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Why can’t some people throw anything away?
November 30, 2011  |  by Michael Anft
Illustration: Brett Affrunti

Illustration: Brett Affrunti

Jack Samuels’ mostly anonymous days as a research psychiatrist ended sometime in the last couple of years, as the subjects of his studies—people who accumulate mounds of things, often to the detriment of their health and relationships—stepped out of their overstuffed closets and into the spotlight. Once dismissed as junk-loving eccentrics and flakes, people who hoard indiscriminately have recently served as subjects not only for sober scientific study but for three so-called reality TV shows and a celebrated novel, E.L. Doctorow’s Homer and Langley, based on the real-life story of two wealthy brothers who were found dead in their New York home in 1947 amid more than 100 tons of useless items they had piled up over decades.

Nowadays, Samuels, an associate professor of psychiatry at the School of Medicine, spends less quiet time in his tiny, semi-cluttered office with a view of a sliver of the Baltimore harbor and a lot more of it talking with the media. With 23 years of research on the subject—all of it performed at Johns Hopkins—he has also become the authority for scientists looking to unravel the mysteries of hoarding. Samuels and several Johns Hopkins colleagues’ groundbreaking research into a sometimes-related ailment, obsessive-compulsive disorder, recently found a genetic basis for hoarding behavior. The discovery comes at a time not only when people who hoard are in the public eye but as longstanding misconceptions about the disorder are being dismissed by the psychiatric world. “Even just a couple of decades ago, we thought that hoarding was merely a subtype of obsessive-compulsive disorder,” says Samuels, a compact man with a mustache and a clear, media-friendly speaking style. “Now, we know that only one-third of people with OCD exhibit hoarding behavior, that many people without OCD hoard, and we suspect that genes can play a key role in it.”

Hoarding, which afflicts an estimated 15 million people in the United States, can endanger families and even neighbors, he adds. Every year, stories abound of people dying in fires stoked by hillocks of things piled within their homes. Those sad tales can border on the incomprehensible: Would-be rescuers often cannot find people in a burning home stacked floor to ceiling with newspapers and other items. Some people who hoard make animals their obsession, sometimes collecting dozens of them. The animals, often malnourished and kept in appalling conditions, can spread disease throughout neighborhoods.

“It’s not uncommon for us to see people who fill one house up with stuff, then move to a second house—sometimes even a third—to get away from this mass of clutter,” says Samuels.

Even though we live in a society where the number of self-storage facilities (51,000) dwarfs that of coffee shops (around 25,000), and where one in 10 households stows excess stuff in places outside their homes, Samuels and colleagues think that the disorder has a lot more to do with activity in the genes—specifically, in chromosome 14—than with Americans’ passion for material things. (Researchers around the world have identified hoarding in all cultures.) Since 2008, his Johns Hopkins research team has interviewed 70 people found through hoarding support organizations—groups with such names as Clutterers Anonymous, Children of Hoarders, and Messies Anonymous—as well as 100 of the participants’ relatives. “We’re finding that a lot of people who hoard have relatives who show the same behavior,” Samuels says. Older people are more prone to exhibiting symptoms of the disorder. “[Hoarding] tends to show up later in life than OCD does,” he says. “The tendency is there when people who hoard are young, but they may live with someone who can help them manage things.” But as people get older, they may lose a spouse and become isolated. “The situation can get out of hand.”

Raising children or maintaining relationships is more difficult for hoarders. Getting them help isn’t easy, either. Although many hoarders are too embarrassed by their surroundings to invite people over (and, hence, become even more isolated), others deny they have a problem, even as their relationships crumble. “There’s often a lack of insight,” Samuels says. Traditional treatments for OCD aren’t much use against hoarding. Prescribing anti-anxiety drugs and behavioral therapy that exposes people to objects they fear—methods used to battle OCD—are less effective in treating hoarding. One emerging cognitive behavioral approach involves sending a therapist to a patient’s home to challenge his thinking about hoarding objects, as the patient works to reduce clutter. The technique, tested in trials, has reduced the severity of the disorder by 30 percent. But such treatments often aren’t covered by patients’ health insurance plans, even though therapy, which can cost up to $7,000 for 40 hours, must be maintained for years. “It’s not like these people are cured,” says Samuels.

As science continues to examine people who hoard and their genetics for clues as to how to help them, Samuels hopes that more mental health professionals will educate themselves about the disorder and take on more of them as patients. In Baltimore, there are only three or four therapists who treat the tens of thousands of people estimated to have the disorder there—numbers that reflect a nationwide trend, he says.

Samuels believes that the sagas of those who amass piles of often useless bric-a-brac have entered the cultural zeitgeist because we all grapple with the hold material things can have on us: “It’s a disorder we can all relate to in some way. We either know of people who hoard things, or we can identify with their difficulty in getting rid of them. Throwing out our kid’s second-grade artwork is hard for us, but most of us can do it.”


10 Comments


  1. Hoarding in my opinion has nothing to do with genes but rather the conditioning of one’s upbringing since the Great Depression. It has to do with going without, rather it be food, shelter, clothing, toys, it does not matter, except for the the first, food.

