Book Review: Martin Seligman, What You Can Change and What You Can’t, Knopf/Random House, 1994.

I remember one of the first things Professor O’Neil said to the 1955 Psychology 1 class at the University of Sydney: ‘One of the most important things you’ll learn in this course is that what a lot of people believe as “common sense” isn’t true…’ Forty five years later, nothing’s changed. I first came across Seligman through his earlier book Learned Optimism. The director of Clinical Training in Psychology at the University of Pennsylvania, he’s well-known as a ‘cognitive behaviorist’ and as one of the world’s experts on motivation. Here’s a typical sentence or two summarizing this approach:

‘All successful therapy has two things in common: It is forward-looking and it requires assuming responsibility. Therapy that reviews childhood endlessly, that does not focus on how to cope in the here and now… has a century-long history of being ineffective. All therapy that works for depression, anxiety, and sexual problems focuses on exactly what is going wrong now and on how to correct it… The past is touched upon, but usually to get insight into patterns of problems…’ (p. 241).

The book’s about the chances of changing your attitudes/behavior, particularly in the areas of anxiety, panic, phobias, obsessions, depression, anger, post-traumatic stress, sex, dieting and alcoholism. ‘There are some things about ourselves that can be changed, others that cannot, and some that can be changed only with extreme difficulty (p.4).’ The well-known Serenity Prayer is quoted at the beginning and the end of the book: ‘God, grant me serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference’.

This is not ‘pop psychology’, so you’ll probably need a couple of tertiary humanities subjects to understand some of the terms he doesn’t explain. But that said, it’s a very important book if you want to have your ‘but everyone knows’ stuff challenged…

First we’ll summarize Seligman’s Facts, conclusions he’s come to on the basis of an extensive review of the relevant research; then his Opinions, ideas about which more research is needed, but have a significant probability of being correct; and finally, Seligman’s Advice: some samples of his wisdom.

MARTIN SELIGMAN’S FACTS

# The ratio of women to men suffering depression is about two-to-one (foreword, and p.107)

# Panic can be easily unlearned, but cannot be cured by medication

# Sexual dysfunctions – frigidity, impotence, premature ejaculation – are easily unlearned

# Depression can be cured by straightforward changes in conscious thinking or helped by medication, but cannot be cured by insight into childhood

# Optimism is a learned skill. Once learned, it increases achievement at work and improves physical health

# Dieting, in the long run, almost never works

# Reliving childhood trauma does not undo adult personality problems (these six from p.5)

# Pessimism can be unlearned, and with its removal depression, underachievement and poor health can be alleviated (p.7)

# If neither one’s natural nor adopted father had ever been convicted of a crime, 10.5 % of sons turned out to be criminals. If the natural father (whom the child had not seen since he was, at most, six months old) was a criminal, but the adopted father was not, 22 % of the sons were criminals (ie. crime rate is doubled by having ‘criminal genes’). If both natural and adopted fathers were criminals, the sons’ crime rate was 36.2 % (p.44)

# Only one mental illness – general paresis (paralysis of brain tissue caused, for example, by syphilis) – has a biological cause. (p.45) # Two techniques are successful for the treatment of phobias: systematic desensitization (in a relaxed state imagining phobias in ascending order of severity), and flooding (in an easier-to-harder routine doing the thing you fear) (pp. 76-77)

# People born in the second half of the century are ten times likelier to suffer depression than people born in the first half (p.106)

# Around the world every culture that has a thin (body-image) ideal has more depression in women and also has eating disorders (p. 109). Before puberty (in our culture) boys are more depressed than girls; after puberty, girls get more depressed (p.110)

# Holocaust victims and rape victims who do not talk about their trauma suffer worse physical health than those who do confide in somebody (p.142)

# Males are better at spatial and math tasks; females are better at emotional tasks; in terms of general ability there are more males with extreme (very low or very high) scores: there are more retarded males (pp.167, 169). Many of the skill differences between the sexes have narrowed in the last twenty-five years, coinciding with society’s treating boys and girls more similarly (p.169)

# After tens of millions of dieters, and tens of billions of dollars, no one has found a diet that keeps the weight off in any but a small fraction of dieters (p.181)

# Cultures that have a thin ideal for women also have eating disorders; and they have roughly twice as much depression in women as in men (women diet twice as much as men) (p.190)

# A minority of alcoholics will recover (about one third), but only one in five recover completely; about half will die prematurely and/or remain alcohol-dependent; socially stable alcoholics have about double the chances of recovery. The four ‘healing’ factors for alcoholics: a substitute dependency, facing dire medical consequences (rock-bottom), finding a source of hope (religious conversion, AA), finding a new love relationship (p.213). There is no evidence that any ‘talking therapy’ will get you to give up alcohol (p.215)

