didn't understand the riches he had acquired. He did concede that the condo had gotten a bit messy, but only because he hadn't had time to straighten it up. He addressed her in a monologue that lasted nearly ten minutes and ended by saying that he appreciated the help she had sent and had enjoyed the conversation with her, but now he needed to get back to supervising the cleaning crew.
Susan asked him another question. He launched into another long answer, telling a story about his life. At the end of the story, he became annoyed and again insisted that he had to supervise the cleaning. Another question by Susan was followed by another story. It seemed that no matter how much he wanted to supervise the crew, he could not stop talking. At the end of one of the stories, he told Susan that he understood that she was trying to distract him from the cleaning, but even then he couldn't keep himself from talking. He seemed to relish the attention. He clearly enjoyed creating intricate stories and making them into formal arguments, as though he were involved in an elaborate debate. He punctuated his arguments with an impish grin, challenging us to find the flaw in his logic.
Finally, he darted into the apartment, jumped onto a cleared coffee table, and started yelling at one of the cleaning crew to put down a broken lamp. The crew member stared at him blankly, leading me to believe that he did not understand English. Later, though, I heard all the cleaners speaking to each other in English and realized that perhaps it was easier to deal with difficult characters such as Daniel by pretending not to understand. Susan asked him to come back out into the hallway and tell her how he thought the cleaning should be done. The question started a spirited description of the ineptitude of social workers and the courts and ended with his interpretation of the judge's ruling. In his view, the judge was giving general guidelines and would never condone what was being done to them.
This pattern repeated itself throughout the day. A simple question produced a long story that sometimes wandered far afield. Daniel's was a world of stories, and during our time there, he communicated almost nothing without one. The question was always answered, after a fashion, but the core of the answer was usually buried in the story. "Novels, no serials" was how his sister described his manner of storytelling. Interrupting the story was nearly impossible. When I tried, he either ignored me or started a new story. On some level, he seemed to understand this problem. When we took him out to lunch, he pleaded, "Please ask me only yes or no questions so I will have time to eat."
Shortly before lunch, we met Tim, Edith's son. Tall and muscular, Tim was in his mid-twenties. He worked at odd jobs but had no steady income. He slept on a single bed on one side of the living room in a niche carved out of the debris. Edith had told Susan that Tim had an anger management problem. One of the social workers had once seen Tim red-faced and angry with his mouth just inches away from his mother's ear, yelling at her for something she had done or failed to do. As he approached us, he looked angry. Susan was afraid of what Tim would do.
"Where are my clothes?" he said, speaking with urgency and anger. "My leather jacket, where is it?"
No one answered. Tim turned to Daniel and asked him to step into the hallway. In the next moment, Tim, who weighed close to two hundred pounds, slammed Daniel in the chest with both hands, sending him flying through the air and into the far wall of the hallway. Daniel slumped to the floor as Tim stood over him shouting, "This is your fault! You were supposed to stop them from taking my stuff!" Daniel tried to placate him, but Tim would have none of it. He continued yelling and threatening: "You haven't got a fucking clue. I should beat the shit out of you."
Susan was already on the phone with the police, and three officers arrived within a few minutes. At Susan's instruction, they pulled Tim aside and began questioning him. They were courteous and respectful to everyone but made it clear they were in control. Once they determined that the papers for the court-ordered cleanout were in order, they focused on Tim. He was still yelling and pacing, threatening Daniel and everyone involved in the operation. The officers surrounded him closely, one of them doing most of the talking. They let him know that he would have to stop pacing and yelling, or they would arrest him. He tried to explain to them what had happened, but they focused not on the cause of his distress, but on controlling his aggressive behavior. I was amazed at how well they gained control of the situation, and through it all, they treated him with respect and courtesy. Tim's anger quickly dissolved into self-pity. He complained to them about his misfortune in having Daniel as an uncle.
