Research and Case Studies on the Misunderstood Condition of Compulsive Hoarding

Stuff: Compulsive Hoarding and the Meaning of Things, by Randy Frost & Gail Steketee (Amazon / Book Depository)

Chances are you know someone with a hoarding problem. Recent studies of hoarding put the prevalence rate at somewhere between 2 and 5 percent of the population. That means that six million to fifteen million Americans suffer from hoarding that causes them distress or interferes with their ability to live.

Hoarding is a topic equally mesmerizing and distressing. There are multiple popular TV shows about it, although these feel more exploitative than educational or helpful. Or maybe the participants do get help to some extent, but not without the caveat that they’re gawked at on television.

Researchers Randy Frost and Gail Steketee studied people suffering from compulsive hoarding and have developed targeted treatment strategies for working with this difficult condition. Perhaps surprisingly considering its prevalence, hoarding is a mental health condition that hasn’t been studied or researched in much depth. Stuff presents their innovative work using case studies from their research, and it succeeds in being sensitive where sensationalist TV shows aren’t, attempting to unpack the complex reasoning behind why people can’t let go. Hoarding becomes filthy, uncomfortable, and damages, if not destroys, a hoarder’s personal relationships. So why is it so hard to stop?

The answers are complicated, and actually apply more to anyone, not only those who suffer from compulsive hoarding.

Anxiety, sadness, grief, and guilt are all part of the human experience. When people go to great lengths to avoid them, the results can be devastating. Avoiding distress is a key feature in the development and maintenance of hoarding. It reinforces the belief that the feelings being avoided are intolerably bad, and at the same time it weakens the person’s strength to cope with those feelings.

I would say that even more than the assertion the book makes that nearly everyone knows someone with a hoarding problem, plenty of people have attachment issues that manifest through stuff. It’s not to such a dangerous degree as what a compulsive hoarder suffers, but can be uncomfortable or worrisome enough. So there ends up being a lot of meaning here related to attachment to things and what they represent.

It begins with the story of the eccentric Collyer brothers, one of whom became a hoarder and filled their Manhattan brownstone to the brim with junk collected on his nightly walks around the city. Eventually they died there, crushed by the weight of their own stuff. It’s an immensely sad story but one that served as a lesson for their New York neighbors, as parents would warn their children to clean their rooms lest they end up like the Collyer brothers.

Not all hoarders are so extreme, and in the course of their research Frost and Steketee look at lesser but still problematic cases along with the more extreme situations. These often involve scenarios riddled with additional mental and emotional problems, like a group of followers of a Manhattan doctor that becomes a cult of cat rescuers as the doctor increasingly lost touch with reality, and wildly rich twin brothers who both hoard, filling luxury apartments they can’t even live in with expensive art.

These stories are, in a voyeuristic way, completely fascinating, and they’re also something of a relief. Anyone clearing out or downsizing can feel overwhelmed by life’s accruals. It seems to be a fine line between collecting or holding onto things with sentimental value and descending into the mental illness of compulsive hoarding, so what delineates it?

The passion of a collector, the procrastination of someone who hasn’t taken the time to put things away, the sentimentality of one who saves reminders of important personal events—all these are part of the hoarding story. How, when, and why do these otherwise commonplace and normal experiences develop into hoarding? What compels these compulsive collectors to create unlivable conditions for themselves and often for others? Why do they go too far? This is what we seek to explain in this book.

There are various answers, and lots of nuance and comorbidities. There are some features we’ll recognize from our own behaviors and emotions, and others that the authors determined are unique to those who suffer this extreme tendency, and thus part of what makes this behavior so difficult for outsiders to comprehend.

With each item Irene picked up, she failed to figure out which features were important and which were not, in the same way that she struggled to distinguish important from unimportant objects. Moreover, she thought of features and uses most of us wouldn’t…

Might this reflect a different way of perceiving the world, one focused on aesthetic pleasures that the rest of us overlook? If so, is this a gift or a curse?

I have met few people who are as interested in the world around them as Irene, though I later learned that this attribute is fairly common in people with hoarding problems. As she talked, I could see the way each of her things was connected to her and how they formed the fabric of her life.

