|  1 Chapter 1: Understandings about Self-Help  Introduction to Self-Help                                                 | Understandings between you, the reader, and me, the author        1.  2.  3.  4.  5.  6.  7.  8.  9.  | The Psycho-social Education Approach                                                        Our attitude toward "self-help" will influence our future.                          | Summary                                                                                                 | 
|  2 Introduction to Self-Help  What is psychological self-help?  I consider self-help to be intentional coping. It is handling your  own troublesome situations by exercising deliberate conscious control  to improve the outcome of the situation. It is recognizing your own  personal weaknesses and working to overcome those faults and  improve yourself. It sometimes involves changing others or the  environment to improve your own circumstances or feelings, but self- help primarily focuses on changing your own behavior, feelings, skills,  cognition (thoughts), or unconscious processes. Self-help is the  conscious reasoning part of your "self" changing other aspects of your  internal self, your actions, and your situation. It is self-improvement  by your self.   The self-change notion may seem a little foreign to you because  our culture attends far more to changing other people--making  children behave, teaching others, motivating employees, fighting crime  and drugs, selling ourselves or products to others, pleasing our lover,  getting people to vote our way, etc.--than to changing ourselves.  "Making things better" often means trying to change someone else.  Even my discipline of psychology spends far more time on studying  methods for changing or treating others than on methods for self- improvement. The old concepts of self-control, self-responsibility, and  self-reliance haven't been in vogue during the last few decades.   On the other hand, if the idea of self-help seems like  commonsense to you, then you may be particularly aware that our  minds are almost constantly attempting to solve some current or  approaching problem. Indeed, most of us are self-helping all the time,  i.e. every time you plan your actions by imagining in advance how to  possibly handle a situation. Even if it takes only seconds during a  conversation to think of what to say, that is self-helping. Our brain's  great ability to quickly imagine different ways of approaching a difficult  situation sets us apart from other animals. We are constantly asking  ourselves "what should I say or do now?" which usually involves  thinking of alternative approaches as well as guessing what the  outcome of each alternative might be. As a person becomes keenly  aware of these constant and complex coping processes, he/she  recognizes a myriad of opportunities for intervening to make things  better. This book should, above all else, enhance your understanding  of these internal mental events involved in coping moment by moment  throughout life. This is the essence of self-help.   I suspect that many of us overlook most of the opportunities we  have to influence our lives (we couldn't possibly act on all of them).  We may feel rather powerless or we feel controlled by outside forces-- others, circumstances, fate, or a higher power. Many others don't  | 
|  3 know or don't believe there are methods for directing our lives.  Perhaps, for the species as a whole, our natural (untrained) but  uncanny ability to problem-solve leads us to the false conclusion that  there is no way or no need to improve our coping skills. How sad. Like  the person who wants to effortlessly be a great conversationalist or  the student who hopes to impress others by doing well on an exam  "without studying," we humans may feel just a little inadequate if we  have to study and work to self-improve. The truth is: effective living  requires hard work, whether it is staying trim and fit or acquiring  expertise in our profession or maintaining a loving relationship.   An effective mind sets our course. Like the tail of a plane, it guides, with small  movements, the power of all the rest of our body and spirit. What is not self-help?   It may clarify the concept of "self-help" if we consider what self- help is not. Examples: it is not habitually, automatically, or impulsively  responding to a situation, even if the response is very effective. It is  not stumbling into a solution by chance or luck. It is not being  oblivious to ways our situation or adjustment could be improved even  if, in our ignorance, we are quite content with the way things are. It is  not going along with or being "pushed" by our emotions in unwise  directions. It is not getting relief by avoiding a bad situation if a better  solution could be found. It is not assuming that we are doing our best  if our coping skills could be improved. It is not living without purpose if  meaning can be found for our life. It is not expecting to fail or feeling  helpless (assuming success is possible). It is not blithely overlooking  the genes, physiological factors, cultural influences, traditions,  perceptual biases, unconscious payoffs and forces, and other factors  that influence our lives in unhealthy ways, if there are ways to become  aware of and counter the undesirable aspects of those factors. It is not  joining a group, going to therapy, talking to a friend, or reading a book  in the hopes of finding someone who will save you.   On the other hand, a person may join a support or 12-step group  as a way of getting ideas and encouragement to manage his/her own  life better; that is still self-helping. Similarly, reading a book, watching  a talk show, talking with a friend or a counselor can also be used by us  to help us help ourselves. While self-helping, even in a group or  reading a self-help book, we continue to assume the full responsibility  for changing our lives. (Sometimes, of course, our psychological  condition may deteriorate to the point we can't cope, then we must let  someone else take over for a while.)   As I state repeatedly, self-help is not just dealing with life's crises  (although that's the current emphasis); it should enable us to prevent  problems and find nobler purposes, to be more loving and giving, and  to achieve greater successes than would have otherwise been the  case. Obviously, a highly competent self-helper is aware of many of  | 
| 4 his/her real or potential problems and weaknesses and is able to  quickly formulate a plan to improve the situation. An ineffective self- helper can't or doesn't do these things.   Psychology's ambivalence about self-control   Humans want to control their lives and they fear a loss of control.  Yet, there is no strong belief that science offers much help with self- control. As I mentioned, even the discipline of psychology left self- control, will or volition, and cognitive control in the hands of  philosophers until the 1960's. Moreover, some experimental theorists  suggest that conscious thought or "will" has almost nothing to do with  our behavior (Bargh & Chartrand, 1999; Wegner & Wheatley, 1999). It  is true that much of human living is done automatically without being  guided by conscious thought. There is too much happening-- perception, behavior, emotions, memory, physiological processes--for  conscious decision-making and planning to handle it all moment by  moment. Automatic mechanisms have taken over. But when things go  wrong and/or we want to make changes, we sometimes have the  option of using our brain's limited conscious resources to plan new  solutions.   Recently, Shapiro (1997) with two colleagues (Shapiro, Schwartz  and Astin, 1996) has summarized the theory and research about self- control during the last 40 years. I'll summarize their summary. The  impressive and growing research showing that self-control (or the lack  of it) is important to our mental and physical health has awakened  research psychologists to the importance of self-change and volition.  Self-help attitudes and skills are becoming major factors in the  treatment of physical, mental, emotional and interpersonal problems.   Normal healthy people tend to over-estimate their control and  under-estimate their vulnerabilities. That makes us feel better. If we  feel able to deal with an illness, it helps (we do more to help and our  immune system actually works better). Feeling helpless decreases our  treatment efforts and increases our anxiety and depression. Believing  you are powerless when you aren't is, of course, a problem. Likewise,  too much belief in one's control or an excessive need for control can  make things worse, health-wise and socially. If you assume you have  more control than you really have, you may also blame yourself  inappropriately for bad outcomes.   Shapiro (1997) shows us that the concept of self-control is  complex. It includes your need to control, the confidence you have in  your control, as well as the actual control you have. This can be in  broad areas of life or in very specific areas, such as "getting this job  done on time" and "controlling my anger with this person." As the  Serenity Prayer tells us, control may mean coping with a situation by  yielding, patiently accepting, or accommodating the situation as well  as coping by assertively doing something to change things. Does  control include denial, such as the alcoholic saying "I can stop drinking  any time," which controls anxiety but worsens the addiction? Well, it's  | 
|  5 not conscious control. Does control also include getting others,  including family, gang, government, and God, to make things better  for you? Maybe. Finally, there is a lot we don't know about teaching  self-control: do different genders, ages, levels of ambition,  personalities, etc. need different control skills and types of instruction?  Also, if society helps people get more self-control and perhaps more  influence over others, do we also need to be concerned about their  values, i.e. how they use their power? Shapiro's book, this one, and  others will answer many questions about self-control but there is much  still to be explored in this neglected area of knowledge.  What will this book do for you?  This book reviews all aspects of self-improvement. It provides you  with a system for analyzing any problem into its manageable parts and  for planning self-change. It invites you to first carefully consider what  you value and want to accomplish in life. It summarizes science's best  explanations of most human problems. It lists the most promising  ways of treating a wide range of unwanted behaviors and emotions. It  describes in detail how to use about 100 self-help methods. In short,  this book gives you a sound, research-based fund of knowledge about  behavior; add to this your own coping experiences and you accumulate  a storehouse of general knowledge that will help you understand  yourself and gain more control over your life. That is offered;  absorbing and applying the knowledge is your job.   Just as experimental psychology has "Introductory Psychology"  textbooks, the science of personally useful psychology needs an  introductory text too, especially one that introduces you to other  practical and highly readable self-help books. No one book could tell  you all you need to know. In this book you will find summaries of  almost all the major self-help books and articles by scholars in the  field. In addition, about 1500 sources of information, mostly available  and easy-to-read books, are cited. You are urged to expand your  knowledge by reading more in areas that really concern you.   No learner knows his/her subject well enough. The best we can hope for is to  know enough to know when we need more information and to know where and  how to find the best available information. Think of reading as probing the best  minds at their best.  This book was designed to help the ordinary person live his/her life  better. But, more specifically, what should a reader expect from a  thorough, comprehensive, effective self-help book? This is what I  would expect, based on my experience with 3000 students. After  carefully reading this book and getting some practice at developing  | 
| 6 and carrying out self-help plans (both in your own life and with others- -friends, family, or a support group), you should be able to:   1.  quickly analyze any problem into meaningful parts for better  understanding, and   2.  select, master, and carry out appropriate self-help treatment  methods, and   3.  assess your progress and make modifications to your plan if it  isn't working.   In fact, I believe a person of average intelligence, with this  knowledge and practice, will be able to develop self-improvement  plans that are as good (judged by experts as "probably effective") as  treatment plans developed by professionals (psychiatrists,  psychologists, social workers, school psychologists, counselors, etc.).  It is an empirical question. I won't guarantee these results, but if the  average person believes he/she can do it (and does the work), I think  they can. Many of us inflate the ability of others and sell ourselves  short.   Lastly, a self-help introductory text should be updated  every three to five years to include the latest research and  techniques for self-improvement. It should contain a wide variety  of self-help methods; one person's way of self-helping may be  totally rejected by another person facing the same problem; we  each find our own way. Such a book is a massive undertaking, but  a wonderful extra bonus would befall us all if self-help books  encouraged researchers to develop and publish more effective self- control or self-insight techniques.   Finding what you need in this book  I have done my best to make this big book user-friendly. I don't  want you to get bogged down in the first chapter, in technical stuff, or  in topics that don't interest you. Therefore, the book has been written  so you can skip around, finding the parts that address your concerns  and interests today. A search engine was added to help you. Of  course, you can read the book straight through if you want to (or are  assigned reading that way).   As you can tell by looking at the table of contents, the remainder  of this chapter provides basic facts or things you need to know about  self-helping in general. Chapter 2 gives you a system for  understanding your problem situations better, and then it guides you  through explicit steps for devising self-change plans and trying them  out. The system isn't amazing, fantastic, or ingenious; the system is  just reasonable. The system isn't fast, simple, and easy; human  problems aren't that way. But human problems and this self-help  system aren't impossibly complicated, either.   Before deciding on major changes in your life, you need to decide  on your life goals, i.e. what you want to become, what your ideals,  | 
| 7 values, and needs are, what major purposes you are going to serve in  life. Chapter 3 provides some help with this. Your morals, values, and  philosophy of life could influence every moment of your life, so they  are of utmost importance.   Chapter 4 discusses how to stop unwanted behavior and how to  increase your motivation to do what you think you should do.  Chapters 5 to 8 explain the four major emotions of anxiety,  depression, anger, and dependency, and suggest ways of reducing  these unpleasant feelings. Chapter 9 gives us insight into our needs  and the development of our personality as well as into our  relationships. Chapter 10 deals with finding and keeping love: dating,  sex, marriage, and divorce. Chapters 11 to 15 spell out the rationale  and detailed steps involved in carrying out the major self-help  methods to treat or solve problems. You would use only one or two  methods from a "solving-the-problem" chapter on a particular  problem. Thus, you usually need to read an "understanding-the- problem" chapter before skimming the "solving-the-problem" chapters.   Note: It would be a mistake to over-emphasize just finding  information to help you with a current problem. Remember, there are  at least three good reasons for reading about topics or problems that  don't concern you at the moment: (1) it is possible that you have a  problem but don't realize it, until you read about it. (2) It is highly  advantageous if you have read in advance about and prepared for an  upcoming, perhaps unseen, problem. For example, surely most of us  will be dumped by a lover sometime in our lives. If you have given  some forethought to coping with that situation--the irrational self- doubts (chapter 14), the dependency (chapter 8), the feelings of  failure and self-doubt (chapter 6), the anger (chapter 7), etc.--surely  you will be better prepared for the unavoidable pain and even for  possible thoughts of suicide. (3) It is inevitable, if you have several  close, intimate friends, that they will face problems different from  yours. Your friends will be very lucky if you are well read and  understand them when they are in trouble, perhaps you can offer  them some helpful suggestions as well as steady support.   My plea is for you to accept the size of this book, the sometimes  distracting referrals to other chapters, and the hundreds of useful  references (where you can go for the best additional information, if  you need it). It is a book of knowledge, not a book for pleasure. Let  me give you an example of how you can quickly find your way around:  I'd encourage you to read the rest of this chapter, but not necessarily  now. If you are in a hurry to "get on with it," just look over the  "understandings" in bold print below and go on to chapter 2. If the  details for doing self-help in chapter 2 are also too tedious for you  now, look over the steps in bold print (that will take you two minutes)  and then go directly to the chapter(s) that interest you most. This  book can't help you if you don't read it. Use the table of contents and  the chapter indices or use the book's search engine on the title page to  get around quickly.   | 
