The effectiveness of self-help literature in addressing mental health

¶ … embarrasses or shames them to such an extent that they might be reluctant to seek professional assistance, has probably looked into some kind of self-help reading. Not all of this reading is found in self-help books. In fact, self-help is such a popular topic, that I went to my bathroom magazine rack and pulled out five different magazines with self-help articles. Some of them targeted fixing certain behaviors, but others, like Oprah magazine, made bold promises about changing one's life after taking a 28-question quiz. It made me realize that, as a society, we are really enamored with the idea of the quick-fix. It also made me a little bit angry. The fact that these magazines, all of them targeted towards women, featured articles promising to help people fix their lives, made me realize that people are really struggling with issues and not seeking the appropriate help. Does the proliferation of all of these self-help books compound the problem, or does it provide some relief for some of the people experiencing turmoil? I realize that is a question that may not be answerable, but it is a question that is worth asking. Moreover, does this proliferation of self-help keep people from seeking professional assistance?

I think that it is likely that these self-help books do keep some people from seeking assistance, and, that by prolonging people's contact with mental health professionals, almost certainly exacerbate problems for some people. However, I think that even ineffective self-help books may provide people with a catalyst to seek out professional help. After all, reading a self-help book means that a person is at least acknowledging that an issue needs to be addressed. They may not be at the point of acknowledging that they need professional help to address the issue, and not all issues require that level of intervention, but they are at least no longer in denial about the fact that there is an issue.

Personally, I have found two self-help type books to be extremely helpful, but the reasons that I found these books helpful varied with the book. The first of these books was given to me by a family friend when I was a teenager struggling to cope with the alcoholism and substance abuse issues that plagued my family. The book was called Al-Anon Faces Alcoholism and discussed the Al-Anon approach to dealing with alcoholism. While I appreciate that Al-Anon is a support group for people who choose to remain in relationships with alcoholics, even as a teenager, I found its approach demeaning. The book seemed to advocate playing a victim's role, though it used empowering language to do so. I rejected the message of the book, determined that I would not develop the same substance abuse problems as some of my family members and that I would never tolerate addictive behavior in the family I created once grown. That rejection of the message in that book has served me well, as I have avoided drug and alcohol abuse and have never been involved in a romantic relationship or a close friendship with an addict.

The second book that I found helpful was a book written by Joel Osteen, a televangelist based out of Houston, Texas. There is a lot of criticism, much of it justified, about Osteen and his ministry. Both the ultra-religious and non-religious critics of his suggest that Osteen is twisting the Bible's message to imply that Christianity and financial security are intertwined, which gives his followers false hope. Reading Osteen's book, I found those criticisms to be rather hollow. While Osteen's treatment of scripture varied from the normal treatment of scripture, it was no more carefully selected to convey his message than the religious messages of most churches. Moreover, I found his advice helpful. I did not become a millionaire, but I found his advice to remain positive and be certain that I could persevere to be uplifting and inspiring. Sometimes, life just seems overwhelming, and a book that conveys the message that a person is never truly alone helps alleviate some of the dread that comes with a feeling of being so overwhelmed. As a result, I have to consider his book helpful, even if I have not yet achieved the financial success the book seemed to promise.

Chapter Two

I love candy, which probably comes as no surprise, since most people love candy. Furthermore, when choosing a non-chocolate candy, I frequently turn to Starburst. I absolutely love the way that they taste. However, as much as I love candy, in general, and Starburst in particular, I actually get physically ill at the thought of Starburst twizzlers. Even contemplating eating them leaves me queasy. What is even more unique is that this did not occur until late in my life. As a young adult, I had Starburst twizzlers just before experiencing a horrible bout of food poisoning. Though the twizzlers are not what made me ill, they were the last food that I consumed prior to becoming ill, and just thinking of them brings on the same nausea I experienced with that illness. Interestingly enough, the other strong example of classical conditioning that I have noticed in everyday life also involves a nausea response to an innocuous food. A relative had cancer and had to undergo chemotherapy. While he was being treated, the hospital served him Jell-o with virtually every meal. He has been cancer-free for well over a decade, but he still cannot stand the sight of Jell-o.

