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>> = Important Articles; ** = Major Articles


**’Marketing of Evil’ turns kids’ lives around: ‘It was like blinders came off my eyes after I read this’ (WorldNetDaily, 060209)

Japan’s Tamagotch craze produces new versions of the game (970819)

Speaking of tongues (National Post, 000712)

America Should Be Ashamed of SHAM [Self-Help and Actualization Movement] (Christian Post, 050824)

For some Americans, every day is Halloween: Bizarre sex, self-mutilation, ‘love of death’ becoming increasingly commonplace (WorldNetDaily, 051101)

Etiquette guru in mission to mend China’s manners (Independent New, UK, 060108)

In California, Clothing Is Optional (Foxnews, 060209)

Discriminate against tattoos, piercings at your own risk: Employers with appearance codes face lawsuits from ‘body modification’ activists (WorldNetDaily, 061020)

Cosmetic surgery special: When looks can kill (WorldNetDaily, 061020)





**’Marketing of Evil’ turns kids’ lives around: ‘It was like blinders came off my eyes after I read this’ (WorldNetDaily, 060209)


It’s not as though the best-selling WND book “The Marketing of Evil” has been short on good reviews – with almost 100 five-star reader reviews on Amazon and rave endorsements from everyone from Dr. Laura to David Limbaugh to Michelle Malkin.


But to author David Kupelian, the most meaningful testimonials are those from young people who say their lives have been radically transformed by reading the book.


“I always love hearing from young people,” said Kupelian, WND’s managing editor. “But when I hear that my book has helped free someone from the horribly corrupting pressures that suck millions of kids into self-destructive lifestyles – well, as a dad, that means a lot to me.”


Here are two letters to Kupelian from young people who read Chapter 3 of “The Marketing of Evil” – a gripping exploration of what’s really behind today’s bizarre youth subculture, titled “Killer Culture: Who’s Selling Sex and Rebellion to Your Children?”


Ellie French, a freshman at Lee University in Cleveland, Tenn., writes:


If you’re a mom or dad and you are worried that your child is deceived and is being unduly influenced by things you know are wrong, if your teenager will read this book, it will change how he sees life.


In January of 2004, I was a junior in high school. My mother gave me David Kupelian’s articles entitled, “Selling Sex and Corruption to Your Kids,” and “Why Today’s Youth Culture Has Gone Insane.” (Editor’s note: These two articles comprise an early version of what ultimately became Chapter 3 of “The Marketing of Evil.”)


It was like blinders came off my eyes after I read this. I began to go to school and each day I’d see more and more how my generation had bought the lie and swallowed it. I realized that I and so many kids in my high school had been hoodwinked by MTV. There’s a force out there that wants evil in my life and my generation’s life. It’s not just the fact that they want our money. They are purveyors of evil.


It disgusted me to see so many of the so-called “coolest” and looked-up-to kids being revered when in fact they were suffering from a hideous identity crisis. Any white senior wearing a Malcolm X hat backwards and intentionally altering his voice so as to sound like an uneducated black male raised in the ghetto is nothing but a joke to me now. The strange thing is, this is what my peers like and respect.


Before I read the article, I was a prisoner of thinking I had to be a certain way. But reading this confirmed what I knew deep down, which was that that was the last way I needed to be. I was very image-conscious before I read this article and it completely dispelled my desire to conform. I was completely exhausted from trying to conform to the way everybody else was. I realized that I no longer wanted my actions to be the result of believing a lie.


I found that I lost interest in watching TV and ended up moving it out of my room and downstairs to the basement. Life suddenly took on new meaning. Other things became interesting to me instead of appearance and the never-ending quest to fit into the image that these marketers told me I must have.


So please, if your teen is going astray, buy “The Marketing of Evil” and point your teen to the right chapter. There’s hope!


Ellie French’s comment about her “blinders” coming off is echoed in an interview with Kupelian in the current edition of one of the nation’s largest homeschooling magazines, “The Old Schoolhouse.” Interviewer Lorrie Flen closes the article this way: “So, now I have a question for you, the reader. Should you read this book? What about your teens? Not necessarily. Not unless you want to have the blinders removed from your eyes. Not if you want to continue to fall prey to their marketing ploys. It should be required reading.” After all, she points out, “the current target is our youth.”


Leaving a culture of self-destruction


A much more dramatic letter came from a veteran of the body modification movement – a professional body piercer deeply involved in today’s radical and often-shocking youth culture – who experienced a personal transformation after reading the same Kupelian chapter on youth culture. His name has been withheld for privacy reasons:


I was forwarded your article [Chapter 3] by my mother and father who raised me in a Christian home. I have gone astray from that lifestyle, until recently, and submersed myself in a lifestyle that had become quite the opposite of that in which I was raised.


After I read your article about how the youth of today have gone crazy (along with the other one you wrote about selling sex to our youth), I felt compelled to post the following post in all the bulletin boards that I was formally associated, including BMEzine and and Tribalectic and others – all three are leading body modification websites. … I just wanted you to know that your article was the inspiration for my feelings that I should post and try and spread what I agree to be a magnificent message you put forth. … I don’t know that this post has survived the supervision of the webmasters but I felt it needed posting nonetheless. Thank-you.


A Call to Revolution from One Among You


I sit here ready to write my final statement, my last exit speech, as it were, as [NAME WITHHELD] and I don’t know quite where to begin. I know what I write here today will be controversial in nature. I know there are many that will condemn me and look down on me for the following words and I don’t pretend to think I will be allowed to be, after writing this, a friend to the body modification industry or culture. I know also that mine is not a big and renowned enough name in the industry to cause much, if any, a stir but I can only hope that what I write now is read and taken to heart by at least one of my brothers or sisters. That perhaps this last rambling of mine won’t be in vain.


I guess the place to begin is by telling you all who I am. Some of you know me but most do not. Many have come to me for advice, many to perform procedures, and some just to be brothers and sisters in this subculture we have fought to establish.


I am [NAME WITHHELD]. I am based in the U.S. in the Midwest and the Southeast. I’ve been a faithful student of the Body Modification lifestyle for a decade now. I have performed countless piercings, scarifications, brands, implants, and a host of other less “pop culture” procedures. Most of what I have done to others I have done to myself at some point or another. That has brought to me an odd revelation.


Now before I continue, let me make it clear to you all that in no way do I intend to hurt anyone’s feelings or harm anyone’s business, but as I step out of our culture and lifestyle I feel some things must be said even if only one gets the chance to read it before the webmasters yank it from bulletin boards.


You see, it’s dawned on me that perhaps we (the Bod Mod culture) have become much darker than we intended. We all in some way or another come into this “tribe” as it were, to rebel and fight on some psychological plane against someone or something, be it our individual parents, an establishment, or even society itself. We’ve come together to be with fellow rebels to find a voice, to be heard, to have an identity that is our own, to be loved and wanted, and to be a part of something.


“We are unique!” we’ve screamed. “We are individuals! We are powerful in our own right! We control our own destinies and choices!” we shout. “Let anyone TRY to condemn us for our individuality, our beliefs, our practices. Let them even TRY to say we’re wrong or foolish or perverse!” we challenge. “How DARE they!”


My friends, I think perhaps our machinations have gotten away from us. It seems to me that we’ve allowed it to come to a point where we must stop and examine their arguments once again and reflect, “Could they be right?”


I think back on some of the things I’ve been paid to do to people (and done to myself) at their own request and I think if someone accused me of doing these things to them without consent it would be undeniable torture. The things done to captives in the Middle Ages as torture in the worst degree I now get hired to do. How far have we come in our own devices? My God, what is the next level of our self-defections?