| 8 Once you have found that this book truly deals with your basic  concerns, you will be more likely to explore the whole volume for  interesting ideas. The important thing is that you stay interested in  improving yourself! The most I can do to help you with your  motivation is to feed you useful information. But useful information  must be used, and only you are in control of that. At least skim the  following understandings, and then decide where you want to go in  this book or in other recommended books.   Finding other self-help books and Internet sites  Useful self-help information exists primarily in two places--in books  and on the Internet. Thus far, these two worlds dont interact very  much, i.e. books cite books and Internet sites link to other sites. Of  course, the 50,000 self-help books published over the last 50+ years  contain much more information than the current Internet, but the gap  is narrowing. The Internet could grow rapidly with more and more  people getting access to free advice within seconds or minutes. The  Web is an ideal way to gain knowledge, but the Internet has a  problem, namely, it doesnt as yet make money, like books do, by  selling information. Therefore, as long as publishers can buy and  control the best self-help material for books, hard copy publications  may, in general, be the better sources. Hopefully, Internet sites will  find support allowing them to compete and buy excellent information  and deliver it free via multi-media formats. In the meantime, the  prudent self-helper will search both the Web and hard copy books. Ill  help you do that.   To find specialized self-help books, the best starting point is  where you are, i.e. reading this book, Psychological Self-Help. Simply  find the topic that concerns you in the chapter indices (or use the  search engine on the title page). Then read the relevant material and  look for references. Most self-help books are rather specific, dealing  with a circumscribed problem area. Once you have the author and  year, you can get the full reference in the bibliography.   In the same way, other comprehensive self-help books could be  used to find specialized books (Weiten & Lloyd, 1997; Creer, 1996;  Butler & Hope, 1997; Epstein, 1996; Lazarus & Lazarus, 1997).  Specific guidebooks to self-help books include Norcross, et al (2003),  Santrock, et al (1994) and Giblin & Bales (1997). Santrock and more  recently Norcross used ratings by professionals to evaluate self-help  books (and I have frequently cited their findings). Unfortunately, a  self-help book is four or five years old before the ratings can be  published by Santrock, et al.   Another good approach to finding a self-help book on a particular topic  is to browse the Health, Mind & Body section at Amazon Books  (http://www.amazon.com) or at Barnes and Noble  (http://www.barnesandnoble.com). Book evaluations by experts and  readers are often provided. Finally, a search for information about a  particular problem on any of the major search engines, e.g. Alta Vista,  | 
| 9 will usually yield useful sites as well as books, tapes, and other  services, often in the form of ads.   To find self-help assistance on the Internet, the best hard  copy directories of diverse mental health resources are John Grohols  (1997) and (2004), The Insiders Guide to Mental Health Resources  Online. Morrison & Stamps (1998) have written a similar book.  However, these books may not be obtained easily, unless you are on a  college campus. And, since you are online now, the sites listed below  are instantly available.   Below are good starting points for seeking specific how-to- cope information and support groups:   (1) To find explicit, detailed directions for coping with a  variety of specific problems, just as if you were searching for a  specialized book, go to the relevant chapters index in this online book  (or use its search engine). Self-help instructions will be found in the  discussion of your problem. In addition, I have cited the more helpful  and science-based books and Internet sites in that area. Other  Internet sites provide many self-help resources: Dr. Grohols Psych  Improvement Online (http://www.selfgrowth.com/topics.html), Cyber  Psychologist (http://www.cyberpsych.com/), and Psych Web  (http://www.psywww.com/). Also, Psych Web lists numerous  brochures and articles available on the Web  Of course, you can simply do a search for your problem on a major  search engine. This will give you some URLs of sites offering help with  your specific concern. But many useful sites will be missed and the  useful sites that are found will be intermixed with unscientific,  marginal sites and with ads.   (2) To find local self-help support groups, call your local  Mental Health Center, a local psychiatric/psychological treatment  Sourcebook Online (http://mentalhelp.net/selfhelp/) which locates  groups all over the US and helps people start their own local support  groups if none is available. To find support groups on the  Internet, called newsgroups, mail lists, chat groups, forums,  provides one list and Psych Central-news  (http://www.psychcentral.com/news.htm) another. Various support  groups are provided at a different section of Psych Central    Improvement Online (http://www.selfgrowth.com/newsgrp.html) also  lists newsgroups. Both sites, Grohols PsychCentral  (http://forums.psychcentral.com/) and MentalEarth Community  (http://www.mentalearth.com/), offer several good Forums. Online  there is a direct link from the title page to the Self-Help Forum. Other  | 
|  10 Forums deal with several different diagnoses and behavioral or  relationship problems.   It appears that support and advice from people who have been  there are often as helpful as self-help books, professional advice, and  therapy. Certainly many people seek understanding, reassurance they  are not alone, encouragement, and just someone to hear their story.  Storm King (http://webpages.charter.net/stormking/) has discussed  in great detail the pros and cons of self-help groups.   (3) To find accurate information about psychiatric  diagnoses, there are several outstanding sites, 
  but only one we really recommend, the mental health resources found at Psych Central . Search  engines will also find information about diagnoses for you.   A surprising number of former, current, and prospective patients  are on the Internet seeking to learn more about their diagnosis and  possible treatment. They often identify themselves by some label: Im  bipolar, Im an adult child of alcoholism, Im a child of divorce,  and Im PTSD... DID... BPD... ADD... OCD...    (4) To find information about treatment methods as applied  to a variety of disorders, good sources are Psych Central,  (http://mentalhealth.samhsa.gov/), and this book, Psychological Self- Help. As mentioned before, the major search engines can locate  information about how to treat a specific disorder and about specific  treatment methods, such as Cognitive-Behavioral or Psychodynamic  treatment.   To learn more about psychopharmacological medications,  see Psychiatric Medications from Psych Central.  For clients seeking talking therapy, it is to their advantage to be  familiar with the rationale of several different psychotherapy  techniques. I say that because I believe that the best therapy is a  cooperative effort with the patient well informed enough to participate  in planning the therapy. Moreover, the client should continuously apply  self-help techniques to supplement the therapy methods. Thus, good  psychotherapy patients are students of self-help.   | 
|  11 (5) To find information on almost any psychological  topic, Psych Central is a well organized source covering many disorders.   In most cases, the key to coping is knowledge. So, go get it!   Understandings between You, the Reader,   and Me, the Author  If you and I, as reader and writer, are going to communicate most  effectively, there are some things you need to know about the "state  of the art" of self-help and about my approach to self-help. I want you  to recognize the scientific basis (or lack of it) for self-help methods. I  want you to be aware of the assumptions I am making and the values  I hold. I want you to know what I would like you to do while reading  this book and afterwards. These 13 understandings should help you to  view self-help realistically, and then, use it effectively.   Understanding 1: We, as humans, primarily learn to be the way we are;  therefore, at any point in life, we can learn to be different. But, it may not  be easy to change.   I assume there are reasons--causes--for everything we do, and  that humans can learn to understand those reasons, which are  dependable, "lawful," useful, cause and effect relationships. Therefore,  each of us could presumably gain considerable control over our own  | 
|  12 futures by understanding and using the "laws of behavior," especially  those in the form of self-help methods, such as:   If I repeatedly highly reward a desired behavior, it will probably  increase in frequency.   If I deeply relax for 10 minutes twice a day, I will probably be  calmer throughout the day.   If I learn new communication skills, such as empathy, I will  probably get along better with people.   If I can view a situation more positively or, at least, as being  "lawful," I will probably be less upset.   I will describe many self-help methods in simple terms, step by  step, almost like recipes in a cookbook. Then, we will learn how those  methods can be used with specific problems, like fears, sadness,  jealousy, selection of a mate, etc. If you understand how a problem  started and what keeps it going, and how self-help methods work, you  are better able to devise a way to change things. And that's what self- help is all about.   I truly believe you learn by doing, not just by reading a book or  talking about your problems. You must use the ideas. So, I'll give you  lots of examples of how to use psychological methods in everyday life.  Hopefully, you can then see many ways to use each method in your  life--and, more importantly, will immediately try out the methods. If  you don't use the idea you have read or heard about within a day or  two, you will probably forget it.   As you read, ask yourself: How can I apply this idea or self-help  method today or tomorrow? As you live, moment by moment, ask  yourself: What have I learned about psychology that would help in this  situation? This learning orientation is crucial to changing; it becomes  automatic and contagious. A few successes will crush the old, cruel  idea that you can't change things, and then you get "high" on learning  about yourself and how to relate to others better. I'd like to see you  take an experimental approach to life, i.e. try out self-help methods to  see what works for you. As you learn and experience more, you  become more self understanding, more in control, less helpless and  more confident, and better prepared for a whole life-time of growth.  We all try to help ourselves all the time, so why not learn to be a really  good, knowledgeable self-helper and steadily improve your future?   Understanding 2: Self-help is a relatively new, still-to-be-proven approach,  involving a few well tested methods, but many methods are unproven.  Research supporting self-help approaches is accumulating.   Psychologists have started to evaluate self-help methods  objectively. However, the methods that have been researched and  proven to be somewhat effective in most cases, like rewarding your  own desirable behavior, relaxation, assertiveness training, and  overcoming unreasonable fears by exposing yourself to the situation,  aren't effective in every case (and neither is therapy). The better  | 
| 13 methods are, at best, effective only 80-90% of the time, even though  you are working on just a small aspect of your life, such as a fear of  public speaking. The only way to know if you are among the 10-20%  for whom a particular self-help method doesn't work is to try it out  yourself and see what happens. The profession, of course, needs to  research self-help methods much more than it does (Rosen, 1987;  Christensen & Jacobson, 1994), but, in any case, you must research  your own self-help methods and efforts (see understanding #5). You  are a different and unique person.   It may surprise many of you that so little is known with any  certainty about self-help methods. Why is this so? Partly because few  funding agencies and scientists are interested in this area. Also,  because there is a dis-connect between personality and stress  researchers and practitioners who would actually advocate or write  about practical coping techniques. Approximately 14,000 research  articles about "coping behaviors" were published between 1967 and  1999, but this research has yielded very little in the way of practical,  personally useful methods for handling stress (Somerfield & McCrae,  2000). That is very unfortunate. Part of the reason is that academic  researchers tend to look at group differences on a single measure;  that's quicker and easier but very different than observing (within  many individuals) the connections over time between an individual's  use of specific efforts to cope and his/her immediate and long-term  outcomes. Only the latter measures tell us much about how-to-cope.   Fortunately, a meta-analysis review of 40 well designed outcome  studies of self-help treatments has been done (Scogin, Bynum,  Stevens, & Calhoon, 1990). The focus was on written or audiotaped  material used by persons with various problems (bad habits, fears,  depression, poor skills) without regular contact with a therapist or a  teacher--typical self-help material, like this book summarizes. The  overall conclusions were that self-help is clearly more effective than no  treatment at all and just as effective in most cases as treatment  administered by a therapist. Do the results last? One study of  bibliotherapy with depression found the benefits lasted for three years  (Smith, Floyd & Scogin, 1997). These are important and impressive  findings, if they hold up over time, suggesting that self-help can  potentially offer you cheap and effective help. However, much of the  self-help material evaluated by these researchers was written by the  researchers; they may have been biased. Also, Scogin, et al. didn't use  the popular self-help material available in the bookstore. However,  another meta-analysis by Clum and Gould of 34 published self-help  books and videos confirmed that popular material also seemed to be  about as helpful as therapy by professionals. Gould and Clum (1993)  concluded that "self-administered treatments achieve outcomes  comparable to those of therapist-administered treatments." Indeed,  some types of problems and patients benefit more from self-help than  from therapy. Altogether 50 to 100 studies have shown that certain  self-help books or methods have been helpful to certain people with  certain problems; that doesn't mean a specific self-help method will  help you with a specific problem. But it means that self-help isn't  quackery.   | 
| 14 Although having minimal contact with a therapist or a teacher  beyond the self-help readings or tapes did not seem to help much in  the above studies, Rosen (1987) provides evidence that people with  certain problems (premature ejaculation and toilet training) are more  likely to persevere and actually complete a treatment method if a  therapist is continuously encouraging them to use the method and  monitoring their progress, than if the "patients" are left entirely on  their own to apply the method. That's hardly surprising. On the other  hand, there is evidence (Journal of the AMA, 1986) showing that 9 out  of 10 people who quit smoking do it on their own, not in a "program."  Smokers in a program--working with a helper--have a 24% success  rate; self-helpers working alone have a 48% success rate. Maybe the  smokers in a program were more addicted than self-helpers working  on their own. In any case, some people, no doubt, need personal  guidance and encouragement from others. A method could be equally  effective if applied by a therapist or by a self-helper alone, but  obviously the method can not do you any good if you won't use it on  your own. Becoming motivated to change is a critical and little  understood part of changing (see step one in chapter 2 and chapter  4).   Why else do I believe self-help can help you? First, self-help  methods are often based on therapy methods which, in general, have  been shown to be fairly effective (Bergin & Lambert, 1978; Bergin &  Garfield, 1994). Specific treatment methods have been shown to work  dependably with 10 or so specific disorders (DeRubeis & Crits- Christoph, 1998; National Advisory Council, 1995). Second, early  research on self-help suggested that it is more effective and certainly  far more economical than therapy, e.g. with self-reinforcement  (Kazdin, 1975), fears (Barlow & Craske, 1989; Clark, 1973; Marks,  1978), and vocational choice (Graff, 1972). More and more positive  results continue to be reported (Christensen & Jacobson, 1994),  especially when people are encouraged to work on their own towards  self-improvement (Smyrnios & Kirkby, 1993). Third, several college  self-help courses have been considered successful by 70-85% of the  students (Grasha, 1974 ; Berrera and Glasgow, 1973; Ladd, 1973;  Tucker-Ladd, 1994; Rakos and Grodek, 1984; Sherman, 1975).   It has been my experience with over 3000 students, who varied  greatly in the seriousness of their problems, their motivation to learn  or change, and their ability, that about half of the students in one  semester became (or were already) rather effective self-helpers.  Perhaps 10% to 20% devoted 6-8 hours a week to the course (16  weeks) and made remarkable progress, turning in well documented  and impressive reports of self-improvement. At the other extreme,  10% to 20% did very little and appeared to learn little. Almost all  "claimed" to have self-improved, of course. When I did a follow up 1 to  8 years after the course, 69% remembered making progress during  the course, 5% said they didn't make progress, and 23% said "some  progress, maybe." At that time, 1 to 8 years later, 8% of the problems  worked on had gone away, 71% had definitely gotten better, 6% had  not changed, and 5% had gotten worse. A 79% success rate for self- help several years later is pretty good, compared to the generally  | 
