Pens & Needles

PUBLISHERS WEEKLY / JULY 20, 1990

The baby boomers’ concern with aging, children, and environment, and their openness to alternative therapies, has made for enlivening changes in health publishing

BY JOHN BETHUNE

Like a demographic bull in a china shop of statistics, the baby boom generation frequently is cited as the source of profound shifts in cultural attitudes. For publishers of books on health and healing, baby boomers, the bulk of their market, represent a massive audience that is likely to increase its interest in health books as it ages. “I don’t think there’s anything more current in people’s minds now than health,” says Elizabeth Perle, vice-president and publisher of Prentice Hall Press, adding, “This is absolutely linked to baby boomers and the aging of our narcissistic culture.”

With increasing acceptance by baby boomers of nontraditional approaches to healing and recovery, the market for alternative health books continues to shed its “fringe element” image and to develop into a mainstream category. But with this new acceptance comes the risk of a glut of books overwhelming the market, particularly in the recovery area, and mixed feelings by many of its publishing participants about the possibility of mainstreaming ultimately leading to a “watering down” of the distinctive category of alternative health.

There seems to be little question that alternative approaches to healing are continuing to influence, and even merge with, traditional Western approaches. Will Thorndike, nonfiction/health editor of Walker & Company, observes that “alternative healing is more and more coming into the mainstream, and the types of people who are reading and writing about it are those who are seen as part of the medical establishment.” As evidence of this transformation, Julie Feingold, sales manager of Moving Books, a Seattle-based distributor, compares her company’s bestsellers with those on PW’s trade paperback list. “How ironic that Moving Books, a small specialty wholesaler in the Northwest, primarily concerned with books on metaphysics, health and the environment, shares about half of PW’s bestseller list! A distribution company that focuses on alternative healing materials must not be that ‘alternative’ anymore if its titles are hitting the bestseller list of a trade magazine.” Noting that alternative health and healing shares some of the characteristics of the New Age movement that helped propel it to prominence, Feingold says that unlike New Age books, which have “really dropped” for her company, healing and recovery books are “phenomenally hot.”

More Open-mindedness

Likewise, Claire Zion, associate executive editor of Pocket Books, sees healing and recovery books as among the “few aspects of New Age that have remained worthwhile over time.” While she believes that the New Age has become a “submarket” without the “huge potential” it once had, its substantial legacy in the health book market has been to bring about “an open-minded and more spiritual approach to these subjects, a lot of very new and valuable ideas.”

As an example of Pocket Books’ program of publishing alternative healing books that are “serious, helpful medical guides” for the average consumer, Zion cites Kristin Gottschalk Olsen’s The Encyclopedia of Alternative Health Care ($8.95), published in January. While acknowledging “there are a few books available that provide overviews of different kinds of alternative healing methods, they tend to be hardcover.” Olsen’s book, says Zion, is intended to be a more accessible and objective consumer guide to alternative healing.

To Prentice Hall’s Perle, the integration of alternative healing and traditional medicine is irreversible: “It will be very difficult to have books from here forward that don’t address both the mental and physical aspects of illness, because the mind-body connection is here to stay.”

An indication of the continuing strength of this trend is provided by the most recent books of Deepak Chopra, M.D. A proponent of Indian Ayurvedic medicine and a pivotal figure in the movement to integrate Eastern and Western medicine, Chopra has had a significant impact on the public consciousness of health, according to his publishers. Bantam New Age editor Toni Burbank reports that Chopra’s Quantum Healing, a philosophical consideration of healing published last year, “has reached out well beyond anything that might be defined as a core market for this.” According to Harmony editor Peter Guzzardi, the first printing of 40,000 copies of Chopra’s latest, Perfect Health: The Complete Mind/Body Guide, sold out in less than three weeks after its May 1 publication. Guzzardi says that the sales figures indicate that the general public is buying the book.