Self-inflicted castrations, lobotomies, amputations, disfigurement of every conceivable nature, suspensions – we do these things to each other and ourselves without a second thought. Think about it unemotionally for a moment: People pay us to hang them from a hook or have a finger, breast, or penis cut off. This used to be the worst form of punishment and condemnation for the worst criminals. Could these acts truly be signs of a perpetually growing disease? Could the fact that our acts are becoming darker and darker, more and more grotesque be a sign that we are heading in the wrong directions?


These acts were once outrageous and horrid acts of torture, and yet we have people standing in line to have us do it to them?? What’s next? Death? Will we continue so far in our devices that we will soon pay to be burned alive at the stake or dismembered? Will we bring back the rack and the gallows to achieve the next level of “ascension” or as the ultimate expression of rebellion?


You see, it starts so innocently, so pure with a simple labret or cage in the ear … but in the tinniest increments it turns darker and darker until we are far beyond the innocence and purity of our beginnings. I’ve seen it a thousand times. I’ve performed it for others a thousand times. I’ve even done it to myself.


Some of you know and are familiar with the psychology of the “cutter” and their “cutting,” but don’t you see that’s what we all in essence are? Ours is just a tad more socially acceptable form of the same disorder.


Oh, I’ve heard all the arguments against this statement. I’ve preached against it my whole life as a former cutter, but it’s true. The statement is valid. It is the same disease. We need to realize that by destroying our bodies in bits and pieces, baby step by baby step, we are undermining the very reason so many of us are in this culture.


We are unique. We are special. We are powerful just the way we were born. Do we need a split tongue to prove it?? NO! Do we need brands or castration to show our individuality?? HELL NO!


We need our minds, our hearts and our souls and that’s all! Each of us at birth was unique and powerful and special in our own right. Let’s not destroy pieces of our beautiful bodies to prove what our own individual minds and voices can accomplish so much more powerfully and perfectly: “We have a place in society and we are all in our own way beautiful and unique!”


And so I withdraw. I exit this subculture that is more and more becoming the “trend,” to enter into what is more completely my individuality. I condemn none of my brothers and sisters who remain. I now turn to what is my uniqueness, my power, and mine alone: my heart, soul, and mind which no body mod can ever symbolize more perfectly then my own emotions, thoughts and voice. Good luck to you all and best wishes. I hope at least one has heard some wisdom in these words.


“The Marketing of Evil” was launched Aug. 22, 2005, when Kupelian appeared on both “Hannity & Colmes” and the Sean Hannity radio show. Since then WND’s vice president has appeared on Fox News’ “Dayside” and “Your World with Neil Cavuto,” MSNBC’s “The Situation with Tucker Carlson,” twice on CBN’s “NewsWatch” and dozens of radio shows.




Japan’s Tamagotch craze produces new versions of the game (970819)


TOKYO (AP) — Parents who have watched their children get hooked on Tamagotch chickens, be warned: New versions of the world-popular video game could have them raising bugs, fish, dinosaurs and even angels.


Bandai Co., the Japanese maker of the hand-held game, has had trouble supplying enough Tamagotches — or “cute little eggs” — since the toy was introduced in Japan in November and overseas in May. In the United States, the game is marketed as Tamagotchi.


Though 10 million games have been sold in Japan alone, adults in some Asian countries worry the game is too harsh for children.


Players must feed and discipline their pet, in the original version a chick that “hatches” at that start of the game. Those who ignore beeps for attention watch their chick die. The toy has been banned in some schools in the Philippines, Hong Kong and South Korea as too distracting or upsetting.


In the Japanese game, the dead chick turns into a ghost and a headstone rises behind it. In the version sold in 25 other countries, it turns into an angel.


“We don’t think the game has a bad psychological influence on children,” Bandai spokeswoman Michi Taneda said. “It is about raising a pet. An egg hatches and you learn how difficult it is to raise a pet. One day it dies.”


In Japan, the game is labeled for children 12 and older; toys sold abroad indicate they are appropriate for ages 8 and above.


Taneda denied that new versions of the games, and others in the planning stages, were created to reduce criticism.


In August, the company introduced Angel’s Tamagotch in Japan. Its players raise a ghost that turns into an angel. It prays for them in return for their tender loving care.


Pushing three buttons, the owners feed, play with, clean up after and protect the angel, just as they do the chickens.


When the angel completes its “training,” it does not die. Instead, it says thanks and goes back to “the city of angels.” If neglected, it becomes a devil.


Sales have been brisk, and Bandai expects to sell 2 million Angel’s Tamagotches by the end of October, Taneda said.


Over the weekend, hundreds lined up outside Hakuhinkan Toy Park in Tokyo to buy the new version of the toy.


“I came here on Monday, Tuesday and Wednesday, and finally on Friday they gave us a voucher,” said office worker Nobuko Kato, who was buying the toy for a friend’s niece.


In June, Bandai introduced Digital Monster, a Tamagotch that features a dinosaur who must be raised.


This version can be connected to another palm-sized Digital Monster machine so the two adult dinosaurs can fight for 20 seconds. A screen message declares a winner, who gets stronger. The loser must be nurtured back into shape.


Angel’s Tamagotch and Digital Monster usually are sold out in Tokyo. But Bandai said it has no plans to sell them overseas yet.


Instead, it is busy developing two new versions of the game, one featuring fish and other sea animals and another one on bugs.


Another plan calls for more chicks — male and female ones that can be raised in two separate hand-held games. Later, they can be connected so the two can mate and produce their own baby chick.


The company isn’t sure when that version will appear.




Speaking of tongues (National Post, 000712)


Dentists and body piercers are knocking heads over tongue piercings. ‘The body piercers don’t see the bad cases,’ says one dentist. ‘They come to us’


‘Metal mouth” no longer just means braces. Over the past five years, tongue piercings have become so common that even Princess Anne’s daughter Zara Phillips got one. But now there is growing concern among dentists that these piercings could damage teeth and are possible health risks. Folks such as tongue-pierced Spice Girl Mel B could literally become Scary Spice.


Dr. Louis Dubé, a dentist in Sherbrooke, Que., who sits on the board of governors of the Canadian Dental Association (CDA), says people with tongue piercings are chipping their teeth. His dental partner even saw a patient who eventually knocked a tooth loose. “The body piercers don’t see the bad cases,” says Dubé. “They come to see us.”


But responsible piercers say they are aware of the risks involved. Tee Defacendis, who has been piercing body parts for eight years in Toronto at her shop, Passage, says: “It’s a big risk for receding gums and chipped teeth. You shouldn’t be clicking it around. Some people get in the habit of rubbing it against their teeth. Over-contact with gums will cause gum problems.”


Defacendis, whose own tongue is pierced, lets her clients know the risks and how to avoid complications. She quips that the procedure isn’t as bad as the dentist chair: “It’s definitely not an uncomfortable piercing when it’s being done.”


When a tongue is first pierced, a longer barbell is inserted to allow for swelling. After the tongue goes back to normal size, it is recommended that a smaller barbell be put in.


“I stress the importance of getting a small barbell. It’s even better when it’s short because you have more control over it,” says Defacendis, referring to the other reason, aside from esthetics, that people get tongue piercings — “mouth-to-body” sexual pleasure.


Tongue piercing is done between two muscles that make up the tongue. “You’d be screaming if you got the tip of your tongue pierced,” says Mitch Roberts, a piercer and owner of Universal Tattoo and Piercing in Ottawa. He says he performs tongue piercings on a daily basis.


The whole procedure, he says, takes five minutes at most. The tongue is marked with a body marker and secured with a clamp. Two triangular holes on the end of the instrument are lined up, and then “you pierce away.”


