Rubbish can get you down in the dumps

By MARTIN JOHNSTON

Health reporter

Next door's rubbish mountain has crept above fence height. It's a fire risk, it stinks and it's infested with rats - you want it gone.

Maybe you are just the victim of a lazy neighbour. Then again, he or she could be a victim of compulsive hoarding - a condition considered a serious illness.

Sufferers store up anything, from old car parts and general junk to new clothes and shoes, and can often mount a good argument for their habit. Some cause a neighbourhood nuisance, others are simply eccentrics.

"It can be of sentimental value or it may not be," said Melbourne clinical psychologist Dr Don Jefferys. "The big characteristic of it is that they have difficulty getting rid of that item."

In a typical case of hoarding he treated recently, a woman bought clothes and shoes compulsively and even took to shoplifting. She had 130 pairs of shoes and had extra wardrobes to store the many clothes she never wore. She even considered having her house extended to fit her habit.

Another woman collected food wrappings, used tissues and tampons for several years, he said. Every tissue had to be opened carefully to see if it contained something valuable.

Keith Montreal, a self-confessed compulsive hoarder, says he gets so attached to his pile of secondhand goods, it takes him six months to recover his self-esteem after any of it is forcibly removed.

For more than 50 years he has been unable to resist collecting bicycles, engines, chairs and other old items - a habit that has landed him in trouble in the past with neighbours, the Whangarei District Council and Housing New Zealand.

In 1998 he was evicted from his state home because of his messy stockpile.

And while he says he has obsessive-compulsive disorder, he also maintains that he hoards goods in order to sell them.

In a deal with his current landlord at Kamo, Mr Montreal is allowed to cram the large garage, which he has, but anything that spills outside can be removed.

"I'm trying to keep on top of it," says Mr Montreal. He proudly states that he has just sold a couple of motorcycles but then admits the junk is starting to build up outside.

The 66-year-old superannuitant also discloses his relish for an occasional "splash," buying up all he can afford at garage sales.

Is the disorder a trouble to him? "It is when I find that the landlord is coming with a trailer to take [goods] away. It's a type of punishment that hurts me deep down because I haven't anywhere else to take it to."

He saw a psychologist and received 12 sessions of therapy which he says helped to control his hoarding and he is involved with a mental health caregivers support group.

Dean Nuralli, a Waitakere City Council environmental health officer with a special interest in compulsive hoarders, recalled one case involving two generations which had been traced back to a family trauma a century ago. The council cleaned out the house after the mother died and continued to monitor it as the problem had the potential to recur.

Hoarding can be a symptom of obsessive-compulsive disorder, a partly inherited, partly environmental condition that afflicts up to 3 per cent of the population.

The most common compulsions with the neuro-biological disorder are hand washing, counting, and checking things like whether the front door is shut.

Dr Jefferys said compulsive hoarding was a difficult illness to treat.

"We don't have all the answers for it.... A lot of work is being done in the States and within five years one would expect to have some good answers."

Drugs could be used, he said, alongside cognitive behaviour therapy to teach people new responses to their obsessions. He cited cases where people with depression and compulsive hoarding had improved once the depression was treated.

The Phobic Trust says compulsive hoarding is stuck in the closet. It aims to bring it out, partly by making it one of the main topics at a conference starting in March at which Dr Jefferys will speak.

The trust's chief executive, Marcia Read, said people suffering from the serious illness and their children were often unfairly stigmatised as being dirty.

Hoarding could become an environmental health risk but people with the illness needed to be handled carefully by local authority officials, she said.

Mr Nuralli is devising guidelines on how councils can improve their response to the problem and present them to the conference.

His council gets on average a dozen complaints a year about hoarders and it usually has to dump junk from one or two properties.

They were so overloaded they resembled rabbit warrens inside, he said.

But while in the past the council took months to get to the dumping stage, now it could take years, said Mr Nuralli.

He advocates treading softly and working with the trust, doctors, neighbours, family - "every significant group around these people so they can feel more at ease about the situation.

"We can't just go in and disrupt them because they feel like they are being raped [when their stockpiles are cleaned out]. We try to bring them around to normality."

He said compulsive hoarders often came close to convincing authorities that their behaviour was acceptable, asking what harm they were doing.