| From Commonwealth | By Vicky Waltz. Video by Devin Hahn

In the video above, Gail Steketee visits the home of a compulsive hoarder.

Q&A session closed. Gail Steketee answered your questions about hoarding.Read her responses below.

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 fifteen 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. Bostonia talked with Steketee about hoarding.

Bostonia: Why do people hoard?

Steketee: 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 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. 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.

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.

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?

From one to two years or more.

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.

You Asked, We Answered

Readers took advantage of our invitation to ask SSW Dean Gail Steketee about hoarding. Here are some of those questions, along with Steketee's responses. Learn more in her book, Stuff: Compulsive Hoarding and the Meaning of Things.

Q I know someone who fits the description of a hoarder. She has so much stuff it is difficult to move around her apartment. It is a filthy place, it smells awful, and there is mold growing everywhere. She is absolutely blind to the conditions in which she lives. Outside of her apartment, my friend is very well put together. No one would ever guess how desperately awful her living conditions are. I rarely visit her at her place because it is so disturbing to me. I want to help her, but am not sure how to approach the matter. Any advice? — Kim (SAR’80)

A This type of situation is among the hardest people face, and the concern here is about her health and safety and that of her neighbors in the building. If you are aware of any adult children or other family members who might step in, I would probably recommend you pass your concern for her safety along to them. In the case of apartment dwellers, the landlord does need to know of these situations, as they put the building and other occupants at risk. If her community has a task force on hoarding (a long shot, but there are 75 of these and growing around the country at this time), they can typically take a call through one of the social service agencies (e.g., housing agency, services for older people).

Once her serious problems are known to others, I hope they will take the time necessary to work with her to insist on significant changes while being compassionate that these will take some time and assistance from others. I recommend reading Tompkins & Hartl’s book Digging Out to help you understand some of the complexities and strategies of family and friend interventions. For a wide variety of information on hoarding, visit the International Obsessive Compulsive Disorder Foundation (IOCDF) at www.ocfoundation.org/hoarding.

Q Thank you, thank you, thank you! My childhood was ruined because of this and I thought I was the only one. Finding websites like Children of Hoarders and seeing research like yours brings hope to those of us who existed with a hoarding parent. I read Buried in Treasure and will definitely buy Stuff.

Learning more about this disorder/disease has made me less angry at my mother, but it is still very stressful. Both my mother and sister have this problem. My sister acknowledges it and would like to get help. When her husband showed pictures of their home to her former therapist, she said, "Just clean it up." She is now jaded about seeking professional help. Do you know of anyone in the Metrowest area that is qualified to treat this properly? She lives and works in Framingham. My mother is in denial and will not change. It is very difficult to maintain a relationship with her. Maybe if she sees progress with my sister, she will try. — Ellie

A To obtain a referral in your area, please contact our research director, Dr. Christiana Bratiotis (cbrat@bu.edu), who will try to assist.

Q Gail, I know a hoarder in Rhode Island and I'm wondering how I can get her professional help. Are there groups, chat lines, or interventions? There is an interesting twist to this hoarder. She is afraid to use her debit card to purchase new items, so consequently she has hoarded EVERYTHING that is thrown out be me and my siblings, i.e., multiple couches, living room chairs, dining room sets, wall art, clothing, multiple glass and dishware sets. She also saves milk cartoons, plastic meat and chicken trays from the supermarket, pizza boxes, yogurt plastic containers, etc. How can I get this individual to address her problem so that she can enjoy her life before it is too late? Thank you for your response. — P.B. (GSM’99)

A See my responses to the above requests for referral information and also to the book Digging Out. People who are interested in becoming members of an online support group for hoarding can contact disi@igc.org for information about this space-limited group, which is likely to have a waiting list for entry.

Q My brother has a hoarding problem, and my parents are beside themselves as to how to get him to seek treatment. Although he no longer lives at home, his stuff is still piled up in his room, his closet, and some hiding places in the basement, attic, as well as a trailer. He seems to have a "sixth sense" about anyone even touching his things, let alone throwing things out. Within the next few years my parents are hoping to downsize to a smaller home or condo. What should we do? Is there any way to stage an intervention so we can get him to realize he needs help? Thanks. — Alison (SPH’98)

A Like other queries above, the challenge is in helping your brother become aware that his problem is adversely affecting others. Again, I refer you to the book Digging Out for advice to your parents on managing this difficult problem.