Roberts says he also recommends people get a shorter barbell to avoid dental problems, but admits most of his clients do not come back to change it because “some people like playing with [the longer version].”


Chipped teeth aren’t the only concerns being raised by some dentists. In a recent press release, the CDA stated: “Piercing the tongue can result in permanent numbness, loss of taste or movement if a nerve is accidentally pierced. Because the tongue has many veins, persistent bleeding or an immovable clot in this region could produce a life-threatening clog in a vessel.”


In Toronto, Dr. John Goodhew, whose practice includes a large HIV-positive patient base, is known as “the piercer-friendly doctor.” Many of the piercing studios in Toronto refer any complications to him. Asked about the CDA’s concerns, Goodhew says: “I’ve never seen any of that. I would be curious to know where they are getting their information from. I probably see two people a day sent to me from piercing studios. Ninety-five per cent are navel piercings. Tongue piercings make up 2% of problems I see. What I tend to see [most with tongue piercing] is swelling.


“I can understand that there is a theoretic concern that if the piercing is done incorrectly it would go through a nerve.”


Goodhew says that with proper piercings there should be almost no bleeding. The tongue, he says, heals very quickly.


“It certainly does heal,” says Defacendis, and once the healing is complete “there isn’t any discharge.” The piercer notes that “for the first six weeks, you need to be cautious, avoiding other people’s bodily fluids and swimming pools.”


Dr. Lorne Tarshis, past chief of ear, nose and throat surgery at the Wellesley Hospital in Toronto, says waiting six weeks “would be a very generous period of time. In actual fact, the tongue heals very well. The mouth area, including the tongue, heals very quickly. It heals much faster than skin. It heals more efficiently and faster because it’s a moist surface. A cut in the mouth heals faster than a cut on the skin. It’s a pretty safe area to pierce. There are few blood vessels there and very few nerves.”


Dr. Christine Botchway, a professor at the University of Alberta’s division of oral diagnosis in the dental department, is very concerned about tongue piercings. In a written statement to the National Post, she says: “Patients should be aware that tongue-piercing may result in a pierced and patent ‘tunnel’ that is not 100% truly protected by the body’s protective epithelial cells. A risk for cross-infection exists. This risk is made greater in the presence of poor oral hygiene, allergic reaction to the metal, or simply chronic irritation of constant and vigorous movement of the barbell, the body’s poor ability to heal (in immuno-compromised persons) or all the above in which instance the tunnel becomes inflamed. Even after four to six weeks’ subsiding of swelling of the tongue, patients should avoid high-risk sexual behaviour and practise safe sex.”


Tarshis agrees that the pierced tongue doesn’t get full epithelialization (the process whereby a skin forms inside the hole). But he feels risk levels for things like HIV infection are not increased by tongue piercing. “I would say [increased risk for HIV infection is] a theoretical consideration, but not more than that.


“If it was a raw area,” says Tarshis, “you’d notice pain if you drank alcohol or ate spicy food.” He also says he hasn’t seen any human studies on tongue piercing and none of the problems cited by the CDA has made it to his waiting room. Botchway, however, writes that “we make reference to animal studies that have shown that after 28 days pierced tongues failed to exhibit any re-epithelialization.” She also has a list of recommendations for people who ultimately choose to pierce their tongues (see sidebar).


Some dentists are simply saying no to tongue piercing. Dubé says that whenever he’s come across an infection, he tells the person to take out their piercing. Following that, he says, there are usually no more complications. On the other hand, Goodhew recommends a mouth rinse if an infection occurs.


“It’s easier for [dentists] to say take it out,” says Defacendis. “It’s no skin off their back. It’s an easy solution. It’s not important to them. It’s not part of their world. They’re looking at eliminating the ‘problem.’ “


“Dentists have been cursing piercing shops since they’ve been open,” says Roberts. “But look at how much money they’re making. People chip their teeth and they’ve got to fix them.”




Dr. Christine Botchway of the University of Alberta provides a list of recommendations to reduce the risks she associates with tongue piercing:


- All instruments including the jewellery barbell must be sterilized, kept in a sterilization pouch and opened in front of the patient.


- Piercers must always wear gloves.


- Ear piercing guns should never be used because the plastic part of this instrument cannot be sterilized.


- No other tongue jewellery except surgical-grade stainless steel, 14-karat gold, titanium or niobium may be used.


- If infection occurs, the patient should see their dentist or physician.


- The barbell must be downsized as soon as the swelling in the tongue subsides to avoid the fracture of teeth.


- Patients must follow post-operative instructions closely, choose a soft diet for the first few weeks and be aware that they are in danger of tooth fracture in the first two-month period.


- Patients should never be tempted to repierce a scarred area.




America Should Be Ashamed of SHAM [Self-Help and Actualization Movement] (Christian Post, 050824)


Steve Salerno is a reporter with wide experience. As a freelance feature writer, Salerno has written for magazines including Harper’s, Esquire, Sports Illustrated, and many others. He has contributed articles to the Los Angeles Times and The Wall Street Journal. Many of his articles have focused upon “money stories,” that deal with financial scandals and controversies in the business world. Now, he is ready to report on the biggest scandal he has ever encountered—America’s self-help movement.


Salerno writes: “In twenty-four years as a business writer and an investigative journalist, I have covered all kinds of ‘money stories.’ I have written about boondoggles on bankers’ row and sleight of hand at Seventh Avenue fashion houses. I’ve written about the gyrations of the stock market as well as the myriad forces that surround, yet never quite explain, investing itself. I’ve written about money as it relates to sales, money as it relates to sports, money as it relates to music, money as it relates to love. It’s safe to say that if it involves money, combined with some form of human aspiration, I’ve probably written about it.”


Nevertheless, Salerno’s experience in reporting still left him amazed when he confronted an industry whose story “represents the ultimate marriage of money and aspiration.” That story is the rise and dominance of what he calls the “Self-Help and Actualization Movement”—identified in his book by the acronym SHAM.


America’s SHAM empire includes an army of therapists, authors, motivational speakers and “corporate coaches,” all ready to offer help, encouragement, motivation, correction, and assurance—for a price.


Salerno knows big money when he sees it. The SHAM industry is big business. Self-help books are never far from the best-seller list, and the products, conferences, and services of self-help gurus come at considerable cost. The top speakers earn more than ten million dollars per year, and the self-help sector of the economy is growing by leaps and bounds.


There’s a good reason for that, Salerno explains. Self-help business is repeat business. The self-help industry would go out of business if its books and products actually solved the problems—real or perceived—that led customers to buy the products in the first place.


Of course, comedians are quick to jump on the oxymoron that lies at the very heart of the industry. If people could genuinely help themselves, they wouldn’t need the self-help movement. As comedian George Carlin has quipped: “If you’re reading it in a book, folks, it ain’t self-help. It’s help.”


No matter what it is called, the self-help movement is big business and a growth industry. Last year, Publishers Weekly reported, “Self-help books are a Teflon category for many booksellers. No matter the economy or current events, the demand is constant.”


The repeat business is often no accident. Salerno served for some time as editor of the books program associated with the magazine, Men’s Health. Part of the giant Rodale publishing empire, Men’s Health offered a book service directed towards male customers. The company conducted surveys in order to identify “the customers’ worst fears and chronic problems,” which then became fodder for future books and products. The secret behind the program’s success was, Salerno reports, the fact that many customers could be enticed to buy yet more books on self-help within eighteen months.