    When one goes without food, one tends to hoard. Society during the Great Depression led folks into keeping and collecting items that would sustain them in keeping food on the table or within reach. Keeping shelter and warmth, wallpaper and insulation made from newspapers and magazines, heat by fire from these products, as it is still being used today by the homeless.

    All in all it is brainwashing, very simply the lack of substance.

  2. Very insightful article. Another aspect of hoarding, especially in the elderly involves the risk of physical injuries, falls, respiratory illnesses from dust and pets or rodents. I live in the Baltimore area and have a mother who is a hoarder. She is nearly 88 years old with macular degeneration and on a blood thinner. A nightmare waiting to happen and intervention causes such anxiety and anger it feels as though our hands are tied. Her new medical doctor is reassessing her risk of being on blood thinners at this time. Hoarders do not volunteer this information to their physicians and I have found I have to inform the physicians ahead of time if at all possible. HIPAA laws make this type of disorder even more difficult to be open about with healthcare practitioners. I would suggest that primary care physicians increase their awareness of this disorder and develop a screening tool or skilled list of questions that might clue them in that this is a “hidden” problem with their patients. Maybe this has already been done, but it truly is a problem overlooked with healthcare.

    Additionally, how do you get help for someone with this disorder, willingly or against their will? Can you force someone to get help? If you remove the person from the environment or the environment from the person, does the anxiety ever lead to fatality?

  3. Robert A. Erlandson

    I enjoyed this article because it allows me free rein for my favorite theory: The existence of a “collector’s gene.”

    There are hoarders, collectors and those who don’t understand either.

    Hoarding is a mutation of the “collector’s gene.” In some individuals, instead of simply being dominant, it goes rogue and frequently leads to news articles, some serious, e.g. animal hoarders with 75 cats or dogs; some less so, hermit dies in a room filled with old newspapers.

    But a healthy “collector’s gene” provides a lifetime of pleasure, the thrill of the hunt. I have been an inveterate collector since childhood and even in old age the thrill remains.

    Any real collector knows that sooner or later someone will say, “You’re sick”‘ it’s usually some benighted individual who lacks the “gene.”

    Looking concerned, the collector will say, gently, “No, I’m not sick. I’m simply lucky enough to have been born with the collector’s gene. It’s a dominant characteristic and I have no control over it, it’s just there. And I love it.”

  4. I visited my childhood girlfriend recently. We r now 65 yrs. her Hugh 3 story home used to b the gathering place. A home comprising of 2 parents, 2 brothers & 2 sisters. On one side of the house on the 2nd floor the father taught Pitman shorthand, typing & dictation. On the first floor, can also b called a basement, as teenagers we called it the studio; is where piano lessons was taught. I left in 1963 to live in England. Approx 3 yrs later the older brother came to England. He was an accomplished pianist, organist & trained teacher. Turned out he was gay, shortly after he moved to France. Another brother moved to America studied & became a CPA . Years later one of the twin sisters who always saw herself as the “black sheep” moved to America, continued her studies as a pianist & organist, & is now an accomplished organist & pianist. Sometime in the 70,s the daddy died of diabetes; that left the mother and one twin sister in that huge house. Commercial school & music sch came to an end years earlier. The mother left in the 80′s on vacation to America, no one would had thought that she would never return home. She died of a massive stroke. Her body was cremated, her ashes brought back home by the twin sister who never left and was buried. Now, that sister lives alone in that huge house. I have returned several times on vacation, but never stayed with her. Presently, I am home on vacation& staying with her. I am writing this because I am shocked to see that over all, all,all these yrs she has not gotten rid of any items of the parents, or sister. I entered the room that was the sister,s room. The room is terribly dusty.i saw clothes hanging in the closet. When I asked whose clothes were they. I was shocked at the reply that they r her sister’s still hanging there after 23 yrs. I asked about the dusty, discolored bottles of toiletries and personal care items on the dressing table the answer was the same, with a shrug of her shoulder, she said they belong to the sister. In shock I said after all these years u have not cleaned or thrown away anything from this room? She sucked her teeth & said no. The room I am occupying has no table top space, all filled with old, old pillows, cushions, old Non Operable tv,s and radios . When I asked what was in the closet? She opened, old curtains, sheets, bed spreads. Pushed in every corner are old valances, brooms, empty boxes. I have never seen this. What is this? Is this hoarding? She has lived for all these yrs just not realizing that she should throw away old, non useable items. I told her that while I am here I will purchase some Huge
    garbage bags, put all old tv’s, computers, radios, pillows etc, call in a truck and cart things away to the dump. She said ok.

