HAVE YOU EVER purchased a self-help book? If so, you are like most Americans. In 2003 alone, publishers put out more than 3,500 new self-help titles, ringing up more than $650 million in sales. Many of the buyers cannot or will not seek psychotherapy, but surveys by John C. Norcross of the University of Scranton and others indicate that 80 percent or more of psychotherapists recommend such books to their patients, too. How well are self-help books fulfilling their purpose?
Authors of self-help books often make grandiose promises that invite a skeptical look. Consider the title of a best-seller by Anthony Robbins: Awaken the Giant Within: How to Take Immediate Control of Your Mental, Emotional, Physical and Financial Destiny! (Free Press, 1992). The dust jacket describes Robbins as an “acknowledged expert in the psychology of change.” Yet he lacks any formal mental health credentials. Elsewhere, Robbins has made eyebrow-raising claims, such as that he can cure any psychological problem in a session, make someone fall in love with you in five minutes and even revive brain-dead individuals. (If he can do this with enough people, he might sell even more books.)
Even trained psychologist authors are not immune to hyperbole. Wayne Dyer, a counseling psychologist, wrote You’ll See It When You Believe It: The Way to Your Personal Transformation (Harper Paperbacks, 2001). The dust jacket promises that “through belief you can make your most impossible dreams come true, turn obstacles into opportunities, rid yourself of guilt and inner turmoil, and spend every day doing the things you love to do.” That’s nice work if you can get it.
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In view of how much time, money and effort buyers spend on these materials, not to mention the hopes they raise, it is remarkable how little the average person knows about their effectiveness. Moreover, as clinical psychologist Gerald M. Rosen of the University of Washington has noted, professional psychological organizations have done little to educate the public concerning the strengths and weaknesses of self-help. Still, some researchers have conducted informative studies of the effects of self-help books, or as they call it “bibliotherapy.”
Typically investigators recruit participants with a specific problem (such as depression, panic attacks or obesity). They take objective measures of the problem before and after the bibliotherapy and compare such statistics with a group that gets no book or any other treatment (the “control” group); the intervening period usually lasts four to 12 weeks. Some studies also compare bibliotherapy with face-to-face psychotherapy.
Results generally demonstrate that bibliotherapy leads to greater mental health improvements than no treatment, and it often equals the benefits obtained by psychotherapy. Before you log on to Amazon.com or rush to the bookstore, however, let us describe the limitations of this research.
Small sample size. Only a tiny percentage of self-help books has been evaluated; a larger sampling may show different effects.
Minor problems. Many studies have employed subjects with relatively minor problems (such as mild fears of public speaking), which may be more amenable to self-help strategies than serious problems are.
Uneven results. Improvements occur for some but not all people, and many of those who do get better are still left with significant symptoms.
Study conditions yield greater success. Study volunteers may be more motivated than casual bookstore or airport browsers who purchase the same book. Subjects may be especially encouraged to read the book because researchers often call to monitor how they are doing. (In contrast, one of us [Arkowitz] has had a self-help book for more than 30 years entitled How to Get Control of Your Time and Your Life. He has not yet found the time to read it. Maybe he should take part in one of these studies.)
Combined treatments. One review found that bibliotherapy study participants also met with therapists for 36 minutes on average per week, making it difficult to separate how much of the positive effects are attributable to psychotherapy versus bibliotherapy.
False hopes. Some self-help books may be unable to deliver on their expansive promises. As a result, readers may perceive their lack of change as personal failures and even see themselves as hopeless cases (“false hope syndrome”). When unreasonable expectations for self-change go unmet, people feel frustrated and despondent and may give up trying to change.
Even when self-help works, it may not work as well as psychotherapy. A recent review by Marisa Menchola, along with University of Arizona colleague Arkowitz and Brian Burke of Fort Lewis College, examined this possibility. In contrast to previous reviews, it included only studies in which contact with a therapist or researcher was minimal and in which subjects suffered from serious problems, such as major depression or panic disorder. Overall, bibliotherapy was better than no treatment, although psychotherapy was still superior to bibliotherapy. Certain self-help books can be valuable resources for personal change—especially if readers follow some simple tips in the accompanying box. A famous Latin phrase, however, remains apt: Caveat emptor! (“Buyer beware!”)