Forgive me, Dr. Phil, for others have sinned

God is dead, but Oprah is alive and kicking. Even those of us who are familiar with Oprah Winfrey's television show only through the brief glimpses we get while channel surfing know that its function is now chiefly religious. The frequency with which one stumbles across members of the audience confessing their sins (aka issues) is astonishing.

Like all the religious leaders who infest the airwaves Oprah promises her flock release from their sorrow and travails. As part of her evangelization she has for yers been aided by one Phillip C. McGraw, a psychologist known to his admirers as Dr. Phil. Dr. Phil is a big Texan with a deep voice which he uses to give Oprah's guests what he describes on his website as a talking to. People with problems describe them to Dr. Phil, and he sternly lectures them about what they need to do to get back on the path of clean living.

These lectures have made Dr. Phil wildly popular. His picture has appeared on the cover of at least one major newsmagazine, and he now has his own television show. But what exactly does he say in these talkings to?

Well, I once saw him inform a large woman who wanted to lose weight that she had to be committed to losing weight. If you try to make sense of this statement, the best translation you can come up with is "If you want to lose weight, you have to do something that will make you lose weight, and you have to keep on doing it." Can't argue with that, eh?

In fact, all Dr. Phil has seemed to be doing, any time I've watched him giving someone a talking to, was saying aloud what most people in the audience were thinking. He was not impressing the audience by demonstrating how he could come up with solutions they wouldn't think of but by showing that a Ph. D. had come up with the same solutions they had come up with. And by allowing the audience to pile on, metaphorically, to the person getting the talking to.

To be fair to Dr. Phil, though, he has not shied away from explaining his ideas about how people should be behaving. He has published three popular books about his ideas, the most recent of which when this article was first published in 2002 was Self Matters, published by Simon and Schuster. On his website Dr. Phil describes this book as groundbreaking. So what does it say?

The central idea of Self Matters is that the feeling that one's life is "incomplete, unbalanced, and altogether more difficult than it really should be" stems from a lack of congruity between one's "authentic self" and one's "fictional self." Your authentic self is "the person you once were before life took its toll," while the fictional self is "the identity...you believe you are supposed to be, the person people tell you you are." The problem, apparently, is not that life is difficult but that you believe it should be difficult. Get rid of that evil fictional self and what's left is your original authentic troublefree self!

Dr. Phil does propose a method for eliminating the fictional self. It involves asking yourself questions like:

• What are the ten most defining moments of your life?
  
• What are the seven most critical choices you have made to put you on your current path?
  
• Who are the five most pivotal people in your world and how have they shaped you?

Of course, the only answer an honest and moderately intelligent person could give to those questions is "How am I supposed to know?" Well, Dr. Phil says you're supposed to know. This is part of what is called an internal audit. You audit your fictional self, decide how you can change your attitudes and beliefs about your defining moments so that they are authentic, and then change them.

In other words, years of conditioning don't matter, social pressures don't matter, economic necessity doesn't matter – you can change your attitudes and beliefs all by yourself and when you do your problems are over.

Of course, it's not attitudes and beliefs which cause problems, it's behaviour, and as psychologists know, attitudes and beliefs are poor predictors of behaviour. For example, we all know people with very liberal attitudes and beliefs about life who still behave like reactionaries – gee, for some reason Bob Rae just popped into my mind. Even in the unlikely event that you can discover for yourself the crucial psychological factors in your life, simply changing your attitudes and beliefs about them, even if that is possible, is likely on average to have zero effect on your behaviour.

I suppose one could argue that Dr. Phil has uncovered an enormous vein of alienation in society and is at least trying to do something about it. And getting people to think about their lives and to take responsibility for them are good things, aren't they?

One could also argue, though, that what Dr. Phil has uncovered is an enormous vein of narcissism and paranoia. According to Dr. Phil, the individual starts out as perfect and his problems begin when other people take part in his or her life. In fact, his conception of the fulfilled life is startlingly similar to the one conventionally assumed to be that of the prettiest girl in high school. The appeal of this conception to such a large part of the North American population is at the very least depressing.

Viewed in this light, Dr. Phil's ability to get people to think about their lives and to take responsibility for them would seem sinister if there were any chance of his ideas working. Would you like to work for an "authentic" boss who thought you were the source of all his problems?

