Obviously the “why” is complicated and depends on an extensive set of proprietary mental rationalizations that the individual establishes. But is there anything approaching a neurological or psychological explanation as to why this situation sometimes occurs?
Probably the most famous and saddest example would be Howard Hughes, whose obsessive single-minded determination - the same one which led to so much innovation and creativity - eventually became an all-consuming fixation on minutiae that led to an extremely severe and destructive case of OCD. Hughes was terrified of germs, he was tremendously paranoid about filth and contamination causing himself and others to sicken or die, yet during the worst stages of his decline, he himself was surrounded by filth, living in squalor, not bathing, etc.
This isn’t the only example that I’m aware of, of people with OCD who are fixated on organization and routine, yet surrounded by junk and clutter.
Does anyone have some ideas about how these seemingly-opposite forces can sometimes coexist in someone’s mind?
For starters, OCD does not always involve a fixation with organization and routine. Sure, sometimes it does- and other times it involves involves obsessions and compulsions that have nothing to do with organization and routine. For example, the person’s obsession might be a fear that they will discard an important document - and therefore they never throw any documents away. They might fear that they they may need the clothes that no longer fit in he future if they gain or lose weight- so they don’t throw them away. They might be obsessed with the number 10- so they buy 10 of everything, even if only one is needed. They could be obsessed with the thought that they didn’t lock the door or left he gas turned on - and leaving the house becomes an hours-long ordeal.
Going from being obsessed with contamination to not bathing is unusual, but I suppose the large amount of codeine he was taking could have caused that.
He was, but the obsession revolved more around other people’s germs and dirt. He didn’t feel germs could come from him, and his hygiene was notoriously poor.
I suspect it’s mostly neurological. fMRI studies have shown that the rationalizations seem to be made after the behavior is already done. The person realizes what they did is bizarre, then comes up with a reason for why they did it.
Perhaps they’re unsuccessful anxiety coping strategies. The person’s thoughts go into a self-reinforcing loop where they apply a coping strategy, it doesn’t solve their problem so instead of pulling back, analyzing the issue and trying something else, they double down on their unsuccessful strategy. When that fails, they double down yet more. Have you ever met or known of alcoholics who worsen their situation through alcohol and try to cope with their worsened situation by drinking more which then worsens their situation which then results in more drinking? Like that.
Someone can be anxious about losing control of their environment or be desperate to feel some sense of control which could result in an exaggerated emphasis on organization and routine. They could also be anxious about lacking resources which would result in an exaggerated emphasis on keeping items around “just in case”.
Often once a place in the home is “contaminated,” you don’t even want to touch it again. So maybe you lay a towel over it. And then you lay towels over other “dirty” things as well. Before long, your home is draped in all kinds of things and it’s messy.
Fear of losing something important. What if one of your lottery tickets was the Big Winner but you accidentally lost it? Better to hoard them all meticulously! And what if the IRS comes to audit you and wants your tax docs from 6 years ago? Better hoard those too.
Someone else with OCD here. I am a testament to the notion that not all forms take on hoarding activities. I am actually a minimalist, if I do not absolutely need it or see something as useful in the near future, I tend to get rid of it. I like things very organized, but I do not get obsessed with keeping things at certain angles or lined up, nor do I care about germs more than a regular. I have learned how to say “Good Enough” to most things. Those with hoarding OCD do it mostly because they are, as Velocity said, afraid of losing something important, or another manifestation of OCD requiring things to be a certain way (messy as it were). I sometimes check my wallet twice when I get home to make sure I didn’t lose any ID’s or Cards, but I do not keep the old ones or paperwork related to them (I knew someone who did this, boxes and boxes of old papers).
Mine manifests more in the fear of my house burning down due to electrical issues, now I just figure… “I got insurance, I’ll buy new stuff” (a wonderful medication combo I found helps). The point being, losing property is something that most people with OCD do worry about, hence hoarding in some.
If I may contribute some observations that I cannot document in medical literature, I think they will contribute toward answering the general question. (Or perhaps opening it to more uncertainty.)
