When Stuff Takes Over

In the video above, Gail Steketee, a professor and dean of the School of Social Work, discusses the meaning of compulsive hoarding.

On March 21, 1947, when police arrived at the Manhattan brownstone occupied by brothers Homer and Langley Collyer to investigate a stench, they found their entry blocked by a ceiling-high wall of rat-infested boxes and furniture. After entering through a second story window, they found Homer’s body amid piles of garbage. Langley’s body was found two weeks later. Police speculated that he was crawling through a newspaper tunnel when one of the booby traps set for intruders fell, burying him alive. The Collyer brothers, whose home held more than 130 tons of waste, are one of the most extreme examples of hoarding on record, but the compulsion is believed to affect up to 4 percent of the population.

Gail Steketee, a professor and dean of the School of Social Work, has been studying hoarding for 15 years and is the coauthor of three books on the subject. Her most recent, written with Randy Frost, a professor of psychology at Smith College, is Stuff: Compulsive Hoarding and the Meaning of Things. BU Today talked with Steketee about her research.

BU Today: Have you met anyone with hoarding compulsions as extreme as the Collyer brothers’?
Steketee: No, but we have worked with people who buy a large house, fill it up, then buy another house, fill it up, and so on.

Why do people hoard?
People hoard for the same reasons that everyone saves their stuff, just more so. They save for sentimental reasons, to avoid being wasteful, for fear they might need it one day, and to have control over their own things. But their identity often becomes tied up in their stuff, and so parting with even a scribbled-on piece of paper can be excruciating.

What kinds of things do people hoard?
Just about anything. Newspapers, magazines, and books are probably the most common, but boxes, take-out containers, and clothes are typical, too.

Do people hoard animals?
Unfortunately, yes. And when that happens, the animals pretty much take over the house and use it like they would the outdoors. Still, we would not define that as a hoarding problem unless the animals are unhealthy. That can be really horrific, which is sad, because we suspect there are strong attachments and a limited awareness of the damage that type of hoarding inflicts on animals and other people who live in the home.

How common is compulsive hoarding?
Our findings indicate that about 3 to 4 percent of the population — or about six million people — have a hoarding problem, which isn’t all that surprising when you consider that one out of every 10 Americans rents a storage unit. Nearly everyone knows someone who has hoarding tendencies.

Do you hoard?
No, but I have an elderly family member who does.

What’s the difference between hoarding and collecting?
Lots of people collect something, often more than one thing. But our collections are things we want to display. We generally put them in a special case or arranged in some special way. And we try to complete our collections. Whereas someone who is hoarding is simply accumulating things they don’t want to part with. They will often collect multiple items of the same type. I recently saw a woman who had multiple jars of the same type of jam and multiple cans of the same type of soup. She has a fear that one day she might run out, so she crams it everywhere she can.

When does clutter become hoarding?
A lot of people have a catchall drawer or closet or even an entire room for extra stuff. It’s when you let it take over two, three, or more rooms that you run into problems. 

Can you have hoarding without clutter?
Yes. I recently watched a film that depicted a man who put everything he hoarded into boxes and stacked them neatly from floor to ceiling. But despite his organization, he was in danger of having the boxes fall on him.

What is the most severe example of hoarding you’ve seen?
We provide intervention sessions at BU as part of our research study, and a woman in one of the studies was under pressure from her town because she had a lot of clutter in her yard: broken appliances, an old swimming pool, tools. The inside of her house was also very full. Rodents had made nests in the debris, and every time we moved something, we found animal fecal matter and insect nests. It was very unsanitary.

Is there a connection between hoarding and depression?
We think there is, because we’re finding that more than half of the people we see fit the criteria for major depression. It’s difficult to know whether the depression causes the hoarding or whether the hoarding causes the depression.

Can hoarders be treated?
Yes. It’s a cogitative and behavioral treatment plan. We begin by determining what the client’s goals and values are, and we refer back to them throughout treatment. We help them understand hoarding and help them build a model for their own hoarding behavior. We also teach organizational, problem-solving, and decision-making skills to promote cognitive change. Sometimes hoarders give their possessions human emotions, or they might feel guilty about discarding those items because they feel it’s wasteful.

How long does treatment take?
Anywhere from one to two years or more.

Is hoarding an innate or a learned behavior?
It’s likely a mixture. We don’t find much trauma in the history of hoarders, but for the most part we find a chaotic or disconnected childhood, particularly one where possessions could be counted on more than adults. But hoarding also runs in families, so there’s likely a genetic component.

What are the consequences of hoarding?
One of the most serious consequences is being investigated by child protection services. A lot of times there won’t be a place for the children to play or there’s no functional kitchen. Children who grow up in hoarding homes can be very angry because there’s no place to bring their friends, and they feel embarrassed. Worse, they feel they are second to the objects in their parents’ lives.

Do hoarders recognize that they have a problem?
Most are aware their behavior is abnormal. Many suffer from significantly low self-image, so they buy and buy to make themselves feel better.

Vicky Waltz can be reached at vwaltz@bu.edu; follow her on Twitter at @vickywaltz. Devin Hahn can be reached at dhahn@bu.edu; follow him on Twitter at @devhahn.