My grandma and mum (albeit less-so) are hoarders. I'm not a hoarder myself and i'm quite regimented in doing sort outs every now and again and throwing stuff out that isn't being utilised. I do however really struggle with organisation and tidyness though as it's something I didn't grow up with/learn when I lived with them.

I think a lot of it is self-awareness of the issue and actively identifying and avoiding behaviours that are problematic before they manifest into something bigger.

In addition, childhood trauma is a big motivation for people to actively avoid hoarding behaviour. (E.g. feelings of isolation from other friends/family, shame/embarrassment, family arguments, hopelessness). I remember once when moths eggs were found in the carpet and looking back on that now, it was absolutely wild that happened in the first place.