Hoarding: What's Going on With All That Stuff?

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Hoarding tendencies are rampant in America. "Seventy percent of home-owning Americans cannot park cars in their garages because there's too much stuff; one in 10 has a storage unit," Sandra Stark, of the Peer-Led Hoarding Response Team at the Mental Health Association of San Francisco, told Pacific Standard. All over the nation, businesses compete to serve hoarders, and more than 85 governments as of 2013 have special task forces to help hoarders whose compulsion threatens their own and the public's health and safety.

The reality shows "Hoarders" and "Hoarding: Buried Alive," both with millions of viewers, prove our fascination with this stigmatized condition. People play fast and loose with the term, although it's a long way from average slob or pack rat to the psychiatric disorder of compulsive hoarding.

Hoarders of note include artist Andy Warhol, Jacqueline Kennedy's aunt and cousin (who were the subjects of two movies, both called "Grey Gardens") and actress Delta Burke, and the most famous U.S. hoarders were brothers Homer and Langley Collyer, who died in 1947, one crushed under the weight of debris they accumulated in their Manhattan brownstone, the other of various conditions. Decades later, some firefighters still call the home of a hoarder a "Collyer mansion."

What Science Knows About Hoarding

The science behind the disorder is fairly recent, with the disorder only added to the Diagnostic and Statistical Manual of Mental Disorders in 2013.

Scientists have concluded that it tends to run in families, with half of hoarders diagnosed having another hoarder among blood relatives. Women tend to hoard more because of a Great Depression mentality (although many hoarders have never been economically deprived, and many are wealthy) while with men, it is more impulse acquisition and then a reluctance to dispose.

Thanks to studies using MRI scans, scientists believe hoarding is a processing disorder in the part of the brain called the bilateral anterior ventromedial prefrontal cortex. One study showed that the cingulate cortex also lights up in hoarders when presented with decisions involving personal possessions -- but not other people's stuff. Hoarders, interestingly, are often well-educated (the Collyers were both Columbia grads) but still have trouble with decision making. Getting rid of something is a decision -- and a traumatic one.

Hoarding Costs Everyone

There are clear costs to hoarding:
  • $20,000 is the minimum to clean out a Level 5 extreme hoarder requiring biohazard-suited cleaners. In San Francisco, Pacific Standard reported more than $6 million annually is spent by city agencies and landlords dealing with hoarders.
  • Six percent of U.S. house fires are attributed to hoarding conditions.
  • Sadly, there is the also the cost of care for those whose lifestyle can attract vermin and disease. Saddest of all is the emotional cost to hoarders whose shame often leads them to a solitary lifestyle without the comfort of friends and family.
Randy Frost, a Smith College psychology professor who pioneered studies on hoarding and co-authored with Gail Steketee "Stuff: Compulsive Hoarding and the Meaning of Things," notes the condition seems to be more prevalent in the Western world probably due to our relative wealth and acquisitiveness. That theory may also explain why the condition, which often manifests in early adulthood, doesn't become a full-blown problem until the hoarder has the wherewithal to acquire more and more.

Are You a Hoarder?

So, you may be asking yourself, am I just a disappointment to Martha Stewart or am I a true hoarder? Frost and Steketee helped develop the clutter image rating along with other self administered tests to help diagnose a possible hoarder. The clinical definition involves excess acquisition, extreme difficulty in disposing of possessions, inability to discriminate between what is valuable and what isn't (because to a hoarder everything is valuable) and -- most importantly clutter -- that is hurting a person's life.

Happily, there is help, and science is making inroads. And despite their sensationalism, reality TV shows have made more of us aware of the problem and -- maybe -- more understanding of the true costs of hoarding.
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