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Self-Help: Shattering the Myths

Self-help books are now a half-billion-dollar industry, but not all "off the shelf" advice is useful or accurate.

It's no surprise that America, land of second chances, fabled site of self-invention, also harbors an endless appetite for self-help. From Poor Richard to Dale Carnegie to Tony Robbins, we love the idea that we can fix what's broken by ourselves, without the expensive ministrations of doctor or shrink. The limits of HMOs, and the limitlessness of the Internet, have lately made self-help even more appealing: Americans spent $563 million on self-help books last year, and surfed more than 12,000 Web sites devoted to mental health. An estimated 40% of all health-related Internet inquiries are on mental health topics, and depression is the number one most researched illness on the Web.

In the spirit of pioneers, we're concocting our own remedies and salving our own wounds. But is it good medicine? Once the preserve of charlatans and psychobabblers, self-help has undergone its own reinvention, emerging as a source of useful information presented by acknowledged authorities. That's not to say snake oil isn't still for sale. Often, the messages of self-help books tend to be vast oversimplifications, misrepresenting a part of the truth for the whole, as the following list of popular misconceptions and distortions demonstrates.

The antidote -- the "good" kind of self-help, grounded in research -- is also available to those who help themselves. Just keep in mind that even the best self-help may be too simplistic to manage complex problems, and that research, with its emphasis on straight science, may not always offer a clear course of action.

DISTORTION 1

Vent your anger, and it'll go away.

SELF-HELP BOOKS SAY: "Punch a pillow or punching bag. And while you do it, yell and curse and moan and holler," advises Facing the Fire: Expressing and Experiencing Anger Appropriately (Bantam Doubleday Dell, 1995). "Punch with all the frenzy you can. If you are angry at a particular person, imagine his or her face on the pillow or punching bag, and vent your rage physically and verbally."

RESEARCHERS SAY: Pillow punching, like other forms of vigorous exercise, might be helpful for stress management, but recent studies suggest that venting anger may be counterproductive. "Venting anger just keeps it alive," says Brad Bushman, Ph.D., a psychologist at Iowa State University. "People think it's going to work, and when it doesn't, they become even more angry and frustrated."

In addition, several studies show that the outward expression of anger leads to dangerously elevated cardiovascular activity, which may contribute to the development of cardiovascular disease.

Bushman recently put the so-called "catharsis hypothesis" to the test, deliberately inducing anger in a group of college students by marking nasty comments on essays they had written. Those who slammed a punching bag afterward were more, not less, aggressive to people they subsequently encountered.

WHAT TO DO INSTEAD: A better tack, says Bushman, is to do "anything that's incompatible with anger and aggression." That includes watching a funny movie, reading an absorbing novel, sharing a laugh with a friend, or listening to music. Given time, your anger will dissipate, and then you'll be able to deal with the situation in a more constructive way.

Though Bushman has found that exercise can actually heighten physical arousal and keep anger alive, other studies have concluded that sustained strenuous activity might indeed release anger and improve mood. And nontraditional exercise programs like tai chi, yoga and stretching may not only dissipate negative feelings such as anger but make people more conscious of their mood states, paving the way for them to do something constructive about them.

DISTORTION 2

When you're down in the dumps, think yourself happy by focusing on the positive.

SELF-HELP BOOKS SAY: "Close your mental doors behind you on unpleasant circumstances or failures you have experienced," commands Napoleon Hill's Keys to Positive Thinking (Plume, 1998). "Use your brain for controlled, optimistic thinking. Take possession of your mind and direct it to images of your choosing. Do not let circumstances or people dictate negative visual images."

RESEARCHERS SAY: Research shows that when we're anxious or stressed -- in other words, exactly when we need a mood boost -- our minds become unable to provide one. That's because we're so preoccupied with our troubles that we don't have enough brainpower left over to suppress negative thoughts. And when we try to distract ourselves, pessimistic notions are the only ones that come to mind. "If you're really under stress, putting yourself in a good mood by thinking positive thoughts becomes not only difficult -- in fact it backfires, and you get the opposite of what you want," says Daniel Wegner, Ph.D., a psychologist at the University of Virginia.

