Hoarding has finally come of age and graduated. It has made it into the Diagnostic and Statistical Manual. It is called hoarding disorder.
If you download Vaknin videos onto your computer and never ever watch them, you are a hoarder and you are suffering from hoarding disorder. Get it, Shoshalim!
Today I'm going to propose that narcissists are both classical hoarders, the kind of hoarder that amasses objects and sometimes people without ever making good use of them, and at the same time an internal hoarder.
Internal hoarding is the hoarding of internal objects such as memories, such as representations of external objects, introjects, snapshots, as I call them in my work.
Internal hoarding versus external hoarding. This is the topic of today's much hoarded video.
My name is Sam Vaknin. I'm the author of Malignant Self-Love, Narcissism Revisited, and a professor of clinical psychology.
I have a confession to make, I'm a mega hoarder. I hoard absolutely everything. Books, pens, paper, you name it, I hoard it.
Okay, so what it is that we are talking about.
Before I go into what is known about hoarding and the etiology, the causation, the behaviors, the comorbidities, etc., in short, before I delve into DSM territory, I want to make a few comments on hoarding.
In a nutshell, hoarding is when you collect things, objects usually, but sometimes also people. Sometimes you hoard abstract issues, abstract notions. You hoard relationships, you hoard sex partners, you can hoard elements of things which are not classical, well-defined, objective, ontological objects.
So I want to make a few observations.
Number one, hoarding has to do with control. The hoarder controls the objects around him or her. Total control. These objects cannot walk away. They cannot abandon the hoarder. They are organized in a way that is meaningful only to the hoarder, so they are inaccessible to outsiders, at least in any meaningful form, or way. They are captives, the objects are captives, usually they're kept in rooms or basements or so they're captives, they're like hostages.
So hoardinghas a lot to do with control.
Number two, safety, a sense of safety, kind of security. The hoarded objects are immediately available. They're always there. They are unlikely to just vanish or walk away or abandon or discard or whatever. The hoarded objects represent permanence and constancy.
Therefore, hoarding has a lot to do with object inconstancy. It's compensatory to object inconstancy.
When you grow up and you learn that people around you are unsafe, they come and go. They're not reliable. You develop object inconstancy. You don't trust the world around you to remain the same, more or less. You don't believe that objects, physical objects and people, material possessions, but also biographical details such as your job or your position, you don't trust anything to remain in place there for you whenever you need it.
This is object inconstancy and hoarding compensates for object inconstancy by generating piles and avalanches and tsunamis of permanent constant objects under the control of the hoarder, as I mentioned.
Number three observation, the third observation is not exactly intuitive.
I think hoarding has a lot to do with the denial of death, a way to delay death.
It's as if the hoarder says, I'm hoarding, for example, books. And as long as these books remain unread, I will never die. I will not die. I'm doing this. I'm buying books, and I have thousands upon thousands upon thousands of books. And I go through them. I do read some of them.
But of course, the majority of them will remain unread. Even if I were to survive another 20 years, which is highly dubious, they will remain unread.
And yet I deceive myself into believing that as long as there is an unread book in my library, I will still be there to read it. I will not die. It's a form of denial of death.
Now, narcissists, for example, they avoid boring routines and details. They hate details. The devil is in the details.
So they are big picture kind of people. They have what we call synoptic, a synoptic view. They're very, they're not serious. They're not committed, they're not invested in anything they do. So they don't want to delve deep. And so whenever they're forced to contemplate minutia, details, bits of information, or whenever they're forced into a routine, they become bored, frustrated, and aggressive. Hording is a combination of routine because it involves an activity of collection. It involves collecting things over time on a permanent and regular basis. So there is a routine there, but they're not details. In other words, the interaction with the collected objects ends with the act of collection. The objects have been collected, placed somewhere randomly, by the way, and from that moment on, there's no further interaction with the object. So there's no need to get to know the object better, to study the object, to learn the various details and aspects and dimensions of the object, to interact with the object, to kind of get used to the user manual of the object. There's no need for any of this.
Hording is an act of collection superseded by disuse. And that's a perfect recipe for the narcissist. Narcissist is a surface person. He's on the surface. He's superficial. He never goes in depth. He's a headline kind of person.
And hoarding is perfect for this. Hording also sustains the narcissist's grandiose delusions. Because hoarding is a shortcut. Rather than write books, you buy books. And the more books you possess, the more intelligent, you look, or you may even pass for an intellectual.
It's a shortcut. It's a kind of, the more I hoard, the more valuable and qualitative I am, the more worthy I am. It's a negation of the internalized bed objects. And so holding, as you can see, has many aspects which have not been explored in the literature at all, or have been explored but insufficiently.
For example, connection between hoarding and addiction.
