Rational Emotive Behavioral Therapy…

(((I’m starting a new internship soon.  My internship supervisor gave me an assignment that involves thinking about what my theoretical approach is.  He also mentioned briefly that his theoretical approach included motivational interviewing and Ellis’s “Rational Emotive Behavioral Therapy”.  I review this theory here from old course notes.))

Acceptance vs. Change

Albert Ellis is a clinical psychologist practiced over 60 years and founded Rational Emotive Behavioral Therapy “REBT”.   In the early years of his practice of psychoanalysis, Albert Ellis was struck by the fact that “irrational premises” (Corsini, 2011) plagued the thinking of his clients. Clearly causing much of their emotional distress, this dysfunctional thinking was largely impervious to any logical counterargument (Corsini, 2011).

As the result of these observations, Albert Ellis came to the conclusion that an individual’s belief systems were at the core of their issues (Corsini, 2011). Conceived by Ellis as being comprised of thoughts, feelings, and behaviors, these belief systems required a multidimensional approach to overcome (Corsini, 2011). It was Ellis’s assertion that cognitive therapies, emotional-affective techniques, and behavioral reconditioning together can help individuals overcome these illogical belief systems (Corsini, 2011). He termed this therapeutic process “Rational Emotive Behavioral Therapy” (Corsini, 2011). What I like about Ellis’s approach is it utilizes a combination of change-based and acceptance-based interventions much like Marsha Lineman’s DBT.

Ellis on Acceptance.

In his book “Myth of Self Esteem book“, Ellis defines esteem as a internal constructed based on an evaluation of one’s self-efficacy and self-worth (Corsini, 2011).  He also makes a point of noting that it is often based on externalized sources.  He states that when self-esteem is constructed in this way, your self-acceptance becomes conditional, based on evaluations of information from outside sources.  He claims the solution for this is an unconditional positive regard.

Ellis on Change Opportunities.

As Jeffrey Mishlove states in his interview with Albert Ellis: “Whatever happens in our life, it isn’t totally responsible for our emotions” (Mishlove, 2010). This observation is a key element of REBT’s overarching view of human nature (Corsini, 2011; Mishlove, 2010). While Ellis makes a point of clarifying that our events can help us understand the consequences of our thought process, this view alone is limiting (Mishlove, 2010). This perspective is limited without an additional consideration of how preferred thought processes determine our feelings, behaviors understanding and consequent experience (Mishlove, 2010). In fact, Ellis states that our interpretations of our events are the ultimate causal explanation for their emotional effects (Mishlove, 2010).

Belief Systems & A Solution

How To Overcome Belief Systems.

Albert Ellis stated that it was our dogmatic belief system in form of unhealthy musterbations that were the central cause of our emotional suffering (Mishlove, 2010). Comprised of behaviors, thoughts and feelings, deeply ingrained as a standard operating system within us, he felt it took a great deal of repetitive practice to overcome (Mishlove, 2010). Utilizing a Rogerian regard, he proposed that these elements could be addressed through guidance and direction (Mishlove). He felt it was important to both educate a client on the benefits of a rational belief system and encourage them to challenge their unhealthy ones (Bernard, 2009).

The Therapist’s Role In Addressing Belief Systems

In interesting article by Michael Bernard which includes an interview with Albert Ellis there is an in-depth discussion of how the therapist role in REBT (Bernard, 2009). What follows are key insights that can help provide a good overview of the therapist’s role (Bernard, 2009).

What beliefs are considered rational?

This is the first question that logically comes to mind when attempting to understand the REBT approach. The following is Albert Ellis’s core definition of a rational belief system:

….accepting yourself as a mistake- maker without putting yourself down, understanding that to be successful you sometimes have to do things that you don’t feel like doing as well as not rating people on the basis of their behavior. (Bernard, 2009, p72).

REBT therapy: An ABCDEF approach.

