My wife introduced me to two television shows, both built on a similar premise but with radically different results.
First, check out this clip from Clean House, airing on the Style Network.
Now, compare that to this ad for Hoarders, airing on the A&E Network.
This is a wonderful example of medicalization. We have people engaging in almost the exact same behavior, but their actions are interpreted in two diametrically opposed ways. Clean House generally (though not exclusively) frames their subjects as having poor habits that, with a little tough love, can be corrected. Hoarders, on the other hand, frames their subjects as having serious mental illnesses. Indeed, they regularly bring in clinicians to treat their subjects. The former invokes judgment (note the eye-rolling and smirking in the first clip), while the latter invokes sympathy (hear the dire music).
Our behaviors do not come with meaning necessarily embedded in them. We have to made sense of them, and the way that we ultimately do so has consequences. We did this in the past with the behavior of children, particularly of little boys. Is Johnny being rambunctious? There once was a time when Johnny was sent to the principal’s office for a spanking, but today, he is much more likely to be diagnosed with ADHD and given a pill. As we medicalize more and more in our society, our acceptance of and reaction to our behaviors change.
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Anonymous — July 20, 2011
I've watched both shows, and it seems to me that there is often a difference between the behaviors of the people on them. That is, the people on Clean House are often easily willing to let go of trash, even if they want to hold on to many sentimental items. People on Hoarders often have more difficulty letting anything go at all. I'm not a doctor, but I'm assuming that the behavior that leads to an overwhelmingly messy house must occur on a spectrum, and that some people will respond to the former methods and others to the latter. (Of course, I'm still not big on the judgmental attitudes on Clean House)
Charlotte — July 20, 2011
Those people can come to my house! Hey, she kicked you out? Get on over here, people, and help me figure out where to put stuff!
This sunny attitude is the result of years of therapy that have probably saved my life, but sadly haven't done much to improve my housekeeping. I guess having people ask for help doesn't really make for good television, because you don't get the drama of conflict. Cleaning folks coming to my house would be like "Road Rules" with no fighting, no drinking, and no cursing.
Ms. Sunlight — July 20, 2011
The first video is not available in my country (UK) so I can't compare the actual clips. I can infer what might be on the clip from your comments.
Some people who hoard do so as a manifestation of mental health difficulties. It's not necessarily incorrect to draw the distinction that sometimes hoarding is a medical issue and sometimes it's not. The only real question for any given person is, is the hoarding behaviour tolerable; is it making the individual unhappy or physically unwell?
Why can't there be multiple approaches to, and reasons for, any one particular behaviour exhibited by different people?
Laughing Rat — July 20, 2011
"The former invokes judgment (note the eye-rolling and smirking in the
first clip), while the latter invokes sympathy (hear the dire music)."
Sympathy? If only. Sympathy is hardly the primary emotional response most audiences feel when faced with so-called "hoarders," or indeed any other mentally ill person. Mental illness is, yes, more increasingly understood as an illness, but that has not prevented its also being deeply and persistently stigmatized. One can be understood as mentally ill AND judged to be weak/stupid/morally flawed. Indeed, media continues to encourage such judgment even as it pretends to encourage sympathy.
You know ADHD really exists and is a medical condition, right? That while there may be instances of inaccurate diagnosis, it is a genuine disability? A real thing in the world, and not a figment of collective imagination?
Miss Disco — July 20, 2011
I thought Hoarding was a joke when they referenced it in South Park last year. Along with the Shake Weight.
My god, America....
Elahadrun — July 20, 2011
I was once asked to help clean a hoarder's home. It was the way it was because she was an intense germaphobe and as such couldn't bring herself to touch anything that she thought might be dirty. Therefore, the home was just piles and piles of garbage, mouse droppings, dirty dishes and mold, all on top of things she treasured--family photos, her musical instrument, keepsakes from international travels. Certainly an army of us with a stoic attitude could have cleaned the house once, but ACTUALLY helping the woman obviously required professional training.
I'm appalled by the implication that spanking Johnny and giving him Ritalin are treatments that have the same effect. For starters, 1960s Johnny wasn't being asked to sit quietly for six hours with one thirty minute recess break (if the weather isn't wet, or too hot, or too cold) processing what is effectively child-level paperwork, then go home and stay inside with only the television and the internet for company. But don't worry! As a special educator I can guarantee you that there are still people trying to hit ADHD out of their children. You aren't the only one who thinks that ahistorical anecdotes are evidence that it works just as well.
Anonymous — July 20, 2011
On Hoarders, the people featured often have deep-seated problems related to throwing stuff away, and buy and stockpile items because of a need to be in control of something. This is clearly different than not noticing things have piled up or not minding a mess/being disorganized. But the woman in the first clip from Clean House is clearly resisting help because she's not ready to let go of the items.
I think there is a spectrum, and I know people who have difficulty getting rid of things but are tidy and organized (like me!) Nobody would ever call Hoarders on me because my house is neat and safe, but I do have huge difficulty getting rid of clothing, even if it doesn't fit anymore and I never wear it. But it's hanging neatly and there aren't five rooms full of clothes, just three closets, so it's a manageable quirk I live with. At least I'm aware it's not really typical behavior!
t.j. — July 20, 2011
I have to wonder if you have really watched both shows, or just the clips you linked to here. I have not watched Clean House, but I have just browsed their website with it's before and after shots of the rooms they tackle. I have watched Hoarders.
These are not equivalent behaviors, or situations. They might exist on the same spectrum, but I don't think that anyone who has watched Hoarders can doubt that there is mental illness involved, and that the situation needs to be treated carefully.
Cocojams Jambalayah — July 20, 2011
I'd like clarification from the poster if he thinks that spanking a child who is said to be rambunction was/is the appropriate approach to take.