Hording is considered to be a form of obsession compulsion. Indeed, in the DSM 5, it is classified the hoarding disorder is under the main headline of obsessive-obsessive-compulsive disorders, OCDs. And yes, of course, there is an obsessive-compulsive element in the act of hoarding, the routine of hoarding. It's compulsive. The hoarder cannot help himself. But isn't this a great definition and a great description of what is known as process addiction? Yes, it is.
And yet, the addictive elements or the addictive dimensions of hoarding have been totally neglected in the literature, which is pretty shocking. Hording is a form of displacement. It is substitute activity. It's a substitute for the real thing.
Rather than read books, I collect them. Rather than studying, I flood my apartment with encyclopedias. Rather than, so it's a substitute. I'm displacing. The hoarder displaces the need to engage life. So hoarding is a simulated life. It's in other words, a paracosome. It's an alternate reality. It's a virtual reality. So the hoarder inhabits the hoarding the hoarding cosmos, the universe of hoarded objects. And within this cosmos and universe, there's a fantasy going on, which involves both the hoarder and his possessions and his collections. I'm very reluctant to use the word collections because collections are structured, orderly, and involve a lot of work, which is not the case with hoarding. So accumulation is a better word.
Within this imaginary fantastic universe, the hoarder and his accumulated possessions maintain the exact equivalent of a shared fantasy with an intimate partner.
There's a lot of intimacy between the hoarder and his hoarded objects.
Again, something which is much neglected, the fantasy element and the intimacy element.
Most hoarders are actually single. They're lonely people.
And I think the reason is that they find the intimacy they need and the companionship in their interactions or lack of interactions with the hoarded objects, the hoarded possessions, reflecting an underlying insecure attachment style, the kind of avoidant dismissive attachment style.
The hoarded objects are there, so they are constant, they provide a sense of safety, they help to aggrandize the hoarder, look how many things I possess, and at the same time they make no demands.
Their intimacy is of the passive kind.
The hoarder doesn't need to go out of his way or her way to accommodate the needs, expectations, dreams, hopes, emotions and cognitions of the hoarded objects or the hoarded internal objects, as we shall see.
And so, hoarding is not a form of principled collecting. It's not, there are not principles. It's not a principled activity, not a disciplined activity.
It's compulsive and the items collected are very often shoddy, low quality items, or items that degenerate and deteriorate very fast, for example, newspapers.
It's not about the actually owned and possessed objects. It's about the interaction with the objects.
In this sense, hoarding is a massive, massive display of displacement, of substitution.
It's a simulated world within which the hoarder finds meaning and direction and purpose. A simulated world which makes sense of the rejection of reality and its absence in the hoarder's life.
It's a form of extreme constriction.
Most hoarders, as I said, are lonely.
Narcissistic hoarders hold people in contempt, they despise them. They refuse to collaborate with people. They don't fake empathy, compassion or interest unless they are pro-social or communal narcissists and psychopaths.
They find people beneath them. They're utterly self-sufficient, and they enjoy solitary activities.
Hoarding is a schizoid solitary activity.
And again, that's a much neglected dimension of hoarding.
The connection between hoarding and a schizoid personality organization.
The solitary nature of hoarding tells us a lot about the way hoarding gratifies and caters to certain psychological needs.
When the hoarder is forced to confront life and reality to interact with other people, the hoarder becomes aggressive, sometimes, quite often actually, violent.
And the reason is that hoarding is a rejection of the world, of reality, of life.
And any attempt to reintroduce the hoarder into reality and life is perceived as an imposition, a kind of bullying, coercion.
And the reaction is, of course, immediate and violent and aggressive.
So these are a few thoughts about hoarding which may kind of cast a new light on this relatively new, or newly recognized, disorder.
So let's now study hoarding in depth.
Hoarding is the carrying or sorting of food or other items believed necessary for survival.
This is the original definition of hoarding, and it occurs in the animal kingdom, among non-human animals.
Among these animals, hoarding is instinctive.
But there are growing indications that hoarding can be taught and acquired intergenerational. There's an intergenerational transmission.
So, when a squirrel collects nuts and buries them all over the place, technically that's a hoarding activity.
But hoarding or food caching in nature is goal-oriented. It has to do with survival. If you are a hoarder, your chances to survive, procreate, much higher.
So this is what distinguishes animal, non-human animal hoarding to human animal hoarding. The hoarding of the human animal, of humans.
In humans, hoarding is a compulsion. It involves a persistent collection of useless, the uselessness is crucial. Persistent collection of useless or trivial items.
Old newspapers and magazines. Even garbage. Packings. Packings are all kinds of things. Packaging.
You won't believe what people hoard. They hoard napkins. They hoard pens. They hoard dirt. It's unbelievable.
It goes to show that the hoarded object is immaterial, irrelevant. It's the act of hoarding that matters.
And as I said, it provides a sense of safety and constancy. It aggrandizes the hoarder and so on so forth. Everything I said at the beginning of the video.