In an experiment, Wegner asked a group of people to put themselves in a good mood -- which they did, fairly easily. But when they were also told to keep a nine-digit number in mind, they actually felt worse. The energy they had available to control their mood was reduced by the effort of remembering the number.

WHAT TO DO INSTEAD: "You have to enlist the help of other people," Wegner says. "Talk to friends or relatives or clergy or a therapist, or anyone else who might be able to help you think about other things." Or go to a place where people are enjoying themselves, like a party or the park or the mall, and you'll soon feel your spirits lift. Finally, if you know in advance that you're going to be upset or anxious about something, make a list of positive things that you can refer to when you need it most: your five favorite memories, say, or three occasions to look forward to.

DISTORTION 3

Visualize your goal, and you'll help make it come true.

SELF-HELP BOOKS SAY: "Hold the image of yourself succeeding, visualize it so vividly, that when the desired success comes, it seems to be merely echoing a reality that has already existed in your mind," suggests Positive Imaging: The Powerful Way to Change Your Life (Fawcett Book Group, 1996).

RESEARCHERS SAY: Sports psychologists have shown the power that visualization has on improving performance, but simply imagining that you've achieved your goal won't bring it any closer -- and might even put it further out of reach.

Shelley Taylor, Ph.D., a psychologist at UCLA, has reservations about visualizing your goals. "First of all, it separates the goal from what you need to do to get it. And second, it enables you to enjoy the feeling of being successful without actually having achieved anything. That takes away the power of the goal" -- and can even make you complacent, unwilling to work hard or take risks to get what you already have in your daydreams.

WHAT TO DO INSTEAD: In addition to picturing your goal as a fait accompli, "you should figure out what the steps to get there are, and then mentally rehearse them," says Taylor.

In an experiment, Taylor asked some students preparing for an exam to imagine their happiness at having received an "A" on the test, and others to picture themselves sitting in the library, studying their textbooks and going over lecture notes. Those in the second group performed better on the test, and experienced less stress and worry.

For short-term goals, Taylor recommends running through the steps you've laid out once a day; for bigger dreams, you can revisit your plan every time you make some progress, and see if it needs adjusting.

DISTORTION 4

Self-affirmations will help you rinse low self-esteem.

SELF-HELP BOOKS SAY: "Write affirmations on paper and put them in places you will see them -- on the bathroom mirror, next to your bed, on the car dashboard," recommends Life 101: Everything We Wish We Had Learned About Life In School -- But Didn't (Prelude Press, 1991). "You can also record them on endless-loop cassette tapes and play them in the background all day (and night)."

RESEARCHERS SAY: Psychologists say this technique may not be very helpful. Changing how we feel about ourselves is a lot more complicated, explains William Swann, Ph.D., of the University of Texas-Austin. "Self-esteem is based on two components: first, our sense of how likable and lovable we are, and second, our sense of how competent we are" at our jobs and at other activities that demand talent and skill. On those scores, we've been hearing from other people -- parents, teachers, bosses, siblings, friends, romantic partners -- all our lives, and their opinions of us continue to reinforce our notions of ourselves, good or bad. Self-affirmations, even when endlessly repeated, don't make much of a dent -- and when they fail to work, they may leave us even more demoralized.

What's more, people with low self-esteem may be especially unpersuaded by self-affirmations. Preliminary research by Swann's colleague at UT, Robert Josephs, Ph.D., indicates that those with poor self-images simply don't believe the statements, because they don't value their own opinions very highly. In Josephs' experiment, high self-esteem people were able to pat themselves on the back for solving a set of problems, while "lows" had to hear praise from someone else before they would credit it.

