Beyond Blue

Beyond Blue

Compulsive Hoarding and 6 Tips to Help

It’s been awhile since I covered the topic of compulsive hoarding, because the last time I did I posted photos of my nut collection and book pile, and the next thing I know I was contacted by Discovery Disney to be fixed on some hoarding special show. Seems like that’s kind of a pattern, now that I think about it. I go public with my stuff … I get invited onto shows!

Well, anyway, I was reading an article in the Fall 2007 issue of The Johns Hopkins Depression & Anxiety Bulletin — an interview with Gerald Nestadt, M.D., M.P.H, Director of the Johns Hopkins Obsessive-Compulsive Disorder Clinic and Jack Samuels, Ph.D., an assistant professor with a joint appointment in the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine and the Department of Mental Health at the Bloomberg School of Public Health at Johns Hopkins. Wow. That’s a lot of school.


I found out that, even though most folks lump compulsive hoarding into the same illness umbrella as obsessive-compulsive disorder, hoarders actually have different brains. The brain-imaging research shows that people with compulsive hoarding have distinct abnormalities in brain function compared to people with non-hoarding OCD and those with no psychiatric problem.

According to Dr. Samuels: “What causes those brain abnormalities (besides genetics) is still not clear, but compulsive hoarding can begin after damage from stroke, surgery, injuries, or infections. In addition, psychology and environmental factors (e.g. traumatic family experiences) appear to contribute to abnormal brain development and function.”


Samuels says that hoarding belongs to a syndrome which also includes:

  • Indecisiveness
  • Perfectionism
  • Procrastination
  • Avoidance behaviors
  • Difficulty organizing tasks

And here are some interesting stats: hoarding obsessions and compulsions are present in approximately 30 percent of OCD cases. However, as a group, says Samuels, OCD-affected individuals with hoarding symptoms have a more severe illness, a greater prevalence of anxiety disorders, and a greater prevalence of personality disorders than people with OCD who don’t have hoarding symptoms. Hoarders are often less responsive to treatment than non-hoarding OCD patients.

Dr. Nestadt offers six anti-clutter strategies for compulsive hoarders:


  1. Make immediate decisions about mail and newspapers. Go through mail and newspapers on the day you receive them and throw away unwanted materials immediately. Don’t leave anything to be decided on later.
  2. Think twice about what you allow into your home. Wait a couple of days after seeing a new item before you buy it. And when you do purchase something new, discard another item you own to make room for it.
  3. Set aside 15 minutes a day to declutter. Start small–with a table, perhaps, or a chair–rather than tackling the entire, overwhelming house at once. If you start to feel anxious, take a break and do some deep-breathing or relaxation exercises.
  4. Dispose of anything you have not used in a year. That means old clothes, broken items, and craft projects you’ll never finish. Remind yourself that many items are easily replaceable if you need them later.
  5. Follow the OHIO rule [which apparently doesn’t work in Ohio, because I’m from there]: Only Handle It Once. If you pick something up, make a decision then and there about it, and either put it where it belongs or discard it. Don’t fall into the trap of moving things from one pile to another, again and again.
  6. Ask for help if you can’t do it on your own. If you feel these strategies are impossible to carry out and you cannot cope with the problem on your own, seek out a mental health professional.

Originally published on Psych Central.

  • Sarah Callender

    I, too, have a nut collection (most of mine are in Trader Joe’s bags that are all contained in a larger Ziplock). My husband laughs at me, but I just tell him, “Hey. You are what you eat.”

    OHIO has never worked for me either. Maybe if the acronym was HAWAII or ROME, I’d be more willing.

  • http://AddaURLtothiscomment Maria

    I have found the strategies on particularly helpful. Her instructions on how to declutter helped me actually make some progress in my craft room, vs. just making several piles of things, getting overwhelmed and quitting.

  • http://AddaURLtothiscomment Rita

    @Sarah – very funny = Hawaii.. lol

    @Maria – I too like the very much. And I have to find a way to keep up with their e-mails, reminders, very helpful concept though.

  • http://AddaURLtothiscomment Jean

    I tried FlyLady, but found their emails so overwhelming – that was just me, though. I’ve gotten a lot of help over the years, from de-cluttering books by Don Aslett. He even has strategies to help one part with ‘thoughtful gifts’ that are in the way. I’m bad about hanging on to things that I imagine ‘would bring a fortune on ebay.’ Would like to get over that hurdle.

