Hoarding is usually considered a subtype of Obsessive Compulsive Disorder (OCD). Like other compulsive behaviors, hoarding is an effort to manage the anxiety raised by obsessive doubts. There are varying levels of hoarding behavior. A diagnosis of OCD of the hoarding type is made when there is significant distress or disruption to feelings of self-worth, interpersonal relationships, education, occupation, housing, finances, legal issues, or health as a result of hoarding behavior.

Symptoms vary from person to person, but may include:

Saving items seen by most people as unneeded or worthless, (i.e., not true collectibles).

Compulsively buying or saving excessive quantities of items of any kind.

Treating all saved items as equally valuable--whether or not the object has sentimental, financial or functional value.

Experiencing intense anxiety or distress when attempting to discard-or even think about discarding-what most others view as useless objects.

Engaging in saving activity to combat anxiety-provoking thoughts such as: "What if I run out?" "What if I need to know something and don't have the information available?" "What if I put it away and can't find it?" "What if the way I organize it isn't the right way?" "What if I throw it away but the day comes when I really need it?"

Being unable to use furniture, rooms, or entire homes in standard ways due to saved items.

Significant deterioration in housekeeping due to excessive clutter.

CAUSES: There appears to be a strong genetic component to Obsessive Compulsive Disorder of the hoarding type. Modeling and conditioning may also play a role in the development of this disorder. OCD usually involves over-activity and/or under-activity of brain regions that underpin the observed behaviors. Hoarding worries and behaviors can begin in childhood, even as young as age five.

TREATMENT: Combining psychotherapy, exposure therapy, and medication can help individuals to make beneficial changes in their lives. Psychotherapy involves exploring the impact of learning, triggers, worrisome thoughts, and intense emotions. Exposure therapy involves practicing new ways of responding to uncomfortable thoughts and feelings that arise when hoarding behavior is challenged. Exposure therapy is often conducted in the home with pragmatic emphasis on both reducing the clutter and managing the doubt and anxiety that perpetuate the clutter. The key is learning to "allow" feelings of anxiety to be present without attempting to neutralize them by saving things. Medications used to treat anxiety and OCD (e.g. Paxil, Luvox, etc.) and to sharpen attention (e.g. Ritalin) can be helpful. Co-morbid conditions such as depression may also need to be addressed.

THERAPY GOALS:

Avoid repetitive questioning (e.g., "Why? Why do I hoard? Why did I let this get out of hand?").
Understand that recovery doesn't require an answer to "Why?"
Remember: OCD and/or hoarding are/is not logical.
Ask instead: "What is my objective? How can I best get there?"

Develop the ability to tolerate intense emotions.
Rate the intensity of feelings on a scale of 1 to 10.
Observe changes in the intensity of feelings.
Notice that feelings come and go; saving things is not required to reduce anxiety.

Accept that less than perfect is "good enough."
Towels do not have to be folded with military precision, cans do not have to be arranged in alphabetical order, etc.
Take care with items of consequence (e.g., bills, medicine, safe deposit box keys), but relax with things of less consequence (e.g., today's newspaper, "junk" mail, spare toothbrushes). Correctly making that distinction is often the key to recovery.
Practice a "so what" attitude if you make a mistake. Ask yourself what is the worst that could happen and how could it be fixed.
Ask yourself if it is worth the time and effort to change something you have done or whether you have better things to do.

"Only Handle It Once." (OHIO)
Deal with each item only once.
Check things only once instead of storing them to check more thoroughly later.
Deal with things as soon as they come into the house.
Do not retrieve items from the trash when second thoughts intrude and raise doubt.

Simplify decision making.
Limit choices, (e.g., keep, recycle, sell, give away, throw away).
Make clear decision rules for each choice, (e.g., keep 10 hole-free plastic bags, throw away dirty bags, recycle remaining bags).
Use broad categories instead of many specific ones, (e.g., "gift wrap items" instead of paper, lace ribbons, small, medium & large bows).
Accept that others, including experts, may do things differently.

Organize and file systematically.
Place like things together in a designated place, (e.g., place grain products in one cabinet, bottled and canned goods in another).
Use broad headings when filing, (e.g., house, cars, medical, insurance, job, education).
File only important papers.

Buy and keep "just enough."
Sales will be repeated.
If you run out, it is not a disaster.
Keep items you use--throw out others, (e.g., You have five handbags--you use one; one has a broken handle; one has a hole in the bottom; one is too small; and, one is a color you do not like. Keep the one you use; throw away the damaged ones; and, give away the other two).

