The Psychology Behind Hoarding

Recently, the phenomenon known as hoarding has come into greater public awareness, propelled by graphic scenes on television showing homes crammed floor-to-ceiling with an astonishing amount of stuff. A&E’s Hoarders has shown not only that hoarding is a relatively widespread affliction—the International OCD Foundation estimates that one in every 50 people struggles with severe hoarding—but also that the public is fascinated by it.

Programs such as Hoarders and TLC’s Hoarding: Buried Alive have featured shocking scenes of safety personnel in hazmat suits scoping out all manner of refuse and garbage, while a distraught hoarder pleads that every last bit of it is necessary. At times, a home is filled with so many pets that they have become unclean, uncared for, and ill. Their compulsion causes the hoarders' mental, emotional, physical, and financial health to suffer. Most tragically, their relationships unravel as families and friends struggle to cope with their condition.

Hoarding is a type of obsessive-compulsive disorder (OCD); it’s estimated that about one in four people with OCD are also compulsive hoarders. But this categorization is being reevaluated, and it is possible that hoarding will eventually be considered its own diagnostic category. In the meantime, it’s very real, and more and more people are opening up about the difficulty that hoarding presents in their lives.

Without exception, hoarding is accompanied by varying levels of anxiety and, often, depression as well. Neuroimaging studies have revealed peculiar commonalities among hoarders including severe emotional attachment to inanimate objects and extreme anxiety when making decisions.

Hoarding both relieves anxiety and generates it. The more hoarders accumulate, the more insulated they feel from the world and its dangers. But of course, the more they accumulate, the more isolated they become from the outside world, including family and friends. Even the thought of discarding or cleaning out hoarded items produces extreme feelings of panic and discomfort.

It can be difficult to determine whether someone is a hoarder or just a pack rat, someone who just likes to hang on to things. The main determinant of whether a behavior is just a personal preference or a disorder usually has to do with whether, and how much, that behavior has begun to negatively impact daily functioning.

According to DSM-5, the following symptoms are diagnostic of hoarding disorder:

• There is a persistent difficulty in discarding or parting with possessions, regardless of their value or lack thereof.
• The difficulty in discarding possessions is due to the distress associated with getting rid of them.
• The difficulty in discarding possessions leads to the cluttering of living spaces and compromises the use of living spaces.
• The hoarding creates clinically significant distress or impairment in functioning, including the ability to maintain a safe space.

What causes someone to become a hoarder? That's not entirely clear, although there are known risk factors such as experiencing a traumatic event; persistent difficulty making decisions; and having a family member who is a hoarder.

There are, however, some commonalities among hoarders. While severe hoarding is most common in middle age, hoarding tendencies often emerge in adolescence. Many hoarders are also socially withdrawn or isolated and may begin to hoard as a way to find comfort.

Researchers continue to search for effective treatments for hoarding, while Americans continue to be captivated by extreme accumulation on TV. In a culture awash in anxiety, worry, and fear, if accumulating things becomes a way to deflect and manage those feelings, the stack is likely to get bigger and bigger.