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n December 2003, police and rescue workers were called to a two-story brick building in the Bronx to extricate Patrice Moore, forty-three, from his one-room apartment. Moore had been lying on the floor for two days, unable to move his injured legs, after huge stacks of the catalogs and magazines that stuffed his apartment collapsed and pinned him to the floor. As it was, Moore had barely been able to squeeze into his apartment between the piles of junk. Nevertheless, when his landlord threw out most of his stash while he recuperated in the hospital, Moore was so upset he threatened to sue.

Like Patrice Moore, we all find ourselves, to some extent, under a constant deluge of the items we accumulate in daily life. Try going away for two weeks, and look at the mail that piles up. Try sorting through your child’s notebooks and arts-and-crafts projects at the end of the school year. Then there’s all the worn-out clothing, and the broken phones and toys and candy dishes and souvenir coffee cups. Even our e-mail accounts are stuffed with photos, messages, and documents.

Most of us manage to maintain equilibrium in our personal material worlds; we bring things in, but we throw out as well. Others, like Mr. Moore, simply never throw out anything at all. For such folks, a twist-tie may be as difficult to part with as an heirloom brooch.

In cases like these, the regular retention of possessions balloons into pathological hoarding, a condition that creates barriers between hoarders and the people in their world, and often puts life and limb at risk. And it’s a far-from-rare condition: pathological hoarding is now believed to affect as many as 6 million people in the US.

The Hoarding Syndrome

It’s indisputable that today we own many more material goods than people did several generations ago, and the houses we put them into, at least in the suburbs, are substantially larger. But hoarding goes way beyond crowding the basement with too many bottles of detergent.

The profile of a hoarder is someone who collects pile upon pile of clothing, newspapers, and gadgets, as well as boxes, containers, and bags full of junk. These items simply pile up in heaps in the middle of rooms, covering all available furniture until the living space becomes impossible to navigate except via narrow “goat paths” between the piles. As the junk (and often filth) accumulate, hoarders stop inviting people to their homes (although some continue to socialize out of the house). Spouses often abandon ship in disgust, young children may be removed by city agencies, and grown children often cease visiting.

Ilsa,* an acquaintance of my family, is a classic hoarder. A Holocaust survivor now in her early eighties, she spent most of her adult life living in a dark house crammed with possessions, unable to throw anything out. Since her husband was niftar, the situation has only gotten worse, and she has become a recluse.

“She won’t even let in a repairman to fix the air conditioning,” sighs a friend of the family. “She’s too embarrassed to let anyone see the house, but she refuses to do anything to change.”

Another extreme example is related by Tyler Gore, who wrote about his family’s dysfunctional hoarding in a prize-winning essay entitled “Stuff.” Gore gives a graphic description of cleaning out his father’s house after he became too sick to live there:

“Like archaeologists at a dig, we had to clear away the top layers of garbage before getting to the actual things embedded near the floor. We wore masks and rubber gloves to scoop up the cardboard boxes, food scraps, dirty dishes, rumpled magazines, used tissues and paper towels, destroyed clothing and fast-food packaging, and crammed it all into Hefty bag upon Hefty bag.”

A year later, the house was still not empty

Many (although not all) hoarders amass possessions by buying compulsively. This inevitably wreaks financial havoc, as their credit cards max out. Many of them find their utilities cut off, when they are unable to locate monthly bills amid the strata of papers. A typical case is Irene, one of the cases described in Stuff: Compulsive Hoarding and the Meaning of Things by Randy Frost and Gail Steketee. When the authors to tried to persuade Irene to throw away an old New York Times, she bargained: “Let me just give it a shake to make sure there is nothing important here.” When she did, out fell an ATM envelope containing $100 in cash.

“My mother could never bring herself to throw anything out,” says Malka G.,* a mother and grandmother from Boro Park. “She’d keep soda bottles and cans massed in her kitchen and garage. Each time she was hospitalized —many times as her health began to fail — she made sure to keep the hospital bracelets. She had a whole drawer of them. She would religiously hold on to the hospital menu cards as well. She had piles and piles of old papers, boxes of clothing so worn no tzedakah organization would ever take them. You couldn’t find the couch, the closets were overflowing, and the basement was completely impassable.”

Similarly, Sari S.* had an aunt who never managed to throw out the games, toys, and papers she had accumulated over a lifetime of teaching.

