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Buried in Stuff: Understanding Compulsive Hoarding


Compulsive hoarding is a disorder that involves the accumulation of belongings to such an extent that the resulting clutter renders parts of the living space unusable.


  • The acquisition and failure to discard a large number of items/possession that are considered by most to be of little or no value
  • These possessions clutter the living space, rendering the space unable to be used in the manner in which it was intended
  • The hoarding behavior causes marked distress or interferes with one’s daily functioning


Clutter is a symptom, not the problem. People who hoard form powerful attachments to objects.


Emotional Attachment – Individuals with compulsive hoarding tend to have strong emotional attachment to objects, finding each unique or meaningful to them and thus have difficulty parting with the items. They often prefer to have control of the items, including who is permitted to touch or sort through them.

Information Processing – Individuals with compulsive hoarding tend to report difficulties in remembering the location of items and like to have items visible or have visual reminders. They often worry that they might forget something and thus hold on to items as reminders. They have difficulty in utilizing broad categorization skills and find it difficult to make decisions regarding the disposition of possessions.

Erroneous Beliefs – Individual with compulsive hoarding tend to have erroneous beliefs regarding their possessions related to perfectionism, control, responsibility, value of individual items, and potential utility of items.
Distress Regarding Discarding/Acquiring – Individuals with compulsive hoarding experience significant distress and anxiety when faced with having to decide whether to discard a possession. They may also experience anxiety when they feel a need to acquire an object they desire and believe that this feeling can only be relieved through acquisition of the item.

Negative Reinforcement – Compulsive hoarding behavior is maintained through negative reinforcement; in other words, individuals are able to relieve their distress by putting off making decisions about disposition or discarding items, which leads to increased clutter and continued avoidance of sorting and/or discarding.


Without therapy, people who hoard typically continue to acquire new objects, repeating the process.


Compulsive Hoarding is considered to be related to obsessive-compulsive disorder (OCD), an anxiety disorder characterized by recurrent unwanted thoughts (obsessions) and repetitive behaviors (compulsions); however many consider it to be a distinct disorder in and of itself.
Compulsive hoarding is a complex disorder and may involve co-occurring disorders, trauma history, genetic factors, and/or learned behavior (modeling).  Hoarding behavior typically begins in late childhood/early adolescence  and progresses throughout the lifespan. Although its exact prevalence is unknown, it is believed that approximately 1% – 5% of the population exhibits compulsive hoarding. Studies suggest that 20% – 30% of individuals with OCD exhibit compulsive hoarding behavior. Insight into the seriousness of the problem may be limited and relatives may be most affected by the behavior.


Although some individuals with compulsive hoarding respond to antidepressant medication, many individuals do not.  Cognitive-Behavioral Therapy has been demonstrated to be helpful in the treatment of compulsive hoarding which involves helping individuals to change they way they think about and make decisions about their possessions in order to control the behavior. This process involves behavioral assessment, psychoeducation, exposure/response prevention, cognitive restructuring, and excavation exposure.


Dr. Deibler

Photo courtesy of CEH

Buried in Stuff: Understanding Compulsive Hoarding

Marla W. Deibler, PsyD

Marla W. Deibler, Psy.D., is a clinical psychologist and nationally-recognized expert in anxiety disorders and the obsessive-compulsive spectrum, including trichotillomania and other body-focused repetitive behaviors, obsessive-compulsive disorder, hoarding, and tic disorders. She is the Founder and Executive Director of The Center for Emotional Health of Greater Philadelphia in New Jersey, an outpatient facility specialized in providing evaluation and evidence-based, cognitive-behavioral therapies for these and other difficulties. She currently serves on the Board of Directors of OCD-NJ, the New Jersey affiliate of the International OCD Foundation (IOCDF). Dr. Deibler gained her formative clinical experiences at the National Institute of Mental Health (NIMH) at the National Institutes of Health (NIH), Children’s National Medical Center, and the Kennedy Krieger Institute at Johns Hopkins University Medical Center. She gained specialized behavior therapy experience in the treatment of obsessive-compulsive spectrum disorders at the nationally-recognized Behavior Therapy Center of Greater Washington. Dr. Deibler served as a clinician at the National Center for Phobias, Anxiety, and Depression. She also served as Director of Behavioral Sciences at the Temple University School of Dentistry and served on the clinical faculty at Temple University Schools of Medicine and Allied Health as well as Temple University Children’s Medical Center. Dr. Deibler has published scientific research in peer-reviewed journals and has presented clinical training seminars and research findings at national and international meetings. She has appeared on the Dr. Oz Show, A&E’s “Hoarders”, TLC’s “Hoarding: Buried Alive”, CBS News, ABC News, FOX News, It’s Your Call with Lynn Doyle (CN8, Retirement TV), and CBS’s “Swift Justice with Nancy Grace”. She has been quoted by media outlets, including the Wall Street Journal, CNN, Philadelphia Inquirer, Philadelphia Daily News, and the Connecticut Post, among others. Dr. Deibler holds licenses to practice psychology in New Jersey (Lic. No. 35S100438000) and Pennsylvania (Lic. No. PS0157790). She is an active member of the American Psychological Association, Trichotillomania Learning Center, International OCD Foundation, OCD-New Jersey, Association for Behavioral and Cognitive Therapies, and Anxiety Disorders Association of America. Dr. Deibler resides in suburban Philadelphia with her husband (who is also a psychologist) and three children.

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APA Reference
Deibler, M. (2012). Buried in Stuff: Understanding Compulsive Hoarding. Psych Central. Retrieved on September 21, 2020, from


Last updated: 7 Dec 2012
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