A Clutter Too Deep for Mere Bins and Shelves

Published: January 1, 2008

After the holidays, many shoppers load up their carts with storage bins, shelving systems and color-coded containers, all in a resolute quest to get organized for the new year.

The country’s collective desire to clean up is evident in the proliferation of organization-oriented businesses like the Container Store and California Closets. Reality shows like “Mission Organization” on HGTV and “How Clean is Your House?” on Lifetime feed a national obsession to declutter. The magazine Real Simple has even created a $13 special issue on cleaning house.

Getting organized is unquestionably good for both mind and body — reducing risks for falls, helping eliminate germs and making it easier to find things like medicine and exercise gear.

“If you can’t find your sneakers, you aren’t taking a walk,” said Dr. Pamela Peeke, assistant clinical professor of medicine at the University of Maryland and the author of “Fit to Live” (Rodale, 2007), which devotes a section to the link between health and organization. “How are you going to shoot a couple of hoops with your son if you can’t even find the basketball?”

But experts say the problem with all this is that many people are going about it in the wrong way. Too often they approach clutter and disorganization as a space problem that can be solved by acquiring bins and organizers.

Measures like these “are based on the concept that this is a house problem,” said David F. Tolin, director of the anxiety disorders center at the Institute of Living in Hartford and an adjunct associate professor of psychiatry at Yale.

“It isn’t a house problem,” he went on. “It’s a person problem. The person needs to fundamentally change their behavior.”

Excessive clutter and disorganization are often symptoms of a bigger health problem. People who have suffered an emotional trauma or a brain injury often find housecleaning an insurmountable task. Attention deficit disorder, depression, chronic pain and grief can prevent people from getting organized or lead to a buildup of clutter. At its most extreme, chronic disorganization is called hoarding, a condition many experts believe is a mental illness in its own right, although psychiatrists have yet to formally recognize it.

Compulsive hoarding is defined, in part, by clutter that so overtakes living, dining and sleeping spaces that it harms the person’s quality of life. A compulsive hoarder finds it impossible, even painful, to part with possessions. It’s not clear how many people suffer from compulsive hoarding, but estimates start at about 1.5 million Americans.

Dr. Tolin recently studied compulsive hoarders using brain-scan technology. While in the scanner, hoarders looked at various possessions and made decisions about whether to keep them or throw them away. The items were shredded in front of them, so they knew the decision was irreversible. When a hoarder was making decisions about throwing away items, the researchers saw increased activity in the orbitofrontal cortex, a part of the brain involved in decision-making and planning.

“That part of the brain seemed to be stressed to the max,” Dr. Tolin said. By comparison, people who didn’t hoard showed no extra brain activity.

While hoarders are a minority, many psychologists and organization experts say the rest of us can learn from them. The spectrum from cleanliness to messiness includes large numbers of people who are chronically disorganized and suffering either emotionally, physically or socially. Cognitive behavioral therapy may help: a recent study of hoarders showed that six months’ therapy resulted in a marked decline in clutter in the patient’s living space.

Although chronic disorganization is not a medical diagnosis, therapists and doctors sometimes call on professional organizers to help patients. One of them is Lynne Johnson, a professional organizer from Quincy, Mass., who is president of the National Study Group on Chronic Disorganization.

Ms. Johnson explains that some people look at a shelf stacked with coffee mugs and see only mugs. But people with serious disorganization problems might see each one as a unique item — a souvenir from Yellowstone or a treasured gift from Grandma.

Many clients have already accumulated numerous storage bins and other such items in a futile attempt to get organized. Usually the home space is adequate, she says, but the challenge is in teaching them how to group, sort, set priorities and discard.

Ms. Johnson says she often sees a link between her client’s efforts to get organized and weight loss. “I think someone decides, ‘I’m not going to live like this anymore. I’m not going to hold onto my stuff, I’m not going to hold onto my weight,’” she said. “I don’t know that one comes before the other. It’s part of that same life-change decision.”

On its Web site, www.nsgcd.org, the group offers a scale to help people gauge the seriousness of their clutter problem. It also includes a referral tool for finding a professional organizer. But since the hourly fees can range from $60 to $100 or more, it may be worth consulting a new book by Dr. Tolin, “Buried in Treasures” (Oxford, 2007), which offers self-assessments and advice for people with hoarding tendencies.

Dr. Peeke says she often instructs patients trying to lose weight to at least create one clean and uncluttered place in their home. She also suggests keeping a gym bag with workout clothes and sneakers in an uncluttered area to make it easier to exercise. She recalls one patient whose garage was “a solid cube of clutter.” The woman cleaned up her home and also lost about 50 pounds.

“It wasn’t, at the end of the day, about her weight,” Dr. Peeke said. “It was about uncluttering at multiple levels of her life.”

(cut and pasted from Yahoo: http://www.nytimes.com/2008/01/01/health/01well.html?ex=1356843600&en=c438e1196ccd5843&ei=5124&partner=permalink&exprod=permalink