Q My mother, who is 55 years old, suffers from severe hoarding and intense periodic feelings of depression. She lives in the NYC metro area. In your article you wrote that a treatment plan would take one to two years. If I were to try and seek treatment for my mother, who does not have medical insurance, what are my options for an affordable treatment plan if I were to pay the costs out of my own pocket? Outpatient clinical programs in a hospital, psychiatrist, therapist or psychologist visits? Given her severe condition, I am not sure what type of plan would be appropriate or helpful. Any suggestions would be greatly appreciated. Thank you. — Maria (CAS’08)

A In your mother’s case, she may qualify for services to elderly, although the age limit for this varies from state to state, and I’m not sure of New York’s regulations. You can seek the advice of a social service worker for elder services to learn this and potential alternatives. Some people will qualify for the assistance of occupational therapists or nursing staff who can come to the home to teach organizing and decision-making skills that can be very useful in addressing hoarding problems. Again, this varies by state so advice from a qualified social worker will be most helpful in guiding your search.

Q How do you get someone to see that their five thousand-plus collection of unused records is taking over basement, attic and garage? — Linda (CGS’68)

A See above suggestions for more reading and online information about this.

Q I would like to help a friend of mine who hoards. My family and I have known her for 20-plus years. She is 60 years old. She definitely would not want her identity known. I have spoken with social workers in the Memphis, Tenn., area regarding her situation. I have been told repeatedly that she has to “want” to get help. Her house (six large rooms) is full of stuff. There is only a pathway in some areas. I am afraid for her. If there was a fire, I do not think she would be able to get out in time. Much of what she has stacked up falls over into the path. Last time I visited, her stove didn’t work. Her microwave didn’t work, but she cannot reach it, anyway. Her sink is full of dirty dishes. Her clothes dryer doesn't work. I don't know if she has a social worker or case manager right now. I believe she is refusing professional help. She drinks beer. She is on disability. She checked into a mental health facility for a week about three months ago. She is at home now. I am pretty sure she has been prescribed psychiatric medication, but she does not want to talk about it. I do not want to cause her to be taken out of her house. She very much wants to stay there. I want to know what I can do to help her. I visit. She asks me to change light bulbs, etc. She does not want me to even put anything in boxes. I offered to purchase shelving so that items can be more organized. She doesn't like people to tell her what to do with her stuff. I cannot help her on my own. It's too much for one person. If you have any suggestions, I would appreciate it. — Mary Alice (CAS’89)

A You are right that you can’t help her yourself at this time. Given that she is on disability, she is likely to qualify for services through the state, which she has already accessed, but not for her hoarding problem. Tell her that your concern for her health and safety compels you to talk to the disability services staff to help her more. You’d really like her to go with you, but if she is not willing, you care too much about her not to do what you think is right. Again, Digging Out will help you know what to do next.

Q I think my dad might be a hoarder. He isn't as far as having rats and mice (probably because he's had a cat for most of my life) but his stuff has taken over the house. It's mostly unopened appliances, books, and boxes filled with odds and ends, but it's as you described the Collyer house, up to the ceiling. My stepbrother and I are worried that it's a fire hazard, and as he gets older we worry about him or my stepmother falling trying to climb around stuff. We pointed out that he might be a hoarder after watching something on TV. He blew it off and gave us excuses for the state of his house. How should we confront him on it being a serious safety issue? Should we just have the fire marshal declare it a hazard? — Elena (SED’09)

A This is a dangerous situation, and recent news events across the country indicate that people who hoard can die in fires and in avalanches of stuff within their homes. You do need to step in and let your dad know that you and your stepbrother are going to visit the fire department staff and/or elder services social work staff to make sure that this does not happen to him. Focus only on his safety, not on other concerns when you do this.