    And person care items on the

  5. I was not a hoarder until the last ten years. I see it as an extension of depression. In 2003, in January, my mother-in-law died abruptly of a heart attack. I had been moving toward divorcing my husband and now with an influx of money for him, I felt free to finally leave. Within months of my separation, my mother was diagnosed with cancer and died. Because I work in the healthcare industry, my sister relied heavily on my scant knowledge and we both made the decision to let her die without numerous attempts at surgery, and other stop-gap methods. It was the right decision, but that didn’t help the guilt that piled on me after her death. Within a year, my father had died too. In fact, they were buried on the same day exactly a year apart. I hadn’t worked through grief for my mom and suddenly dad was dead too. In addition, my divorce went through, amicably thank God. Over the next 8 years, I lost 4 more people including my older sister. In between the deaths, it was discovered that I had a blood clotting disease that put me in the hospital 3 times in 3 years. I am now on medications for it for life. I’ve also been diagnosed with type 2 diabetes, hypertension, and depression. I became scared of thunder storms and started hoarding. Some of the hoarding was because every time I had a blood clot, it would end in my lung and I wouldn’t be able to breath very well. Although I managed to stay at work, by the time I got home at night, I was a zombie…unable to do anything but sit and stare at the walls. The clutter and trash built up. I became a more compulsive shopper, frequently buying things that never made it out of the plastic bags I brought them home in. When I did clean and try to declutter, the trash rarely made it out of the house. I couldn’t take out the trash. As things broke down in the house, I was too ashamed to let any one in to fix things. I lost hot water, the use of one bathroom, and eventually my A/C and heating. I was terrified that someone coming into my home would report me and I would be exposed and ridiculed. I have made plan after plan to take trash out. I’ve made bargains with myself to take out 1 trash bag a day or to take out so much trash before I get on the computer. I’ve even tried to give myself permission to trash useful things. Just because I can’t use them doesn’t mean that someone else can’t use them. But I can’t even take them to the dump. The back seat and storage area of my car are packed with items. I have bags of clothes in their from when I did laundry and have brought in the clean clothes piece meal. I have the trails that I work through to get from room to room.

    Does this all bother me? Absolutely it does. I’ve become reclusive and shut off from other. I’m ashamed that I have this problem and can’t seem to cope with it. I am in the process of trying to find a CBT therapist to help. But therapy is expensive, although I will still go for it. At this point, I don’t know if I’ve become a hoarder because I don’t want any more loss in my life or if it’s because the walls of clutter and junk surround me and protect me from some nebulous something that’s “out there”. I just know that it’s an extremely hard compulsion to work through or with.

    • Sarah, know that there are those of us out here who can relate, and don’t judge you. I have a similar story. If you would like someone to talk to, and are back here, send me a contact point, like an email address. Take care.

  6. Genes? Why must we blame every disorder on a genetic disposition? By doing so we remove responsibility for our own behavior; “It’s not my fault and I can’t do anything about it, it’s my genes.”

    However, I admit that there might be some factual basis for this theory; did my parents tend to keep things? My dad kept boxes, thinking he might need them someday. However, our house was tidy, clean, and uncluttered.

    I came upon this article as I prepared to sell a microwave that has been packed in storage for ten years, in the original box. I took photos of it and began to write the advertisement for Graig’s list.

    I read this description of the microwave:

    “LG’s innovative curved cavity optimizes interior space within the same footprint. At 14.2″ in diameter, the turntable can accommodate large round serving dishes.

    Another benefit is the round cavity is easier to clean because there are no hard to reach edges. LG\’s life ready thinking.”

    Then I had this thought: “It’s a good microwave, and I won’t be able to buy one like it. I really like the curved interior; I might need a microwave someday.”

    I did not finish writing the advertisement. All my life I have had a ‘saving’ disorder. I ‘saved’ cake my mom baked until the next day. I saved my pennies and dimes. I saved my clothes, even though I outgrew them or wore them out.

    I’m getting better. I disposed of uniform pants that I no longer need, after keeping them for two years. I thew out socks that I didn’t like or wear.

    However, I still have shoe boxes of items that I’ve had for decades. I have boxes of clothes that I don’t wear. I have brochures from travel destinations that I can’t seem to dispose of.

    My house is not filled with stuff; I can be guest ready in about an hour; just don’t go into the back bedroom. My stuff is well organized in bins in the garage.

    I wrote this to provide some insight into the mind of a ‘saver.’

  7. In my business we come across people who can’t throw away anything. They try to declutter and organize their stuff but I see them struggle with the ultimate decision to toss their belongings. They are so emotionally attached to their belongings that it would take a psychologist or an extreme life event to force their hand. Every item on the chopping block has a story and I learned to stop judging and start listening because some of their stories are very interesting.

  8. I live with a clutter-bug. gene??? If so.. it must be a normal gene and those who don’t have it are just weird. I know to many people on both sides of my family who have this problem from moderate to great degrees. I’m respectful with his clutter.. I leave it for him…. however he loses stuff all the time (because of many many piles) and claims it’s been tossed. I can toss my stuff. I keep it for awhile, then it just starts looking like clutter on top of his so I’ll pitch it. He is a wreck when he cleans.. I’m respectful during that process too. He is emotionally attached to “things” because of memories. How do you help with that? I really do not think we need to keep the 4′x4’5th grade school project that he helped our son make now that our son is 26!!! So what if it fits on a shelf… It’s now dusty & pieces are broken. My jaw dropped when he said it brought him good memories and it would just slip onto a shelf in the basement… How do you help someone like this?? For something like this… I really just shake my head. I really have a problem comprehending this.

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