The Secret Lives of Hoarders: True Stories of Tackling Extreme Clutter
upbeat for the most part—a confrontation with her husband brought the whole process to a halt.
    Even under the best circumstances and with full support, a hoarder who isn’t really ready may feel overwhelmed by the loss of control and just shut down. The more the hoarder feels threatened, the more likely it is that he or she will blow up and order everyone out of the house, and out of the hoarder’s life. An ambush, in the end, simply confirms a hoarder’s belief that people can’t be trusted.
    So, before any successful cleaning starts, the hoarder has to be ready. Family members are anxious to get started long before the hoarder is, but pushing just doesn’t work. The best thing everyone can do is what Roger’s sisters did: wait until the hoarder is ready, even if that takes years.
    The waiting is critical, but it can feel unbearable. The anxiety and worry can pull families apart as they descend into bickering, blaming, and name-calling. Many stop speaking to one another. Ironically, all of that energy comes from concern—family members want to help, but without a clear plan, they get frustrated, and that frustration can come out in negative ways.
    Fortunately, there is something more productive to do during the waiting period. That’s the perfect time to fully assess the situation, learning more about what causes it and what will be involved in a cleanup. This is a critical step toward building a cleanup effort that will stick. Hoarding cleanup is a huge job, so big that the people involved (including the hoarder) only want to do it once in a lifetime.
▶ The Intervention
    The difference between an ambush or secret cleanup and an intervention is subtle but important. In an ambush the hoarder may be taken by surprise—or surprised when he or she returns home to see the deed has been done—but the hoarder does become part of the process. Interventions are usually forced when a state of imminent danger exists, or they are prompted by outside authorities. Whatever action is taken is done even though the hoarder may resist.
    Some hoarding situations have strained a family’s patience and resources to the breaking point—and an intervention is the only solution. The hoarder may have medical issues that mean he or she needs live-in or home health care. Or the hoarding progresses so far that local authorities—child, adult, or animal protective services—get involved. Under the worst circumstances, a building is condemned and the hoarder is forcibly removed. When a situation attracts that kind of outside involvement, it almost always involves a Stage 5 hoarder, who inevitably opposes a cleanup.
    Given such extreme circumstances, the priorities set by family, friends, professionals, and the authorities move from simply supporting the hoarder to remedying a sometimes life-threatening situation. If the hoarder is facing the threat of having his or her children removed, then an intervention can be an option for putting the children first and finding a way to keep the family together. Usually there isn’t any pretense that the hoarder is in charge of the process.
    An intervention is the option of last resort and is usually a major decision. It can’t be undone. Interventions should only be undertaken after serious thought and preceded by family meetings, consultation with a therapist or hoarding specialist, and discussions with the authorities. Aside from the physical issues of the cleanup, any concerns about the hoarder’s mental state (depression, severe anxiety, or suicide) should be discussed with a therapist or specialist before the intervention. This is a really big deal, and an apology will not fix this decision after the fact. Families choosing this option need to appreciate and prepare for all of the consequences, including a complete rejection by the hoarder.

4
    THE PLAN: LAYING THE GROUND - WORK

    A cleanup is not a linear process, with one step

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