As the two quotes above suggest (or state), OCD is fear based. In my understanding usually so ingrained it does not seem unusual to the principal until after the fact when he or she can objectively see the behavior is “not normal” in the human condition. The fear is usually that if certain criteria (say a ritual) are not adhered to, something bad will happen to them or a(n innocent) loved one. It seems to be a huge moral burden on the afflicted as they can “break their mother’s back” by simply walking normally down the street without regard to cracks in the walkway. Jenny Traig’s book on the subject is very interesting and informative: THE DEVIL IS IN THE DETAILS.
The contamination issue Velocity mentions is a huge issue as some good juju has to be used to overcome the contamination. You cannot clean contamination with contaminated tools, or even common tools—the tools must be hyper cleaned (and often times discarded after use). So perhaps the OCD person will sterilize and sanitize a tool a dozen times, then use it to clean the contaminated thing or area then discard the tool which can never be sanitized again—then the area or original object will be clean enough to be cleaned with “normal” means. It is exhausting to sterilize to the tools, use them then eliminate them (can’t just throw them in the trash- often they must be discarded in a very permanent manner). After that you can start the usual cleaning process which is probably quite difficult and complex as the previously contaminated area is now just ‘normal’ dirty. Any break in the ritual, or even the possibility of break can mean abandoning the project to start from the very beginning again. If any minor human need like sleep or nutrition interrupts the ritual…… repetition!
Eventually the loop becomes too big for even the most fit and attentive Obsessive Compulsive. Then you have to choose one of only two options: Abandon the effort (perhaps with the resolution to attack it with fresh vigor when conditions are better, or as anomalous1 says, call it “good enough”*. That is tough to do if it was so important to require that level of concern just an hour (day, week, or month) ago. In either case but especially if one postpones the effort, several other things have stacked up that have not been addressed with the proper ritual. So the self respecting OCD depletes his or her energy catching up on all the other matters and rests up to finish the original project. Unfortunately, there is a new contamination in the morning, and being distracted by the first contamination they do a poor job of bringing the second thing into compliance with “good enough” (which is usually far beyond any normal semblance of ‘clean’) which means repeating that project again from the start with new supplies and tools because who can remember what has come into contact with what level of contamination at what step of the process.
The afflicted already use too much of their time worrying about what is not a concern for the general population. Now they have these two big projects covered with towels to be addressed later. Of course the towels used to cover the contamination need to either be discarded (dismembered, burned, buried in sacred ground) or cleaned as thoroughly as the original contamination. It does not take long to fall into squalor, and it takes forever to dig out of even a small mess. In my experience, an OCD individual will do an absolutely spectacular job of clean something, but it needs to be a small something with well defined borders. Don’t ask one to clean your cabinets, ask one to clean one drawer in one cabinet. Wait a week before you ask them to help you clean the adjacent drawer, if you ask them right after they finish the first one, the job will become too big. You might end up with everything out of every drawer and space to be inventoried to be placed in the most logical place with the objects with which it has most in common. The drawers and all your items will be meticulously cleaned, sorted, and organized—but they will never get back into the drawers and cabinets. You might however be able to eat off the surfaces of the empty drawers.
Concerning the concept of good enough, In the first few chapters of THE ORGANIZED MIND by Daniel Levitin, he mentions a colleague coining a term which combines the words satisfy and perhaps sufficient. Sorry, I cannot recall at the moment, but it suggests the idea of making a decision (and I am expanding it to include cleaning a mess) that is perhaps not optimal- but good enough. He uses the example of renting an apartment in a large city. Everyone wants the best apartment available, but there could be 2,000 (or even just 200) available. One cannot visit that many in one day, but as the day’s move on, the selection changes. Some are taken by other renters, others become available that were not yesterday. It is almost impossible to get the VERY best apartment, and some of it is just luck, so you have to “sufficify” (satisfy sufficiently- and I don’t think this is quite the word he discusses). That can be very difficult for an Obsessive Compulsive. In my observations, anything other than the optimal solution (whatever it is in their mind) will cause an unacceptable danger.
Sorry this goes on for so long, I am not very good at being concise, and I am often misunderstood so I tend to over explain. Just appreciate the specific observations that led to the conclusions above that I spared you.