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Rational Emotive Behavior Therapy

Rational Emotive Behavior Therapy (REBT) is a comprehensive, active-directive, philosophically and empirically based psychotherapy which focuses on resolving emotional and behavioral problems and disturbances and enabling people to lead happier and more fulfilling lives. REBT was created and developed by the american psychotherapist and psychologist Albert Ellis who was inspired by many of the teachings of Asian, Greek, Roman and modern philosophers. REBT is one of the first and foremost forms of Cognitive Behavior Therapy (CBT) and was first expounded by Ellis in the mid-1950s and developed to this day.

Overview

Rational Emotive Behavior Therapy (REBT) is both a psychotherapeutic system of theory and practices and a school of thought established by Albert Ellis. Originally called Rational Therapy, its appellation was revised to Rational Emotive Therapy in 1959, then to its current appellation in 1992. REBT was one of the first of the cognitive behavior therapies as it is predicated in articles Ellis first published in 1956 , nearly a decade before Aaron Beck first set forth his Cognitive Therapy.

One of the fundamental premises of REBT is that humans, in most cases, do not merely get upset by unfortunate adversities, but also through how they construct their views of reality through their evaluative beliefs, meanings and philosophies about the world, themselves and others. In REBT therapy, clients usually learn and begin to apply this premise by learning the A-B-C-model of psychological disturbance and change. The A-B-C model first states that it normally is not merely A, adversities (or activating events) in people's lives that lead to a disturbed and dysfunctional emotional and behavioral consequences - at C, but adversity times what people B, believe (the explicit and implicit philosophical meanings and assumptions) in relation to these events and their personal desires and preferences. This belief system is highly evaluative and consists of interrelated cognitive, emotional and behavioral aspects and dimensions. Generally, if a person's evaluative B about the activating event A in relation to his desires and preferences is rooted in an self-defeating, illogical and dysfunctional ways the emotional and behavioral consequence is likely to be self-defeating and destructive. Or, alternatively, if it is rooted in an empico-logical, functional and self-helping ways, the emotional and behavioral consequence is likely to be self-helping and constructive. It is also important to emphasize that an A can be both an internal or an external situation, and it can refer to an event in the past, present, or future.

Through REBT by understanding the role of their mediating, evaluative and philosophically based illogical, unrealistic and self-defeating meanings, interpretations and assumptions in upset, people often can learn to identify them, begin to D, dispute, refute, challenge and question them, distinguish them from and subscribe to more constructive and self-helping constructs.

Theoretical assumptions

The REBT framework assumes that humans have both innate rational (meaning self- and social-helping and constructive) and irrational (meaning self- and social-defeating and un-helpful) tendencies and leanings. REBT claims that people to a large degree consciously and unconsciously construct emotional difficulties such as self-blame, self-pity, clinical anger, hurt, guilt, shame, depression and anxiety, and behaviors and behavior tendencies like procrastination, over-compulsiveness, avoidance, addiction and withdrawal by the means of their irrational and self-defeating thinking, emoting and behaving. REBT therapy is then applied as an educational process in which the therapist often active-directively teaches the client how to identify irrational and self-defeating beliefs and philosophies which in nature are rigid, extreme, unrealistic, illogical and absolutist, and then to forcefully and actively question and dispute them and replace them with more rational and self-helping ones. By using different cognitive, emotive and behavioral methods and activities, the client, together with help from the therapist and in homework exercises, can gain a more rational, self-helping and constructive rational way of thinking, emoting and behaving. One of the main objectives in REBT is to show the client that whenever unpleasant and unfortunate activating events occur in people's lives, they have a choice of making themselves feel healthily and self-helpingly sorry, disappointed, frustrated, and annoyed, or making themselves feel unhealthily and self-defeatingly horrified, terrified, panicked, depressed, self-hating, and self-pitying . By attaining and ingraining a more rational and self-constructive philosophy of themselves, others and the world, people often are more likely to behave and emote in more life-serving and adaptive ways.