Focus on functionality.
Select a target, (e.g., an area such as the kitchen or even a corner of a particular room).
"Excavate" the target by throwing away and organizing.
Maintain the clear space.
Use the cleared space only for its intended purpose.

Seek assistance or another opinion.
Individuals who hoard often have a difficult time determining what is "important vs. unimportant," "just enough vs. excessive," or "necessary vs. inconsequential." Enlisting the aid of a trusted friend or professional can provide guidance in developing appropriate guidelines and persevering with your goals.

ADDITIONAL RESOURCES: Obsessive Compulsive Foundation P. O. Box 70, Milford, CT 06460 (203) 878-5669 For more information: OCFoundation Books: See "Dealing with OCD" for bibliographic citations.

JP/ST/VB

This was a clash, a struggle, a pitched battle with our stuff, and each other. The chafing dish would be our Waterloo. Like everything, the dish came attached to a story: it was a wedding present from someone, now deceased, and was once used "all the time" at dinner parties of yore. I wasn't really listening, because I had heard many such tales in the course of the decluttering, and the fate of the chafing dish had already been decided. It was pretty but pointless and had clearly warmed no meatballs in my lifetime, so I would toss it in the wagon for the next run down to the Salvation Army. But as she had so many times before, Mom dug in. She extolled the dish's beauty and utility, and the kindness of the friend who bestowed it on her 45 years ago. And she insisted I would want it-even need it-someday.

The rarely used objects that clutter our lives are not really objects at all but symbols of our plans and untapped potential. This defied all logic, just as it had for the giant punch bowl, the set of crockery shaped like waterfowl, the candelabra with the broken arm, and the peculiar vacuum cleaner that was designed to vacuum hot fireplace ash. I would never need them, because I did not have a life that involved punch parties or large amounts of wood burning and did not anticipate acquiring one. And I knew from bitter experience that there was probably another chafing dish lurking nearby, poised to emerge and replace its fallen comrade. (There were, in fact, two more.) We fought, and things got ugly. I was trying to wipe out her life; she was losing her mind. The chafing dish went out the door, only to be rescued, a bit later, by my father. "Your mother," he said gravely, "really wants this." Defeated, I pulled the accursed thing out of the car and pondered what would become of it, and all it represented. I would have to take it to my house and consign it to my own basement in the hope of someday conjuring up a situation that required a chafing dish, before my own children discovered it and asked me what it was so they could throw it out. We stood there in the driveway, the dish and I, and I looked back at the house, so dense with belongings it all but vibrated with anxiety. And I wondered how life had deposited my family at this point, hostages to the bric-a-brac that once served us.

In Dante's Inferno there is a circle of Hell reserved for two warring armies, the Hoarders and the Wasters, who spend eternity rolling enormous boulders at each other on a desolate sun-baked plain. The boulders are actually diamonds and represent the possessions they had such unhealthy relationships with during their lives. "Why do you hoard?" the Wasters shout. "Why do you waste?" the Hoarders scream back. This repeats, endlessly, joint punishment for their respective sins. The contemporary earthly equivalent of this infernal battlefield is the self-storage facility, the charmless metal sheds that sprout alongside interstates and in industrial parks across the country. All but unknown before 1970, such facilities now number 45,000 nationwide, representing slightly less than 2 billion square feet of rentable space filled with the excess material burden of Americans whose caches have outgrown their houses and garages. (This despite the fact that a quarter of homeowners with two-car garages use them exclusively for storage and park in the driveway.) The rise of the self-storage industry in the past decades has been accompanied, counterintuitively, by the supersizing of the American home, which has swelled about 60 percent since 1970, from an average of 1,500 square feet to about 2,400 square feet today.

So voracious is our appetite for acquiring stuff-and so great our attachment to it once acquired-that we are willing to rent space to hold it, miles away from these homes, even though the investment in monthly upkeep is typically greater than the worth of the contents themselves. Why do we hoard? Why do we waste? The answer is somewhere deep in our genes, perhaps, or in the social programming of millennia that is colliding with an era of unprecedented access to consumer goods. Survival of the fittest once favored the far-thinking fellow with the biggest collection of rocks and sticks, and even the advent of eBay and the $29 DVD player has not dimmed this evolutionary urge to collect everything we can lay our hands on. Once acquired, such objects tend to become permanent additions to the collection, despite age, disrepair, or manifest uselessness. After all, maybe the children will need them someday. In many cases the tools and materials for creative projects stack up, while the projects remain uncompleted. The price of this psychic grudge match between Darwin and Calvin is being paid to another recent addition to modern life, the professional organizer.