  • http://AddaURLtothiscomment Jan

    So fortunate to see this subject this morning! My husband is a hoarder. Just last night we were going through items, trying to “hoard down.” I struggle with living with a hoarder, but I am aware that my husband really can’t help how he is. I appreciate seeing this article this morning as I needed some assurance that God is in control, even if we aren’t. We are making little gains and, I thank you, Lord, for a reminder that we are not alone and that you love us despite how our brains work! We’ll get through this – bit by bit. Thank you for the OHIO suggestion but my husband will never make it with this – ha ha. It’s reassuring that there are others out there that understand the difficulties… Thank you!

  • http://AddaURLtothiscomment Susan

    I have just realized that since my husbands death on October 1, 2010 that I have to force myself to throw things out. I still have not taken away his clothing and all of his golf memorabilia. I have gone to a grief counselor and she tells me that I need to do this when I am ready. I believe I have not accepted his death and have not allowed myself to grieve yet. I have printed this out and will take home and hopefully begin to get rid of the things I no longer need or want.
    I printed this out

  • http://AddaURLtothiscomment Jean Berryman

    so what are you doing about those books?

  • http://AddaURLtothiscomment Kim Israel

    What is the name of the syndrome that Samuels lists symptoms to include: Samuels says that hoarding belongs to a syndrome which also includes:
    Avoidance behaviors
    Difficulty organizing tasks
    I am a very neat and orderly person but I do struggle with the forementioned symptoms. I hoard books and food….help me to understand? Thank you, Kim

  • http://AddaURLtothiscomment May

    The thing is, sometimes items AREN’T easily replaceable! Your child’s baby toys, for example, and even old clothes that you might need if you lose weight, etc. Sometimes people honestly don’t have the money to replace things, thus the urge to save things ‘just in case’. I know I can’t go out and buy new clothes or other new things, so I have to save what I might need in the future.

  • http://AddaURLtothiscomment Bern

    Wow–thanks Therese. I didn’t realize my various piles of stuff (including my bottomless email Inbox)were sort of an outward sign of anxiety. (Anxiety runs up and down my family tree–like a squirrel!) I’ve sort of tried several “get organized” methods like OHIO . . . but I actually have in my OFFICE mind you junk I know what to do with but “don’t have time” to do it.

  • http://AddaURLtothiscomment Razz2

    My husband and I are in the process of “downsizing”. I say process because we’ve been at it for over a year now and still seem to have a long ways to go. However what really brought home to me the idea that we become too attached to “things” was last year when we had to move my mother into a seniors lodge. Going from 1500 sq. ft. to 400 sq.ft. means really getting rid of a lot of “stuff” and it was a very painful process for her. I don’t want to go through that myself. I have a house full of “stuff” and “things” and I procrastinate about dealing with them. However since our basement flooded this summer I am really ready to ditch the “stuff” and move to something smaller. All I can do is shake my head as I go through box after box and see all of the things I’ve hung onto that serve no purpose what so ever. I will never need them “someday”. They will never get fixed “someday”. No one else will need them “someday”. And I really no longer care what I read or wrote in high school 39 yrs. ago.

    In the end we’ll all find ourselves in a place where we can’t take it with us. My husband and I are saving ourselves a lot of heartache by giving it up now and in the end….it really is only “stuff”.

    Be good to you – Razz

  • http://AddaURLtothiscomment Jerry

    Hi Therese,I too am Bi-Polar and have ocd and I collect pen,pencils,shoes,and Bibles. I really enjoy your thoughts and insights. Thank you and God bless.

  • http://AddaURLtothiscomment Your Name

    Thank you – original post and added comments are helpful – motivated to get into it!

    Hmmm and right about the indecision, procrastination, perfectionism, difficulty organizing tasks …. can add overwhelm to that too!!

  • http://AddaURLtothiscomment Sugarx2

    I am doing garage sales, and reorganizing closets, and my weight changed again, a size smaller, but may go back up, so I am afraid to discard clothes. I have small, medium and large clothes, and have worn all within three years, depending on my health. If I gain, I need them, if I lose, I need them. So some things fit the USE IT IN A YEAR RULE and some do not. I cook, scrapbook, knit and craft. I am an information junkie, and my mom passed away recently, leaving me her entire houseful of STUFF. This is tough. I am trying to do this all by myself. One step at a time, one day at a time. I could use help, but do not know where to get it. I read the books, and they help…. SOME.

  • http://AddaURLtothiscomment Erica

    I am sorry, and accept that my keeping EVERYTHING is not perfectly normal. And I have to throw stuff away. And yes I’ll start next week. BUT, I really think someone who just throws everything away immediately and has no sense of sentimentality may also not be quite normal – even a bit inhuman. What say you? :-)

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