Richard G. Petty, MD

The Changing Landscape of Self-Help

The self-help movement has been through three phases, and we are now entering a fourth phase, which is, I think, the most exciting of all.

The first phase began with those philosophers, both Eastern and Western, who first began to talk about human freedoms and our capacity as humans to use the powers of our minds to influence our emotions, beliefs, attitudes and life circumstances. There is a clear line running from Plato and Aristotle, through philosophers like Marcus Aurelius (the same person who was such an important figure at the beginning of the movie Gladiator), Saint Augustine, Francois de La Rochefoucauld, Emanuel Swedenborg, Benjamin Franklin, Thomas Jefferson and Emerson. In the east, both Buddha and Lao-Tzu talked about the way in which our minds construct our reality.

The second phase built on the insights of these good people with the growth of the “Positive Thought” movement, which started rather over a hundred years ago and revolved around the idea that “thoughts are things”, and was buttressed by folk psychology. That is common sense psychology. Names like Ernest Holmes, Charles Haanel, Napoleon Hill and Earl Nightingale were some of the standard bearers of this phase. The trouble with commonsense psychology is that a lot of commonsense turns out to be wrong. Let me give you an example. In recent years there has been a lot written about self-esteem. This remains a poorly defined term in psychological research, but the National Association for Self-Esteem (NASE) defines healthy self-esteem as “the experience of being capable of meeting life’s challenges and being worthy of happiness.”

The theory has been that if you have low self-esteem, that is a bad thing, so boosting your self-esteem must be a good thing. Indeed entire educational systems have been built up around this idea. I lived through a time in Britain when some people tried to ban competitive games on the grounds that competition is bad and that if someone lost, it might damage their self-esteem and cause them psychological damage.

There is a very interesting study that came out in 1989, comparing mathematical competence in students in eight different countries. Korean students ranked the highest in mathematical skills, while those in the United States had the lowest rating. Now the study had an interesting sting in the tail: the researchers asked the students to rate how good they thought they thought they were at mathematics. The American students who did so poorly, actually had the highest overall opinion of their ability, while the Koreans who had the best results had the lowest opinion of their abilities.

I was reminded of that study by watching a few minutes of an early episode of American Idol on which Simon Cowell was skewering some of the contestants, who then protested loudly despite that they were brilliant, despite having just given a lamentable performance. There is good quality scientific research that has shown that self-esteem has little or no effect on personal goals, academic achievement, healthy lifestyles or interpersonal relationships. Indeed, there are several studies suggesting that inflated self-esteem may be dangerous: extremely high self-esteem can make some people narcissistic and is a feature of many sociopaths and some psychiatric illnesses. People who have exaggerated views about their self-worth often become hostile if they are criticized or rejected. It seems clear that boosting self-esteem on its own does not seem to do anything very much. But having it raised by achievement is very valuable.

The third phase of development of the self-help movement incorporated some pop psychology and some experimental work. I am thinking of pop psychology like the false dichotomy of right and left hemispheres of the brain, or the primacy of channeling emotion to get tasks completed. It led to claims that all that was necessary for success was to learn this, or master that, and you would be successful beyond your wildest dreams. We were instructed to live more passionately, to generate a burning desire for something, to have an unshakable belief that we would be successful, to set clear goals, to create a plan of action, to persist, affirm, visualize, give ourselves permission to succeed. The list goes on and on. I am quite certain that each of them was correct and that each has helped a lot of people, but in our changing world, mastering any one of those will not be as effective as using all of them together. We also saw the problems that could sometimes occur when folk took little bits of psychological research out of context and tried to apply it to human problems.

We are now entering a fourth phase, in which sophisticated empirical research is driving a new psychological enterprise. Much of the credit for this new approach must go to Marty Seligman at the University of Pennsylvania, who has become the guru of positive psychology. I know that many people have been surprised when I, and others, make self-help recommendations, not based solely on my personal experience, but also rooted in careful research. We are now entering an exciting time, and the challenge is to see which self-help programs really hold water, and to use the scientific method to improve them further.

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Online Therapy

There is a very interesting article in Newsweek that talks about the growing trend to offer psychotherapy online. The article highlights the main reasons for this new development: convenience, anonymity and low prices. Without the overhead of running an office, internet therapy is roughly half the price of a regular office visit.