“Everything had some sort of sentimental value for her,” Sari says. “My kids would be thrilled when she’d pull out some fifty-year-old game for them. But she’d never let them take the games home — she couldn’t bear to part with them. You couldn’t see the bed in her room under all the piles of stuff. We’d say to her, ‘Doda, think about your kids! At the end of 120 years, what do you think will happen to all this stuff?’ But she couldn’t think about that. It was much too upsetting for her.”

Amassing, not Collecting

A lot of children and adults make a hobby of collecting things: baseball cards or (l’havdil) gedolim cards, stamps, rare books, Judaica.

“Most of us have a kind of magical relation with the things we own,” says Dr. Randy Frost, professor of psychology at Smith College and the coauthor of Stuff. “We relate to them as pieces of ourselves, as representations of a relationship to people or events. For example, you might cherish a ticket stub from a concert you attended. One of my students bought a T-shirt worn by a celebrity. The shirt itself had no particular value, except that by owning it she felt connected to that celebrity.”

Compulsive hoarders, he told Family First, seem to have an extra measure of the ability to invest objects with meaning.

“Many of them are highly intelligent,” he says, “and their thought processes are quite complex. They seem to make even more associations with objects than the rest of us. They won’t pick up a bottle cap and think, ‘Oh, this is garbage.’ They’ll notice the specific color, or shape, or they’ll think of all the ways a bottle cap could be used.”

After a while, however, investing every random item with meaning wipes out any ability to distinguish between useful and useless, ultimately creating a gridlock.

“Those associations become too rich to be productive,” Dr. Frost says. “One of my subjects said, ‘It’s like a tree with too many branches.’”

Another of his subjects called her objects “a river of possibilities,” seeing potential in each and every one of them.

A collector, by contrast, sees gradations of value between his objects. An antique teapot is worth more than a teapot mass-produced last year in China; a matchbox from a fancy restaurant has less sentimental value than a matchbox from his parents’ wedding. Collectors tend to organize their collections in systematic ways, grouped into categories, and often with an eye towards displaying their finds. $$$(For example, the stunning dreidel collection of Rabbi Eliyahu and Clary Safran of Boro Park, featured last Chanukah in Mishpacha. Or Imelda Marcos’s famous collection of 3,000 pairs of shoes, that she acquired during her tenure as first lady, now on display in the Philippines.)$$$

Hoarders, unlike collectors, attach no wider social value to their possessions, nor do they distinguish between treasure and trash. While value is always, ultimately, in the eye of the beholder — who’s to say the two-million-dollar Jackson Pollack painting is intrinsically more valuable than a paint-spattered board picked out of the trash? — those who hoard aren’t even able to identify what’s most worthwhile among their own things.

“Once, for a special birthday, I gave my mother a painting I had worked on for hours in an art class,” Malka G. remembers. “I can still picture it — it was a picture of a shtetl in Europe, and it came out really well. Well, when my mother passed away last year, my siblings and I took turns clearing out all her stuff, and I remembered I had done that painting and tried to find it. Wouldn’t you know, I couldn’t find it anywhere! My mother probably mixed it in with a whole lot of other junk, and then somebody tossed it into the dumpster.”

Despite their inability to differentiate between merchandise and junk, hoarders perhaps deserve credit for never underestimating the potential value of objects. (Think of impoverished villages in Africa, where even a broken shoelace or old tire gets recycled into something useful).

“They may be more responsible than the rest of us, if you think about it,” Dr. Frost remarks. “A lot of us send perfectly good items to the landfill every day. A hoarder refuses to do so. Of course, in the end, he’s usually forced out of his space, or he passes away and the stuff ends up in landfill anyway.”

Toby Golick, a professor of clinical law at Cardozo Law School who has worked on hoarder eviction cases, characterizes this as a “Depression-era mentality.”

“Hoarders have this sense that they might need every item someday,” she says. “If they have a cracked butter dish, they won’t throw it out, because the attitude is, ‘Why throw out a usable butter dish? Maybe tomorrow I won’t be able to buy another one!‘”

Ms. Golick found herself spearheading a New York City task force on hoarding through her work on hoarder eviction cases.

“In New York, a person can be evicted for creating a public nuisance,” she says. “This includes offensive or unsanitary living conditions, as well as creating hazards to oneself and others. Hoarding very often presents a fire hazard; people pile papers on their stoves. There are also risks of dust inhalation and insect or rodent infestation.”

Today, task forces on hoarding now exist in places as diverse as Seattle, Ottawa, and Washtenaw County, Michigan.

