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The big challenge with Aimee was her emotional attachment to much of her stuff. Her “keep” items consisted mostly of things that had belonged to her late mother, who had been her closest friend and a major source of support during a difficult divorce from an abusive man. Aimee came to realize that the trauma of losing her mother had, in fact, triggered her hoarding.

Aimee’s self-image had become extremely poor. It was particularly hard for her to recognize the glamorous model that she once had been. But the cleaning was an opportunity to build a new, positive attitude. One day, one of the cleanup guys found a magazine with a gorgeous, much younger Aimee on the cover. He knew it was Aimee, but he asked her who the “hot babe” was, to encourage her to embrace her former beautiful non-hoarder self. Aimee blushed and smiled; as if that was the first time she had received a compliment from a man in years. After weeks of positive reinforcement about her appearance and decision-making ability, Aimee’s behavior changed. She began to smile, share stories, and became much more confident and relaxed. She began to remember her old self, before hoarding, and she enjoyed rediscovering that person.

STAGE 5: MARGARET

Margaret had been hoarding so many years that her possessions had started to decompose at the bottom of her five-foot piles. Everything in her double-wide trailer home was either broken, rotting, or chewed or peed on by the fifty or so dogs that had free run of the place. There was extensive water damage from broken pipes, with walls and ceilings split and falling down in spots. The house stank, it was hot, and the air was thick with dust. Cobwebs waved from the ceiling and flies buzzed at all of the windows.

In the kitchen, spoiled food stank up the refrigerator, and dirty dishes were molding in the sink. Cockroaches scattered whenever items were moved. The narrow walkways between the piles were swimming in a thick brown muck that actually sucked one of Margaret’s clogs off her foot as she walked through the kitchen on cleanup day. She ignored it and kept walking.

In this house the hoarding had been going on for so long that everything was rotting, even the building. Once her house was condemned, Margaret moved in with one of her adult daughters who lived nearby. On cleaning day, Margaret’s daughter drove her to the house to meet the cleaning crew, building inspector, animal control officer, and social worker.

With a cleanup this aggressive, it’s mostly about damage control, because this stage of hoarder house will never be perfect. The building inspector told Margaret that we might get the house clean only to discover that it wasn’t salvageable and had to be bulldozed. Animal control warned Margaret that the house had to pass inspection for some of her dogs to be returned.

It was hard for Margaret to say good-bye to her pets, because some of them she would never see again. In fact, getting the house clean enough for animal control to return six of the dogs became her main goal, and it motivated her through a cleanup that she really had no desire to do.

The dogs aside, the main problem for Margaret was accepting the trash in the house for what it was: just junk. The dogs and that stuff were all that Margaret had. Most of her friends and family had abandoned her and she truly looked to the things in her house as friends. As soon as the crew started touching empty food wrappers in the kitchen and asking her if they could throw them away, Margaret’s anxiety level skyrocketed and she got angry. She grabbed an empty toilet paper roll out of a worker’s hands and put it in her sweater pocket, yelling at him not to handle her things. Every item they touched provoked an equally angry reaction.

I kept calm, reminded Margaret that her goal was to get her pets back, and offered to hold the trash bag open and let her choose what to throw away. This was slowgoing because Margaret didn’t want to part with anything. Each item she touched had an argument attached to it about why she needed to keep it. Every time Margaret