Of course the truth is probably less threatening, or at least we can hope that it is. I don't believe that Dr. McGraw is a charlatan or any other kind of crook. Unlike respected members of the conventional religious community he isn't peddling consecrated prayer cloths or oil with the story that they'll make you rich or cure you of cancer. He actually wants people to think, which in my experience is a sign of sincerity. For all I know Dr. McGraw's intent is to use people's narcissism and paranoia to get them to examine their own lives rationally, and then to substitute effective non-narcissistic and non-paranoid strategies and tactics for the ineffective narcissistic and paranoid ones they have been using. Where was id, there let ego be, and maybe Dr. McGraw thinks you have to trick people into substituting ego for id.

If that is Dr. McGraw's strategy, it is still likely to be ineffective, for the reasons which have been given above. So why do people swear by Dr. McGraw's immature ideas and patently ineffective internal audits? One reason is that, like many psychologists and psychiatrists, Dr. McGraw may well have an ability to get people to change which is independent of his ideas. That is, he does help people personally, but not for the reasons he thinks he does.

Of course that doesn't do anything for people who just buy his books or sit in a large audience at one of his seminars, but there is also a phenomenon called cognitive dissonance reduction. If you pay money for a book or to attend a huge seminar at which you do not get personal attention you have an interest in believing that you got your money's worth, so you believe it.

Then again, people's problems are not naturally immutable. As we know, many people's problems become less serious over time without therapy or counselling. If that improvement follows a reading of one of Dr. McGraw's books then one may attribute it to the application of his principles. And Dr. McGraw makes a lot of money, so everybody's happy. Which is what everyone wanted in the first place, isn't it?

It is most likely, though, that the reason people swear by Dr. Phil is that there is always a seller's market in hope. As Dr. Johnson observed, hope is the chief species of enjoyment that human life affords. Unfortunately, the supply of hope is always limited, especially since conventional religion lost its ability to inspire it. Obviously Dr. McGraw's contention that your life is not hopeless but in fact an unending opportunity for unlimited gratification is going to appeal to people, and it will be all the more appealing for being so lengthily argued.

In other words, ideas like Dr. Phil's are religious. In a country which has abandoned the old gods, people like Dr. Phil step in to introduce a new opiate for the masses, a new improved god for a new improved society. The most popular new god is the self, which if left unfettered will, according to Dr. Phil, bring about paradise on earth. You can say another thing for Dr. Phil, though – he's got enough guts to place his paradise on earth, rather than in the neverneverlands where conventional religions place theirs.

Forgive Me, Dr. Phil, For Others Have Sinned © John FitzGerald, 2002

Oprah hates you, girlfriend

Oprah – what a gal! I didn't have to use her last name for you to know who I was talking about! She's on TV, she writes books, she has a glossy magazine, she raises millions for charity, she puts millions of her own money into philanthropic projects. Why does she have those millions of dollars? Because millions of people hang on her every word.

And what are those words saying? Often they're saying admirable things. Oprah (the NIH style book says I should call her Ms Winfrey, but really – she's Oprah!) – as was saying, Oprah was one of the few major American figures in either show business or the news business to question the utility of invading Iraq (which was a Good Thing regardless of whether or not you think the invasion was a Good Thing). She has played a major role not only in making the mainstream of society aware of the problems of people on its margins, but also in getting the mainstream of society to accept marginal people into the mainstream.

But...there's another side to Oprah. Much, if not most, of what she tells her audience, which consists chiefly of women, is "There's something wrong with you, girlfriend." There is a lot of money to be made in telling women they don't measure up, and Oprah seems to have made most of it.

The most frequent theme on her website is that women need to improve themselves. They need to be more organized, they need to figure out what they want to do with their life and then do it, they need to improve their health, and, most of all, they need to lose weight.

But – you don't have to take my word for it. Simply visit her website. I visited it on March 26, 2007 and here's what I found.

First of all, here are some of the topics on the page that day:

• Top five personal rules to live by
  
• How to improve yourself from the inside out
  
• The five best things to do for your relationship
  
• Dr. Oz's Excuse-Busting Workout

Do you get the feeling, girlfriend, that Oprah thinks that maybe you're totally messed up? I mean, you don't even have your
own rules to live by! Or, if you do, they're not as good as Oprah's!

What are those five rules to live by, anyway? They turn out to be the opinion of one Martha Beck, who starts her advice by writing "When you spend almost all your time thinking about how people can achieve their best destiny, as I do....." And here they are:

1. A little pain never hurt anybody.
   
2. Sunscreen is for necks and chests, not just faces.
   
3. Television is a vitamin (Ms Beck goes on to say that watching television is "essential for social and personal well-being").
   