Albert Ellis posits three major insights of REBT:

Insight 1 - People seeing and accepting the reality that their emotional disturbances at point C do not stem from the activating events or adversities at point A that precede C. Although A contributes to C, and although strong negative As (such as being assaulted or raped) are much more likely to be followed by disturbed Cs (such as feelings of panic and depression) than they are to be followed by weak As (such as being disliked by a stranger), the main or more direct cores of emotional disturbances (Cs) are people’s irrational beliefs—the absolutistic musts and their accompanying inferences and attributions that people strongly believe about their undesirable activating events.

Insight 2 - No matter how, when, and why people acquire self-defeating, irrational beliefs that mainly lead to their dysfunctional, emotional-behavioral consequences, if they are disturbed today, they tend to keep holding these irrational beliefs and upsetting themselves by them -- not because they held them in the past but because they are still actively, though often unconsciously, reaffirming them and acting as if they are still valid. They still follow, in their minds and in their hearts, the core "musturbatory " philosophies that they may have taken over or invented years ago, or that they have more recently accepted or constructed for themselves.

Insight 3 - No matter how well they have achieved insight 1 and insight 2, insight alone will rarely enable people to undo their emotional disturbances. They may feel better when they know, or think they know, how they became disturbed and are still making themselves upset largely because they believe these insights to be useful and curative. It is unlikely, however, that they will really get better and stay better unless they accept insights 1 and 2 and also go on to 3: There is usually no way but work and practice to keep looking for and finding one’s core irrational beliefs; to actively, energetically, and scientifically dispute them; to replace one’s absolutist musts with flexible preferences; to change one's unhealthy feelings to healthy, self-helping emotions; and to firmly act against one’s dysfunctional fears and compulsions. Only by a combined cognitive, emotive, and behavioral, as well as a quite persistent and forceful, attack on one's serious emotional problems is one likely to significantly ameliorate or remove them—and keep them removed.

Regarding cognitive-affective-behavoral processes in mental functioning and dysfunctioning, originator Albert Ellis explains::

"REBT assumes that human thinking, emotion, and action are not really separate or disparate processes but that they all significantly overlap and are rarely experienced in a pure state. Much of what we call emotion is nothing more nor less than a certain kind—a biased, prejudiced, or strongly evaluative kind—of thought. But emotions and behaviors significantly influence and affect thinking, just as thinking. Evaluating is a fundamental characteristic of human organisms and seems to work in a kind of closed circuit with a feedback mechanism: Because perception biases response and then response tends to subsequent perception. Also, prior perceptions appear to bias subsequent perceptions, and prior responses appear to bias subsequent responses. What we call feelings almost always have a pronounced evaluating or appraisal element."

REBT then generally proposes that many of these self-defeating cognitive, emotive and behavioral tendencies are both innately biological and indoctrinated early in and during life, and further grow stronger as a person continually revisits, clings and acts on them.

REBT differs from other clinical approaches like psychoanalysis in that it places little emphasis on exploring the past, but instead focuses on changing the current evaluations and philosophical thinking-emoting and behaving in relation to themselves, others and the conditions under which people live.

Psychological Dysfunction

One of the main pillars of REBT is that irrational and dysfunctional ways and patterns of thinking, feeling and behaving are contributing to much, though hardly all, human disturbance and emotional and behavioral self- and social defeatism. REBT generally teaches that when people turn flexible preferences, desires and wishes into grandiose absolutistic jehovian dictates and commands, this tend to contribute to disturbance and upsetness.

Albert Ellis has suggested three core beliefs or philosophies that humans tend to disturb themselves through:

"I absolutely MUST, under practically all conditions and at all times, perform well (or outstandingly well) and win the approval (or complete love) of significant others. If I fail in these important—and sacred—respects, that is awful and I am a bad, incompetent, unworthy person, who will probably always fail and deserves to suffer." "Other people with whom I relate or associate, absolutely MUST, under practically all conditions and at all times, treat me nicely, considerately and fairly. Otherwise, it is terrible and they are rotten, bad, unworthy people who will always treat me badly and do not deserve a good life and should be severely punished for acting so abominably to me." "The conditions under which I live absolutely MUST, at practically all times, be favorable, safe, hassle-free, and quickly and easily enjoyable, and if they are not that way it's awful and horrible and I can't bear it. I can't ever enjoy myself at all. My life is impossible and hardly worth living."
This belief tends to contribute to feelings of anxiety, panic, depression, despair, and worthlessness. This belief tends to contribute to feelings of anger, rage, fury, and vindictiveness and lead to actions like fights, feuds, wars, genocide, and perhaps ultimately an atomic holocaust. This belief tends to contribute to frustration and discomfort, intolerance, self-pity, anger, depression, and to behaviors such as procrastination, avoidance, and inaction.

