about writing her myself, but I never did. Still, I don't want to get rid of the contact. Julia might change her mind."
I have met few people who are as interested in the world around them as Irene, though I later learned that this attribute is fairly common in people with hoarding problems. As she talked, I could see the way each of her things was connected to her and how they formed the fabric of her life. The advertisement for the tires led to a story about her car, which led to a story about her daughter wanting to drive, and so on. A piece of the hoarding puzzle seemed to be falling into place. Instead of replacing people with possessions, Irene was using possessions to make connections between people and to the world at large.
As we were soon to learn, the hoarding phenomenon is composed of a number of discrete factors, some well hidden and unexpected. But the most obvious factor was the simple problem of accumulation: from a scrap of paper with an unidentified and long-forgotten phone number on it to a broken vase purchased at a tag sale, Irene had great difficulty getting rid of things. The value she assigned to objects and the reasons she had for saving them were many and varied. Irene's beliefs about what should be saved seemed isolated from everything going on around her. She was truly baffled that her son and daughter didn't share her penchant for keeping things. One day, as she went through the mound on her kitchen table, she found instructions for one of her son's toys. "I'll put it here in this pile of your stuff, Eric," she told him when he got home from school. Eric immediately picked up the instructions, walked to the wastebasket, and threw them away. She stopped what she was doing, looking surprised. Eric saw her and responded angrily, "I don't need it. I know how it works." She didn't say anything. A few minutes later, she found a bookmark. "Oh, this has all the book award people on it. Do you want it, Eric? I'll put it in your pile."
"No," he responded before she'd finished her sentence.
"Don't you even want to look at it?" she asked incredulously.
A few minutes after that, she found an old birthday card someone had sent Eric. She put it on top of the pile of things she was saving for him without saying anything. Almost as if on cue, he walked by, picked it up, and threw it out. Irene stared at him in disbelief. She simply could not comprehend his lack of interest in things she considered full of significance.
The sense of emotional attachment that Irene felt for her possessions has been shared with us over and over by people seeking help with their hoarding problems. These sentiments are really not that different from what most of us feel about keepsakes or souvenirsâthe abnormality lies not in the nature of the attachments, but in their intensity and extremely broad scope. I find many articles of interest in the newspaper, but their value to me is reduced when piles of newspapers begin to impinge on my living space and overwhelm my ability to read what I have collected. For Irene, the value of these things seemed unaffected by the trouble they caused.
Hoarding involves not only difficulty with getting rid of things but also excessive acquisition of them. Irene's upstairs hallway contained hundreds of shopping bags filled with what she described as gifts for other people. Whenever she saw something that she thought might make a great gift, she purchased it, even though she had no particular recipient in mind. The items were all still in their original wrappings. Many people shop ahead to have gifts on hand when the need arises, but Irene and many like her cannot control their urge to buy when they see something they fancy. In addition to buying excessively, Irene collected things that could be had for free. She had an agreement with the postmaster of her town: he placed any newspapers or magazines that were undeliverable in a box, and on Saturday morning he put the box in the foyer of the post