4. It is good to be wrong.
   
5. You can work miracles.

Hmm. Do you think Oprah might have some ulterior motive in promoting the idea that television watching is essential to your well-being? And I wonder how much sunscreen stock she holds. No, I'm not being cynical here. It just seems strange to me that an intelligent woman like Oprah would think that two of the most important considerations in leading the Good Life should be slathering on the sunscreen and plunking yourself down in front of the box.

The advice about being wrong is good, and presents some important ideas from the philosophy of science in a way that's easy to understand. But, you know, a little pain can hurt you. For example, if you're like me and have a high threshold of pain, you can find out that those little pains you were feeling were symptoms of a big problem, the probability of whose existence you discounted because you weren't feeling big pain.

Anyway, Ms Beck advises you to get through pain at the dentist by thinking "It's only pain," when the most effective way of getting through it is to say "Hey, cut that out and give me some more freezing."

And then there's "You can work miracles." I have news for Ms Beck and Oprah – if anyone could work miracles, they wouldn't be called miracles. Ms Beck's idea of a miracle is the nice backyard she built for herself. That ain't a miracle, Martha – that's gardening. If you want us to believe in your power to work miracles, tell us how you managed to build that garden when people were throwing things at you every time you stuck your head outdoors (a request whose relevance will become apparent over the rest of this article).

The idea of people being able to work miracles is fundamental to Oprah's view of the world, as it is to her close comrade-in-arms Dr. Phil. Dr. Phil tells Oprah's followers that they have the power to accomplish whatever they want. Oprah also vigorously promotes The Secret, a book full of new Age nonsense about how your thoughts about becoming successful "magnetically" attract success to you. If you surf through the "Thoughts for the Day" on Oprah's website, you find one quotation after another about pulling yourself up by your own bootstraps. Of course, that implies that you need to pull yourself up by your bootstraps, and the rest of the site is about how you're too dumb to find your own bootstraps.

For example, as we noted before, Oprah tells you how to improve your "relationship" (by which is meant your relationship with the man – sic – you're sleeping with) by following just five simple rules for dealing with problems in it. Here they are:

1. Stop all shame, blame, and criticism
   
2. Change from a critical habit of mind to a positive one.
   
3. When your relationship has a "breakdown," deal with it by apologizing, showing affection, and promising to take action to improve things.
   
4. Don't expect your man to give you the sex a porn star would.
   
5. Don't let your relationship get stale.

Not bad advice, as far as it goes, but the problem is that it only goes as far as the woman. Men apparently need to take no action to promote a good relationship. The commentary about rule 1 advises women that "men need to feel competent." You know, maybe if they want to feel competent they could start being competent. Isn't that a plan?

As for rule 3, the irony of this advice being the tactic men use to cop out of their responsibilities in a relationship is lost on Oprah. "If you take me back, baby, I'll never do it again, I swear. C'mon, give me a hug." You know, Oprah, men are hip to that jive. Anyway, how about getting them to promise to take some action? How about them doing something to keep the relationship from going stale?

Oprah's vision of paradise is of a world in which women have improved themselves by becoming more satisfactory to men. Again, you don't have to take my word for it. Just visit her website and look at all the links on the home page to articles about losing weight, becoming more beautiful, and complying with men's wishes.

Where does this vision come from? My colleague Wentworth Sutton believes it may be a neurotic manifestation of psychic traumas Oprah suffered in childhood. According to Oprah, she was horrifically abused in her mother's questionable care, and became a success after going to live with her father, who loved her and encouraged her to become the success she is today. And today she thinks women are defective. Hmmm.

As Wentworth freely admits, his analysis could be a load of the old cobblers. I have included it here chiefly because I need a structural device to get me to my boffo finish. Nevertheless, Oprah's fondness for Dr. Phil, who advises people that
they become successful only when they liberate themselves from the influence of others, suggests that Wentworth may be on to something.

Wentworth's explanation, even if it's valid, does not, of course, imply that Oprah's advice to women is bad. The thing that implies that it is at least partly bad, though, is that it encourages women to believe that they are solely responsible for their own problems and that they can extricate themselves from their problems solely through their own individual action. Okay, sometimes that's true. I have good reason to suspect, though, that usually it's not. Ask the women who have tried to deal with their abusive husbands by implementing rule 3 about improving your relationship.

