Hoarding is a comfort behavior. It is done to reduce discomfort, pain, or anxiety, using some of the same 'pathways' as pleasure. It also is intertwined with attachment feelings.

Hoarding has three behavioral components:

  1. acquiring additional things on a regular basis.
  2. inability to take care of those things realistically,
  3. emotional inability to part with those things

All three must occur together. For instance, some people love to shop and acquire new things, but if they part with an equal number of things, that is not hoarding. Also some people acquire more things than they part with, but if they take care of these things properly, then the activity is collecting not hoarding. Some extremely frugal people are loath to part with anything, but in this case, there is also a strong reluctance to acquire things, (unless for free), and also a strong reluctance to let things spoil. Hoarding, however, is a process in which new things are being acquired, almost nothing is being parted with, and many things are spoiling, breaking, and encroaching on living space because they are not being taken care of.

As hoarding increases it causes very real practical problems, and almost always, a very conspicuous denial of those problems. Many people are puzzled about how the behavior can exist and progress at such cost to 'everyday comfort.'

Hoarding seems to have three emotional components:

  1. A redemptive belief behind each acquisition. Each additional item has a proposed use in the future which is greater than the present use. Whether it is finding use or value in something others do not value, or using 'raw materials' in creative or frugal ways, or acquiring extra items 'at a great price', the idea is that the hoarding person does something good that (and this is often unconscious) undoes or redeems some past, perceived defect or wrongdoing. 'Saving' animals is also redemptive. This contrasts with the straight-forward intent of achieving pleasure most people have when they acquire things.
  2. Relating to the objects as placeholders or 'vessels' of meaning only, not as actual physical objects. Often the person cannot describe the objects in great detail. Eye contact and ability to scrutinize the object is limited. If there are many animals, the owner may not be able to reliably tell them apart. Handling the objects for more than a short time seems to cause agitation and bad feelings. This is part of the reason for the disarray and mess. Occasionally attempts are made to clean up, but bad feelings arise quickly. Relating to the objects as actual things seems to interfere with the 'dream' behind the object.
  3. Extreme guilt and fear of error in parting with objects. Perhaps since objects equal the promise of redemption, the loss of them brings on the feeling of guilt. Also any neat storage activity that places objects out of sight (like placing neatly in boxes) risks losing the objects in an emotional sense, (there is little objective constancy for this type of object) and so is resisted. Since it is not possible to give or throw away objects, and also not possible to put them away, everything ends up in piles. Things do end up disappearing under the welter and being destroyed anyway, but while this causes distress, it is not the same as deliberately 'doing away' with objects. Being urged to get rid of objects brings up the fear that just the the most needed (redeeming) object will be discarded. Cleanup attempts by others evoke 'life and death' intensity of fear, shame, or guilt

Hoarding is absolutely not laziness. A lazy person does not resist someone cleaning up for them! Hoarding does end up exploiting the dopamine reward system in the brain that is stimulated when a 'opportunity' is acquired because each new object represents an opportunity. However, acquisition of objects is a reward strategy that many people use, and alone it does not explain the inability to part with or take care of objects that a smaller group of people have.

Though cognitive distortions are necessary to maintain hoarding, it is not a cognitive problem but an emotional one. Some contribution might be lent from inborn neurology, but it is often the case that hoarding began only well into adulthood, where presumably the 'wiring' was the same before the hoarding started.

It is often noted that hoarding often begins after a loss. This seems to support the idea that hoarded objects represent transitional objects and reparation. Hoarding might represent a symbolic act of 'undoing' something that has not be integrated because grieving has not been done.

Hoarding is an incredibly tenacious behavior, so the approach to helping has two tiers. On the first tier is addressing the practical cleanup when health or safety is at issue. This is usually done with lots of support and some distraction. It is epitomized on the A&E Channel's show Hoarders. The second tier involves work to re-establish satisfying relationships with people and work to re-establish the capacity to grieve and complete the grieving of significant past losses. Unnecessary first tier interventions may complicate second tier intervention, but it should be made clear that no one that must live with a hoarder needs to tolerate hoarding encroaching on shared space.