Until recently, most people believed that hoarders were eccentric people who died surrounded by a lifetime collection of stuff. Hoarding in families was cloistered in a vault of family secrets or passed off as an individual peculiarity. The effects of hoarding on other family members was rarely examined or understood. Only recently have we confirmed that hoarding is more common than we once thought. Hoarding disorder (HD), a diagnosis proposed for the DSM-5, affects an estimated 2% to 5% of the general population.1-5
Partly because of attention given through reality television, the general public knows much more about hoarding and its ramifications. The greater awareness about hoarding is sparking an outpouring of concern for its effect on families—especially children. Mental health professionals are starting to address this growing concern with research, education, outreach, and intervention for the benefit of children who grow up in hoarding households (See video).
HD is unique from other disorders because its symptoms are tangible and entail a large accumulation of objects that prevent the use of space for necessary or usual human functions. This abundance of objects results from a pathological failure to discard objects and not accumulate more; that is, more objects come into than leave a home. This imbalance causes undesirable conditions that impede human functioning and cause distress. When hoarding is severe, it presents risk of physical and psychological harm to hoarders and their families. Risk of harm extends to neighbors and their properties.
Mental health professionals need to spearhead strategies for change, which will be most effective when based on an in-depth knowledge of the disorder and its effects on people. My research focuses on the long-term consequences of being raised in the homes of hoarders. I hope that knowledge of these effects will be met with increased outreach, resources, and a plan for moving families from hoarded homes into functional lives. Public confidence in outreach depends on compassionate understanding and available resources to guide well-conceived plans for recovery.
Many adult-children of hoarders communicate with me through email and phone calls. A closer view of the effects of hoarding comes from my intensive work with families during the filming of “Hoarders,” an A&E televised, reality series. This summer, adult-children of hoarders traveled from all over the country to participate in a 3-day workshop at my OCD Institute of Greater New Orleans. They shared details about their childhoods and the enduring effects of being raised in a hoarded home.
Workshop attendees joined my staff of 2 psychologists, 2 social workers, and a professional organizer in developing a leadership group with a common mission—to help children of hoarders. The attendees’ ongoing projects in outreach, peer-support and education for adult-children of hoarders inspired new projects to promote public awareness and assistance for children of hoarders.
Since the workshop, networking within the leadership group has been fruitful. The group has produced brochures, authored literature for children, presented to special interest groups, prepared for upcoming professional workshops, developed Web sites, hosted Internet forums, participated in media coverage, partitioned city officials for publically funded task forces, and promoted participation in my research.
A large number of adult-children of hoarders have participated in my research by completing mailed questionnaires, an online survey, and telephone interviews. Preliminary results support that being raised in a hoarded home produces lifelong, deep, and widespread effects, including losses in every sphere—physical, emotional, psychological, social, and familial.6
Safety surrenders to stuff
Inside hoarding homes, cultural norms of family life are squeezed out as parents become entrenched in the flow and placement of objects. With a need to feel in control of a process that is clearly out of control, hoarders are unable to distinguish between healthy and unhealthy, unneeded or just “too much.”3
Processes that support appropriate growth and differentiation of family members are overlooked. A person’s value becomes secondary to a “good deal.” As family members struggle through, hoarders often feel criticized, rejected, and shunned, and they turn to objects for safety, success, and the fulfillment of many misguided beliefs or values. Hoarders cannot see that their behavior subjugates the entire family to a life that is permanently altered.
Where severe hoarding exists, families rarely have space for shared activities or they are forced to combine spaces inappropriately—such as when an older child has to sleep in the same bed as a parent. Sometimes children are forced to live in one space that serves multiple functions. A vacant spot on a couch is used for sleeping, doing homework, watching television, and eating.
In some cases, objects that should never be in homes occupy living spaces. Contaminants, rotten food, garbage, and molded piles of newspaper that attract insects and rodents infiltrate the home. Air quality eventually becomes toxic. When pets are in the home, objects often get covered with animal waste. As a result, children suffer health problems, such as asthma, and are at grave risk for being trapped in a house fire or being bitten (and infected) by pests.
Even when the house is unfit, hoarders often view their children as safest under their care. Some hoarders will expose their children to abhorrent conditions rather than face public scrutiny and risk losing them. Children often realize if they talk about their family secrets, they could lose their parents and homes.
Naturally, children will endure a great deal of pain before risking home and family. When they reach adulthood, they see that the disorder has only gotten worse, yet their parents resist treatment or intervention of any kind. What kind of disorder is so gripping that it won’t let go? What kind of disorder takes hoarders, often good and decent people, away from their families, away from any possibility of a truly fulfilling life?
Hoarders have poor insight into their problem and underestimate its severity.7 They fear societal repercussions such as public scrutiny and consequences that could dramatically change their lives. If reported to governmental agencies, they could face an eviction or loss of home and its contents, and have their children taken away by a child welfare agency. Hoarders often think that neighbors should mind their own business and do not realize that a hoarded house is a community concern. They simply want to be left alone—and being alone seems to be the inevitable result of unchecked hoarding.
Early in life, children of hoarders are confused by their parents’ behavior. Parents can show clear signs of devotion, especially in areas that do not compromise hoarding. They will work tirelessly to support their children’s opportunities but refuse to get rid of the objects that most jeopardize their lives. For example, at work, a mother cheerfully organizes treat bags to celebrate every holiday; at home, she confines food preparation to microwave meals. Fearing a report to the authorities, parents avoid calls for repair services.
Children learn how to live without basic comforts and relinquish all hope for a home-cooked meal shared at a family table. Attachment to the hoarding parent is commonly secured by participating in the gathering process. A trip to the zoo is replaced with a trip to the flea market.
While parents acquire objects, their children fail to live a normal family life—a huge cost for a parent’s distorted relationship with objects. Children of hoarders witness their parents and family slipping away, one object at a time. Boundaries are often blurred because a hoarder’s choices overshadow or dominate those of other family members. A hoarder’s need to decide what everyone will have and keep restricts children’s personal choices.
As objects invade spaces in homes, they block usual pathways to intimacy. Relationships occur in a vacant spot on a couch and the remaining edge of a table. In cases where only one parent is a hoarder, the non-hoarding parent runs the risk of eventually becoming disabled in one way or another; s/he ceases to function, expires like cans of inconsumable food, becomes a hoarder, overfunctions to compensate for the disorder—or simply disappears.
1. Frost RO, Hartl TL. A cognitive-behavioral model of compulsive hoarding. Behav Res Ther. 1996;34:341-350.
2. Mataix-Cols D, Frost RO, Pertusa A, et al. Hoarding disorder: a new diagnosis for DSM-V? Depress Anxiety. 2010;27:556-572.
3. Samuels JF, Bienvenu OJ, Grados MA, et al. Prevalence and correlates of hoarding in a community sample. Behav Res Ther. 2008;46:836-844.
4. Iervolino AC, Perroud N, Fullana MA, et al. Prevalence and heritability of compulsive hoarding: a twin study. Am J Psychiatry. 2009;166:1156-1161.
5. Mueller A, Mitchell JE, Crosby RD, et al. The prevalence of compulsive hoarding and its association with buying in a German population-based sample. Behav Res Ther. 2009;47:705-709.
6. Tolin DF, Frost RO, Steketee G, Fitch KE. Family burden of compulsive hoarding. Results of an internet survey. Beh Res Ther. 2008;46:334-344.
7. Tolin DF, Fitch KE, Frost RO, Steketee G. Family informants’ perceptions of insight in compulsive hoarding. Cognit Ther Res. 2010;34:69-81.