Q My wife is an absolutely wonderful wife and mother to our college age kids. She has a very difficult time throwing things away. Our bedroom, spare room, and kitchen are all very cluttered. Our cabinets are full of papers and trinkets, leaving no available storage space. Our basement is packed with bags and boxes of clothes, books and other "stuff." More stuff comes in, but rarely does anything leave. I try to help, and I do, but we have an understanding that I will not throw things out or give anything away without her knowing about it. I have suggested hiring an organizer, but my wife is not interested. She says she will do a little bit every day, but it is rarely the priority and, therefore, rarely gets done. We are getting older (early 50s). We live in a large colonial. We will be looking to downsize at some point in time. I fear that we are approaching that critical point in time where our physical ability to get rid of stuff will be insufficient to actually do it when we have to. I believe my wife realizes this is a problem, although probably not to the full extent. So, it is a very difficult subject to discuss. Any suggestions on helping us move forward would be greatly appreciated! Thank you. — Robert (SMG’80)

A I think you will find several suggestions above to help your wife, although health and safety may not yet be a serious problem and therefore consultation with social services is probably not yet needed. It is also important not to get into arguments about this, as it only solidifies her stance about the importance of the stuff she has kept. If you can convince her to read Stuff, this might help, and Buried in Treasures (Oxford University Press) may be useful to her in understanding treatment strategies for this problem. If she is not responsive to these efforts, you probably do need to put your foot down to indicate your own rights in this situation and what you require of her to meet your needs. Of course, you must never threaten any action unless you truly mean to take it. Decide what you can and cannot tolerate and stick to your guns.

Q I have a friend who is a hoarder. We joke about it, and although there is no evidence of animal waste or insect infestation, it has gotten to the point where its negative impact is getting serious. Is it appropriate for me to recommend that she get help? How would I go about doing it? — Jonathan (CAS’72)

A See above for several suggestions to help.

Q I am very interested in your work. My sister is a very well-educated woman with an excellent job in the federal government. She lives in Virginia in a three-bedroom house that is so cluttered there is nowhere to sit. I fear for her safety but she states she has "collections.” She is overwhelmed by it all but makes no attempt to sort things out. I recently took pictures of her home to show our elderly mom, as she wanted her to visit, and I knew it was not safe for her to do so. She became enraged when she learned of this. How can we help her? Do you know anyone in the Arlington, Va., or D.C. area who she can be referred to? I know some of the issues stem from our growing up in poverty and now she is upper middle class so can't part with anything as she "might need it.” She is 54 and has clothes from junior high that fit her about 125 pounds ago. It is so sad. Please send advice. Thanks. — Patty (SSW’79)

A Please contact my colleague Dr. Christiana Bratiotis (cbrat@bu.edu) for a referral, as I know there is a task force in the Arlington, Va., area that can help.

Q My dear friend is almost blind, an amputee above the knee on her right leg, on kidney dialysis, has diabetes and in general poor health. She has three sheds (storage houses) built behind her home for all the extra stuff she "needs" seasonally. Everything is organized and labeled in totes. She has two old dogs that stink and four cats she loves dearly. Her daughter (age 35) has three young children, and when they come to visit, playing in the yard is next to impossible.

I have local responsibility for her. She is independent in that she can transfer from bed to electric wheel chair to electric lounge chair. She cooks most of her own meals. She is hospitalized frequently for skin grafts to her foot, MSRA and pseudomonas.

I have suggested she look at local assisted living facilities, and she gives a very flat no because "I can't take my animals.” A neighbor has a farm and has promised to take all of them there if she moves. I have a problem with all the stuff in the storage sheds and what to do with them. Her daughter doesn't want them and she has no other children.

How can I keep my sanity and help her when I also keep unneeded things from my past? She is newly 63 and I am almost 65. I do get her to sell some clothing at a consignment store but very little. She thinks I am a clutter magnet, but I think she is hoarding in a very organized way. She has been treated for major depression for years. Certainly with her health problems it is necessary. What can a friend do? — BJ (SED’81)

A Perhaps both of you might go together to a Clutterers Anonymous or Messies Anonymous group if you can locate one in your area. You both likely qualify for elder services (even if you are yet young!) and can likely benefit from an effort to find someone to help both of you remove clutter, even if it is organized. Think hard about how long you expect to live and what you both value and your goals for those coming years. Does the amount and type of stuff you keep actually match those values and goals? I suspect probably not. You might wish to get a “coach” to assist you in making those hard decisions. Doing it together could be the best approach to a difficult but slightly different problem for both of you.

