I seldom write reviews, but this book was so disappointing and irritating that it inspired me to draft a review. 'Sham' is a bizarre jumble of legitimate inquiry and feckless fear-mongering. The book explores several legitimate problems with the self-help movement in America. Salerno points out that the techniques offered in the genre literature frequently are unproven, at best, meaning that consumers are paying for a product whose efficacy is dubious. In addition, the author points out the questionable evidence behind the disease model of addiction, including alcoholism, and discusses the growing body of research demonstrating that 'recovery' is an ineffective tool for addressing these problems. Salerno also provides a competent review of the credentials (or lack thereof) possessed by the key players in the self-help market, and the connection between the cult of self-esteem and the epidemic of narcissism that has swept this country. But that's where Salerno runs off the rails.
In the section titled "Looking for Love...on All the Wrong Bases" Salerno discusses the ways self -help contributes to the high rate of divorce, decline of the nuclear family, and the resultant social chaos. He refers to alternative families as "broken homes" and alleges that these types of arrangements can't be good for children, claiming that "statistics on crime, drug abuse, and teen pregnancy leave scant room for dissent." Finally, after criticizing "artificial" approaches to dating and marriage that are recommended by self-help, Salerno quotes Sarah Allen of Divorce Forum. Asking her why we have so much divorce, she answers "we have more divorce because marriage isn't based on unconditional love."
And there ya go. It's that simply. Except it isn't. First, the nuclear family is only one of many family forms found throughout human history, so simply assuming that the nuclear family represents the default natural, healthy arrangement for rearing children (while other family forms represent a dire decline) is an unwarranted leap in logic. In fact the "traditional family", idealized in the 1950s, is a historic flash in the pan. Additionally, Salerno fails to quote the statistics about crime, drug abuse, and teen pregnancy that we're supposed to be so concerned about, most likely because doing so would substantially weaken his argument. Teen pregnancy and birth rates reached a historic low in 2012, according to the CDC and the Guttmacher Institute. Teens are delaying sexual activity, and when they do become sexually active, are more likely to use contraceptives. Drug abuse and crime have also declined, leaving one to wonder exactly what statistics are supposed to keep us up at night.
Then there is the question of the "artificial" approach to marriage, as offered by such self-help books as 'The Rules: Time-Tested Secrets for Capturing the Heart of Mr. Right'. Salerno implies that these contrived approaches stifle true love, thereby creating unstable unions, leading to high divorce rate and on and on. But the notion that romantic love should be the impetus for marriage is as much a new, 'artificial' idea as any other. In other times and places, the idea of basing a lifelong commitment on something as ephemeral as an emotion would seem ludicrous. In point of fact, arranged marriages (obviously not based on unconditional love and clearly manufactured) enjoy some of the highest rates of longevity and satisfaction, so Salerno's causal connection between self-help, lack of true love, and high divorce falls apart.
He does point out that selfishness is also a factor in divorce, and alleges that self-help advocates selfishness. Perhaps this is true in some cases, but it should be noted that the connection between self-help and selfishness is unproven- it's Salerno's personal thesis. This is significant because that's the biggest issue that Salerno takes with the self-help genre; the books/seminars/videos/web sites make untested, unproven claims regarding their treatment. If we shouldn't believe self-help authors when they claim their treatment produces desirable results, why should we simply take Salerno's word that it does the opposite?
Salerno also addresses alternative medicine, recounting the sad story of a woman named Debbie Benson who died of cancer because she refused biomedical treatment, opting for alternative medicine instead. He then attempts to terrify his readers, informing them that 86 percent of Americans have sought out alternative medicine at some point in their life. 62 percent of Americans are at risk of being the next Debbie Benson! But wait- the story of Debbie Benson is relatively rare. Obviously 62 percent of Americans don't eschew all Western medicine; according to the CDC, 82.1 percent of American adults saw a physician last year alone and the figure is even higher for children (92.8 percent). So it's clear that alternative medicine must be used in conjunction with biomedicine, not in place of it. But still, the mere fact that there are cases like the Debbie Benson case... Preventable medical errors, that's biomedicine folks, result in anywhere from 98,000 to 195,000 deaths a year (making it the sixth leading cause of death in America if these numbers where counted as an independent category). Alternative medicine doesn't even make at top 20. In comparison to Western biomedicine, alternative medicine is rather innocuous.
But the danger posed by each respective practice is only part of the story. Another important aspect of medicine is whether or not it works. Biomedicine works, and alternative medicine doesn't. Except it does (at least within a limited sphere). Major medical studies have demonstrated that numerous alternative practices (acupuncture, prayer, therapeutic touch, etc) are successful at reducing the subjective experience of pain. The catch is that these effects are psychosomatic. However, psychosomatic relief is STILL relief. This brings us closer to what people like Salerno actually mean- alternative medicine doesn't work through "appropriate" biomedical mechanisms and is therefore bad. Opponents of non-Western medicine want you to feel better, but only is it's on their terms, and the trumped up dangers of alternative medicine provide a convenient smokescreen.
Salerno also fails to present any solutions to the perceived self-help problem. He seems quite content to criticize the genre's patrons and the American lay-population, implying that they're naive, lazy, and that they're only seeking easy answers. He even manages to squeeze in some racism, saying this of the decline in verbal scores on the SAT: "we've also incorporated into mainstream expression increasing amounts of street dialect (think Ebonics) and other linguistic corruptions...Moreover, American schools contain an ever-larger population of immigrant children whose parents are disinclined to give up their native tongues." This book is a huge disappointment, leading me to believe that perhaps Salerno should help himself to a hearty portion of his own advice.