At the clinical end of the continuum, those who hoard choose to suffer:
social isolation, relationship breakdowns, health risks, eviction, steep monetary fines and much more besides in order for the chance to live without negative experiences.
By dismissing the realities of their unliveable environment, using various techniques to avoid dealing with the psychological stuff under the physical stuff, they attempt to avoid the predicted distress and uncertainty they might experience if they were to let go of their possessions.
The truth is, avoiding negative emotions, sensations, and thoughts with every fibre of our beings will not guarantee we never experience them…because, human suffering is universal.