The National Association of Professional Organizers currently boasts 3,900 members, who, for an hourly fee, help their pack rat clients stack their CD collections, shred old bank statements, toss broken flashlights, and clean all the dead batteries, twist ties, and soy sauce packets out of their junk drawers. Failing that, the clutter-prone can join 12-step support groups such as Clutterers Anonymous or Messies Anonymous, or self-medicate with any number of how-to books and instructional DVDs that promise to put the untidy life in order. And then they can curl up in front of home-makeover reality shows such as Clean Sweep or Clean House, those curious entertainments devoted to chronicling how a team of happy young people descends on someone else's disaster-zone household and swiftly renders it stylish and habitable again.

For older people the challenges of keeping clutter at bay take on a specific dimension. Depression-era mindsets about the value of manufactured goods have not adapted to the short shelf lives of today's technology. That same technology is making it even easier, via the Web, to participate in the consumerist frenzy that is American culture. Meanwhile, household demands have grown in complexity as an array of vendors now deliver cable TV, Internet access, and cell phone service-and their accompanying monthly bills-to a home already lashed with a steady stream of junk mail. Add the inevitable health concerns, complicated medication schedules, and related memory issues that advancing age can bring on, and a once functional household can descend into chaos practically overnight. The dangers are both physical-a cluttered house is an obstacle course for people with limited mobility-and psychological. Particularly when the day comes that all that stuff has to go.

In the early 1990s Smith College psychologist Randy Frost, Ph.D., placed a classified newspaper advertisement for "pack rats and chronic savers" to participate in a research study and was surprised by the scores of responses he and his team received. "We suspected that we were on to something," he says. Frost, an expert on obsessive-compulsive disorder (OCD), became a pioneer in the then-little-known field of compulsive hoarding, a clinical term for the most severe form of cluttering behavior. Hoarding cases emerge via newspaper headlines periodically whenever authorities uncover homes filled to the rafters with newspapers, garbage, or simply piles of possessions that cover every available surface and often render the homes uninhabitable because of animal infestations or structural damage. Frost estimates there are as many as 4 million hoarders nationwide, but there are far greater numbers of individuals who fall elsewhere in a spectrum of problematic cluttering behavior. Understanding the mind of a clutterer is a difficult process.

Frost breaks down the behavior into its three major manifestations-compulsive acquisition of useless possessions, living spaces so cluttered they can't be used, and distress or an inability to function because of the hoarding. The syndrome can appear in patients as young as 13 and tends to worsen with age. While the phenomenon is often associated with obsessive-compulsive disorder, "it happens outside of OCD as well," he says. There's also a link with attention deficit hyperactivity disorder, or ADHD. Frost's studies have found hoarders across the income spectrum and around the world. "We know it's related to materialism, but it's not just a Western phenomenon," he says. "There may be a cultural component. We also know that it runs in families, so there may be some genetic influence." Nor is it a peculiarly modern malady: history, Frost notes, is full of case studies, including Mary Todd Lincoln, whose compulsive shopping proved a political liability for the 16th president. Frost once speculated that adults who exhibited such behavior were responding to childhood poverty, but the studies did not bear this out. He did discover, however, a different background issue-a link to emotional deprivation and the level of warmth expressed in the family during adolescence.

The National Study Group on Chronic Disorganization (NSGCD), a nonprofit group of 440 professional organizers and psychiatric professionals that Frost consults with, has compiled a five-point Clutter-Hoarding Scale to assess potential clients. Levels III and up are clinical cases that require psychological intervention. At Level I and Level II the sins of the chronically disorganized are detailed: "slight narrowing of household pathways; unclear functions of living room, bedroom; one exit blocked." It is these minor offenders-the "common clutterers"-that Terry Prince, a Sacramento professional organizer, tries to help. Prince teaches clutter-control classes and workshops for the chronically disorganized, and she's made her own observations of the species during her career in the field. "Clutterers are interesting," she says. "They're creative. They're people with a lot of interests." About one in three of her students, she points out, are teachers-notorious compilers of paper clutter-and many others have craft hobbies, along with an unrealistic number of projects in process and a large backlog of supplies and materials for which they claim, "I'll get to that someday," a familiar clutterer's refrain. "If that's what you're hearing," Prince says, "you're in trouble."

