As the author sees it, the problem with this approach is not simply that it’s delusional (while there is evidence that things like stress can adversely affect the immune system, there’s no convincing proof that attitude makes a material difference to cancer outcomes). It also discourages patients from asking questions about the efficacy of conventional treatments, and fosters an unwillingness to consider the very sort of environmental factors that may be responsible for the startling jump in the percentage of American women with breast cancer. Paradoxically, it made people more passive, not less, in the face of their disease.

In some respects, opening the book with this chapter feels jarring, because so much of what these cancer patients are doing can be understood (and empathized with) as literally whistling past the graveyard. It’s hard to avoid the sense that most sick people cling to positive thinking not because they really believe it will work, but because they have nothing else to hold onto. But in fact, the role that positive thinking plays among cancer patients ends up providing a template for Ehrenreich’s broader critique of American culture. Time and again, she argues, objectively bad circumstances are imposed on people from without, circumstances that most are ill-equipped to deal with on their own. And instead of working with others to come up with collective solutions to their problems, people cast about for magical answers.

The author spends much of Bright-Sided eviscerating the flapdoodle spread by books like The Secret and by the so-called personal coaching industry, which have turned the perfectly useful sports technique of visualization into an imaginary recipe for personal success. In many cases, mantras are the primary teaching tool. “Ask, believe, and receive,” commands one. “Name it and claim it,” chimes another. These messages, Ehrenreich points out, are essentially traditional folk magic, dressed up in pseudo-scientific language (some advocates invoke the power of magnetism or quantum physics to explain how an individual can literally shape the universe to her wishes). Yet millions of Americans who would be wary of someone claiming to be Gandalf the Grey have happily embraced The Secret.

In a similar vein, Ehrenreich traces the discomfiting rise of enormously successful preachers whose primary emphasis is not the need for spiritual redemption but rather the enormous temporal rewards that Christianity supposedly promises true believers. Of course, Christians have always believed that God can intervene in the material world—that prayers may be answered. But preachers like Osteen have taken that idea to new and literal heights. “You will produce what you’re continually seeing in your mind,” Osteen writes, while suggesting that God can help you find a parking space or get a seat in a crowded restaurant.

As these examples suggest, most of Ehrenreich’s subjects in Bright-Sided are proverbial fish in the barrel. And since it’s clear from the start that she has absolutely no patience for positive thinking, there are no real surprises in store. This isn’t necessarily a bad thing: Bright-Sided is a polemic, after all. But in part because her targets are so obvious and self-indicting, Ehrenreich’s cultural analysis is often less illuminating here than in her earlier work like The Hearts of Men.

There are, happily, some exceptions. The most convincing and powerful chapter in the book traces the relationship between changes in the workplace and the boom in the ideology of positive thinking in the corporate world. Over the last thirty years, we’ve seen the breakdown of the traditional corporation, the erosion of the old compact between companies and workers, and the vitiation of unions—all of which have put enormous pressure on individual workers, who are now forced to think of themselves (and market themselves) as free agents. The rhetoric of positive thinking, though, turns this minus into a plus. Hence the profusion of motivational gurus declaring that “job loss presented an opportunity for self-transformation, that a new batch of ‘winners’ would emerge from the turmoil.”

James Surowiecki is a staff writer at The New Yorker and the author of The Wisdom of Crowds.