Once the hoarded objects reach a certain critical mass, it's impossible to organize them any longer. The collection becomes randomized, all over the place.
Many hoarders, though, maintain an intimate acquaintance with the location and the position of the hoarded objects. They just walk into the mess, walk into the chaos, and take out a single issue of a single newspaper from 1874.
It's pretty amazing. They have a mental representation, a mental representation of the mounds and mountain ranges of useless objects that they collect.
Hoarders can never ever get rid or discard anything they have collected, which is proof positive that the act of hoarding is cathected.
The cathexis is in the objects, of course. The objects are cathected, but they are cathected through the act of hoarding.
In other words, there is an emotional investment in each and every item in the growing, disorganized, out-of-control collection, or accumulation.
Each and every item has an intimate relationship with the hoarder, and the hoarder gets emotionally attached and bonded to the totality of his possessions, of her possessions, and they are unable to get rid of these, to discard them somehow.
As I mentioned, when you try to force the hoarder to reduce or to get rid altogether of the piles of trash, and they go absolutely insane, they go crazy, they become very dangerous.
The accumulation of items, usually in towers and piles, usually vertical. Accumulation is vertical usually. Leads to the obstruction of living space, causes distress, impairs functioning.
It's a dysfunctional activity. And any attempt or encouragement by others to discard the items causes extreme anxiety, frustration, aggression, and violence.
So this is a general overview of hoarding disorder.
The existentialist psychoanalyst, Erich Fromm, came up with an idea of what he called the hoarding orientation. He said that it's a character.
The hoarder or the hoarding orientation. He said that it's a character.
The hoarder or the hoarding personality is a character pattern.
The individual doubts that personal needs can ever be completely satisfied.
And they base their sense of security on what they can save, pilfer, scavenge and own.
Whatever you own is safe. Whatever you own is yours. Whatever you own is going to be there for you.
Everything else is contingent. Everything else is uncertain. Everything else is unsafe.
The world is unsafe. The world is unsafe. The world is hostile. The world is comprised of scarcity and poverty and denial and rejection and abandonment.
That's the world of the hoarder.
The hoarding character is rigid, stubborn, and obsessive, obsessive compulsive.
This is known as the hoarding character.
Now, there's a difference, of course, between hoarding and collecting, though superficially from the outside, an observer might fail to see the difference.
There are huge differences. There is an internal order in a collection, an imposed order.
And collection, collecting items is a rational activity dictated by outside parameters.
So if you collect silent cinema items, you collect them by year, by actor, by studio, and so on. Some outside classification, outside nosology, outside taxonomy, that rigidly constrains and dictates both the contents of the collection and the activity involved in collecting the items that go into the collection having been vetted via the taxonomy.
That's not the case with hoarding. Hoarding is totally random.
The only defining parameter is what is being hoarded.
And another important distinction is between hoarding and cluttering.
Cluttering is a tendency to collect items without any intention to do so. It's not hoarding. Hoarding is a clinically diagnosable condition.
In cluttering, the saved articles don't include trash, unsanitary items, useless items. The individual makes rational decisions and periodically discards possessions or materials or objects.
So cluttering is about spatial organization, organizational space or actually misorganization of space, wrong, badly organized space, but it has nothing to do with hoarding, because it doesn't involve the compulsions and the dynamics that I've described at the inception of this video.
The diagnostic criteria for hoarding disorders say persistent difficulty discarding or parting with possessions, regardless of their actual value.
The difficulty is due to a perceived need to save the items and to distress associated with discarding them.
The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use.
If living areas are uncluttered, it is only because of the interventions of third parties, family members, cleaners, authorities.
The hoarding causes clinically significant distress or impairment in social, occupational or other important areas of functioning, including maintaining a safe environment for self and others.
The hoarding is not attributable to any medical condition, like brain injury or cerebrovascular disease, or Prader-Willi syndrome, whatever. The hoarding is not better explained by the symptoms of another mental disorder.
For example, obsessions in obsessive-compulsive disorder, decreased energy in major depressive disorder, delusions in schizophrenia or another psychotic disorder. Cognitive deficits in major neurocognitive disorder, restricted interest in autism spectrum disorder, and so on and so forth.
There's excessive acquisition. There's difficulty discarding possessions.
And this is accompanied by excessive acquisition of items that are not needed and for which there is no available space.
Now, some hoarders realize that they're hoarders. We'll come to it in a minute.
But here's an exercise for you.
Rewind this video. Go back. Go backwards. To the very beginning of the diagnostic criteria.
And now apply this criteria to the internal objects, including memories, in the narcissist mind.
And you will see that the narcissist is hoarding internal objects exactly like a typical hoarder would hoard newspapers or rubbish. The narcissist hoards internal objects.
Why would I say this?
Because there is no rhyme or reason or structure to the collection of internal objects in the narcissist's mind and mental space.