Both my parents, unluckily, fit this description: one was a university professor; the other, a piano teacher with a lengthy rÃÆ'Æ'Ã'Ã'©sumÃÆ'Æ'Ã'Ã'© of homemaking sidelines, from furniture refinishing and cooking to sewing her own clothes and knitting several closets' worth of sweaters. Their home was a monument to their shared pursuits, completed and otherwise. Books climbed to the ceiling, hid in stacks underneath tables, and clogged narrow upstairs hallways. The paperwork of decades in academia filled my father's office until the door could barely be opened, so he simply moved his desk into a vacated bedroom and started a second office. In basement boxes sat every paper and journal he ever read and every note he ever jotted, dating back to his undergraduate days, and perhaps beyond. Amid all this, in heaps and bags and unregulated piles, was a dense residue of family history: trunks packed with imported fabric for dresses that were never sewn, hand-hooked rugs too worn to walk on, heirloom furniture built for another age-all of it so freighted with memory that it might as well have been bolted to the floor. In other words, it was a house probably much like many others, well lived in and a bit overstuffed by the passing of years but certainly not a job for the local health department; and I expected that the chore of emptying it would be just that: a chore, slow and grimy and unpleasant. But there were unexpected difficulties.

Discarding even the most innocuous bits of junk from the garage-a half-emptied propane tank, a stack of catalogs, full jars of paint and weed killer-seemed strangely painful to my parents. Progress was agonizingly slow, and each station wagon load of detritus I managed to wrest from the house seemed only to deepen their attachment to what was left. My father's books were declared untouchable; my mother's majestic trove of kitchen gadgetry-enough to stock an exhibition of postwar American cooking-was culled only after objections so fevered and persistent that I sometimes caught myself wondering if one really did need two kinds of cherry pitters. What I didn't understand until it was much too late was that the objects going out the door were not objects at all. Often the items that had been used the least were the hardest to throw out, symbolizing as they did not fond memory but never-tapped potential. They were, as my father said while I hauled off a nearly new portable gas grill, "artifacts of unused life."

According to professional organizer Jeanne Smith, her older clients often have a connection with their possessions that other family members can't fathom. "They're going through a life-review process and a grieving process," she says. "They're reliving 20 years of their lives through that coffee cup." Smith specializes in what she calls estate organization: helping downsize households prior to moves to assisted living or after the death of one spouse. Such events, stressful at the best of times, are often handled by adult children who are woefully ill-equipped for the task. Today's more mobile families mean that offspring are often geographically distant, and typically there are fewer siblings to share the load. Smith, who lives in the San Francisco Bay area, serves as a sort of field general for this traumatic process, coordinating the intricate logistical ballet of charity donations, estate auctions, paper shredding, and lost- heirloom-finding that accompanies the upending of a well-rooted household. She can help sell cars and homes, work with trustees and executors with the clients' assets, and ease the psychological transition to new and unfamiliar lives. (The National Association of Senior Move Managers offers a referral service to similar businesses on its website.)

More than once, Smith has taken photos of a client's living room, then duplicated the arrangement of books and knickknacks in the new apartment to create a miniature facsimile of the old home. It's a delicate role. "We are invited into the most intimate parts of their lives, especially if there's a clutter issue," Smith says. Sometimes she's hired by adult children to take over or jump-start a stalled decluttering initiative, and her arrival signals something of a gentle ultimatum: "If you don't go through your stuff, I will." For individuals who are horrified to leave such a mess behind for their children but are unable to tackle the problem alone, the situation may be laced with denial and shame. As an outsider, Smith can wade into this fraught family dynamic without exacerbating what is likely to be an already tense situation. "I don't have that history with the client," Smith says. "If it's your child [helping with the process], it's twice as irritating," agrees Prince. "It's a lot easier when it's a third party." Much of her work involves simply listening to her clients talk about their stuff, a ritual that the kids may no longer have the patience for. You also have to avoid the drastic measures that many exasperated family members might take when faced with an overloaded home, a stubborn parent, and a moving deadline-just throwing everything out on the curb. At a time of life when loss of control is a painful reality, forced decluttering can be devastating. "Clients need to make the decisions themselves," Prince says. If you throw things out for them, "they're not going to feel happy. They'll feel violated." To help break the grip, organizers rely on a number of strategies. Smith will act as a family archivist, assembling photographs and recorded reminiscences into a "memory box" of beloved belongings that just don't belong anymore. "You're validating the objects without actually having to hold on to the objects themselves."

