• Myths & Misconceptions about Hoarding Disorder

    This post is part of a series of guest posts on GPS by the graduate students in my Psychopathology course during Spring 2014. As part of their work for the course, each student had to demonstrate mastery of the skill of “Educating the Public about Mental Health.” To that end, each student has to prepare two 1,000ish word posts on a particular class of mental disorders, with one of those focusing on evidence-based treatments for those disorders and the other focused on a particular myth or misunderstanding about mental illness.


    Myths & Misconceptions about Hoarding Disorder by Kelly Jent

    How many of us have watched shows like Hoarding: Buried Alive or My Strange Addiction and immediately judged the people on the show?  Comments like “Ew. Look at all of that junk in their house… it’s so dirty!  How could someone live like that?!  That’s disgusting!” tend to surface.  As a matter of fact, while writing this and googling different addictions, I said (to my empty house), “Oh, woah that’s weird.”  It’s natural to have reactions like that about something that appears so odd to many of us and something that seemingly would be so easy to fix by quitting getting new things, cleaning, stop saving, etc.  However, these comments aren’t helping anyone and are only adding to the stigma about people who having hoarding problems.  Speaking of stigma, a reoccurring pattern that I noticed while researching obsessive-compulsive related disorders (e.g. hoarding disorder, trichotillomania, body dysmorphic disorder) is that the stigma surrounding them severely misrepresents the reality that the people with the disorders actually live.  To the uneducated, the people are “freaks” or “weirdos” and likewise, these disorders just appear “weird” and are dismissed and justified as “being glad you don’t do stuff like that.”  Once disorders like hoarding become media-ized, the public assumes they know the in’s and out’s of what goes on; they feel that they know enough to give you the gist of the problem (which most likely consists of subjective judgments rather than empirical evidence), which is all you really need to know anyway, right?


    There are a number of myths surrounding Hoarding Disorder (just referred to as “hoarding” from here on out), but I think in order to know what hoarding is not, it is important to understand what hoarding actually is first.  Hoarding is a newly recognized diagnostic category in the DSM-5 in the Obsessive-Compulsive and Related Disorders section.  This disorder involves difficulty parting with possessions regardless of what their actual value is.  There is a perceived need to save possessions and distress is linked to the idea or process of discarding them, therefore, items accumulate and clutter living areas which takes away from the functionality of the space.  The effects of hoarding must also cause significant distress or impairment in different areas of functioning (social, occupational, familial).  I stress: significant distress and impairment in functioning is a must for a diagnosis.  That being cleared up, on to the misinformation!

    One common myth about a person who hoards is that they are lazy, unmotivated, selfish, or gross. This is false.  In fact, people who hoard ARE bothered by the clutter and dirt; they just learn to mentally block it out.  They also feel shame and embarrassment due to their living situations.  Studies have compared the brains of people who compulsively hoard with “healthy” brains and found that compulsive hoarders have decreased activity (less activation) in their anterior and posterior cingulate cortex.  Great…but what does that mean?  These brain areas are highly responsible for actions such as problem solving and decision making (anterior), spatial orientation, memory, and emotion (posterior).  Decreased activity in these areas is likely contributing to the difficulty  that people who hoard experience in deciding what to keep and what to throw away.  People who hoard are worried that if they discard something they may actually need it someday in the future – so they keep everything from actually valuable items to items that appear meaningless such as dozens of second-hand eyeglasses that are kept “just in case.”  With an accumulation of items comes a significant amount of impairment and distress and this is what distinguishes this disorder from regular collecting.  Rather than being lazy or unmotivated, individuals simply may not be as able as an average person to carry out certain tasks in order to make decisions and organize things.  With this in mind, it is easier to understand that hoarding is largely an information processing issue.

    Now, back to the decreased activation in the posterior cingulate.  Many people who hoard experience extreme anxiety when being faced with having to discard items.  This is due partly to the unique emotional relationship that they have formed with their possessions.  For example, some individuals anthropomorphize objects.  For example, they may think that if they throw out the box that a gift came in, it would hurt the box’s feelings.  There is also an association with the memory of when they received something or an event surrounding an item.  The lower activity in this area of the brain also governs memory and spatial orientation; they need to have things in sight in order to remember where it is.  Individuals think that they will lose items or not remember where something is if it is not in clear view which explains the plethora of items stacked from the floor to the ceiling, covering beds and spilling over tables and counters.  Another example is the collection of newspapers – by throwing them away, one might forget the information that is inside of them.

    Finally, people who hoard are likely to show signs of other accompanying disorders.  Depression and anxiety are the two most common co-morbid disorders.  Cory Chalmers of the TLC show ‘Hoarders’ says that 80-90% of all cases that they see on the show are trauma or depression based – meaning that these other experiences trigger the hoarding behavior in individuals as a way to fill a void in their life.  Not surprisingly, a higher level of social disability is also found in people who hoard than not.

    I was looking up YouTube videos to go along with this blog and decided to read the comments written about the videos to see what the general attitudes were towards the people in the videos.  While, yes, there were some commenters who were positive and/or sympathized for the person featured in the video, the vast majority were negative and downright ignorant and rude.  Here are a few gems that I came across.