| 15 agreed upon 70% improvement rate for psychotherapy. But, keep in  mind that 75% were still "working on it" and 40% expected it to  always be a problem (Tucker-Ladd, 1994). Therefore, while the data is  promising, psychologists pushing self-help or therapy can make no  promises to an individual about curing a specific problem.   Finally, nearly 90% of all therapists consider self-help material  helpful. Between 60% and 88% of professional psychotherapists, who  are in a position to know what helps and what harms, recommend self- help books to their clients, almost 50% do so "often" or "regularly."  Among the therapists who recommend self-help books, 92% to 94%  consider the books to be "sometimes" or "often" helpful. As discussed  in understanding #4, very few or no therapists observed self-help  books doing harm (Starker, 1988).   Has the effectiveness of this book been assessed? No, certainly not  in the sense that every method has been tested for every problem  when used by every kind of person in every circumstance. That will  take decades! Yes, in the sense that this general approach (see  chapter 2) has been used successfully by me in approximately 100  classes over a period of 21 years. Please note, however, that there has  been no objective evaluation of using this book alone; my follow up  evaluation involved college students. My students were in a college  self-help class for credit and also at the same time, as part of the  class, in a paraprofessional-lead mutual helping group (much like a  group of helpful friends). You will notice that I frequently recommend  talking to friends. There is no way to tell, at this point, to what degree  the help came from my class, the readings, or the group. All seemed  helpful.   Reader Feedback about Psychological Self-Help   Psychological Self-Help (PSH) is a 30-year effort and it is still a  work in progress. The book was started in 1970 to serve as an  undergraduate college text for a new psychology course (Psychology  Applied to Personal Adjustment) at Southern Illinois University. From  1974 to 1991, several editions served as the textbook for Mental  Hygiene and for Introduction to Helping (Self-Help) at Eastern Illinois  University. Over 3000 students have taken the 3-hour credit class, and  each participated in a mutual helping group and completed a lengthy,  well documented self-improvement project. By the way, even though  this book gives you far more information than you could possibly get in  any one class, the class/group/text/project combination is, in my  opinion, the preferred way to teach effective self-help. Most of the  students, I'd say 75% to 85%, in those classes and groups made  impressive changes in important areas of their lives. As mentioned  above, the remaining 15% to 25%, as you might expect, threw  something together at the last minute.   Psychological Self-Help has been online at the Mental Help Net  (MHN) site since March, 1997. Dr. John Grohol was the Director of  MHN at that time. Dr. Mark Dombeck is Director now. The book is over  | 
| 16 1,000 typed pages long and cites well over 2,000 references, plus  linking to hundreds of Web sites. Since 1970, PSH has been repeatedly  updated and revised. How much is it read? One can't tell, but during  the last two years, PSH has had about 8,000 visitors per month who  have viewed about 375,000 "pages" per month. That is about  1,500,000 hits per month. That still doesn't tell you much about how  many words are read or how many ideas are grasped.   The main page of PSH provides a feedback form for visitors. I will  give a very brief summary of the feedback. Out of all these visitors  only 272 people have partially or completely submitted responses,  about equal numbers were consumers (74) and professionals or  students (72). The remaining 110 described themselves as "just  wandering the Web." They were asked to list the most interesting  chapter. Each of the 15 chapters were listed about equally often.   About 92% of the people giving feedback rated PSH as  "comprehensive enough," but 7% felt more information was needed in  specific areas. 97% judged PSH to be easily understood (but some  commented they didn't have the time to read and use the  information). On a 5-point Overall Rating scale, 63% rated PSH as a 5- -"one of the best," and 34% rated it a 4--"a very good source." There  were two ratings of 3--"average," one rating of 2--"Not great," and  three ratings of 1--"Well, you tried!"   There is space at the end of the feedback form for comments. Here  is sample of the comments: "excellent source;" "it has helped me;"  "where can I buy the book?" "very supportive;" "persuaded me to seek  therapy;" "led me to great material;" "a detailed and in depth review;"  "my problems are ____(a request for help);" "I'm telling everyone  about PSH;" "I started a S-H group;" "can I duplicate parts of PSH?,"  "can I translate it into my language?," etc.   Of course, this feedback can not be taken as an accurate  assessment of PSH. For one thing it is only 272 responses (between  March, 1997 and 1999) out of almost 100,000 visitors per year. This is  also probably a positively biased sample of readers. Dependable,  useable outcome research would involve careful, complex  measurements of change as well as a comparison with the amount of  change achieved by other matched experimental and/or control groups  in order to identify the causes of the changes. Programmatic studies of  many self-help methods used with hundreds of different kinds of  problems in specific situations need to be done.   Besides the responses via the feedback form, I receive about an  equal number of emails from readers, almost all positive. Some are  touching, such as those who are desperate for help, others who  describe using self-help to turn their lives around, people without  resources who are grateful for the free guidance, spouses and parents  who very much want to help a loved one, former students who share  fond memories of being in the class/groups, and many others.   | 
| 17 I believe some self-help methods can be used by some people to  make some changes in some areas. There is a lot more to learn.   Summary: learning and carefully applying self-help methods  (which isn't just vaguely "trying to change" on your own) seem to be  about as effective for many people as undergoing much more costly  psychotherapy. This may astound many of you, especially those who  are in awe of professionals. The data, thus far, also suggests that  minimally trained "paraprofessionals" are as effective with specific  problems as highly trained therapists with years of experience  (Christensen & Jacobson, 1994; Dawes, 1997). This too is amazing.  Your understanding of these findings may be increased if you know  that two thirds or more of psychotherapy by professional practitioners  is not based on the best and latest scientific research (Sanderson,  2002). Perhaps the self-helper (or paraprofessional) is like a mechanic  in comparison to a physicist or engineer. You can't expect your  mechanic to design and perfect a revolutionary engine or fuel, but you  can expect him/her, and not an expensive engineer, to fix your car.  Perhaps in psychology we are too dependent on scientists and high- paid therapists to fix our minds, our feelings, and everyday  relationships, when we could be seeing trained assistants working  under professional supervision or reading and doing a lot of self- changing ourselves.   Before I leave this "understanding" I want to divorce science-based  psychological self-help from other approaches which may, in ordinary  person's mind, be considered a part of self-help. First, there are  support lists, forums, or boards--some are very beneficial, some are  not. Second, there are several thousand  inspirational/spiritual/motivational books and tapes published every  year--it is mostly "feel good" material, but I seldom review it. I prefer  more specific methods which have an empirical basis. Third, there is  the popular psychology found in many self-help books, on the radio,  on tapes, and on TV. Much of this material is not produced by  outstanding psychologists, but rather by publishers and media  corporations designed to sell books, talk shows, and personalities. I  will review a couple of articles about this type of "self-help."   Are self-help writers generally more snake oil salesmen than  scientists?   In answer to this question, Rosen, Glasgow & Moore (2003) say,  Yes, in many ways and they document that answer in sobering and,  for psychologists, embarrassing ways. First of all, what some writers  call the advice industry is big business: books, tapes, videos,  seminars, coaching, CDs, groups, workshops, etc., are sold for a total  of about $3 billion a year. Most of these educational services have  not been proven to be effective. And they are pushed by  advertisements filled with enticing promises and unsupported praise  from their publishers and other self-help writers. Nona Wilson (2003)  also documents the massive and unfettered-by-facts commercialization  | 
| 18 of self-improvement (via the development of star personalities), such  as by John Gray, Tony Robbins, the Oprah-Dr. Phil team, and many  others. Self-improvement has often been turned into entertainment  and infomercials. Billions have been made off of troubled, hurting  people hoping for help from professionals on TV and radio and in  print.   The real questions are: Is this any way for a discipline, claiming to  be a science, to behave? Is deceptive marketing and over-selling of  products and services beneficial in the long run to the public or to the  helping professions? What happens when the promises are not  fulfilled? Some, no doubt, will seek self-improvement via the next  hot book or workshop by a big name. But, many others may give up  on even authentic professional help, science-based books, and other  established sources of help. Even the esteemed American  Psychological Association, once the bastion of science, has been deeply  involved in publishing and selling unproven tapes, videos, books and  training programs. Who warns or protects the needy-but-unaware-of- the-facts public?   I have to admit that my specialty (healing, growth and prevention  via psychosocial education), as a whole, often looks like it is expending  enormous efforts to make big bucks while almost totally neglecting  to do and advocate outcome research and avoiding informing the  consumer about the sometimes flimsy scientific basis for our products  and services. The two articles I just cited should be required reading  for every real or pretend professional
and for every user of self-help  books, seminars, videos, TV & radio talk shows, and other services.   The above authors present persuasive data to make their points.  For instance, the research done in the heyday of self-help, the 1970s,  was a commendable effort and yielded both positive and negative  findings. In the negative direction, it was reported that many self-help  books were hardly read (Tony Robbins says only 10% of self-help  readers get beyond the first chapter
I doubt if there is any hard data  supporting that.). Even those who read the self-help material often do  not get satisfactory results, certainly not the outcomes promised.  Some studies have reported that 50% of the subjects in a self- administered group (they just read self-help material) didnt  understand or follow the books recommendations. Some researchers  found that some popular books actually upset more readers than were  helped. Studies of other books showed that the written material was  fairly successful when monitored by a therapist or researcher, but  were not successful when self-applied. These authors concluded: all  self-help material, all kinds of readers, and the various conditions  under which the information is read (or heard) need to be researched.  One cant just assume Oh, it will help to read this. [NB: In contrast  with these authors, I have found that books are rarely harmful, but  many books are abandoned early on or just not used much. Books are  usually inexpensive but still not a wise buy if bought because they  have a clever title or misleading ads or if they are not read.]   | 
| 19 Reality is that most self-help books are not published because they  have been objectively shown to be helpful. Instead, the publishers  editor believed it would sell well. Rosen, Glasgow & Moore (2003)  explicitly mention that certain well known writers have published a  new edition, using misleading claims, even after negative empirical  results from the first edition had been reported in the literature. They  conclude that money, in these cases, was clearly more important to  writers and publishers than professional standards. Even when a book  appears to produce desired changes for some readers, the percent of  successful readers was often 50% or much less. So, is this a waste of  time and money for over 50% of the readers? These kinds of data are  relevant to the purchaser but almost never included in the ads. Also,  Ive never seen an ad for a book that says the content is essentially  the same as in 20 or 30 other books
any self-help reader can tell you  there is great redundancy in this literature.   In a survey of all the bibliotherapy books published between 1990  and 1999, Rosen, Glasgow & Moore found only 15 well controlled  studies. The ratio of self-help evaluations to self-help books is tiny.  Again, stated in another way, the data suggest that the time and  professional investment in trying to help AND make money at the  same time is perhaps hundreds of times more than the energy put into  careful, honest research.   The conclusions and recommendations of Rosen, Glasgow &  Moore are sobering: To the reader they say dont take the claims for  a book seriously, unless there is independent empirical evidence.  (They also say dont blame yourself if a book doesnt help you, it may  not be your fault.) To the psychologist or any self-help writer in an  allied discipline, they say the idea of individual professionals giving  psychology away was and is overly optimistic. Thus, the idea that one  person could develop and adequately evaluate a self-help procedure  for a specific problem should be discarded. Instead, self-help should  adopt an objective, programmatic approach, more like public health,  involving (a) several professionals from different disciplines who (b)  undertake a coordinated effort to design science-based self-change  procedures for a specific problem, (c) select a large representative  sample of clients for a clinical trial, (d) carefully educate the users in  how to use the methods, (e) thoroughly evaluate the behavior-change  techniques using a variety of outcome measures, and (f) continuously  improve the self-change system over time before marketing their  product. I say, Amen! Im ready to join a team.   Is the advice industry personally beneficial to some  people? Are infomercials harmful to psychology as a  profession?   Many well trained professional therapists view the advice  industry as a regrettable but unavoidable annoyance. It is an  elephant in the house but most psychologists may try to ignore it.  Nona Wilson (2003) thinks that may be like ignoring a cancer that  could displace the professionals and science. Her argument is that  | 
| 20 once therapeutic skills and knowledge are offered for sale in the  open marketplace, it is tempting to popularize these services within  the entertainment industry, placing them in the hands of advertisers  and corporate investors. In the extreme, the results could be  something like the Jerry Springer Show, capitalizing on sensationalized  sex and relationship problems, or the Oprah Show, a seemingly  sincere and emotional one-hour production involving charming  personalities giving personal, relationship and spiritual advice. Most  observers will realize this is an hour-long smooth, polished commercial  to sell advice and products (books, media personalities, the next show,  etc.). The Oprah Program is certainly a more impressive love-in or  pep-rally type of show than your individual therapist could possibly  produce during a once-a-week one-hour therapy session. Do such  shows distract distressed people from getting professional help? Or,  does Oprah and the products she sells fix problems as well as  therapists? We dont know.   The television talk shows have been defended by many  psychologists, including me, because it was assumed (there was no  proof) that they increased the general publics interest in and  awareness of psychological problems and provided some helpful  information about coping. Indeed, between 1970 and 1990 I thought  TV, like the early Phil Donahue shows, would be the major way to  provide practical, realistic psychosocial knowledge to everyone.  Somewhere things went awry. I still have hopewhat better choice is  there?   Now, Dr. Wilson (2003) argues that popularized and  commercialized pop-psychology degrades and distracts from the basic  scientific psychological methods and treatment. This quietly tolerated  growth industry (we dont know, yet, if it is malignant) has quickly  expanded in 15-20 years to become huge, wealthy, and powerful. And  I agree with her that all this young pop-psychology, but especially the  trash, may have a down-side that could seriously harm its original  sources, i.e. therapists and the science of helping. Both the mental  health professions and the public should stay alert to the dangers. In  the mid-90s there were about 150 shows offering advice each week.  They were popular and profitable, e.g. each Montel Williams show  costs about $50,000 to produce but it earns $400,000. It is estimated  that Oprah has earned about 800 million dollars, largely by offering  psychological advice, support, and motivation. Just because a show  makes money doesnt prove it improves the listeners. But millions  would say they have benefited from Oprahs shows and the books she  recommended.   Even though any knowledgeable viewer can tell the TV shows are  primarily to entertain, hold attention and sell products, rather than to  pass on science-based psychological knowledge, the talk shows (and  self-help books) have certainly influenced millions of peoples ideas  about the nature of mental health, psychological treatment, who are  the experts, and so on. There are many personal opinions about the  content but virtually no objective data about the psychological impact  | 