Prince coaxes reluctant clients with positive language. "Find charities your family honors and loves," she says. "Say, 'Who would be the perfect person to give this to?'-not 'Can I throw this away?&rsquo " When all else fails, she's also willing to put things in self-storage, briefly, to get an intractable homeowner out of the house. "Some battles don't need to be fought then and there," she says. "It's costly, but it's less costly than ruining the relationship." In the end, the decision to go was made for us, as it often is.

A series of health problems made staying in the home difficult, and then impossible, for my parents. It was their stuff or their lives, and, thankfully, their stuff lost. Let us skim past the actual mechanics of that move, a journey best forgotten by all parties. When the dust settled, my parents were safely installed into a bright one-bedroom apartment, several states west of me but just blocks from my brother and his family. A great deal of their stuff also made the journey, though only a fraction of it could be unpacked. Much of the rest was warehoused in a storage facility at the windswept edge of town. Once, my brother drove my mother by this place and rolled up the metal door of their unit, so she could survey the towers of boxes and blue plastic storage bins stacked to the ceiling. Left behind in their vacated home was yet another subset of that stuff, the stubborn dead-enders. For several weekends I labored at this archaeological dig until the last holdouts were donated, auctioned off, or stuffed into my garage and basement to await some uncertain fate. And there they rest: the steamer trunks full of tweed, the old rugs, the boxes of papers and toys and camping equipment.

Sometimes I poke into a box and pull out some bit of family ephemera-the 50-year-old receipt to my grandfather's watch, photographs from a trip to Europe in the early 1970s, the original architect's drawing of the home I would grow up in. They have the familiar, earthy scent of that house's basement, transplanted into my own. I am plotting a garage sale, of course, just as you probably are. I will not inflict this curse on the next generation. Everything will go, and I will live as I did in my 20s, when everything I owned fit in the back of my car. And as I contemplate the unburdening of this great payload of memory, I am confronted, again, by a brass chafing dish. Several months after their move, my parents visited me at my house, and I surprised my mother by dusting off this dish and showing it to her. At the sight of the thing she immediately burst into grateful tears. The dish sat on the dining room table, useless as ever, for the duration of their visit. When they left, I carefully replaced it in its box and put it back in the basement, with everything else.

David Dudley is a writer and editor in Ithaca, New York.

Five key tips for the clutter-besieged:

Try an experiment

Can't bring yourself to part with your beloved collection of vintage bank statements? "Think about it as if you were a scientist," advises psychologist Randy Frost. Make a hypothesis about how sad you'd feel if you got rid of these artifacts. Then throw them away and compare your resulting distress with that hypothesis. Frost says that typically your reaction will be far less severe than you'd feared. Once you know that, it might be a little easier to let the next treasured object go.

Create a record

Photograph or videotape belongings before you give them away. "It's the memories that are important, not the objects," says professional organizer Jeanne Smith. A single digital CD can hold a warehouseful of family knickknacks, along with the client's recorded reminiscences about each one of them, and copies can be made and distributed to the children and grandchildren.

Give and take

Giving your belongings to charities whose work you support is more satisfying than selling them to strangers-and, thanks to the tax deductions, usually more profitable.

Start small

Tackle one room-or one part of one room-at a time. Don't leave the area until it's finished, because you'll get distracted trying to find a home for all the stuff you've just picked up and will end up "churning"-shuffling the same clutter from one part of the house to another.

Find a friend

Clutter support groups, many using the familiar 12-step techniques, can be effective for chronic offenders. One very helpful online support club is led by Marla Cilley, better known as the FlyLady. Via e-mail and a website, FlyLady.net, Cilley goads, coaxes, and exhorts her followers to maintain a system of easy, regular routines that gradually clear households of clutter. Follow the FlyLady program for a month, she says, and her decluttering habits become all but reflexive. "It's behavior modification in a very simple way," Cilley says. "I call it FlyWashing." Source: Association for Psychological Science Date: April 5, 2007

Facing jail because his house is filled to the brim,
a hoarder finds hope in a woman with a talent for organizing -- and a big heart.