Although this was compelling and handled sensitively, it was also deeply sad. Not only because of what happens to lives and relationships, but because it’s an incredibly difficult condition to manage and overcome. The prognosis for beating it isn’t great, and treatment options are difficult, limited, and not well studied. Slipping back into problematic patterns and behavior is also common. Consider Grey Gardens, for instance, perhaps the most well known example of hoarding on film. That 1973 documentary was shot after — yes, after — Jackie paid to clean up the house.

Stuff is readable even as it breaks down psychological concepts, page-turning and enlightening in regards to how sufferers think, function and how they can sometimes be helped. There are lessons here that are applicable to everyone, about how we can deal with loss without transferring feelings to objects, or imbuing them with more value than they warrant.

She couldn’t stand to let anything go without such a laborious procedure, designed to avoid the experience of loss. Had she let herself experience the loss, she may have been surprised at how well she could tolerate it, and subsequent attempts to get rid of unneeded things would undoubtedly have been easier.

A sympathetic look at a misunderstood and understudied condition that affects an overwhelming number of people to various extents, with ideas and psychological concepts that will be helpful for anyone to learn about.

As another of our clients on her way to overcoming hoarding once remarked, “You can’t hook up a U-Haul to a hearse.

Stuff: Compulsive Hoarding and the Meaning of Things
by Randy Frost & Gail Steketee
published 2010 by Mariner Books

Amazon / Book Depository

19 thoughts on “Research and Case Studies on the Misunderstood Condition of Compulsive Hoarding

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  1. This sounds like such a fascinating book. I struggled for years with my inability to part with certain types of things, I was never as bad as the people you see in documentaries but I was bad enough that it really affected my life. I’m fascinated by what makes other people hoard things and how they get it under control so I think this is a book that I need to buy. I finally got my hoarding under control early last year and so far my house has stayed clutter-free for the most part but I have to make sure that I keep on top of it.

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    1. I’m so sorry to hear you’ve dealt with issues around it in some way. That’s why I mentioned a couple of times in the review that I think even if someone isn’t an extreme case, or even close to that, really, there’s a lot more here that’s relevant to a wider group of people. I’ve become pretty good at letting go out of necessity due to moving around often in the past decade, but I read this right before doing a major clean-out and it helped shape my thinking, like around why I was holding on to certain things, and they definitely weren’t the right reasons.

      I think you’d get a lot out of it. It’ll help you understand the motivating behavior and maybe know how to better address some of it. It sounds like you have it under good control though, so maybe it’ll just be the little encouragement you need 🙂 I’m glad I could introduce you to it!

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  2. I also found this interesting, and sad, and even surprising at times. My family will tell you I’m a hoarder… it’s fairly obvious by looking at the books stuffed into the bookcases, piled on the floor in corners, and wherever else they fit, I prefer the term collector 😉

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    1. I’m glad you got a lot from it too! It was very eye opening, more so than I expected in what it had to say about people who aren’t actually compulsive hoarders, but how these tendencies play out in people in general. I think “hoarder” is one of those terms that gets thrown around loosely without a lot of understanding of what it actually entails. Although it does seem like a very fine line at times between collector and hoarder! 😂

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  3. Excellent review on a fascinating subject. As you say there are many reasons and issues attached to hoarding and I appreciate that this book handled it in a sensitive way. Often an adult child is left to deal with a similar situation when a parent passes. I’d be curious to know if the book talked about that part.

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    1. Thank you!! I appreciated that it was done sensitively too, especially because this is an area that doesn’t have so much research to begin with (which I didn’t realize) so the kind of sensationalized gawking that the TV shows do just makes it worse, I think. They do address the family relationships, but less so after someone has passed and more how it feels for the people living through it, trying to help and being incredibly frustrated.

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  4. Great review, this sounds so interesting! I tried to watch a few episodes of a Hoarders show once, but there seemed to be so many pets that weren’t living well amidst all the stuff that I just couldn’t do it. You make a good point about those shows being more designed for gawking than actually helping anyone, I can definitely agree with that from what I did manage to watch. I didn’t know there were books on the subject (silly me!) but I’m glad this one handles it with more respect!