Getting Serious About Chi

YMAA Inc., a publisher specializing in Chinese health and martial arts subjects, has likewise found a sub-stantial and growing interest in Oriental healing. YMAA titles such as The Root of Chinese Chi Kung, by Dr. Yang Jwing-Ming, explain the theories and practical applications of the Chinese concept of Chi, or “bioelectromagnetic energy.” According to marketing director David Ripianzi, the company is “seeing that Western medicine is getting serious about Chi,” and expects the concept to gain increasing acceptance by both professionals and the general public. Ripianzi adds that while YMAA originally entered the trade market through New Age and metaphysical bookstores, it recently sold some of its titles to the chains.

If alternative approaches to health are given increasing credence by the public, reflects Avery Publishing’s managing editor Rudy Shur, there continues to be a resistance to some books, especially those with stronger, nontraditional points of view. According to Shur, “If your books are not perceived by reviewers as produced by establishment types, then they will not be reviewed and will not be picked up in large quantities.” Shur worries that publishers seeking to expand the audience for alternative health books too rapidly may dilute the alternative point of view by “trying to appease everybody.” Avery’s books generally have “very strong points of view,” Shur says. “I don’t believe in producing a book that is watered down and tries to meet everybody’s needs.”

Shur represents the kind of publisher that has defined the market for alternative health care books, and will no doubt continue in the vanguard as an advocate. Because alternative healing has had a “profound effect” on improving Shur’s own health, he is committed to publishing books on the subject, whatever the state of the market. Similarly, Ehud Sperling, president of Inner Traditions, asserts that “I’m constantly looking for understanding in this area; it’s part of a quest for self-understanding and discovery for me and for members of our staff. What we have to offer in this publishing program are books that can make a significant impact on people’s lives and can help them, just as these books have helped us.”

How Recovery Titles Fare

The recovery segment of the health and healing market has been hot enough long enough that some publishers foresee an imminent glut and shakeout. “I think the market is still strong,” observes Peter Vegso of Health Communications, “but a lot of publishers are now jumping on the bandwagon. I don’t know when it will hit saturation, but it’s probably not too far off.” Perle predicts flatly, “There will be a glut of these books on the market, and it will shake out.” Like Vegso, Perle believes that the market will remain strong enough that publishers with established lines of recovery books will continue to prosper.

If the recovery market is threatened by an excess of books, it is also enriched, according to Julie Feingold, by the great number of high-quality works available. To help bookstores and their customers find useful titles not offered by the better-known houses, Moving Books has compiled a retail-oriented catalogue listing.

Being able to offer both depth and breadth of titles in the recovery area is seen as particularly critical, whether for retailers, distributors or publishers. Citing statistics that show that buyers of recovery books are not only educated and willing to spend money, but also likely to buy more than one book at a time, Perle describes the area as “the last of the great multiple purchase markets.” Similarly, Larry Chilnick, publisher of PIA Press, notes that when PIA offers four or five of its books in an issue of its Psychiatry Letter, “people will buy all of the titles. Consumers of this kind of material want as much information as possible.”

Feingold describes the recovery market as one that “creates itself.” As she explains it, readers of recovery books find that one topic leads to another, so that a person who begins buying books on recovering from alcoholism may well go on to purchase books on codependency and other related issues.

But reaching the market remains a challenge for publishers, despite the trade success of such titles as Harper/Hazelden’s Codependent No More and Health Communications’ Adult Children of Alcoholics. According to Chilnick, the trade distribution system remains one in which “you have to hope that the person looking for your book finds it.” While publishing and touring authors help get the attention of the potential consumer, Chilnick believes in pursuing several distribution avenues at once. When he established PIA Press in 1987, Chilnick set out to combine a direct-mail operation with licensing agreements to distribute PIA titles to bookstores through trade publishers. Eight titles that originated with PIA Press are being published in hardcover through the Villard imprint, Fair Oaks Press. Chilnick expects the upcoming Fair Oaks title The 800-Cocaine Book of Drug and Alcohol Recovery by Mark Gold, M.D. to be “our big hardcover bestseller.” A series of PIA trade paperbacks sold by direct mail are licensed for reprint by Berkley Books in the Berkley Total Health Series. The 10 titles in that series include High Times, Low Times by John E. Meeks, M.D.; Guide to the New Medicines of the Mind by Jeffrey L. Berlant, Irl Extein and Larry S. Kirstein; and A Parent’s Guide to Common and Uncommon School Problems by David A. Gross and Irl Extein. Chilnick also reports that PIA has just concluded a six-book reprint arrangement with Bantam. The first in that series will be Sixty Ways to Make Stress Work for You by Andrew Slaby, a title that has already sold more than 100,000 copies through PIA Press.