The narcissist is unable to discard these internal objects, no matter how hard he tries. No matter how hard she attempts to replace the internal object with another internal object, there's no way for the narcissist to get rid of the internal objects.
And they don't try, actually. They never try.
They cherish these internal objects. They have intimate relationships with these internal objects. They are afraid of these internal objects when these are a persecutory object.
But this is the world of the narcissist. The world of the narcissists consists of a paracosm, an alternate reality, within his mind, which is populated by hoarded internal objects.
The narcissist's mind is like a cluttered living space. Cluttered with what? With memories, with representations, with internal objects, with voices, with avatars, with snapshots, of you, among others.
And the narcissist feels the need to go through this. It's compulsive. A shared fantasy is a compulsive pattern, a repetition compulsion in clinical terms, in the case of the narcissist.
So he's compelled to do it. He's compelled to collect and hoard these internal objects and can never ever discard them. They congest and clutter his mind to the point of dysfunction and distress, impairment in social functioning, in intimate relationships.
So the narcissist hoarding of internal objects ultimately leads to extreme dysfunction.
And the narcissist is compulsive in pursuing, for example, intimate partners. The minute he has discarded one intimate partner, he moves on to the next.
It is as if the narcissist cannot remain alone without his hoarded objects for a minute.
And in this sense, the narcissist's behavior looks very much, appears to be identical to the borderline's behavior, but the motivation is different.
Whereas the borderline transitions seamlessly and with alacrity from one intimate partner to another, she does so because of abandonment anxiety, separation anxiety, insecurity. She feels abandoned and rejected, and she needs to compensate for this with a new intimate partner.
That's not the case with the narcissists. The narcissist transitions with equal speed and as seamlessly from one intimate partner to another, exactly like the borderline, but the motivation, the etiology, is different.
With the narcissist, it's compulsive. It's the compulsion of the shared fantasy. Narcissus robotically reenacts early childhood conflicts time and again and again, frequently unaware of what's happening.
And indeed, in hoarding, we distinguish between good or fair insight hoarders and poor insight hoarders.
Good or fair insight hoarders are individuals who recognize that hoarding related beliefs and behaviors, for example the difficulty to discard items, the clutter, the excessive acquisition, they realize that these are problematic.
They have insight. They're self-aware. They know what they're doing is crazy.
And then there's poor insight hoarders.
These individuals are convinced that hoarding related beliefs and behaviors are not problematic. They're actually essential. They're life-sustaining.
Despite all evidence to the contrary, and in this sense, hoarders with poor insight are clinically delusional.
And that's where the narcissist fits in.
The narcissist's hoarding of internal objects, delusionally. He believes that the way he relates, or she, half of all narcissists are women, the narcissist believes that the way he relates to the world via the compulsive shared fantasy, a compulsion which forces him, coerces him to collect, to hoard, to acquire internal objects. He believes this is a highly efficacious and even clever, smart way of relating to the world.
This is the narcissist's grandiosity. The narcissist's grandiose cognitive distortion prevents him from gaining insight into his hoarding behavior.
Ostensibly from the outside, the narcissist is collecting intimate partners. He is hoarding intimate partners.
Actually, he is not.
Narcissists are unable to recognize the externality and separateness of other people, intimate partners, friends, children.
So they convert external objects into internal objects. When the narcissist is hoarding intimate partners or friends, he is actually hoarding internal objects.
And he is not aware that this is a problem. He doesn't accept it. He doesn't think it's problematic in any way, shape, or form. He has poor insight.
And this involves a lack of insight and delusional beliefs. The narcissist is completely convinced that his hoarding activities and the beliefs and behaviors that are attendant upon this hoarding of internal objects he believes that these are not problematic and actually very beneficial.
Approximately 80 to 90% of individuals with hoarding disorder display excessive acquisition.
And the most frequent form of acquisition is excessive buying. They purchase things unnecessarily. They're shopaholics.
And the second most common activity is the acquisition of free items. They collect leaflets, labels, everything discarded by other people. They pick up trash in the street. They bring it home.
Stealing is very uncommon, by the way. Hoarders don't steal.
Which again proves my point at the beginning of the video.
The relationship with the hoarded item, via the act of hoarding, is a relationship of intimacy. It's intimate.
The interaction with the hoarded object is the equivalent of an intimate relationship. It's a form of bonding and attachment that is displaced and replaced and substituted.
It is ersatz love affair with the object that is picked up in the street or purchased.
Again, some hoarders deny excessive acquisition.
When you confront them and you say, you don't really need this 200th pair of shoes. You never wear the clothes you buy. You never wear the shoes you buy. You never read the books you buy. You've never laid the finger on the mountains and mounds of newspapers, yellowing and disintegrating, rat-infested newspapers in your apartment. What are you doing? This is excessive.
They would deny this. They deny this. Many hoarders deny this.
And they experience distress if they are unable or are prevented from acquiring additional items.
And this is of course the exact equivalent of object inconstancy.
