Hoarding Disorder: How to Get Rid of the Objects That Clutter Us Up

I recently helped my mother sort through some boxes she inherited after my grandparents passed away. The label on one of them read—probably half seriously, half ironically—"toothpick holders and other treasures." It contained many mementos from moments that were now part of our history, but no toothpick holders.

Of all the objects we sorted, my favorite turned out to be a puzzle piece. This artifact made me remember how my late grandmother had a habit, when a puzzle was being completed, of stealing a piece and hiding it so that she could add it at the very last moment, and thus be the one to complete the puzzle...

After several hours of reminiscing, my mother and I threw away 90% of what we had painstakingly sorted.

This brought me back to a question I hear frequently, whether from family members, friends, or patients: "Why did I keep this?"

As a clinical psychologist, I conduct research on the characterization, assessment, and treatment of compulsive hoarding disorder , particularly – but not exclusively – in adults aged 60 and older.

Suffice it to say, I spend a lot of my time thinking about the answer to this question. Here's what I know.

Hoarding disorder is a psychiatric disorder characterized by a strong tendency to hoard and difficulty disposing of possessions. Adults with a clinically severe level of this disorder may find themselves living in a home environment so cluttered that daily functioning is impaired . Their home may even be at significantly increased risk of fire.

However, in my experience, many adults accumulate possessions that end up cluttering their daily lives without meeting the clinical criteria for hoarding disorder.

Hoarding items that have sentimental value or that "might come in handy someday" is a natural tendency that increases with age . However, in some people, this tendency intensifies to such an extent that this hoarding behavior eventually meets the clinical criteria for the disorder mentioned above.

The increase in the prevalence of hoarding disorder over time may be related to changes in the brain's executive functions that occur with aging . Increased difficulties with decision-making have implications for household clutter.

The traditional model of hoarding disorder suggests that difficulty disposing of items stems from distress experienced during decision making . However, my research shows that this may be less true for older adults .

When I was a doctoral student, I conducted a study in which my colleagues and I asked adults with hoarding disorder to spend fifteen minutes deciding whether to keep or throw away various items they had brought from home.

Participants could choose to sort any items they wanted. Most chose paper documents, such as old letters, cards, or notes.

We found that age was associated with less distress during the task: older participants experienced less stress when making the decision whether or not to keep an object.

We also observed that many participants, especially the older ones, felt positive emotions while sorting through their belongings.

In a new study, to be published soon, my team replicated this finding, but this time by asking participants to perform a similar task at home.

The results suggest that our tendency to keep everything is not systematically motivated by the fear of making a bad decision.

In fact, another study published in 2024 and conducted by my team on adults over 50 with hoarding disorder suggests that altruism, a personality trait characterized by a willingness to help others , may explain why some people keep things that others would have thrown away.

Altruism also frequently emerges in my clinical practice, when I interact with older adults suffering from clutter. Participants in our studies often tell me that they have kept a particular object out of a sense of responsibility, either to the object itself or to their environment.

"I want to find him a good home" or "My grandmother gave him to me" are frequently cited justifications.

It seems, then, that people do not necessarily keep certain objects out of fear of losing them, but because keeping them corresponds to their values.

In a 2024 study, we demonstrated that adopting a values-based approach to sorting helps older adults reduce clutter in their homes and improves their emotional well-being.

We found that starting by identifying their values helped participants stay focused on their long-term goals. Too often, people only ask whether an object gives them a “spark of joy,” without thinking about its deeper meaning…

We also discovered that rather than questioning the reasons why someone wants to keep an item, it is more helpful to help them express their reasons for letting go, and the goals they have for their living space.

Based on my work on motivational interviewing for decluttering and my observations of an ongoing clinical trial , I believe I can suggest some strategies for decluttering your home.

Start by writing down your values , then tell yourself that every item in your home should align with them. However, keep in mind that your values can sometimes conflict with each other. When this happens, ask yourself whether keeping or discarding an item brings you closer to your goals or further away from them.

If you're helping a loved one declutter their home, show interest but don't judge. Where you see a box full of useless items, your grandmother might see a box containing her "toothpick holders and other treasures"...