UNDERSTANDINGS BETWEEN YOU AND ME

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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 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 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, 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. 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 have 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 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 yourself, 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.

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, 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 $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).


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