What You Can Change . . . And What You Can't*: The Complete Guide to Successful Self-Improvement (3 page)

No sacred cows
. This book walks a political tightrope. On one side is the racist segment of the right, fervently hoping that intelligence, femininity, and criminality are all entirely genetic. On the other side are many aging 1960s liberals and their “politically correct” campus heirs, condemning all who dare to speak ill of victims; failure, they say, results from poverty, racism, a bad upbringing, a malevolent system, under-privilege, deprivation—from anything but oneself.

My loyalty is not to the right or to the left. I have no patience for their sacred cows or their special pleading. My loyalty is to reasoned argument, to the unfashionable positions that deserve a hearing, to the thoughtful weighing of evidence. I realize that much of what I will say in this book is grist for the agendas of both political positions. I believe that facing the beast entails airing unpopular arguments. When the evidence points toward genetic causes, I will say so. When the evidence points toward a bad environment or bad parenting as responsible, I will say so. When the evidence points toward unchangeability, I will say so. When the evidence points to effective ways of changing, I will say that too.

Outcome studies as best evidence
. Suppose for a moment that an epidemic of German measles is predicted. You are pregnant and you know that German measles causes birth defects. Two vaccines, Measex and Pneuplox, are on the market. A famous Hollywood star says on TV that she was given Measex and didn’t get German measles. An Olympic sprinter also adds her testimonial. Your best friend has heard good things about Measex. Pneuplox, on the other hand, is not advertising. But it has been tested in what is called an
outcome study
, in which it was administered to five hundred people: Only two of these people contracted German measles. Another five hundred received a sham injection: Twenty-eight of them got German measles. Now assume that Measex has not been so tested. Which vaccine do you want? The one that has passed a rigorous outcome test, of course.

Making up your mind about self-improvement courses, psychotherapy, and medications for you and your family is difficult because the industries that champion them are enormous and profitable and try to sell themselves with highly persuasive means: testimonials, case histories, word of mouth, endorsements (“My doctor is the best specialist on
X
in the East”), all slick forms of advertising. Just as this is no way to pick a vaccine or to decide on whether to have chemotherapy versus radiation for cancer, this is no way to decide on whether to try a particular diet, or whether to send your father to a particular alcohol-treatment center, or whether to take a particular drug for depression or to have psychotherapy. Much better evidence—outcome studies—is now often available.

In the collision between self-improvement and biological psychiatry, the two sides have until recently used different sorts of evidence. The biological psychiatrists started with case histories but then built up to outcome studies—comparing a treated group with a group given a sugar pill, a placebo. The self-improvement and psychotherapy advocates still rely, for the most part, on single case histories and testimonials: before and after snapshots of some formerly obese person, a dramatic case report from a professional football player in Alcoholics Anonymous, a case of sudden recovery from profound depression following an angry confrontation with Mother. Case histories make absorbing reading, but they are clinically very weak, and, usually, self-serving evidence. The seller presents the case history that testifies to his product’s effectiveness. You never know how many failures there were.

The evaluation of change has improved recently. When the late Gerald Klerman became director of ADAMHA (the Alcohol, Drug Abuse, and Mental Health Administration of the federal government) under President Jimmy Carter, he argued that psychotherapies should be evaluated in the same hard-nosed way that the Federal Drug Administration evaluates drugs. He funded comparisons of drugs and of psychotherapies. Much of what psychology and psychiatry professionals now know comes from many such careful and costly studies. But little of this has filtered down to the general public, partly because of the power of the drug and psychotherapy guilds. For many problems, we can now assert with confidence that some therapies work and some do not. Little of this technology has found its way into the self-improvement industry, but when I make claims about effectiveness, I will lean heavily on outcome studies. I will often use case histories to illustrate important points, but only when they are backed by more substantial evidence.

These, then, are my biases. Now that you know them, you should also know your own. What are your underlying prejudices about self-improvement? Do you think that therapy can change almost all of your personality traits? Or do you think that character is fixed? Do you think that what you do is the product of choice, of the environment, or of genes?

Lisa Friedman Miller, the author of the following survey, has obtained responses from thousands of people in order to explore how different views of change relate to emotions and politics. There are no right or wrong answers, but your score will tell you where you stand on the crucial issue of change. Circle the choice that best fits your view. This survey will take you less than five minutes.

HUMAN PLASTICITY QUESTIONNAIRE
³

Tom is shopping at a department store when he spots a sweater that he likes. He goes into the dressing room to try it on but notices that it costs too much money. Tom steals the sweater by covering it with his jacket and then walking out of the store.

What accounts for Tom stealing the sweater from the department store?

Your opinion:

1. How much is Tom’s behavior influenced by the immediate situation?

Not at all   1   2   3   4   5   6   7   Very much

2. How much is Tom’s behavior influenced by more removed situations (e.g., childhood, race, the system)?

Not at all   1   2   3   4   5   6   7   Very much

3. How much is Tom’s behavior influenced by the kind of person he is? Not at all   1   2   3   4   5   6   7   Very much

4. How much is Tom’s behavior influenced by his own decision to act that way?

Not at all   1   2   3   4   5   6   7   Very much

Now suppose that you explained to Tom that what he had done was wrong. You suggested that he change. He agreed that he should change and that he wants to change.

5. How completely could Tom change?

Not at all   1   2   3   4   5   6   7   Completely change

Now suppose that you had never approached Tom on the issue of his behavior.

