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An intensive cleanup commonly known as a shovel-out or “blitz” may sound like a good solution, especially if you consider doing it voluntarily. You may even believe that the only way to get on top of the clutter is to start fresh and then keep it maintained. But what you may not realize is that if the accumulation and buildup is serious enough to consider a blitz, the underlying reasons it happened in the first place may still exist, which will cause it to happen again.
If a blitz is involuntarily, because an outside party such as a municipal enforcement branch requires it, history tells us that as soon as the cleanup crew is finished, gradually the hoarding will likely happen again. History also tells us that the re-accumulation is often worse and happens faster than originally.
It is important to acknowledge that when a hoarding situation has gone unidentified and unresolved for too long it may represent an immediate threat to life for the person who hoards or others living in close proximity (including pets). In these situations, unfortunately, an intensive short-term cleanup may be required as a last resort. Yet, even though the buildup must be resolved quickly due to the risk it represents, the shovel-out approach almost universally increases the damage done to the individual who hoards and, with a high degree of certainty, will result in re-hoarding more quickly and severely.
The destabilizing effects of intensive short-term cleanup blitzes intensify the existing anxiety the person is already living with, and causes feelings of disconnection from the only place they can call home. There is a compelling need to recreate the familiar, even though they may not have felt good about it and it may have caused them immense stress and suffering.
This was certainly the case for one of my past clients who desperately wanted to return to a home that had been deemed too unsafe for him to live in. After the blitz, his home, while now up to code, was very disorienting for him. We tried to orient him to where his prized possessions were by putting sticky notes on each cupboard and drawer so he would be able to find things when he needed them. One of the most frustrating things about extreme cleanups to someone who hoards is that they feel they can’t find anything after, combined with the fear that things have been mistakenly discarded. Whether or not anything they needed or wanted kept is actually missing, there is always an intense feeling and belief that there are items missing, even when they are unable to name the missing thing.
Though his house was now habitable, it didn’t feel like his home. He appreciated having his lovely hardwood floors to see and enjoy—and not having to move the furniture and remove the rugs that had covered them. The musty smell was gone. He really liked the labeling of the storage areas, for example, closets, cupboards, and drawers. But he couldn’t reconcile the intensely experienced feelings of loss and unfamiliarity. Despite his awareness that keeping everything would have prevented him from returning home, the loss and inability to reconcile himself to the cost/benefit trade-off was tremendous for him.
For this reason, unless imminent, extreme health or safety concerns necessitate a blitz, working with clients in a spirit of voluntary partnership using evidence-based strategies is best. I combine counseling with hands-on decluttering, taking the time the person needs to develop insight into their unique, underlying vulnerabilities to promote integrated learning. By doing this, clients learn about themselves while acquiring skills that inoculate them against serious relapses. This method is client-centered, respectful, and effective.
This approach supports individuals to make “I can live with it” decisions while having their pace respected. They are also supported and guided to develop understanding and strategies tailored to their personal circumstances (strengths and limitations) and what works for them. Their decisions fit with their values, beliefs, needs, and how they want to live their lives. By the time the work ends, they have developed effective ways to set SMART goals, meet their needs, identify triggers, and lessen the chance of relapse.
Ongoing monitoring and management are also important components of any aftercare program. Support should be qualified and offered immediately, perhaps incorporating additional treatment and services for comorbid issues on a session-by-session intervention plan.
