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List watch: A brief look at glazomania

“Real happiness consists in not what we actually accomplish, but what we think we accomplish” (Charles Green Shaw, American abstract artist)

Ever since I can remember I have always been someone that compiled lists. Back in my youth it was lists of my favourite pop groups, film stars, sports stars, etc. I still make loads of lists but these days they are more likely to be long ‘to do’ lists (in fact, I’ve even written articles on getting the most out of ‘to do’ lists and being organized – see ‘Further reading’ below) or writing articles in the form of lists (in fact, I used to write what I called ‘psychol-lists’ for the British Psychological Society’s in-house magazine The Psychologist). When I make lists I feel more productive, and they are often the spurs to get things done (as long as I actually do the things on the list).

Obviously, list making can be an important activity in the organizational skills of many working individuals. Based on my own observations, most people make lists so they (i) don’t forget things, (ii) don’t procrastinate, (iii) feel in control and focused in what they are doing, (iv) can relieve stress, and (v) can cross things off the list and feel a sense of accomplishment. However, for a minority of people, making lists appears to be obsessive and a mental health issue. In short, there may be a fine line between being organized and being neurotic. From my own personal experience, I know that writing lists can be related to perfectionism. But life isn’t perfect and not completing activities on ‘to do’ lists can raise stress and worry levels. Ironically, the only way some people can deal with this is to make even more lists of things to do.

Obsessive list making is sometimes referred to as glazomania (check out the ‘Manias’ page at The Scorpio Tales website). Online dictionaries tend to define glazomania as either a passion for list makingor an unusual fascination with making lists”. However, the term ‘glazomania’ doesn’t appear to be used much academically. I did come across one recent paper in Distinktion: Scandinavian Journal of Social Theory, by Dr. Urs Staeheli that mentioned it:

“Recently, quite a number of coffee-table books have been published that collect different sorts of everyday lists. Some authors even speak of a ‘glazomania‘ (Cagen 2007) – that is, an uncontrolled urge to produce lists and a fascination with list-making”

However, there was no other information provided. I managed to track down the 2007 reference to Sasha Cagen’s book (To-Do List: From Buying Milk to Finding a Soul Mate, What Our Lists Reveal About Us). The book includes creative list-making exercises with the aim of helping individuals to “get in touch with their passion for life, inside and out of work, and refocus them on what brings them alive”. Cagen now makes a living on writing and giving workshops on the benefits of list making (one of her major clients being Google)

Although the term ‘glazomania’ is seldom used academically or clinically, obsessive list making is often mentioned as one of the symptoms of obsessive-compulsive disorder. As one online admission I came across noted:

“I have OCD, and recently my OCD flares up in the form of compulsive list making. This behavior totally affects my ability to be productive because I am constantly afraid of forgetting something and of spending time doing the wrong thing. Does anyone have any tips on how to break the cycle?”

The Wikipedia entry on obsessive-compulsive personality disorder notes that the main symptoms are “preoccupation with remembering and paying attention to minute details and facts, following rules and regulations, compulsion to make lists and schedules, as well as rigidity/inflexibility of beliefs or showing perfectionism that interferes with task-completion. Symptoms may cause extreme distress and interfere with a person’s occupational and social functioning” (my emphasis)

Psychologically, an argument could be made that obsessive list makers are simply trying to create an illusion of control in otherwise chaotic lives. The reason whyindividuals with OCD make lists compulsively is that they often afraid (in some cases, to the point of being phobic) that they will forget something important (even though research shows they do not have memory problems). These (arguably unnecessary) lists provide a reminder to carry out daily activities (i.e. brushing teeth, making breakfast, etc.). As with other OCD-type behaviours, the action of making a list helps the individual to feel psychologically better (albeit temporarily). The etiological roots may lie in the fact that the sufferer may at some point in their past history have been reprimanded severely, or repeatedly, by others for innocently forgetting things that were important. The OCD Types website adds:

“They never learn that they do not need the list to remember things. People with OCD may also make lists to remember things that may be contaminated to later wash or avoid, which also contributes to the OCD process. List-making can be in writing or verbalized aloud”.

In 2010, the BBC reported an exhibition at the Archives of American Art in Washington featuring lists made by eminent artists (everything from “scribbled on scraps of paper” to the “elaborately illustrated” including lists by Pablo Picasso, Alfred Konrad, Oscar Bluemner, Eerp Saarinen and Harry Bertoia). Bluemner even kept lists of lists. The curator of the exhibition (Liza Kirwin) told the BBC that:

“In trying to give order to his life, [Bluemner] obscures the clarity of the inventory of his work. He’s completely obsessed with this type of record keeping…This very mundane and ubiquitous form of documentation can tell you a great deal about somebody’s personal biography, where they’ve been and where they’re going. People can relate to this form of documentation because so many people are list keepers and organise their lives this way”.

In the same article, the BBC interviewed the US psychoanalyst Dr. Michael Maccoby who claimed that there are various types of list makers. However, there was little detail and the only quote in relation to types of list makers claimed: “The extreme is the obsessive who has to make lists of everything. These are people who have an unconscious fear that everything is going to be out of control if they don’t make a list”. As far as I am aware, there is no published empirical research on personality types and list making although there is some psychological literature showing that list making – as part of time management practices – appears to have some beneficial effects on both student grade point averages and workplace productivity.