When the baby is denied feeding by the mother, when the mother leaves the room, doesn't feed the baby, doesn't touch a baby, doesn't smile at the baby, doesn't interact with the baby, the infant, early infancy, the baby experiences terror. It's terrifying. Mother's absence is terrifying. This is no guarantee she will ever come back.
It's the same with the hoarder. If the hoarder is prevented from hoarding, the acts of collecting, acquiring, are somehow hampered or hindered or stopped, coercively stalled, they go crazy. They feel they have a panic attack.
That's an anxiety disorder, in effect. I would classify hoarding under anxiety disorder as well as obsessive compulsive disorder.
So there's a difficulty discarding or parting with possessions regardless of actual value.
The persistency is crucial here. It's a long-standing difficulty, not only a transient life circumstance or, you know, excessive clutter because of something, you're in a crisis or whatever, you inherited property and now you're cluttered.
No, that's not the case here. It's a lifelong pattern which cannot be broken.
And here you can, those of you who are sufficiently attuned to this mind-numbing lecture may raise a hand and say, but Mr. Vaknin, the hoarder cannot get rid of his possessions. He's unable to discard them, while the narcissist discards his intimate partners all the time. It's the opposite of hoarding.
Pay attention. The narcissist discards the external objects because they don't exist for him or her.
I'm talking about hoarding of internal objects. The narcissist hoards internal objects. He pays no attention to external objects.
So external objects are just handles or excuses to generate yet another internal object. External objects, other people, for example, they're like reminders, allowing the narcissists, they trigger the narcissists into generating a new internal object, to add to the clutter of internal objects in his mind.
The hoarding of internal objects in the narcissist is triggered by external objects, but then they're gone, then they are of no use or function anymore.
So narcissists find it impossible to discard internal objects. In this sense, they're hoarding them.
And this applies to any form of discarding, throwing away, selling, giving away, recycling of physical objects, or forgetting, dissociating internal objects, getting rid of them somehow by combining them with other internal objects, silencing them.
These are all impossible within the narcissist's mind.
Internal objects may be transformed from idealized to persecutory, devalued. But it's impossible to simply ignore them or get rid of them or eliminate or erase them or delete them or vitiate them or negate them. None of this.
The main reason in classical psychology, the main reason given for this difficulty is the perceived utility or aesthetic value of the items.
The hoarder says, but one day I'm going to use this item, one day I'm going to read this book, and look how beautiful it is. How can I get rid of it?
That's by the way, precisely the way I relate to my books. I find them exceedingly beautiful, aesthetic objects. And I comfort myself with utterly delusional belief that one day I'm going to read them. Maybe this would guarantee that I'm never going to die.
So there's a strong sentimental attachment to the possessions, to the objects. As I said, then even the narcissist affects emotionally invests in the act of hoarding of internal objects.
Some individuals feel responsible for the fate of the possessions of the objects. They would say, but if I throw the books away, people are going to trash them or burn them or use them as decoration. That's horrible. I can't even contemplate this.
And they go, hoarders go to great lengths to avoid this waste, to protect, they're very protective of their possessions.
Fears of losing important information are also very common. They say to those, among these mounds and hills of material, there's buried crucial information. One day I'm going to need it. One day I'm going to use it. One day is going to be helpful to me.
So if I discard, I may inadvertently get rid of something which is really, really important, really crucial, would be a serious mistake.
Newspapers, magazines, clothing, bags, books, mail, papers, any item can be hoarded and saved.
The nature of the items is not limited to possessions that other people would define as useless of limited value. That's a common mistake.
A common mistake is to say that hoarders collect only trash, only useless things, only discarded items, only broken thing. It's completely untrue.
Hoarders collect anything and everything. The thing is that whatever is being hoarded is useless to the hoarder or is not being used by the hoarder. It may be useful or it may be used by others, but as far as the hoarder is concerned, there's no utilitarian interaction with the items hoarded.
Same applies to the narcissists and the internal objects hoarded by the narcissist. The narcissist has no useful interaction with the hoarded internal objects in his mind. The usefulness of these internal objects is long gone. They have been deactivated. They've been rebranded as persecutory. They've been buried in silence and shut down and so on. There's been an attempt to bury them and silence. They are no longer considered useful even to a large extent. They're considered counterproductive, inducing, that could induce dysfunction.
So it's the same. Same characteristics of hoarding apply to internal objects.
Many individuals collect and save large numbers of valuable things. And these valuable things are in piles mixed with less valuable items. There's no rhyme, reason, order, structure, logic in any of this.
Same with the Narcissus' mind. If you were able to enter the narcissist's mind, you would see a room or a cathedral, basilica, populated, cluttered, with thousands of internal objects, introjects, fragments of memory, and so on so forth. None of them in any given, rational, reasoned location, they could not be mapped into an interaction. There's no sense in any of this. Total unmitigated chaos.