REBT commonly posits that at the core of irrational beliefs there often is explicit or implicit rigid demands and commands, and that extreme derivatives like awfulizing, frustration intolerance, people deprecation and over-generalizations are accompanied by these. According to REBT the core dysfunctional philosophies in a person's evaluative emotional and behavioral belief system, is also very likely to contribute to unrealistic, arbitrary and crooked inferences and distortions in thinking. REBT therefore first teaches that when people in an insensible and devoutly way overuse absolutistic, dogmatic and rigid "shoulds", "musts", and "oughts", they tend to disturb and upset themselves.

Further REBT generally posits that disturbed evaluations to a large degree occur through over-generalization, wherein people exaggerate and globalize events or traits, usually unwanted events or traits or behavior, out of context, while almost always ignoring the positive events or traits or behaviors. For example, awfulizing is mental magnification of the importance of an unwanted situation to a catastrophe or horror, elevating the rating of something from bad to worse than it should be, to beyond totally bad, worse than bad to the intolerable and to a "holocaust". The same exaggeration and overgeneralizing occurs with human rating, wherein humans come to be arbitrarily and axiomatically defined by their perceived flaws or misdeeds. Frustration intolerance then occurs when a person perceives something to be too difficult, painful or tedious, and by doing so exaggerates these qualities beyond one's ability to cope with them.

Mental Wellness

As would be expected, REBT argues that mental wellness and mental health to a large degree results from a surfeit of self-helping, flexible, logico-empical ways of thinking, emoting and behaving. When an a perceived undesired and stressful activating event occurs, and the individual is interpreting, evaluating and reacting to the situation rationally and self-helpingly, then the resulting consequence is according to REBT likely to be more healthy, constructive and functional. This does not by any means mean that a relatively un-disturbed person never experiences negative feelings, but REBT does hope to keep debilitating and un-healthy emotions and subsequent self-defeating behavior to a minimum. To do this REBT generally promotes a flexible, un-dogmatic, self-helping and efficient belief system and constructive life philosophy about adversities and human desires and preferences.

REBT clearly acknowledges that people in addition to disturbing themselves, also are innately constructivists. Because they largely upset themselves with their beliefs, emotions and behaviors, they can be helped to in a multimodal manner dispute and question these and develop a more workable, more self-helping set of constructs.

REBT generally teaches and promotes:

  • That the concepts and philosophies of life of unconditional self-acceptance, other-acceptance, life-acceptance are effective philosophies of life in achieving mental wellness and mental health.
  • That human beings are inherently fallible and imperfect and that they had better accept their and other human being's totality and humanity, while at the same time not like some of their behaviors and characteristics. That they are better off not measuring their entire self or their "being" and give up the narrow, grandiose and ultimately destructive notion to give themselves any global rating or report card. This is partly because all humans are continually evolving and are far too complex to accurately rate, even though all humans do both and self- and social-defeating and self- and social-helping deeds and acts and have both beneficial and un-beneficial attributes and traits at certain times at certain conditions. REBT holds that ideas and feelings about self-worth are largely definitional and are not empirically confirmable or falsifiable.
  • That people had better accept life with its hassles and difficulties not always in accordance with their wants, while trying to change what they can change and live as elegantly as possible with what they can not change.

Scientific foundation and critique

REBT and CBT in general have a substantial and strong research base to verify and support both its psychotherapeutic efficiency, effectiveness and its theoretical underpinnings. A great quantity of scientific empirical studies have proven it to be an effective treatment for many different kinds of psychopathology, conditions and problems. A vast amount of outcome studies and an estimation of hundreds of experimental studies has shown to supports the effectiveness of REBT. Recently, REBT randomized clinical trials have offered a positive view on the efficacy of REBT.

