Guest Post: Hoarding and OCD in The Butterfly Clues

I'm happy to welcome Rebecca Taylor back to the blog for another Psychtember guest post! You can read her guest post for last year's event here.

I wanted to start by thanking Danya for inviting me to guest blog on her site, I love connecting with other bloggers and having the opportunity to reach a wider audience. So to all you fellow bloggers who are reading this (hint, hint) feel free to hit me up about a multitude of topics (psychology, writing, reading, working, kids…you name it!)

So I wanted to write about hoarding for several different reasons. One, I have had my copy of THE BUTTERFLY CLUES by Kate Ellison sitting on my bedside table for months waiting patiently for my attentions. For those of you who are not familiar with this book, the main character, Lo, is a hoarder AND has OCD (counting, word repetitions, and complex rituals.) Two, I have recently become completely addicted to watching HOARDING: BURIED ALIVE on TLC. And three, it was the first topic that sprang to mind that wasn’t already being covered by another guest blogger.

I like to start by saying that unlike many other “topic” YA books, THE BUTTERFLY CLUES is not actually about hoarding or OCD. It is actually a mystery about a murdered exotic dancer named Sapphire and Lo’s drive to solve that murder. For you writers out there, the hoarding and OCD are really used more as interesting character flaws and also serve (quite nicely I might add) to create conflict and serve certain plot elements where needed. Having said this, I would say that the hoarding and OCD come up so frequently throughout the book, that they are almost like another character in and of themselves or a C storyline if you will. Which, given the nature of these disorders, seems appropriate because both hoarding and OCD can be so disruptive to typical life functions that they become entities to contend complicating even the most simple of daily functions. So why the book is not about hoarding directly, I think Kate Ellison did a really wonderful job of showing how the disorder impacts Lo’s ability to solve this mystery much the same as how real people need to manage their real life under the constraints of a debilitating disorder.

I really did enjoy this book.

As far as hoarding goes, oh lord, what a challenging mental health condition that impacts every area of a person’s life. Hoarding is a new disorder being considered for addition to the DSM V (now set for publication in May of 2013) and the criteria under Obsessive Compulsive and Related disorder are looking something like this:

A. Persistent difficulty discarding or parting with possessions, regardless of their actual value.  

B. This difficulty is due to a perceived need to save the items and distress associated with discarding them.

C. The symptoms result in the accumulation of possessions that congest and clutter active living areas and substantially compromise their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (e.g., family members, cleaners, authorities).

D. The hoarding causes clinically significant distress or impairment in social, occupational, or other important areas of functioning (including maintaining a safe environment for self and others).

E. The hoarding is not attributable to another medical condition (e.g., brain injury, cerebrovascular disease, Prader-Willi Syndrome).

F. The hoarding is not better accounted for by the symptoms of another DSM-5 disorder (e.g., hoarding due to obsessions in Obsessive-Compulsive Disorder, decreased energy in Major Depressive Disorder, delusions in Schizophrenia or another Psychotic Disorder, cognitive deficits in Dementia, restricted interests in Autism Spectrum Disorder).

Specify if:

With Excessive Acquisition: If symptoms are accompanied by excessive collecting or buying or stealing of items that are not needed or for which there is no available space.

It goes on to address to what degree the person has insight into their disorder and this appears to be the key to whether or not they are successful in diminishing the hoard through therapy because the people who have poor insight into their hoarding tendencies seem to go round and round in a frustrating and confusing cognitive loop of justification for their hoarding. Practically every item has great necessity and value to the individual and their anxiety about parting with their belongings is so intense, when challenged to even make decisions about letting a singular item go to either the dump or donation, those with poor insight become masters at avoidance, deflections, and circular logic. When pressed, they sometimes become very angry and aggressive probably as a learned behavior that is often successful in driving others away. If hoarding continues unabated, living conditions can become so dilapidated that routine maintenance and cleaning become impossible. Kitchens and bathrooms become unusable as toilets and sinks overflow, pipes break, walls and roofs deteriorate, bugs and animals move in and food, garbage and feces pile up and into the preexisting piles.

