Olga Chernyavska
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Understanding Hoarding, Clutter, and Collecting: A Guide for Frontline Professionals and Support Seekers
The terms hoarding, clutter, and collecting are often used interchangeably, but they describe very different experiences. These distinctions matter because they influence not only how individuals perceive their own behaviours but also how professionals assess risk and determine the most appropriate type of support.
Understanding what differentiates these experiences and how emotional and neurological patterns contribute to them can help reduce shame and provide the most support for those who need it.
This article provides practical applications for frontline professionals in the form of comparative tables, making it easier to refer to and plan for the best support.
Understanding what differentiates these experiences and how emotional and neurological patterns contribute to them can help reduce shame and provide the most support for those who need it.
This article provides practical applications for frontline professionals in the form of comparative tables, making it easier to refer to and plan for the best support.
Hoarding, Clutter, and Collecting: What’s the Difference and Why It Matters
- Hoarding Disorder: A clinically recognised mental health condition defined by a persistent difficulty discarding items, regardless of their actual value. This behaviour results in clutter that significantly disrupts living spaces and causes distress or impairment in functioning (American Psychiatric Association, 2013)
- Clutter: A state of disorganisation in which items accumulate beyond a person’s capacity to manage them effectively. While not necessarily a clinical issue, clutter can still cause stress, avoidance, and difficulties with daily living (Frost & Steketee, 2014).
- Collecting: A purposeful, structured activity involving the acquisition and organisation of items that typically hold sentimental, artistic, or financial value. Collecting is not distressing and does not interfere with functioning (Steketee & Frost, 2003).
Why Does This Feel So Hard? A Practical Look at the Brain
Tasks such as sorting, discarding, and organising may seem straightforward, but for many people experiencing hoarding behaviours or chronic clutter, these tasks can be emotionally and cognitively overwhelming.
Clinical psychologist Dr Jeff Szymanski explains that the prefrontal cortex (the part of the brain responsible for executive functioning, such as planning, sequencing, and organising) does not activate effectively during tasks that require sorting or decision-making in hoarding (McLean Hospital, n.d.).
Even in non-clinical clutter, the experience of decision fatigue is well documented. Clutter can reduce the brain’s ability to focus, process, and initiate action particularly under conditions of stress or burnout (Frost & Hartl, 1996; Frost & Steketee, 2014).
Clinical psychologist Dr Jeff Szymanski explains that the prefrontal cortex (the part of the brain responsible for executive functioning, such as planning, sequencing, and organising) does not activate effectively during tasks that require sorting or decision-making in hoarding (McLean Hospital, n.d.).
Even in non-clinical clutter, the experience of decision fatigue is well documented. Clutter can reduce the brain’s ability to focus, process, and initiate action particularly under conditions of stress or burnout (Frost & Hartl, 1996; Frost & Steketee, 2014).
Emotional Landscape: The Role of Shame and Other Emotions
The emotional experience of hoarding and chronic clutter extends far beyond difficulty organising or discarding items. Both conditions are linked to powerful internal experiences (particularly shame, anxiety, and emotional overwhelm) which can become major barriers to change or help-seeking.
In Hoarding Disorder (Clinical Definition)
The central emotional experience in hoarding disorder is shame, accompanied by persistent anxiety and distress. These feelings are often triggered by the idea of discarding possessions or being perceived as failing to manage one’s living space.
Common emotional themes include:
These emotional states often lead to:
These dynamics make early and gentle engagement essential. Approaches that emphasise empathy and trust-building are more likely to reduce resistance and foster collaboration (Frost & Hartl, 1996; Tolin, Frost, & Steketee, 2007; Cherrier & Ponnor, 2010).
Common emotional themes include:
- Anxiety and fear – especially about needing an item later, making the wrong decision, or losing something important.
- Grief or loss – when possessions are linked to deceased loved ones or meaningful life events.
- Shame and guilt – about the living environment, the volume of possessions, or perceived judgement by others.
- Confusion and overwhelm – particularly when required to make organising decisions or categorise belongings.
- Frustration and anger – directed at oneself or others who attempt to help.
These emotional states often lead to:
- Avoidance of help – particularly from family or professionals due to fear of criticism or rejection.
- Social isolation – avoiding visitors or concealing the extent of clutter.
- Delays in intervention – resisting therapy or organisational support even when risk is high.
These dynamics make early and gentle engagement essential. Approaches that emphasise empathy and trust-building are more likely to reduce resistance and foster collaboration (Frost & Hartl, 1996; Tolin, Frost, & Steketee, 2007; Cherrier & Ponnor, 2010).
In Chronic Clutter (Non-Clinical)
The dominant emotional experiences associated with clutter are embarrassment and internalised self-judgement, particularly among individuals with high personal standards or limited capacity due to stress, burnout, or mental fatigue.
Common emotional themes include:
These emotional states often lead to:
Although the severity of distress is typically less than in hoarding disorder, the impact on emotional wellbeing, confidence, and daily functioning can still be significant (Kellett & Holden, 2014; Tolin et al., 2008; Frost & Steketee, 2014).
Common emotional themes include:
- Embarrassment – especially when clutter prevents inviting others into the home or hosting guests.
- Internalised judgement – feeling like a failure, particularly for those who pride themselves on being organised or capable.
- Overwhelm and guilt – related to the ongoing presence of clutter and unsuccessful attempts to address it.