Depending on how one defines the category, publishers release thousands of new self-help books each year. Some of these books make their way to the very top of the best-seller list—and stay there for months or years. But the market for self-help books and products is not limited to mainstream bookstores. Salerno reports that such products are staples of the more than 5000 New Age bookstores now found in the United States. In reality, much of the energy behind the New Age phenomenon has now been refocused into SHAM with New Age consultants and coaches now ready to talk about profits and marketshare rather than meditation and channeling.


Salerno acknowledges that the self-help tradition has a long pedigree in the United States. After all, Benjamin Franklin wrote what may be identified as America’s first self-help book, Poor Richard’s Almanack. But the real rise of the self-help industry, at least in publishing, can be traced to 1937 with the publication of Dale Carnegie’s How to Win Friends and Influence People and Napoleon Hill’s Think and Grow Rich. Thirty years later, Thomas A. Harris redefined the industry with his best-seller, I’m OK-You’re OK, which revolutionized the genre.


Once again, a book’s title was the reverse of its content. As Salerno understands, Harris “explicitly posited that the average person is damaged early in childhood and walks around thereafter in a paranoid, self-pitying state.” His book supposedly offered a way out of that state of victimization.


In reality, victimization has become a major theme of the entire industry. Salerno suggests that the SHAM industry is divided into two camps. The first is Empowerment and the second is Victimization. He explains: “Victimization and Empowerment represent the yin and yang of the self-help movement. It is likely that this schism will always exist, no matter which guru or message becomes the flavor of the day.”


The focus on victimization allows Americans to blame other persons—or impersonal forces—for their problems. Salerno sees Alcoholics Anonymous [AA] as the “template” for the victimization worldview. Human problems are translated into the vocabulary and categories of victimization so that persons can speak of overcoming what has been done to them, what has happened to them, or those who have afflicted them.


The truth is that virtually everyone can find someone to blame. In her spoof of the self-help movement, I’m Dysfunctional, You’re Dysfunctional, skeptic Wendy Kaminer asserted that the victimizers are usually close at hand: “Grandfather was an alcoholic, mother is a compulsive rescuer, Uncle Murray weighs 270 pounds. Father is a sex addict, your sister is anorexic,”—and the beat goes on.


There is simply no way to get around the fact that the self-help movement is more focused on the self than on help. Americans are evidently quite ready to focus on themselves as an ongoing project and to buy, read, and accept arguments that place blame far outside our own responsibility.


Problems are redefined in terms of therapeutic categories. Individuals are described as dysfunctional, and those who deny this diagnosis are charged with being in denial.


Salerno identifies “five overlapping messages” of the Recovery movement—one of the central streams in the self-help river. These messages include: 1. You’re damaged goods. 2. Good is bad. 3. It’s all about you. 4. All suffering is created equal. And 5. It’s not your fault. Together, these five messages explain everything from the nation’s current focus on addiction and a general proclivity to self-centeredness, to the moral evasions of President Bill Clinton and the executives caught in recent business scandals.


Beyond this, Salerno detects a significant cultural damage. Children are raised in an increasingly therapeutic culture in which, as children, they are taught to take responsibility for their actions, but as they become adults are told to blame someone or something else. Salerno also suggests that the impact of SHAM is leading to something like the feminization of society. He accurately notes that most of the central categories of the self-help movement are essentially feminine. Perceptively, he notes that many of these categories are now being sold to men under the category of “corporate coaching.” As management theorist Warren Bennis has observed, men will accept this therapeutic advice so long as it is packaged as “coaching.”


Steve Salerno is hardly the first to criticize the self-help movement, nor will he be the last. Nevertheless, his unique perspective as an investigative journalist offers a perspective that other authors may miss. Salerno suggests that the self-help movement is making America helpless. Christians will understand that the problem is far worse than that. Indeed, the self-help movement represents a false gospel that offers an unreal hope of redemption. The very category of “self-help” represents a repudiation of the Christian message—that God in Christ has done for us what we cannot do for ourselves. But then, the entire biblical worldview of sin is missing from the self-help worldview. The greatest threat of the self-help movement is that it will leave Americans not merely helpless, but hopelessly lost.




R. Albert Mohler, Jr. is president of The Southern Baptist Theological Seminary in Louisville, Kentucky.




For some Americans, every day is Halloween: Bizarre sex, self-mutilation, ‘love of death’ becoming increasingly commonplace (WorldNetDaily, 051101)


Halloween is a time of the bizarre, of make-believe, of the dark and macabre – all in the spirit of fun, of course.


“But,” says David Kupelian, author of the popular new book, “The Marketing of Evil: How Radicals, Elitists, and Pseudo-Experts Sell Us Corruption Disguised as Freedom,” “as usual, truth is stranger than fiction. While Halloween party-goers and ‘trick or treaters’ dress up to look ‘mutilated’ or ‘bizarre,’ countless Americans are caught up with real-life mutilation and beyond – outlandish practices stranger and darker than the most imaginative Halloween costumes.”


What sorts of practices?


* First there’s sex. Kupelian exposes how “there seem to be neither boundaries nor taboos anymore when it comes to sex. Anything goes – from heterosexual to homosexual to bi, trans-, poly-, and you-don’t-want-to-know sexual experiences.” One such sexual experience that pushes the extreme end of the envelope is “bug-chasing.” “Very simply,” writes Kupelian, “bug-chasers are people for whom getting infected with the AIDS virus is the ultimate sexual experience. You heard it right: The main focus of their lives is to seek out sexual encounters that will infect them with HIV.”


* Body piercing has “progressed from traditional earrings for females, to earrings for males, to multiple piercings for both males and females in literally every part of the body – the tongue, nose, eyebrow, lip, cheek, navel, breasts, genitals – again, things you really don’t want to know.”


* Then there’s the national epidemic of self-mutilation, or “cutting” as it is commonly referred to. Countless young Americans, mostly girls, purposely cut their own bodies with razors and knives to obtain relief from emotional conflict.


* Tattooing and piercing are just the tip of the “body modification” iceberg. “Ritual scarification and 3D-art implants are big. So are genital beading, stretching and cutting, transdermal implants, scrotal implants, tooth art, and facial sculpture.”


* “How about hanging from your skin by hooks?” asks Kupelian “It’s called ‘suspension.’ In literally any other context, this would be considered gruesome torture. But to many people who frequent suspension parties, it’s a spiritual experience.”


* Tongue-splitting is also considered by some to be a positive, spiritual experience. According to Body Modification Ezine, a major online “body mod” site: “The tongue is one of the most immense nervous structures in your body. We have incredibly fine control over it and we receive massive feedback from it. When you dramatically alter its structure and free yourself of the physical boundaries your biology imposes, in some people it triggers a larger freeing on a spiritual level.”


In love with death


Why are so many teens in love with the forbidden and bizarre? Why do they find it exciting? (As pop star Britney Spears admitted to an interviewer: “When someone tells me not to do something, I do it, that’s just my rebellious nature.”)


Why is American culture becoming more and more bizarre, so that every day seems like real-life Halloween?


Kupelian argues that America is becoming increasingly a culture in love with death. “Bug-chasing,” suspension, tongue-splitting, radical piercings and the like allow people to feel that they “are moving, not toward death, but toward life and greater ‘spirituality,’ a more unique and authentic sense of self. Somehow the ritual of pain and mutilation – or in extreme cases, death – drives out their awareness of inner conflict, replacing it with an illusion of freedom and selfhood.”


“Every parent in America needs to read this book,” says author, columnist and Fox News contributor Michelle Malkin. “David Kupelian skillfully exposes the secular left’s rotten-apple peddlers in devastating detail. From pitching promiscuity as ‘freedom’ to promoting abortion as ‘choice,’ the marketers of evil are always selling you something destructive – with catastrophic results. Kupelian shines a light on them all. Now watch the cockroaches run for cover.”