Because PIA Press is the publishing arm of the Psychiatric Institutes of America, it can use its network of affiliated hospitals not only as a source of authors, but also as a vehicle for its direct-marketing efforts. In addition to such print media as the Psychiatry Letter, Chilnick points to author tours as a significant source of book sales. “Through the network of hospitals that we are affiliated with, we can send our authors to every market in the country and hold lectures at which the consumer can buy our books.”

Pocket Books’ Zion observes that publishers of recovery and alternative healing titles “can get a lot of mileage out of advertising, getting notices in special catalogues and regional newsletters, and tapping into the grassroots organizations of the New Age networks.” According to Julie Feingold, Moving Books has made numerous sales in cooperation with organizations that sponsor addiction and recovery conferences. Moving Books advises the sponsors on titles that will likely sell, and allows seven days following the conference to return books, charging a restocking fee.

It was the appeal of such co-marketing arrangements as the Harper/ Hazelden partnership that encouraged Prentice Hall to enter into partnership with Parkside, a chain of rehabilitation centers with some 100 affiliates nationwide. According to Perle, the idea behind Prentice Hall Parkside is “to combine our sales and marketing strength in the bookstores with their direct-mail and community-based resources.” She hopes the Parkside centers will be important local sources for marketing Prentice Hall Parkside titles. “Each center will contact the book-selling community around them, and each will have an expert available for the local media.” The first Parkside titles will be published in August, and include books for survivors of incest (Growing Through the Pain), caregivers (Help for Helpers) and adults abused as children (Sole Survivors). Parkside has signed such well-known recovery authors as Terance Gorski, Earnie Larson and Melody Beattie, whose Codependent’s Guide to the Twelve Steps is scheduled for November publication.

In May, Ballantine Books began publishing Hazelden titles in a mass market format, according to senior editor Cheryl Woodruff. The first three in the series are The 12 Steps to Happiness by Joe Klaaf; Barriers to Intimacy by Mark Worden and Gayle Rossellini; and Back from Betrayal by Jennifer Schneider. Titles forthcoming in August and September are Living Recovery by Men and Women in Anonymous Fellowships and Compulsive Eaters and Relationships by Aphrodite Matasakis. The Hazelden titles supplement Ballantine’s other recovery titles, the most notable of which this year, says Woodruff, is Claudia Black’s Double Duty. Woodruff explains that “while previous books on adult children have focused on how adult children are alike, this is the first book to provide an in-depth examination of how and why many adult children are different from one another.” The book profiles nine special adult children populations, who have been raised not only with the burden of family alcoholism, but also with such complicating traumas as physical or sexual abuse or in such special circumstances as being gay or lesbian or a person of color.

The major recovery book this year for Bridge Publications, according to marketing director Phil Anderson, is Clear Body, ClearMind, written by L. Ron Hubbard in the late 1970s but never before published. According to Anderson, Hubbard discovered that “residual toxins” from drugs lodge in the fatty tissues of the body and can continue to affect people long after they give up drugs. Hubbard’s book, says Anderson, presents a program involving vitamins, sauna and exercise to help people cleanse their systems of the toxins, which can also be produced by environmental pollutants.

The Importance of Backlist

Because reaching the audience for health and healing books can be a long and complicated process, the backlist plays a prominent role in the health and healing market. Observing that “an old book is brand-new to the person who has never seen it before,” Avery’s Rudy Shur argues that “if you think you can reach the entire market in the first two years, you’re wrong.” Shur says that Avery actively pushes its backlist, and will take every opportunity that arises to “show off” relevant older titles. According to Thorndike, Walker & Co. looks specifically for titles “that might seem very narrow on the surface but tend to sell very consistently for us over a longer period of time. We are concerned with having books that fill a very clear niche in the marketplace.”

