Compassionate Counseling

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The Great Invention:REBT/CBT

In 1955, Albert Ellis invented Rational Therapy which over the years became better known as Rational Emotive Behavior Therapy. In doing so, he began the most important pioneering movement away from earlier Freudian and Jungian therapies that could not stand the test of modern outcomes research. REBT has the largest base of such research of any therapeutic model and tool.

So What?

REBT is the most effective form of therapy in dealing with a wide range of emotional problems that people experience in their ordinary lives. This is not an empty claim. It has been demonstrated in study after study, research projects have shown its superiority over every other form of therapy in treating anxieties, phobias, depression and other emotional dysfunction. It’s not just extreme and “Emotionally disturbed” people who can use REBT, but ordinary folk like you and me can develop the habits of emotion that will help us live a more satisfying and happy life.

REBT was the first of several versions of what later became known collectively as Cognitive Behavior Therapy. Each of these versions has some different twist, but they all use the same basic concepts. (My own version is specifically aimed at everyday living and is called Emotional Retraining.)

What is REBT?

REBT is based on the premise that whenever we become upset, it is not the events taking place in our lives that upset us; it is the beliefs that we hold that cause us to become depressed, anxious, enraged, etc. The idea that our beliefs upset us was first articulated by Epictetus around 2,000 years ago: "Men are disturbed not by events, but by the views which they take of them."

The Goal of Happiness

According to REBT, the vast majority of us want to be happy. We want to be happy whether we are alone or with others; we want to get along with others—especially with one or two close friends; we want to be well informed and educated; we want a good job with good pay; and we want to enjoy our leisure time.
Of course life doesn't always allow us to have what we want; our goal of being happy is often thwarted by the "slings and arrows of outrageous fortune." When our goals are blocked, we can respond in ways that are healthy and helpful, or we can react in ways that are unhealthy and unhelpful. We can block our own happiness by pursuing short-term hedonism.

The ABC Model

Ellis discovered that our reaction to having our goals blocked (or even the possibility of having them blocked) is determined by our beliefs. To illustrate this, Dr. Ellis developed a simple ABC format to teach people how their beliefs cause their emotional and behavioral responses:

A. Something happens. B. You have a belief about the situation. C. You have an emotional reaction to the belief.For example:

A. Your employer falsely accuses you of taking money from her purse and threatens to fire you. B. You believe, “She has no right to accuse me. She's a bitch!” C. You feel angry.If you had held a different belief, your emotional response would have been different:

A. Your employer falsely accuses you of taking money from her purse and threatens to fire you. B. You believe, “I must not lose my job. That would be unbearable.” C. You feel anxious.

The ABC model shows that A does not cause C. It is B that causes C. In the first example, it is not your employer's false accusation and threat that make you angry; it is your belief that she has no right to accuse you, and that she is a bitch. In the second example, it is not her accusation and threat that make you anxious; it is the belief that you must not lose your job, and that losing your job would be unbearable.

The Three Basic Musts

Although we all express ourselves differently, according to Albert Ellis and REBT, the beliefs that upset us are all variations of three common irrational beliefs. Each of the three common irrational beliefs contains a demand, either about ourselves, other people, or the world in general.

I must do well and win the approval of others for my performances or else I am no good.

Other people must treat me considerately, fairly and kindly, and in exactly the way I want them to treat me. If they don't, they are no good and they deserve to be condemned and punished.I must get what I want, when I want it; and I must not get what I don't want.

The world should treat me as I wish to be treated. It's terrible if I don't get what I want, and I can't stand it.

The first belief often leads to anxiety, depression, shame, and guilt. The second belief often leads to rage, passive-aggression and acts of violence. The third belief often leads to self-pity and procrastination.
It is the demanding nature of the beliefs that causes the problem; the "Must-iness", the "Shoulds". Less demanding, more flexible beliefs lead to healthy emotions–even if sometimes unpleasant–and helpful behaviors.

Another way of remembering this is the negative versions.

  1. I stink-Since I’m not perfect, I’m worthless.
  2. You stink-Since you don’t treat me as I want to be treated, you are horrible.
  3. The world stinks. Since I don’t get what I want, when I want it, life is terrible and I can’t stand it.