By this time, Susan had let her office know of the difficulties we were having. Two more social workers showed up, both of whom had worked with Daniel before. Now standing in the hallway were three social workers, three police officers, myself, and Tim. Inside the apartment were four members of the cleaning crew, Edith, and her sister. Two more police officers arrived. The commotion and the crowd added to Tim's misery. In all the confusion, no one noticed that Daniel had disappeared. One of the social workers set off to look for him. She came back to report that he was out on the sidewalk tearing open the bags the cleaning crew had left by the truck. Now the whole crowdâpolicemen, social workers, Tim, and Iârushed out to see for ourselves what was happening.
As we got to the street, we could see Daniel tearing madly through bag after bag. He had a pile of clothing and other things he had rescued sitting beside the bags. The neighborhood was a fashionable one in midtown Manhattan, with lots of well-dressed people walking along the street heading to work. Many stopped to stare.
The policeman in charge asked Daniel to stop and come over to talk with him. Daniel said, "Sure, I just need to find the rest of Tim's clothes," and he continued to open bags. More people stopped to watch.
"No, I mean now. You need to stop that and come over here right now." The policeman was firm.
"Yes, but I have to find these clothes. You can see how upset he is." Daniel didn't even look up as he responded.
The policeman raised his voice above the volume of a simple request. "You need to come over here right now, or we are taking you to Bellevue," he said, referring to the famous psychiatric facility in Manhattan.
At this, Daniel stopped and came right over.
"You know about Bellevue, I guess," the officer said. Daniel didn't respond. Although the threat of Bellevue stopped Daniel's foray, it was a hollow threat. Involuntary commitment to a psychiatric facility requires imminent threat to cause harm to oneself or others. Digging through trash bags would not qualify.
In the meantime, Tim had located the pile of clothes Daniel had rescued. Just as a very nicely dressed woman walked by with her dog, he picked up his leather jacket and shook it. Cockroaches flew in every direction, spraying the woman. She screamed and then froze, looking at once confused and disgusted. The officer who was talking to Daniel saw it happen and turned to Tim just as he shook the jacket again. This time the cockroaches peppered the police officer. He wheeled around with a look of horror in his eyes. "Get them off of me," he shouted at me as he tore at his shirt. I tried to brush them away, but they had gotten inside. He stripped down to his T-shirt, squirming. When he got his shirt back on, he was mad. He rushed at Tim, pulling out his handcuffs. Tim spun around and fell to the sidewalk, breaking down in tears. He pleaded, not with anyone in particular, "Why is this happening to me? What have I done? It's not my fault."
The policeman took pity and put his handcuffs away. "Look," he said, "you're coming with us. We're not going to arrest you. We're just going to escort you away from here. If you don't come back until this cleaning is done, we won't arrest you. If you do come back, the social worker will call us, and we'll take you to jail."
Daniel was again tearing at the bags in the street, and again the officer stopped him. He sent Daniel back upstairs to the apartment, where he set about giving instructions to the cleaning crew, who did their best to ignore him.
At one point, a nicely dressed woman emerged from the condo next door. I wondered what it was like living next door to such a mess. Surely, the cockroaches had migrated into her apartment, and the smell couldn't have escaped her notice.
All morning, the other elevator stopped on the fifth floor, and other residents peeked out until the doors closed. They were curious about the commotion and all the trash bags. Midway through the morning, I went outside for some fresh air. On my way back, I waited by the elevator with several other tenants in the building. They were talking about Daniel.
"They're clearing out Daniel's apartment. He's a collector, you know. He collects junk. You can see him going out and coming back every day with stuff off the streets. He's crazy."
"I knew his father. He had diabetes, like my father, so we had a connection. The collecting, it's an illness, like diabetes."
"That's just like Mrs. Palmer in 63A. Her apartment was packed full. They cleaned her out last week."
In the time we spent with Daniel, he was lucid and could not be considered out of touch with reality. Yet he seemed unable to tell us why he had collected all this stuff. When I asked where it came from, he insisted that his sisters had pressured him into collecting cans and bottles for the refunds and old packs of cigarettes for the coupons they contained. He argued that it was really their problem and not his. But very few bottles, cans, or cigarette packs were visible among the tidal wave of trash in the apartment.