So, is Oprah a force for good? Yes. Is Oprah a force for bad? Yes.

In the end, then, Oprah is just like us.

What a gal!

Oprah Hates You, Girlfriend ©
John FitzGerald, 2007

Pathology is destiny

Thirty years ago the progressive opinion about the differences in the characteristic behaviour of men and women was that they were the result of sexist childrearing, but these days progressive opinion is divided. Behavioural differences are thought by some to be the product of hormonal differences, for example, by others to be the result of a conspiracy among men to oppress women, and so on and so on.

One possibility appears to have been neglected, though. When we look at the conventional catalogue of differences between men and women, we find that men are assumed to have characteristics remarkably similar to the characteristics of people with brain injury.

On the whole, men are more violent than women and more likely to express anger. They are more likely to be restless and impatient. They have been shown to have poorer verbal abilities than women. They are often assumed to have difficulties with attention (being unable to find things which are in plain view, for example) and with memory (as when they forget important anniversaries). They are often assumed to be more egocentric and impulsive.

All these characteristics are associated with brain injury. Men are twice as likely as women to be diagnosed with traumatic brain injury, and most victims are young men aged 15 to 30. Young men are more likely than young women to take dangerous risks and to suffer head injury as a result. These figures, of course, apply only to diagnosed brain injuries, injuries which at the very least have resulted in loss of consciousness, loss of memory, alteration of mental state, or neurological deficit – that is, injuries other people notice and arrange to have treated in hospital.

However, men are also more likely to suffer concussion which, although it usually does not have the catastrophic consequences of more serious brain injury, still has some pretty serious ones. "Repeated concussions," note Kelly, Nichols, Filey, Lillehei, Rubinstein and Kleinschmidt-Demasters in an article published in JAMA in 1991 (vol. 266, no. 20, pp. 2867-2869), "can lead to brain atrophy and cumulative neuropsychological deficits."

As children we often hit our heads without the idea crossing anyone's mind that we should undergo a neurological examination. Boys are more likely to hit their heads. As boys grow older they take part in contact sports. Kelly et al. reported that in 1991 football was producing an estimated 250,000 concussions every football season in the United States, and that 20% of high school football players in the United States suffered at least one concussion every season. The probability that at least some of the behavioural difference between men and women can be explained as a result of brain trauma seems fairly high.

History confirms the thesis. The behavioural differences between men and women are less marked than in the past, and society is less violent and less dangerous. Until fairly recently, for example, a large part of the male population spent much of its time working in dangerous occupations without head protection; one of these occupations was war, in which men often found themselves fighting hand to hand in conditions likely to lead to brain injury. Today, of course, jobs are less dangerous, workers wear head protection, and war is fought with weapons which act from a distance. As the likelihood of brain injury has decreased, so have the behavioural differences between men and women.

In North America, contemporary worship of sport threatens to widen the gap again. The most popular sport in the United States is football, while in Canada it is hockey. Both sports inflict head injury at a high rate, and both are played primarily by men. Women's hockey is popular, but the women's game is less violent (bodychecking is prohibited) and far fewer women than men play hockey. The fanatical devotion of young boys to these sports seems likely to create a more "masculine" generation.

In the end, then, the behavioural differences between men and women may not be due to hormones, the worldwide male conspiracy, or, as women seem commonly to suppose, men's inherent moral and intellectual inadequacy. They may after all be due to sexist childrearing, but not in the way people thought in the 1960s and 1970s. That is, the problem may not be that girls are trained to act in submissive ways, but rather that boys are encouraged to act in ways which endanger their physical, emotional, and intellectual function.

The question remains of how we are to eliminate this sexism. Well, one thing that would help would be for young women to stop encouraging young men in this behaviour. Young women reward football players, hockey players, motorcyclists, and so on. They reward the recklessness which produces brain injury. Another big help would be for schools, including our institutions of higher learning, to stop promoting sports which produce brain injury. Movies and television will have to stop promoting the invulnerable action hero as the model of masculine behaviour.

Okay, I knew it was too much to ask. We won't act on this problem, even though action, even if it didn't eliminate differences between the sexes, would reduce the horrible toll exacted by brain injury among both men and women. The opportunity for each of the sexes to feel superior to the other would be reduced, opportunities for profit would be reduced, and we couldn't have that. What was I thinking?

Pathology is Destiny © John FitzGerald, 2001