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July 4, 2025 29 mins

Psychiatrist Carolyn Rodriguez studies hoarding disorder and says that all of us have attachments to our possessions. But for many, these attachments can disrupt daily life and even pose health risks. For those with loved ones who struggle with hoarding disorder, she says treatments exist, including cognitive behavioral therapy (CBT). Lately, she’s been studying how virtual reality can augment CBT through virtual discarding practice and ways brain stimulation may improve symptoms. But, Rodriguez says, never underestimate the value of empathy for those in need of help, as she tells host Russ Altman on this episode of Stanford Engineering’s The Future of Everything podcast.

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Chapters:

(00:00:00) Introduction

Russ Altman introduces Carolyn Rodriguez, a professor of psychiatry and behavioral science at Stanford University.

(00:02:47) Motivation to Study Hoarding Disorder

Why Carolyn chose to focus her research on hoarding disorder.

(00:03:44) Collecting Versus Hoarding

Distinguishing between normal behavior and clinically significant hoarding.

(00:05:47) Prevalence of Hoarding Disorder

The universality and pervasiveness of hoarding disorder.

(00:07:11) The Brain Science Behind Hoarding

Early neuroscience findings on attachment and discarding behavior.

(00:08:47) Dopamine and Excessive Acquisition

The connection between hoarding and potential dopamine reward pathways.

(00:09:55) Risk Factors and Cognitive Challenges

Personality traits, genetics, and processing difficulties involved in hoarding.

(00:11:14) Gender Differences and Insight Issues

Gender prevalence in treatment-seeking and the concept of anosognosia.

(00:12:35) The “Why” Behind Hoarding

How motivations and emotional attachments influence behavior.

(00:13:50) Onset and Progression of Disorder

Typical onset age, aging effects, and early warning signs.

(00:15:05) Historical References to Hoarding

Accounts from ancient literature of hoarding-like behavior

(00:17:16) Attachment to Objects

The emotional, aesthetic, and identity-based reasons people retain objects.

(00:20:45) Current Treatment Options

The treatment landscape, including lack of medications and focus on CBT.

(00:22:30) Chronic Nature of Hoarding Disorder

Framing hoarding as a long-term condition with hopeful outcomes.

(00:23:08) Virtual Reality for Treatment

A study on using VR to safely practice letting go of personal items.

(00:25:58) Neuromodulation Research

Using non-invasive brain stimulation to reduce acquisition urges.

(00:27:00) Advice for Individuals and Families

The importance of empathy and self-care for individuals and caregivers.

(00:28:47) Conclusion

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