Some hoarders see in their junk piles the promise of a better life, like the woman who never threw out magazines because she was convinced that one of them might contain some information that could turn her life around. There are people who hoard appliance parts or crafts supplies with the vague hope that someday they, or somebody else, might use them to make something. One New York Times article mentions a woman who amassed a group of toys she didn’t need or even want from a television shopping channel, because she “felt sorry for them when no one else bid on them” — clearly another reflection of hoarders’ unhealthy association with outside objects.

Profile of a Pack Rat

The expressions “pack rat” or “to squirrel away” reflect hoarding instincts that occur in the animal world, mostly among small birds and rodents. Animals may store food for a few days, or stock larger amounts to tide them through the winter. Their gathering is focused — food for survival, or twigs and fibers to build nests or dams. However, those normal hoarding behaviors can be amplified by feelings of stress. Dr. Stephanie Preston, an assistant professor of psychology at the University of Michigan, found that administering stress hormones like cortisol to rodents resulted in higher levels of hoarding.

There’s a common stereotype that people who have been through extreme stress, trauma, or deprivation — Holocaust survivors like Ilsa, for example — are also prone to dysfunctional hoarding behaviors, stocking their garages with arsenals of canned goods and toilet paper.

“That was one of our first research questions when we began studying hoarding —if it was related to deprivation,” says Dr. Frost. “But we found no support for the hypothesis that material deprivation causes hoarding behavior. We did find, however, that people who hoard have a higher frequency of trauma in their pasts.”

Dr. Ronit Zweig, a psychologist who works with hoarders in her Flatbush practice, believes that even the children of trauma victims are prone to hoarding.

“Their parents transmit a mentality of ‘You never know,’” she says. “Possessions allay the anxiety of anticipating the next catastrophe.”

On the other hand, Frost has found that hoarders are more likely to come from lower socioeconomic classes.

“But not always,” he qualifies. “There are rich people with large houses who hoard as well.”

Money is not the crucial factor in how much a person can amass, because just under half of hoarders take in their loot passively, picking it out of other people’s castoffs or salvaging it from incoming mail and food containers. The other half, who acquire possessions more aggressively, are just as likely to buy in a 99-cent store or a flea market as in a higher-end department store.

Hoarders abhor a vacuum, so no matter how much space you give them, they’ll fill it up.

“No matter how large the house — or houses — a compulsive hoarder will eventually fill them up,” Dr. Frost says. “But the problem tends to be noticed faster in cities, where hoarders start to overflow their small spaces much faster.”

In Ms. Golick’s experience, hoarding is more common among the elderly.

“Young people move around much more, and moving always forces you to get rid of a lot of stuff,” she says. “Older people don’t, and they’ve had that much more time to accumulate ‘souvenirs’ and other sorts of junk.”

The elderly also are at risk for depression, which accompanies hoarding in as many as 60 percent of all cases. They may also be undergoing physical or mental decline that prevent them from making decisions or being able to control the flow of objects in and out of the house. The elderly often have no one around to observe the condition of the house. The combination of isolation, decline in faculties, and lifetime accumulation makes for, in the words of Dr. Stephanie Preston, “a perfect storm for clutter.”

But most hoarding begins well before old age.

“The average hoarder is in his or her fifties,” says Dr. Frost. “But hoarding behaviors usually begin around age thirteen. It actually tends to run in families — there have been linkage studies showing some genetic heritability for hoarding. Hoarding may have to do with a more general problem of information processing.”

Dr. Frost believes that hoarders have a different approach to information than the rest of us do. Most of us organize our things by category: clothing in the closet, bills in a file, old books in the basement. Hoarders, by contrast, lay out their possessions in full view, so they’ll know where to find them (although the overwhelming amount of stuff often cancels out any such advantage). Frost’s subject Irene was able to remember the provenance of each item in her jam-packed home, but left everything in full view because she didn’t trust herself to remember where she put things.

Hoarders also seem so paralyzed by decision-making that they ultimately opt out of it. Like the woman who buys three pairs of shoes because she can’t decide which is the nicest, hoarders obsess about which items to discard, but ultimately leave everything right where it was. It’s often hard for them to focus for any length of time in order to evaluate an object’s true utility, resulting in an avoidance of any final verdict.