“The Marketing of Evil” has consistently scored high on the Amazon charts since it was launched in late August on “Hannity & Colmes” and the “Sean Hannity Radio Show.”


“The Marketing of Evil” reveals how much of what Americans once almost universally abhorred has been packaged, perfumed, gift-wrapped and sold to them as though it had great value. Highly skilled marketers, playing on our deeply felt national values of fairness, generosity and tolerance, have persuaded us to embrace as enlightened and noble that which all previous generations since America’s founding regarded as grossly self-destructive – in a word, evil.




Etiquette guru in mission to mend China’s manners (Independent New, UK, 060108)


It’s a brave person who thinks they can change the behaviour of an entire nation, but that’s what June Yamada is trying to do. Outraged by the bad manners and rudeness that she encountered when she moved to Shanghai, the etiquette and style expert has embarked on a crusade to introduce the Chinese to a world of refinement.


Some would say Ms Yamada has taken on a Herculean task, given the fondness of the Chinese for hawking and spitting in public, queue-barging, pushing their way on and off buses and trains and spitting out bones on restaurant floors. Then there’s the fact that “please” and “thank you” are the least-used words in the Chinese language. [KH: no!]


So ingrained are these behavioural quirks that the mayor of Beijing, Wang Qishan, believes the hardest part of preparing to host the 2008 Olympics will be improving the manners of its residents: “I really worry whether the audience will stand up when the national anthem of another country is played, or whether Chinese athletes will be greeted with applause if they lose.”


Born in Tokyo and educated in Los Angeles, Ms Yamada worked as a fashion consultant to moguls and movie stars before coming to Shanghai. One of her clients was Sean Connery. “On the screen he looks very nice,” she says, “but in daily life he’s a bit of a slob, so I tidied him up a bit.” Ridding the Chinese of their bad habits may not be so easy. But the petite and stylish fortysomething promises that anyone who completes her course on table manners at the June Yamada Academy will be “ready to dine with Queen Elizabeth II”. “Absolutely. You’ll learn how to dress properly, how to say ‘thank you’ when you’re escorted into the room, how to sit correctly. There are a lot of things to learn before we get around to teaching them how to cut their meat,” she says.


“I think the lack of table manners is the worst thing. It was very mysterious to me at first, because I come from Japan, which is probably the politest nation in the world. I wondered why we were so different.”


Now, after four years of living in China, Ms Yamada believes she has the answer. “For the past 5,000 years, China has been a peasant culture,” she states flatly. “When the Chinese don’t say ‘please’ or ‘thank you’, it’s because they’ve been too busy trying to find a bowl of rice to eat.”


But with China’s economy booming, and an ever-increasing urban middle class, Ms Yamada has had no shortage of students willing to pay up to 990 Yuan (£70) an hour for her course.


Her battle against bad manners is being echoed by the authorities. Last year, Shanghai launched the “Be a lovable Shanghainese” campaign to try to dissuade locals from spitting on the streets, and Beijing began a three-year programme to improve behaviour at sporting events. It was inspired by complaints from some of the world’s top snooker players about the way the 2005 China Open was disrupted by people refusing to switch off their mobile phones during frames.




Model Behaviour


Don’t: If invited somewhere but you can’t attend, never bluntly say “I can’t” but “I’d love to but I can’t”.


Do: Expect appreciation and gratitude for everything you do for others.


In The Restaurant


Don’t: If a steak is not cooked as requested, customers never compromise but insist on having it done the way they want.


Do: The Chinese like to remind restaurant staff that they are the clients and that the restaurant must accommodate their whims. A fussy attitude is respected.


Out On The Town


Don’t: Suits are out of bounds for women on evening dates, they are strictly for business. For men, jeans are a no-no - unless it’s a trip to a fast-food restaurant.


Do: Smart clothes are obligatory for both sexes. Women are also expected to look soft and feminine.




Don’t: Young people don’t expect their bosses or seniors to pay for them when they go out together.


Do: Seniors do expect the respect, however, of having the odd coffee bought for them once in a while.




In California, Clothing Is Optional (Foxnews, 060209)


Maybe it’s the warm weather. Or maybe it’s just California. This much is for sure: in the Golden State, clothing appears to be optional.


From naked dining to mass-mooning an Amtrak train, California offers a little something for the budding exhibitionist — or voyeur — in all of us.


Naked Dining


For starters, there’s dinner. Like everyone else in America, couples in California are getting ready to spend Valentine’s Day over a candlelit meal for two.


But leave it to Los Angeles to incorporate delicious food and a hot body without the worry of getting fat. Impossible? Hardly, assuming the food never actually reaches your mouth because you are — and this is no joke — the plate.


Gary Arabia’s Global Cuisine — a posh event-producing/catering company that boasts clientele like Kanye West and Shaquille O’Neal — offers the Body Sushi Experience, a sensual dining soiree in which Asian delicacies are painstakingly laid out on strategically placed tea leaves atop a beautiful nude model.


Arabia says the idea came to him years ago after spending time in Japan and feeding, if you will, off the country’s unique cultural and culinary experiences.


“I am based out of L.A. where people have seen it all and done it all. I had clients who were looking for a unique culinary experience. A young lady who worked for me, a beautiful girl, was my muse for bringing Body Sushi out of the closet. It was just natural,” Arabia said.


Au natural, indeed. Fortunately for those of us with a sweet tooth, Arabia’s foray into naked noshing did not stop there. How does a nude model covered in chocolate sound?


“Body Chocolate was an evolution from Body Sushi,” Arabia said. “They are both intimate, sensual, culinary performance experiences.”


But those with shallow pockets or a propensity for beer bongs and thongs need not inquire. The Body Experience will run you $500 a person, at least.


“Body Sushi encapsulates all of the senses. It’s not a bachelor party environment. That’s not to say it’s not incredibly sensual, but it’s not girls on poles,” Arabia said.


Get Your Strip On


The Erotic Museum in Los Angeles wants you to take your clothes off.


And not only if you’re supermodel-thin. The museum is looking to create a naked database of all kinds of bods in hopes of painting a more accurate picture of the modern human, as opposed to the altered and often unattainable versions often served up by the media.


Not up for stripping? The museum also features adult-themed pictures, movies, paintings, graphs, etchings, dioramas and interactive exhibits. Not to worry, though — this is no house of ill repute.


“We never wanted to shock people. Our general motto is to educate, to entertain and to inspire people to talk about sex,” said Erotic Museum CEO Boris Smorodinsky.


The Erotic Museum will be open late for Valentine’s Day.


Naked Race


For those who enjoy their naked Valentine’s Day so much that they feel the need to incorporate random nudity into their life year-round, all that’s necessary is a pair of sneakers.


Bay to Breakers, dubbed “the world’s most popular and colorful footrace,” is a 7.46-mile race through the hilly streets and parks of San Francisco that encourages participants to wear costumes, enjoy live music and lose themselves in the free-wheeling San Fran atmosphere along the way.


But the madcap costume circuit got more than they bargained for when people started shedding their inhibitions until there was nothing left to shed.


Bare-to-Breakers is an actual organized group of people that run the race — you guessed it — as nature intended. These pioneering pedestrians say that they do it because it is their constitutionally protected right, but the official race organizers beg to differ.


“The Bay to Breakers wants to remind everyone that public alcohol consumption and nudity are both illegal in the city of San Francisco. Those who wish to partake in these activities risk being cited and/or arrested by the San Francisco Police Department,” race manager Angela Fng said.


