Self Help : With Improvement Books Cramming the Shelves, Experts Are Asking: Do They Really Work?

Lisa Marsoli and Mel Green had planned on having some fun when they set out to promote their book, “Smart Women, Stupid Books: Stop Reading and Learn to Love Losers.” A good-natured jab at the avalanche of self-help guides for women in search of Mr. Right, the book urges desperate single women to reconsider some undesirable personality types, including the clam, the egomaniac and the mad artist. Chapter 3, “Breaking the Rules: Dating the Deranged,” tells how.

Trouble is, some talk-show listeners refused to take the book lightly, and pressed the authors for advice. Exasperated by their demands, Green began offering these stock suggestions to lovesick callers, whatever their dilemmas: “Loosen your garters and eat some cheesecake.”

Marsoli and Green’s experience demonstrates what many mental health professionals have suspected for years: America’s love affair with self-help books has become a steady relationship. More than 2,000 are published annually, estimates Chandler Grannis, contributing editor of Publishers Weekly. And if their success is an indication, many will continue to land on best-seller lists.

But while some experts believe self-help books can motivate readers to break bad habits and live life more fully, others caution that with promises of quick and easy solutions come pitfalls, including the possibility of psychological harm.

Heeding the call for a reform of the genre, psychologists and publishers are debating ways to improve self-help books, an effort complicated by the fact that American Psychological Assn. and the American Psychiatric Assn. do not have official policies regarding them.

“The claims (on book jackets and in advertisements) have become increasingly outrageous,” said Gerald Rosen, a Seattle psychologist and a clinical associate professor of psychiatry at the University of Washington Medical School, Seattle.

“Some of the titles themselves are ridiculous,” said Rosen, who chaired the American Psychological Assn.’s now-defunct Task Force on Self-Help Therapies. As an example, he cites “The Doctor’s Guide to Instant Stress Relief,” adding, “There’s no such thing as instant stress relief.”

Surveys suggest the likelihood of self-help books leading to psychological damage is rare. Only 8% of the psychologists polled by Portland psychologist Steven Starker reported clients had complained of being harmed by self-help readings. And none of the surveyed psychologists considered self-help works generally harmful, although 4% rated them “unhelpful” and 29% found them “rarely helpful,” said Starker, author of the new book “Oracle at the Supermarket: The American Preoccupation with Self-Help” (Transaction Books).

Such surveys, however, may not reflect the actual incidence of psychological damage, other mental-health professionals maintain.

“In many of the books, people are given instructions on how to solve difficult problems without a support system,” said Patricia Keith-Spiegel, a psychology professor at Cal State Northridge. “Suppose a reader tries something (suggested in the book) and it fails. There’s no one to say, ‘You’ve misinterpreted me here.’ There’s no one there to mop up the consequences.”

And if a book doesn’t deliver on its promise, experts say, readers may blame themselves, discouraging even the most enthusiastic.

Helen Swanner, for instance, a La Crescenta real estate agent who credits much of her professional success to the seven to 10 self-help books she reads each year, was recently frustrated by one that called for myriad behavior and attitude changes. “Who can make all these changes at once?” she said.

But to some self-help book proponents, even a little help is better than none. Says one: “If I get just one good idea, it’s worth the price of the book.”

Psychologist Starker explains the fascination with self-help books this way: “We all want to better our lives, to become more beautiful, to be happier. In our mobile society, people have fewer sources of immediate support. A self-help book can be a pep talk that keeps people hopeful and gives them some direction. There’s the constant hope that the next book will change your life for the better. If someone promises that, why not take a risk, particularly if it costs $3.95?”

In a survey of reading habits, Starker found that Portland residents read an average of three self-help books a year. In other surveys, he found that a majority of psychologists recommends self-help books at least occasionally, and that West Coast therapists are more apt to do so than those in the East.

Self-help books also appeal to our penchant for independence, say experts. “We tend to pull ourselves up by our own bootstraps,” said Keith-Spiegel of Cal State Northridge. And for some, the books work as well or better than other psychological assistance.

A group of smokers who used self-help workbooks, for example, were just as likely to be long-term nonsmokers as the group who participated in group meetings, concluded Susan Curry, assistant professor of psychology at the University of Washington, Seattle, and an investigator at the Center for Health Studies at the Group Health Cooperative of Puget Sound, a health maintenance organization. “In both groups, one of three was a nonsmoker at the one-year follow-up,” she said.