I was initially rather skeptical about the potential effectiveness of internet therapy: any experienced therapist will tell you of the amount of non-verbal material which is used during a session. Body language is a potent indicator of internal psychological states, and there is often a meta-text in communication, that can be difficult to pick up if you are not in the room with someone. And good therapy requires a lot of intuition. But on the other hand, there are times when people will open up when they do not see another person. It is one of the reasons that psychoanalysts used to use a couch, with the therapist out of sight of the patient.

So I have reviewed the research literature on the use of the internet for psychotherapy for an array of conditions, including addictions, and found over 190 studies, at least a third of which were reports of well conducted studies. Although it is still early days, and most of the research studies are small, the results are almost all positive. Clearly we cannot use the internet for trying to treat people with severe or life threatening problems, but for many of the problems which create such difficulties in many peoples’ lives, I think that this is a very positive development. So much so, that I am currently considering setting up an online service myself. I would be interested to hear of other people’s experiences of online services, and whether they would like me to offer one myself.

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Stressful Marriages Can be Damaging to Your Health

There is an extremely interesting article in the month’s Archives of General Psychiatry, which was picked up by the media that examined how marital stress effects healing.

Most people now accept that the mind has powerful effects on the body, though as recently as the 1970s this was still regarded as rank heresy by many in the medical community. This new study is important for our understanding of the relationship between stress and physical health, and gives us further insights into how we can help ourselves stay well.

The study was done at Ohio State University and examines 42 married couples. Each person was given small skin lesions, and the startling finding was that in hostile couples, the wounds healed 60% more slowly than they did in non-hostile couples. The investigators even identified an inflammatory mediator called interleukin-6 (IL-6), as the biochemical link between hostility and slow wound healing. IL-6 levels are linked to long-term inflammation, which is in turn implicated in a number of illnesses, including diabetes mellitus, arthritis and cardiovascular disease.

A thirty-minute disagreement with a spouse could push back wound healing for 24 hours. The skin is the largest organ in the body and is exquisitely sensitive to stress: just thing of blushing and getting zits when under stress. So it is difficult to extrapolate from these findings in the skin, to try and predict what would happen with healing of internal organs. But we do have enough information already to say the following:

1. Allowing yourself to become involved in an argument may have long-term physical effects on you.

2. Some years ago I worked with a group of fine people who did just one thing that I did not like: they were wedded to the idea that it is a really good idea to vent your feelings. They would go as far as allowing patients to hit walls and other inanimate objects. I was never keen on this, feeling that expressing a lot of negative emotion could be counter-productive. After a patient broke bones in his hand after striking the wall, I quietly put an end to the practice. This new research indicates that I was correct to do so.

3. If you are going to have surgery, it is a good idea to be in a calm and peaceful frame of mind.

4. Stress is often unpredictable so it is a really good idea to be engaged in some ongoing stress management practice, so that you are better able to deal with the "slings and arrows of outrageous fortune," as Shakespeare put it over four hundred years ago. Clearly this doesn’t mean that you have to walk around like a burned out hippy on Quaaludes. Unless you really want to…. The best techniques that I know of for dealing with stress are the Sixty Second Peace Technique, Qigong and Yoga Breathing. If you have your own method, then stick with it. Otherwise you may want to check out some of the materials that I have written and recorded.

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Synchronicity

In my forthcoming book, Sacred Cycles: Regaining Health and Harmony by Mastering the Natural Rhythms of Life, I disucss synchronicity as  a really important aspect of our lives. The notion of synchronicity, or meaningful coincidences, was first proposed by the famous Swiss psychologist Carl Jung and his friend the Nobel Prize-winning physicist, Wolfgang Pauli. Are there really such connections in our lives, or do we live simply at the whim of random chance in a Universe whose every law has been laid bare by the impassive probing of modern science?

There have been countless attempts by mathematicians and physicists to explain away synchronicity, which some skeptics describe as some sort of refuge of the mathematically challenged. Yet other plenty of other scientists have said, “Wait a minute, there really may be something here.” Or is the whole discussion a pointless comparison of objective mathematical apples with subjective metaphysical pears?

I am very interested in hearing your views as well as any personal experiences.

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