By Jean Merl, Times Staff Writer
December 4, 2003
The Los Angeles Times

By the time Dorothy Breininger dropped - miraculously, it seemed - into his life, Lloyd Drum, at 75, had pretty much resigned himself to going to jail. The reasons lay in the odiferous piles of moldering, rodent-infested clothing, furniture, books, expired coupons, bikes and bike parts - thousands of bike parts - that crammed his two-bedroom house and flowed over the yards, porches and garage. Inside the house, a person had to turn sideways to navigate pathways through clutter that, in places, almost reached the ceilings. Unable to eke out space for even a bed, and bothered by the dust, Drum slept in a broken recliner on his front porch.

Drum is intelligent and well educated, a churchgoing vegetarian who likes to help others. He is also a hoarder, a seemingly indiscriminate accumulator and keeper of stuff. As many fire officials, building inspectors, mental health workers and the families of "pack rats" can attest, Drum's situation is hardly unusual. And many familiar with the case hope that the story of Drum and Breininger, a professional organizer who agreed to help at no cost, will guide officials in developing better ways to handle a problem that mental health experts have only recently begun to understand and treat.

Severe hoarding is often a symptom of obsessive-compulsive disorder, which afflicts as many as 3% of Americans at some point in their lives. It can also be a manifestation of depression, delusional disorder, or, in the elderly, of senile dementia. People of all ages and from all walks of life can be hoarders, but the problem often worsens with age. No one keeps statistics on hoarding, but more and more jurisdictions nationwide are forming special teams to deal with what appears to be a growing problem. In Los Angeles County, officials formed a hoarding task force two years ago and plan to be hosts to a conference on hoarding next year.

News reports give glimpses of extreme hoarding's toll: the fire that kills a man trapped by his jampacked possessions; the widow who dies alone, surrounded by filth and scores of cats, dead and alive. In Orange County, a college professor, after years of court battles over the refuse inside and outside her house, fled the state in early 2000, giving up her job, her home and most of her possessions, to avoid jail.

The threat of jail loomed over Drum. More than eight years of citations, interspersed with short-lived cleanups, eventually led to criminal charges. Last year, Drum pleaded guilty to some of the counts, was put on probation and ordered to fix the problems that posed dangers to himself and his neighbors in the working-class community of Lennox. Drum joined Clutterers Anonymous, stopped bringing home castoffs and even sent some discarded TV sets to recyclers. But he seemed powerless against the tide of stuff that had filled his home, eating away at floors and drywall as it all slowly sank into dust and decay.

By summer, a frustrated judge had run out of patience, and Drum had resigned himself to jail, or - even worse, in his view - being placed under the county's conservatorship. Looking for a better solution, Sari Steel, an attorney for the county counsel's office, located Breininger, then president of the local chapter of the National Assn. of Professional Organizers. Drum agreed to work with her, so the judge postponed Drum's probation violation hearing and gave him and Breininger until Oct. 24 to get the job done.

Although a proud and private man, Drum allowed The Times to follow their progress. "I'm grateful for the help, and maybe this will do some good for others," Drum said. Aug. 28 Eight Weeks To Go: "Tell me about this space, Lloyd," Breininger, clipboard in hand, says evenly as she and assistant Jill Colsch pick their way through the living room. They have driven down the 405 Freeway from Breininger's Center for Organization and Goal Planning in Canoga Park. Breininger has a seven-page to-do list, complete with supplies needed (commercial vacuum cleaners, trash bags, rat poison) and deadlines.

Colsch takes notes and videotapes each room to help plan and create a record for the judge. First step: Get rid of the mice and rats. Then take everything out of the house, clean it, sort it and replace what is to be kept in labeled, neatly stacked boxes. The original plan is to do this all in one day, but Breininger, after sizing up Drum, decides to do it gradually.

When she offers a reporter and photographer surgical masks as shields against air heavy with the smell of mold, decay and rodent excrement, Drum looks embarrassed. "Is there an odor in here?" he asks anxiously. "I don't notice it." "Many people's homes have their own unique scents, and they are so used to it they don't notice," Breininger, who is not wearing a mask, says soothingly. "If you can decide what is really important to you and give up the rest, you'll be able to use and enjoy what you love most," Breininger adds, delivering what will become a mantra over the weeks ahead. "It's about setting priorities."

Experts say that's a very big if. Hoarders, who tend to be perfectionists, often can't decide what is important and fear tossing something they might need later. "I agree that I need help getting organized," Drum says, glancing around. "Somewhere in here I sincerely hope is my high school yearbook." (White Plains, N.Y., Class of 1946. He was class valedictorian.) They move to the "bike room," a back bedroom piled to its missing ceiling with frames, wheels and gears. Out in the backyard are more bikes, more parts - maybe 5,000 altogether, Drum estimates.

