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Even hoarders and families who aren’t strongly religious might consider reaching out to a priest or minister for help and information about community support. Getting involved in a church will also create a support network for when the cleanup is complete.

▶ The Therapist

Thalia is the Stage 5 hoarder from Pennsylvania who had been a political volunteer—and saved pretty much every bit of paper from every campaign on which she had worked. (She is also our case study for high anxiety in Chapter 2.) During her cleanup, she asked for frequent stops and retreated to a bedroom. Her family members told us that her behavior was pretty typical, that she had been under a therapist’s care off and on for years, and that she had a history of suicide threats and attempts.

The second day, Thalia fell completely apart. As soon as the crew approached her to make decisions about her stuff, she panicked. She ran outside and locked herself into her car, which was also full of bags, clothing, and memorabilia. As we stood outside the car and tried to get her to open the door, she started trying to open a bottle of pills, threatening to swallow them.

Because of Thalia’s unstable mental state, we made sure that her therapist was on call during the cleanup, and it was the therapist who was able to talk Thalia out of taking the pills, and out of the car. At the therapist’s insistence, Thalia was committed and spent the next few days in the hospital.

As extreme as Thalia’s case may be, it is not uncommon for advanced hoarders to be wrestling with some deep psychological issues that will surface during the stressful time of the cleanup. Any hoarder with a previously diagnosed or suspected mental disorder, like OCD or depression, should have the support of a good therapist whose professional training will make him or her a critical and still impartial member of the team. In many cases, the therapist not only helps the hoarder directly but can manage the high emotions of the whole team.

▶ The Social Worker

Sam and Wendy met at church when both were in their seventies. When they fell in love, their children didn’t have a problem with their racial difference. What shocked Sam’s family was the condition of Wendy’s house. When Sam moved in, the house was so cluttered and decrepit that they worried about his safety.

Both Sam and Wendy were strong-willed people. Sam made a commitment to stick with Wendy even though she simply wasn’t interested in undertaking a cleanup. In frustration, Sam’s daughter finally called the county to report Wendy’s house. While this move could have alienated Sam from his daughter, it turned out to be the best move because it brought an empathetic social worker into the picture.

The social worker determined that Wendy and Sam were capable of living independently, and since they were adamant about staying in the house, she took steps to help them with a cleanup.

The social worker was also instrumental in getting Wendy and Sam the medical attention that they both needed. Sorting out the prescription drugs was a major issue. From old aspirin to expired heavy-duty narcotics, Wendy had hoarded old medications, which she took on her own judgment whenever she felt ill. She also kept empty bottles so that she would have a record of her medication history. The social worker got a doctor to visit and explain that medicines lose their effectiveness after time, and that her doctors would all have her medication records on file, so she could throw away the old bottles.

During the cleanup, the social worker checked in every day or two to make sure that Sam and Wendy were holding up during the difficult process. If new problems had cropped up, she would have been the go-to person to coordinate additional resources and support.

With the help of the social worker, the cleanup crew was able to get Wendy and Sam’s immediate cooperation. Social workers not only have the confidence and respect of their clients but give an air of urgency to the situation. And, trained as they are, they know the best and most