In general REBT is arguably one of the most investigated theories in the field of psychotherapy and a large among clinical experience and a substantial body of modern psychological research has validated and substantiated many of REBTs theoretical assumptions on personality and psychotherapy. Some critiques have been given on some of the clinical research that has been done on REBT both from within and by others. Originator Albert Ellis has on occasions empathized the difficulty and complexity of measuring psychotherapeutic effectiveness, since many studies only tend to measure whether clients mere feel better after therapy instead of them getting better and staying better. Ellis has also criticized studies for having limited focus primarily to cognitive restructuring aspects, as opposed to the combination of cognitive, emotive and behavioral aspects of REBT. As REBT has been subject to criticisms during its existence, especially in its early years, Ellis has a long history of publishing and addressing those concerns. It has also been argued by him and by other clinicians that REBT theory on numerous occasions has been misunderstood and misconstrued both in research and in general. In 1998 when asked what the main criticism on REBT was, he replied that it was the claim that was too rational not dealing sufficiently enough with emotions. He repudiated the claim by saying that REBT on the contrary empathized that thinking, feeling, and behaving are interrelated and integrated, and that it includes a vast amount of both emotional and behavioral methods in additions to cognitive ones. Seen as a quite controversial figure in some camps, Ellis has also received criticism that has arguably been more directed at him than his psychotherapy. These include his use of four-letter words and confrontational attitude. In addition Ellis has himself in very direct terms criticized opposing approaches such as psychoanalysis, transpersonal psychology and abreactive psychotherapies in addition to on several occasions questioning some of the doctrines in certain religious systems, spiritualism and mystism.

Many, including REBT practitioners, has warned against dogmatizing and sacredizing REBT as a supposed perfect psychological cure-all and panacea. Prominent REBTers have promoted the importance of high quality and programmatic research, including originator Ellis, a self-proclaimed "passionate skeptic". He has a many occasions been open to challenges and acknowledged errors and in-efficiencies in his approach and concurrently revised his theories and practices. In general with regard to cognitive-behavioral psychotherapies interventions, others have pointed out that as about 30-40% of people are still nonresponsive to interventions, and that REBT could be a platform of reinvigorating empirical studies on the effectiveness of the cognitive-behavioral models of psychopathology and human functioning.

REBT has generally in quite many ways been developed, revised and augmented through the years as understanding, knowledge and science about psychology and psychotherapy has progressed. This includes both its theoretical concepts but also its practices and methodology. Inherent in REBT as an approach has been the teaching of scientific thinking, reasonableness and un-dogmatism and these ways of thinking has been part of REBTs empiricism and skepticism.

REBT Intervention

As explained REBT is a therapeutic system of both theory and practices; Generally on of the goals of REBT is to teach how people learn how they often needlessly upset themselves, how to un-upset themselves and then how to empower themselves to lead happier and more fulfilling lives. REBT is used with a range of clinical and non-clinical problems and is applied in many forms of traditional psychotherapeutic settings, such as individual, group and family therapy and counseling. In addition REBT also has many interfaces and applications in self-help, workplace and educational settings etc as well.

In traditional REBT therapy the client together with the therapist in an active-directive manner often work through a set of target problems and establish a set of therapeutic goals. In these target problems, situational dysfunctional emotions, behaviors and beliefs are assessed in regards to the client's values and goals. After working through these problems, the client learns to generalize insights to other relevant situations. In many cases after going through a client's different target problems, the therapist is interested in examining possible core beliefs and more deep rooted philosophical evaluations and schemas that might account for a wider array problematic emotions and behaviors. Although REBT much of the time is used as a brief therapy, in deeper and more complex problems, longer therapy is promoted.

In therapy, the first step often is that the client acknowledges his problems, accepts emotional responsibility for these and has willingness and determination to change. This normally requires a considerable amount of insight, but as originator Albert Ellis explains:

"Humans, unlike just about all the other animals on earth, create fairly sophisticated languages which not only enable them to think about their feeling, and their actions, and the results they get from doing and not doing certain things, but they also are able to think about their thinking and even think about thinking about their thinking."
This is quite essential to the REBT thought. In addition Ellis also further emphasizes:
"Because of their self-consciousness and their ability to think about their thinking, they can very easily disturb themselves about their disturbances and can also disturb themselves about their ineffective attempts to overcome their emotional disturbances".