Helping the Hoarder

Many people imagine that hoarders are lazy, since they’ve apparently done nothing to clean up their living spaces. However, many are quite occupied in efforts — most of them nonproductive — to organize their things. Hoarding experts call this “churning”: ceaseless examining of their possessions in an attempt to organize them, ending in things pretty much remaining as they were. They may also spend hours “checking” their possessions, assuring themselves everything is still in its place.

Malka G. remembers that her mother “would spend hours deep in concentration, seemingly working. Then we’d realize she’d simply been writing list after list of things she’d bought, down to the last penny.”

Based on behaviors like Malka’s mother’s list-making, hoarding was long believed to be a form of obsessive-compulsive behavior, and classified as such in psychiatric manuals. Today, however, Dr. Frost says that definition is under reconsideration.

“Obsessive-compulsive disorder (OCD) is caused by intrusive, anxiety-provoking thoughts,” he explains. “The main emotion is anxiety, and the point of the compulsive behaviors is to alleviate it. With hoarding, it’s hard to identify any sort of intrusive thought, and there aren’t the same kinds of anxiety-allaying rituals. Instead of anxiety, the main emotion in hoarding is the pleasure subjects feels in acquiring objects.”

In addition, the traditional treatments of choice for OCD — cognitive-behavioral therapy in combination with medication — don’t seem particularly successful with hoarders.

“It seems a different part of the brain is involved,” Dr. Frost says. “We’ve hooked people up to an FMR machine while they watched a video of someone deciding whether or not to put their junk mail through a shredder. Hoarders’ brains showed patterns distinctive from normal people and people suffering from OCD.”

Dr. Zweig has a different take. She sees hoarding as an addictive behavior, with dynamics similar to overeating or alcoholism.

“Like people who eat to fill a void, hoarders accumulate things to pad themselves against reality,” she says. “They feel rewarded when they take in something new, the same way an overeater rewards herself with food. And like being overweight, hoarding creates a barrier between themselves and the world.”

So how can pathological hoarders be helped?

“They tend not to come in for help on their own,” Ms. Golick warns. “Their landlords report them. Or, in the case of the elderly, sometimes caretakers will arrive at the home and refuse to stay when they see the conditions the person lives in.”

Dr. Zweig’s clients likewise present when an emergency arises, like a broken refrigerator the repairman can’t get to, or a diamond ring that gets lost in the piles.

There’s been a recent slew of media coverage of cleaning crews brought in to “solve” a hoarder’s problem by hauling away her “treasures.” But this generally only traumatizes the hoarder, who then hits the restart button on a new cycle of hoarding. People like Irene derive a feeling of safety and protection from living encased in piles of objects, as if they were a shell or nest. Taking away their things feels as painful as stripping away a layer of skin.

Golick’s task force, which included social workers, found that taking things out little by little from hoarders’ homes produced more long-lasting results.

“We’d tell clients to take on one small, manageable area to clear, like a bed,” she says. “The person would then feel less overwhelmed and enjoy the benefit of actually being able to sleep on his bed. We also used a harm-reduction approach, the way therapists do with addicts: if you can’t stop the behavior, you try to make it safer, like making sure heroin addicts are supplied with clean needles. In the case of hoarders, that might mean moving papers off the stove so they don’t set the apartment on fire.”

Since many hoarders are pained at the idea of throwing out something useful, Golick says, they can sometimes be persuaded to part with things if they believe the goods will be given away to needy people.

“Hoarders often do well in support groups,” she says. “They may not be so good at throwing out their own stuff, but they can be very good at telling other people what to throw away!”

The practice of giving antidepressants to hoarders has been largely discontinued due to uneven results. Today’s therapists are more likely to work on reducing the anxiety provoked by getting rid of things; and to work on cognitive restructuring in the areas of responsibility for possessions, control, perfectionism, emotional attachment to things, organization strategies, and memory. Sometimes therapists take pictures of the hoarder’s home and show them to the hoarder, because most have developed, in the words of Frost’s collaborator Gail Steketee, “clutter blindness.” They don’t see their own homes as cluttered until they see it in a photo.

 No Place for Me

Spouses of hoarders often give up on them, moving on to — well, cleaner pastures. But children of hoarders may not have that option. According to Dr. Frost, the effects are particularly injurious if they live in a hoarded home before the age of ten.

“They end up extremely angry at their parents,” he says, “and have a hard time overcoming that anger as adults.”

Having lived in circumstances in which it was impossible to invite friends over to their homes, many of them carry into adulthood a reluctance to allow other people into their private sphere.