Thorsons, an imprint of Harper-Collins Publishers, has also found that “titles targeted to special needs do best,” according to product manager David Wolfson. Distributed in the U.S. since January 1990, it offers a wide range of holistic health titles, but has had its greatest success so far with titles such as Judith North’s Teenage Diabetes: What It Is and How You Can Get the Best Out of Life and Roger Turner’s Diet to Help Asthma and Hay Fever, part of Thorsons’ Special Diet Cookbook series, which also covers such conditions as arthritis and colitis.

The ultimate key to successful marketing, of course, lies in the material itself. A primary requirement for success is that the books and their authors be authoritative. In more traditional approaches to health, this can mean having a physician author. PIA Press, says Chilnick, will “only publish books by M.D.’s,” both because readers buy health-care books “on the basis of perceived authority” and because PIA wants authors “who have both clinical and medical experience.” Will Thorndike says that Walker & Co. looks for books written by a coauthor combination of a doctor and a professional writer, as it provides “the right blend of expertise and accessibility.”

Macmillan credits the success of its 1988 title The New Age Herbalist, edited by Richard Mabey, to the fact that “the information provided is authoritative and the contributors are experts in their fields,” says senior publicist Patrick Sadowski. According to editor Elisa Petrini, who handles many of Macmillan’s alternative healing books, medical accuracy in some New Age books is not monitored as closely in America as it is in such countries as England. Macmillan’s upcoming health list will include The Mt. Sinai Family Guide to Dental Health, Nutrition and Pregnancy and a book on drug interactions for the layperson.

Books for Children

Given the demographic dominance of the baby boom generation, it should come as no surprise that one of the emerging trends in subject matter is health books for children, particularly adolescents. Says Chilnick, “There’s no question in my mind that parenting issues are going to be very big. Children of the baby boomers are beginning to enter the middle years between childhood and adolescence, a difficult time for parents to deal with.”

Health Communications has recently purchased a company called Children Are People, now renamed Children Are People Too, with a curriculum for elementary school children at risk. According to Vegso, Health Communications is using the company’s existing line to introduce “a new series of books on feelings for kids five to eight years old and a series on life issues for kids nine to 12.” Although he is concerned that “it is difficult to introduce new kids’ books,” he perceives a lack of material available to those age groups that “deals with feelings and emotions.”

From the perspective of a company that has long specialized in children’s books, Walker’s Thorndike sees the overlapping subjects of parenting and child care as “an area with lots of opportunities.” In its line of health books for children, Walker offers the Know About series, written by Margaret O. Hyde, with titles including Know About Drugs and Know About AIDS. Hyde’s book AIDS: What Does It Mean to You?, written with Elizabeth Forsyth, M.D., now in its third edition, was the first book on AIDS for adolescents, according to Thorndike. It was recently named Outstanding Science Book for Children by the National Science Teachers Association.

With its emphasis on family issues, recovery books increasingly address not only the “child within” adults, but also the problems of real children in dysfunctional families. A notable example is Pocket Books’ How to Avoid Your Parents’ Mistakes When You Raise Your Children, by Claudette Wassil-Grimm. According to Zion, this book “specifically addresses how to break the generational cycle of dysfunction in families.”

The Aging Issue

Another health-related issue of increasing concern to baby boomers is aging. While concerns about aging raise interest in a wide spectrum of health issues, they are perhaps most notable, suggests Ehud Sperling, in connection with nutrition and diet. Under the Inner Traditions Healing Arts Press imprint, Sperling points to Harish Johari’s The Healing Cuisine, coming in October, which “focuses on using foods to heal specific diseases,” and Nutrition and Mental Illness, by Carl C. Pfeiffer, M.D., a book intended primarily for professionals that addresses ways “to treat various psychological disorders nutritionally.” In Avery’s line, Rudy Shur points to Bernard Jensen’s Foods That Heal and Prescription to Nutritional Healing byJames and Phyllis Balch. According to Shur, Jensen has been “a pioneering nutritionist for the last 50 years,” and before signing with Avery had sold “millions” of copies of his books through self-publishing. Shur expects the Balches’ book, an alphabetical reference on treating illnesses through nutrition and nutritional supplements, to be a bestseller for Avery. Published in May, the book had almost 20,000 advance sales.

