I actually turned it on initially for the Train Wreck factor, got interested in it. I also used to watch Clean House, but when I saw when they worked on the homes of a few (not many-they screen pretty well) hoarders with REAL problems and didn't know how to deal with them, I stopped watching. Not all the people on the show who participated truly understood what they were in for. One neurotic woman hated absolutely everything that was changed, even her adult daughter's bedroom; but if she wanted to keep her daughter at home, she had to let her clean up her room from her, the mother's, crap.
Anyway, one of the reasons I turn Hoarders on sometimes is to passively aggressively get my husband to understand that although we have clutter (mine and the children's) it's not anywhere near as bad as it could be, and most of it is from the reality of having children in the house. He flips out too much and only notices when things are NOT done, as opposed to noticing the things that ARE cleared up. I hate that. What's the point, then?
It also a relief to me that I am NOT a hoarder; that I'm no where near as bad as he would have me believe. His grandmother was a type 4? hoarder, I think. Papers, cat litter, crap, junk, piled high in her house. They had to rent an enormous storage box the size of an 18 wheeler container to move her crap into when she moved into my FIL's house.