Tuesday, July 24, 2007

Repeat 5 times: this is doing nothing, this is doing nothing....

Some might consider it dirty pool to take one self-help regimen, hold it up against another self-help regimen, and use the contradictions between the two as evidence of cracks in the foundation of the SHAMscape itself. And I'd agree that you can't do that with entire contrasting schools of thought. For example, Victimization* and Empowerment have wholly different views of human nature, interpersonal relationships, and life itself. Those must be taken as givens, much as the respective core beliefs of Catholicism and Islam must be taken as givens; it's unfair to use Islam to point out flaws in Catholicism, because the two religions just start from different premises. It's another story, however, if within a specific system or school of thought, the internal givens don't quite mesh. For example, you'd be altogether justified in taking one of the Catholic Church's bedrock Ten Commandments, holding it up against another Commandment, and saying, "You know what? These two don't gibe."** Within any specific system or way of thinking about life, you're looking for internal consistency. And when it's not there, then you have potential evidence of a serious problem: shoddy logic and/or shoddy research and/or unsupported conclusions drawn from that research ("leaps of faith"), all the way up to outright fraud.

This is even more true of a specific self-help technique. If different gurus are using the same technique to promise diametrically opposed results, then what are we to conclude about the inherent validity of the technique and the thinking that underlies it? It's kind of like the latter-day status of, say, caffeine. (Caffeine may not be the very best example, but I'm rushed today.) If 50 credentialed experts are telling you that caffeine is bad for you, and another 50 credentialed experts say it's good....at that point, you pretty much have to throw out the validity of what any of them says. It's all a big wash. We can only conclude that we have no idea what caffeine does, or doesn't do, for us.

That's a long intro to the fact that I'm always on the lookout for new SHAM spins, or embellishments of old ones, expressly so that I can make such analyses and comparisons. Yesterday I came across this piece in the London Times, which talks about the rise of "health-care perfectionism": a particular type of hypochrondria that, says Dr. Robert Leahy, president of the International Association for Cognitive Psychotherapy, results from today's emphasis on physical perfection combined with the sheer volume of medical info that floods mainstream culture via the Internet, 24-hour cable news, etc. According to Leahy, these health-care perfectionists, who want their bodies to be flawless inside and out, tend to panic every time they hear about a new disease or symptom, worrying that they might have it or get it.

Among Leahy's "prescriptions" for such worry is the following technique, and I quote the article:

"...Leahy gets his clients to repeat: 'It's always possible I have cancer [or whatever it is they fear],' over and over, hundreds of times a day. Many who have tried it have found that the internal struggle quietens**. In fact, the thought becomes boring."

(Ahhh, it becomes boring. Hold that thought for a moment.)

This is the same desensitizing technique that panic-disorder therapists have used for a while now with fearful fliers. Counterintuitive as it sounds, such passengers are supposed to board the plane thinking, This jet is going to explode. This jet is going to explode. This jet is going to explode... (Helpful hint: You really don't want to say such things aloud in these times of high paranoia, unless you want to be escorted off by a K-9 unit and spend the next few hours chatting with the FBI.) After a while they don't even hear themselves. Or it actually becomes funny to them.

OK. But...now...does this desensitizing process remind you of anything? How 'bout, say, the much-vaunted theory of affirmations? That is, telling yourself wonderful things, usually the same wonderful things, each day as you shave or put on make-up. (Some gurus suggest doing this every time you have a quiet moment to yourself; the more, the better.) Yessir, the process of affirmations relies on this same repetitive chanting. So why doesn't that become boring and meaningless? Why don't people become desensitized to those positive thoughts, in the same way that Leahy's subjects, and the fearful fliers, become desensitized to the negative ones?

This is no small question, because there may be no single element that's more critical to the Empowerment schema than this whole idea of self-talk: the messages we send ourselves daily. If one guru says that through self-talk, you can learn to believe in the literal truth of what you're saying ("you're wonderful! nothing can stop you!"), while another guru says that you can use the same technique to make the words (and underlying concepts, like fear of flying) totally meaningless...then where does that leave us?

And of course, it's not fair to blow off Leahy as "one guru" in the same way that we might bracket some hot new SHAM artist. Leahy, at least, has formal mental-health credentials on his side. He has studied the phenomenon in an academic setting (and possibly a clinical one as well, though I can't say so for sure). Plus, if we're allowed here to throw in a little bit of empirical/anecdotal evidence, those of us who are parents have a more-than-passing familiarity with this situation. We know what happens when we repeat things endlessly to our kids: Do your homework! Do your chores! Put the bong away and go out and mow the lawn, dammit! We know that they tune us out. They don't hear it after a while. Or they hear it, but it means nothing. It has zero impact.

