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By Susan Donaldson James, ABC News
Cary feels like a king when he is in front of an audience -- The King.

The 51-year-old Elvis impersonator has performed before 30,000 in Las Vegas and just recently placed ninth in the Ultimate Elvis Tribute Artist Contest in Myrtle Beach, S.C., singing, "I Can't Help Falling in Love With You."

But the former New York City gym teacher with a master's degree has a dark secret, one that only his closest friends know.

He is a compulsive hoarder and has mountains of Elvis memorabilia taking over his 600-square-foot apartment -- thousands of old newspapers, scarves, costumes, T-shirts, Elvis figurines and action figures, books, CDs and DVDs, even a driver's license from the long-dead king of rock 'n roll.

"You name it, I got it," he confessed to ABCNews.com.

Cary's multiple televisions and DVDs play Elvis around the clock, and on weekends at city clubs and in national gigs, he becomes Elvis.

"When I'm dressed up like Elvis, I feel like Superman. I'm the king of rock 'n roll -- TCB," says Cary, quoting Elvis Presley's acronym for "taking care of business," a phrase the singer coined when his life, like Cary's, began its downward spiral.

"I am poor man, but my things make me feel rich."

Cary's story kicks off the first episode in the fourth season of TLC's "Hoarding: Buried Alive," which airs Sunday, July 8 at 9 p.m. The series examines the lives of those whose emotional attachment to objects causes serious health and safety dangers and threatens their relationships with family and friends.

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"The real Cary doesn't exist anymore," says his friend Joe, who, with wife Francesca on the TV show, unsuccessfully tries to help clear a pathway through the bags of food and debris that eat up every inch of Cary's apartment.

"There is the Elvis Cary that gets all the attention and accolades he's desperate for, and the lunatic Cary," he says. "But there is no normal Cary."

Eight years ago, Cary was diagnosed with manic depressive disorder and anxiety, but his illness escalated into compulsive hoarding.

"The hardest thing for me to do is get rid of stuff," he said. "To make that transition is very, very difficult. I am a big Elvis fan and I didn't want to get rid of all the Elvis stuff. It's very traumatic and difficult when you are a hoarder."

Compulsive hoarding is strongly associated with obsessive compulsive disorder, a condition that affects about 4 million Americans, according to the International OCD Foundation.

About 80 percent of all hoarders have a first-degree relative, such as a parent or a sibling, with the disorder. It can often be triggered by a loss or trauma.

Such was the case with Cary. His mother was an Elvis fan and they "bonded" over a mutual devotion. She died of breast cancer 20 years ago and he began his descent into mental illness.

"I didn't want to let her go," he said. "I didn't think in a million years I'd be like this."

Cary moved into her apartment, where he couldn't bear to give up her treasured mementos. Her room has been kept a shrine to his late mother, whom he describes as "a little bit of a hoarder" and a fan who saw Elvis from a front-row seat at Madison Square Garden in 1972.

"He gave her a scarf -- with his sweat on it," said Cary, who keeps that souvenir enclosed in a case. "I will never give that up."

It got worse with the death of his father three years ago. "I didn't want to let his mattress go," said Cary. "It was too devastating."

The bedroom is so crammed with trash and collectibles that he has to put his bed in the kitchen.

TLC asked psychologist Becky Beaton to help Cary organize his apartment for the hourlong episode, but when she leads him to his mother's room, Cary, riddled with anxiety, lets out a primal howl.

"I can't do this," he says on the show. "I'm stressed out. People don't understand me -- they don't get it. I can't help myself."

Only breaking into a rendition of Elvis' "Love Me Tender" calms him.

"In my 20 years, this is one of the worst cases I have ever seen," said Beaton, founder and director of the Anxiety and Stress Management Institute in Atlanta.

But for Cary, music is "his therapy," she said. "He gets comfort from singing songs ... And when he starts to talk like Elvis, it's a coping mechanism."

"When he was a little kid, his mother dressed him up like Elvis," she said. "She got such a kick out of it, she entered him in contests, and he got a lot of love and affection from doing impersonations ... When she died, he went off the edge."

Cary's fear of abandonment, after such intense bonding with his mother over Elvis, is at the root of his illness, according to Beaton.

His recovery is complicated by the well-meaning intentions of his closest friends and his support system, Joe and Francesca.

"My wife and I believe he needs a strong kick in the ass," says Joe in the episode.

Beaton says that their "tough love" approach to Cary exacerbates his trauma. "Yelling doesn't make it better," she tells them on TV. "Ultimatums never work. They were adamant about trying to control him, but this was really hurting him."

Moving vans arrive, to help clear out his apartment, and Beaton tries exposure therapy -- letting Cary choose which things to throw out, slowly -- but it is too traumatizing for him. Instead, she introduces a harm reduction plan, just removing items that present safety hazards, not things that are precious to him.

The movers took away 20 large trash bags in March and now, "on a scale of 1 to 5, he is about a 3," she said.

Beaton is now guardedly hopeful. Like addicts, only about 20 percent of all hoarders get better.

But today, Cary sees a psychiatrist and a therapist and is on medication. "I have cleared a lot and am making more improvements," he said. "I am doing the best I can. I haven't regressed. But it takes a lot of willpower."

But when he is Elvis, "I feel like a totally different person," said Cary. "I am giving the world back something. Elvis was the greatest entertainer with the greatest voice. A real humanitarian. People still miss him. I miss him."

"I wasn't living like a human being," said Cary. "You can't get rid of it all, but try to get rid of some of it. It's not healthy. It's still difficult for me ... I'm not cured yet. But I am a little more restrained."

With that, when asked by ABCNews.com, Cary transforms his nervous demeanor and confidently belts out back-to-back two of his favorite songs, "Suspicious Minds" and "I Can't Help Falling in Love With You."

At that moment, he was The King.

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