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