Q I was very drawn to the article in the recent Bostonia featuring your interview about hoarding. I wanted to take the opportunity to tap your expertise on something that has been in my life and bothering me for years. I will be turning 30 years old this year. I am recently married, a homeowner, a teacher, started a photography business, and just received my master’s degree. Life for me is "good" and "normal,” but I worry about my parents and their home, but very specifically, my mother.

Throughout my childhood and beyond, my mother has always been what I'd call a "saver,” which presents itself as her being a "stacker.” My mother saves everything, from the most important and personal, to what I perceive as curiously mundane, insignificant, and unnecessary. It was the latter of these saved items that has increasingly become worse over the years. I have seen TV shows and read articles about people saving garbage and take-out containers. Mom is not like that, but she saves everything, and sometimes excessively. Examples range from saving numerous pamphlets and fliers, taking several of something, saving stacks of newspapers, catalogs, theater playbills, and magazines (read and yet-to-be-read), insignificant school and art work (math worksheets, scribbles from a coloring book), letting dishes stack up in the sink, keeping old/baby/not-worn-anymore clothing, random notes and papers from the mail, etc. You should also know that she has been a stay-at-home mother since I was a toddler, has four children with the last one going into her sophomore year in college, and does not drive because of an eye condition.

Over the years, the stacks of "stuff" have increased, and despite her children's lessened need to rely on her for care and for her time (we are all adults now), the saving continues. Her dining room is literally unusable with papers and stacks everywhere. The kitchen counter and desk are covered with stacks and clutter, her bedroom walk-in closet isn't a walk-in anymore, her bedroom also has stacks of items, and the finished basement is filled with a jungle of toys and stuffed animals, many of which are mismatched or broken. There are boxes upon boxes of photographs never taken out of their envelopes from the store.

As a child, I was slightly embarrassed to have friends over, and as an adult, despite my husband knowing me for six years, I'm embarrassed to go over there to hang out. In the 20-plus years my parents have lived there, decor is minimal and ill-chosen or placed, and the house has a general feeling of being unsettled, stressful, and lacking a positive family energy. I have wondered for years how to encourage my mother to take steps to get rid of "stuff" and take back control of the way the house and she feels. I've talked to my dad about it, and he knows it's a big problem, but fails to push the issue strongly enough to bring about change. About a year ago, she started cleaning up some of the clutter, which was promising, but then has gone lax on it.

I want her to have the resources, tools, and support to start the cleaning process, but I know this saving must be strongly tied to her emotionally and psychologically. She saves items because she'll "need" them someday, for sentimental sake, to feel important as the "memory keeper" of the family, and for the control she probably feels she doesn't have in her life.

So, with that huge description and background, and knowing she's not at the extreme of extremes, I want to know what I can do to help her out, to push her towards something positive, and to get her to loosen her grip on what is most likely 90 percent "stuff.” I also know that looking down the road, if Mom doesn't take care of this now, it will come down on me to sort and deal with the mess when she ages, moves, and eventually passes. I want my mom to live a healthy life in her house, to feel pride in her home, and to lead an active social life by having friends and family over to her house regularly. I want the excuses to go away and the action to begin.

Thank you so much for listening and considering this situation. Any guidance, suggestions, or help you think you may be able to give us would be priceless. Many, many thanks. — Aliza (SED’03)

A This must be about your mother and what she values and what are her goals in her coming years. Your being stuck with it in future won’t really help her move forward. Try to keep your emotional distance and let her talk and figure out for herself what she cares about and what she is trying to accomplish in the coming 20 years. Then take it from there. Sometimes you may need to disabuse her of some outdated notions about her relationship with her children and what she may be keeping for the grandchildren that you and they don’t want. Good luck in this; it is a challenge to avoid telling her what you think, but that is the name of this game—what she thinks will ultimately determine her behavior.

