It’s a new year, time to get going on projects and look at things afresh, to weed out the old, eliminate clutter and give ourselves space to breathe and create. Many of us believe this would be a great start for the year, others feel it’s a good goal but idealistic and still others see no problem with having a lot around us it makes us feel cosy.This article is about those of us who just cannot get rid of things, we can’t throw them away we can’t give them away, we have to have them, even though we’re not using them, we feel we need them. We’re hoarders.There’s nothing wrong with keeping things, but when you lose the ability to be able to part with any of the things you have, you are treading into dangerous territory. There are some who become so committed to holding onto their things that it affects their physical safety, health or well-being. Hoarding to these extremes is considered a psychological disorder and is called chronic disorganisation or CD. It’s a problem that usually is unrecognisable to those afflicted.Personal organiser Cindy Swan said working with a compulsive hoarder requires specialist training. “I don’t accept clients who are hoarders,” she said. Instead she refers the would-be-clients to her American-based colleague Sheila Delson.Ms Delson is a certified chronic disorganisation specialist. She works with adults and students who suffer disorganisation due to neurological, physical and/or environmental challenges. Co-founder of the National Study Group on Chronic Disorganisation in the US, Ms Delson is considered a leading authority on the topic. She’s been featured in The Wall Street Journal, New York Post as well as several TV news programmes.Johns Hopkins researchers estimate between 700,000 and 1.4 million Americans are affected with the disorder. In Bermuda there are no figures on how many people have chronic disorganisation and I was unable to find a personal organiser on-Island who is certified in the area. But I do know there are people here who are afflicted. I’ve personally encountered some of them. People who have ducks nesting in their house and months worth of dirty dishes around the place, people with floor to ceiling stacks of newspapers dating back to the 1950s, people who have so much stuff, some of their entranceways are blocked and you have to shuffle sideways to manoeuvre inside.So I spoke with Ms Delson about the work she does.Q: How prevalent is hoarding in the US?A: Compulsive Hoarding varies from person to person, and because of its social implications it is difficult to calculate how many compulsive hoarders there truly are. With the onset of the ‘baby boomer’ population now beginning to emerge, we suspect the numbers are quite large. However, due to the expansion of the Professional Organising Industry, several US television shows and tons of media attention, individuals who suffer with hoarding issues are realising that they are not so alone, and that help is available. Through education, the social sting isn’t quite as intolerable as in the past. As such, we are finding that they are beginning to reach out, as well as many family members begging for interventional help.Q: How much of your business involves this?A: This number varies from month-to-month. However, it is important for you to understand that the majority of my client base (about 75 percent) is comprised of most “chronically disorganised” individuals. CD individuals comprise of a wide range of physical, emotional, and psychological (mental health) conditions which can impede their ability to organise, structure or manage their lives. It affects their overall quality of life on a daily basis. Some examples of CD issues are; attention deficit disorder, obsessive compulsive disorder, dyslexia, life trauma, depression, compulsive hoarding and acquiring, Parkinson’s or multiple sclerosis, brain trauma, dementia, etc. As you can see, chronic disorganisation involves a wide range of difficulties. The remaining 25 percent of my client base are ‘average’ individuals who are simply overwhelmed with general life issues including, time, space, poor or lack of systems, and sometimes just due to low energy. Intervention help can run from a few hours to a few weeks, but the project does eventually come to a successful end, or completion.Q. How do you know when someone is a hoarder and not just sentimental?A: All hoarding is based upon a type of sentiment an emotional response. Compulsive hoarding is a pathological disorder, meaning it is a type of chemical imbalance that affects the prefrontal cortex area of the brain the area that controls emotions, cognitive function, problem solving and complex thought.Q: Does hoarding always equal disorganisation?A: Yes, in a very profound way. Although the symptoms of hoarding do indeed involve excessive ‘clutter,’ what defines general clutter from hoarding clutter is the fact that there are usually health and safety factors involved in the hoarder’s environment, some quite serious. Some of the significant symptoms of a hoarding situation might include, blocked doorways and windows, electric and plumbing issues, fire hazards, blocked stairways, mould, rotting food and animal/rodent infestation.Q: Are there different degrees of hoarding?A: Yes, and it varies from person to person. However, please remember that compulsive hoarding is a ‘chronic’ issue, therefore was probably somewhat always present in the person’s early life in some form. We do know that the compulsion (to acquire and inability to let go/eliminate) seems to increase as a person ages. Dismissed and characterised as “lazy” or “slob” in earlier life, it goes unrecognised as a mental health issue and never gets addressed, and so it escalates over time on into adulthood. Compulsive hoarding also has a pathological component which can be ‘ignited’ with the onset of some type of significant traumatic experience. Development of a compulsive