"What we find is that the brain is acting very, very differently when a person hoards," Tolin said. "When the person is trying to make a decision about what to throw away, it seems that the person who is hoarding is processing this activity as if it is deeply punishing."
"The person who hoards is going through a very, very effortful search of their memory to try to think of as many things as they can about this item before they make the decision," Tolin said. "What this all amounts to then is a painful and effortful process of decision making, that you and I might take for granted."
There is no cure for hoarding, and there is no medication to treat the condition. Right now, cognitive behavioral therapy is the only way to help hoarders make decisions and deal with their emotions.
In Beth Johnson's Clutter Workshop in Hartford, hoarders and clutterers practice throwing out possessions to which they have grown attached. Johnson also takes her clients on nonshopping -- or nonacquiring -- trips to teach them not to buy things they don't need.
"I try to help them see the larger picture and how this item won't fit into their life," Johnson said. "If you have a jam-packed house, if you're adding to it on a weekly or daily basis, you're basically defeating yourself."
Randy Frost, a professor of psychology at Smith College in Massachusetts, focuses on helping hoarders make their homes clutter-free.
"One of the things we know about hoarding is that the beliefs people have about their possessions are so powerful, that it's very difficult for them to get out of this behavior," said Frost, who also wrote the book "Buried in Treasures," co-written with Tolin. "If the person throws something away and experiences distress, and does it again and again, eventually, they won't have that extreme emotional response, throwing something away."
Frost held a one-on-one session with Brennan to see if he could help her. After a few hours, she was able to throw away receipts and a few pieces of junk but, as with most hoarders, there was still a long road ahead.
One major motivator for Brennan was the possibility of losing her fiancé if she didn't clean up her home. When asked if she thought he would really leave, Lorraine said, "I don't want to find out. I don't want to end my relationship. I want to do better. I want to make it work. I don't want to live like this anymore. I really don't."
Today, Alloca said the biggest change is that she can actually "see" the mess. "I can acknowledge and accept that I have this problem," she said, but she cites things such as stress, emotional upheavals, bad habits and avoidance of dealing with old memories as still hampering her progress.
Alloca said clutter workshops and support groups did help, although "there is no magic pill, no one way that works for everyone."
"I did handle my flooded basement better than I ever thought I would," noted Alloca, whose house is still cluttered with stuff on the first floor. But she now rents the top floor to her nephew. "It's a challenge and slowly but surely I'm advancing."
At the Institute of Living, Tolin recently completed an Internet-based study on the harmful impact of hoarding. They were surprised to find the results were worse than other forms of anxiety and depressive disorders. In the most severe hoarding cases, there is a substantial economic burden, where those hoarders actually take themselves out of the work force.
Tolin said additional research on compulsive hoarding may show the disorder is more widespread than originally thought, "possibly as much as five percent of the population or 15 million people."
For more information on compulsive hoarding syndrome, click here