These emotional states often lead to:
- Avoidance behaviours – such as ignoring unopened mail, avoiding specific rooms, or delaying action.
- Anxiety or low self-esteem – associated with feeling disorganised or "behind".
- Social withdrawal – due to shame about the physical environment or fear of being perceived as messy.
Although the severity of distress is typically less than in hoarding disorder, the impact on emotional wellbeing, confidence, and daily functioning can still be significant (Kellett & Holden, 2014; Tolin et al., 2008; Frost & Steketee, 2014).
References supporting this table:
This comparative table serves as a valuable tool for social workers, mental health professionals, and other frontline workers. By quickly identifying the characteristics and associated risks of hoarding, clutter, and collecting, professionals can tailor their interventions appropriately. For instance, recognising the high health and safety risks associated with hoarding can prompt timely referrals to specialised services, while understanding the nature of clutter may lead to organising support.
- Hoarding features: American Psychiatric Association (2013); Frost & Hartl (1996); Tolin et al. (2007).
- Clutter features: Frost & Steketee (2014); Kellett & Holden (2014).
- Collecting features: Belk (1995); Pearce (1998).
This comparative table serves as a valuable tool for social workers, mental health professionals, and other frontline workers. By quickly identifying the characteristics and associated risks of hoarding, clutter, and collecting, professionals can tailor their interventions appropriately. For instance, recognising the high health and safety risks associated with hoarding can prompt timely referrals to specialised services, while understanding the nature of clutter may lead to organising support.
Readiness for Support: Tailoring Interventions
Understanding an individual's readiness to accept various forms of support is crucial. The table below outlines the receptiveness of individuals with clutter versus hoarding disorder to different support types.
References supporting this table:
- Tidying and decluttering receptivity in hoarding: Frost & Hartl (1996); Tolin et al. (2007); Steketee & Frost (2003); Gilliam et al. (2011); American Psychiatric Association (2013).
- Tidying and decluttering receptivity in clutter: Frost & Steketee (2014); Tolin et al. (2008).
- Group and informal support challenges in hoarding: Gilliam et al. (2011); Cherrier & Ponnor (2010); Tolin et al. (2008); Steketee & Frost (2003).
- Counselling and formal support effectiveness: Tolin et al. (2007); Frost & Steketee (2014); American Psychiatric Association (2013).
- Impact of shame on help-seeking: Frost & Hartl (1996); Steketee & Frost (2003); Tolin et al. (2007); Cherrier & Ponnor (2010).
Support Services: Coaching and Guidance
For those not yet ready to engage in therapy or who feel overwhelmed by the idea of seeking help from friends or family, coaching and guidance can offer a valuable and compassionate starting point.
My Tidying Support service provides a structured and compassionate way forward for those who may feel overwhelmed, anxious, or unsure where to begin.
This support includes:
This approach offers a safe, non-judgemental pathway forward and can act as a bridge to more intensive interventions if or when individuals feel ready.
My Tidying Support service provides a structured and compassionate way forward for those who may feel overwhelmed, anxious, or unsure where to begin.
This support includes:
- Coaching: Emotional support, encouragement, and anxiety management during the decluttering process.
- Guidance: Step-by-step help with decision-making, organising, and identifying goals that feel achievable.
This approach offers a safe, non-judgemental pathway forward and can act as a bridge to more intensive interventions if or when individuals feel ready.
Bibliography:
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
- Belk, R. W. (1995). Collecting in a consumer society. London: Routledge.
- Cherrier, H., & Ponnor, B. (2010). A study of hoarding behaviour and its implications for consumption. Journal of Consumer Behaviour, 9(6), 384–396. https://doi.org/10.1002/cb.326
- Frost, R. O., & Hartl, T. L. (1996). A cognitive-behavioural model of compulsive hoarding. Behaviour Research and Therapy, 34(4), 341–350. https://doi.org/10.1016/0005-7967(95)00071-2
- Frost, R. O., & Steketee, G. (2014). Stuff: Compulsive hoarding and the meaning of things. Boston: Mariner Books.
- Gilliam, C. M., Norberg, M. M., Villavicencio, A., & Tolin, D. F. (2011). Group cognitive-behavioural therapy for hoarding disorder: An open trial. Behaviour Research and Therapy, 49(12), 802–807. https://doi.org/10.1016/j.brat.2011.08.007
- Kellett, S., & Holden, K. (2014). Compulsive hoarding: A review and a cognitive-behavioural model. Clinical Psychology & Psychotherapy, 21(2), 157–166. https://doi.org/10.1002/cpp.1829
- McLean Hospital. (n.d.). Hoarding disorder: What it is and how to help [Video]. Retrieved from https://www.mcleanhospital.org/essential/hoarding-disorder
- Pearce, S. M. (1998). Collecting in contemporary practice. London: Sage.
- Steketee, G., & Frost, R. O. (2003). Compulsive hoarding: Current status of the research. Clinical Psychology Review, 23(7), 905–927. https://doi.org/10.1016/j.cpr.2003.08.002
- Tolin, D. F., Frost, R. O., & Steketee, G. (2007). Buried in treasures: Help for compulsive acquiring, saving, and hoarding. New York: Oxford University Press.
- Tolin, D. F., Frost, R. O., Steketee, G., & Fitch, K. E. (2008). Family burden of compulsive hoarding: Results of an internet survey. Behaviour Research and Therapy, 46(3), 334–344. https://doi.org/10.1016/j.brat.2007.12.008