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    1. I’ve watched it too, just because there is a fascination with it, but it made me deeply uncomfortable. We don’t film other types of mental illness for entertainment so I’m not sure why hoarding gets a pass for that. The animals are the most disturbing part of this, and that’s a certain disorder within hoarding, as I learned here. They have good intentions but it gets away from them so quickly. Ugh, it’s so disturbing all around. There’s really not a lot of writing or research around the subject, surprisingly, but I thought they handled it well!

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    1. Thank you!! That’s exactly it, it’s exploitative and this is already such a hard condition to deal with. I don’t know why it’s become so popular on TV shows, we don’t go to schizophrenic peoples’ homes and broadcast their mental illness for entertainment. I hope they actually help them by featuring them but I don’t get that impression. And I’m so sorry you’ve had to go through it in your family. Really so many people are affected by this and yet it’s still so misunderstood, it’s a shame.

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  5. Another thought provoking review. My mother is a low level hoarder, her house is cluttered, untidy, dusty, no room to live comfortably, depressing – it drives me insane and I hate being there. We have attempted in the past to help her de-clutter but this resulted in a tug of war between me and her over a book of poetry in Russian, with me screaming “You don’t even speak Russian!” and her replying, “Yes, but I might learn one day!” She is now 89. The psychology is complex – for her I think it’s a mix of the result of a bereavement, fear, stubbornness, her against the world… and it definitely has affected our relationship negatively. I started reading a book called Coming Clean by Kimberly Rae Miller – maybe one of your recommendations – about hoarding. I must get hold of this books too. The plus side of my mother’s hoarding is that a visit to her house always inspires another round of decluttering at my house.

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    1. Oh that’s tough. I’m so sorry you’re dealing with that. I can believe it affects your relationship negatively. It sounded from this that they’re endlessly difficult to reason with, like about the Russian poetry! It also sounds similar to the scenarios they describe here, always the idea that they might need something/do something one day so it’s imperative not to throw it out. And like you say, it’s a very complex psychology, and often multiple issues at play. I hope you can get through it with her. But yes, it can be helpful in reminding yourself what objects are important for you. I read this shortly before a big clean-out and it helped SO much! I think you should definitely give it a read, could be helpful for you.

      I tried reading Coming Clean and didn’t really like it. I was interested in the topic but something about it wasn’t clicking for me. I’ve heard great reviews about it though!

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  6. That sounds like a fascinating and well-done study. My husband keeps computers and electronics and bits in case they come in useful but I think we’re reaching a time where some of them might leave the house … I hope so! I do hold on to books to an extent, but only ones I have room for, and I’m quite good at assessing what I will likely re-read and what I won’t.

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    1. I know what you mean, I recently did a big clean out of books and felt so much better about being able to let so many go. I’d just been holding on to so many I knew I was never going to read again! It does sound like your husband has a good reason for keeping some parts but yeah, everyone can benefit from a reassessment and lightening up a bit, I think!

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  7. I don’t think we have those programmes here in the UK. Fortunately so because they sound like the worst kind of television, exploiting people with real issues for entertainment . This book sounds far more thoughtful and sensitive.
    You make a good point that this book could be helpful for people who don’t have the disorder but do tend to have a problem letting anything go.

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    1. You’re not missing much. They’re like train wrecks, you can’t help but stare at them when they’re on but they play up the horrifying aspects of it and although they’re nominally helping people to clean their homes out, I think the shaming aspect cancels it all out.

      I was pleasantly surprised that it had so much insight for people who don’t have serious problems. It helped me sift through some things I needed to and made decisions a lot clearer. I think it’d be helpful for everyone!

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  8. I’m not sure what makes the topic of this book so immediately fascinating to me. Perhaps simply my interest in books that look at explanations for human behavior. I also appreciate that it handles this topic well, without being voyeuristic or unsympathetic, and that it has some discussions that are more broadly applicable to how everyone interacts with their stuff. It sounds very well done!

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    1. I completely get it, the topic was magnetically fascinating to me too. This one does do a good job of explaining the behavior and all its complexities. I was also glad that it dealt with the topic seriously and sensitively, without being voyeuristic. I was also pleasantly surprised at how broadly applicable it felt! I think you’d really like this one.

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