Avery also publishes The Macrobiotic Way by Michio Kushi, with more than 135,000 copies in print, as well as other titles by this leading proponent of macrobiotic diets. Kushi’s books are also central to the health book offerings of Japan Books, distributed by Kodansha International. According to Gillian Jolis, Kodansha’s director of marketing and sales, Kushi’s Natural Healing Through Macrobiotics has more than 75,000 copies in print, while his Natural Foods Cookbook has sold more than 100,000 titles. Other similar new titles from Japan Publications are Diet for Natural Beauty and 30 Days: A Program to Lower Cholesterol, Achieve Optimal Weight and Prevent Serious Disease.

The demographic impact of baby boomers on health books is long predated by that of women, who continue, notes Ehud Sperling, “to be the primary care givers in our society,” adding that the “majority of books on health we publish are picked up by women, even if the ultimate user is a man.” Inner Traditions titles for women include Homeopathic Medicine for Women by Trevor Smith, M.D. and Alternative Health Care Guide for Women by Patsy Westcott and Leyardia Black.

Personal Health and Environment

The rise of interest in ecological issues has had an increasing impact on health books in recent years. According to Walker’s Thorndike, public concern with such environmental issues as the apparent degradation of the ozone layer “has led to concern about a number of health-related problems. We’re going to find that there is increased concern over new health-related questions coming out of environmental issues.” Thorndike believes that the complexity of health-related environmental issues, “where there seem to be new dangers arising constantly,” gives rise to a number of topics that can be successfully addressed by publishers. As an example, he cites Walker’s Safe in the Sun by Mary-Ellen Siegel, which provides strategies for protecting the skin from the ill effects of excessive exposure to the sun. This October, Harmony Books will publish David Steinman’s Diet for a Poisoned Planet, which Peter Guzzardi says has been described as “the most important book [on the environment] since Rachel Carson’s.” Steinman’s book provides extensive details on how insecticides have contaminated the food chain to varying degrees, and provides a guide to which foods are safe.

Susan Stautberg, president of MasterMedia Ltd., in New York, notes that the 1990s will be the Earth Decade. She, too, points to “the increasing attention being paid to environmental pollution as a source of major disease—from allergies exacerbated by poisonous emissions and holes in the ozone to cancers attributed to nuclear explosions.” Two titles they have published in response to these concerns are The Solution to Pollution: 101 Things You Can Do to Clean Up Your Environment and Solution to Pollution in the Workplace.

Sperling takes the philosophical position that personal health and environmental health are directly related. “Our inner environment is just reflective of our outer environment. From a philosophical point of view . . . the polluting of the external environment is directly related to the polluting of our internal environment.” Sperling’s view is echoed by Inner Traditions’ newly released Our Healing Birthright: Taking Responsibility for Ourselves and Our Planet by Andrew M. Cort. Similarly, Julie Feingold connects such issues as codependency and dysfunctional families with more global matters. “If we’re going to make an attempt to clean up our planet and develop peaceful relationships with other peoples, a lot of work begins at home. That’s the microcosm in which we’re going to be able to effect a more global change.”

The most explicit and detailed connection between the health of the individual and that of the planet may be made by Fit for Life author Harvey Diamond, in his book Your Heart—Your Planet, published this summer in a first printing of 50,000 by Hay House. Noting that the word “heart” is an anagram for “earth,” Diamond states, “We cannot separate our personal health from the health of the earth.” Diamond argues that the industry that produces “the animal products that we are eating and that are clogging up our arteries” is also “the leading contributor to the destruction of the environment in several areas.” In his book, Diamond proposes that people reduce their intake of animal products by 10%, a reduction that would “not only afford ourselves protection against the number one cause of death, cardiovascular disease, but would also bring about tremendous healing through the planet earth.” The environmental benefits, he explains, would result from the reduction in size of the animal-products industry and subsequent savings of water, fuel, topsoil and trees. Asked if he expects his new book to have the same kind of impact as Fit for Life, which has sold over eight million copies, Diamond responds that, given the importance of the message, he will be doing “a tremendous amount of promotion” for Your Heart—Your Planet, and “will not rest until it is in the hands of millions of people.”