Q As a daughter, how do you help a mother who knows that she struggles with hoarding but does not want to enter treatment, therapy, or any kind of external assistance? I have had many conversations, helped (sometimes hurt) my mother by trying to help her help herself. I have lived many, many years of my life living in the home and out and have seen its effects on myself, my siblings, and my father (who lovingly endures but cannot push her too far because of her historical depression).

My mother loves "clean slate" houses where she can just decorate and not have "stuff" to manage but will not allow anyone to help her or organize for her to achieve that state within her own house. In an 11-room house, there are four rooms that are in some functioning shape and the rest have small pathways or are not assessable at all. We have had the conversations, and cleaned rooms for her, with her, without her, try throwing things out and have learned that none of these work. However, the state of her house upsets her terribly and she refuses to take action. Your thoughts? — Sara (CAS’05)

A See some comments above and also read Digging Out. I think this will help you make some decisions about next steps.

Q I have a brother who compulsively collects all sorts of tools. He has now stocked my elderly mother's basement, tool sheds, garage with all sorts of tools—I’m talking floor to ceiling. My mother is quite elderly and will inevitably pass on. When she does, I will inherit this house. My brother is 62 years old and wants for nothing, but becomes violent when his tools that he has collected are threatened. What can be done with such a person? I want to be fair with my brother once I inherit this house, but I cannot afford to hold and expensive piece of property just so he can warehouse tools that he has no intention of ever getting rid of. I'm pretty sure this is a question for an attorney, but maybe you can offer some insight on how to deal with this.

Believe me, it is an extreme case. I had promised my father before he died that I would take care of the property and never sell it. I intend on keeping it and renting it, but will have to thoroughly clean it out—a task I am not looking forward to, especially with dealing with my hoarding brother. My sister, my other brother, and I show none of these tendencies. Any insight you can offer would be appreciated. Thanks! — Sandra (SED’80)

A This will not be easy to manage given your brother’s temper. You probably do want to consult with an attorney, but litigation will not help your relationship with your brother, as you undoubtedly know, so that consultation is to understand your legal rights and where those limits are. Are you inheriting the home and not your brother? I would also suggest you consult with someone who is wise and independent of the family who can review the pros and cons of each action you might consider taking. We often need a carrot and stick approach in which someone (yourself) is the “good guy” who helps work with the person to deal with the “bad guy” (authority figure—housing landlord, fire department, etc.—who has the law behind him or her) who requires the clean up. Good luck with this.

Q I have a friend who had 15 horses removed from his care for neglect. He continues to believe that he was taking good care of them. Two of them died. What can I say that might help him to understand, or where can I send him for more information about animal hoarding? How is it different than other hoarding? — Chris (SSW’93)

A This is a serious lack of insight and not easily fixed except to have the authorities (animal control) monitor his behavior. He should be allowed to keep only one or two animals with regular monitoring, as he does not comprehend how to care for them. Not an easy problem to solve and probably due to some serious attachment difficulties that impair his capacity for understanding the impact of his actions on his animals. I wish we knew more about this, but management is all I can recommend at this time.

Q Greetings from New Mexico! I am quite sure my dad is a hoarder, and after 46 years of marriage, it has definitely caused major problems for him and my mother. I haven't watched the video yet at the top of this article, but the room in the opening scene looks like one of the rooms in my parents' house. And he keeps things for all of the reasons you mentioned in response to the "why do people hoard?" question. I don't think my father would admit to having a compulsive hoarding problem, though. Do you have any suggestions about how to help a hoarder recognize that he or she is a hoarder? As with any problem, I suspect that's the first step in initiating change. Thanks. — Deb (STH’77)

A I think I have covered my recommendations in the above suggestions, in his case for services from an elder service agency. My best wishes in helping them identify resources that can be useful in creating a healthy aging experience.