Like many hoarders, Drum has a specialty. He has loved bikes as long as he can remember. Years ago, he built a bicycle for two, and he and his bride (from whom he is long divorced) pedaled around San Diego on it on their honeymoon. Until arthritis and a bum knee forced him onto public transportation, Drum biked everywhere. He still uses a ladies'-style cruiser (because it's easier to get on) for short trips, including appearances at the Airport Courthouse. He repairs them, for free or at cost, for neighborhood children. If Social Security someday no longer can sustain him, he figures he can expand his repair business to make ends meet. "What percentage of this do you think you could give away?" Breininger asks. Drum thinks long and hard: "I'd say 50%. If you can guarantee that someone will make use of it."

In coming weeks, Breininger and Drum will seek out charities, bike manufacturers and shops. A church in Manhattan Beach takes some for its bike giveaway program. The fat-tire models are welcomed by a group in Africa. None, Breininger promises him, will land in the trash heap.

Sept. 12, Six Weeks to Go: Drum has just come from Clutterers Anonymous, one of three meetings he attends each week, when he joins Breininger at a Hawthorne restaurant to plan. She says that the big push will come Oct. 13 - Day of Overhaul on her memo - and that she has arranged for an enormous dumpster. Drum winces. "That's a dirty, dirty word!" But he smiles gamely when he says it. "Excuse me," laughs Breininger, "I mean a large, wheeled receptacle." Then she gets serious. "I promise you, again. Nothing will be thrown out without your approval. You're going to have the final say before anything goes into the, uh, the receptacle."

It's clear that Drum has come to trust the 40-year-old businesswoman, a self-described "type-A personality" who has written books and counted CEOs and celebrities among her clients. "I help my clients simplify their lives," Breininger says. She says her work has brought her a growing awareness of Americans' problems with clutter. "She was just what I was looking for," recalled Steel, the county attorney. "A professional with a big heart." Breininger attended the University of Wisconsin on a gymnastics scholarship but dropped out after two years. After secretarial school, she discovered her talent for organizing. After several years working as an executive assistant to deans at Northeastern University and UCLA, she established her own company.

Drum grew up on the East Coast, the only child of a mother who he said was loving but overprotective and a father whom he described as emotionally distant. Drum studied engineering at MIT but dropped out, moved west and eventually earned a degree in psychology from UCLA. He married a teacher, and they bought the house in Lennox in 1964. Its breakfast nook, dining room and master bedroom all opened onto a back patio and a large, tree-shaded yard. Drum mostly worked with computers, but did not stay at any one job long enough to earn a pension. After he and his wife separated, Drum worked on his bicycles, read voraciously, watched TV documentaries and attended the Unitarian Universalist Community Church of Santa Monica. Nine years ago, he opened his door to a homeless veteran, allowing the man to live rent free. The stuff, both Drum's and the roommate's, just kept piling up.

Over lunch, Drum talks at length about his fascination with a magazine article challenging the existence of God; he quotes it from memory. "I'm telling you all this," he says when his listener tries to steer the topic back to his house, "so you'll know I am not just somebody who collects junk." Breininger gives him a hug. Oct. 2 Three Weeks to Go: A crew from Labor Ready in Inglewood arrives in the morning, along with Breininger and some of her staff. All are wearing masks, gloves and name tags and holding brooms and shovels as they assemble for Breininger's instructions. Drum, wearing a wide-brimmed straw hat tied under his chin, will supervise from a chair near the garage. Breininger is jazzed.

Drum has kept his promise not to bring anything back into the two rooms the crew cleared out a week ago. Drum is nervous. He frets about the broken windows and rotting flooring, things that must be fixed to put him back on the right side of the law. And he wants shelves so he can have his books, now boxed, around him. "First, we get you organized, then we'll figure out how to take care of the repairs and the beautification," Breininger reminds him. Inside the small kitchen, neighbor Pat Gentry is scrubbing at the grease-encrusted stove. She and her husband befriended Drum a decade ago, when he showed up at their yard sale. "Lloyd is a good man. He helps us, and we help him.," Gentry says, setting a freshly washed plate in a cabinet long missing its door. "This is nothing to ever make fun of him about."