Spiritual Healing

Toni Burbank discerns “an ascending curve of sophistication” in both the material available and readers’ interests. She foresees considerable growth in books on mental health, which she describes as being “where physical health was 10 to 15 years ago.” As a result, she expects to see “more and more explanatory books that . . . talk about mental illness as an illness rather than as some sort of stigma.”

Similarly, Elizabeth Perle believes that the market for health books “has gotten very sophisticat-ed about itself.” She points to recovery books in particular as adding a new level of sophistication to attitudes toward health. “If we started with straight body books, and then moved into body-mind books, the recovery books add the spiritual element.”

From her perspective at Morehouse Publishing, a venue primarily for Christian books, editor Deborah Grahame-Swift notes that faith healing is becoming more “mainstream,” and that “a lot of conservative churches now have healing services the way they would any other meeting.” This renewed interest in spiritual healing has been reflected in such Morehouse titles as The Ultimate Healing: Living with Cancer by Ken Farnsworth, and a forthcoming book by Earle Fox, tentatively titled Biblical Inner Healing.

Ken Stuart, editor-in-chief of Paragon House Publishers, points to a similar interest reflected in The Healing Spirit: Explorations of Religion and Psychotherapy by Paul Fleischman and Mystics, Magicians, and Medicine People by Doug Boyd, author of Rolling Thunder.
The diversity of issues that the health and healing category readily encompasses suggests that while interests within the field may wax and wane, the category itself will continue to grow.

If Ehud Sperling is correct, publishing will continue to play a critical role in improving the health of people and of the planet: “This is an extremely important subject and the publishing community is one of the key players in getting the message out. You can’t do it in a newspaper or magazine article. This is an issue of education, and the way to educate people substantively is through books. If we are going to continue the human experiment, we need to address the ill health of our planet and our own ill health . . . . I can hardly think of any issue as important as that of health.”

Bethune is a freelance writer and editor based in Los Angeles.

Sidebar:

A Coffee-Table Healing Book

Of forthcoming books on health and alternative healing, none may be more representative of the way the baby boom generation has made health issues a part of daily life than Prentice Hall Press’s The Power to Heal.

Set for publication in September, The Power to Heal combines photographs and text in a format that aims to move health issues from the operating table to the coffee table.

The Power to Heal was created by the RxMedia Group, which comprises Matthew Naythons, physician-photojournalist; Phillip Moffitt, former Esquire editor-in-chief; and photojournalist Rick Smolan, creator of the Day in the Life books. Elizabeth Perle, v-p and publisher of Prentice Hall Press, says that having passed on Smolan’s proposal for the first book in the series years ago, she quickly accepted his idea for The Power to Heal. The RxMedia Group was publishing Rx Adventure, which Perle describes as “a yuppie-doctor adventure magazine.” Perle recalls that “Smolan sketched out the idea for a book about healing around the world. I fell in love with the idea and basically bought it on the spot.”

For Perle, much of the promise of the book lay in the way in which baby boomers have adopted healing with the same intensity they once poured into protest and rebellion. Remembering that these were people who once “thought that sex, drugs and rock ‘n’ roll were alternatives to a heartbeat,” Perle marvels that “now I don’t know a person who can’t tell you his or her cholesterol count.”

Like the Day in the Life series, The Power to Heal showcases the work of 100 photographers who, in one week in November 1989, photographed healers at work around the world. Subjects photographed range from healers in central Africa using soldier ants as sutures, to an emergency-room team in a high-tech Baltimore hospital. The photographs are accompanied by essays from Maxine Hong Kingston, Barbara Ehrenreich, Norman Cousins, Elisabeth Kübler-Ross, Richard Restak and Michael Crichton, among others. The essays, says Perle, “expand our concept of healing and medicine and make it human. Too often, medicine has been the province of people in white coats who mysteriously write on clipboards and don’t tell you what’s going on.” Perhaps in keeping with this, only three of the 12 essayists are physicians.

Prentice Hall is launching an extensive marketing campaign to back the book, which will have a first printingof 150,000 copies. Serials have been taken by Newsweek, Ladies’ Home Journal and Self, and Smolan and Naythons will embark on a 20-city publicity tour. Photographs from the book will be featured in exhibits at the International Center for Photography and the Nikon House in New York City.

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