QI really enjoyed reading Stuff and found it an interesting and compassionate look at this problem. After reading the section on children of hoarders, and thinking about how many toys my own kids have, I wondered if you have any suggestions for teaching children how to make decisions about sorting and throwing away their own stuff. — Ginna (COM’94)

AMy suggestion is to first establish reasons why the toys need to move on (no longer suitable for their age, too broken to use, etc.) and allow them to make choices about where they will go (give to others in need, trash for toys that are damaged, etc.), as well as how many need to go away and a rationale for this (must get rid of ¼ so they fit into the toy box, playroom, etc.). If there is any way you can make this a game, that’s great. Altruism - the importance of sharing and giving to others - might also be a value you are trying to encourage.

QWhat advice do you offer family members of hoarders who would like to encourage their loved ones into treatment? Have you seen cases in which a frustrated family has simply cleaned out the house when the hoarder was not home? If so, what was the emotional impact on the hoarder? — RKM

AThe emotional impact of cleaning out someone else’s home without their permission is typically devastating to the person and to the relationship. We don’t recommend it unless the situation is so extreme that there is no alternative and the person with the hoarding problem is likely to need to move into some sort of assisted care in any case because they are not able to make decisions for themselves. I recommend Michael Tompkins and Tamara Hartl’s book Digging Out which outlines best practices for helping family members understand hoarding and help their loved ones address the problem. They advocate addressing the real health and safety risks with the minimum necessary intervention to resolve the immediate concerns and more gradual efforts to help after that point.

QI've seen the shows that feature hoarders, and they always seem to live in such great clutter and filth. So I would like to know if you have ever seen a hoarding environment that is very tidy--clean even--albeit very full of stuff? The woman interviewed in your video is obviously very tidy herself in the way she dresses, etc., so hoarders may not be identified just by their personal appearance. But I've never seen a hoarder's house that is also clean. — MS (SPH’03)

A Squalor or seriously poor housekeeping and hoarding are not the same thing. A number of the homes we’ve seen are kept as clean as possible given the clutter. As you might imagine in extreme hoarding homes, cleaning is almost impossible, but people still throw out their garbage and the smell is more musty than filthy. I have seen homes in which there is a great deal of clutter that is surprisingly tidy, but this is rarer — one such home can be seen in Arwen Curry’s interesting short video, “Stuffed” (this may be available from the bookstore section of www.childrenofhoarders.com).

QI buy a lot of books, especially used music books. As a musician they have special meaning to me, and I feel they help me increase my knowledge of my art. My interests are not limited to music, however, and I obtain books on various other subjects; mathematics, philosophy, psychology, for instance. While living in Park Slope, Brooklyn, it is easy to find many of these books just being set out for the taking by my neighbors! Needless to say, the books are flowing into all the rooms in my small apartment. Also, I have a double problem, in that my income is limited, and I find I am using up needed funds buying these books. What can I do? Should I buy your book, and make it the last one?? — Donald (CFA’86)

A I wish I thought that buying Stuff as you last book would solve your problem, but it won’t unless you decide to get pretty serious about resolving the book overflow problem. You have probably crossed the line into hoarding because you buy more than you can afford and they are taking over your living space which is distressing. I’m sure it’s not too late to fix this and if you are serious about doing so, the better book for this purpose is Tolin, Frost & Steketee’s Buried in Treasures which we wrote as a self-help volume for people like yourself based on our model for explaining the problem and some tested strategies for fixing it. However, prepare yourself that you will first have to decide that limiting your spending and actually getting rid of a significant number of books is very high on your list of immediate goals. Because effective treatment requires making many hard decisions (esp. what to remove from your home, limiting future buying), figuring out your real values and goals will be essential to maintain motivation to resolve the problem. This is like an addiction — no small thing to undertake till you have decided that the pain is worth the gain.