| 21 of 25 years of talk shows and self-help books. Dr. Wilson suggests that  the primary focus of mass media gurus has shifted from sympathy for  the victim during the 1980s Recovery Movement to critical, scolding,  take responsibility lectures, e.g. Dr. Laura and Dr. Phil, in the 1990s.  She also believes that the players in mass media psychology have  become far more powerfulmore influential with the publicthan the  professional helpers and their disciplines (that the shows take their  material from). I believe that. The tail (entertaining performances some quite elaborate) is wagging the dog (the scientific foundation for  psychological help).   As several communication experts have observed: Watching  emotions and humor seduces us away from hard reality and the  intellect. Emotions appeal to us more than reason. This is well known  by advertisers and TV producers. So, the mass advice industry attracts  viewers with dramatic emotions. Often we are convinced that the  person who expresses emotions and arouses emotions in us is a  genuine, honest, real person who is working towards a solution to  his/her problem. And, Dr. Wilson says the advice industry tries to  persuade the audience that emotions are unquestionably valid and all  one needs to know about a situation or relationship. Emotions and  emotional reasoning are so valued, she says, that pop-psychology  considers personal feelings to be a reasonable way to make decisions  about coping. Consider the advice listen to your inner voice, follow  your heart, and if you feel that way it must be so. Letting emotions  over-ride logic, reason, and knowledge is a dangerous way to go,  hardly in line with established psychology.   Another powerful point made by Dr. Wilson is that the advice  industry (talk shows, call-in radio, self-help books, workshops, etc.)  strives to get everyone involved and thinking alike, e.g. believing there  are one or two major causes for the problem being discussed, such as  domestic violence, unfaithfulness, over-eating, addictions and on and  on. Media advisors try to explain such events in just a few minutes;  there is no time for considering individual differences, backgrounds,  and unique circumstances. To sound profound or to make a quick sale,  the advice-giver also wants to propose a simple solution (usually buy  my book or seminar) which seems believable to many listeners. The  mass media advisor often offers a one-cure-fits-all solution so that all  the listeners can feel they have benefited from the advice. On the  other hand, the thorough individual psychotherapist explores many  different details of the client being treatedthe individuals  background, the disorder, the needs, the circumstances, the stress,  the strengths, the hopes for the future and so on. They see the person  as a unique individual and the treatment is tailored to serve that one  person. In contrast, the media advisor looks for commonality among  us in an effort to interest and serve all the viewers, readers, and  audience. That isnt good advice giving
it is serving some other  purpose.   The advice industry offers not just generalities but also vague  advice, rather than explicitly defined methods. (Often, however, the  | 
| 22 advice giver will say the solution must involve five specific steps, then  the steps are left vague.) Dr. Wilson gives several examples of Dr.  Phils advice: have the courage to change your life, realize you dont  have to get mad, if something is wrong with your relationship its  because you set it up that way, you have to teach people how to  treat you, take personal responsibility, you either get it or you  dont, life is managed, not cured, etc. There is no empirically based  professional knowledge and little clinical acumen in these comments  but Dr. Phil calls his own advice transformative. Id call his advice  mostly showmanship or platitudes (a common comment) or truisms  (so self-evident it doesnt need to be said). Most of these statements  sound a lot like the ordinary Introduction to Psychology student who  thinks she/he has come up with a solution to some psychological  problem simply by stating what the outcome should be (example: Ill  stop procrastinating by studying every night), without any description  whatsoever of exactly how one might actually get from no studying to  studying every night.   This commercialization of psychology causes harm, says Dr.  Wilson. It pretends to offer wisdom but instead offers unoriginal ideas  expressed in an authoritative, pretentious manner. That may sell  books the next day but she thinks it probably lowers interest in  established psychology in the long run. It would be quite possible  and interesting to investigate the consequences of a person becoming  deeply immersed in the advice industry (books, talk shows,  workshops
) in terms of seeking more or less psychological help via  therapy or in terms of respect one has for Clinical Psychologists and  other therapists. Actually, some of the star media advisors, such as  Tony Robbins, are quite hostile towards psychotherapy.   Advertising is critiqued by Dr. Wilson because of its powerful role in  defining the good life. The strategy of advertising is to arouse new  wants and feelings of insecurity and then offer solutions (for a price).  Psychological needs fit well into that scheme (some would call it a  scam), it is pretty easy to make someone want better relationships,  more power, or to feel inadequate or insecure or unsure of how others  feel about them. Advice, like advertising, usually involves selling  something. In talk shows, the entire program is the commercial. Tony  Robbins sold 25 million copies of his book, Personal Power, mostly  through late night infomercialsdo you suppose that was the best  book available between 1990 and 1997? No. Dr. Wilson describes in  detail how Oprah and Dr. Phil teamed up to produce a series of self- promotional shows to sell his books. Dr. Phil interviews people briefly,  and then just as briefly tells them what to do. His advice is not  profound, it is not based on research, and it is similar to what an  overly confident neighbor might tell you. But in the right  circumstances, it can seem impressive. Most practicing psychologists  think giving quick, blunt, over-simplified advice is a poor therapeutic  response.   Psychologists invited to talk shows have been encouraged to be  interesting, clever, and describe brief cases
but to avoid reciting  | 
| 23 boring statistics. Other guests report being encouraged to stir up  excitement by confronting members of the audience; other  professionals report being surprised by attacks on the show from other  hostile guests who were clearly invited by the shows producers. Does  this sound more like entertainment or sharing professional knowledge  and expertise?   Dr. Wilson observes that professionals who havent had the luck to  make their fortune by getting on a TV talk show are often encouraged  to develop their own Web site. This, too, may encourage advertising  and seem to underscore the commercial aspects of the helping  professions, especially if the Web site implies Im a better therapist  than other online therapists. She again uses John Gray, who has a  correspondence school doctorate and no license to practice, as an  example of commercialism gone amuck. Gray has developed, in  addition to his books, an expensive training program for counselors,  Counseling Centers for the counselors to work in, a pyramid system to  sell his various books and games, a Web site to sell romantic  accessories, including lingerie, and several major efforts with  publishers to sell his books. In terms of advertising, when I started  practicing psychology in 1960, it was acceptable to publish in a local  paper a small formal announcement about your opening an office. Any  other advertisement was frowned upon. Things have changed
for the  better?   Wilson contends that whenever professionals enter the  marketplace, perhaps selling a book, therapy, a group, or other  service, they experience pressures to impress others as well as be  entertaining. They are also likely to feel some temptations to make  overly optimistic promises, use testimonials (which are not scientific or  objective), and approve blatantly misleading ads. These kinds of  enticements tend to sabotage the integrity of professional service and  research. Professional helpers need to guard against being influenced  by the advice industry. Some psychologists have insisted that their  publisher tone down the advertisements.   Lastly, there is to me one more special irony in the current  situation. By dealing with psychological content--personal and  interpersonal problemsTV and radio talk shows, workshops and self- help books have become very popular and made enormous profits.  Clearly, the general public has enthusiastically welcomed dealing  publicly with these topics, giving their time and their money. Yet,  during the same 20-30 years, there has been almost no public support  for meaningfully teaching practical how-to-cope psychological  information in our public schools and colleges. Likewise, there has  been no support for psychosocial education coming from mental health  professionals, university faculties, or public school officials. This  contrast seems strange; why might this be?   Why dont we want realistic, practical psychology in schools?  Probably for several reasons, depending on the impact these changes  would have on ones own career or role. But I believe Dr. Wilsons  | 
| 24 analysis of the advice industry suggests another major barrier to  change. If a psychological or interpersonal helper had a chance to be  interviewed or to go on TV or radio, this would be appealing to many  because it could yield several benefits, such as improve his/her  reputation, result in more sales, 15 minutes of fame, status, and  others. In addition, the professional would have little to lose as long as  he/she doesnt make some embarrassing mistake. Such a guest would  not be assuming any grave professional or legal responsibilities, even  if they interviewed someone on the air for a few minutes and gave  some simple advice. Contrast this situation to the psychologist who  agrees to teach a small, daily, year-long, personally useful, skills- oriented psychology self-help class to a small, intimate group of High  School juniors. This would deal with each students immediate  concerns and with preparing for the future. Wow! That could be scary  for the teacher. It would be an awesome responsibility requiring a high  level of skills, hard work, devotion to every student, and perhaps  involving some legal risks because it would be so intimate an  involvement in the students lives. That might be why psychology  classes are not proposed. Yet, if you, as the teacher, had a truly  significant impact on each students life, you would surely feel proud  and deeply gratified. And the world might benefit. [End of lecture. (:-)]   It seems fairly safe to conclude that the meteoric rise of  psychological topics and advice in the media is not due to great  writers, creative producers of the shows, self-help literature of proven  effectiveness, astonishing methods displayed by media advisors, or  due to support from professionals in psychology. The popularity and  the profitability of the advice industry are surely attributable to the  commercial drive of corporate Americathe nearsighted drive to be as  profitable as possible. As yet, we have opinions but no data to indicate  if the advice industry has, on balance, advanced or harmed the helping  professions
or, more importantly, if all this advice has helped the  general public to grow and cope better or not. This lack of adequate  research is what I would underscore.  Understanding 3: I prefer to be honest with you about the effectiveness of  self-help methods. I'm not going to "talk up" a method or try to "sell" you a  product; I'm trying to get you to learn and to think for yourself. Also, I don't  want to deceive you by implying that understanding or changing human  behavior is simple or always possible.   Most popular psychology books emphasize how fantastic their  methods are and how much they can help you. In this way, popular  writers use the "power of suggestion" to increase the effectiveness of  their methods or ideas and/or to increase their sales. This works.  Instead, I choose to tell you, as best as I can, the results of my  experience and the limited research evaluating each self-help method  (if any). Hopefully, you will take a realistic attitude and say, "I want to  know the research findings--or lack thereof--as well as see how well  this method works for me." Your faith in self-help should eventually be  based on your own experience, not on research alone and certainly not  on this book or, even worse, on some unfounded claim by an  | 
|  25 ostentatious writer. (Don't misunderstand me, research is the best  basis for "knowing" about the general effectiveness of some method,  followed by the opinion of a practitioner with lots of experience.  Eventually, your own experience with the method in question may  dominate your evaluation of its effectiveness in your situation.)   Some popular writers even tell you that it is simple to achieve  some major change in your life (like stopping smoking with one  hypnotic session or "getting rich" by having a "positive mental  attitude"). Simple solutions may sometimes work but that doesn't  prove that human behavior is simple. There is probably a wish for  things to be simple. However, you will be more accurate, in my  opinion, if you assume that humans are very complicated. Most people  have no conception how complex the psychological world really is. This  over-simplification may account for astrology, for a belief that a  weekend workshop will solve marital problems, for the hope that a few  hours with a psychologist or psychiatrist will overcome depression, for  the incredible sale of one diet book after another, etc.   Hope Springs Eternal...that's good but watch out for false  hopes.   Hope springs eternal in the human breast;   Man never Is, but always To be blest:   The soul, uneasy and confin'd from home,   Rests and expatiates in a life to come.   -Alexander Pope, An Essay on Man, Epistle I, 1733   In spite of repeated failures, people often try to make the same  self-improvement over and over again. The fact is that most self- change efforts fail, especially in the areas of eating, smoking, drinking,  gambling, poor study habits, New Year's resolutions, etc. Many people  have failed many times on the same project. Yet, people keep trying.  Why? Is it just human nature to have hopes, even unrealistic ones, for  things to be better?   Polivy and Herman (2002) try to explain what they call the "False  Hope Syndrome," a sequence of hoping for self-improvement, trying  some change method for a while, then relapsing and experiencing a  disappointing outcome, analyzing the reasons for their failure, and  eventually deciding to make a new effort to change (even though the  person has not learned much more about self-change techniques).  These authors start their analysis by asking "Why do self-change  efforts fail?" Their answers: we tend to start with unrealistic  expectations, namely, big, fast, easy, far-reaching changes. The goals  | 
| 26 are too high, so we fail. We run out of energy. We start to back slide.  We could have set lower goals but we don't. The fact is self-change,  especially big, fast, easy change, is usually far harder than we imagine  (hope?).   Then Polivy and Herman ask "How does defeat get turned into  some new hope?" Sometimes the self-helper, who has failed,  concludes "I didn't try hard enough" or "I didn't have the  time/energy." Of course, one could always try harder or give more  time; thus, there is reason to try to change again. Or one can conclude  "the diet didn't work" or "that self-help technique wasn't right for me"  (the failure wasn't my fault!). Of course, there are thousands of other  diets, many other techniques, more promising programs to buy,  hundreds of new self-help books; thus, you find another basis for  trying again.   "Why do people try again and again?" The same hoped for rewards  are still there. Often the previous attempt did produce some success at  first--that memory of success motivates us to try again. Just making a  commitment to try again is reinforcing, helps us feel in control, and  gives us hope. Overconfidence is, in part, ignoring the reality of our  past failures so we can believe we will succeed next time. However,  the repeated starting and stopping of self-change efforts--the yo- yoing--takes a toll, sometimes the tasks are unpleasant (like dieting)  and certainly the failures are frustrating and may make us self-critical.  So, for some people, this repeated failure may take a toll on our self- esteem.   On average, it takes 5 or 6 tries to make most self-improvements.  But repeated tries doesn't guarantee eventual success. If you have  had several failures and have seen little evidence that the desired  change is actually possible, consider (a) lowering your goals--settle for  less or a slower pace--or (b) revising your self-change methods so  your self-change plans are scientifically more sound. Eventually, it is  wise to face the fact that you don't know how to change at this time,  accept that reality, and set about learning what you need to know to  change. No need to be a victim of your own false (unrealistic) hopes.   Rather than viewing the common repetitive urge to try to change  as a problem and serious human failing, as Polivy & Herman seem to  do, I choose to see this dogged perseverance as beneficial overall and  probably an important element in human evolutionary survival. The  problem isn't so much foolishly taking on impossible self-change tasks,  but rather neglecting to gain the knowledge needed to know how to  make the desired changes before launching another self-improvement  project. Getting this knowledge is often admittedly very difficult...our  ignorance is a challenging barrier.   I recently read an example of life's awesome complexity (Fischhoff,  1992). I'll share it with you. It should make you question quick, simple  solutions for and advice about almost any human problem.  Researchers have gathered ideas for preventing or handling a rape.  | 
