Some argue that it is a form of OCD, but there is research that calls this into question. Research done by Dr. David Tolin and his team at Hartford Hospital, has implicated the anterior cingulate cortex and insula, areas of the brain associated with emotion. This is different from OCD, which is most notable in the orbitofrontal cortex, and in the caudate nucleus.
Hoarding is distinguished from collecting by the level of dysfunction that results. A collector or packrat, may experience conflict with loved ones, but their collections don't become a fire hazard or limit the use of rooms in the home. Collectors are typically proud to show off their collections, but the person with Hoarding Disorder are embarrassed by their collections. Also, a packrat doesn't feel any anxiety about throwing things away. You might feel that their decisions of what to save are illogical, but there is no great disruption to the functioning of the home, just clutter in storage areas.
If you know or live with someone who hoards, it may be very frustrating and hard to understand. To better understand hoarding, try skydiving. Please bear with me for a moment while I explain.
Skydiving is easy. All you have to do, is go to the US Parachute Association's website to find your nearest drop zone. Find a trainer and take your ½ dozen hours of training. Schedule your jump. You are all set to go. Hop on the plane with your instructor. Don't forget your parachute! Enjoy take off and engage in trivial chit chat while you wait. The pilot will tell you when you are at the proper place and altitude. Strap on your helmet and parachute, open the door, and step outside. Easy, right? All you have to do is give a little time and money and you too can skydive. Not me. I can picture myself standing at the door rocking back and forth to the count of three, and...I'm still in the plane. Doesn't matter if I count to three or a hundred, I'm glued to that plane.
I have a friend who hoards. I see that he has several empty water bottles in his house. I suggest that he throw some into the recycling bin. He responds with several reasons why he needs all of his bottles. I reason that he must have over four dozen full bottles of water, and that he couldn't possibly need a dozen empty bottles; why not recycle just a few. He responds – I interrupt, “Anything that you might have to say is just a rationalization. Don't speak, just throw the bottle into the recycling bin.” He is clearly anxious about the loss of this empty 12 oz water bottle. He picks it up, walks to the bin, and proceeds to throw it in the bin. Only, its still in his hand. He does it again, but to no avail, as if the bottle is glued to his fingers. It just wont let go of his fingers. Its kind of like me at the open door of the airplane. It looks so easy, but I can't move.
The above story may sound funny. I found it funny, but then I saw how anxious he was. Anxiety is actually very painful. In a milder form, it is uncomfortable, but when it is extreme, it is painful. My friend was in great emotional pain due to my forcing my will on him. I'm reminded to be gentle and compassionate and non-judgmental. I am no better than my friend. He needs patience from his friends and compassion and the prayer of faith.
Sometimes, friends and family will try the clandestine “Dumpster” method of treatment, where they take the loved one who hoards out of the home for the day, clean out all the junk, and then return the person home for a “big surprise.” This is ill-advised. It creates great anxiety and does nothing to cure the sufferer. Before long, the home is back to the same condition, the person who hoards is more anxious, and the family is angry.