Disputing

The goal of REBT is to help people change their irrational beliefs into rational beliefs. Changing beliefs is the real work of therapy and is achieved by the therapist using many tools, disputing the client's irrational beliefs. For example, the therapist might ask, "Why must you win everyone's approval?" "Where is it written that other people must treat you fairly?" "Just because you want something, why must you have it?" Disputing is the D of the ABC model. When the client tries to answer the therapist's questions, s/he sees that there is no reason why s/he absolutely must have approval, fair treatment, or anything else that s/he wants.

Insight

REBT contends that although we all think irrationally from time to time, we can work at eliminating the tendency. It's unlikely that we can ever entirely eliminate the tendency to think irrationally, but we can reduce the frequency, the duration, and the intensity of our irrational beliefs by developing these insights:

  1. We don't merely get upset but mainly upset ourselves by holding inflexible beliefs.
  2. No matter when and how we start upsetting ourselves, we continue to feel upset because we cling to our irrational beliefs.
  3. The only way to get better is to work hard at changing our beliefs.

Insight is important, but it takes practice, practice, practice.

Acceptance

Emotionally healthy human beings develop an acceptance of reality, even when reality is highly unfortunate and unpleasant.

REBT therapists strive to help their clients develop three types of acceptance: (1) unconditional self-acceptance; (2) unconditional other-acceptance; and (3) unconditional life-acceptance. Each of these types of acceptance is based on three core beliefs:

  • Unconditional self-acceptance:

I am a fallible human being; I have my good points and my bad points.There is no reason why I must not have flaws.Despite my good points and my bad points, I am no more worthy and no less worthy than any other human being.

  • Unconditional other-acceptance:

Other people will treat me unfairly from time to time.There is no reason why they must treat me fairly.The people who treat me unfairly are no more worthy and no less worthy than any other human being.

  • Unconditional life-acceptance:

Life doesn't always work out the way that I'd like it to.There is no reason why life must go the way I want it to.Life is not necessarily pleasant but it is never awful and it is nearly always bearable.REBT Today

Clinical experience and a growing supply of experimental evidence show that REBT is effective and efficient at reducing emotional pain. When Albert Ellis created REBT in the 1950's he met with much resistance from others in the mental health field. Today it is one of the most widely-practiced therapies throughout the world. In the early days of REBT, even Dr. Ellis did not clearly see that consistent use of its philosophical system would have such a profound effect on the field of psychotherapy or on the lives of the millions of people who have benefited from it. He also did not foresee that so many other psychotherapists would take the core of REBT and build new versions, people like Aaron Beck and David Meichenbaum.

REBT in Daily Life

When a driver on the highway changes lanes and cuts you off, you can get angry and irrationally do something to retaliate, thus endangering yourself and others. At the very least you can upset your own stability and cause yourself more suffering—perhaps a stomach upset. Or remembering your REBT knowledge, you can accept that the other driver simply made a mistake—as which of us has not occasionally. In the worst case he was intentionally being “doltish” and inconsiderate. Upsetting yourself will not change reality nor help you get to work safely. Only add to your pain.

Your son left his bike in the middle of the driveway where you almost ran over it. You may get angry and after removing the bike and parking, you can storm into the house and royally chew him out, resulting in a pall of anger falling over your relationship and even the whole household. Or you process the situation through your new-found REBT skills. Then you may calmly explain his error—again, for the third time—assign a consequence that my help him change his future behavior and enjoy the rest of the evening with your family.

Of course, learning to apply REBT in daily life is no easier than any other major skill. You must learn to identify the irrational belief that you are saying to yourself in that split-second before your emotional outburst. Then you must learn to dispute that irrational belief and do it quickly, before you explode. This is not so simple as an intellectual exercise. You are going against a lifetime of habit and the craziness that others have taught you and that you have continually reinforced. This why sometimes good counselors will combine REBT/CBT with hypnotherapy and teach people self-hypnosis.But the rewards are worth the effort.

Having a good REBT/CBT therapist to help you is often worthwhile, especially in the initial learning period.

Other common derivatives of REBT

  • CBT–the generic term
  • RT–the original name of Rational Therapy but quickly abandoned
  • RET–the most common term for REBT until the 1980s
  • RBT–Rational Behavior Therapy, a version by Dr. Maxie Maultsby
  • DBT–Dialectic Behavior Therapy is especially useful with Borderline Personality Disorder
  • CT–As taught by Aaron Beck and his students
  • ER–my own Emotional RetrainingAnd more . . .