Individuals with hoarding disorder purposefully save possessions and they experience distress, anxiety, frustration, regret, sadness, guilt, aggression when they're faced with the prospect of discarding these items. It's as if they're being torn limb from limb. These items became extensions. The hoarded items are extensions of the hoarder.
Sounds familiar? The hoarded items in classical hoarding, in hoarding disorder, have been converted into internal objects.
Even a classical hoarder, who is not a narcissist, converts external objects, external objects, external objects, into internal objects. When such a person is asked to discard or get rid of the hoarded objects, they're being asked to get rid or discard of some part of themselves. It's equivalent of amputation. It's painful, it's terrifying.
The saving of possessions is intentional. Hoarding disorder is intentional. And there is a passive accumulation of items or absence of distress when possessions are removed in other mental health issues.
But hoarding is an intentional activity.
Now, the narcissist does not hoard internal objects consciously or intentionally, but he does collect, he does hoard external objects, for example, intimate partners, very intentionally.
And the aim is to convert them into internal objects.
So indirectly, the narcissist is intentional about hoarding internal objects via the agency and the mediation and the intercession of external objects.
Individuals who suffer from hoarding disorders, they accumulate large number of items and these items fill up and clutter active living areas, to the extent that these areas can no longer be used as they were intended to. It's no longer possible to even move. There's like very narrow corridors in a canyon between two walls of accumulated items. That's how my library looks by the way.
So hoarders are unable to cook in the kitchen, sleep in bed, sit on a chair. The hoarded items spill over and fulfill every available space. If a space can be used, it's used for hoarding objects.
Clutter is a large group of usually unrelated or marginally related objects piled together in a disorganized fashion in spaces designed for other purposes.
But we have discussed the difference between cluttering and hoarding.
The difference is in the perception of the hoarded objects and the inability to get rid of them. Hoarders cannot get rid of such objects.
Again, when we discuss the hoarding of internal objects, there is a strong element of compulsion here, an extreme anxiety about the internal objects, about, for example, getting rid of an internal object that explains the hovering behavior.
The narcissist hovers external objects in order to revive internal objects because he cannot get rid of them.
Now, many people collect things and many of these items are not necessary.
So you collect, you know, old newspapers, old photographs, broken bicycles. You collect these things, most people do.
But they do it in garages, in attics, in basements. They don't do it in the living room or in the kitchen or in the toilet.
So individuals with hoarding disorder have possessions that spill beyond the active living areas.
And so, a hoarder after a few years, the hoarded objects fulfill the entire apartment, any vehicle, yards, courtyards, workplaces, friends' houses, relatives' houses. It's incredible.
Living areas are so clouded, so consumed by the hoarded objects that usually third parties intervene at some point. Members, cleaners, local authorities, police, they intervene because there's vermin, unhygienic, danger. It's a danger to public health, it's unsanitary.
And so then the hoarder is forced to clear these spaces.
And when this happens, there is a highly specific reaction, which is a combination of anxiety, even I would say panic attack, coupled with a psychopathic kind of behavior, aggressive, violent, defiant, and at the same time, depressive. Suddenly the hoarder may collapse, sit down and not move, become almost catatonic.
So the symptom picture is fascinating because you can see an interplay of various mental illnesses flowing and ebbing, waxing and waning as the process of decluttering and removal and discarding of items proceeds.
It's a very sad picture. Hoarding and hoarders, that's a very sad picture.
It's not a selective organized activity. And it's not a question of quantity. Some hoarders have the same quantity of physical possessions as, you know, a normal person would have.
It's not about this. It's about the compulsion, compulsive nature. It's about the anxiety. It's about the childlike, infantile defenses and terrors, like the fear of abandonment. The need for object consistency, secure base.
The hoarded objects are maternal substitutes. They're like mothers.
The hoarder uses hoarding as a form of self-soothing and self-comfiting. The same way in eating disorders, people eat in order to soothe themselves or comfort themselves or compensate for something.
So food can be used for self-soothing in hoarding the hoarded items, or actually the activity of hoarding is a form of self-soothing.
And the symptoms cause huge distress. Even in hoarders that are not insightful, that are delusional, under the surface, there is great distress, the inability to discard items, the clutter, which renders habitation utterly beyond any reach.
And the impairment and the distress, they afflict every dimension, every field of life, social, occupational, and the environment gradually becomes less and less safe.
It is a transitory path, a trajectory that is very common in narcissism as well.
As the narcissist hordes internal objects and his mind becomes more and more cluttered and populated with his useless non-functioning internal objects.
There's a deterioration. There's a degeneration or devolution of the narcissist. Becomes a lot more antisocial, less safe to himself and to others.
And the same happens with classical hoarders who are not narcissists.
The very act of hoarding somehow causes extreme mental illness in due time. It takes decades, but in due time.
The narcissist is a hoarder, a hoarder of internal objects.