What’s needed to improve the books, said Rosen and others, are scientific studies proving that a self-help idea or technique works--at least for books that promote a step-by-step approach.

In Rosen’s view, a diet book author should write the manuscript and ask subjects to read and follow its advice, then compare the results with those of other methods before publishing the work.

But such scientific studies can be time-consuming and expensive, as Keith-Spiegel learned. Four years ago, she wrote a self-help book on how to get into graduate school. Ever since, she has been field testing the advice, at an out-of-pocket cost of more than $3,000, she said.

Much information contained in self-help books is based on clinical experience--which should be proof enough, say some psychologists. Not all techniques are tangible enough to be easily studied, Starker said. “What about books on how to have a happier image?”

Still other therapists say authors should demand approval of book jacket and promotional copy to tone down sensational claims. While they consult with authors on book jacket and promotional copy, many editors acknowledge that only big-name authors get approval clauses written into their contracts.

Meanwhile, publishers and editors feel pressured to use the best cases and most dramatic claims as selling tools. “People who write the promotional materials sometimes get carried away, and may promise more than the author actually does,” said Channa Taub, senior editor at Henry Holt and Co. in New York, who edited “Getting the Love You Want.”

“You don’t sell a book by saying, ‘Maybe this will help,” ’ said James J. Forest, associate professor of psychology at the University of Manitoba. In his study of 232 paperback self-help books, reported recently in a letter to the editor of the journal American Psychologist, Forest found new , unique and revolutionary were the words used most often. The most frequent promises made by self-help authors centered on fear and anxiety, self-awareness, successful life performance, happiness and human potential, he said.

What gives a self-help book the most validity is an author-expert who espouses a sound program or technique, publishing executives observe. Barbara Alpert, senior editor at Bantam Books, said she looks for books that include the three P’s--a legitimate problem, a workable program and a legitimate payoff or promise.

As publishers and mental health professionals continue to discuss ways to improve self-help books, buyers must continue to take a caveat emptor approach. “You can find everything on the shelves, from flat-out quackery to helpful books,” said Christine Schillig, publisher at G. P. Putnam’s Sons, New York. “You have to be a discerning consumer.”

Here’s how, according to the experts:

-- Don’t judge a self-help book by its cover. Skim it before buying. Choose a book that promotes an “open system” of improvement, rather than a “closed” one, Starker suggested. A closed system might include such statements as, “Forget everything you ever learned about diet. Everything important is in this book.” An open system, acknowledging options, might say, “This book suggests one way to lose weight.”

Look for easy-to-follow programs or realistic techniques, along with warnings that it won’t work instantly or for everyone.

-- Determine if the author is an expert. Many book jackets include an author biography, but readers can do some checking of their own. “In public libraries, check professional directories (such as the Directory of Medical Specialists),” said Keith-Spiegel. Affiliation with a university is usually a good indication of expertise, some experts say. If all else fails, telephone the author directly and ask about his or her background.

-- If your therapist recommends a book, ask if he or she has read it. A therapist should never prescribe a self-help book without reading it first, said Michael J. Mahoney, a professor of counseling psychology at UC Santa Barbara. When Mahoney recommends self-help reading, he also asks clients to write about their reactions to the book’s ideas and to share their thoughts at the next therapy session.

-- Read media reports of self-help books with a grain of salt. “When a book becomes popular, everyone (in the media) seems to jump on the bandwagon,” said Schillig of G.P. Putnam’s Sons. She believes techniques and authors’ credentials are not always checked thoroughly.

-- Don’t expect miracles . “I do think a good self-help book has a place,” said Keith-Spiegel, “but these books aren’t magic pills.”

Even the best-researched books written by respected experts may not change lives as much as we would like, Forest said, partly because it’s difficult to transform information and motivation into action. In one study of self-help books, Forest posed 50 questions based on a self-help book to one group of people who had read it and to another group who had not. “Those who didn’t read the book got 25 of 50 questions right on the average,” he said. “Those who did read it got 29 of 50 right.”

When he retested both groups a week later, the self-help book readers scored only one question better than those who had not read it. “We get highly motivated (by self-help books),” he said, “but there’s so much information, we forget a lot.”