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Janelle was someone who relished “fighting the system.” By hoarding food and keeping items far after their expiration date, she was refusing to let someone else tell her what she could or could not eat. She struggled with what she saw as arbitrarily imposed restrictions on her life.

Many hoarders simply stop trying and, whether actively (like Janelle) or passively, they ignore the basic rules that we’ve come to expect functioning members of society to follow. Hoarders who want to get their lives back have to recognize and accept these basics, whether they involve looking after personal hygiene, having a job, respecting their neighbors, or living within a budget. Those rules seem fundamental to most people, but they can feel restrictive to a hoarder who has lived for years without them.

Perhaps one of the most significant issues for many hoarders is the management of their finances. For most, the solution is ending the use of credit. As far as I am concerned, this should be a hard-and-fast rule, especially when people have put themselves into debt with their acquisitions or are simply living on credit because they have lost control of their finances.

After my gambling problem, I lost everything and was forced to use cash only. Although it was hard, not having credit cards was one of the best things that ever happened to me. I learned during those years to ask myself if I needed an item or just wanted it, and I also figured out how to make myself happy by doing something instead of buying something.

I encourage hoarders to ask themselves these questions whenever they are tempted to shop: Will this item make my life better? Does it help me keep my home in order? If this is a gift, does the person I am buying it for really want or need it? If I don’t have enough cash for this, am I willing to wait until I do?

Living without a credit card forces people to get their financial house in order, just as they have to get their physical house in shape.

▶ No Quitting

I’ve always believed that a hoarder house is a house full of quitting. To make a change, the hoarder has to stop quitting and start trying. The hoarder has to want to change. I have heard hundreds of hoarders’ stories, and they all start with one or more tragic events. We are all challenged in life, and sometimes challenged to the point of failure. A hoarder is someone who has responded to those challenges by giving up in one or more places in life, including battling clutter.

The worst part about quitting is that every time someone makes that choice, it gets easier to do it again. Of course, there is a difference between quitting and making a strategic decision to stop. Stopping makes sense when someone has exhausted every ounce of effort and continuing to push forward would be emotionally or psychologically damaging. But stopping before giving 100 percent is quitting.

When hoarders quit, they are cheating their potential. Every time they quit, they are taking a shortcut and they know it. The guilt builds, which is why hoarders can’t allow themselves to quit again, not even once. Quitting on small actions eventually leads to completely giving up. And completely giving up is what fills a house with junk and leaves a hoarder hopeless and feeling alone.

I am diligent and firm about the “no quitting” rule with hoarders. It’s much bigger than just one quick decision not to wash the dishes one night because it’s easier to sit on the couch in front of the TV. Hoarders need to learn how to make themselves do things that they don’t want to do. Building that self-discipline is what will keep a hoarder clean for a lifetime.

▶ Rebuilding a Network of Family and Friends

It’s one thing to have professionals on call, and pay them for their services, but perhaps the most critical engagement that a hoarder can have to ensure ongoing success is a strong network of family and friends involved in his or her welfare.

When it was time on the last day of cleaning for us to leave Katrina, the divorcée who had studied to become a lawyer, we left her with two rooms to finish on her