By the way, many narcissists, as I said, are classical hoarders. They really hoard externally as well as internally.
When there is poor insight, the individual does not report the distress, exactly like the narcissist would deny that he's in distress.
But the impairment is apparent. Apparent to everyone around the individual.
The same way everyone around the narcissist sees the problems of the narcissist, is witness to the narcissists, gradual, disintegration, dysfunction, and yet the narcissists would go on denying it.
And the more you try to intervene in classical hoarding disorder and in internal hoarding, the more you try to intervene, the greater the distress.
That's the irony here.
It seems that the act of hoarding of external objects or internal objects, the very act of hoarding is anxiolytic, reduces anxiety.
As I said, self-soothing, self-comfiting. It reduces anxiety, mitigates it, places it under control, converts it into something else.
There's a kind of sublimation of the anxiety, displacement of it.
And when you remove this, when you don't allow the classical holder to collect physical objects and we don't allow the narcissists to continue to generate internal objects, for example, by placing the narcissist in an environment which doesn't allow the narcissist to create internal objects, then we see extreme anxiety and distress, almost debilitating.
There are many features, hoarding disorder has many features, and many of them are not typically associated with hoarding in the minds of laymen and unfortunately in the minds of many therapists.
But for example, hoarding is closely associated with indecisiveness, perfectionism, avoidance, procrastination, difficulty planning and organizing tasks, and distractibility.
Some individuals who are hoarders with hoarding disorder, they live in unsanitary conditions. That is an outcome, a logical consequence of cluttered spaces and so on and so forth.
But at a more profound or deeper level, these people are simply unable to plan and organize things. They're the mercy of their impulsiveness.
And they need to immediately gratify their impulses, the highly impulsive in the process of acquisition. It's impulsive acquisition, uncontrolled.
And so you see that hoarding has many dimensions and that it is a systemic problem. The hoarding is like the tip of an iceberg. It's a symptomatic indicator, like temperature in a variety of illnesses.
Now, hoarding is perhaps more common than you think.
There are various studies. Some studies say that hoarding is, that about 1.5% of the population are hoarders. Some studies suggest, especially in Europe, that 6% of people are hoarders.
There has been a meta-analysis of 12 studies across high-income countries and the prevalence was established at 2.5%. There's not gender difference as far as we know, although that is debatable. So the figure today that we use is 2.5%. That's not a small figure. It's not a small figure. In clinical setting, most hoarders are women. There's been a population study in the Netherlands, and hoarding symptoms appear to be three times more prevalent among older people, older than 65 years old, compared with younger people, people ages 30 to 40. Now hoarding is not a late life or late onset phenomenon. That is a common mistake. To believe so.
Hoarding actually starts very early in life, sometimes in very early childhood, like age three or four. These kids begin to collect things. They begin to hoard under the bed, under the covers, under the mattress, in cupboards. I remember that I started hoarding at age four or five. I was hoarding old newspapers, huge quantities of old newspapers, and books I could find, torn, defiled, trashed in the garbage. I would collect them, and I would hide them in the cupboard under the sink. And in other places, other nooks and crannies in the apartment, I was only four years old, five years old. So it starts early in life. And it's lifelong, usually. It's across a lifespan. But more typically, hoarding is visible and discernible and diagnosable between the ages of 15 and 19 years because then it starts to interfere with everyday function causes clinically significant impairment. Participants in clinical research studies, unfortunately, are not representative in this sense. Usually these are people in their 50s and 60s. I have no idea why. They're very precious few studies of hoarding among, for example, college students, which is pretty shocking.
The severity of hoarding increases with each decade of life, especially after age 30. Once the symptoms begin, the course of hoarding is often chronic.
There are few individuals which report a waxing and waning course. The majority remains stable across a lifespan. Undergoing crisis, when they're forced to discard items and then they start the collection from zero, all over again. There is no item constancy. A hoarder can transition from newspapers to pens and from pens to books and from books to movies. I used to hoard books and then there was a period of 10 years that I ordered DVDs. To this the very day, I have thousands of DVDs, hidden in all possible cupboards, in all possible spaces. We don't have a place to hang clothes and so on. Now, there are various dimensions to hoarding, temperamental, environmental, genetic, physiological. In children, pathological hoarding appears to be easily distinguished. I mean, children developmentally begin to save things, collect things. That's a healthy behavior. That's an adaptive behavior.
But there's a difference between saving and collecting and hoarding. Children and adolescents typically don't control the living environment. And so their behaviors are largely dictated from the outside. The locus of control is external in the true sense of the world. That's not a pathology, that's simply a fact. So discarding things, organizing things, and so on, depends to some extent or even to a large extent on other people, the adults. Third parties intervene very often. Parents, for example, keep spaces usable, and so and so forth. So hoarding cannot blossom, coming to its own when you're a child or an adolescent, but still, child hoarders and adolescent hoarders collect mostly trash, collect mostly utterly useless things, and hide them. They hide them. And they become very, very morose and angry when you try to discard them. Indecisiveness I mentioned is a prominent feature of individuals with hoarding disorder, but also first degree relatives, which is a strong indication of genetic link or hereditary foundation. Individuals report, especially retrospectively, report stressful and traumatic life events preceding the onset of the disorder or causing an exacerbation of the disorder.