In THE BUTTERFLY CLUES, Lo’s hoard is contained in her bedroom and is not noticed by grief stricken parents: a drug dependent and depressive mother and a workaholic father. I would say that Lo’s insight into her hoard is very poor and, while it is not addressed directly in the book, it does not seem like she would, at this stage of her life, be very receptive to therapy. But, as I said before, this is not really the point of the book in the first place so I’ll just keep my armchair quarter back opinions to myself, ahem.

In short, yes I recommend reading THE BUTTERFLY CLUES. I do not recommend hoarding.  And now, I’m going to go clean out my closet.

Rebecca Taylor is a school psychologist and author of YA fiction. ASCENDANT, the first book in her ASCENDANT series, releases in June 2013 from Crescent Moon Press. She is represented by Emma Patterson at The Wendy Weil Agency Inc.

Follow her at:

Twitter: @RTaylorBooks

Facebook: http://facebook.com/RebeccaTaylorBooks

Blog: http://rebeccataylorbooks.blogspot.com

If you would like Rebecca to be a guest blogger on your site, email her at Rebecca@rrtaylor.com

     

ASCENDANT by Rebecca Taylor
(Crescent Moon Press, June 2013)

When I was twelve, my mother disappeared. I was the first person to never find her.

I’m sixteen now and she has never been found, alive or dead.

I’m not the girl I should have been.

When Charlotte Stevens, bright but failing, is sent to stay at her mother’s childhood home in Somerset England her life is changed forever. While exploring the lavish family manor, Gaersum Aern, Charlotte discovers a stone puzzle box that contains a pentagram necklace and a note from her mother—clues to her family’s strange past and her mother’s disappearance. Charlotte must try to solve the puzzle box, decipher her mother’s old journals, and figure out who is working to derail her efforts—and why. The family manor contains many secrets and hidden histories, keys to the elegant mystery Charlotte called mom and hopefully, a trail to finding her.

Thanks very much, Rebecca, for this thoughtful and informative discussion of the OCD/hoarding portrayal in The Butterfly Clues!

For those of you who have read The Butterfly Clues, what did you think of the presentation of Lo's mental health issues?

Dirty Little Secrets: A Psychtember Review

Patient: Dirty Little Secrets by C.J. Omololu

Presentation:  

"Everyone has a secret. But Lucy’s is bigger and dirtier than most. It’s one she’s been hiding for years—that her mom’s out-of-control hoarding has turned their lives into a world of garbage and shame. She’s managed to keep her home life hidden from her best friend and her crush, knowing they’d be disgusted by the truth. So, when her mom dies suddenly in their home, Lucy hesitates to call 911 because revealing their way of life would make her future unbearable—and she begins her two-day plan to set her life right. 

With details that are as fascinating as they are disturbing, C. J. Omololu weaves an hour-by-hour account of Lucy’s desperate attempt at normalcy. Her fear and isolation are palpable as readers are pulled down a path from which there is no return, and the impact of hoarding on one teen’s life will have readers completely hooked." (from Goodreads)

Assessment:

Axis 1. Characters

Lucy's a sympathetic narrator with a lot of admirable qualities: a great survivor's instinct, an ability to push on, and strong self-reliance. But she's also obviously suffering from the effects of her mom's hoarding, paying the price with a limited social life and low self-esteem (not to mention the house situation itself, which is a whole separate issue). We're shown how much Lucy fears the stigma of living in such a house — she was called "Garbage Girl" and bullied before she transferred schools — and she must keep everyone at a distance. I don't blame her for feeling ashamed; I'm sure I would feel sick, mortified and stifled living the way she does.

She has a pretty poor relationship with her mother, not surprisingly. I think I would have felt sympathy for the mother if in every way, except for the hoarding, she was a wonderful mom...but she's not! She's always yelling at Lucy and blaming her for everything, spending all of her kindness on her patients and treating her family like crap. Since it's told from Lucy's perspective, I admit I couldn't feel a lot of sympathy for her mom, although I did feel a little sorry for her at one point when she starts crying, and it seems like she does get really stressed about her job. It's sad that she doesn't have a better relationship with her daughter, but I suspect that it's due to more than just the hoarding, since the mom seems to have other issues.

