RATIONAL EMOTIVE BEHAVIOR THERAPY (REBT) Eleanor Wend Bellevue University

August 8, 2011

Abstract This paper will present an overview of Rational Emotive Behavior Therapy (REBT) as a theory of personality and a method of psychotherapy developed in the 1950s by clinical psychologist, Albert Ellis. REBT views cognition and emotion as integrated, with thoughts, feelings, desires and action interacting with each other. In summary when you think, you feel and act; when you feel, you think and act; and when you act, you think and feel. Underlying these thoughts, feelings, desires and actions is a set of core beliefs and these are what the therapist attempts to guide and confront the client to perceive and by assisting the client to change these belief systems to change their lives. This paper will explore the history, the concepts and assumptions, the strengths and weaknesses and the Best Case match for REBT. Keywords: Rational, emotive, behavior, REBT, cognitive, active-directive, multi-modal modifiers, core beliefs

History The history of Rational Emotive Behavior Therapy (REBT) has precursors in Asian and Stoic philosophers including Confucious, Lao Tzu and Epicurus. As Epicurus wrote in 1st century AD, People are disturbed not by things but by the view which they take of them. Adler described in his writings that meanings are not determined by situations but we determine ourselves what meanings we give to situations. By the 1950s a number of psychoanalysts had taken on the active-directive approach of therapy through giving homework assignments and tasks to try out between therapy sessions. Some of these include: Eric Berne, Jerome Frank, George Kelly, Abraham Low, and several others. Albert Ellis practiced psychotherapy in the late 1940s and early 1950s and came to the conclusion that no matter how much insight his clients gained or how much they understood their early childhood experiences they not only continued to exhibit the same symptoms and were indoctrinated into their irrational, mistaken ideas of their own worthlessness. Even when pressed to surrender these irrational beliefs they often resisted and held on even more tightly to these old beliefs. He came to the conclusion that humans are self-talking, self-evaluating and self-construing. Further there is a strong inclination to take strong preferences and define these as needs. Thus the individual is responsible for creating their own difficulties. These irrational ideologies are so deep seated that warmth and support combined with free association and reflection of feeling merely reinforced them rather than changing them. What he found worked more effectively and quickly was a combination of active-directive, cognitive-emotive behavioral attack on self-defeating beliefs, musts and shoulds. REBT is a therapy that is based on the premise of Unconditional Acceptance plus a direct campaign against ones own self-defeating ides, traits and performances. REBT acknowledges genetic

predisposition and how these traits interact with environment which will combine to create a system of thinking, feeling and acting which is environmentally determined and continues throughout the individuals entire life creating and re-creating relationships and situations which continues to reinforce this belief system. REBT believes that individuals have an innate desire to grow and self-actualize but these irrational beliefs sabotage and retard this process effectively inhibiting growth and maturation. REBT focuses on the assumption that humans have the ability to choose different thoughts if they see with clarity the irrational thinking they have been repeating. The ABCs are the A Activating Event results in the C emotional consequence where B is the Belief or interpretation How Horrible of A based on a must or should or judgment of worth which actually can cycle quickly into a secondary A2-C2 with a reinforcing B2 which repeats the interpretation How Horrible and so on. (Corsini & Wedding, 2011) Much research has been conducted on the effectiveness of REBT which shows that 1.) Clients tend to receive more effective help from a highly-active directive approach than a passive one; 2.) Efficient therapy includes activity-oriented homework assignments; 3.) People largely choose to disturb themselves and also choose to surrender these disturbances and 4.) Helping clients to modify their beliefs helps them to make significant behavioral changes. The research on severely depressed individuals has shown that the belief system is largely negative about all aspects of their lives. Also utilizing REBT techniques in combination with medication has proven more effective than medication alone. (Corsini & Wedding, pp 201-204)

Major Concepts

1. People are born with a potential to be rational (self-constructive) as well as irrational (self-defeating) 2. Peoples tendency to irrational thinking, self-damaging habituations, wishful thinking and intolerance is frequently exacerbated by their culture and their family group. 3. Humans perceive, think, emote, and behave simultaneously.
4. Even though all major psychotherapies employ a variety of cognitive, emotive and behavioral

techniques, and even though all (including non-scientific techniques such as witch doctoring) may help individuals who have faith in them, they are probably not all equally effective or efficient. 5. REBT emphasizes the philosophy of unconditional self-acceptance (USA), unconditional other acceptance (UOA) and unconditional life acceptance (ULA). 6. Rational emotive behavioral therapists do not believe a warm relationship between client and counselor is necessary or a sufficient condition for effective personality change although it is desirable. 7. Rational emotive behavior therapy uses role playing, assertion training, desensitization, humor, operant conditioning, suggestion, support, and a whole bag of tricks. 8. REBT holds that most neurotic problems involve unrealistic, illogical, self-defeating thinking, and that if disturbance-creating ideas are vigorously disputed by logico-empirical and pragmatic thinking, they can be minimized. 9. REBT shows how activating events or adversities (A) in peoples lives contribute to but do not directly cause emotional consequences (C); these consequences stem from peoples interpretations of the activating events or adversities that is, from their unrealistic and overgeneralized be-

liefs (B) about those events. Or to paraphrase its not what happens to you its what you do with what happens to you.