Nonetheless, they run en masse every year, and will do so again this year on May 21.


Naked Transportation


Far from the highbrow nudity served up in L.A., thousands of beer-swilling, pants-dropping folks swarm upon the Laguna Niguel’s Mugs Away Saloon in Orange County every July with a purpose.


These are people on a mission. These are people with a message. These are people who travel for miles, on word of mouth alone, to line up along a chain link fence and moon an Amtrak train.


Dawn Capitan, a bartender at the Mugs Away Saloon and longtime train-mooner, explained that the tradition started 26 years ago when some guys were sitting in the bar, drinking what had to have been an astronomical amount of beer, and one of them bet another to moon the Amtrak that ran behind the bar. He did.


Somehow this small act of defiance started a rear-end revolution which today is complete with T-shirt stands and cookouts.


“You know when the Amtrak’s about to come because everyone’s got their butts pressed up against the fence. The train slows to a crawl,” Capitan said.


California’s naked celebrations might be too much for most. But if you ever wake up one day with an insatiable urge to be seen in your birthday suit, pay no heed to the hysterical objections of your friends and co-workers. Whether you’re a nudie foodie or goon who longs to moon, Cali’s got it (un)covered.




Discriminate against tattoos, piercings at your own risk: Employers with appearance codes face lawsuits from ‘body modification’ activists (WorldNetDaily, 061020)


WASHINGTON – You run a fashionable restaurant with a dress code for employees and customers that discourages pierced tongues and noses.


You are a personnel director at an upscale department store known for customer service and refuse to hire women with prominent tattoos.


You supervise a supermarket and require those with pierced body parts who handle food to remove the piercings before reporting to work.


According to legal experts in employment law, if you fit any of these categories, you are setting yourself up for lawsuits from members of a new activist lobby representing the ever-growing population of those into “body modification.”


“Employers are getting involved in expensive legal battles as they attempt to adapt to the ever-changing workforce,” said David Barron, an attorney with Epstein Becker Green Wickliff & Hall, P.C. “Long-accepted rules are now being challenged and questioned in court.”


The firm cited one of the nation’s largest wholesale clubs that was recently sued by a member of “the Church of Body Modification,” who complained that she should not be required to remove a facial piercing.


“The employer required that all food handlers remove any such piercings for both sanitation reasons and to reflect an appropriate appearance for customers,” said Barron. “This time, the company prevailed in the action, but employers in a non-food handling workplace might not be so lucky.”


Laws prohibiting discrimination based on appearance and behavior of this sort already have been passed in several cities in California, and restrictions against tattoos and piercing are breaking down all over the country as the trend becomes a craze among young people.


In fact, 49 percent of Americans ages 18 to 29 have tattoos, according to a 2004 Harris Poll. A study recently published in the Journal of American Academy of Dermatology indicated 24 percent of people ages 18 to 50 have at least one tattoo. The study, based on a survey of 500 people in the United States, noted tattoos in past years “became associated with marginalized groups, signaling time spent in jail, punk status, membership in a motorcycle gang or a traveling circus.” But now, it said, tattoos “have become increasingly eclectic, and the practice has become mainstream.”


There are even children’s books like “Mommy Has a Tattoo” and the “Tattoo Coloring Book.” The topic of tattoos and body piercing is one of the hottest for campus speakers. Major corporations are working the “hip” new trend into their TV commercials and ad campaigns. And as tattoos and piercings become more common, some zealots are moving to extremes once unthinkable.


Just as “Heather Has Two Mommies” is now required reading for kindergartners in some school districts, how long will it be before the tolerance police mandate Phil Padwe’s new books. He’s the author and illustrator of the two new children’s books on tattoos.


In “Mommy Has a Tattoo,” a little boy, James, is afraid of a heavily tattooed neighbor – until he realizes his mother has one, too.


“I wanted to keep it simple,” says Padwe, who is not even sure how many tattoos he has but figures it’s somewhere between 25 and 30. “I didn’t want to get into really heavy questions or pass judgments. It’s about teaching tattoo tolerance.”


Tattoos are the rage even among young teen-agers. They are becoming so common that many parents are allowing their children to make what are, in effect, lifelong decisions about indelible, permanent “body art.”


Children – both boys and girls – are staining their bodies with the permanent ink for no better reason than “everybody is doing it” or “I thought the picture was cool.” It’s not just an urban thing any more, either.


Jon Smith, a senior at Conneaut Lake High School in Meadville, Pa., has a medium-sized tattoo of a wizard on his back. He got it last March because he just “wanted one.” Wizards have no particular significance for Smith, who picked the image from a tattoo parlor book full of various designs.


“I just liked the wizard,” Smith told the local paper. He had it placed on his back with the idea of adding more tattoos later.


Lindsey Galbo, 16, of Saegertown, Pa., not only got her parents permission to get a red star tattooed on her upper back, she took her father with her.


“When I got mine I didn’t get it for any particular reason,” she said. “It was my birthday. Something I can think back when I’m older – my dad took me to get my first tattoo.”


Meanwhile, in colleges across the country, student programming boards are finding a big demand for tattoo artists to speak on campus. At Mills College in Oakland, Calif., earlier this month, Don Ed Hardy, an “internationally-acclaimed” tattoo artist, delivered a speech to a large and appreciative audience.


The tattoo taboo is definitely breaking down. One of the last states to outlaw tattooing – Oklahoma – has repealed the prohibition effective Nov. 1. In Illinois, a new law will end a prohibition on the donation of blood by those who are tattooed or pierced.


“My clientele has changed completely,” said Mace Arnold, who owns Body Art in Overland Park, Mo. “Now, everybody gets tattoos. Bankers, lawyers, doctors, everybody.”


Television shows are helping to make the trend more popular. One is called “Miami Ink” on TLC, the other is “Inked” on A&E.


“Every other person who walks through the door asks if we watch those shows,” explains Mike Paquette, owner of Aftershock Tattoo in Olathe, Kan.


Madison Avenue is catching on to what’s hot, too. Jeep’s advertising campaign for the 2007 Wrangler will meld traditional and new media – including a hookup with the tattoo-parlor reality TV show “Miami Ink.”


“Wrangler will be integrated” into the show, says Eileen Wunderlich, a Chrysler group spokeswoman. A Wrangler Unlimited will be decorated by the show’s artists and appear in three episodes this fall, she says.


The partnership also includes Jeep sponsorship of the show’s podcast, a sweepstakes and an online “Tattoo Your Own Wrangler” promotion. The Wrangler’s target buyer is 25 to 35 years old. The Unlimited’s target buyer is 30 to 40 years old.


But still some recognize there are plenty of downsides to tattoos and piercings – messages they’re not sure kids are hearing before making the permanent decision.


Dr. Betty Ann Lowe, an Arkansas pediatrician, past medical director of Arkansas Children’s Hospital in Little Rock and professor emeritus at the University of Arkansas for Medical Sciences, points out a few of the hazards:


* Tattoos are expensive and painful.


* Removal is not impossible, but it is expensive, painful and very time consuming. It is certain that the skin will never be the same.


* What is considered “in” today may turn out to be embarrassing later.


* Disease can be transmitted through unclean needles.


* Infection of the skin under the tattoo can be severe and sometimes disfiguring.


“Body piercing is not safe,” she said. “Dermatologists object to all forms of body piercing, with the exception of the ear lobes, and dentists oppose oral piercing to the point of calling it a public health hazard.”


She says health complications associated with body piercing include prolonged bleeding, scarring, tetanus, abscesses, boils and chronic infections such as halitosis (bad breath) from tongue rings.