WHAT TO DO INSTEAD: The only way to change the final product -- your self-esteem -- is to change what goes into making it -- feedback from other people. "If you find yourself in bad relationships where your negative self-view is getting reinforced, then either change the way those people treat you by being more assertive, or change who you interact with," says Swann. "If you're in a job where you're getting denigrated, insist that you be treated more appropriately, or change jobs. Try to do your job better than you've done it before."

IN OTHER WORDS: Stand up for yourself. Surround yourself with people who think you're great, and tell you so. Do your best to live up to their high opinions. And be patient. Self-esteem is the sum of your interactions with others over a lifetime, and it's not going to change overnight.

DISTORTION 5

"Active listening" can help you communicate better with your partner.

SELF-HELP BOOKS SAY: "The technique of 'active listening' ensures that you not only hear, but really understand what your partner is trying to tell you," reads Going the Distance: Finding and Keeping Lifelong Love (Plume, 1993). You do it by "paraphrasing your partner's words, then repeating in your own words what you believe your partner is trying to communicate to you."

RESEARCHERS SAY: There's only one problem with active listening: hardly anyone does it. Although the technique has been promoted by therapists for over three decades, research shows that actual couples -- including the long-lasting, lovey-dovey ones -- completely ignore it when they argue. "It just doesn't happen," says Sybil Carrere, Ph.D., a psychologist at the University of Washington who's been leading a six-year study of how newlyweds interact. "Intuitively it does make sense, but the fact is that when you look at happy couples, they're not doing it. They're being affectionate, they're using humor to break up tension, they're indicating interest in what their partner has to say -- they're doing a lot of positive things. But they're not doing active listening." In fact, one of the few studies that has been conducted on the effects of active listening shows that it does nothing to help couples in distress.

WHAT TO DO INSTEAD: According to Carrere, couples should focus their efforts on three other areas. First, women should try to present their complaints in a calm way: Research shows that men are more likely to listen if their partners tone down hostility and avoid contemptuousness. Second, men need to really listen to their partners, taking their feelings and opinions into account. And third, both sides should do what they can to keep the male half cool and collected. "Men have a tendency when they get into conflict to get physiologically aroused, and then they tend to withdraw from the conflict in order to soothe themselves, which only makes the woman more angry," says Carrere. If the two of you can work together to head his anger off at the pass -- by throwing in a joke, maybe, or offering a hug -- you'll both be better off.

The five distortions presented here are only a few of the misconceptions you may encounter. To protect yourself against others, be sure to take self-help prescriptions with a measure of skepticism and a healthy dose of common sense.

SIFTING SCIENCE FROM SNAKE OIL: How to Find Top Psychology in Pop Psychology

Americans turn relentlessly to books, magazines, radio, TV and the Internet in the hopes of finding their way to a better, less problem-filled life. But there's a catch. Some of this popular psychology is based on solid psychological science and practice, and some is not. How to distinguish which is which?

Consider the source of the information. Does it come from a mental health professional? Beware of materials written by fellow sufferers who are laypersons. Experiencing a problem doesn't automatically confer the ability to help others. And what works for one may not work for all.

The problem that's addressed has to be one that is amenable to change. Psychological states that are genetic, like manic-depressive disorder, are extraordinarily difficult to change. So are those that are at the core of what we think or do, such as sexual orientation. Depression is more responsive to deliberate efforts at change, and panic disorder and issues of sexual performance more susceptible still.

The material must provide both facts about and specific strategies for dealing with the psychological concern. It's important that the information review the symptoms of any condition, and ideally a self-diagnosis questionnaire should be provided.

Quality information also takes into account individual differences among readers. Most helpful is an array of techniques for tackling the problem. The more specific the problem-solving strategies., the more useful. And all of the strategies presented should be based squarely on science or professional practice.

The material should refer the reader to authoritative sources, such as professional organizations. Does it contain a bibliography? A resource guide? These are important for possible follow-ups.

