What is hoarding disorder and how is it different from collecting? Why some people cannot let go, advice for families and how therapy can help.
Every time you visit your mother's home, the hallway is a little narrower. First the balcony filled up, then the door of the spare room would no longer open. On the kitchen worktop there are newspapers from years ago, empty jars and carrier bags stuffed with more carrier bags. When you say, "Mum, let's throw these out," her face changes: "They'll come in handy, don't interfere." One day, while she is out, you secretly throw a few bags in the bin; on your next visit, not only have new ones taken their place, but a coldness has also come between you. For both the person living with it and their family, hoarding disorder is often a process that lasts for years, woven through with shame and anger. In this article we talk about the feelings behind hoarding, why families get nowhere with a "let's clear it all out and be done with it" approach, and how more effective support can be given.
What Is Hoarding Disorder?
Hoarding disorder is defined by a persistent difficulty parting with possessions, regardless of their actual value. When the person thinks about throwing things away or giving them to someone else, they feel intense distress; as a result, possessions accumulate and living spaces can no longer be used for their intended purpose. It may become impossible to cook in the kitchen, sleep in the bed or get into the bathroom.
For many years, hoarding was seen as a subtype of obsessive compulsive disorder. Today it is treated as a separate diagnosis, although it is counted as part of the same family as OCD. One important reason for this distinction is that in hoarding the person is often not troubled by their behaviour. Whereas in OCD the person wants to be free of their rituals, in hoarding the person wants to protect their possessions; the distress begins with the prospect of parting with them.
How it differs from collecting and thriftiness
- A collector gathers items on a particular theme, arranges them, displays them and takes pride in them. In hoarding, possessions sit in disorganised piles and the person often cannot find what they are looking for.
- A thrifty person keeps things that will be useful but sorts through them when necessary. In hoarding, broken, faulty and unusable items are seen as equally valuable, and sorting cannot happen.
- A messy home and a home affected by hoarding are not the same thing. When a messy home is tidied it works again; with hoarding, the problem is not tidying but being unable to part with things.
Digital hoarding
Hoarding is not always limited to visible possessions. Tens of thousands of photos, emails that are never deleted, screenshots and files downloaded but never opened can accumulate with a similar logic. When the person thinks of deleting a photo, they become uneasy: "What if I can never remember that moment again?" Because digital hoarding takes up no space in the home, it is often not seen as a problem; but when it carries the same cycle of indecision and being unable to let go, it offers an important clue about the person's general tendency.
What Are the Symptoms of Hoarding Disorder?
- Difficulty discarding: Being unable to throw away items such as old bills, broken electronic devices, unworn clothes and empty packaging
- Excessive acquiring: Buying or collecting things without needing them, from sales, markets, second-hand websites or even the street; taking everything that is handed out for free
- Intense emotional attachment to possessions: Feeling that throwing something away is like "throwing away a part of me" or "erasing a memory"
- Indecision: Struggling to decide whether an item should stay, and therefore not touching anything at all
- Living spaces filling up: Rooms, hallways and the balcony becoming unusable
- Intolerance of others touching things: Reacting with anger, tears or panic when family members touch possessions
- Shame and social withdrawal: Not letting anyone into the home, avoiding visits from repair people, doctors or neighbours
In many people, awareness of the extent of the problem is limited. The person may say, "My home is a bit untidy, that's all"; this is less denial or stubbornness than the result of getting used to a situation that has developed slowly over the years.
Seeing some of these symptoms does not on its own amount to a diagnosis. Particularly with hoarding behaviour that begins for the first time in later life, it is important for a doctor to assess conditions that affect memory and thinking skills.
What Causes Hoarding Disorder?
There is no single cause behind hoarding; feelings, habits of thinking and life history are usually intertwined.
The "it'll come in handy one day" thought: The person fears that if they throw something away they will need it in the future and then regret it. This fear is far stronger than how much the item will actually be used.
Concern about waste and responsibility: Values such as "Throwing things away is a sin" and "We mustn't be wasteful" are deeply felt in many families in Turkey. In generations that lived through years of scarcity, these values are even stronger. The value itself is precious; the problem is trying to protect every item with the same care. When the handle of a broken umbrella, a mixer that has not worked for years or boxes of out-of-date medicine start to receive the same protection as a perfectly good coat, thrift stops serving the person.
Emotional meaning and identity: Possessions can carry memories, relationships and past selves. An old letter, the jumper of a loved one who has died or the children's primary school exercise books can give rise to the feeling that if they are thrown away, that person or that period will also be lost.
Difficulties with decision-making and organising: Many people who hoard find it hard to categorise, prioritise and make quick decisions about possessions. When every item requires a separate decision, indecision turns over time into a mountain. We discuss the broader form of indecision in our article on being unable to make decisions.
Loss and loneliness: Hoarding often becomes noticeable after a loss, a divorce, retirement or a period when living alone begins. Possessions can provide a sense of security and continuity in a life that has emptied.
Predisposition: A family history of hoarding can increase the likelihood of this tendency developing. Hoarding is often seen together with depression, anxiety and attention difficulties.
The Effects of Hoarding Disorder on the Person and the Family
Hoarding is not just a problem of tidiness; it can have serious effects on health, safety and relationships.
Safety risks: Falls in cluttered hallways, a fire risk from piled-up papers and electrical appliances, and being unable to get out of the home quickly in an emergency such as an earthquake. In a country located in an earthquake zone, blocked escape routes are a matter that deserves particular attention.