QI have inherited lots of nice furniture, clothing accessories, dishes and clothes, so much that it overfills my big house. I want to move into a smaller home. I am happy to give things to anyone who will appreciate it, but when no one will take any more, I find I am putting things into a storage building. I tried setting criteria for keeping: it had to have real value, sentimental value, and be useful. But useful when? In some fantasy of the future? Please advise. — Shelley (SED’84)

A Yes, you’ve hit the nail on the head as these decisions are not easy to make when they are family items, but it is also clear that you don’t need or even want all of these things. You also seem to feel some obligation to keep them unless they can go to a “good home”, something most people who hoard also feel very strongly — guilt is the unfortunate consequence and it takes some work to settle this feeling down. One strategy is to find a young adult family member who needs the money and can post photos of your lovely items onto Craig’s list or other web sale site or take them to a local consignment store. If you sell these items, they will go to someone who wants them and your family member takes a cut of the proceeds. You will still need to deal with items that are not sold, and these are probably best given away. This will require you to weigh the pros and cons of letting these things go to strangers versus keeping them and paying storage fees. I would only do the latter when you know there is a family member you would very much like them but cannot take them at this time — an example might be a teenager or young adult who does not yet have a home for these items. Otherwise, who are you storing them for? Your heirs who don’t want them and will only get rid of them when you are gone?

Q Do you think that hoarding can be an inherited quality or characteristic of a person? My grandfather was a "hoarder" in the sense that he kept everything from clocks to lamps to trains, tools, thousands of books, file cabinets, clothing, etc. and I have been spending the better part of three years attempting to sort through it all. I've junked a lot of it and sent tons of scrap metal to the recycling plant; however, there is so much more that remains and I am having difficulty parting with the contents (even after a major tag sale on memorial day). I've sold trains and furniture and ironically the things that no one else wants are my treasures. There are scads of dishes, clothing, knick knacks, records, scores of music, etc. that remind me of him (and my mother) who are now both deceased. I want to donate objects to charity but I am unable to spend the time at this house to sort through everything, as I have a young child at home. Further, I cannot keep the house any longer because the taxes are extraordinarily high. In my own house, I have brought a lot of his furniture: grandfather clock, bedroom set, desk, records, dishes, etc. Pictures, letters, etc. obviously are the most sentimental. I recall that my mother and uncle in (particular) would keep lots of things such as books and magazines. I notice that I have the same tendency. I have trouble organizing the tremendous amount of papers from my teaching career: lesson plans, supplementary teaching materials, etc. coupled with the everyday bills, pamphlets, instruction manuals. Like you mentioned, I have trouble parting with papers that I've scribbled names, numbers, and notes on from years ago that are no longer relevant. I have closets overflowing with clothes, purses, shoes, and shelves filled with books. My husband does not like clutter on any surface whereas I like to see objects on counters (almost as a security blanket, which makes me feel as though I am here and that I exist). My mother in law is excellent at sorting through things and throws things away without any compunction. My husband and his mother share this trait. I suppose I answered my own question. However, it's likely that it's not only a learned behavior but also potentially ingrained genetically. Perhaps you can understand my situation. I watch the show "hoarders" and I see an extreme version of myself and it's very frightening. I try to keep the tendency in check. Do you suppose if I were to read your book I could be helped? — Dora (CAS’99)

A It’s hard to know if you’d benefit from reading the book so you’ll need to make that decision yourself. We wrote it as a series of cases of people who represent the many facets of hoarding. No doubt you will see yourself among them, although it may not be clear to you what to do about that. Your symptoms do sound classic (too much stuff, hard to organize, liking to keep things in sight rather than put away), but you’ve been able to part with many of the items already. Earlier I recommended our self-help book (Tolin et al., Buried in Treasures) that explains a model for understanding hoarding (and yes, there is probably a pretty strong genetic linkage) and for treating these symptoms effectively. In addition to this, you might consider finding a “coach” (friend, impartial family member, undergrad student helper) who could help you sort your way through all the items and make the hard decisions of what to keep, toss, give away, sell and provide some assistance in doing these tasks as well. Good luck!

Q A close family member is a hoarder. She's also a kleptomaniac. I see a close parallel; what do you think? Some people have suggested they are both obsessive/compulsive disorders. Her problems go back to childhood. — Holly (CAS’73)

A Kleptomania does sometimes occur in the context of hoarding although it is not common. Neither is really the same as OCD, although hoarding (but not kleptomania) is classified as an OC Spectrum condition. Her problem is pretty serious as jail time is the potential outcome. Above I recommended a book called Digging Out that might help you help her.

