Fear meets Sarah Wolff in the elevator.

It’s standing beside her as she rides to her third-floor apartment. Taunting her. Tapping her shoulder and whispering in her ear.

“When I get off the elevator up here, I panic,” she says. She can’t see her apartment door from the elevator. “Is there a note saying ‘You’re evicted, you can’t live here anymore?’ I have that panic every time I leave the apartment … I’m like, ‘Oh please don’t let there be anything on the door. Dear God. Please.’”

Wolff, a 29-year-old formerly homeless mother, is haunted by that fear. She thinks about loss constantly. Losing her apartment. Losing her things. Losing Aiden, her 9-year-old son, again.

Sometimes those fears are so great, she doesn’t leave her apartment at all. Safe in her home, she surrounds herself with the things she loves: balls of yarn for knitting blankets and scarves, books, movies. There are toys and books for Aiden, too.

“I’ve always been one to hold onto stuff,” she says. She thinks that’s because she lost so many people in her life when she was young. Now she holds everyone, and everything, close.

She wonders if all that loss is why she has so much “crap.” That’s what she calls it. Wolff literally surrounds herself with possessions. Before visitors come over, there’s a skinny path she and her son walk to navigate the apartment—a path that carves through piles of dirty clothes, shopping bags overflowing with balls of yarn and knitting needles, through books, shoes, DVD cases, and empty soda cans. Tidying up means she crams piles of dirty clothes into a closet and hopes the door stays shut. She shoves some things into a plastic garbage bag, but leaves the bag in the middle of the living-room floor. Dishes are piled on every surface in the kitchen. Jumbo packs of toilet paper are crammed under a desk.

Her case manager tries to help her get a hold of her hoarding issue, but Wolff says trying to clean and organize all of her things is so overwhelming, she’ll often break down crying while sorting through a pile of clothes or dirty dishes.

Hoarding—a condition Americans have come to know well from television shows like Hoarding: Buried Alive, which shines a voyeuristic light on the cockroach-infested homes of people with hoarding disorder—is something researchers are just starting to get their arms around. Some argue it’s a symptom of obsessive-compulsive disorder, while others—like those featured in the short documentary Stuffed—say hoarding could, in fact, be a “completely separate, neurologically distinct condition.” While there’s evidence out there suggesting that an attachment to material objects isn’t necessarily bad, when it reaches the extreme level of hoarding, it's hard to rationalize.

Hoarding among homeless or formerly homeless women is something several women’s nonprofits in Spokane, Washington—the city where Wolff lives—have noticed more and more frequently. At a 28-year-old Spokane nonprofit called Transitions, staff recently saw one woman chain her shopping cart, overflowing with trash, to a utility pole outside their daytime drop-in shelter. That prompted complaint calls.

Another woman, pregnant with a baby girl, filled bags with jeans from their clothing bank—jeans that could fit a teenager. She was shopping 13 years in advance for her unborn daughter, concerned this might be the last time she’d have access to such nice clothes.

“There’s this idea of ‘If I can just have stuff, I’ll feel better. If I have stuff I’ll be able to be like everybody else,” Mary Tracey, development director for Transitions, says. “‘I need to have these things to feel OK.’ It’s not something where you can be mad at them or you can say ‘just stop doing it.’”

Tracey says it's fear.

“A lot of times in their minds, it’s [preparing for] the personal apocalypse,” Tracey says. “It’s ‘When my life falls apart and I have this personal apocalypse, I need to be prepared because I’ve seen it happen before.’”

* * *

When it comes to hoarding, DeAnne Wilfong has seen everything: homes where bathtubs were used for storage, where appliances don’t work, where doors are blocked and windows won’t open, where appliances are broken and plumbing so damaged that people tape plastic shopping bags to the insides of their toilet seats to catch waste.

Transitions called in Wilfong, who runs a company called Smooth Transitions of the Inland Northwest, to help a woman in one of its communities who had acquired so many toys that she couldn't open her bedroom door. Wilfong helps people downsize: seniors moving to assisted living facilities from longtime family homes, people with hoarding disorder who are trying to get hold of their lives again.

She says in some cases, people save things because they think it would be wasteful to throw them away.

“I had a man who was a hoarder and he had a box of string in his closet—and the box was marked ‘String, too short to keep,’” she recalls. “Now what was in that box? String. Too short. To keep.”

And yet he was keeping it. “That’s the essence of hoarding because first of all they are embarrassed and they aren’t going to know when they’re going to need it … I asked him ‘What can you do with this?’ And he said, ‘Well, I suppose I could tie it together if I had to?’”

If he had to. That stuck with her. Something might happen, essentially, and these people feel like these things—this extra toilet paper, this box of string—might be the thing that saves them.

“Maybe they had a point where their income was way off or they didn’t have a job for a while,” Wilfong says, “and they thought, ‘I don’t know when I’m going to get a job again. I need to start keeping things back that I may need.’”

In his 1931 book The Epic of America, James Trunslow Adams talked of the American Dream, “that dream of a land in which life should be better and richer and fuller for everyone.”

Fuller, he said. For everyone.

So what does the American Dream look like today? How does Adams’ message translate to someone living in poverty?

Wolff says if she’d been asked that five years ago, she’d have said the American Dream means “to be rich and famous.” Today, though, she thinks it means a life free from worry.