In his interview with Albert Ellis, Michael Bernard essentially summarizes Ellis’s approach as follows:

Ellis supports adding an ‘‘F’’ to the ABCDE model— forcefully agreeing with and applying new rational beliefs…..it’s always cognitive, emotional and behavioral. You’re giving them an idea but you’re getting them to think of it emotionally, forcefully and act on it. (Bernard, 2009, 66-74)

In keeping with this theory’s name, the specific approach to changing belief system involves cognitive, emotional as well as behavioral components. This “ABCDEF” model, according to Bernard, defines the overall process for working with clients to create change (Bernard, 2009):

  • Step one: Asking About The Activating Events (Bernard, 2009). Understanding the relevant details of the situation and life/event in question at the core of the client’s problems. (Bernard, 2009)
  • Step Two: Understand The Underlying Belief Systems (Bernard, 2009). When learning about the details of the activating event, also try to piece together the belief systems. (Bernard, 2009). What are the specific beliefs, feelings, thoughts, that related to their retelling of the story (Bernard, 2009).
  • Step Three: Understand the Consequences of the current belief system (Bernard, 2009). Understand the logical consequences of the belief system and choose together how they belief systems can be challenged (Bernard, 2009).
  • Step Four: The Doing Phase (Bernard, 2009). In recognition of the behavioral and affective components of REBT, this phase involves assigned homework, in which the client is given an opportunity to dispute irrational beliefs (Bernard, 2009).
  • Step Five & Six: Evaluation of progress & continual forceful agreement with positive rational beliefs (Bernard, 2009). This phase helps to counteract Ellis’s assertion that overcoming irrational belief systems took much practice and effort, (Mishlove, 2010)

Strengthening positives and eliminating the negatives.

One final observation regarding Ellis’s REBT theory, is its dualistic approach (Bernard, 2009). It is a directed approach that involves a dualistic goal of overcoming irrational beliefs and replacing them with positive ones (Bernard, 2009). Addressing the cognitive components underlying this goal means teaching clients the benefits of rational belief system (Bernard, 2009). Alongside this, there is the need to help them work through toward the affective and rational consequences of their irrational beliefs systems (Bernard, 2009). Since his early experiences with psychoanalysis lead him to the conclusion that reason alone was not enough, he added another key component (Bernard, 2009). By assigning homework, and encouraging follow-through, they could address the affective and behavioral components (Bernard, 2009). This was said to help further reinforce the insights of the rationality of a new belief system (Bernard, 2009>

Ellis on Relationships

Another key insight that is unique to REBT is its assertion that our inner thought world is what helps to define and further perpetuate our emotional experiences (Corsini, 2011). There are many theories, which are helpful in point to externalized factors and past events as determining factors in our emotional experiences (Corsini, 2011). While these theories are all valid and beneficial, they are limiting by themselves (Corsini, 2011). This theory provides an added dimension to understanding the cause of our experiences (Corsini, 2011). As Ellis states in this video, it is the complex interrelated system of thoughts, feelings, and behaviors that define the lives we live (Mishlove, 2010).   As a preferred way of coping and relating with the world, this belief system can become healthy when rigid and absolute (Corsini, 2011). Defining this notion as “musterbation”, he felt is was a key component in our emotional suffering, and cause of many of our problems (Mishlove, 2010).  Should’s, on the other hand, are unrealistic expectations or demands people impose on themselves or others (Metcalf, 2011).  “Awfulizing” involves the exaggeration of an unpleasant situation so that it is worse than it really is (Metcalf, 2011).

Criticisms of Ellis’s REBT

When watching the videotaped interview with Albert Ellis for this assignment, two key areas of disagreement with Ellis’s observations were found.   Springing from empirical observations and theories, that negate Ellis’s observations, my thinking on these matters diverges from his.

Developmental Psychology and Ellis

In the videotaped interview between Jeffrey Mishlove and Albert Ellis, is a bit of commentary that runs counter to observations within the field of developmental psychology (Broderick, 2010; Mishlove 2010). Specifically, Ellis seems to focus primarily on the individual as the central causal factor in one’s own lifespan development (Mishlove, 2010). On the one hand, it is certainly true generally speaking, that our ways of thinking do tend to define our experiences (Corsini, 2011). On the other hand, applying this observation to child development results in the painting of an inaccurate picture (Broderick, 2010). So what are the areas of divergence from the field of development psychology within Ellis’s theory?