6. How much do you think Tom would have changed anyway?

Not at all   1   2   3   4   5   6   7   Completely changed

John meets a woman at a friend’s party and asks her on a date for the next evening. At the end of their date, John says that he wants to have sex with the woman. When she refuses, he presses her against a wall and starts taking off her clothes.

What accounts for John taking off the woman’s clothes?

Your opinion:

1. How much is John’s behavior influenced by the immediate situation?

Not at all   1   2   3   4   5   6   7   Very much

2. How much is John’s behavior influenced by more removed situations (e.g., childhood, race, the system)?

Not at all   1   2   3   4   5   6   7   Very much

3. How much is John’s behavior influenced by the kind of person he is? Not at all   1   2   3   4   5   6   7   Very much

4. How much is John’s behavior influenced by his own decision to act that way?

Not at all   1   2   3   4   5   6   7   Very much

Now suppose that you explained to John that what he had done was wrong. You suggested that he change. He agreed that he should change and that he wants to change.

5. How completely could John change?

Not at all   1   2   3   4   5   6   7   Completely change

Now suppose that you had never approached John on the issue of his behavior.

6. How much do you think John would have changed anyway?

Not at all   1   2   3   4   5   6   7   Completely changed

Dave is on his way home from class when he sees a brand-new automobile on the street. Taking his keys from his pocket, Dave deliberately carves three long lines across the hood of the car.

What accounts for Dave defacing the automobile?

Your opinion:

1. How much is Dave’s behavior influenced by the immediate situation?

Not at all   1   2   3   4   5   6   7   Very much

2. How much is Dave’s behavior influenced by more removed situations (e.g., childhood, race, the system)?

Not at all   1   2   3   4   5   6   7   Very much

3. How much is Dave’s behavior influenced by the kind of person he is?

Not at all   1   2   3   4   5   6   7   Very much

4. How much is Dave’s behavior influenced by his own decision to act that way?

Not at all   1   2   3   4   5   6   7   Very much

Now suppose that you explained to Dave that what he had done was wrong. You suggested that he change. He agreed that he should change and that he wants to change.

5. How completely could Dave change?

Not at all   1   2   3   4   5   6   7   Completely change

Now suppose that you had never approached Dave on the issue of his behavior.

6. How much do you think Dave would have changed anyway?

Not at all   1   2   3   4   5   6   7   Completely changed

To score your test, simply add up your numbers for each one of the six questions and fill in the total score below. Each of your totals should be between 3 and 21.

Question 1 (Immediate situation) _______

Question 2 (Removed situation) _______

Question 3 (Character) _______

Question 4 (Choice) _______

Question 5 (Change) _______

Question 6 (Change by himself) _______

What do these scores mean?

Question 1 taps your belief that people are pushed around by the immediate situation. If you scored 18 or above, you are in the quarter that believes most in the potency of the immediate situation; 15 is average; if you scored 9 or below, you are in the quarter of Americans who believe least in the power of immediate circumstances. Democrats tend to score 16 and above, whereas Republicans and independents usually score below 15.

Question 2 is about the importance of a person’s life history, and the higher you score, the more you endorse its significance. People who score 19 or more are in the quarter that most believes in life history; above 16 is in the top half; and 12 or below is the most skeptical quarter. The higher you score, the more you endorse welfare, affirmative action, and foreign aid; also, the more depressed you tend to be. The lower you score, the more you are for the death penalty, abortion, and military intervention.

Question 3 is about character. People who score 21 or more are in the quarter that most believes in character; 18 or more is in the upper half; and 14 or less is in the lower quarter. The higher your score, test results have shown, the more you believe in welfare, affirmative action, and economic assistance, and the more you believe in the death penalty, military intervention, and abortion. The older you are, the more you believe in character. As you can see, this scale breaks apart liberal and conservative stereotypes.

Question 4 taps your belief in the power of choice and willpower. The top quarter of Americans score 21; above 19 is in the top half; 16 or below is in the quarter that least believes in the power of choice. People who score high are more socially and economically conservative, less depressed, and older.

Question 5 is about how sweeping you think change can be. A score of 20 or above puts you in the top quarter; 16 or above in the top half; and a score of 10 or below puts you in the bottom quarter. People who score high are socially liberal and more in favor of welfare, affirmative action, and foreign aid.

Question 6 taps your belief in change. If you scored 11 or above, you are in the top quarter of those who believe that things naturally change a lot; 8 or above is the top half; 3 marks the quarter of those who most believe things stay the same. People with high scores believe more in foreign aid, welfare, and affirmative action, and are more socially and economically liberal. People with low scores believe more in the death penalty, military intervention, and abortion.

I
N THE DOMAIN
of human personality, what are the facts? That, of course, is what this book is about. I want to provide an understanding of what you can and what you can’t change about yourself so that you can concentrate your limited time and energy on what is possible. So much time has been wasted. So much needless frustration has been endured. So much of therapy, so much of child rearing, so much of self-improving, and even some of the great social movements in our century have come to nothing because they tried to change the unchangeable. Too often we have wrongly thought we were weak-willed failures, when the changes we wanted to make in ourselves were just not possible. But all this effort was necessary: Because there have been so many failures, we are now able to see the boundaries of the unchangeable; this in turn allows us to see clearly for the first time the boundaries of what
is
changeable.