MARTIN SELIGMAN’S OPINIONS

# Most drugs induce a lesser malady (euphemistically dubbed ‘side effects’) to cure a greater malady (p.37). To the extent that anxiety is a message to do something about your life, anti-anxiety drugs prevent your getting the message (p.39)

# Claims that schizophrenia, Alzheimer’s and manic-depression have bio-chemical causes are plausible but unproven (p.45)

# At most, personality is only partly genetic: half of personality comes from what you do and from what happens to you – which opens the door for therapy and self-improvement (p.45)

# Lithium has an 80% effectiveness rate in curing manic-depression: ‘the highest cure rate in the annals of psychotherapy’ (p.66)

# Psychoanalysis does not work on phobias (p.77)

# There are only about two dozen common phobic objects, most prominently open spaces, crowds, animals, insects, closed spaces, heights, illness, and storms – all dangerous to our ancestors. ‘Phobias lurk in each of us. They are the rekindling of dark, primordial fears’ (pp. 81, 83)

# Neither psychoanalysis nor cognitive therapy appears to help those with Obsessive-Compulsive disorders. Anafranil is a drug that helps many. But behavior therapy is best: repeatedly exposing the patient to the feared situation, and when there is no harm, the ritual should extinguish (pp. 91-92).

# The first half of this century was the Age of Anxiety: Freud believed that all neuroses stem from anxiety. The second half? Helplessness, with depression and sadness in its wake (p.95). Bi-polar depressives have manic episodes; unipolar depressives never do. Psychotherapy without drugs will not help manic depressives. At any given time approximately 25 % of us are going through an episode of mild depression (p.104)

# Why do women get more depressed than men? Three possibilities: learned helplessness (in a society that deprecates the role of wife/mother), rumination (women ponder trouble, men act), body image (95% of women have trouble keeping the extra pounds from coming back) (pp. 108-109)

# Four therapies work moderately well for depression – drugs (when they work they relieve symptoms 65% of the time), electroconvulsive shock (scary, but works 75% of the time), cognitive therapy (changing the way the depressed person thinks, bringing relief to 70%), interpersonal therapy (concentrating on how to get along with other people – brings relief in about 70% of cases) (p.113)

# There is simply no evidence that depression is anger turned inward (as Freud believed) (p.125)

# As many as one out of every three to five women will be raped in her lifetime (p.139)

# ‘Exposure therapy’ is best for lasting healing for Post-traumatic stress: describing aloud, in the present tense what happened, to the therapist, repeated session after session (p.144)

# Our erotic life has five layers: from the deepest: [I] Sexual identity (your maleness/femaleness is fixed at the end of the first trimester of foetal development: transsexuals, who have ‘wrong sex’, can’t change their core identity); [II] Sexual orientation (homosexual/heterosexual: because there is a genetic component to sexual orientation it is almost impossible to change); [III] Sexual preferences (the objects of male preference are mainly female body parts; women on the other hand develop more subtle preferences – intimacy, character, etc. The most effective way to curtain sex offenders – castration, where reoffense drops from 70% to 3%); [IV] Sex roles (young children see these as black-and-white – ‘I’m a boy, not a sissy’ etc.; young boys don’t like playing with dolls, even when adults encourage them; these demarcations decrease over time; adults can drastically modify them; [V] Sexual performance (men have two major problems – impotence and premature ejaculation; women also have two problems – arousal problems – frigidity – and failure to reach orgasm: these problems are mostly curable today; both men and women may have another problem – acedia, loss of sexual passion).

# Obesity may cause premature death, but underweight is clearly associated with substantially greater mortality… There is probably a serious health risk from losing weight and regaining it… That is, the weight-fluctuation hazard may be larger than the hazard of staying overweight (pp. 188-9)

# Alcoholism is not essentially a ‘disease’ (as AA believes) but if a client and his therapist sees himself as ill, this therapeutic illusion may help make life more bearable (pp. 206-7)

# There is no ‘alcoholic personality’: people who become alcoholic are more like to have alcoholic relatives, and be Northern European (particularly Irish) (p.209)

# (Seligman’s ‘bombshell’ opinion): ‘There is a widely popular view that adult problems are caused by childhood mistreatment. I criticize this view on factual and moral grounds: you can make major changes all throughout adulthood if you know the ways of changing that actually work’ (pp. 226-7)