Daniel spent most of the day insisting that there was nothing wrong with him, but for one short period he admitted that his collecting had become a problem. The interval occurred late in the day, after I had listened to a story about his father and asked a question about their relationship. He talked about how he had tried to stop collecting, and how his family had tried to help him stop by telling him what he could bring home and in what quantity. Then, as quickly as his insight came, it was gone, and he was back to arguing with us about the unfairness of it all and about the incompetence of social workers.
We left at the end of the afternoon with the cleaning crew. They had cleaned about two-thirds of the apartment and were scheduled to return the next week. Edith allowed Daniel to stay in the condo, which disappointed Susan.
"He will fill it again," she predicted.
I called Susan a week later to check on how the rest of the cleaning had gone.
"Well, they finished it, but when I went for a visit the next day, the security guard told me he had seen Daniel wheeling in shopping carts full of things all night after the cleanout."
Within a month, the apartment was full again. At that point, Susan, in her role as Edith's guardian, had Daniel evicted and placed a restraining order against him to prevent him from visiting. Then she had the apartment cleaned again, this time with out much fanfare. For several months, things went well, and then Daniel sued for visitation rights. Much to Susan's dismay, the judge agreed. The apartment filled up for a third time, forcing yet another heavy-duty cleaning. In the five years after the first cleaning, Susan arranged for a total of eight heavy-duty cleanings, at a total cost of more than $20,000, a high price to pay for one man who could not control his urge to collect junk.
Just how many people have as little insight as Daniel is unclear. In a recent study, we asked family members of people who hoard about this issue. More than half of them described the hoarder as either having poor insight or being delusional with regard to the hoarding. Whether this is accurate and representative of all those who hoard is questionable. Frustration from years of trying to get a loved one to change can make family members believe that the hoarder is delusional. Perhaps people with more severe clutter are especially non-insightful. They have lost the battle of mind over matter, and declaring their innocence may seem easier to them than admitting loss of control over their lives.
In our experience, most hoarders have some degree of awareness of the problem. Even people who insist that they have no problem will go to great lengths to hide the stuff packing their homes. They seem to know, and feel ashamed of, what other people will think of their homes. Some, like Nell (see chapter 8), see their clutter only when others are present. Most people who hoard also experience shame at the prospect of someone discovering their secret. This requires at least the understanding that one's behavior is different. Most of the hoarders we have seen know that they have a problem when they think about it in the abstract. But when a hoarder is holding a ten-year-old magazine and thinking about what valuable information it might contain, that insight evaporates. After all, keeping only one magazine will not matter in the grand scheme of things.
Despite the multiple heavy-duty cleanings and Susan's feedback, Daniel's behavior did not change. He insisted that others misunderstood him and were misguided in their concerns. Daniel was not someone who would volunteer for therapy. Even if he were forced into treatment, it would be unlikely to have much effect. Ultimately, I was unable to provide Susan with the key she'd sought to unlock the problem of obstinate hoarders, for the same reason that no one can help a non-insightful drug addict or anorexic: the patient has to want to change.
For those lacking insight into their hoarding, heavy-duty cleanings are seldom more than a short-term fix. The condition of the home may change temporarily, but the collecting behavior does not. Perhaps it would be impossible to get Daniel to stop collecting, but getting him to organize or store his hoard in a different manner might reduce the risk to Edith and the rest of his family. In such cases, we encourage agencies to take a different approach. Instead of clearing out the home, we recommend working with the hoarder to determine what needs to be done to meet and sustain basic standards of safety. The effort requires the development of a personal and trusting relationship with ongoing contact. Though potentially costly, it may in the long run result in public savings by reducing the number of heavy-duty cleanings. Such an approach requires at least a minimum of cooperation and effort, however, of which Daniel seemed incapable.