Finally, a few months ago, an online article by Dr. Carrie Barron at the Psychology Today website provided a brief summary of why making lists is psychologically good for people. I’m not sure about the empirical basis of her claims but they seem to have reasonable face validity. I’ll leave you with her reasons (her verbatim list of “six great benefits”!). In summary, Barron believes that lists:

  • “Provide a positive psychological process whereby questions and confusions can be worked through.
  • Foster a capacity to select and prioritize. This is useful for an information-overload situation.
  • Separate minutia from what matters, which is good for identity as well as achievement.
  • Help determine the steps needed. That which resonates informs direction and plan.
  • Combat avoidance. Taking abstract to concrete sets the stage for commitment and action. Especially if you add self-imposed deadlines.
  • Organize and contain a sense of inner chaos, which can make your load feel more manageable”.

Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

 

Further reading

 

Barron, C. (2014). How making lists can quell anxiety and breed creativity. Psychology Today, March 9. Located at: http://www.psychologytoday.com/blog/the-creativity-cure/201403/how-making-lists-can-quell-anxiety-and-breed-creativity

 

Cagen, S. (2007). To-Do List: From Buying Milk to Finding a Soul Mate, What Our Lists Reveal About Us. Chicago: Touchstone.

 

Griffiths, M.D. (1995). Psycholo-lists. The Psychologist: Bulletin of the British Psychological Society, 8, 240.

 

Griffiths, M.D. (1996). More psycholo-lists. The Psychologist: Bulletin of the British Psychological Society, 9, 384.

 

Griffiths, M.D. (2006). Tips on…To do lists. British Medical Journal Careers, 332, 215.

 

Griffiths, M.D. (2008). Tips on…’To do’ lists. Psy-PAG Quarterly, 68, 27-28.

 

O’Brien, J. (2010). The art of list-making. BBC News, March 3. Located at: http://news.bbc.co.uk/1/hi/8537856.stm

 

OCD Types (2014). About obsessive-compulsive disorder. Located at: http://www.ocdtypes.com/unusual-compulsions.php

 

Staeheli, U. (2012). Listing the global: Dis/connectivity beyond representation? Distinktion: Scandinavian Journal of Social Theory, 13(3), 233-246.

 

Wikipedia (2014). Obsessive-compulsive personality disorder. Located at: http://en.wikipedia.org/wiki/Obsessive–compulsive_personality_disorder

 

Flaw management: A brief psychological overview of Body Dysmorphic Disorder

Over the last few years, Body Dysmorphic Disorder (BDD) has become the focus of increasing media attention particularly in relation to being cited as one of the main reasons why people seek out cosmetic surgery, as well as being implicated in a wide variety of diverse medical and/or psychiatric conditions including people with eating disorders, obsessive-compulsive disorders, and apotemnophilia (i.e., the desire to be an amputee).

At its simplest level, BDD is a distressing, handicapping, and/or impairing preoccupation with an imagined or slight defect in body appearance that the sufferer perceives to be ugly, unattractive, and/or deformed (hence the recent upsurge in relation to those with an insistent desire for plastic surgery). BDD sufferers can think about their perceived defect for hours and hours every day. Other BDD sufferers may indeed have a minor physical abnormality, but the concern attached to it is regarded as grossly excessive. There are hundreds of published papers on BDD but most of this article is based on the writings and reviews of Dr Katharine Phillips (Professor of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, USA) and the British psychiatrist Dr David Veale (The Priory Hospital North London).

People with BDD have been written about for more than 100 years and there has been a large increase in research into BDD over the last two decades. Like pathological gambling, the criteria for BDD changed quite radically between the publication of the American Psychiatric Association’s DSM-III (1980), and DSM-IV (1994). Until relatively recently, BDD used to be called ‘’dysmorphophobia’. In the DSM-III, BDD didn’t have any specified diagnostic criteria and was only mentioned as an example of an atypical somatoform disorder. In the revise edition of the DSM-III (1987), BDD became a separate disorder in the somatoform section. Subtle changes were then made to the DSM-IV criteria.

Arguably the most notable change was that the distinction between ‘delusional’ and ‘non-delusional’ BDD was diminished due to empirical evidence showing that the delusional and non-delusional variants of BDD may be variants of the same disorder (it should also be noted that in the World Health Organization’s International Classification Diseases (ICD-10), BDD is classified as a type of hypochondriacal disorder along with hypochondriasis, in the somatoform section). There is frequent comorbidity in BDD (e.g., social phobia, depression, suicidal ideation, and obsessive-compulsive disorder). In fact, almost all BDD sufferers engage in at least one compulsive behaviour such as compulsive checking of mirrors, excessive grooming and make-up application, excessive exercise, repeatedly asking other people how they look, compulsive buying of beauty products, and persistent seeking of cosmetic surgery. These behaviours can become potentially all encompassing and consuming, and like many addictive behaviours become unpleasurable and typically difficult to control or resist. The current DSM-IV diagnostic criteria for body dysmorphic disorder are that there is:

  • Preoccupation with an imagined defect in appearance. If a slight physical anomaly is present, the person’s concern in markedly excessive;
  • The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
  • The preoccupation is not better accounted for by another mental disorder (e.g., dissatisfaction with body shape and size in Anorexia Nervosa)

Dr David Veale notes that among BDD sufferers, any body part may be the preoccupying focus. However, research has indicated that most BDDs involve skin, hair, or facial features (e.g., eyes, nose, lips) that the sufferer feels is flawed (e.g., acne), out of proportion and/or asymmetric. Research has also shown that the pre-occupying focus can change over time. Dr Veale speculates that this changing focus may explain why some people are never happy after cosmetic surgery procedures. Sufferers may repeatedly examine the ‘‘defect’’ that for some may become obsessive and/or compulsive.

A couple of empirical studies have reported the prevalence of BDD as 0.7% in the general population. The prevalence rate among other specific groups – such as adolescents and young adults – tend to be a little higher, and among some groups it is significantly higher. For instance, much higher prevalence rates of BDD have been reported among people wanting plastic surgery (5%) and among dermatology patients (12%).

Dr Veale notes there are very limited data on the risk factors associated with the development of BDD. Furthermore, those factors that have been associated with BDD may not be unique or specific to BDD (for instance, risk factors such as poor peer relationships, social isolation, lack of support in the family, and/or sexual abuse). Risk factors identified in BDD include:

  • Genetic predispositions;
  • Shyness, perfectionism, or an anxious temperament;
  • Childhood adversity (e.g., teasing or bullying about appearance)
  • A history of dermatological or other as an adolescent (e.g., acne) that has since been resolved.
  • Being more aesthetically sensitive than average
  • Greater aesthetic perceptual skills, manifested in their education or training in art and design.

Although there are various worldwide case studies, most published studies on BDD comprise people from Westernized societies. Dr Katharine Phillips and her colleagues claim there are no studies that have directly compared BDD’s clinical features across different countries or cultures but concluded that BDD studies from around highlighted there were more similarities than differences. Dr Phillips says that men and women had many similarities in these studies (demographic and clinical characteristics). She has also reported that both male and female BDD sufferers are equally likely to seek and receive dermatological and cosmetic treatment.

Dr Veale claims that although there are broad similarities between the genders there are some gender differences. For instance, men with BDD show a greater preoccupation with their genitals, and women with BDD are more likely to have a co-morbid eating disorder. Perhaps somewhat predictably, female BDD sufferers have a greater preoccupation with weight, hips, breasts, legs, and excessive body hair. They are also more likely than BDD males to conceal perceived defects with make-up, to check mirrors, and to pick at their skin. Male BDD sufferers have a greater preoccupation with muscle dysmorphia, and thinning hair. Compared to females, BDD males are more likely to be single, and have a substance-related disorder.

The most recent review by Dr Phillips and her colleagues concluded that: “Much more research is needed on all aspects of BDD. Advances in knowledge will likely lead to future refinements of this disorder’s diagnostic criteria and an increased understanding of the relationship between BDD’s delusional and non-delusional forms as well as BDD’s relationship to other psychiatric disorders”.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Didie, E.R., Kuniega-Pietrzak, T., Phillips, K.A. (2010). Body image in patients with body dysmorphic disorder: evaluations of and investment in appearance, health/illness, and fitness. Body Image, 7, 66–69.

Kelly, M.M., Walters, C. & Phillips, K.A. (2010). Social anxiety and its relationship to functional impairment in body dysmorphic disorder. Behavor Therapy, 41, 143-153.

Mancuso, S., Knoesen, N. & Castle, D.J. (2010). Delusional vs nondelusional body dysmorphic disorder. Comprehensive Psychiatry, 51, 177-182.

Phillips, K.A. (2005). The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder. New York: Oxford University Press.

Phillips, K.A. (2009). Understanding Body Dysmorphic Disorder: An Essential Guide. New York: Oxford University Press.

Phillips K.A. & Diaz, S.F. (1997). Gender differences in body dysmorphic disorder. Journal of Nervous and Mental Diseases, 185, 570–7.

Phillips, K.A., Wilhelm, S., Koran, L.M., Didie, E.R., Fallon, B.A., Jamie Feusner, J. & Stein, D.J. (2010). Body Dysmorphic Disorder: Some key issues for DSM-V. Depression and Anxiety, 27, 573-59.

Phillips, K.A., Menard, W. & Fay C. (2006). Gender similarities and differences in 200 individuals with body dysmorphic disorder. Comprehensive Psychiatry, 47, 77–87.

Phillips, K.A., Didie, E.R., Menard, W., et al. (2006). Clinical features of body dysmorphic disorder in adolescents and adults. Psychiatry Research, 141, 305–314.

Veale, D. (2004). Body dysmorphic disorder. Postgraduate Medical Journal, 80, 67-71.

Veale. D. (2004). Advances in a cognitive behavioural model of body dysmorphic disorder. Body Image, 1, 113-125.