“Infection of Hepatitis B and C also are a threat, with no effective cure,” she adds. “Any time permanent holes are made in the lips, nose and eyebrows, they are not easy to repair. Ear piercing of the cartilage of the upper ear is frequently associated with prolonged infection and occasionally permanent disfigurement. Studs and rings can catch in clothes, and can cause large tears in the skin, lip, tongue, etc.”


She’s not alone. In Israel, where the tattoo phenomenon is less advanced, the Knesset Labor, Social Affairs and Health Committee has set down regulations that will force parlors to warn customers of the dangers.


In 60 days, the new regulations – approved by the committee on Monday – will require piercing and tattoo parlors to post signs at the entrance with warnings that these procedures are “not medically desirable. They are liable to result in pain, infections, scars, disruptions in body functioning and other medical problems such as allergic reactions. They must not be performed on people who suffer from chronic illness, especially those with heart valve problems, and pregnant women.”


A new study conducted by U.S. researchers has shown that tattoos make skin slightly less sensitive to touch, as the process through which they are made may disrupt the nerve signals in the skin.


Todd Allen at the University of Northern Colorado, Greeley, conducted an experiment on 54 people, out of which 30 had tattoos. The skin sensitivity was revealed using an aesthesiometer, a common scientific device consisting of two adjacent plastic points that can be moved further apart.


He tested participants’ reaction to the aesthesiometer on five body parts – the lower back, the back of the calf muscle, the inner forearm, the tip of the index finger and a cheek.


Allen found that there was no difference between the sensitivity of the unmarked body parts of tattooed participants, and those of their “uninked” counterparts but that the corresponding marked regions of the tattooed subjects were less slightly sensitive to touch than the tattoo-free areas.


In Boston this week, a mother whose teenage daughter nearly died from an infection caused by a bellybutton piercing was convicted of endangering the girl’s life by failing to seek medical attention until she was gravely ill. Deborah Robinson, 39, could get up to five years in prison.


The girl developed an infection after piercing her own navel and inserting a ring. Prosecutors said Robinson watched for several weeks as her 13-year-old daughter dropped from 115 pounds to 75 pounds, became incontinent and grew so weak that she could not get off the couch.


The girl suffered extensive organ damage from an infection that ravaged her body. For nearly a week, doctors were unsure whether she would survive. But after a series of operations and weeks of rehabilitation, she made a full recovery.


In Chicago, a teenager reported to doctors that she felt stabbing pains in her face – like electrical shocks that lasted 10 to 30 seconds and struck 20 to 30 times a day. Her doctors diagnosed trigeminal neuralgia, a nerve disorder sometimes called “suicide disease” because of the excruciating and dispiriting pain it causes.


All symptoms ceased two days after the girl removed the metal stud from her pierced tongue.


In the latest issue of the Journal of the American Medical Association, the account is used to illustrate the complications, some life-threatening, linked to body piercing. Other problems include tetanus, heart infections, brain abscess, chipped teeth and receding gums. One woman developed so much scar tissue that it resembled what she called a “second tongue.”


The tongue is “a particularly dangerous place to pierce” because it is rich in blood vessels that can spread infection to major organs and because it is near important nerves and the upper airway, said Dr. Marcelo Galarza, a neurosurgeon at Villa Maria Cecilia Hospital in Ravenna, Italy, who reported the case to the journal.


Even the dangerous tongue-piercing isn’t cutting edge enough for some body modification extremists.


Take Allen Falkner’, for example. His tongue is split down the middle, and when he sticks it out, it looks like a two-pronged snake tongue.


Extreme body modification features a wide range of alterations. Some people get horns implanted on their heads. Some install magnets in their hands. Others remold their ears to make them pointy.


For those who already regret their earlier decisions to tattoo themselves, there is some good news on the horizon.


A company called Freedom 2 claims to have invented a tattoo dye – removable in a single laser treatment. And they say the ink is safer, made of filler material used in cement by orthopedic surgeons and less likely to cause allergic reaction. The laser destroys the tattoo ink using much less energy than a conventional tattoo requires.


But tattoo critics believe “less permanent” stains might make it even easier for people to make the body modification choice.




Cosmetic surgery special: When looks can kill (WorldNetDaily, 061020)

(from New Scientist)


Last year, 291,000 American women had bags implanted in their breasts, 324,000 Americans had fat vacuumed out of their bodies, and 231,000 had fat, skin and muscle cut from around their eyes. Add less common operations such as buttock lifts, pectoral implants and vaginal rejuvenations, as well as “minimally invasive” procedures such as Botox injections, and the American Society of Plastic Surgeons estimates that Americans underwent at least 10.2 million cosmetic surgery procedures last year. Cosmetic surgery has gone mainstream.


Like any other surgical procedure, cosmetic operations can never be completely free of risk. Although anyone contemplating cosmetic surgery is likely to have talked over with their surgeon the risks to their physical health, there are some forms of ill health associated with the procedures that are far less likely to be mentioned. In particular, people who go under the knife in the quest for a more attractive body or face are more likely than the average person to be suffering from psychiatric problems. There is mounting evidence that those who choose to undergo cosmetic surgery are more likely to commit suicide. What isn’t known is just how much people’s mental health is being placed at risk by the burgeoning nip and tuck culture.

“People suffering from body dysmorphic disorder may be 45 times as likely as normal to commit suicide”


A related question is whether cosmetic surgery brings any long-term mental health benefits. After all, implicit in the advertisements and promotional TV shows is the promise not merely of bigger breasts or flatter stomachs, but also the idea of a psychological lift. “We have to believe that cosmetic surgery will improve our self-esteem and body image, and make us feel better about ourselves. If not, we’re wasting an awful lot of time, effort and money,” says David Sarwer of the Center forHuman Appearance and the University of Pennsylvania School of Medicine in Philadelphia. Yet while cosmetic surgery is booming, research into the mental well-being of recipients has not kept pace, says Katharine Phillips, a psychiatrist at Brown Medical School in Providence, Rhode Island.


The results of the few quality studies that have been done are equivocal. Perhaps unsurprisingly, cosmetic surgery patients are more likely than average to have a poor body image. More striking is Sarwer’s finding that 18 per cent of a sample of patients having cosmetic surgery were taking drugs to treat a psychiatric condition, typically an antidepressant (Plastic and Reconstructive Surgery, vol 114, p 1927). Only 5 per cent of patients undergoing non-cosmetic plastic surgery were taking similar drugs.


That in itself doesn’t mean cosmetic surgery is a bad idea, says Sarwer. These patients also invest more than others in their appearance, fitness and health, and the greater use of psychiatric medicines may be a sign that they pay equal attention to their mental health.

Short-term satisfaction


Numerous studies have found that most patients seem satisfied with their procedures, at least in the short term, and surgery might even improve body image. A 2002 study led by Thomas Cash of Old Dominion University in Norfolk, Virginia, found a woman’s perception of her body image improves for at least two years after she has had breast implants, while a 2005 study of general cosmetic procedures by Sarwer’s team found it improves for at least one year (Aesthetic Surgery Journal, vol 25, p 263). Whether such improvements in body image last longer than a few years is not known, and studies of patients’ self esteem, depression rates and perceived quality of life are inconclusive.


However, findings from epidemiological studies of a link between cosmetic surgery and suicide are firmer and more disturbing. Five recent studies, including a US study of over 13,000 women who received breast implants and another from Canada of 24,000 (American Journal of Epidemiology, vol 164, p 334), set out to investigate the alleged link between silicone breast implants and cancers, autoimmune diseases and other disorders. Though they failed to confirm any such connection, another striking link did emerge: women who have received breast implants are two to three times as likely to kill themselves as those who have not. “The only consistent finding from all the studies has been the unexpected one of suicide,” says Joseph K. McLaughlin, director of the International Epidemiology Institute in Rockville, Maryland, who ran some of the studies.