Health problems: Damp, mould, pests and hygiene problems can arise in areas that cannot be cleaned. When the kitchen cannot be used, nutrition suffers.
Relations with neighbours and the building: Complaints may come from neighbours because of smells, pests or an overflowing balcony; problems may arise with the building management or the relevant authorities. This leads the person to withdraw even further.
Family relationships: Children avoid coming to their mother's or father's home, grandchildren are not brought round, and bayram (religious holiday) visits are cut short. Serious conflicts arise between spouses. Children who grew up with a parent who hoarded may carry the shame of this experience into adulthood.
Imagine a man in his seventies who lost his wife of forty years a few years ago and cannot throw away any of her belongings. Nor does it stop there; "useful" tools bought from the market and junk dealers, radios he says he will repair one day, and heaps of newspapers and magazines fill the house. His daughter comes every week and says, "Dad, nobody can live like this," and every visit ends in an argument. For the man, the possessions are a shield: a shield against his wife's absence, against loneliness, against feeling useless. For his daughter, her father drifts a little further away with every passing day.
Caring for a relative who hoards is also exhausting for family members. We discuss this burden separately in our article on caregiver burnout.
Behind every hoarded item there is often a fear, a memory or an unspoken loss.
Advice for Families: How to Approach a Relative Who Hoards
- Do not clear things out in secret. Throwing away the person's belongings without permission, whether they are home or not, deeply undermines trust. Possessions usually build up again quickly and the person becomes even more defensive.
- Focus on the person, not the possessions. Saying "I'm worried about you, I'm afraid you'll fall here" instead of "Look at this rubbish tip" moves the conversation from conflict to care.
- Talk about safety first. Rather than targeting the whole house, agree on small safety-related goals such as clearing an escape route, freeing up the area around the hob or creating a walking space in the hallway.
- Leave the power to decide with them. Even though it slows the process down, it is necessary for lasting change that the person decides for themselves which items will stay. You simply accompany them.
- Start with small areas. A limited area such as a drawer, a shelf or the top of a chair is far less overwhelming than a whole room.
- Protect your own boundaries too. While supporting your relative, do not neglect your own life and health. If necessary, get support for yourself as well.
If you hoard: first steps for yourself
If you are reading this article about your own home, having read this far is already an important step. You could try the following:
- Take a photo of one corner of your home. A photo lets you look from the outside at a scene you have grown used to over the years.
- Set aside fifteen minutes each day for just one small area; stop when the time is up.
- For every new item that comes into the house, try parting with one item.
- Rather than throwing out an item you find hard to part with straight away, put it in a box and write the date on it. If you have not needed it at all within a month, reconsider the decision.
- Share your shame with one person. Hoarding grows in isolation and becomes lighter when shared.
When Should You Seek Professional Support?
- The rooms of the home cannot be used for their intended purpose
- A risk of falls, fire or health problems has developed
- The person experiences intense distress or panic when trying to part with possessions
- Hoarding has caused serious rifts in family relationships
- Low mood, loneliness and hopelessness are also present
- There is hoarding in later life that appeared over a short time and occurs together with forgetfulness; in this case a doctor's assessment is also needed
How Is Hoarding Disorder Addressed in Therapy?
For hoarding disorder, forms of Cognitive Behavioural Therapy specifically adapted to this problem are used. You can find the general framework of individual work on our individual therapy page.
Strengthening motivation
The first step is often not the possessions but the person's wish to change. The person explores, in their own words, why they might want to change and the conflict between their values and their hoarding: for example, "I want my grandchildren to be able to come to my home" or "I want to cook in my kitchen again."
Decision-making and organising skills
Skills in categorising possessions, setting priorities and making decisions are worked on step by step. Questions such as "Have I used this item in the past year?" and "Where could I get one if I really needed it?" become tools that make decisions easier.
Getting used to letting go and not acquiring
The person gradually tries parting with items agreed together and staying with the distress this creates. Similarly, coming back without buying anything from acquiring situations such as sales or market trips is also part of the work.
Working with beliefs and feelings
Beliefs such as "If I throw it away I'll regret it" and "If I throw this away I'll forget my mother", and the grief, loneliness and anxiety beneath them, are addressed. When needed, working in the home setting, or on areas of the home via video call, can also support the process.
A patient, long-term process
Because hoarding builds up over years, change also takes time. In the first weeks there may be no visible difference, because much of the work is first devoted to understanding the way decisions are made, the emotional bond with possessions and acquiring habits. Visible change usually starts with small areas: a hallway that has been cleared, a kitchen worktop that is back in use, or a sofa where the grandchildren can sit. When family members notice and appreciate these small steps, it helps the person keep up their motivation.
Frequently Asked Questions
If we empty and clean my mother's home in one day, will the problem be solved?
One-off big clear-outs usually bring short-term relief, but when they are done without the person's consent and involvement, possessions soon build up again and trust is damaged. Except where there is an urgent safety risk, a slow approach in which the person takes part in the decision-making brings about more sustainable change.
Does hoarding begin in old age?
The tendency to hoard often begins in youth and slowly increases over the years. One reason it becomes noticeable in later life is that possessions accumulate over time and loneliness increases. Where hoarding starts suddenly in later life, however, a doctor's assessment is important.
Is keeping someone's belongings after a loss a form of hoarding?
Keeping a deceased loved one's belongings for a while is a natural part of grief. The problem arises when the possessions make the living space unusable, new items are constantly added and the person cannot part with anything. In such a situation, both grief and hoarding can be addressed together.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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