The romance is cute — I really liked Josh, since he's so obviously into Lucy (the coffee shop scene is adorable!). His mom has problems too, which helped Lucy realize that she wasn't the only one with parents who have problems, but also that her mom's hoarding is different from more common disorders (like an addiction). I liked Lucy's brother Phil and I wish she'd opened up to him, because he understood what it was like to live that way; it's a shame that he wasn't there for her.

Axis 2. Premise/plot

As the presentation of what it's like to live with a mom who hoards, Dirty Little Secrets is very effective. As a story, though, it doesn't really work, because it doesn't have much of a plot. There are basically two major plot points (one at the beginning, one at the end) and the middle is all Lucy cleaning the house. We get flashbacks about the mom, Lucy's siblings, and what it was like living in this house, but it's very slow and lacks momentum. The fact that Lucy has a deadline helps a little, but seriously, she spends most of the book cleaning. If you are the kind of person who loves to have a huge mess to clean up, and that makes you happy, then you will love this book, because you can clean vicariously through Lucy. There are a few gross scenes in here, so if maggots and the like make you squeamish, you might want to be aware of that before reading this one. 

I appreciated that Lucy took initiative, first with trying to clean the house up, and then with the final action she took to try to free herself (although I don't necessarily agree with what she did, so I ended up feeling kind of mixed about this choice). The ending was very abrupt, and I was left feeling somewhat dissatisfied; I wanted more resolution with Josh and Kaylee, Lucy's siblings' reaction, and just a glimpse of Lucy's future generally.

Axis 3. Writing Style

Some of the descriptions in here are quite appallingly disgusting (which they should be, given that stuff is going bad), so the author does a good job with the grossing-out-the-reader side of things.

Axis 4. Psychological Accuracy

This is a very realistic portrayal of a girl who has lived for years with a mom who's a hoarder in a house that is completely suffocating her with stuff. It's gotten to the point where things are molding and it's unlivable, really. There's a lot to do with the stigma of hoarding in here, and since stigma is a very important aspect of mental health I was pleased to see that brought in.

However, I would have liked more detail about the psychological explanation of the mom's hoarding behaviour. I really wish that this had been clearly explained to the reader; there's so much blame put on the mom in this book, and while I can understand that the author wants to validate how people with hoarding parents feel, and that's perfectly reasonable, I think it also needs to be pointed out that hoarding is caused by a mental disorder and that these individuals need help, and may not be able to stop without help. After all, some types of hoarding are classified as subtypes of obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD), but that's not mentioned here. At times it sounded like Lucy's mom was choosing to be like this, like she could have stopped at any time, and we never get to see what's going on in terms of the complexity of the mom's mental state, so I was disappointed about that. There are some oblique references to the cause of the hoarding behaviour (like the fact that it's genetic) but we never actually get told straight out that the mom has a mental illness.

Still, kudos to the author for picking an unusual topic that needs to be highlighted more in YA, and for doing her research about what it's like to live with a hoarder, and believably portraying the emotions one might experience in that tough situation.

"Fast Facts" about hoarding: Did You Know?

• Hoarding typically begins in the early teenage years. 

• Approximately 50% of hoarders have a history of dependence on alcohol.  

• Some people hoard animals without giving them appropriate care. 

• There's a specific term for the hoarding of books: bibliomania. (I wonder how many book bloggers have this?)

Validity Score: How psychologically accurate was Dirty Little Secrets?

Axis 5. Miscellaneous

There's actually an additional final chapter to this one, posted online (thanks to Bonnie from A Backwards Story for alerting me to this!). 

Patient shares symptoms with: The Opposite of Tidy by Carrie Mac

Patient's statement:

The phone's display shone brightly as I opened it to dial 911, the numbers blurring through the tears that had started to form in my eyes. I blinked hard. My fingers hovered over the first number as I looked down the hall at the piles of magazines, newspapers, clothes, plastic bags, and boxes of her stuff that choked all but a few narrow, winding paths through the house. I knew it smelled like rotting garbage in here, remembered it in one of the recesses of my brain. It was the same smell of decay I always worried would follow me out of the house, clinging to my clothes like a sock to Velcro. I'd lived with it for so long, I didn't even notice the smell anymore.

But the paramedics would.

Diagnosis: 3.5 shooting stars. 

For more information about hoarding, see here.