“The more money you have, the better stuff you can have … the better your life will be,” Wolff says. “I’m still way below the poverty level, but I have a roof over my head, I have a place I can sleep every night. I have food and I have my kid. I would be happier if I had more—if I was able to provide better for [my son], but you know what? What I can provide is enough.”

Gail Steketee, co-author of the book Stuff: Hoarding and the Meaning of Things, says hoarding isn’t just an American issue—but it’s certainly seen very often here. “As a culture we have too much stuff. Period,” she says. We’ve got more stuff than ever before—some estimate the average American home has 300,000 things in it. A 2009 New York Times article on the self-storage boom in America noted that one out of every 10 American households rents a storage unit and that it’s now “physically possible that every American could stand—all at the same time—under the total canopy of self-storage roofing.”

Steketee says poverty and a tendency to hold onto material goods don’t necessarily equal hoarding. But in someone like Wolff’s situation, it could lead to more problems.

“People with hoarding issues are at much greater risk of losing their housing than someone without a hoarding problem,” she says, pointing toward pest infestations and cleanliness issues that can come from having too many things, problems that a landlord might see as grounds for eviction. “So again we’ve got a little bit of chicken and egg problem—poverty goes along with that loss of housing.”

And she says chaos can have an effect on hoarding.

“We can find a relationship to a more chaotic early life, [where] the household was not stable. We’re not talking about two parents raising kids,” Steketee says. “There’s more drama. There’s more loss. People are moving a lot, people are coming and going. It’s just not stable.”

Steketee says that most of the subjects she has studied have been female, “but women tend to volunteer for more research than men.”

She says it could make sense for a woman who has been homeless to have an issue with hoarding—though her research hasn’t pointed at hoarding being specific to any income bracket. But “the home and the household is a nest,” she says. “As a gender role, being in the home and managing a home is something women more often do. Perhaps it’s connected to that.”

* * *

Nadine Van Stone, director at St. Margaret’s, another homeless shelter for women and kids in Spokane, says she first realized hoarding was an issue a few years back when there was a fire at the shelter, and several families had to clear out their rooms.

“Someone donated a [portable storage unit].  And [one woman] pretty much filled [it] up with her own room,” she says. “She’d be in there in the morning, her daughter was trying to get her school clothes and she’d be in there ransacking through that [unit] looking for that stuff.”

The woman’s case was hardly unique or the first time she had seen an issue of homeless women having too much stuff, Van Stone says. If homelessness wasn’t a big enough hurdle to clear, she says many women are equally focused on what to do with their things. Or how to get more. “The sad part is, the stuff takes over their life because they can’t manage all that stuff,” she says. “But they need all that stuff, in their own mind, to manage their own internal life.”

A few years ago, Van Stones says staff noticed that when the St. Margaret’s in-house clothing bank would open each day, women would take piles and piles of clothing—far more than what they needed. The shelter eventually closed the clothing bank to prevent the women there from taking more things than they had space for. In its place, the shelter opened The Pearl—a boutique where the clothes are sorted and sized, and that allots women from the community 40 “Pearl Bucks” per month to spend there. In a way, it’s putting stock into the value of “retail therapy.”

“Our boutique shop is recognizing that there is a cultural difference for women living in poverty, and particularly homeless women,” Van Stone says. “What do you get to take pride in? Where do you get to be nurtured? The shopping experience is one that hits home.”

“I’ve seen that make such a difference in lives. And it makes me think, why do people go to Walmart? You know? Because part of it is the shopping experience. It’s like, ‘Why don’t we get to participate in that American Dream, where you get to go spend your money?’ So we make the Pearl like that.”

* * *

Hoarding issues among people who are formerly homeless is not unique to Spokane.

Michael Stoops, director of community organizing for the National Coalition for the Homeless, says he’s certainly noticed a complex relationship with “stuff” in his four decades serving the homeless in Washington, D.C.

He says he’s known homeless folks to save their money to pay for a storage unit filled with possessions from a time before they were living on the streets. “Their goal in life is to survive on a day-to-day basis,” he says. “They still have hopes and dreams for the future, in that they can get back to their former life or they can start a new life.”

Cheryl Sesnon, executive director at Seattle’s Jubilee Women’s Center, says the women she’s seen hoard things there often cling to them as if they’re a life raft.

“For a lot of women, it feels like if their stuff goes away, they’re not safe anymore. That everything will fall apart,” she says.

Nora Karena, director of housing services for YWCA Seattle, says she used to be homeless herself—but at that time she took pride in how few things she owned. Now she says she always has at least one person in her caseload who hoards.

Karena says she views hoarding as clinging to a memory. A better time. A feeling. She sees a lot of women struggling to hold onto “accoutrements of home,” she says. “Things that can make it feel like it’s home again. Like I’m secure again.”

“It’s very much about safety and control. When they’re in a transitional housing program, they have people coming into their houses every week and telling them how to live,” Karena says. “These become issues of control for them. ‘You can tell me how to live, you can tell me what I can and can’t do, but these are my things and they represent me and you cannot take them away from me. They represent my history, my story.”

That’s how Sarah Wolff feels. Her stuff helps her feel safe. Comfortable. Like she’s home again.

Here in her apartment, she’ll re-read the same books and watch the same movies over and over again. She loves Twilight—the books and the movies.

“I like it,” she says. “I know what’s going to happen.”

They carry her away, even for just a few minutes, to a place where she forgets about everything that was, everything around her, and everything that’s yet to happen.