    “That isn’t hoarding she is a slob!”

    “That’s so sick. How could anyone live in there?”

    “Oh please miss stop making excuses and clean up your nasty house.” 

    “This ain’t called being a horder, this is called being a lazy bum.”

    “Hoarding possessions I can go some way to understanding but the ones who sit in a pile of rubbish are just filthy pigs, that is not hoarding that is blatant slobbery and laziness.”

    So… there’s that.  I don’t know about you, but I didn’t really get warm fuzzy feelings reading those.  The only warm feeling I got was due to my blood boiling.  These delightful commenters perfectly illustrate why this disorder is stigmatized, and as you’ve hopefully seen, these comments only reinforce the myth that hoarders are lazy, selfish, unmotivated, or gross.  Unfortunately, with the saturation of these shows and comments in the media, I don’t foresee this changing any time soon.  However, next time you’re watching a show like this, keep in mind that these individuals in fact are not merely too lazy to clean, but there is most likely other underlying issues that are exacerbating this behavior.

    Category: Mental HealthPsychologySkepticismTeaching


    Article by: Caleb Lack

    Caleb Lack is the author of "Great Plains Skeptic" on SIN, as well as a clinical psychologist, professor, and researcher. His website contains many more exciting details, visit it at www.caleblack.com

    2 Pingbacks/Trackbacks

    • Shatterface

      I’m a hoarder and this is related to my Asperger’s. My book, comic, CD and DVD collections take a considerable amount of space.

      However, none of this ‘clutter’ is ‘dirty’ or a sign of ‘slobbishness’: most of it is in immaculate condition. Books are preserved, spines unbroken, and organized according to author and genre; comics are bagged and backed with card treated to prevent fading; DVDs and CDs are kept in their cases.

      I could switch to ebooks and downloaded music, but they lack the tactile quality that makes books and CDs ‘real’. And to be honest, what else should I spend my money on? Socializing and travel are incredibly stressful.

      • http://www.caleblack.com/ Caleb W. Lack

        Seems like “collector” would better fit you, based on this description! If it’s not interfering with you using your living space, and not causing social and other kinds of impairment, it’s not hoarding (as a diagnosis).

        • Lokksi

          True, my grandmother was a hoarder and it definitely nothing like collecting things you like. There was situation when she refused to throw away old nasty and moth-eaten down-padded coat because “we can still use it, probably”. Or situation when storage room was choked up with half-rotten planks that she found in a dump because “we can use them for fixing something in the future”.

    • http://skepticink.com/backgroundprobability/ Damion Reinhardt

      Good piece! Until this post, everything I knew about hoarding was from this video.

      • http://www.caleblack.com/ Caleb W. Lack

        Oh my FSM, how had I not seen this BWC masterpiece before?!?!

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    • pandora delphy

      I think when people use the word selfish, they do so because hoarders in fact behave selfishly. Many hoarders neglect their children and families to obsess over or care more for the hoard than the frightened kid or spouse standing right in front of them. It is incredibly difficult to feel empathy for a hoarder. Much of the time they are also controlling, unpleasant people to be around. Whether this is their illness or not I can’t say, but it is the one form of mental illness that actively angers me.

    • Kay_Rock

      I don’t get it. I just don’t. If a person is ill, they go to the doctor or follow whatever protocol to get well. Hoarders just don’t. Every single day they wake up and CHOOSE not to. They like it. They don’t care how much it hurts anyone or effects anyone else’s life. If there was something going on with me that was causing extreme damage to other people’s lives or home I would immediately try to get help. That’s the selfishness of a hoarder. They love their mental illness. They love it more than they love you. At any moment they could say “yeah, this is a problem. I should get help.” But they don’t. I don’t understand it. I used to think of myself as a compassionate person until I lived with a hoarder. It’s hard to have compassion for someone who has zero compassion for anyone else. Telling a person who lives with a hoarder to be more compassionate is like telling someone who is in a physically abusive relationship to have more compassion for the man who beats her. At some point, the responsibility has to lie on the shoulders of the abuser. And as the victim in this situation, I will be vilified for saying it. That’s what hoarding is. It’s a way of victimizing people without any thought of repercussions. If the victim says “stop!” they are the bully. I do not understand it. And believe me, I have tried. I have cried and meditated and read books on it and done everything I can to say “yes, this person who is destroying my life is the victim, not me” but the irony of it is destroying my brain. The only truth I can find is that yes, hoarders are deeply selfish people.

      • http://www.caleblack.com/ Caleb W. Lack

        While I can certainly empathize with your frustration, having worked with numerous people who hoard and their families, I think that saying they “choose” not to get better is a bit misleading. Much like with almost all mental disorders, their behavior is being reinforced (in ways that might seem odd to the outsider) and has been shaped over years (and decades, with most hoarders) to be a particular way. While you can choose to seek out help, you can’t really choose to just “stop” having a mental illness.

        This isn’t to say that, via their behavior, that they are not hurting and harming others – they surely are. But just because a hoarder is harming others doesn’t mean that he or she doesn’t have something seriously wrong with them.