Assumptions of the Theory 1. Human thinking and emotion do not constitute two disparate or different processes, but instead, significantly overlap. 2. Although activating events or adversities (A) significantly contribute to emotional and behavioral consequences (C), peoples beliefs (B) about (A) more importantly more directly cause C. 3. The kinds of things people say to themselves, as well as the form in which they say these things, affect their emotions and behaviors and often disturb them.
4. Humans not only think and think about their thinking but also think about thinking about their

thinking. Whenever they have disturbances at C (consequence) after something unfortunate has happened in their lives at A (Adversity), they tend to make C into a new A to perceive and think about their emotional disturbances and therefore create new ones.
5. People think about what happens to them not only in words, phrases and sentences but also

via images, fantasies, and dreams. Nonverbal cognitions contribute to their emotions and behaviors and can be used to change behaviors.
6. Just as cognitions contribute to emotions and actions, emotions also cause or contribute to

cognitions and actions and actions contribute to or cause cognitions and emotions. When people change one of these three modalities of behaving, they concomitantly change the other two.

THERAPY TECHNIQUES: Some of the techniques utilized in therapy include the following: 1. Distraction: Utilized by the therapist when the client is afraid of being rejected, the therapist will direct the client into activities such as sports, aesthetic creation, a political cause, yoga, meditation or personal reflection to divert the individual from focusing on the relationship fear of being rejected and demanding attention and reassuance. 2. Satisfaction of demands: If the client insists on being catered to in a demanding fashion, the therapist will assign the client to a group where these demands might be met, teach methods for having demands met such as assertive techniques. 3. Magic and Mysticism: Reinforce the fantasy that a magical solution can come about through therapy and continued belief in magic. This technique may lead to greater disillusionment if it is utilized over to long a period of time but in the short run can prove effective. 4. Minimization of Demandingness: Encourages clients to minimize demanding and increase tolerance. 5. USA Unconditional Self Acceptance; UOA Unconditional Other Acceptance and ULA Unconditional Life Acceptance are the 3 approaches that summarize the REBT approach to therapy and change in the individual thinking. In the book, The Myth of Self-esteem by Albert Ellis he describes USA as the following, You always, under all conditions, evaluate yourself as (your being or your personality) as a valuable, good person. 1.) Because you are you (and no one else); 2.) Because you are alive; 3.) Because you decide to do so; 4.) Because you acknowledge your bad traits and dislike them but still accept yourself with

these; 5.) Because you believe in some God, who always accepts you with all of your failings and has the power to make you a good person ; 6.) Because you use some other unconditional form of total personal acceptance of you with all your good and bad characteristics and performances. (Ellis, p 86-87)

Strengths of the Theory REBT offers an alternative to client-centered therapy and behavioral therapy approaches that provides short-tern, effective cognitive-behavioral changes in clients who are strongly motivated by unhappiness and neurotic symptoms to change their lives. It has been clinically shown through many empirical studies to work well in combination with medication as well as on its own in clients with depression, anxiety, compulsion disorders. One of the online applications of REBT is called SMART recovery (Self Management and Recovery Training) which assists recovering alcoholics and addicts to maintain their sobriety through REBT techniques and online support groups. (www.smartrecovery.org) REBT has been shown to work effectively in non-therapeutic settings such as public presentations and educational settings to benefit the audiences and the students to change their perception of their lives and move in the direction of a happier more contented existence.

Weaknesses of the Theory REBT will not work well with patients with cognitive deficits or severe mental illness or physiological issues that have impaired memory function. The effectiveness of the therapy is dependent on the ability of the client to self-intervene with new thoughts and different beliefs after confronting their old beliefs that continue to create self-defeating behaviors and reactions. Patients who are out of contact

with reality, in a highly manic state, seriously autistic or brain injured or mentally deficient fall into this category.

Best Case Match The REBT approach is most effective with clients who have a single major symptom (such as sexual dysfunction or a gambling addiction) than with seriously disordered clients. However as mentioned it works effectively with a serious condition that is being medicated. It requires a commitment on the part of the client to changing ones thinking and doing homework activity assignments. It also has been shown to be effective in a preventive fashion in education environments to keep neurotic symptoms from appearing in otherwise normal functioning children.

Questions to Ponder (1) What did Albert Ellis discover in his early years in traditional psychoanalysis that led him to the breakthrough to REBT? (2) How does Albert Ellis describe the approach of USA Unconditional Self Acceptance in a clients life? How would you assist a client to utilize this concept in a counseling session?

Conclusion REBT has proven its effectiveness as a clinical therapy and also in other settings like educational and business. The goal of REBT therapy is to empower the individual by changing their thinking and their feelings to act differently in a way that is desired by the client, by the therapist and by society.

REBT encourages people to act differently (B) and thereby to think and feel differently. In other words when you think, you feel and act; when you feel; you think and act and when you act; you think and feel.

References

Corsini, R. & Wedding, D. (2011). Current Psychotherapies, 9th ed. New York: Brooks/Cole. Ellis, Albert (2005). The Myth of Self-esteem. New York: Prometheus Books. Snyder, John F. ; Han, GiBaeg; Vieten, Mary Neal. (2006). Sprague's Law: A profoundly simple strategy for counseling and self-help. Professional Psychology: Research and Practice 37. 5 (Oct 2006): 485-488 Solomon, A., Freidman, D. & Haaga, D. (1998) Priming irrational beliefs in recovereddepressed people. The Journal of Abnormal Psychology 107. 3 (Aug 1998): 440449. Smart Recovery Network. http://www.smartrecovery.org Rebtnetwork.org, http://www.rebtnetwork.org/whatis.html

Running head: RATIONAL EMOTIVE BEHAVIOR THERAPY (REBT)

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