| 27 They have collected 1,100 strategies! Thus far, there have been only  24 studies evaluating the effectiveness of any of those strategies (like  do something crude, such as vomit, or try to get him to see you as a  human). Only 1, 075 strategies to go! Of course, beyond strategy,  would be other considerations, such as rapist's strength, woman's self- defense skills, presence of others nearby, etc. My points are: we are  incredibly ignorant about handling rape (there is almost no general  advice we can give at this time); we are not doing nearly as much  research as we should; the sexual assault situation is very complex;  watch out for over-confident, self-appointed "experts;" question  anyone giving the same advice to everyone; and listen to ordinary  people as well as "experts." These same points probably apply to 1000  other problem situations in which humans find themselves, including  the problems you face.   In short, I refuse to lie and over-simplify life, and I refuse to  pretend I know it all (or that science does). There is still some help  available, however. Indeed, one recent "self-improvement" book  (Seligman, 1994) emphasizes which problems can be treated  effectively and which can not. (Can be changed=panic disorders,  phobias, anxiety, depression, certain sexual problems, pessimism, etc.  Often can't change=over-weight, addictions, homosexuality, serious  personality problems, psychosis, post-traumatic stress disorders, etc.)  Keep in mind that Seligman is primarily talking about the effectiveness  of changing by going to see a therapist, which is being carefully  evaluated. Science has not evaluated the effectiveness of self-help  methods in many of these areas yet.   Understanding 4: Any therapist or self-help method may do harm. Reading  and self-help seem to rarely do damage. Note: pessimism and the fear of  trying to help yourself, resulting in your doing nothing, cause much more  harm than any self-help method.   Halliday (1991) asked persons on their first visit to a  psychotherapy clinic if they had tried psychological self-help books.  Forty-three out of 100 said "yes." Of these 43, 37 (86%) said they  benefited from their readings, 5 didn't get any benefit or harm, and 4  experienced some harm or distress. Of these 4, three got a mixture of  benefit and harm, but the remaining one became upset by descriptions  of child abuse and simply stopped reading. Two more people reported  being upset by reading--one by a medical book and one by religious  literature. It seems fairly certain that reading psychological self-help  does less harm than undertaking psychotherapy (although see the  caution below). But, keep in mind that the effectiveness of very few  self-help books has ever been assessed.   Of course, reading something which uncovers a problem you hadn't  realized before would be stressful. But, would you be better off not  knowing? Certainly, it can be scary to try out some self-help methods,  such as exposing yourself to a feared or a stressful situation. Talking  to another person or a group about a problem may be hard, although  the end results are usually beneficial. These uncomfortable situations  | 
| 28 associated with gaining awareness or with working hard to learn new  skills may be a necessary part of growing. No one promised you that  life would be easy.   It is possible that trying to help yourself and failing to do so could  cause problems. For example, it harms your body to go on diet after  diet, losing a few pounds each time and gaining them back in a few  weeks. Failure at efforts to solve interpersonal problems may worsen  the conflicts. Repeated failure at self-helping would surely be  depressing and may lower your faith in yourself, in self-help methods,  and in therapy (Rosen, 1987). Repeated success might yield the  opposite positive effects.   Research has shown that individual and group psychotherapy do  harm (relative to no treatment) in about 5-10% of therapy cases  (Bergin, 1975; Bergin and Lambert, 1978; Mays and Franks, 1985). In  therapy, the harm seems to frequently be done by the critical,  probing, hostile personality of the therapist, not by the treatment  method itself. Since self-help does not involve a critical, pushy  therapist, perhaps it is not as harmful as therapy. But it is probably  harmful in ways we just don't know about yet. Popular psychology  books, like the ones available at your local library or bookstore, have  been criticized, however, because (1) the reader may misdiagnose or  not realize that he or she has a serious problem and, thus, may not  seek appropriate help. Of course, attempting to relax to cure a  headache caused by a fast growing tumor is foolish. That's why, in a  case like this, you must seek professional help right away. Regardless  of the problem, if self-help doesn't work, get help! (2) As discussed  above, a therapist may be needed before some people can change or  correctly use a method. (3) Many self-help authors may promise much  more than they can deliver. This harms by raising false hopes. (4)  Self-help books sometimes encourage self-centeredness, i.e. only  taking care of your self, not others. (5) Supposedly, "a little knowledge  is dangerous" (Barkas, 1977; Levin, 1975). But how often is having a  little accurate knowledge more dangerous than having even less  knowledge? These may be valid faults; they haven't been thoroughly  researched yet.   I tend to agree with the above criticisms, except for point (5)  above, as you can tell from my question. There is also an old adage,  "The doctor who treats himself has a fool for a client." But, in this  case, we all have to be self-helpers! Of course, we should seek help  when we are ineffective self-helpers. Some people have feared that  self-helpers will not seek professional help when it is needed. Early in  our work, this was a concern. But, research does not support this fear;  in fact, students in self-help classes seek counseling more often than  other students (Rasche, 1974). Other people worry that self-helpers  will attempt to treat others. There is no evidence for this either. In  fact, an experienced self-helper would be more aware of his or her  limitations, know how hard it is to change, will respect professionals,  and encourage others to be self-directed or get professional treatment.   | 
| 29 An important final word of caution   There is one small area where harm may be especially likely.  Beware of anyone who tries hard to persuade you that you have been  sexually abused but you have repressed it. This action by  therapists/writers has generated a heated controversy. Many  therapists believe that certain psychological problems, such as bulimia,  multiple personality, and a variety of fears and personality traits, may  be caused by child sexual abuse or incest (Loftus, 1993). The problem  occurs when the assumed "victim" doesn't remember any sexual abuse  (most abused people do have some memories), but a therapist, group,  or writer strongly believes that remembering the sexual experiences in  detail is crucial for the victim's recovery. The therapist/writer may  attempt to uncover the incest or sexual abuse experiences, using a  variety of methods, such as hypnosis, age regression, visualization,  dreams, or simply "try to remember being molested" (Tavris, 1993;  Wright, 1994). Given just brief encouragement and suggestions,  however, some clients/readers will start to falsely "remember"  incidents, sometimes ones that took place when they were less than  one year old (when as adults we have no memories) and sometimes  fervently believing really wild bizarre experiences. Research has shown  that memories often distort reality and can be easily influenced by  others. So implanting a memory of sexual abuse may not be hard to  do in suggestible people, but a false accusation of child molestation is  a devastating charge, likely to result in a long prison sentence and  destruction of a family (plus more emotional stress for the victim).  Therefore, until we know more about the causes of specific emotional  problems, helpers and writers will have to carefully avoid vigorously  implanting these destructive ideas. You will occasionally find warnings  about specific books in this book.   In my experience, self-help readings and methods are often not  acted upon (and, thus, don't do any good), but only in very rare  circumstances do they cause lasting harm. A temporary disturbance  from reading, usually worry about some "illness" or some self- dissatisfaction, rarely lasts more than a few days (and often results in  self-improvement). On the other hand, both the exaggerated-but- debilitating fear of harming yourself (by trying to self-help) and the  self-defeating feelings of helplessness cause great harm in many lives  because these feelings obstruct our attempts to change. Learn as  much as you can about self-help, and then do something! If you don't  get the results you want, try something different or get professional  help.   Understanding 5: It may be difficult to measure changes in your  adjustment, but you should try. Objective measurement is necessary for  honest evaluation. Every self-helper should try to be his/her own  researcher.   We all live life alone in many ways, even when intimate with  someone else. For example, married couples talk on the average only  20 minutes per day (often much less); long-term therapy, costing  | 
|  30 $7500+, is only 100 hours or so; a self-help course is 150-200 hours;  but life is over 600,000 hours. No scientist studies your life. No one  knows as much about your life as you do. Thus, you are not only your  own therapist, you are your own researcher. Mahoney (1975)  advocates training students to be "personal scientists." The task is to  find out what self-help methods work for you; that is research!   Science is simply common sense at its best.  One thing to guard against is the tendency (wishful thinking?) to  believe that "things are getting better." Double check your optimistic  subjective impressions by objectively measuring your progress while  trying to self improve. Chapter 2 tells you how to know if you are  really making progress or wasting time. This evaluation of your efforts  is important but not easy, especially if you try, like a good scientist, to  find out if the self-help method is really helping or if some other factor  is responsible for the changes. Such a determination requires you to  record daily or even hourly your efforts to cope and the results of  those efforts (see steps 2 and 7 in chapter 2).  Understanding 6: Honestly looking at ourselves and changing may be  stressful, but we need to do it.   It is often comfortable and easy to stay the way we are. Changing  may be gratifying or stressful and is frequently both. Temporary stress  is a natural, necessary part of recognizing a weakness or feeling we  had previously hidden from ourselves, trying out a new behavior,  facing a fear, releasing a pent-up emotion, and changing. Growing as a  person may take you to new places, provide new challenges, require  leaving old and acquiring new friends, etc. Giving up an old security  blanket is scary; yet, many therapists, based on their experiences,  believe that crises frequently lead to important improvement and  growth in our lives. So, some stress is good and/or can be used to  advantage. Understanding 7: Do not hesitate to work on your most serious, meaningful,  and intimate problems.   Self-help is not just for simple behavioral changes, like nail biting  or working harder. You are encouraged to work on any deeper  problems that you may have, too. Examples of these would be  excessive self-criticism and feelings of inadequacy, fear of intimacy  and jealousy, lack of purpose in life, irritation with others, sexual  concerns, and others. Granted, you may want to do some easier  projects first, but don't procrastinate with the tough problems. Self- help must pay off in meaningful ways for you to keep trying.   | 
| 31 This understanding is not to exclude simple self-improvement  efforts. At this point in your life, it may be more important for you to  strive for further improvement in areas where you are already doing  okay. A good socializer can become a more intimate and helpful friend.  A pretty good student can become a true scholar. A morally good  person can become a moral leader, who encourages others by  example to become a genuine, caring Candy Striper, Big Sister, or  Hospital Volunteer. Your "problem" at this time may not be serious,  like suicidal depression, but rather to become the best person you can  possibly be. Both are important "projects." Prevention of problems is  important too.   Understanding 8: Becoming a good self-helper will probably require a lot of  time and effort. You should prepare for problems in advance. It is a life-long  task.   You may feel overwhelmed and discouraged when you realize all  there is to learn about self-help, all the books that have been written.  Certain of your problems may have existed so long that it seems  impossible to change them. The idea that changing may require daily,  even hourly, attention could seem like "too much trouble." Many  attempts to change ourselves fail because the old habits seem so  strong; indeed, change may be a long, uphill battle. Expecting some  failures may help you deal with them.   Many of our attempts to change ourselves fail because we are  unwilling to put in the time and effort necessary. Our entire culture  expects quick, easy solutions. Related to this is my experience that  many students do not understand a treatment or self-help method  after reading it the first time. It is not because the methods are too  complex to be understood but because many people are newcomers to  "self-help" and others are careless readers and in a hurry. They think  they understand, but they often need to read it again and discuss it  with someone else. This takes time.   Moreover, as mentioned earlier, much of popular, self-help  psychology is remedial, not preventive. That's too bad. Too many  people only read about marital problems after divorce is threatened.  Too many people read about depression after feeling suicidal. Too  many people change their diet after a heart attack. The best time to  learn to swim is before falling overboard, not afterwards. Try to  anticipate and prepare for problems. Try to prevent problems, nip  them in the bud. Therefore, you should read about possible problems  as well as about pressing problems.   All I can say is: learn as much as you can, keep trying different  approaches until you succeed. Don't be so discouraged by failure that  you give up (you have learned something from failing: namely, what  doesn't work for you with this problem at this time). Think of yourself  as continuously learning to be a better person; try to generate high  enthusiasm for self-improvement; resolve that you will overcome the  obstacles in your way.   | 
| 32 Understanding 9: Don't wait for magical solutions. DO SOMETHING to help  yourself. Be strong! Confront any resistance to change and challenge all  your defeatist attitudes. Learn to believe you can change things.   There are many reasons why people avoid change--fears, lack of  motivation, resentment of pressure, helpless feelings, procrastination,  wanting to fail and/or avoid responsibility, wanting to live  spontaneously without planned change, wanting sympathy and to be  taken care of, feeling that it's too much trouble to change, pride and  stubbornness, being willing to accept our own rationalizations ("it runs  in my family"), being inflexible and "set in our ways," feeling that we  are not okay and deserve to be miserable, and other motives.   It may be hard to understand your reasons for avoiding change if  you are a procrastinator, but remember, there are reasons for  everything (the procrastinator should read chapter 4). Look for your  reasons (it's likely to be several reasons). For example, shyness may  enable you to avoid the stress of socializing; being irresponsible may  get other people "off your back" since they are likely to stop expecting  you to be a mature, capable, dependable person (see chapter 4).   If you decide some self-improvement is especially important but  haven't made plans for changing within a day or two, then focus on  the reasons for your inactivity. If you can't be sure of the reason(s),  then guess at it. Try to deal with the possible resistance to change like  any other problem, i.e. develop a plan of attack by analyzing your  resistance to change as well as the problem itself, as described in  chapter 2. There is good reason to believe that self-help techniques  aren't remembered and used unless the person believes he/she is able  to change him/herself. Question the validity of your pessimism. And,  people who have failed to change in the past won't believe they can  change until they have drafted a good plan and done it. So, give it a  try.   Practice thinking positively about your ability to change; be strong  and do things to prove your self-help skills; daydream frequently  about how nice it will be after you change (see chapter 14). Likewise,  face up to the bad consequences of not changing; don't give excuses  and let yourself "off easy;" refuse to accept weakness, helplessness,  and self-defeating attitudes. As Epictetus said 2000 years ago, "No  man is free who is not master of himself."  Understanding 10: This book does not prepare you to be a therapist. Help  others, but don't take control and "treat" others.   While I want to urge and help you to take responsibility for your  own life, I want to persuade you not to take charge of anyone else's  life. It is important to distinguish between what might be called  "helping" and "treating." A "helper" may listen and give empathy,  suggestions, encouragement, feedback, care, and share his/her  experiences, plus many other things, but both helper and helpee  should always realize that the helpee must make the decisions, be  | 
| 33 responsible for applying the self-help methods, and "live with" the  outcome.   A "treater," such as a surgeon, is highly trained and usually takes  responsibility for diagnosing the problem and assumes full control in  the operating room because the patient can't help him/herself in that  situation. You have not had the years of training and supervision  necessary to become a competent therapist to someone else. If you  feel that a friend of yours is allowing or asking you to take charge and  tell him/her what to do or to make him/her feel better, please refuse  to do so. Tell your friend that he/she must make the decisions, take  the action, and assume the responsibility (no matter how much you  would like to be a hero and save him/her). If the friend is unable or  refuses to handle his or her own problems and needs someone to take  over, please insist that your friend to seek professional help (and stay  only a friend, not a second competing therapist).   On the other hand, I want to make it clear that it is great to help  friends and to receive help from them. The world would be a healthier  and more beautiful place if all of us helped each other. But that  "helping" never includes taking over their life. Mutual helping or  support groups are wonderful opportunities to help and be helped (see  chapter 5 and Gartner and Riessman, 1984).   Understanding 11: If your problem(s) could be caused by physical-chemical  factors, see a physician first.   Certain physical conditions, such as low blood sugar or  hyperthyroidism, can cause symptoms that seem to be psychological,  such as fears, nervousness, irritability, depression, etc. Likewise,  psychological factors can cause physical symptoms, like exhaustion,  paralysis, pain, nausea, baldness, headaches, backaches, skin rashes,  sleeplessness, impotence, high blood pressure, etc.   Probably, physical, chemical, and constitutional factors play a role  in almost all personal-emotional problems. A psychologist or social  worker cannot deal with the physical causes; you must consult a  physician if your problems are possibly physical and not psychological  or interpersonal (see step 1 in chapter 2).   Understanding 12: When your problems are severe and/or your self help  efforts are ineffective, seek professional help immediately.   While knowledge of self-help may prevent or relieve many  problems, there are certain situations in every life where outside help  is necessary. Self-help is like first-aid; so, if you need surgery, don't  use band-aids, see a surgeon right away! What are some of the  psychological situations that call for professional help? When one is so  depressed that there are thoughts of suicide, when one's thoughts are  confused or unreasonable, when a person experiences urges to hurt  someone, when feelings towards other people are very strong (so that  one is not likely to be thinking straight), and when someone has tried  | 