hoarding issue can happen over a lifetime, or with the onset of an emotionally traumatic event.Q: As a certified professional organiser in chronic disorganisation, are you trained in psychology?A: No, I’ve had no ‘formal’ (ie college) mental health training as a psychotherapist. Although it may be desirable, a degree in psychology is not a requirement to being a professional organiser. However, since my interests, and intuitive talents, do lie with the CD population, I made it my business to learn on my own.While professional organisers do not practice “psychology” with their clients, it is still very wise of us to gather as much knowledge on the subject as possible. Therefore, in 2001, I played a significant role in the development of the National Study Group on Chronic Disorganisation, which is a not-for-profit organisation specifically created to research the subject of CD and to then teach member subscribers (professional organisers and other related professionals), how to work directly with the CD population relating to their disorganisation issues.It was also developed to teach the general public about the subject so others can understand and learn how to appropriately respond and intervene. Learning about this subject has had a huge impact on our industry for the betterment of all our clients, and society. In 2002, I co-developed the group’s certification programmes the first certification program in the Professional Organising Industry. As such, all of our programs are 100 percent educational. All of our member subscribers join because ours is the only organisation offering this type of education for professional organisers, specifically with regard to the CD population. Becoming certified is no easy feat, it takes about 30 months to accomplish all requirements.Q: As hoarding is a psychological problem do you insist that your client also have psychological counselling?A: Absolutely. In fact I will not work with a hoarding client unless they agree to be in therapy.Q: Can you list the steps you take clients through to combat their hoarding problem?A: First I do an intake evaluation using the Clutter-Hoarding Scale (see inset). Each situation is different, and therefore approaches vary. I start slowly, ask a lot of questions, and do a lot of listening. Developing trust is the most important first step, it can happen quickly, or develop over time. I am very sensitive to a client’s surroundings and to their thoughts and words as well. I tell them that it is a partnership and that I will not impose anything that upsets them (this could do extreme psychological damage). I tell them that my objective is not to focus as much on extracting the stuff from the person, but rather extracting the person from the stuff. My emphasis is on the importance and value of the person first.However, I do insist that we start with making the environment safe and healthy which may require other outside sources. The goal has to be theirs, we usually work in one area at a time. They must feel that they own the project …the failures and the successes. The process is always excruciatingly slow, extreme patience is required. I use a myriad of techniques, depending upon the situation and the person. Success can take many months to several years.Q: Can hoarders combat it on their own?A: Not likely, and I haven’t seen any reports that suggest that they could. Remember, CD individuals do not have the skills and personal insight hoarding is a pathological disorder. Any heavy CD client needs consistent ongoing support. Help could come from a trained family member, but the key is to be ongoing and consistent in managing the problem.Q: Have you noticed an underlying reason in your experience, on what leads someone to become a hoarder?A: More often than not, there is a familial hereditary component or even a predisposition to it which is triggered by some traumatic experience, such as abuse or neglect as a child, an onset of a particular disease, brain injury, sudden tragic loss or death of a loved one.Q: In your opinion what are the warning signs that you are becoming a hoarder, or are there any?A: I think it is difficult to self-diagnose or self-recognise. It needs to be recognised by other family members or friends when the situation presents itself early on. Greater management success happens when intervention is caught early. Sadly, because there are so many judgments attached to having a family member or friend identify the issue, that doing so has an enormous impact on the family unit, as well as other disturbing implications socially. That is why we (the NSGCD) were created to educate the public on this very important subject and how to appropriately respond to the issue.Q: Have you ever worked long distance with hoarders or do you have to be physically with them to achieve results?A: Another good question. We call it ‘Virtual Organising.’ Yes I have. However, it won’t work for a lot of people. Again it depends on the client’s level, interest, motivation and learning style. The client must be somewhat technically savvy and have access to a camera, a computer, and Internet with Skype accessibility. The client also must be highly motivated and have a strong auditory learning ability.Q: How successful would you say you have been with getting hoarders to become organised?A: How long does it typically take? Actually, a compulsive hoarder almost never becomes organised as we know it. Chronic means just that chronic. There is no cure. However, in the case of a compulsive hoarder, what ‘success’ does mean is living in a safe, clean environment, with minimised clutter, with plumbing and heat, cooking and food preparation areas clean and accessible, all rooms functioning as designed, and with easy systems in place that are supportive to the way they think. Ongoing success requires ongoing regular consistent support of others, either family or a professional organiser.