‘If you want to blame your parents – blame them for the genes they gave you, but you are not entitled – by any facts I know – to blame the way they treated you’ (p.232). To put it another way: ‘I know of no data that childhood trauma (in anything but its most brutal form) has more power than adult trauma’ (pp.234-5)

MARTIN SELIGMAN’S ADVICE

# There are two techniques that reliably lower everyday anxiety levels: progressive relaxation and regular meditation (p.57)

# Pessimists see the causes of failure as permanent (it’s going to last forever), pervasive (it’s going to ruin everything) and personal (it’s all my fault). Optimists dispute pessimistic thoughts: if this becomes a habit, this skill stays with you (p.115)

# When you are provoked “count to ten’, sleep on it, see yourself from the provoker’s point of view, use humour, make a plan for defusing the attacker (p.132)

# Achieving fitness is much more sensible than fighting fatness. Moderate exercise – burning off 2,000 calories per week – produces two extra years of life. Exercise also fights depression and increases self-esteem (pp.192-3)

# We are not prisoners of our past. We are free to change many things about ourselves. Don’t focus endlessly (as some in the ‘Recovery / Inner child movement’ do) on your past: rather accept responsibility and be forward-looking (p.241)

AND THINK ABOUT THIS:

# Until this century in the West, more than half the population thought life was a vale of tears. Now it is not unusual to go through an entire lifetime without tragedy (p.136)

SUMMARY OF SELIGMAN’S THEORY:

# The ‘deeper’ the source of the problem the harder it is to change. Deepest causes are biological – you can’t fight your genes easily; but ‘learned habits’ are nearer the surface: they’re easier to change. Transsexualism, for example, is biologically laid down in gestation, and is totally unchangeable; sexually orientation is almost as deep. Alcoholism has some biological underpinnings, and therefore is not easy to change. Some fears have a strong evolutionary basis, but everyday anxieties can be overcome. There is some evidence for anger’s heritability, but it, too, is somewhat modifiable. Sexual preferences can be modified in therapy, as can obsessive-compulsive disorders. Sex roles are powerful and inflexible for children, but their power wanes with maturity. Depression and phobias are near the surface: they can be healed. And problems of sexual performance can be changed easily.

‘The influence on adult life of childhood and its trauma is weak: there’s a lot you can change. We are not prisoners of our past’ (p.232)

I take it Seligman is a Jew, and Jews above anyone have a right to teach the rest of us how to cope with childhood and adult trauma. But he’s also a devoted family man. Now I wonder how those two factors bear on his theory and opinions? The people who come to me as a counselor with problems relating back to severe childhood trauma, have usually not had these two factors working in their favour: a deep-seated gift of hope, and a strong, affirming relationship with a significant other. I’d want to counter Seligman’s perspective by saying that if counseling provides these two healing contexts, then it matter less what is talked about in therapy than that a relationship of trust and grace (from which can spring hope and a strength to change) is formed. Rollo May (The Art of Counseling) taught me about the importance of the gift of hope: that should be present in every counseling encounter. And William Glasser (Reality Therapy) taught me about the importance of the client’s taking responsibility for their present and future, rather than simply blaming their past for their problems. (Freud was a genius, and has given us many key insights, but he has a lot to answer for).

Rowland Croucher

January 1999.

[from a netfriend in South America]

 Hi Rowland,
  This is something you might find highly interesting as a follow up to your book review “What You Can Change and What You Can’t” by Seligman.   In that review you had pointed out that nobody had ever proved a biological source for depression and mood disorders.   Around about the time of your review a 70 year old neuroscientist in New York University was wrapping up a medical journal paper which outlines a cure for depression….completely based on biology.   If you have some contacts with a science background, they may be able to interpret the medical paper.  She went on to write a lay version which she left in 26 languages just before her death in 2001.   Her name was Elnora Van Winkle.   She even had a post were about a thousand letters were exchanged…..and many people have been cured of a variety of mood disorders and nervous illnesses.   She was not a communicator and a man who has been cured put up a site called www.gocure.com which he leaves behind as a way to help others.     It deserves to be read carefully.    It will take about 4 hours to get up to speed on this cure….it is no less than amazing.    Many people in Chile are using it.   With the drug trade and SSRI’s it is going to be a long time before it is widely known.   But here you have the information now.     It took me about  a year to accept it…and now I do completely.     I personally know of people who have overcome addiction, CFS, panic disorder, bipolar and depression.   Permanently.
  Have a read….following your comments, I thought you might be quite interested to find out about this.
  The internet is a wonderful thing.