Even more interesting to me than the impact of operant conditioning on my own interpersonal relationships is the impact that operant conditioning has had on a child in my life. One of my friends has a young son who is autistic. He is non-verbal, though not considered severe or profound. For example, he is non-violent, but he does engage in a wide repertoire of self-soothing stemming behaviors, and interfering with his performance of those behaviors can result in him causing self-harm and occasionally physically lashing out at others. This child has recently begun getting ABA therapy, and an in-home trainer comes to work with his mother to teach her how to work with her son.

I am struck by how much his ABA therapy relies on the basic principles of operant conditioning. There is no punishment involved in his training. While some people may feel that punishment is appropriate for an autistic child, his in-home trainer feels that applying aversive stimuli to a person who is already over-stimulated is not conducive to learning. However, the rest of his therapy relies heavily on positive reinforcement, rewards, and negative reinforcement. For example, at five, this child is far away from being toilet-trained, and, since toilet-training is a particularly difficult issue for many autistic children, my friend has been told to expect that he may be in his teens before mastering that skill. Prior to the in-home trainer, my friend had never had success attempting to get him to use the bathroom on the potty. However, the trainer showed her how to implement a chocolate reward system for when we sat on the potty and tried to go. Now, he will sit on the potty and attempt to get his reward.

In addition, his mother and his trainer have used operant conditioning to help make him somewhat verbal. His favorite food is popcorn, and he used to simply point at it and his mother would supply it for him. Then, the trainer said not to give any to him unless he vocalized. Once grunting or making some other noise was established as a popcorn request, the trainer told her not to give it to him unless he made a "popcorn"-like sound. Then, he was to be rewarded with one piece of popcorn. Now, he must say the word "popcorn," and each utterance earns him exactly one piece of popcorn. If he begins to tantrum, which is common because he gets very frustrated during his training, then my friend has been instructed to remove the popcorn and not let him have any more of it that day. This has been an incredibly effective technique and has increased his vocabulary from one word, "Wonderpets," to 10-15 words, depending on the day. While a 10-15-word vocabulary may seem insignificant, for a child who was non-verbal for almost five years, it is an incredible achievement, and it is all due to operant conditioning.

Chapter Four: Ways of Coping

Stress is such a pervasive part of everyday life that people come up with a bunch of different methods of coping. Unfortunately, a significant proportion of those coping methods are not healthy ways of dealing with stress. For example, people use drugs, alcohol, and food to help them cope with stress. Even people who do not turn to substances to help them ease stress may deal with stress in an unhealthy manner. Personally, I am a clean-freak. Under most circumstances, I like to have a very tidy home, and I find it difficult to relax if my home is not clean and relatively tidy. However, when I am experiencing a significant amount of stress, my desire for cleanliness increases almost exponentially. At those times, it is not enough that my house be relatively tidy. On the contrary, at those times, I must experience my home as absolutely clean or tidy before being able to relax or being able to concentrate on fixing the stressful issue. I know that exerting control over my environment, even in a seemingly insignificant manner; by making sure that my home is clean is my way of regaining a sense of control and feeling able to tackle larger stressors. However, I also know that it is not the healthiest way to deal with stress.

What I have been trying to do is work on ways to deal with stress in a more direct manner, because I know that my current coping skills are not as constructive as they could be. What I learned from reading this chapter is that constructive coping skills have specific characteristics. First, constructive coping involves confronting problems rather than symptoms. Constructive coping means that one does not engage in excessive self-deception or other forms of unrealistic thinking. Constructive coping starts with recognizing stressors. Finally, constructive coping means that I have to control potentially destructive coping behaviors. For example, at this point in time, my desire to clean when stressed is not constructive, but it is also not destructive. However, I could imagine a scenario where such a desire for cleanliness could be destructive. For example, I had a childhood friend whose mother was a "clean-freak;" her obsession with cleanliness was so severe that she would not permit her children to play in her home.

