There’s an irrefutable connection between hoarding and one’s decision-making ability.

“No duh, Rachel,” you may say. “Obvi, hoarders decided to keep way too many things. Case closed.”

But as I read Stuff (by Dr. Randy O. Frost and Dr. Gail Steketee) and The Hoarder in You (by Dr. Robin Zasio), I realized that the relationship between hoarding and decision-making isn’t as simple or straightforward as I’d initially thought.

You see, hoarding isn’t solely about choosing to buy or obtain more objects. It’s also about not choosing, or being unable to choose, healthy ways to manage those items.

The Devil’s in the Details

In Stuff, Frost and Steketee mention that many hoarders have a hard time discerning between important and irrelevant details. They note that this difficulty could be one factor that contributes to hoarders’ troubles with making decisions. Frost and another colleague, Dr. Tamara Hartl, theorized about hoarders’ possible information-processing deficits.

These concepts could explain why someone might hang onto both a three-week-old newspaper and their wedding photos with equal fervor. If you’ve ever tried to throw away something that a hoarder hasn’t yet decided to let go of, you know what I mean.

My mom and I once got into an argument over a scrap of carpet that was covered in bug casings. Despite being unable to even identify the item, she imagined it had some kind of useful potential and didn’t want me to put it in the trash. Thankfully, she relented after a while. Even so, the episode was one of those “Are you kidding me right now?!” moments that made my heart sink over the magnitude of the problem.

Zasio’s book also references studies by Dr. Sanjaya Saxena that “suggest that compulsive hoarders are more likely to have mild atrophy or an unusual shape to their frontal lobes, which is the part of the brain associated with excessive functions and decision-making.”

So hoarding and decision-making issues could be related to the brain’s physical shape, chemistry, or processing abilities. That means we can’t and shouldn’t chalk it all up to lack of willpower or a character flaw.

Anxiety, Hoarding, and Decision Making

Hoarding has its own entry in the Diagnostic and Statistical Manual of Mental Disorders (DSM) but is often associated with other mental health conditions, such as obsessive-compulsive disorder (OCD), depression, anxiety disorders, or attention-deficit/hyperactivity disorder (ADHD).

Anxiety seems to play a prominent role for hoarders, particularly when it comes to making choices about how and when to acquire, organize, and dispose of items.

When push comes to shove, a hoarder often will base their decision on what will cause them the least amount of anxiety in the moment. Frankly, a whole lot of us make decisions this way, too. But this modus operandi is more visible for hoarders because it results in a surplus of objects.

As Zasio notes, people come to believe they’re making good decisions because they’ve temporarily relieved their anxiety and doubt. However, avoiding short-term anxiety isn’t the same thing as truly being calm, nor does it help achieve long-term happiness.

Pain Avoidance Can Influence Your Choices

Frost and Steketee also observed the following behavior in some of the hoarders they treated:

“There is a flip side to the pleasure hoarders derive from acquiring and owning things, but it is not merely the pain of discarding those possessions. Rather, it is the avoidance of that pain, or of any negative emotional experience at all. This is as fundamental to the development and maintenance of hoarding as acquiring things in the first place.”

Hanging onto items indefinitely means that the hoarder never has to consider what it might be like to not have those “treasures.” And they never have to imagine losing the memories, emotions, creative potential, opportunities, or other powerful concepts that those items represent to them.

A friend of mine who also has trouble making decisions explained the thought process like this: “If I choose a particular one, I’ll always wonder what it might’ve been like to have the other one instead.”

The Problem with Pain Avoidance

As I hinted at earlier, avoiding pain can provide a quick dose of relief in the here and now, but it does nothing to strengthen your ability to make good, long-term decisions or handle challenging situations. Instead, the avoidance technique causes your good-decision-making muscle to atrophy.

Here’s one of Frost and Steketee’s patients as an example:

“Over time, Irene learned to avoid even the simplest decisions and slightest negative emotions. This meant never dealing with most of her things, since that would involve difficult decisions and raw emotions. Instead, she just let them pile up. Most hoarders end up here, avoiding even the stuff they collect.”

You may think you’re protecting yourself by dodging any pesky or unpleasant emotions. However, you’ll never know how capable you are of managing your anxiety and learning to gradually substitute new habits and behaviors if you never challenge yourself to genuinely feel your emotions, acknowledge them, and deal with the discomfort.

You Can Get Better at Making Decisions

There’s hope. You can improve your decision-making skills the same way you get to Carnegie Hall: practice, practice, practice.

