In 2006, Jessie Sholl’s mother was diagnosed with cancer. But before Sholl could deal with the illness, she had to first confront a sickness of a different sort: her mother’s compulsive hoarding, which rendered everything—her home, her car, and her life—completely unmanageable. In her memoir “Dirty Secret,” Sholl documents a disease that affects millions of Americans and recounts a life spent parenting a mother who, despite her best intentions, was unable to provide stability—and who slipped from mere disorganization into something far more dangerous. This week, Sholl kindly took the time to answer questions about hoarding and her book; an edited version of our exchange appears below.

The book’s title reflects how you felt for years about your mother’s hoarding. What made you decide to write about it in such a public way?

I never thought I’d write about my mother’s hoarding; I never thought I’d tell anyone other than my husband about it because I was so embarrassed. Also, I didn’t think anyone could possibly understand. But after I joined an online support group for the children of hoarders, and began to really consider the massive amounts of shame that we all carried around—for something over which none of us had any control—I changed my mind. My hope was that by getting the secret out, it would lose some of its power.

I also wanted to put a human face on hoarding, to move beyond the stereotype of the crazy cat lady. Hoarders shouldn’t be the objects of mockery. They’re real people who happen to have a mental illness. They also have feelings, pasts, and sometimes even children.

In your book, you discuss the different types of hoarding—clean, squalor, animal—and their traits. Could you explain them a bit here? Which is the most common?

To me, the difference between a clean hoarder and a squalor hoarder is that of a dry mess versus a wet mess. My mother is a clean hoarder: her clutter is comprised of things like clothing, books, broken sewing machines, pairs of cowboy boots she’s convinced she can sell for a fortune, magazines, cardboard boxes, pots, pans, pizza stones, etcetera. In general, dry things.

In a squalor hoarder’s home you may find standing pools of putrid water, carcasses of dead animals, discarded dirty adult diapers, and the like. Sometimes the line is crossed from clean hoarder to squalor hoarder, when, for example, the plumbing goes out. Neither type of hoarder would feel comfortable having a plumber come in, so accommodations have to be made, in the form of buckets or those adult diapers.

Animal hoarding involves keeping a large number of animals without providing adequate space, sanitation, food and water, and veterinary care for them. The suffering that the animals endure in those situations is horrific. Animal hoarders are blind to that suffering, and often believe that they’re helping or even saving the animals—in my book I explore some of the reasons for the disconnect from the reality of the situation. My own dog, Abraham Lincoln, came from an animal-hoarding situation, and after seven years he’s still distrustful of strangers and very skittish.

Animal hoarders are the least common type of hoarder, but between clean and squalor hoarders, I’m not sure which occurs more frequently, especially since there’s some fluidity—no pun intended—between them.

How do different types of mental illness play into hoarding?

Compulsive hoarding is often accompanied by another mental disorder, which is one reason it’s difficult to treat successfully. The features of compulsive hoarding—information-processing problems, perfectionism, perceived memory deficits, and chronic indecisiveness, among other things—must be addressed, and if the hoarder has another type of mental illness, that must also be treated. Some of the most common comorbid psychiatric conditions with hoarding include depression (fifty-five per cent or more of hoarders suffer from it), social phobia, generalized anxiety disorder, O.C.D., and A.D.H.D.

When did you become aware that your mother was a hoarder, and not a “pack rat”?

When I was growing up, my mother was always disorganized, lackadaisical about cleaning, and a compulsive shopper. My parents split up when I was seven, and once my dad moved out, I did most of the cleaning. At ten, I moved in with my dad and stepmother, but still I’d go over to my mother’s to clean, weed her garden, and make sure the outside of the house was presentable—a necessity because my mother lived across the street from my elementary school and I was mortified at the thought of my classmates knowing about the mess inside.

That said, it wasn’t until about 1998 that my mother’s pack rat-ism blossomed into full-fledged hoarding. As is common, it was set off by a trauma: her longterm boyfriend died. The first time I saw the house after he died, I knew she’d entered the realm of pathological. Unopened bags from her favorite thrift store, Savers, packed the hallway, her stove was stacked three feet high with dirty pots and pans, her oven was on the brink of breaking down (it eventually did), and the living room was absolutely packed with unnecessary furniture, cardboard boxes, perilously piled stacks of books, empty soda bottles, and crumpled bags from cookies, chips, and crackers.

Toward the end of the book, you say that during your research people opened up to you about their experiences with a hoarder. How has that feedback continued, now that the book is available?

I’ve been getting lots of e-mails from children of hoarders who’ve read the book. They’re all very happy that I wrote it—happy to know they’re not alone and pleased to see the issue of how hoarding affects families addressed. By far the best part of having written “Dirty Secret” is knowing that it’s helped someone in some way.

Has your mother read the book?

She has read it and she claims to love it. To my mother’s credit, when I asked her if she’d mind if I wrote about her hoarding and the way it’s affected our family, her one requirement was that I employ “radical honesty.” As I was working on the book I let her read sections and told her that if she objected strongly to something, I’d take it out. Whenever I’d ask her about a specific scene, like the time I found the ashes of her boyfriend buried under a pile of clutter, she’d always say, “That’s the truth. Leave it in.”

(Author photo: Kate Lacey)