| 34 and tried to help him/herself but nothing seems to work. Usually when  your psychological problems are quite serious, you will need therapy,  medication, a support group, and self-help. Get what you need.   Furthermore, if anyone earnestly suggests that you seek  professional help, take their advice even if you don't understand why  or don't agree with them. Never be embarrassed about seeking help;  why should you expect yourself to know everything about psychology,  any more than you would expect yourself to know calculus or how to  repair a TV set? Indeed, what is really foolish is to need help but  decide not to get it. Research has clearly shown psychotherapy to be  helpful 2/3rds or 3/4ths of the time. Don't let your own lack of  knowledge or fear of what might happen or concern about "what  people will think" keep you from getting help whenever you need it.   See the section in chapter 2 about Finding a Therapist. Make your  selection of a therapist carefully by getting recommendations from  people who know and by checking his/her training and credentials. It  pays to know a lot about psychotherapy, the training of therapists, the  types of therapy and which are most effective with different problems,  the cost of different approaches, etc. Several links cited there provide  the information you may need.   Understanding 13: This book cannot meet all your needs.   The highly self-controlled person needs more than a bunch of self- change techniques. He/she must pick his/her own values and goals,  set his/her priorities. He/she must have insight into him/herself and an  accurate view of the world. He/she needs companionship, acceptance,  and love.   None of us can solve all our problems by ourselves, no matter how  well informed we are about self-help methods. This book, plus  hundreds of others, can suggest many effective methods and even  "care for you from a distance," but you may need specific feedback to  identify your specific problems, confrontation about some foolish idea  you have, warm approval and support when your confidence lags, or  someone to take you to a hospital. This book can't give you individual  attention or a hug or a shoulder to cry on, in times of stress. I wish I  could, but those things must come from a caring person near by, such  as a friend, a relative, or a teacher. Getting and giving care are both  highly therapeutic. You will have to reach out to others and when you  do--please be very explicit about what you need. Most people want to  help others and benefit from helping.   Understandings for groups and classes: Be clear about the purposes of your  group, know how you can contribute, maintain confidentiality, and help  others feel safe. Be sure you understand the reasons for the requirements  of your group.  Many students tell me they learn more from small group  discussions than from reading books and classroom presentations. I'm  | 
|  35 sure that is true for some. We all have our favorite ways to learn.  Mutual helping groups are interesting but require work--dedication to a  purpose, self-disclosure, an eagerness to listen, learn, think, accept  and help others. Every person must be willing, after getting to know  each other well, to openly share his/her problems and positive or  negative feelings, to learn and use good communication skills, and so  on. In a good helping group, the payoffs are great: you learn from  others' lives, from their successes and failures. You gain useful skills.  You profit from the helpful ideas and honest feedback of 8-12 other  people. You also get the warm feelings and insights that come from  helping others.   Be sure the rules of confidentiality adopted by the group are clear  and accepted by everyone. Insist on it. Be sure that everyone in the  group or class knows that they don't have to answer any question if  they don't want to. Accept your share of the responsibility for making  the group a meaningful experience; that usually means sharing your  experiences and your deepest concerns at the moment. Be gentle and  empathic with everyone in your group at all times, no matter what  they disclose. See the discussion in chapter 5 of self-help and support  groups for handling all kinds of stress and unwanted behaviors.   All these understandings are to prepare you for making maximum  use of this book and to introduce you to the ideas of self-help, mutual- aid, and psycho-social education.   The Psycho-Social Educational Approach  Why haven't psychological techniques for managing and improving  our lives been more vigorously developed and taught to everyone? If  self-help is occurring in every life almost all the time, improving our  self-help ability and efforts seems like such a sensible idea. Strangely  enough, the methods of self-direction, self-control, and other forms of  self-help have never been organized and taught as a distinct part of  our family, educational, religious, informational, or social systems.  Let's consider for a moment why self-help knowledge might be  neglected. Why is self-help an orphan, apparently not wanted as a  whole, integrated discipline by any social institution? Why would  anyone or any group conspire to keep suffering people from getting  useful information?   First of all, in spite of all our "fascination with people," we humans  have resisted studying ourselves psychologically and scientifically. As  Francis Bacon said, "Man prefers to believe what he prefers to be  | 
| 36 true." We like having a grandiose view of ourselves. For instance, one  of the last sciences to develop was psychology; that was only 100  years ago. About 450 years ago, Copernicus almost lost his head for  suggesting that man and earth were not at the center of the universe.  About 150 years ago, Darwin suggested humans evolved along with  other living things. That idea is still bitterly opposed by some religions.  About 100 years ago, Freud suggested that we humans aren't even in  conscious control of ourselves, unconscious forces really determine  what we do. Unconscious factors are still denied by many people.  Humans are prone to oppose anything that lessens their greatness,  superiority, power, or importance. Thus, we as a species may even  resist the idea that anyone (or anything less than God) is needed to  help us cope better with our lives.   Most of us don't like the idea that living optimally requires work.  Look at it this way. If each one of us is attempting to mentally cope  with some concern or task almost every moment of our life, in the  course of a lifetime every person will deal with millions of unique  situations and thousands of different kinds of problems. Every day  there are probably several situations in which you think: "I'd like to do  that better." That's real life. Sometime during your life you will  probably face almost every kind of human difficulty. In this sense,  intelligent living is complex and a lot of trouble. On the other hand,  many, many other people before you have faced the same concerns.  Therefore, given the right flow of information, you could benefit  greatly from the experience of others and from some advanced  preparation to face a wide variety of predicaments. As a species, we  seem more inclined to say "Oh, it won't happen to me" than to do our  preventative homework.   Ideally, each of us would have in our heads a readily available,  comprehensive self-help system for solving many kinds of problems.  Such a system would be based on a sound general understanding of  behavior and relationships, i.e. a science of coping. Much knowledge is  already available. Wise people have gathered wisdom for thousands of  years. In addition, during the last 100 years, psychology has learned  much that is new as well as confirmed many of the beliefs of wise  people. There is a rough consensus about how to best handle many  situations. Self-change methods (which are essentially the same as  therapy techniques) have been shown to be effective with a very wide  variety of problems. We have many such methods. We don't need to  invent the wheel every time an ordinary problem comes up. But we  haven't yet learned how to systematically pass this information along  to everyone.   Twenty-five years ago, I thought self-help books, informative TV  talk shows, and personally useful Psychology classes taught in schools  would have "given psychology away" by now. I assumed that by the  year 2000 almost everyone in this country would be a skillful self- helper (in terms of understanding and managing their own lives) . The  truth is the general public, I suspect, has made very little progress in  acquiring useful psychology. Let's see if we can understand why self- | 
| 37 instruction--the most cost effective source of help--has been neglected  or mishandled, while expensive and questionable sources of help have  flourished, such as individual psychotherapy, psychiatric drug  prescriptions, chiropractors, faith healing, astrology, mystical  channeling or past lives therapy, illegal drugs for pleasure, etc.  The publishing business and self-help books   The first thing you need to know is that, unlike drugs, self-help  trade books (mass market books in local bookstores) are not "tested  for effectiveness." These books, even those written by journalists and  free lance writers, aren't even reviewed by psychological experts for  accuracy, effectiveness, or dangerousness of the ideas. Instead, the  publishers seek books that seem likely to sell because the topic is  "hot" or the book has an attractive "gimmick." The largest publishers  require that writers have a literary agent before they will even  consider a manuscript. Thus, it is these agents who really select the  books for the big New York publishers. Agents ask "will it sell," not  "will it help?" Later, if the book is printed, the publisher's sales  representatives have only seconds (maybe a single sentence) to sell a  book to big bookstore buyers (there are 50,000 new books every  year). By contrast, professional books, like college textbooks or books  for psychotherapists, which you won't find in the usual bookstore, are  very carefully reviewed by several highly respected professionals  (because no teacher would use a textbook with glaring errors). With  self-help books (almost all are trade books) the attitude is "let the  buyer beware." Selecting a highly advertised "best seller" tells you  almost nothing about the scientific quality of the book. In fact, only  about half of the so-called "best sellers" are considered good books by  mental health professionals (Santrock, Minnett, & Campbell, 1944).  Publishing a self-help book is not a highly scientific process.   Next, you need to realize that more than 2,000 self-help books are  published each year. So, over the last 25 years more than 20,000 such  books (maybe 40-50,000) have been pushed by bookstores. That  sounds like a very commendable effort to help you, but the question  is: What is the main motivation of many publishers, helping the  suffering or making money? No doubt, some care; most are more  concerned with making money (yet, supposedly 75% of published  books lose money). Many new books merely repeat what has already  been written. It is also not unfair to point out that several  psychologists have complained that their own book publishers have  made exaggerated claims. Do you suppose these untrue  advertisements are for benefiting people in crisis or for profits? Did  you ever see a publisher recommend that you look up his/her best  books at the library?   Publishers seem to believe that people will not try to generally self- improve or prevent problems. We readers are assumed to be so stupid  that we will only seek help after we are in trouble. Therefore, the self- help book industry publishes books about specific, serious crises which  will drive us (while in distress) to buy their books. Fortunately, many  | 
| 38 of those books are written by experienced professionals and are quite  helpful. However, truly effective self-help education should emphasize  early detection of problems and prevention, as well as crisis  intervention. Prevention is sorely neglected (discussed later).   What are other consequences of primarily publishing specialized  (one topic), crisis-oriented books? For one thing it may discourage the  ordinary person from reading self-help books. If self-help books  become associated with weird problems and serious crises (such as  depression, addictions, abuse, divorce, etc.), it might strengthen our  belief, as long as we are coping barely adequately, that "I don't need  to know or think more about psychological coping unless I have a real  serious problem." That's wrong but it fits with our desire to feel  capable. (Note that talk shows have become so associated with rare  and bizarre behavior that many people have lost interest and become  scornful, feeling the talk show topics are weird and unrelated to them.)   There are other problems related to the emphasis on thousands of  books with a very limited scope. Examples: Could such books be used  in a group or class where people have many kinds of problems? No.  Will reading one specialized self-help book give you general knowledge  which you can apply to different kinds of problems? Probably not  much. When you are having serious problems, are the difficulties  usually limited to just one area? No. Is it common to buy a book for a  specific problem and soon discover that you don't really have that  problem? Yes (perhaps that is partly why 90% of self-help books never  get read beyond the first chapter). Is it reasonable for every specific  problem to require its own self-help books? No, although that would  sell more books, wouldn't it? Do the thousands of unique problems  require thousands of different methods for coping? No. This is an  important point; let's look at it more closely.   There are only 15-20 self-help methods for changing our own  behavior, no matter what problem or crisis we are having. Likewise,  there are only a few basic methods for controlling emotions which are  used in all upsetting situations. The same for learning skills, changing  our thoughts, uncovering unconscious factors, and so on. In short, it is  easier and better to know the general principles of behavior and the  basic methods for changing than to study hundreds of seemingly  unrelated problems. Therefore, 20,000 self-help books are overkill. A  case in point: this book deals with hundreds of problems (chapters 3  to 10), but the methods for coping with those problems are described  in entirely different chapters (11 to 15) because the same method will  be useful with many different problems. What we all need is  comprehension of the general principles of behavior and changing, as  well as carefully designed research (not necessarily by professionals)  testing the effectiveness of self-help methods. Our knowledge needs to  be integrated and unified, rather than split into little atomistic books.  This brings me to the last major point.   Why is it so hard to find the information you need?   | 
| 39 With 20,000+ different self-help books sitting on book shelves  somewhere, the biggest problem is finding the book you need! These  are the conditions: (1) publishers favor one-topic books, (2) self-help  writers often recommend only one or two types of self-help methods,  and (3) self-help authors range from untrained in psychology to world- class experts, thus, the quality of information in books ranges from  worthless (or even harmful) to the best available. Thus, what you get  in a book may be very limited--a small slice of applied psychology.  Certainly, the quack and the mystic won't reveal their ignorance on the  front of their books. So, obviously, a person seeking up-to-date  knowledge about a problem has a problem. Genuine expertise about  self-help books is not available, certainly not from publishers or  bookstores. No one has read all this stuff. I have read a lot of it and  attempted to provide you with summaries. This book cites and  recommends the best books I could find, but quickly finding the  knowledge you need at any one time is a monumental task that needs  solving in this age of information and technology. Most public and  university libraries have relatively few self-help books, but through a  state-wide, inter-library loan system you can get many books (if you  know the author or the title).   So, in case you assumed that some intelligent body (psychologists,  publishers, a government agency) was coordinating and insuring the  cogent development of personally helpful psychology, disabuse  yourself of that good idea right now. While publishers grind out their  2,000 new self-help books every year, they do not print general, broad  scope, introductory self-help textbooks for teaching students to  prevent or cope with common personal problems. Why not? As we will  see, because schools and colleges don't offer personally useful  psychology classes (partly because there isn't an acceptable textbook).  However, don't forget: amid the junk, there are lots of good specific- focus books available, if you can find them.   My conclusions again are: coping effectively with life in general-- and all lives are complex--requires us to know how to handle many  ordinary problems as well as knowing how to improve what we already  do well. That requires a basic knowledge of useful psychology which  can be applied by everyone in almost any situation. Currently, the  typical specialized self-help books fail to provide us with generalized  self-control, and there is no bibliographic system to help you find the  specific information you need for solving today's problem.   Bookstores   There are about 9,000 bookstores in this country, although many  of the small ones are being driven out of business by the giant  discount chains. Bookstores are just a part of the publishing business-- they provide storage bins and advertisement for selected new books.  They stock only a fraction of all books in print. The chain bookstores  don't even order their own books; they just shelf whatever corporate  headquarters ships them. The clerks don't know the contents or  quality of the books in stock, and certainly not unstocked books. So  | 