In REBT terminology, this is often referred to as secondary disturbances, and often is subject to intervention before clients' primary issues are assessed.

Through the therapeutic process the, REBT employs a wide array of forceful and active, meaning multimodal, disputing methodologies. Central through these methods and techniques is to help the client challenge, dispute and question their destructive and self-defeating cognitions, emotions and behaviors. The methods and techniques incorporate cognitive-philosophic, emotive-evocative-dramatic, and behavioral methods for disputation of client's irrational and self-defeating constructs and helps the client come up with more rational and self-constructive ones. REBT seek to acknowledge that understanding and insight are not enough; In order for clients to significantly change, they had better pinpoint their irrational and self-defeating constructs and work forcefully and actively at changing them to more functional and self-helping ones. Although REBT teaches that the therapist had better demonstrate unconditional other-acceptance or unconditional positive regard, the therapist is not necessarily always encouraged to build a warm and caring relationship with the client.

REBT posits that the client had better work hard to get better, and in therapy this normally include a wide array of homework exercises in day-to-day life assigned by the therapist. The assignments may for example include desensitization tasks, i.e., by having the client confront the very thing he or she is afraid of. By doing so, the client is actively acting against the belief that often is contributing significantly to his disturbance.

Another factor contributing to the brevity of REBT is that the therapist seeks to empower the client to help himself through future adversities. REBT only promotes what is seen as temporary solutions if more elegant solutions are not found. An ideal successful collaboration between the REBT therapist and a client results in changes to the client's philosophical way of evaluating him- or herself, others, and his or her life, and which is then likely to yield effective results: The client moves toward unconditional self-acceptance, other-acceptance and life-acceptance while striving to life a more self-fulfilling and happier life.

References

Further reading

  • Albert Ellis, Mike Abrams, and Lidia Abrams, Theories of Personality; Sage Press, 2008 (this book, Ellis' final work and presents the final revision of his approach).
  • Albert Ellis & Windy Dryden, The Practice of Rational Emotive Behavior Therapy (2nd ed.); Springer Publishing, 2007. ISBN 9780826122162
  • Windy Dryden & Michael Neenan, Getting Started with REBT; Routledge, 2005. ISBN 9781583919392
  • Windy Dryden, Rational Emotive Behaviour Therapy in a Nutshell (Counselling in a Nutshell); Sage Publications, 2005. ISBN 9781412907705
  • Windy Dryden, Fundamentals of Rational Emotive Behaviour Therapy: A Training Manual; Wiley, 2002. ISBN 1-86156-347-7
  • Windy Dryden, Rational Emotive Behaviour Therapy; Theoretical Developments; Brunner-Routledge, 2003. ISBN 1-58391-272-X
  • Albert Ellis, Overcoming Destructive Beliefs, Feelings, and Behaviors: New Directions for Rational Emotive Behavior Therapy; Prometheus Books, 2001. ISBN 1-57392-879-8
  • Albert Ellis, Feeling better, getting better, staying better; Impact Publishers, 2001. ISBN 1-886230-35-8
  • Windy Dryden et al., A Practitioner's Guide to Rational-Emotive Therapy; Oxford University Press, 1992. ISBN 0-19-507169-7
  • Albert Ellis et al., A Guide to Rational Living (3rd rev ed.); Wilshire Book Company, 1997. ISBN 0-87980-042-9
  • Stevan Lars Nielsen, W. Brad Johnson & Albert Ellis, Counseling and Psychotherapy With Religious Persons: A Rational Emotive Behavior Therapy Approach; Lawrence Erlbaum, 2001. ISBN 0805828788.
  • Windy Dryden, Raymond Di Giuseppe & Michael Neenan, A Primer on Rational-Emotive Behavior Therapy (2nd ed.); Research Press, 2002. ISBN 978-0878224784
  • Albert Ellis & Catharine MacLaren, Rational Emotive Behavior Therapy: A Therapist's Guide (2nd ed.); Impact Publishers, 2005. ISBN 978-1886230613

See also

External links

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