Q I have an inability to discriminate. It manifests chiefly in my work. For example, the floor around my desk is covered with notes. I even have 80 windows open on my computer! When I have had someone organize for me I never use the result. Whenever I try to give myself 1/2 hour to "straighten up" I stop because I can't decide what to do with the first few papers I look at. I do not have this problem with other things. How can I chip away at this problem? — Confidential (SMG’65)

A This sounds like a decision-making problem that affects your organizing efforts and is a bit overwhelming to it’s hard to make progress. I’m not the expert in this part of the brain. One strategy is actually to get some neuropsychological testing to identify the specific nature of the testing and request a referral to someone who does specialize in training people with this sort of challenge. I suspect it will require some hands on practice with the right person next to you in your own office to improve your skills in this area. Good luck!

Q What’s the difference between compulsive hoarding, attention deficit disorder and just being old and having a lot of stuff? — Bert (STH’72)

A Hoarding is defined by the difficulty making decisions about objects and papers, excessive acquiring that feels almost compulsive by nature, and excessive clutter that results from these. These are not clinical problems unless they significantly impair functioning (social, work, home) and cause distress to the person or people around them. Attention deficit is evident when a person has trouble staying on task in many situations, not merely when they are trying to sort or organize things. Attention deficit makes resolving hoarding harder, but stands alone as a separate problem in everyday life management. Stuff does accumulate with age and sometimes it is tricky to determine whether this is a hoarding problem (which tends to be lifelong, starting in teenage years with difficulty discarding) or just the challenge of having accumulated a lot of things as we get older with limited time and interest in addressing the clutter that results. One way to determine what is present is to get serious about trying to get rid of things and schedule a session to do this. Notice how hard it is to stay on task; is that a problem even when the emotional content of the stuff is not really a problem? If so, attention deficit is likely involved. Also, if guilt, fear, sadness or other negative emotions interfere with making decisions to get rid of items that others would have little problem with, hoarding is probably the problem.

Q My mother was a hoarder. She saved everything, especially newspapers, magazines, and mail. How do I avoid ending up as a hoarder? I throw out most of those things. I save material and yarn for quilting and sewing. My other hobby is genealogy so I also save family papers and pictures. — Sue (CLA’64)

A If the saving is not interfering with the use of your home because of clutter and these activities are how you’d like to be spending your time, it’s not clear that you have a problem, especially as you throw out most things. In Stuff we provide some descriptions of people who were unable to pursue their hobbies because of hoarding — they collected and saved so many craft items that there was not room to do the crafts, although they always intended to. That’s hoarding.

Q My family are all hoarders. I have my dad's receipts for bills from 1930s and 1940s etc. I have recycled all those plastic containers and peanut butter jars, but I get overhelmed. Now that several relatives have passed away in the last several years, I have 'acquired' lots of stuff, i.e. needlepoint, crocheted items, african violets, etc which are all beautiful. I have figured out how to 'freecycle' their used furniture, but too much other stuff collects. My husband collects too much stuff also, and his son has 153 motors most of which are 'stored' in our basement. I would like to have hardwood floors installed in our first floor home, but you can't see the floor, but all the stuff is 'usable' but overwhelming. I don't really buy anything except for food. I did just give away 800 pens to a local school. They were free... they had a misprinted phone number on the pen barrel. I am not as bad as the pictures or video you show, but..... I'm not sure where to start to de-clutter or how to get my husband and step-son to step up to the plate also. — Karen (ENG’77)

A Unfortunately, I fear your problem and that of your husband and his son will only get worse. I’m pleased you are able to get rid of some items and that you acquire very little at this time. Still, it sounds like the clutter accumulates faster than you can control it and your family members contribute substantially to the problem. I suggest that you do seek help for this. A website on hoarding that my colleague Randy Frost and I have worked on — www.ocfoundation.org/hoarding — provides a wide variety of information about hoarding and also many resources. You can also e-mail me to see if we have a referral in your area of the country.