| 40 don't expect the store clerk to wisely recommend a book for your  problem.   Magazines   Many popular magazines depend on self-help material to increase  sales. Notice the featured articles--dieting, exercising, handling stress  or the blues, improving relationships, better sex, etc. Many of these  short articles are by professional writers who make their living writing  anything that will sell; they are not psychologists or therapists. Yet,  the short articles are often of interest and reflect some recent work by  a psychologist or psychiatrist. Because of the brevity, however, the  article usually deals with only one part of a problem and seldom  provides detailed instructions for self-improvement.   The major problem with magazine articles is the same as books,  namely, how to find what you need. You may stumble upon a  magazine article of value to you, but if you were to set out to find an  article about your particular problem, your chances of success are very  slim. The lasting value of magazine articles is shown by the fact that  they are seldom kept more than a few months, even by libraries.   Talk shows   Ten or fifteen years ago, I thought talk shows were the ideal self- help education for adults. The early talk shows were informative and  practical, i.e., many dealt with solving common problems. They  discussed controlling bad habits, relieving stress or depression, gaining  confidence and asserting your elf, improving relationships, etc. When  watching the early shows, you might have said, "Wow, that's the way I  am. Maybe I should try that approach with my problem." When the  shows did deal with abnormal psychology topics, the thrust was on  understanding the behavior, helping relatives accept the patient, or  helping the patient seek help from mental health agencies. As the  years passed and competition among talk shows increased, the topics  became more and more sensationalistic. Sadly, now, they are usually  a waste of time, unless you are entertained by bizarre situations or  behavior. Now, if you watch, you say, "Wow, what a weirdo! Thank  God, I'm not anything like that." The great educational potential in talk  shows is being neglected because they focus only on the problems, not  the solutions (don't blame the shows or the sponsors, they give us  whatever attracts the greatest number of us). Heaton and Wilson  (1995) say the talk shows distort real life so badly that they harm the  mental health of all of us.   The talk shows do not showcase psychological knowledge well.  Often the "expert" is given only a few minutes near the end of the  show under terrible circumstances: "OK, doctor, now instantly cure  these very long-term, disturbed subjects who have been whipped into  an emotional frenzy for 45 minutes." It is common for the talk shows  to also have a critic on the show to attack whatever the "expert" says.  It seems carefully planned to demean the value of psychological  | 
| 41 knowledge. Certainly the public doesn't end up clamoring for more  useful knowledge (unless they are in a crisis and desperate). We as a  society don't need more titillation by aberrant behavior, sex, or shrill  arguments; we need more insight into human behavior and feelings,  more honest useful facts, and more practical research about effectively  handling common, ordinary problems. We need to be able to separate  the informative shows from entertainment based on someone's rare,  abnormal, and pitiable behavior. (We also need to confront our own  compelling, unquenchable thirst for entertainment.)   The media   Except for a few public television series, television has given us  very little practical psychological education. Useful information has not  been made and probably can't be made interesting enough to draw our  attention away from the romantic glamour of the soaps, the intrigue of  a murder mystery, the thrill of a chase, the sexual excitement of a  seduction, or the humor of a comic. What does this mean? Are we  doomed to the hell of eternal psychological ignorance? No. I think it  means we have to change psychological education, perhaps using the  soaps as a way of describing solutions to problems as well as  describing the innumerable conflicts of humans. This means self-help  specialists should be writing soaps. Most importantly, as the  effectiveness of psychological knowledge is proven, I think the general  public will give up some of its mental masturbation via entertainment  TV and turn to more worthwhile and informative programs. We are  learning to eat healthy food instead of high fat junk food and desserts,  so we can learn to absorb healthy information instead of TV junk. Put  on helpful shows about attracting a good mate, overcoming bad  habits, handling anger, tactfully asserting yourself, or having orgasms  and people will watch. Changing our TV viewing habits will take some  intentional coping, however.   Churches   Since churches teach religious beliefs and morals, it is possible that  they could also teach useful psychology to help us cope. While the  relationship between religion and psychology is generally quiet, there  is a reserve and distrust between the disciplines that interferes with  many ministers actively endorsing applied psychology. For one thing,  many preachers are not well trained in psychology or counseling,  although some are very well trained. The most likely inter-disciplinary  barrier is that self-help psychology believes you should think for  yourself. This carries the risk to religion that you might even question  the dictates of your religion. Most churches would be uncomfortable  with that much individual freedom of thought. Religions are  authoritarian organizations preaching "the truth," rather than  searching for scientific laws and "the truth" through science. Religions  tell you how to live and condemn living any other way even though a  majority of their members actually "stray," e.g. having premarital sex  and using birth control. This conflict over who should be in control of  | 
| 42 individual lives would interfere with many churches advocating self- help psychology to improve your life.   Schools   One would think that schools are the perfect place to give away all  the useful knowledge science has found. But that doesn't happen. Why  not? In the case of self-help, there are many reasons. There are no  special advocates for psychology in schools (no clinical psychologists  work in public schools). Schools fear having even more responsibilities,  especially with very limited budgets. School schedules are filled and  other disciplines don't want self-help psychology to take part of their  class time. Neither psychology nor education has prepared teachers to  handle a class in which students learn to direct and change their lives.  In fact, only 50% of high schools offer psychology (the watered down,  easy-to-teach academic kind) and only 50% of those high school  psychology teachers have a background in psychology. Teachers who  would help children actually practice self-improving need to be highly  qualified and experienced (well trained school counselors might be  good choices). Such training would require at least a four-year college  program leading to teacher certification in "self-help psychology,"  which doesn't exist at this time. As mentioned above, there isn't even  a comprehensive textbook that all students could use to plan self- improvement projects. Our public education system can't be prepared  to teach useful psychology at the junior high and high school levels  until 2020, at the earliest.   University psychology professors yearn to publish research with  the brightest graduate students, but most would abhor intimately  teaching personally useful courses to ordinary undergraduates.  Community college teachers and counselors might be more interested  in teaching useful psychology. Most professors are in academia  precisely because they are untrained and/or uninterested in helping  with personal problems. The list of barriers in education could go on  and on. Yet, there could be great advantages to individuals and society  in the future from teaching personally useful psychology in schools;  some advantages are listed at the end of this chapter.   The neglect of prevention by books and institutions   Just as specialized self-help books leave much of your life  untouched, thinking of self-help as being primarily for solving serious  problems may cause us to neglect the prevention of problems. Since  the 1980's government funding of research has focused on the  physical, genetic and biochemical causes of diseases. The  psychological, interpersonal, environmental causes, like poverty,  prejudice, and dysfunctional families, are considered less important  (Albee, 1996). Prevention should be a strong point of self-help. Who  else is going to guide you away from trouble? And, we all face trouble.  A 1993 national survey about mental health lead by Ronald Kessler, a  sociologist at Michigan, found that half of us will have a mental illness  some time in our lives. It is a part of life. In fact, according to that  | 
| 43 survey one third of us will be at least mildly mentally or emotionally ill  sometime during the next year! (The most common disorders are  depression, drug or alcohol dependence, and social fears. Problems in  living are in addition to the one third with "disorders", including  problems like being over weight, procrastinating, being anxious or  having a bad temper, being unhappy at work, having marital  problems, etc.) Obviously, we are not doing a very good job of  preventing mental-emotional disorders or ordinary problems, but there  is evidence we could.   Several studies have shown that adolescent problems, like  depression, introversion, and aggressiveness, can be forecast in the  first and second grade. There are early signs of stress in a love  relationship that warn us of serious marital problems. It doesn't take a  genius to predict that a hostile, mean bully is going to cause and have  interpersonal problems as a teenager and as an adult. Even totally  untrained observers can pick out the young child who is more likely to  become schizophrenic at age 20 or so. Prevention of problems,  however, requires your attention: you will need to assess how likely  you are to develop a variety of particular problems (a task you will be  tempted to avoid); you will need knowledge to decide how to best  avoid the long-range undesirable consequences; you need to plan a  self-help project to carry out the preventative measures. Probably the  majority of serious psychological and interpersonal problems could be  avoided by alert self-helpers (and a school system oriented to  psychological well-being). I do not want to suggest that psychology  has already perfected prevention methods, but psychologists are  finding some effective self-help ways to prevent serious problems,  such as depression (Munoz, 1993). Albee & Gullotta (1997), working  with the National Mental Health Association, have described 14 award- winning prevention programs; these could serve as how-to manuals  for other communities. Other researchers (Durlak & Wells, 1977;  Weissberg & Greenberg, 1977) have evaluated several prevention  programs for children and adolescents, these involve schools and  professionals but education (and self-help) plays a part too. Prevention  requires attending to parts of your life that are not yet problems.  Clearly, some of the self-help methods, especially behavioral-cognitive  methods (see chapters 4 & 14), for handling a serious problem could  be used to prevent the problem.   Conclusions   You are, thus far, pretty much on your own to take care  of your life. No system or basic institution, such as family, church,  school, friends, or health/psychological caretakers, has taken on  the task of helping you learn to cope with the minor or serious  troubles that will come your way (denial is easier and, thus, self- help isn't a big money maker). A lot of your welfare depends on  luck--being born middle class... or being raised in a psychologically  healthy family... or being given healthy genes... or being endowed  with the ability to learn coping skills on your own. To become  effective at coping, you need to practice thinking of self-help as  | 
| 44 being applicable to all parts of your life, i.e. helpful all the time  with serious problems, minor concerns, and self-improvements of  all kinds. Self-help is for preventing as well as solving problems.  Self-help is for improving in areas in which you are already  adequate or superior. To think of self-help in a more restricted way  will limit your efforts to be a better person. We all need to  periodically review all aspects of our lives, looking for any danger  signs and taking preventive action if it is needed. We must  vigilantly guard against believing that self-help is natural,  automatic, instinctive, easy, unlearned, not-improvable or in God's  hands. All are excuses for doing nothing. We all need to know the  major methods for coping before the trouble strikes.   Why should self-help psychology be given away?  How can it be?  The human condition involves an astonishing amount of misery. A  recent national survey (Kessler, et al, 1994) reported that 50% of all  Americans between 15 and 54 have had a diagnosable mental or  emotional disorder sometime during their lifetime. Almost 25% of us  have had a serious psychiatric problem within the last 12 months (less  than 20% got any treatment). One out of five of us is in fairly serious  psychological trouble right now. About 50 million (20%) Americans are  at least mildly depressed (200,000 attempt suicide), 20 million are  anxious neurotics, 10 million turn to alcohol (1 million are in AA), 10  million are arrested for a crime, 5 million are schizophrenic or  antisocial, 12% abused his/her spouse during the last year, 6 to 20  million (12-20%) of our children and teenagers are diagnosable and  13% of 9-17-year-olds have a "serious emotional disorder," 1 million  college students leave school each year because of personal-emotional  problems (1-2 million are addicted to drugs), 50% of marriages end in  divorce and half of the remaining marriages are "empty shells," one of  every seven women has been raped, etc., etc. (U.S. Surgeon General,  1979). During any given month, 15-20% of us Americans suffer from  substance abuse or mental disorder. And, beyond all the serious  problems, the fact is that almost all of us have things--bad habits, self  criticism, lack of motivation, unclear goals--we'd like to change (Kidd,  1974) but can't or don't. We shouldn't remain indifferent to all this  pain. We need a scientifically based system for preventing and  alleviating this misery.   I believe our greatest hope in the long run, in our country and  throughout the world, is to improve the human condition by using our  fantastic educational systems--schools, TV, computers, self-help  groups, the information highway, etc. Why can't adults learn practical,  useful psychology watching public television and TV soaps? Why can't  useful information be delivered via computer and VCR to a hurting  person just as soon as he/she needs it? Why couldn't all children learn  in school to recognize, prevent, or cope with their personal and  relationship problems? It isn't a new idea; Proverbs in the Bible were  written to "educate in wisdom and moral discipline" and, thus, help  young people, the inexperienced, and everyone (Scott, 1965). The  problems associated with schools, self-help books, talk shows, and  | 
| 45 bookstores were discussed earlier in the chapter, but their  effectiveness could be radically improved   A recent American Psychological Association task force said  "prevention programs" are frequently effective and should be  evaluated and expanded (Price, Cowen, Lorion, & Ramos-McKay,  1989). Prevention usually involves education about alcohol, drugs,  unwanted pregnancy, poor health, etc., but it could be extended to  many problems. It is also estimated that 7 to 15 million Americans  were in almost 1 million self-help groups in 1990 (Riordan & Beggs,  1987; Jacobs & Goodman, 1989) and that such groups have become a  major source of help with mental health problems in the late 1990's.  Psychology is being given away to adults, but not primarily by  psychologists. Helpful psychology is being talked about and used  because the people want it, need it, enjoy it, and, probably, profit from  it. Burnham (1987) has warned the discipline of psychology, however,  to take more seriously the task of "giving useful psychology away to  the ordinary person;" otherwise, the major uses of psychology may fall  into the hands of lesser qualified journalists, talk show hosts, and TV  commentators. I wish my discipline would heed the warning (although  I think many people in the other disciplines are dispensing psychology  fairly well).   If we, as a society, become serious about prevention and  psychological self-help, we must start early. We could help all children  handle problems. Ideally, every child would take a course in self-help  or interpersonal skills every semester from shortly after birth through  college--perhaps 40-50 courses, each tailored to the common  problems for their age. For instance, a course in "caring" at age 6-7, a  course in career choice at 10-12 and again at 16-18, a course in  sexual development and moral choices at puberty, a course in relating  to the opposite sex at 13-15, a course in selecting a partner at 18-20,  a course in developing a philosophy of life at 12-13 and again at 18- 20, etc. It won't be easy, but psycho-social education has tremendous  potential advantages within the public school system:   1.  Everyone can be reached at a young age via the educational  system; therefore, problems could ideally be prevented or  handled early.   2.  The amount of time available via the educational approach far  exceeds any other currently available delivery system. For  example, in just one course at the college level, students spend  approximately 150 to 200 hours working on their problems as  contrasted to an average of 5 or 7 hours in counseling centers  or perhaps the 15 to 30 hours of counseling for clients who  remains in treatment until termination. Suppose there was one  course every semester from nursery school to graduate school;  that's a total of 4,000 hours of study and application! Every  child could become much better trained than the current  psychiatrists and clinical psychologists. Why not? What else  would be more beneficial?   | 