Malka G. says that her mother’s hoarding affected her relationships with her children and grandchildren.

“None of us remember her ever kissing or hugging us,” she says sadly. “Her head was more into her piles of old junk.”

The effects can be physical as well; Irene’s daughter suffered from dust allergies, and piles of junk invite other sanitary hazards from six-legged intruders to rodents. Tyler Gore writes, “While cleaning out my dad’s house, we all developed hacking coughs, and our noses became clogged with dust ... It is just possible that my father [who died of a lung condition] was killed by his own stuff.”

When Tyler Gore’s father’s hoarding became pathological, his mother moved out. Gore’s father continued to see the children, but those memories aren’t pleasant:

“For years, he wouldn’t even let us in the house. On my rare visits, he’d open the door a crack — just enough to let a unidentifiable yet unpleasant smell waft out — then he’d squeeze out with his jacket and coat and take me to a diner.”

His father’s hoarding rubbed off on his mother and brother and sister, and Gore feels himself still struggling not to fall into the same syndrome. So far, he says, he’s been able to avoid amassing large quantities of junk, but he does have countless crates of beloved books ,and can’t resist bringing home the odd, interesting piece of junk he finds on the street.

As hoarders store more and more possessions, their children amass more and more anger. It especially spills out when parents pass away and the children are left with a house chock-full of debris to clean out. Already angry at having grown up in pathological circumstances, they are far from pleased at having to spend countless hours and dollars disposing of the accumulation of decades.

As with addictions, support is often necessary for the children of those who hoard. Task forces on hoarding often offer such groups, and the International OCD Foundation has a “hoarding center” that offers help to hoarders and their families.

 A Caricature of Us?

The fascination many of us feel towards hoarding may very well come from a feeling that, in the words of Dr. Frost, “Hoarders are just exaggerated versions of us.” All of us fear being overwhelmed by too much stuff. We fall prey to the “seven-hammer syndrome”: we can’t find our hammer, so we buy another one, then we can’t find that one either. It helps that we make Pesach, but that’s a once-a-year solution, and many of us go away!

In the end, sometimes nothing is better than something, as Toby Golick discovered when she had to clean out her mother’s apartment.

“My mother was something of a hoarder, and when she passed away, my sister and I had to clean out her apartment,” she recounts. “We came across about thirty unused rolls of adhesive tape, and my sister, who’s a throw-it-away type, immediately said, ‘Garbage!’ Me, I’m more the saving type, so I was horrified: give away perfectly good tape, worth a lot of money? My sister responded, ‘We need the space more than we need the tape.’ From that, I learned that space and clarity are also worth something.”

Rabbi Avi Shafran of Agudath Israel recently remarked that “simplicity is a Jewish value.” Perhaps all of us should be trying our best to travel lightly through this world. After all. as the the Chofetz Chaim once pointed out so succinctly, we are all “only passing through.”

* Names have been changed.

Keeping Clutter under Control:

• Don’t try to tackle the whole house at once. Start by organizing smaller, well-used areas that will bring fast and visible results. This can energize you to do more.
• Prepare to make a mess in order to reorganize, as you get everything out in the open and begin organizing it into useful categories.
• Start with the objects with the least sentimental value. This is not the time to linger over old photo albums or scrapbooks. Instead, organize the coats in the front closet.
• Try putting away clothing or objects you use only rarely. If you haven’t used them in six months’ time, throw them out.
• Don’t buy things unless you really need them, and are absolutely sure you have room for them in your home. In the words of my great-grandmother: “It’s not a metziah if you don’t need it.”
• Find a good gemach, tzedakah organization, school, or needy neighbor to whom to donate your gently used clothing, craft supplies, furniture, and toys. You get a bigger mitzvah from contributing them to a needy person than from storing them, and that’s worth more than the price of those items.
• Remember that in many instances, computers obviate the need to keep a lot of paper documents on file. “Throw out your junk mail immediately, along with all the extra papers that are stuffed into your bills,” says Dr. Zweig. “Keep your checkbook, stamps, and envelopes all in one place.” Efficiency experts say, “Never touch paper twice — look at documents and take care of them immediately.”
• If you’re helping someone else declutter, make sure to bring large supplies of patience. “Recognize that someone else may not organize the way you organize, or may not maintain the system later,” advises Zweig. “Don’t expect to be able to clear thirty years’ of accumulation in four hours.”

(Originally featured in Family First Issue 212)