Along with G. Ann Schultis, I have analyzed self-help books and offer these additional guidelines in choosing good ones. The book's title should reflect its contents. The purpose of the book should be stated in the preface or the first chapter.

Some radio and TV stations air entire programs devoted to psychological matters, often hosted by a "mental health professional." Highly dependent on the skills and knowledge of the host, these programs may play on the voyeuristic interests of listeners who may be titillated tuning into the intimate details of an anonymous caller's life. On the other hand, such programs may reach millions and motivate some to seek professional help because of what they heard.

TV talk shows may feature "victims" of a particular problem -- but they often encourage the very behaviors they are purporting to fix. For instance, a couple with poor interpersonal skills is goaded into fighting before the studio audience. Then a guest therapist (typically the author of a topical self-help book) suggests a quick fix to the problem. In this way, the program reinforces both the antisocial behavior and the idea of overly simple solutions to far more complex matters.

Psychologically related sites have virtually exploded on the web. Look for those hosted by a reputable organization and that present in-depth coverage of issues. The best Web sites offer bibliographies of relevant articles and books; they also offer a listing of professional organizations.

No matter where you turn for information, you can't abandon your critical thinking skills.

THE BEST SELF-HELP BOOKS

GENERAL RESOURCES

The Authoritative Guide to Self-Help Resources in Mental Health By John C. Norcross, Linda Frye Campbell and Thomas P. Smith (Guilford, 2000)

THE BEST SELF-HELP AND SELF-AWARENESS BOOKS:

A Topic-by-Topic Guide to Quality Information By Stephen B. Fried and G. Ann Schultis (American Library Association, 1995)

Caring for the Mind: The Comprehensive Guide to Mental Health By Dianne and Robert Hales (Bantam, 1995)

RESOURCES ON ANXIETY

An End to Panic: Breakthrough Techniques for Overcoming Panic Disorder By Elke Zuercher-White (New Harbinger Publications, 1998)

Anxiety & Depression: The Best Resources to Help You Cope Edited By Rich Wemhoff (Resource Pathways, 1998)

RESOURCES ON DEPRESSION

Feeling Good: The New Mood Therapy By David D. Burns (Avon, 1992)

Understanding Depression: A Complete Guide to Its Diagnosis and Treatment By Donald F. Klein, M.D., and Paul H.Wender, M.D. (Oxford University Press, 1993)

SELF-HELP RESOURCES ON OBSESSIVE-COMPULSIVE DISORDER

Getting Control: Overcoming Your Obsessions and Compulsions By Lee Baler (Plume, 1992)

The OCD Workbook: Your Guide to Breaking Free from Obsessive-Compulsive Disorder By Bruce M. Hyman and Cherry Pedrick (New Harbinger Publications, 1999)

RESOURCES FOR TRAUMA AND PTSD

Coping with Post-Traumatic Stress Disorder By Carolyn Simpson and Dwain Simpson (Rosen Publishing Group, 1997)

Coping with Trauma: A Guide to Self-Understanding By Jon G. Allen (American Psychiatric Press, 1995)

THE BEST SELF-HELP WEBSITES

GOVERNMENT-SPONSORED WEB SITES:

U.S. Dept. of Health and Human Services www.mentalhealth.gov

eNational Center for PTSD (operated by the U.S. Department of Veterans Affairs) www.dartmouth. edu/dms/ptsd

eNational Institute of Mental Health www.nimh.nih.gov

NON-PROFIT SITES

eAmerican Psychiatric Association www.psych.org

Anxiety Disorders Association of America www.adaa.org

The Help Center of the American Psychological Association www.helping.apa.org

The International Society for Mental Health Online www.ismho.org

eNational Alliance for the Mentally III www.nami.org

National Depressive and Manic-Depressive Association www.ndmda.org

COMMERCIAL WEB SITES

Online Psych www.onlinepsych.com

eBasic Information www.realpsychology.com

eSelf-Help and Psychology Magazine www.shpm.com