Ask Dr. Neil (Oct. 2023)

Dr. Neil Weiner, Ph.D.

Dear Dr. Neil,

How do I help a sibling who is a hoarder and sometimes goes through the garbage to retrieve items. Our dad was an alcoholic and emotionally unavailable. So was our mother.  Concerned sister

Dear Concerned,

Hoarding behavior, as exhibited by your older brother, affects an estimated 2% to 6% of the population—about 5 to 14 million people. It is linked to early trauma such as having an alcoholic parent like your father and to parents who have difficulty communicating love like both your parents, or to other physical, emotional, and sexual trauma. 

Hoarding is a coping mechanism that can help regulate emotions. Hoarders have trouble categorizing items into valuable and non-valuable. Hoarders may dread wasting an object and form emotional attachments to them.

Trying to intervene is difficult since hoarding is not amenable to logical interventions by family or friends. Hoarding is most successfully treated by healthcare professionals, but family and close friends can learn to support the hoarder by following these suggestions. They should appear understanding and helpful rather than critical.

• Instead of “Why don’t you get rid of this stuff?” ask why an item is important to the person.

• Instead of “You don’t need this junk,” remember that all items are valuable to a hoarder.

• Instead of “I’m going to help you sort and throw things away,” you might suggest discarding something small.

• Instead of “Why can’t you stop collecting stuff,” remember hoarding is a compulsive addiction.

• Instead of “How can you live like this?” you might suggest it is a health and safety issue.

These resources can help:

The National Association of Productivity and Organizing Professionals offers a directory of organizers who can help with decluttering and cleaning. The International OCD Foundation provides resources for support groups. has educational sessions to help people with hoarding disorder. 1-800-Hoarders offers a 24-hour helpline to refer for remedial help.

The best help for your brother can be a referral to therapies that specialize in trauma/compulsive behavior. The most effective treatments bypass the conscious mind and intervene at the underlying causes of symptoms. Examples of therapeutic interventions include the below:

  1. EMDR (Emotional Movement Desensitization and Reprocessing). This therapy addresses triggers for hoarding, enhances emotional regulation, shifts negative beliefs, and improves treatment engagement for exposure response prevention.
  2. Somatic therapies to treat the mind/body connection by learning to cope with stress. It focuses on stored traumatic tension in the body.
  3. Biofeedback therapies help people gain control over involuntary impulses by changing brain patterns.
  4. EFT (Emotional Freedom Technique), a technique that involves tapping on the body’s meridians, the same ones affected by acupuncture.
  5. CBT (Cognitive Behavioral Therapy) which teaches those who hoard, such as your brother, to challenge irrational beliefs related to saving items, resist the urge to collect, organize and group valuable and non-valuable items, improve decision making, and increase desire for change. CBT is often taught in a group setting with the additional goal of decreasing isolation by increasing social support activities.