So again we're beginning to see links with narcissism, adverse childhood experiences, and some genetic template, which is very common or has been identified in psychopathy in borderline, but not yet in narcissism.
Hoarding behavior is familial. More than 50% of individuals who hoard report having a relative who hoard.
Twin studies indicate that approximately 50% of the variability in hoarding behavior is attributable to additive genetic factors. And the rest is non-shared environmental factors. 50% is high.
So it seems there's a genetic predisposition to hoarding.
I think in due time, when we do find the genetic template for pathological narcissism, when we do identify the locus of the genetic predisposition for pathological narcissism, we are going to find some affinity with the genetic disposition for hoarding.
Narcissism is a form of hoarding, the hoarding of internal objects, trying to hang onto the world via the inside of your mind.
The narcissist is incapable of interacting with reality and with external objects owing to cognitive distortions, biases, and numerous other dysfunctions.
So what the narcissist does, he creates an internal world and he hangs onto it by hoarding internal objects.
I think hoarding and narcissism are very closely related, genetically, environmentally and behaviorally.
In Western industrialized countries and urban communities, there is a consistency in clinical features, even cross-culturally. There are similarities in severity at clinical presentation. They are associated cognitions and behaviors.
But I must say that there are cultures, especially in poor countries, indigenous countries, countries where the level of income is very low or uncertain.
And in these cultures and societies, there's a high value placed on thrift, on storing possessions, on collecting things that may be useful one day.
It's very important to be culturally sensitive and culturally aware when diagnosing people. The presence of distress and functional impairment should be the only basis for diagnosis.
If someone lives in Sub-Saharan Africa, in Mali, or Chado, Sudan, or Sierra Leone, or in Western Africa, or whatever, and it's poor. They would collect and hoard anything and everything because they never know.
And that would be a rational, reasonable behavior, not hoarding. This is not hoarding.
And their culture would tell them to do this, would justify it. It would be normative. That's not hoarding.
Although it's behaviorally indistinguishable from hoardingin the West, it's not hoarding.
Because the availability and accessibility of goods and services in these four countries is such that one must become self-sufficient. And one must plan for contingencies of any conceivable kind, hence the constant acquisition of possessions.
I mentioned that hoarding disorder is generally comparable in men and women, but the truth is that it's a woman's disorder so women are more likely to display excessive acquisition, excessive buying than men.
When it comes to narcissists, the hoarding of internal objects is gender neutral. There's nothing to do with gender.
The life of a typical hoarder is very sad.
Clutter impairs even basic activities. You can't move through your own house. You can't cook, you can't clean, you can't wash yourself, maintain personal hygiene. You can't even sleep. The items clutter the bed itself. Sleep in a contorted way, if at all. Sometimes you sleep standing or sitting in a luncheon.
Appliances are broken, utilities, I know, water, electricity are disconnected. Access to repair work would be impossible, very difficult. Quality of life is catastrophically impaired.
In severe cases, hoarding is a fire hazard. Falling, people, especially older individuals, keep stumbling over and falling and, you know, over strewn, objects, strewn all over the place. Poor sanitation, health risk.
Hoarding disorder is associated with occupational impairment as well. Poor physical health. High social service utilization. I mean, you name it. These are invalids.
Family relationships are frequently under enormous strain. Conflict with neighbors, local authorities, police. That's very common. Litigation is a way of life.
A substantial portion of individuals with severe hoarding disorder are involved in legal eviction proceedings. Some of a history of evictions.
Again, it's a public health hazard. Rats, infestations of rats and insect, cockroaches and so it's extremely common.
And so this is a life of a hoarder.
And again, if you were to enter the mind of the narcissist, you would see the equivalent life unfolding within the alternate reality of the narcissist's mind, unsanitary, dysfunctional, conflictive, unhealthy, painful, distressedful, and so on.
The hoarding of internal objects clatters the narcissist's mental living space to the extent that the narcissist becomes as impaired as a typical hoarder who accumulates newspapers or books or pieces of clothing or bags.
There is no difference in the outcomes between internal hoarding and external hoarding. The psychological outcomes are the same.
Outwardly, the internal hoarder appear to be, you know, perfectly okay. As far as collecting and acquiring and clutter, it's perfectly normal.
But if you were to look into his mind, you would see the real tsunami and avalanche of tottering towers, of internal objects competing with each other for increasingly more limited space.
The cacophony and raucous inside the narcissists mind that drowns every possibility for functioning and self-awareness.