Selling sickness with help from the self-help movement
by Alice Friedemann   
30 June 2006

Editor's note: Here are two book reviews of new works that pose tough questions at the ever-weakening underbelly of U.S. society. Alice Friedemann, of Oakland, California has found fascinating source material on health that's of relevance to anyone concerned about peak oil and petrocollapse.

Alice has contributed to Culture Change on four other occasions, on energy (see Energy and Survival section in this website, and see Archive section as well). These book reviews help us to focus on a neglected area: what happens when health care is compromised by the end of cheap, abundant petroleum. Our introduction to this section, Health and Petro-addiction, is published simultaneously with Alice's reviews, and its webpage is http://culturechange.org/cms/index.php?option=com_content&task=view&id=61&Itemid=33

After the first review below, of Steve Salerno's 2005. book SHAM. How the Self-Help Movement Made America Helpless comes Alice's review of Selling Sickness. How the World’s Biggest Pharmaceutical Companies Are Turning Us All into Patients.

June 23, 2006, Oakland, California

SHAM. How the Self-Help Movement Made America Helpless Crown Publishers, 2005
Steve Salerno

by Alice Friedemann

There is a great deal of talk in the Peak Oil community about how we're going to all have to band together and cooperate if we're going to get through the coming energy crisis with an intact society. If we don't localize and form strong communities, we risk sinking into chaos, crime, fascism, and worse. But do we have what it takes?

Salerno’s book "SHAM" makes me wonder how Americans are likely to behave as times get harder in the future. Salerno believes that even if you've never picked up a self-help book in your life and don’t whine, you’re still affected by this movement -- this sensibility pervades institutions, legal decisions, and so on in our society to a large extent.

Salerno splits the Self Help and Actualization Movement (SHAM) into two main branches, which he calls Empowerment and Victimization. In many ways this is a companion book to be read along with "Selling Sickness". Both of these discuss how syndromes and diseases are made up, with Selling Sickness concentrating more on the physical, and this book mainly on the mental side of the coin.

Anyone who squirms when they hear psycho-babble will greatly enjoy Salerno’s skewering of Oprah, Dr. Phil, Tony Robbins, John Gray, and the other luminaries of the movement.

My main criticism of this book would be that it’s uninformed by the findings of evolutionary biology, and perhaps takes too hard a line in some instances, without considering what kind of a species we are.

Before the book "I’m OK – You’re OK" by Thomas Harris came out, excusing one’s faults or blaming them on others was seen as a character flaw. Now not just alcoholics were gripped by uncontrollable and self-destructiveness, we all had problems to recover from. Victimization was born.

Since it wasn't your fault you were behaving badly (genetics, family, and so on were to blame), there was no reason to feel guilty. As Salerno points out, this implies that conscience is a bad thing. Worse yet, not only were people being told to shed their guilt, but to consider the world to be "All About You".

To lessen the guilt people felt about their failings, the victimization movement cleverly redefined bad behavior to sound tamer. Your character defects were a disease, a medical or psychological condition out of your control. Women were made to believe that they were slaves to their hormones, a giant step backward for the feminist movement.

Salerno sees the main problem with the Victimization movement as follows. "The gospel of Victimization gave its followers easy outs for ugly behavior; it also made questions of guilt or innocence eye-of-the-beholder judgments — and in the end made such judgments largely irrelevant anyway. If individuals were driven by dark circumstances and barely remembered (but irresistible) forces from childhood, how could they be blamed for whatever stupid or immoral acts they committed along the way?...if you can’t stop smoking or snorting or stealing or gambling …it’s probably not because you’re weak, venal, or decadent. It’s because you can’t help yourself."

Salerno believes SHAM is weakening society, reducing our sense of community, and in many other ways harming us. He asks: "Does it not make sense that a society in which everyone seeks personal fulfillment might have a hard time holding together? That such a society would lose its sense of community and collective purpose? That the self-centered individuals who compose that society would find it difficult to relate to, let alone make sincere concessions to, other self-centered individuals?"

Salerno believes that SHAM may have helped contribute to America’s very high divorce rate, because people are convinced they’re only in a so-so marriage, when in reality it’s a pretty normal marriage. SHAM teaches people to ask what they can get FROM a marriage, not what they can give TO it. And what they want from marriage is not realistic.

SHAM "sportsthink" leaders tell audiences that winning is the only thing. Forget about compromise. Many critics see this attitude as one of the reasons business ethics has declined so much in recent decades. The ‘win at all costs’ idea of the 1980s increased the temptation to cheat.

The codependent movement encourages you to care more about yourself and to stop caring so much about other people.

Some of the other major points he makes are:

Recovery groups don’t work – there isn’t any hard evidence they can help people recover from anything. A 1995 Harvard Medical study shows that alcoholics are more likely to stop drinking on their own than if they join AA.

Anyone, no matter what their qualifications, can be a SHAM leader. Consider AA – where the leader’s sole credential is his being in recovery. Salerno believes that could make an AA leader too close to the problem to be effective and impartial. Plus if your lights weren’t working, would you pay a qualified electrician to come over, or the guy next door who can’t get his lights to work ?

Sportsthink: endless inspirational drivel about triumphing athletes, usually spouted to a poorly performing sales force. The sales force will learn absolutely nothing about how to sell their particular widget or how to sell anything at all. The notion that the locker room is a metaphor for the meeting room is thoroughly shredded by Salerno.