Outside, workers sift through shovelfuls of old magazines, tools, bolts and crumbling books, politely holding everything out for Drum's inspection. If he says, "Keep!" the items are boxed. A "toss," usually uttered with a sigh, sends the material to a trash bag and the curb. The mice and rats that scurried as startled workers dug into the piles on the first day are gone now, but someone has playfully propped a plastic rat against the fence. Breininger's good pay, pep talks and free lunches have kept many, but not all, of the workers coming back. Oct. 13 10 Days to Go: Breininger has been up since 3 a.m. By the time her full crew, 22 strong, arrives at 9, she has her flip charts posted and crammed with instructions.

From his recliner on the porch, Drum contemplates the red dumpster parked out front. The house already has been transformed. The previous weeks' work has liberated the 1890 "parlor grand" Steinway that belonged to Drum's grandparents, and it holds center stage in the living room. A china vase and pitcher, hand-painted by Drum's mother, have somehow survived and now rest on top of the piano. The yearbook hasn't turned up. Breininger has brought shades for the windows and fabrics to cover the battered sofa and to loop through exposed beams. She sets a timeworn, ornately carved side table, another antique from Drum's grandparents' home, with a cloth and a couple of place settings "to give you some homey touches," she tells a somewhat amused Drum.

Outside, the crew is making a final push, and more boxes and bikes go tidily into the garage. The workers cleared the space by lifting the long-disabled, mustard yellow 1971 Toyota Corona that once belonged to Drum's father and setting it in the driveway. Most experts on hoarding would say Breininger has done things correctly. She gave Drum time to adjust, helped him make decisions and respected his attachment to things that might appear useless to others.

"Many of the professional organizers have an understanding of hoarding, and they are doing some of the things a therapist would do," said Dr. Sanjaya Saxena, director of research at UCLA's Obsessive-Compulsive Disorder Research and Treatment Program. But he cautioned that cleaning out a house without treating the underlying problem is rarely successful. By midday, Drum is upset, red-faced and trying to control the panic rising in his voice. The dumpster is filling, and he has spotted some empty audiotape cases and old coupons that got tossed in without his permission.

Even though the judge's deadline looms and piles of stuff still cover the yards, Breininger jumps into the dumpster and pulls them out. "You good?" she asks Drum. "I'm going to go talk to the crew." Drum sighs. "I'll survive. It's just that nothing was being thrown away before, and now it seems like once something comes out to the curb, it's gone." Drum is calmer now and he thanks the crew "for putting up with all my complaints." Oct. 31 Time to Celebrate: Dressed in a fresh khaki shirt and pants, white hair tied back in a neat ponytail, Drum is steering his guests toward a goodie-laden table set up in the driveway. Drum and Breininger are celebrating the good news they received a week earlier - the judge praised their progress and gave Drum another three months to correct the remaining violations.

Drum stood up in court and thanked Breininger profusely, moving her nearly to tears. She promised the judge she would visit Drum regularly to help him stay on track. Breininger, who figures she has spent nearly $10,000 of her own money on the project, is planning to seek donations from clients and charitable organizations to complete the overhaul. She dreams of setting up a program for others like Drum. Attorney Steel stops by, as do some of Drum's friends from Clutterers Anonymous. So do a field deputy for county Supervisor Yvonne Brathwaite Burke, and a neighbor or two. Drum beams as his guests marvel at the transformation. And yet, he admits, he is still sleeping on the porch. The dust inside still bothers him. And, well, the place just doesn't quite feel quite right. "I miss my stuff," Drum says.

Help for hoarders A sampling of resources: ÃÆ'Ã'¢Ã¢'Ã'¬Ã'Ã'¢ The UCLA Obsessive-Compulsive Disorder Research and Treatment Program conducts research on hoarding and offers treatment and referrals. (310) 794-7305 ÃÆ'Ã'¢Ã¢'Ã'¬Ã'Ã'¢ The Los Angeles County Department of Mental Health's Genesis program for the elderly has a Web site with a hoarding fact sheet and resource lists: http://www.la4seniors.com Follow the "hoarding behavior" link. ÃÆ'Ã'¢Ã¢'Ã'¬Ã'Ã'¢ Clutterers Anonymous is one of several 12-step programs: http://www.clutterersanonymous.net (310) 281-6064 ÃÆ'Ã'¢Ã¢'Ã'¬Ã'Ã'¢ Madison (Wis.) Institute of Medicine's Obsessive-Compulsive Information Center has articles and other materials on hoarding: (608) 827-2470; http://www.miminc.org

Maryland Association of Professional Organizers

Anxiety and Stress Disorders Institute of Maryland:
Treating anxiety disorders and stress-related disorders in Towson, Maryland, since 1978.