In the videotaped interview for this assignment, Ellis seems to make the assertion that parents and early upbringing aren’t responsible for our development (Mishlove, 2010). He states that it is our chosen way of applying and using these early influence that exists as the central explanation for our overall developmental course (Mishlove, 2010).   While listening to this commentary, an array of contrary evidence within the field of human development can come to mind. Research on brain and child development, both point to the very real limitations on the human mind at early points in our lives (Broderick, 2010).

A child’s mind can be best defined as egoic in nature, and immediate in its overall focus (Broderick, 2010). With a level of understanding of their truth as the only truth, there is little capacity to not only consider other’s points of view, but also effectively the process abstract notions (Broderick, 2010).   Additionally, with the brain very malleable at that point, our earliest attachments and emotional experiences have long ranging effects on brain development (Broderick, 2010).

When taking in Ellis’s commentary above with this in mind, it would be wrong to apply his observation of “the self as cause”, to child development (Broderick, 2010). In reality, the matter of what causes us to develop as we do is much more complex than Ellis’ would lead you to believe (Broderick, 2010).

The Scientific Method Can Solve Our Problems.

When you think antiscientifically…then you disturb yourself, therefore we use the flexible scientific method to get you to undisturb yourself. (Mishlove, 2010). 

This quote above comes directly from the interview between Jeffrey Mishlove and Albert Ellis. In his desire to stress this as a key element in his theoretical perspective that sets it apart, he states unscientific and dogmatic perspectives are unhealthy (Broderick, 2010). The reason for using the scientific method in therapy is that, according to Ellis, it can help counteract the roles we play in creating our own experiences.

On the one hand, it is important to not take this statement alone and mischaracterize Ellis’s theory. While the scientific method is innately objective and logical nature, it is wrong to limit our description of REBT as one-sided in this manner (Corsini, 2011). Additionally, it is certainly true this theory by its very name, is multidimensional in its approach, utilizing, emotional, rational, and behavioral elements (Corsini, 2011). His utilization of a Rogerian positive regard as a key element in the therapeutic relationship, for example, helps address the affective elements of our problems (Corsini, 2011).

On the other hand, with this said, the introduction of a scientific method as a key founding principle of an approach to therapy is still troubling.   Using an objective logical in nature isn’t always the ideal way to address human concerns.   Doing so can ultimately limit our effectiveness as counselors. For example, changing your basic philosophically, rationally and affectively, doesn’t always address every elemental cause of our problems (Broderick, 2010).

Evidence of this fact can be found by again referring to our discussion early of human development (Broderick, 2010). For example, our earliest experiences, in the pre-memory stages of live, affect our brain development, and attachment styles (Broderick, 2010). These effects are very real, life lasting, and existent at subconscious levels (Broderick, 2010). Addressing them requires more than an objective or logical approach (Broderick, 2010).

When you consider the role of psychiatric diagnosis, the limit of this scientific perspective can also be seen (Broderick, 2010). The experiences of depression and anxiety based on an altered brain activity that defines a psychiatric diagnosis, exists independent of any logic or reason (Broderick, 2010). However illogical or irrational, they are still that individuals reality and can’t be altered through scientific reason alone.

References

Bernard, M. E. (2009). Dispute irrational beliefs and teach rational beliefs: An interview with
Albert Ellis. Journal of Rational – Emotive & Cognitive – Behavior Therapy, 27(1), 66-76. doi:10.1007/s10942-009-0089-x
Broderick, P.C. & Blewitt, P. (2010). Life Span Development: Human Development for Helping Professionals. (3rd. Ed.) Boston, MA: Pearson.
Metcalf, L, (2011). Marriage and family therapy: A practice oriented approach. New York: Springer Publishing Company

 

 

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