If the poster is saying that people (American society in particular) often mis-diagnose so-called "rambunctions" children (especially boys) as ADHD and over-medicates those children so diagnosed, I agree.
meow — July 20, 2011
If you watch the shows more closely you’ll notice that
the problems ARE different. Yes they’re framed differently (and filmed –entirely-
differently), but clean house goes for more of the “we’ve got too many kids
toys and no way to organize them” and horder is more … dead animals and moldy
What is more interesting is the possibility of class issues.
Horders tends to be (from the ones I’ve seen) lower class situations and Clean
House is often more middle class situations. It might have to do with the
incentive offered to be on Horders? I donno. I just think that would be an
Umlud — July 20, 2011
While this is "a wonderful example of medicalization", I would submit that the process of medicalization has been happening for centuries. The difference between today's prescription of a pill and the prescription of a "tonic" in the past are myriad, but include better scientific knowledge and technological know-how, a strong history of medicines providing a tangible and measurable result, a greater advertising pressure from pharmaceutical companies, and the increased level of testing and licensing done by the FDA (and similar governmental agencies in other countries) to ensure that the medicine is effective and the public are not harmed. (Yes, there are many examples of shady practices at the FDA, but I feel that those conversations are more about funding sources and management goals of the agency, rather than the good that it has accomplished.)
Umlud — July 20, 2011
Part of this trend is also due to changing what we diagnose as a disease as our scientific understandings of human health continue. What we called "rambunctiousness" is now called "ADHD"; the forms and degrees of autism have also been refined and expanded; the genetic and environmental causes of different cancers are being isolated; greater understanding of adult dementia are leading to increasing types of diagnoses; etc. In short, how and what we consider a specific "disease" (and thus a potentially treatable physical condition) today plays a strong part in the degree to which we think of medical interventions, as opposed to the religious, civic, folk medicine, or psychological interventions that may have been pursued previously.
Anonymous — July 20, 2011
Hoarding is "medicalized" because it is a medical condition, like other mental illnesses. I think that saying that society "medicalizes" health issues with the implication that this is A Bad Thing is reductive to say the least---after all, 500 years ago, European society didn't "medicalize" schizophrenia (caused by demons) or leprosy (caused by sin and/or an imbalance of the bodily humours), and that's hardly a condition to aspire to.
Anonymous — July 20, 2011
Note that it could also be the opposite. The most horrific example of that that I've seen on tv would be Trinny and Susanna who on their shows links little things things like not putting on make up or wearing skirts to profound mental problems and almost seem to appoint themselves the role of psychologists.
Ravi M. Singh — July 20, 2011
I think the author is certainly correct in saying that there are major consequences when we choose to medicalize a behaviour or treat it as pathological and requiring medication. I'm not writing off medication at all as a solution, and I understand that it is often necessary, but I think it's important not to discount the fact that our own personal choices can go a long way in dealing with certain conditions.
When I felt I was suffering from certain symptoms of depression, I was able in large part to control them through changing my lifestyle (more exercise, better sleep patters, less drinking, etc.). These steps themselves are not always easy and might also require assistance. Once again, I don't deny that these types of conditions can be biological or chemical and require medical treatment (I'm not going Jenny McCarthy on everyone), and perhaps some of these behavioural patterns stem from similar causes. Nonetheless, I think it's important to consider the balance between what we can and can't accomplish with medication, though I'm sure all medical professionals take this into consideration already.
Either way, as I said, the point about the consequences of medicalizing cannot be understated and I think is often ignored.
Tim Owyn Phan — July 20, 2011
That's true with many mental conditions - Is it sadness or depression? Perfectionism or OCD? Shyness or social phobia? The answer seems to depend on how much it impairs daily life, which is sort of subjective. On the other hand, some "conditions" that were once treated as disorders are now generally considered normal, e.g. PMS (which was once diagnosed as "hysteria") and homosexuality.
Liz Scott — July 20, 2011
i am not a big fan of shows like Hoarders because i feel as though they are exploiting the people while pretending to help them "get better". Though, i will watch an episode of Hoarders when i need motivation to clean
Kat — July 21, 2011
Bradley obviously has never been in a Hoarders house. You know the sort of those "medicalized" people who get buried under their garbage and asphyxiate.
BrainPlop — July 21, 2011
I have never watched Clean House, but I did watch my first episode of Hoarders last night. The two women involved in this episode very clearly had major psychological issues leading to their hoarding, both of them completely unable to throw away a single thing. When psychological issues, rather than sheer laziness, are causing your house to turn into a serious health hazard, the intervention of a therapist will accomplish things that tough love simply can't.
Betty Jo Complete — July 22, 2011
Clean House is about families who are being passive-aggresive toward each other (I can stand this mess longer than you can, so take that, you lazy slob) whereas Hoarders is about folks who are OCD.
Anonymous — July 23, 2011
Is it just me, or does the author seem to be opposing medicalization? Because it sort of pisses me off. Medicalization of behaviors- sign me the fuck up. It saved my fucking life. When I was 'lazy' and 'sulky' I was told to try harder and grow up. Now that I'm depressed and have ADD, I get meds that work. Amazing! It's almost like I have real medical issues.
SydneyWithaSea — July 24, 2011
I enjoy watching both shows because they motivate me to let go of some of my own clutter, but "historically" the Clean House crew was visiting and helping people who just got a little busy, messy, lazy and overwhelmed. I agree with aproustian that they were willing to let go of almost everything. Hoarders on the other hand features people with real mental health issues involving Hoarding. However, I have noticed that recently, Clean House has started venturing into more extreme borderline, if not full blown hoarding homes, probably for ratings!
eashtonmiles — October 26, 2022
Now it is very important to maintain mental health so that there is motivation to do anything in general