When most people hear about animal hoarding, they recall shocking news stories or imagine the “crazy cat lady.” They immediately side with the rescued animals, rarely considering the life of the hoarder or what led to this behavior.
The term "animal hoarding" refers to the compulsive need to collect and own animals for the sake of caring for them that results in accidental or unintentional neglect or abuse. Most hoarders of animals fall victim to their good intentions and end up emotionally overwhelmed, socially isolated, and ultimately alienated from family and friends. The problem causes immense suffering for both animals and people. It also creates great expense for local animal shelters and may require regional and national efforts to find homes for large numbers of animals.
No one really knows the number of animal hoarders, but reports in the media and to animal control and law enforcement agencies have increased five-fold in the past decade. Approximately 40 percent of object hoarders  also hoard animals. Hundreds of thousands of animals are affected each year, and the Internet may make it easier for hoarders to engage in animal rescue. And like object hoarding, this problem is underreported and hidden because animal hoarders tend to come to the attention of mental health professionals and animal control authorities only when others complain..
Animal hoarders have problems with acquiring animals, handling and managing, and , getting rid of them. Compulsively reading animal-adoption websites, visiting shelters on euthanasia days, or searching alleys for stray animals can lead to acquiring too many pets. Frequently hoarders imagine all the wonderful ways in which they can save or rescue animals. They have every intention to care for their pets, but their difficulties with organization, attention, and focus make it easy for them to keep their living spaces very messy with animal waste and clutter; many have attention-deficit/hyperactivity disorder. Hoarders have a hard time letting go of their objects or animals because they have a terrible time making even simple decisions; for example, “Is this dog my favorite or should I adopt him out?” They also may have subtle memory problems and feel that they cannot trust their recall, so they keep things to preserve memories.
Hoarders also have an intense emotional attachment to the animals in their care. Their behavior helps them avoid the pain of letting go of things that seem very special, even when the clutter prevents comfortable living. Many object hoarders believe that things should be saved for some special event, even though the event never happens. This is true for animal hoarders, too. They imagine the wonderful way in which they will heal love, and nurture their pets, while overlooking the terrible effects of having too many of them.
Most of the hoarders that I treat confuse their good intention to manage or reduce their clutter with the actual act of organizing or discarding their clutter. They churn through their piles of junk, feeling as if they have accomplished something significant, even though we would be unable to discern any improvement. Animal hoarders do the same thing. They clear a small area of their home of animal waste, or find a special container for pet food, but fail to address that their home, furniture, and lives are destroyed by having too many animals.
Studies on animal hoarders show that their behavior frequently begins after an illness, disability or death of a significant other, or another difficult life event such as a trauma during their youth.
They appear to seek out social relationships with animals and people. They view their animals as the sole or major source of love, and they emphasize how much they give and receive from their animals. Those I treat seem to have a great capacity to give love and are beloved by their family and friends. For many, keeping their animals appears to guarantee a conflict-free relationship. They often refer to their animals as their babies, and they confuse their loving the animals with the reality of their inability to provide a safe, clean, and healthy home for them.
Many see themselves as a rescue service for animals that others reject. Their hoarding may give them a special role as a person who saves the animals that are unloved by others. Their hoarding provides them a special identify that helps them feel special, loved, and important. Consequently they feel unable to give up their animals for adoption because they believe no one else will provide the intense love that they feel for them—despite the fact that the hoarder can’t provide adequate food, shelter, safety, or veterinary care.
The result of animal neglect is especially sad. Everyone suffers with animal hoarding—the animals, the hoarder, and those who love the hoarder. Hoarders frequently neglect their own health, nutrition, and social life because they spend all their time, money, and energy caring for their animals. They are emotionally overwhelmed and trapped by their indecision and sense of responsibility and are often sleep-deprived. Their homes are overcome by animal waste, and they can suffer health problems created by inhalation of ammonia, fleas and tics, and animal-borne illnesses.
And the animals suffer the same fate: poor health, malnutrition, disease, and even death. They are stressed by frequent fights over food; territory, or mating in crowded conditions and usually are not spayed or neutered. Hoarded animals can’t retreat when they feel stressed or threatened, which is natural behavior for pets living in healthy homes or in the wild. All hoarding leads to a sad outcome, but the saddest of all is the animals who lie and die in an environment of neglect, filth, and stressful overcrowding as innocent prisoners of well-intentioned but misguided love. These animals are innocent victims, enduring tragic lives with people who are equally trapped.
Like object hoarders, animal hoarders rarely seek treatment unless those who love them motivate them. Their inability to make decisions, stop acquisition behaviors, and trust others with their animals keeps them stuck. Many have few alternative activities to help them feel productive because they are consumed with vain attempts at animal care. Simply removing the animals from a hoarder’s home doesn’t teach them new ways to manage their lives and prevent additional hoarding. We know that cleaning out a hoarder’s home only provides more open space to refill with clutter. Animal control officials report that without treatment, those who have their animals removed are at risk for becoming repeat animal hoarders.
Unless a hoarder engages in cognitive-behavioral treatment (CBT)  designed to address whatever leads to and maintains hoarding, they are likely to repeat their mistakes. Research on treatment outcome for object hoarders shows that they can eliminate or decrease hoarding with the proper cognitive-behavioral therapy. We have every reason to believe that this is true for animal hoarders, but the research studies have yet to prove it.
Treatment for animal hoarders will usually involve coordinating intervention with local or regional animal shelters and animal control officers to make it harder for the hoarder to rescue or adopt more animals. It also helps to have the family and friends become involved in treatment so that the hoarder can quickly develop or maintain satisfying relationships that provide opportunities to give and receive the love that their animals offered. Simply trying to confront a hoarder with all of their mistakes and the terrible state of their animals and home will make them feel defensive and allow them rehearse their reasons for being a hoarder. Often furious and horrified by the hoarder’s behavior, family and friends usually need the help of a therapist to learn to how to be helpful, rather than bludgeon the hoarder with their confrontations.
Karen L. Cassiday, PhD,  is Clinical Director and Owner, Anxiety & Agoraphobia Treatment Center in Northbrook, Illinois, and Clinical Assistant Professor, Rosalind Franklin University of Medicine and Sciences