What Hoarding Tells Us About Connection and Isolation
A challenge to the assumption that hoarding is purely behavioral or rooted in indecision.
Posted October 21, 2025 | Reviewed by Michelle Quirk
In Amanda Uhle’s recent book, Destroy This House (Summit Books, 2025), Uhle describes an interaction between her hoarder mother and nonhoarder father: “It was weird how Dad never complained about Mom’s endless and towering piles of stuff everywhere, while my bike on the lawn was a nagging, burning annoyance. I’d learned that Dad seemed not to see Mom’s messes, or any of her flaws. She returned the favor, and for each other, they were blameless.”
Hoarding Disorder and Relationships
In neuropsychology, the most fascinating disorders often blur the line between the mind and the social world, showing how relationships, perception, and emotion are tightly bound to the brain’s circuitry. Hoarding disorder is one of these. People who hoard are often portrayed as eccentric or overwhelmed by clutter, but research is increasingly showing that the issue runs much deeper. It’s not just about collecting objects; it’s about how those objects come to fill an emotional and social void. A recent study by Victoria Edwards, Paul Salkovskis, and Victoria Bream, titled “Do they really care? Specificity of social support issues in hoarding disorder and obsessive-compulsive disorder” (2023), explores this psychological and neurobiological terrain by asking a simple but revealing question: How do people with hoarding disorder perceive social support compared to those with obsessive-compulsive disorder (OCD) or no psychiatric condition at all?
At first glance, hoarding disorder and OCD might seem like close cousins. Both involve intrusive thoughts and repetitive behaviors. Both show patterns of cognitive rigidity and anxiety -driven rituals that are mirrored in the brain’s cortico-striatal-thalamic loop circuit. That same loop helps govern habit formation and inhibition. Yet Edwards and her colleagues found that when you look at how individuals experience relationships, the two disorders diverge dramatically. The researchers hypothesized that people who hoard may not simply be disorganized or sentimentally attached to their belongings. They may, at a deeper psychological level, be compensating for a deficit in social connection. When humans don’t feel emotionally supported by other humans, their brains may seek stability elsewhere, in objects, routines, or material surrogates for affection.
The study recruited individuals diagnosed with hoarding disorder, individuals with OCD, and a control group without psychiatric conditions. Each participant was evaluated through structured interviews and a set of questionnaires designed to measure the size of their social network , their perception of how much support they receive, their levels of loneliness , and their sense of belonging. What emerged from the data was striking. People with hoarding disorder did not just have smaller social networks than healthy controls; they also felt less supported by the people in their lives. This distinction between objective and perceived social support is crucial. It suggests that the neural and cognitive systems involved in appraising social feedback, those that help us interpret emotional signals, empathy, and trust, may function differently in individuals who hoard.
In neuropsychological terms, this could point to differences in regions such as the anterior cingulate cortex, the insula, and the medial prefrontal cortex—areas deeply implicated in social pain, emotional regulation , and self-referential thought. When these regions underperform or miscommunicate with the limbic system (which controls basic emotions such as fear , pleasure, and anger , as well as the drives for food, sex , and care of offspring), the result can be a heightened sense of isolation, even in the presence of others. The study found that participants with hoarding disorder reported significantly higher levels of loneliness and thwarted belonging than both the OCD and control groups. Interestingly, individuals with OCD did not show this same pattern, even though their social networks were also smaller. The difference lay in perception, not just behavior. People with OCD might struggle with anxiety and compulsions, but they did not report feeling as profoundly unsupported as those with hoarding tendencies did.
The absence of differences in supposed criticism or trauma history across the groups adds another layer of nuance. It suggests that the social deficits in hoarding disorders aren’t merely the result of negative interpersonal experiences or past emotional harm. Instead, they may arise from how the brain encodes and interprets social relationships—a kind of misalignment between external reality and internal representation. Neuropsychologically, this aligns with evidence showing that hoarding disorder involves abnormal activity in the orbitofrontal cortex and anterior cingulate cortex, both of which are involved in evaluating the emotional significance of stimuli. If one’s brain is wired to overvalue possessions but undervalue social cues, it becomes easy to see how objects might come to feel safer, more reliable, and less judgmental than people.
From a cognitive perspective, the study challenges the assumption that hoarding is purely behavioral or rooted in indecision. Instead, it points toward a more profound interplay between emotion, perception, and social cognition . The mind’s need for connection, when unmet, may be rerouted toward the tangible, an adaptive strategy gone awry. The clutter that fills a hoarder’s home, then, might be read as a neuropsychological footprint of loneliness: a visible manifestation of an invisible social deficit. This idea fits within broader theories of the “social brain,” which propose that humans are neurologically driven to maintain bonds with others. When that drive is thwarted, the same systems that motivate attachment can attach instead to the inanimate.
Clinically, this insight has powerful implications. Traditional hoarding treatments have often focused on cognitive-behavioral strategies to reduce clutter or challenge beliefs about possessions. While useful, they may miss a key ingredient, the restoration of social connection. If someone feels fundamentally unsupported or excluded, asking them to discard objects that represent comfort and continuity can feel like emotional annihilation. Therapeutic approaches that rebuild a sense of belonging, whether through group therapy , social skills training, or community engagement, might therefore be essential. Neurobiologically, fostering positive social interaction could modulate the same brain circuits involved in reward, attachment, and emotional regulation, gradually rewiring the patterns that sustain hoarding behavior.
Limitations of the Study
Edwards and her colleagues are careful to note the limitations of their study. Because it was cross-sectional, they cannot determine whether low perceived support causes hoarding or whether hoarding behavior erodes social networks over time. The sample sizes were small, and all data were self-reported, which could introduce bias . Still, the study’s implications are clear: The social brain plays a central role in understanding why people hoard and how they might recover.
Ultimately, the study’s question, “Do they really care?” captures both the psychological and neurobiological essence of hoarding disorder. It is a question not only about others but also about the self’s ability to register care, trust it, and reciprocate it. In that sense, hoarding may represent a misfiring of one of the brain’s oldest imperatives: to seek safety in connection. Where human bonds fail, the brain improvises, clinging to the objects that never leave.
Edwards V, Salkovskis PM, Bream V. Do they really care? Specificity of social support issues in hoarding disorder and obsessive-compulsive disorder. Br J Clin Psychol. 2023 Sep;62(3):573–591. doi: 10.1111/bjc.12426. Epub 2023 May 12. PMID: 37173862.
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Shirley M. Mueller, M.D., is a neuroscientist board certified in neurology and psychiatry. She is also an avid collector. Combining these two disciplines, she wrote Inside the Head of a Collector: Neuropsychological Forces at Play.
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This article is part of the Bringwise Psychology Journal — daily insights on human behavior, mental health, and personal growth.