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The excuse used to be that they "grew up during the depression." But for the most part that isn't true anymore. I honestly think that clinical hoarding behavior is just one of the many neuroses that can creep in with old age.
I imagine the shrink's way of unraveling it would be that you don't want to waste the time (things) you have left, and even more metaphorically, you don't want to be thrown out yourself just because you're old.
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