| 46 3.  The psychology-for-everyone approach may remove some of  the stigma against seeking professional help with personal or  interpersonal problems. At least, everyone would know where  to go to get the extra help they need.   4.  Practical psychology could eventually be made available to all  people, not just students. Surely knowledge of psychology and  how to apply it in one's life might not only be beneficial to the  sickest members of our society and to those who come into  conflict with the law, but also to the better adjusted or even the  leaders of our communities.   5.  The students are more motivated and the teachers have more  reinforcers to use than counselors. Self-help psychology is the  only class that I've ever taught in which students encourage  others to do their homework, so that they can make a better  contribution to class.   6.  Self-help applied psychology courses build self reliance,  personal pride, and self-direction, and reduce dependency upon  others. It helps correct the common notions that only a  psychiatrist or a psychoanalyst can deal with tough human  problems.   7.  The person who is hurting knows his or her background better,  is aware of the problem sooner, and sees his/her goals more  clearly than anyone else. Only the person is always available  (to your self) and more responsible than anyone else for the  problem's existence, its treatment, and its outcome. The  knowledgeable self-helper is in the best position to help.   8.  There are fewer drop-outs and fewer people really dissatisfied  with the psychological services offered in a class, partly, I  suspect, because there are so many sources of help in a course  that do not exist in a therapy situation, such as the readings,  the lecture-demonstrations, the instructors (usually a  classroom teacher and a small group leader), the other  students in the class (individually and in the group process),  and their own learning by doing, i.e., self-help efforts.   9.  Credit courses provide credit to the learning institution, the  faculty members, and the students. I feel "giving psychology  away" is a real credit to the profession as well. Psychology is  clearly relevant to everyone's life every day.   10. Courses are an excellent training opportunity for  paraprofessionals and graduate students. There have been 8-12  graduate students, interns, counselors, other faculty,  undergraduate paraprofessionals, etc. co-teaching with me  each semester for over 20 years.   11. Intensive, personalized courses in school provide a much better  opportunity for doing realistic, meaningful "psychotherapy"  research and self-help research than does the typical outpatient  mental health center or private practice.   These "advantages" are only my hunches, not proven facts. It will  take our society years to develop, research, and evaluate an  integrated sequence of age-related courses. Intentional coping is not  well researched. We know little about moving from one stage of self- help to another, e.g. from avoidance of the problem to thinking about  | 
|  47 it, from being concerned to preparing to act and then acting, from self- improving to maintaining the gains. New research on the whole self- help process is just getting started (Prochaska, DiClemente, &  Norcross, 1992; Klar, Fisher, Chinsky, & Nadler, 1992). Furthermore,  new kinds of psychology teachers are needed, and delivery systems  must be changed or developed. It won't be easy, but how else are we  going to help all our grandchildren cope well with the daily problems  that are a part of living? Let's get on with making this a better world.   Every profession is a conspiracy against the laity.  -George Bernard Shaw  An appeal to all scientists and practitioners: Share your useful  knowledge. Remember, "Tis better to light one candle than to curse  the darkness."   A brief review of the idea of self-control  When the discipline of psychology started to develop over 100  years ago, it left terms like will, free will, volition, self-control,  determination, and cognitive control in the hands of philosophers. But  since the 1970s or 1980s, cognition has become an expanding part of  psychology. Now, concepts like choice, decision making, problem- solving, self-esteem, self-efficacy, optimism, feelings of mastery and  many other similar terms are in favor in psychology, partly because  researchers continue to find relationships between ones self-control,  including sense of mastery, and ones mental and physical health.  Shapiro (1996, 1998) has summarized well the research and theories  about self-control during the last 40 years.   Most people assume they have free will, i.e. the ability to make  choices that purposefully guide their lives. Indeed, our legal, moral,  and social systems assume that individuals have free will because  punishment, rewards, blame, praise, etc. would make no sense if the  person were not responsible and/or couldnt help what he/she was  doing. Among scientists free will is still debated, but a growing group  believes that humans can weigh options, make decisions, and form  intentions that direct, within limits, their lives (Rychlak, 1977). This  self-direction or will is considered lawful and understandable, not  magical or mystical. If you are interested in a more detailed discussion  of "free will," "moral responsibility," and self-control, please see  Method #4 in chapter 14, Determinism.   We humans want to control our lives, being out of control is often  very scary. So, it shouldnt be surprising that normal, healthy people  over-estimate their degree of control and under-estimate their  vulnerability to control by others or circumstances. When confronted  | 
| 48 with illness, the patient who believes he/she retains control over  aspects of the disease generally does better than the patient who feels  out of control. An optimistic, hopeful attitude about ones self-control  actually changes our bodies--the body chemistry and immune system  improves.   However, too much (unrealistic) belief in ones ability to control  things and/or too high a need to be in control, sometimes resulting in  making extreme efforts, can often make things--your health or social  situation--worse. For example, the alcoholics belief that I can quit  any time I want surely contributes to a loss of control over the  addiction. Also, as managers have seen, it is often harmful to give a  person more control responsibilities than he/she wants or can handle.  Likewise, as we will see in chapter 8, if a person believes he/she is  personally in control of a situation when in reality external factors are  the dominating forces, the consequences can be detrimental to his/her  health and self-concept, especially if the person continues to feel  responsible for the unwanted outcomes. Thus, it seems that the  concept of free will may sometimes assign far too much  responsibility (blame) to the actor (often a victim) when things go  wrong. In the opposite direction, feeling more helpless than you  actually are is problematic--and perhaps in this case the actor  (sometimes a victim) hasnt taken enough self-responsibility.   Shapiro (1997) illustrates the elusiveness and complexity of the  seemingly simple concept of self-control by asking: Is self-control  merely a belief (Oh, Id never have an affair) or is it actual control in  real life? Is it a general trait (Im totally in control) or very specific  (I can handle alcohol but not sweets) to thousands of tasks or areas  of control? Is there one level of control desired over external events  and another level of control expected over ones own emotions,  choices, and actions? Is self-control only mastery, i.e. consciously and  intentionally improving ones behaviors, emotions, skills, and thoughts,  or is it also coping by yielding, adapting, accepting, accommodating a  situation or powerful force until one has a better chance to change  things?   There are other complexities: Is it still self-control if others are  helping you cope, such as family, friends (gang), government  program, self-help group, self-help book, religion, or God? How does  one naturally learn self-control? Where does one go to learn to  improve ones self-control? Who in our culture are the self-control  experts--what discipline wants this area of research?   Shapiro, Schwartz, and Astin (1996) suggest that the kind of  therapeutic intervention or self-help instruction a person wanting  better self-control will need depends on his/her control  characteristics. For instance, it is quite possible that gender  differences, age level, genetic factors, level of aspiration, situational  differences, confidence, and several other personality traits will  influence the kind of control methods that each specific person needs  to learn or be taught. Because of these uncertainties I have listed  | 
| 49 many possible self-control methods for each major problem (see  chapters 4 to 10).   Sperry (1993) makes an important observation: your values and  major purposes for living, if well developed, are perhaps the most  powerful determinants of your major life decisions. Therefore, each of  us needs to take great care in deciding on the values we will live by  (see chapter 3). Moreover, in the absence of a strong, thoughtful value  system, if one starts to believe that he/she is at risk of having little  control or if one becomes extremely emotional when his/her self- control seems fragile, such a person is at risk of joining others who are  threatened and deciding to seriously harm another group through acts  of greed and by social domination (e.g. seeking power through wealth,  politics and war, or religion). Humans run amuck without effective self- control and values.   Our attitude towards "self-help" will influence the future of humanity   Joseph Rychlak (1997), one of the best thinkers of our time, says  that unfortunately modern society considers the notion that a person  can responsibly guide his/her own behavior to be an illusion. At least,  it certainly seems that we resist the idea of preparing for personal- emotional problems until we are in deep trouble. In any case,  humankind is obviously not rushing recklessly towards self- responsibility and self-control. So, it is no surprise that general self- help knowledge and classes have not become big business. The  thousands of little crisis books have not shown the general population  that psychology is helpful in every life every day. Likewise, the TV  documentaries or talk shows have not convinced many people to study  self-help techniques carefully (that is certainly no surprise considering  the few minutes the bewildered "experts" on talk shows are given to  solve highly complex, emotional issues). Our limited systems for  distributing useful knowledge to everyone are lousy because they are,  thus far, primarily devoted to entertainment and selling products.  Schools, families, and churches don't support self-help instruction.  Moreover, therapists know a lot but they aren't giving it away (in our  competitive, individualistic culture, who wouldn't want to make $100  an hour?). In short, our society does little to encourage and help us to  self-improve. What can be done about these skeptical or pessimistic  attitudes?   Producing better self-improvement methods, proving the  effectiveness of self-help by research, getting useful information  published in magazines, on TV, or anywhere that honestly reports the  effects of these techniques will eventually persuade enough people to  change the educational system, the media, and the publishing houses.  The real "proof" about self-help accumulates one person at a time-- one successful self-helper at a time. So if you read enough about self- help that you give some methods a try (and if they work for you), you  will become part of the force that changes human thinking. Your belief  in using knowledge derived from science to control and change your  life will gradually influence other people's attitudes.   | 
| 50 I believe, like Alfred Adler, that the wide utilization of self-help  psychology is inevitable within your life-time (if you are young).  Psychological coping is like health, everyone has to work on it. And, in  both areas, science is finding more and more ways to improve our  bodies and our personal-interpersonal adjustment. For the last 600 to  800 years, science has steadily advanced; it can be slowed but not  stopped or rolled back. Once you think of an idea, like germs or  evolution or genetics or self-help, you can't un-think it.   Practical, useful psychology will eventually be taught to everyone  so that we all can cope better with problems, suffer less, love more  fully, and contribute more to others. Comprehensive psycho-social  education is not an impossible dream, but it involves major changes  which no one can foresee today. We only see the problems clearly  now, e.g. most people would agree that the most important part of  growing up is developing character. And, great moral character is not  the hallmark of our society these days. "Character" is defined as  having the ability to control impulses and defer gratification, which is  essential for achievement, performance, and moral conduct. Character  requires self-discipline and moral values, which are not major topics in  our country any more (Etzione, 1993). Indeed, the lack of discipline is  the #1 problem in schools today: classes are often restless, impatient,  disorderly, and disrespectful, resulting in little learning. Much  experimentation about character development is needed, but my faith  in people--and in the usefulness of knowledge--makes me an optimist,  a believer in the eventual goodness of people and in the triumph of  reason.   In our early years, we humans seem to be capable of  understanding many of the complexities of life--and doing something  (a lot) about them. As youngsters we can influence our futures; the  earlier we start the better. Walter Mischel (1988) has shown that 4- year-olds, who have learned how to distract themselves and resist  temptations, like candy, are more able to concentrate, make friends,  do well on the SAT, and deal with stress as teenagers. Self-taught self- control apparently has important consequences (science doesn't know  yet if self-control taught to us by others has the same implications as  self-taught self-control but possibly so). The teen years and young  adulthood are also important in many ways: you develop trust or  distrust of yourself and others; you acquire attitudes, habits, values,  and emotional reactions which will have great impact on your entire  life. Youth isn't just a time for living day to day, as some think; the  early and teen years form the basis for much that you will become.  You can change at anytime in your life, even on your death bed, but it  is harder if you haven't had much practice self-changing earlier in life.   So, hopefully, you can now see the big picture of where we are  going. Clearly, a life-long psycho-social education isn't just one book  or one course. Learning to cope is an unending task from birth to  death. It is a process of realizing your personal and social problems, of  deciding on the important purposes of your life, of planning how to  accomplish as many of those goals as possible, and, then, gathering  | 
|  51 the knowledge you need to actually cope with the almost inevitable  stream of pitfalls in life, carrying out your day by day plans for  achieving your ideals, and living your values and dreams to the fullest.   I urge you to seriously start self-helping yourself to cope now. You  don't need to be a good student or to know much about psychology  (you only need to be able to understand what you read); you don't  need to have problems because you can always work on self- improvement and prevention of problems; you don't need to be in  good psychological shape because self-help is for all kinds of personal  and interpersonal difficulties. Why am I urging this on you? My goals  reflect my values of helping others, using knowledge honestly and  wisely to make this a better world, and encouraging each person to  take responsibility for his or her own life.   Every creator painfully experiences the chasm between his/her inner vision and  its ultimate expression.  -Isaac Bashevis Singer  Summary   Psychology has accumulated a lot of useful knowledge--how to  improve behavior, handle emotions, acquire skills, change attitudes,  gain insight, and much more. So, why shouldn't these methods and  ideas be taught to everyone? Eminent psychologists have  recommended this for many years (Miller, 1969; Guerney, 1969). Of  course, we can't prevent all problems; some rain must fall in every  life; we all suffer the occasional pain of failure or self-criticism or  rejection or loss. But we could suffer less. Furthermore, we all could be  better--more caring and giving, and less angry or greedy, more  reasonable and calm, and less tense and impulsive, more capable and  aware, less timid and repressed, etc. Since we all have problems and  we all have room for improvement and much to contribute to others, a  good society would surely help us all live the best life we can. And,  since we are more responsible for our own lives than anyone else,  often having to cope with problems alone, everyone needs to be an  expert self-helper. It makes sense. It can probably be done, but not  quickly and easily. I hope this book makes a small contribution to that  distant goal.   | 
|  52 A warning: any society which emphasizes individual responsibility,  self-help, building self-esteem... must guard against burdening  individuals alone with the awesome task of coping with life's problems.  The knowledge needed by individuals must be developed and  distributed by massive research programs and improved educational- informational institutions. Society must change as well as individuals.  When we say that every person must help him/herself, it is crucial, in  order to be fair, that every person be provided the self-help knowledge  and opportunities he or she needs to succeed. Otherwise, "self-help" is  just another mean-spirited ploy by the advantaged to "keep the  disadvantaged in their place."   Bibliography   References cited in this chapter are listed in the Bibliography (see  link on the book title page). Please note that references are on pages  according to the first letter of the senior author's last name (see  alphabetical links at the bottom of the main Bibliography page).   |