Zasio advises that you think of a personal “Greater Good,” something you care more about achieving than you do about avoiding temporary anxiety. The idea is that you’ll be able to reframe your choices, acknowledge your fear, and make better decisions based on what will benefit you most in the long-term, not what will benefit you in the next 10 seconds.

She writes:

“New decisions are likely to bring new anxiety, and you may need to learn and relearn how to question the cognitive distortions that led you to acquire and keep things in the first place. Like breaking any bad habit, learning how to think about things differently and substitute other, better habits is a process, and setbacks should be incorporated into that process.”

It’s not that you lose your fear. It’s that you can recognize the fear, practice thinking in a new way, and not let it negatively influence the decisions you make.

Inheriting a Lifetime of Unmade Decisions 

I’ve mentioned before how daunting it is to confront a hoarded home that’s filled to the brim with objects.

I expected that the clean-up task would be physically demanding. Naturally, having to work in unpleasant conditions and going through thousands upon thousands of items, many of which are ruined or decaying, will tucker you out.

I also prepared myself for the emotional toll it would take due to the sadness, resentment, anger, grief, and other feelings that would invariably surface.

But one thing I hadn’t considered is how utterly draining it would be to inherit a lifetime of unmade or poorly made decisions.

In the process of working on those two houses, I made millions of decisions. (This is not hyperbole.) And it sucked the life-force from me better than any vampire could. No wonder hoarders have trouble.

Let me direct your attention to Exhibit A, the average list of decisions required for merely one small bag o’ stuff:

Decision 1: “Should I look in this plastic grocery bag?” (Yes.)

Decision 2: “It looks like paper trash. Should I dig through it?” (Yes.)

Decision 3: “Looks like mail. Could it be important?” (Maybe. Better open it and find out.)

Decision 4: “Should I look at this piece of financial junk mail?” (Yes.)

Decision 5: “Should I call the toll-free number on this financial junk mail and investigate whether there’s still an account there?” (Yes, because it turns out there was, and it was one whose existence Mom had completely forgotten, thanks to memory loss and dementia.)

Decision 6: “Should I throw this in the trash, shred it, recycle it, donate it, or keep it?” (Shred it if it’s got account or personally identifying info that you don’t need to hang onto; recycle it if it’s made of recyclable material and you’ve already removed any sensitive info; and trash it if it’s covered in toxic mold or another unsanitary substance.)

Decision 7: “When should I make a run to the recycling center/landfill/Goodwill?” (Whenever you need a sanity break. Yes, cleaning out a hoarded home will make a trip to the dump feel like a visit to Disneyland.)

Wash, rinse, repeat one million times.

And if you’re dealing with an object rather than mail, you’re faced with other time-consuming decisions that might include:

“Is this item worth researching?”

“Where can I find out its worth?” 

“Do I need a specialist to do an appraisal?”

“How do I find one?” 

“Should I keep it for an estate sale, donate it, give it to someone who might cherish it more than I will, or toss it?”

Et cetera.

The Moral of This Story: Don’t Delay Decision Making 

Decisions only get harder the longer you put them off. If you rinse the cake batter out of the mixing bowl while it’s still moist, it’s easy to clean off. If you wait until the batter hardens, it’s that much tougher to chip away at it.

And if you put off the decisions forever, consider this: You’re leaving them for your family or friends to make after you die. Which may sound like you get the best part of the deal—all of the pain avoidance with none of the tough choices—but how do you feel about sticking someone you love with the huge mess that caused you so much anxiety? What kinds of emotions do you think they’ll have, on top of the grief they’re already feeling about losing you?

You owe it to yourself to work on your decision-making abilities, because you deserve to have a life you enjoy in a space that’s safe and comfortable for you. If you won’t do it for yourself alone, think of your Greater Good, such as an improved relationship with family members who’ll be able to come over and spend happy times with you at your place, having dinner, relaxing, or playing games together.

The Bonus Moral of This Story: Compassion Is Key 

That could really be the title to this whole blog. Compassion is something I’m continuing to learn and trying to practice, along with better decision making.

This analogy from Zasio really hit home for me:

“Think of this person as you would someone whose immune system is compromised: He could be exposed to the same pathogens as anyone else (in this case, tempting sales) but is far more susceptible to picking them up and getting sicker than someone who had a healthy immune system to fight off disease.”

Non-hoarders, please be kind to your loved one who’s struggling, assist them in finding the help they need (even if you start off small with a conversation, an article, or a helpful bit from a book), and provide your nonjudgmental support.

Hope and joy,

Rachel