Hoarders Are Just Extremely Indecisive People

A new study led by Yale University School of Medicine’s David Tolin has discovered that those maddeningly oblivious hoarders we gape at on TLC aren’t especially keen on collecting as many lawn gnome limbs or paper towel rolls — they just can’t decide which of their many worldly possessions they really want to get rid of.

In an effort to figure out how a hoarder’s brain may differ from the brain of an otherwise healthy adult (or someone with OCD), Tolin and his fellow colleagues shrunk their magic school bus to the size of a neuron and entered the brains of 43 adults diagnosed with hoarding disorder. Or that’s what they would have done if life was actually the whimsical children’s cartoon we all wish it was — Tolin & co. gathered 43 hoarders, 31 adults with OCD and 33 healthy control adults to undergo fMRI brain scans. The subjects also had to bring in stacks of 50 miscellaneous papers (newspapers, grocery lists, unfinished lists of things to discard) from their homes, which were intermingled with 50 random objects provided by the researchers. Objects were projected into each subject’s field of view in the fMRI machine and subjects were asked whether they wanted to keep or discard the projected object (the objects were later destroyed for real, just so the researchers could see some genuine tears).

Controls discarded an average of 40 objects, while subjects with OCD discarded an average 37 objects. Subjects with hoarding disorder only discarded an average of 29 items, which isn’t all that surprising, but Tolin and his team did notice that it took hoarding subjects longer than healthy controls (2.8 seconds compared to 2.3 seconds) to make a decisions about discarding objects. The hoarding subjects also demonstrated significantly more anxiety, indecisiveness and sadness in trying to choose items for scientific sacrifice than either the controls or the subjects with OCD.

When deciding whether or not to discarded someone else’s items, hoarders registered relatively low activity in both the anterior cingulate cortex (associated with detecting mistakes during uncertain conditions), as well as the mid- to anterior insula (linked to risk assessment, importance of stimuli and emotional decisions). However, hoarding subjects showed much higher activity in both of those areas than controls or OCD subjects when deciding on their own objects. Tolin and his team have suggested, therefore, that hoarders are not really interested in accumulating a whole bunch of crap — they just can’t decide what to keep and what to get rid of because they attach an inordinate amount of importance to seemingly inconsequential decisions. Getting rid of an object, to someone with hoarding disorder, carries with it a risk that is simply too overpowering to ignore. So, instead of purging their closets, cabinets and underbeds of all the bleach-splotched clothes, cracked crockery and monsters like the rest of us, they just keep accumulating possessions out of indecision. “The slower decision-making,” note Tolin and the super science squad, “may be a central feature of impaired decision making in hoarding.”

So, just remember — if you find yourself slowly accumulating New Yorker magazines because you’re planning to make a timeline of your New Yorker-reading career and absolutely cannot abide leaving out a single cover, it’s probably time to burn all of your New Yorkers in a druidic bonfire. Invite your neighbors, buy some marshmallows. It’ll be a gas. Otherwise, you might end up as that one effete hoarder on TLC talking sententiously to the audience about John Cheever.

Scans of Hoarders’ Brains Reveal Why They Never De-Clutter [Scientific American]