Anyone who’s survived an ordeal, even if self-inflicted, can now go on the road to inspire us to stop whining and make the most of life. The idea is that if that person coped with such-and-such then our own ordinary travails don’t amount to much. Anyone who’s been in pain or dysfunctional is now qualified to lecture the rest of us on the lessons they learned from their pain.

Alcoholics Anonymous throughout its history has fought independent research to test its methods and done what they can to stamp out critical thinking in its members, making many critics compare them with cults.

All of the 12-step recovery groups send followers the following messages:
1) You’re damaged goods – whatever is wrong with you will always be wrong and ready to flare up. Which gives members the feeling of being flawed and permission to not feel so bad about future failures.

2) Good is bad. Those in recovery who are "in denial" of the gravity of their condition often receive psychological battering from the rest of the group, including constant retelling of members most regrettable moments of self-loathing, or "coercive introspection in which members learn to see the hidden pathology in their unremarkable memories of childhood". You’re taught that your family is the source of the unhappiness and lack of achievement in your life.

3) It’s all about YOU.

4) All Suffering is Created Equal. "When an influential voice like John Bradshaw draws outrageous analogies between children of alcoholics and Holocaust survivors, he encourages a loss of perspective that isn’t helpful in a society struggling to fine-tune its moral bearings". David Blankenhorn says, "Having annoying or even emotionally dysfunctional parents is not the same as physical abuse. An occasional episode of spanking cannot be compared to living through the Holocaust."

5) It’s not your Fault

Yet in the end, Salerno points out that "despite all the talk of personal empowerment and limitless potential…Americans have become ever more dependent on chemical modification. In the final analysis, it’s not the thousands of seminars or millions of books with their billions of uplifting words that Americans seem to count on to get them through the day. It’s the drugs."

* * * * *
June 22, 2006, Oakland, California

As higher energy prices sink the world economy into a never-ending depression, it will be important to stay healthy, because medical costs are likely to be more expensive in the future. A great deal of fat could be cut out of the health care system right now as you'll see in the book review below.

Selling Sickness. How the World’s Biggest Pharmaceutical Companies Are Turning Us All into Patients Nation Books, 2005
Ray Moynihan and Alan Cassels

by Alice Friedemann

Getting healthy people to buy drugs they don’t need, which won’t cure what they don’t have, and potentially have unpleasant to dire side effects, sounds like such a crazy premise, even Hollywood wouldn’t buy it.

Yet that’s just what’s happened, as Moynihan and Cassels document in their book "Selling Sickness". The 500 billion dollar pharmaceutical industry has plenty of money to spend convincing us that our ordinary travails mask mental illnesses, and common aches and pains need treatment.

Americans represent five percent of the world’s population, but we consume fifty percent of prescription drugs.

Millions of healthy people have asked their doctor about that purple pill they saw on television, or been given drugs pushed by the army of 80,000 drug salesmen who’ve influenced your doctor with free lunches and far more.

Many people now take drugs that may have harmful side effects and won’t make much of a difference in improving their health. Hormone replacement therapy turned out to increase the chance of heart attacks for women, one of the blockbuster cholesterol lowering drugs was withdrawn from the market because it was implicated in causing deaths.

The FDA isn’t looking out for you either, as shown in the chapter on irritable bowel syndrome. The FDA let the drug Lotronex remain far too long on the market, despite evidence coming in from doctors that it was killing, hospitalizing, and causing complications never seen before by doctors treating this syndrome.

How has the pharmaceutical industry pulled this off?

1) The point where you "need" to take a particular drug is continually lowered (i.e. for cholesterol, high blood pressure, etc), often far lower than necessary. Many of the doctors setting these lower standards have financial ties to the drug companies, so when more drugs are sold to more people, they stand to profit. Every time the good cholesterol level is lowered, millions of new customers are created overnight.

2) New diseases are invented that don’t really exist. Menopause, for example, is a natural part of the life cycle. It’s doubtful that attention deficit disorder and other "diseases" in the book exist.

3) Pharmaceutical companies exaggerate the good the drug will do for you. Brittle bones are only 13% of the problem in osteoporosis, which tends to affect people the last chapter of their life. Far more important is: don’t fall! Be sure you’ve got good eyeglasses; your rugs won’t slip, exercise, and so on.

4) You’ll never see ads telling you the one thing you need to know: if you want to lead a healthy life, eat a good diet and exercise. But you will see all sorts of deceptive ads, which this book does a good job of describing. You’ll be angry and sometimes shocked when you see the dirty tricks used to promote drugs.

There are people who stand to benefit from these drugs, the book is definitely not saying they’re totally useless, and in fact, many of the people who do need these drugs aren’t getting them.

But before you decide to take a drug, be sure to do research first to make sure you really need it. If you have one of the following, or know someone who does, you might want to read this book, which discusses depression, high cholesterol, menopause, attention deficit disorder, high blood pressure, premenstrual dysphoric disorder, social anxiety disorder, osteoporosis, irritable bowel syndrome, and female sexual dysfunction. The final chapter is entitled "What can we do?"

* * * * *

"Psychiatric Drugs: An Assault on the Human Condition" Street Spirit Interview with Robert Whitaker, August, 2005:
www.thestreetspirit.org/

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Nice article. It's very informative. Thanks for sharing.
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