Compulsive hoarders are not collectors of antique porcelain dolls or vintage die-cast toy cars or first-edition books. Compulsive hoarders are those who can’t stop acquiring things, cannot bring themselves to throw anything away, and keep items that are completely useless, like old newspapers, burned-out light bulbs, open cans encrusted with rotting food (I'm sure you get the idea).

In the worst case scenarios they can’t cook a meal (stove covered with stuff), eat off the table (table inches deep in papers, rusted screws, dried fruit juice, dirty socks), sleep in the bed (dirty laundry, clean laundry, books, tool boxes), or even, sometimes, are unable to walk through the house without a tremendous amount of difficulty, following something similar to an animal trail in the deep grassland.

The weirdest part of this whole syndrome is, to my mind, the fact that the hoarder is blind to the clutter and will deny its existence, even when shown pictures of his own home.

He assigns emotional or financial value to objects that other people don't: I might need it some day. It was my high school sweater (now nearly consumed by moths because he didn’t pack it properly).

She will “file” utility bills neatly balanced on the edge of the wastepaper basket (into which they occasionally fall and therefore go unpaid); she will add to the mixture a can of refried beans, torn open envelopes that once held bills to be paid and an unnameable assortment of computer parts, stirred with a magnifying glass missing its handle.

Hoarders have a fundamental inability to organize things. They have a problem with finishing tasks, setting priorities. They refuse to recognize they need help, let alone seek help, and become extremely agitated and hostile if others try to clean out their homes or throw away any of their “treasures”. Meanwhile the 6 foot high columns of newspapers and magazines stress the floor supports and provide nesting places for vermin, become cat litter boxes for cats too lazy to go outside.

Do hoarders need help? PET scans show a lower activity in a specific part of the brain involved in decision-making, focused attention, and the regulation of emotion (hence the lability of their responses). Their pattern is not that seen in other OCD patients. And, yes, they need professional psychological help, particularly if they are in possession of the trump card called "handicapped" or "ill".

Meanwhile, family and friends of hoarders do their best to maintain basic levels of hygiene and organization for them, sneak discard items into the trash (or collections for secondhand stores), and try not to breathe too deeply once they set foot inside the front door. The lucky ones get their hoarder into cognitive behavioral therapy.

It all seems like a nightmare to me.