Why should it be that much different when the person you're continually talking to is you?

* This link takes you to a blog containing a review of SHAM that I hadn't seen. Though the review is not totally favorable to my book, it does present a nice summary of my feelings on Victimization.
** I'm not saying that's the case. It's just an example.
*** The word exists in English, in case you were wondering, but it's primarily a Brit usage.


Cal said...

I guess whatever affirmations Lindsay Lohan learned at her drug rehab didn't work. She might have set a record for the quickest relapse. I don't think Robert Downey Jr. (among others) fell off the wagon this quick.

I guess that she (purportedly) read Machiavelli didn't work either.

I missed my calling. I wish I had gotten into the celebrity drug rehab racket. I would own several mansions. It's the gift that keeps giving.

It's really too bad because she is a gifted actress.

RevRon's Rants said...

Steve, Having successfully applied the technique of Systematic Desensitization, as well as a very divergent technique called Flooding, I can assure you that in the right circumstances, each is quite effective, yet equally dangerous if misapplied, or used on a patient whose illness renders the technique destructive.

As you know, I am almost as fed up with the self-help industry as you are, but have to acknowledge that like the above example, some techniques may be helpful for some people. Not remotely the panacea the aggressive promoters would claim, but still capable of improving some individuals' lives. The real crux is that unlike the professionally trained psych therapist, there is little in the way of ensuring that the new wage practitioners are even remotely qualified to determine whether a given process is viable for a given individual. The "qualification process," such as it is, is limited to the customer's ability to pay for the program.

To revert to my original example, I have dealt with patients whose exaggerated fears were diminished after they were immersed in a situation that placed them face to face with their greatest fear (flooding). On the other hand, I have dealt with patients who required a gentler, more progressive confrontation with fear stimuli (systematic desensitization), and who would likely have suffered a psychotic episode had they been confronted with a sudden, exaggerated example of their particular fear stimuli. A good part of the value of intense training and closely regulated certification involves ensuring that the therapist possesses sufficient skill to recognize which technique is best utilized with a specific patient. Until the self-help industry matures to the point where a practitioner's knowledge and skill are as important as their willingness to pay for a "degree," the efforts of that industry will be, at best, suspect. I do believe that there are some practices within that industry that will eventually prove to be efficacious, and would hate to see potential benefits lost due to association with an industry currently awash in snake oil. On the other hand, I would no more recommend that someone enter an unproven and unregulated program, led by an untrained practitioner who offers dubious results, than I would send a paranoid schizophrenic to Miss Cleo to be cured.

Cosmic Connie said...

Good post, Steve. I've always felt that affirmations (or whatever people choose to call them) become pretty meaningless with endless repetition. They become just another ritual, the words empty of any emotional import.

Contradictions appear all over the SHAMscape, and "The Secret" culture is rife with them.

A latter-day incarnation of affirmations has popped up in the wake of "The Secret," in the form of "intentions." Or, as Marcy from Maui would have it, "powerful intentions." If you go on her Powerful Intentions discussion forum, you'll see that on members' profile pages they state their "intentions." Marcy herself likes to say, "It's a done deal and it sticks!"...as if this will ensure that the intention comes to pass.

However, Joe Vitale and other advocates of the Law of Attraction (the central focus of The Secret) have written that your thoughts or affirmations or intentions have to be accompanied by emotion -- sincere desire -- in order for you to get the expected results.

Which led me to wonder: If you keep on repeating the same words or phrases over and over again -- no matter how "powerful" those phrases are supposed to be -- doesn't the emotion, and therefore the power, wear off for you at some point?

Even more importantly, and relevant to the topic of cognitive psychotherapy, the whole desensitization process would seem to be contrary to the Law Of Attraction as interpreted by the Secretrons. After all, to make LOA work for you, you're supposed to focus on desired results and NOT focus on the undesirable, lest you "attract" it to yourself.

I'd hate to be a cognitive psychotherapist, or an advocate of that discipline, AND a Secretron.

Blair Warren said...

Steve, the contradiction you point out is very interesting and I'm sure has caused a lot of confusion in self-help circles. That's why the only affirmation I use anymore is, "Affirmations do not work." I've been repeating this for several months and am now convinced that affirmations do not, in fact, work. But the funny thing is, I no longer care.

Steve Salerno said...

That's priceless, Blair: a perfect, succinct, self-contained comedy bit. All that's missing is the rimshot at the end...

Mary Anne said...

I thought the affirmations were suppose to be changed on a perodic basis to work, but I am not sure about that. If anyone spent the time to investigate most of this self-help gurus, they would find they do not practice what they preach. Once you dig a little digging, you see these people are not leading such great lives. If the affirmations do not work for the guru, why would they work for me? That's what I always ask myself.