Looking at the information for constructive coping methods, I realize that I use one of those coping mechanisms on a regular basis. I used to get extremely upset when people made mistakes on simple things. For example, if I went to a fast food restaurant and they made a mistake in my order, I would get really upset. I figured that, with such a simple job, it should be difficult to make a mistake. However, a friend of mine, who is rarely upset by incompetence or mistakes, suggested that I take the approach that every person I encounter working in an environment like that is special needs. She suggested that because she has volunteered with special-needs people for an extensive period of time and knows that they are frequently employed in low-pay, low-skilled jobs. She also knows that they are frequently the targets for people's anger and ire, even though the reality is that a messed-up fast food order generally does not have dire consequences for any of the people involved. Therefore, she suggested that I act as if any person I encounter in a service position has a hidden disability, and that I adjust my expectations and response accordingly. I have found that this approach reminds me that all human beings make mistakes. As a result, I am not so disappointed or angered when someone makes a mistake. Moreover, when someone makes a mistake, even if I do get upset about the mistake, I remind myself to be nice about it. I have found that refusing to dwell on the mistake or take out my frustration by venting undeserved anger at another person results in reduced stress, rather than increased stress.

Chapter Five: Self-esteem

Self-esteem refers to one's evaluation of one's self. Generally, people who feel good about themselves have high self-esteem, and people who feel bad about themselves have low self-esteem. However, self-esteem is slightly more complicated than it appears. First, there are two different ways of looking at self-esteem. There is trait self-esteem, which refers to someone's ongoing confidence. Trait self-esteem tends to remain constant over a lifetime. In addition, there is state self-esteem, which refers to how someone feels in a particular moment. State self-esteem is more subject to influence by temporary, outside factors than trait self-esteem. For some people, state self-esteem is very fluid and fluctuates tremendously with outside events. Other people are less sensitive and tend to have a more static view of self.

What I found the most interesting were the text's discussions of the accuracy of people's views of themselves. Generally, I considered people who thought well of themselves to have high self-esteem. It never occurred to me that sometimes people may not think very highly of themselves, but if these people are not good people, that they may actually have relatively high self-esteem. For example, I recall reading a fiction book that featured a villain who was a serial killer. He was not one of those serial killers who were otherwise successful in life, where it came as a big surprise that he was a violent criminal. On the contrary, he was a serial killer who lived alone in a basement apartment, held a web-based job that allowed him not to interact with people, and generally lacked the traits one associates with success. However, this character, as portrayed by the author, actually had a very high self-esteem. He regarded himself as a loner and on the fringes of society, but he was a loner who lived on the fringes of society. However, he regarded himself as an extremely empathetic and caring person because he had a number of cats. Obviously, that example is fiction, and even real-life serial killers are not great examples of mental health, but it demonstrates the idea that self-esteem is relative and really cannot be judged outside of the context of society. The text supported this with the fact that people with high self-esteem feel more likeable, more attractive, and more likely to have better relationships with people, despite the fact that the empirical evidence did not support those claims.

In fact, I was fascinated by the text's discussion of self-esteem and place in society. It is easy to dismiss criminals who boast of their activities as simply narcissists. Narcissists differ from people with a healthy high self-esteem. For narcissists, self-image is critical and criticism can be very damaging. While an individual with high self-esteem may firmly believe that he deserves to be treated equally with other people, narcissistic individuals believe that they deserve to be treated better than other people. As a result, narcissistic people are very likely to be aggressive, when confronted with something challenging their self-esteem. It should come as no surprise that domestic violence offenders are frequently narcissistic.

That made me wonder about the role that narcissism plays in the perpetuation of the macho ideal in certain cultures. I know that cultural norms and gender roles can contribute to gender and family violence. While no culture is free from family violence, those cultures that promote the idea of machismo are more likely to view family violence as an entrenched party of the family dynamic. I found the idea of treating individuals for narcissism rather than low self-esteem very interesting, and it made me wonder about how to translate that to a culture. For example, cultures that value men much more than women probably do not have higher rates of violence against women simply because they treat women like disposable commodities, but also because the false ego-inflation that men in these cultures receive as the result of being so strongly favored sets them up for narcissism and makes them more likely to aggress when challenged. I would love to see further research into that area.