The suicide risk revealed by these studies could turn out to be an underestimate, as deaths due to suicides are frequently attributed to other causes. For example, an update to the US study this year found that women with breast implants also have a higher risk of suffering a fatal road accident and some of those deaths could be suicides, suggests study leader Louise Brinton of the National Cancer Institute in Bethesda, Maryland (Epidemiology, vol 17, p 162). Meanwhile, McLaughlin has been re-examining death notices of Swedish women with implants. He says that early indications suggest that suicide may turn out to be even more common than reported in these women (BMJ, vol 326, p 527).


Other surgical cosmetic procedures may also be associated with a suicide risk, although it has yet to be quantified for most of them. The largest mortality study, conducted in Canada, found the suicide risk was almost doubled for the 25,000 women who received breast implants and 16,000 women who underwent other cosmetic procedures. A Danish study also found a moderate increase in suicide risk in breast reduction patients (Archives of Internal Medicine, vol 164, p 2450).


There is also anecdotal evidence to suggest that it’s not just women who are at risk. According to Leroy Young, a plastic surgeon in private practice in St Louis, Missouri, the patients most prone to violence against themselves, and their surgeons, are young, narcissistic males who have had nose or penis surgery. “There’s a plastic surgery aphorism - don’t operate on the male mid-line,” he says.


Trying to get at the reasons behind this increased risk of suicide is difficult. Some commentators even argue that the findings so far may not be relevant to women currently considering breast implants, as most of the women in the studies got their implants decades ago. “It’s a very different world now,” says James Wells, a plastic surgeon in private practice in Long Beach, California. “The implants are better, how we assess the patients is better, and implant failure rate is lower.” This does not reassure epidemiologists such as Brinton and McLaughlin, who have continued to search for clues to what is behind the increased risk of suicide.


One possibility - admittedly very remote, but not yet ruled out - is that leaks from implants can alter women’s brain chemistry, triggering suicide in some. Another idea is that women with breast implants commit suicide more often because they are also more likely to use drugs or alcohol. The findings of the US study are consistent with that hypothesis, as it found that women who had breast implants were more likely than other women to die for reasons related to drug and alcohol use.


A more plausible explanation is that women who receive implants have personality traits or psychiatric disorders that go undetected by surgeons or are ignored by them, and that these put the women at risk of suicide. This view is backed up by the Danish study, which discovered that 8 per cent of women who had breast implants had earlier been admitted to a psychiatric hospital, the most common diagnoses including “neurosis and personality disorders” and “substance or alcohol abuse”. Half the women with breast implants who committed suicide had been admitted to a psychiatric hospital before their surgery. It is unclear whether these women were predisposed to suicide and were tipped over the edge by a poor response to cosmetic surgery. “There are some who contend that patients who receive implants demonstrate a host of psychological problems that put them at risk for eventual suicide,” says Brinton. “Whether this is the sole explanation or whether patient dissatisfaction after the operation is also involved is not yet clarified.”


Another condition that is common among people having cosmetic surgery is body dysmorphic disorder or “imagined ugliness”. BDD patients obsess about barely noticeable or non-existent flaws in their physical appearance, and the condition now turns out to affect far more people than previously suspected. A study by Sarwer found that 2.5 per cent of female American college students have BDD. And while there have been no definitive epidemiological studies for the general population in the US, the prevalence is expected to be similar to that in Germany, where a study published this year revealed that between 1 and 2 per cent of the population meet all the diagnostic criteria, and a far higher percentage experience milder versions of the disorder (Psychological Medicine, vol 36, p 877). “People seemed puzzled by suicide in women with breast implants, but I would not be surprised if BDD was behind it,” Phillips says.


Around three-quarters of people with BDD seek treatments such as cosmetic surgery or dermatological procedures, and an estimated 6 to 15 per cent of cosmetic surgery patients in the US are believed to have BDD. Cosmetic treatment for these people is rarely beneficial and it often makes symptoms worse. “When they are satisfied, which doesn’t happen very often, their concerns move on to another body part - this problem is on the inside, not the outside,” says Sabine Wilhelm of Harvard Medical School.


The main reason to think that BDD might account for at least some of the unexpected suicides in breast implant patients is the extraordinarily high risk of self-harm among people with BDD. A preliminary study by Phillips’s team found that someone with BDD is 45 times as likely as normal to commit suicide (The American Journal of Psychiatry, vol 163, p 1280). That is more than twice the rate of people with major depression and three times that of people with bipolar disorder.


To find out whether BDD or some other psychiatric disorder is behind the suicides, and whether cosmetic surgery alters the risks, would require thousands of women to undergo extensive personality testing before and after surgery, something that psychologists and epidemiologists contacted by New Scientist doubted will be done. One stumbling block is that cosmetic surgery treatments are not based on rigorous research. “It’s a field of artistic endeavour and technique, not research,” says McLaughlin. Cosmetic surgery patients tend to be reluctant to volunteer for trials, preferring to remain anonymous. Some women with breast implants don’t even tell their husbands that they have had the procedure, says Brinton.


Also, a source of funds for such trials has dried up. In 1999, the US Institute of Medicine effectively cleared silicone implants of causing cancers, immune disorders and other life-threatening diseases. This meant that manufacturers lost an incentive to fund large trials. Add to that the lack of a comprehensive US registry for breast implant patients, or cosmetic surgery patients in general, and it’s hard to see such studies ever taking place.


Many cosmetic surgeons do try to screen their patients for “psychological appropriateness”, but even they need to be more aware of BDD and other psychiatric conditions, Wilhelm says. “I tell them to look out for what motivates the patient. Don’t operate on anyone who thinks the surgery will change their life, or who has unusual or excessive requests for surgery. Focus on their suffering and seek help from a psychologist,” Wilhelm says.


For surgeons who are still uncertain, Wilhelm has more advice. “Cosmetic surgery is an elective procedure. Some surgeons say: ‘If a patient elects to do it shouldn’t I go ahead?’ My answer is: ‘You as the surgeon can elect not to do it.’”


While it is not yet known whether women get an enduring psychological lift from breast implants (see main story), at least the idea that implants can trigger silicone-induced cancers, autoimmune disorders and other deadly diseases was laid to rest by a US Institute of Medicine Report in 1999.


Yet dangers remain. “Breast implants will not last a lifetime,” warns a 2004 pamphlet on silicone and saline implants from the US Food and Drug Administration. “Either because of rupture or other complications, you will probably need to have the implants removed. Many of the changes to your breasts following implantation may be cosmetically undesirable and cannot be reversed.”


Despite the graphic photos used to make this point, more than 290,000 women in the US had breast implants in 2005, up 37 per cent from 2000. “I tell these women about all these complications and more, and they still want to do it. They say they want to look better in clothes and feel more confident and less self-conscious. It’s a very powerful motivator,” says Leroy Young, a plastic surgeon in private practice in St Louis, Missouri.


The desire to perfect your body, even at such high potential cost, is a consequence of living in image-conscious America, says David Sarwer, a clinical psychologist and body-image researcher at the Center for Human Appearance and the University of Pennsylvania School of Medicine in Philadelphia. According to one survey, over 56 per cent of women and 43 per cent of men are dissatisfied with their appearance. “That dissatisfaction motivates a whole host of behaviours - weight loss, cosmetic and fashion purchases, and cosmetic surgery,” Sarwer says.