The Greek Stoic Philosopher, Epictetus, wisely observed that
“Men are disturbed not by things, but by the views which they take of them.”
Though the statement itself may be short and simple, the philosophy behind it is profound. It is a philosophy that was not lost on Dr. Albert Ellis who, as a result of his own neurotic self-disturbing, learned at an early age what Stoics like Epictetus had known long before — we are, with few exceptions, responsible for our own psychological well-being and that, for the most part, we create our own neurotic tendencies. It is upon the foundation of this simple philosophy that Ellis created the forerunner of all cognitive-behavior therapies — Rational Emotive Behavior Therapy (REBT). It is a therapeutic approach which empowers the individual by exposing the myth of self-esteem, and by offering instead the philosophical approach of unconditional acceptance.
The Myth of Self-Esteem
In a general sense, self-esteem is the positive or negative evaluative perception of oneself. As most commonly expressed, self-esteem is conditionally derived from a global rating of self on the basis of a partial assessment of current and/or past traits. As such, the “self” is rated as “good” when “good”, socially approved things are done; and rated as “bad” when “bad” things are done.
Though many mental health professionals claim that achieving high self-esteem is the keystone of good mental health, such claims are dubious at best. Because self-esteem is conditioned on perceived successes and failures, human fallibility ensures that even the most positive self regard will be transitory — never permanent — and must be continuously rebuilt since thoughts, feelings, and behaviors are constantly changing for both the good and the bad.
Further complicating matters is the fact that even in times when the self is esteemed highly, there will nevertheless persist a nagging anxiety about the inevitable failures of the future and the resultant ego injuries. If these psychological pitfalls were not enough, consider the following additional arguments that call into question the wisdom of so-called “esteem building”:
- Operating under the philosophy of conditional self-esteem (CSE) leads to neurotic dichotomies of existence such as the “egomaniac with an inferiority complex”;
- CSE is based upon the fallacious generalization that overall value and worth can be extrapolated from rating a small part of the totality of being;
- The nature of CSE is such that so much is emotionally invested in achieving successful outcomes, performance anxiety paradoxically increases the chance of failure;
- The pursuit of CSE perpetuates phoniness and other forms of dishonesty (“the false self”);
- CSE often leads to the belief that one is a “better person” which can easily turn into grandiosity, narcissism, and bigotry;
- CSE encourages ignoring problems instead of facing and solving them because such denial works to guard a false sense of high self-esteem; and
- Deriving a global self-rating necessarily involves comparing one’s own traits to those of others. The result of this constant game of comparison is loss of true perspective and sometimes the deification and, at other times, the demonizing of oneself and others.
Clearly, the arguments for disavowing the pursuit of high self-esteem are compelling. But before considering the alternative, it should be noted that the drive to obtain high CSE did not emerge nor has it endured without evolutionary purpose. By its very nature, CSE is based on the sort of social competition that, at the dawn of civilization, promoted survival on both the individual and group levels. However, the practical need for CSE has been rendered largely moot by cooperative modern societies. The remnants of this cognitive relic now only fuel petty pursuits of prestige. The consequence is that individuals end up seeking status for most of their lives rather than pursuing and finding joy.
A Different Philosophical Perspective
Among cognitive therapists, Ellis was unique in that he advocated a wholesale change in one’s attitude, perspective, and outlook upon life rather than piecemeal adjustment of maladaptive thoughts. Having recognized the futility of esteem building, and even referring to the pursuit thereof as “the greatest emotional disturbance known to man and woman”, Ellis proposed adoption of the principle of unconditional self-acceptance (USA) as a healthy psychological and philosophical alternative to popular notions of self-esteem.
The philosophy of USA begins with the following premise:
The human being is fully and unconditionally acceptable in his own right as a unique and singular person; that he always has value to himself for so long as he is alive; and that his intrinsic worth, or self-value, need not depend in any way upon his extrinsic value, or worth to others.
Thus, while evaluating thoughts, feelings and behaviors in relation to achieving goals and maintaining values is productive, one should refrain from the destructive practice of assigning a global rating to self based upon those same thoughts, feelings, and behaviors. Similarly, rating oneself globally based upon the approval (or lack thereof) of others is equally unhealthy. Conversely, the self is unconditionally accepted, respected, and valued in totality even when thoughts, feelings, and behaviors are viewed as undesirable. The internal dialogue changes from “I am a good person because I do good things” or “I am a bad person because I do bad things”, to “I am person who does both good and bad things, neither of which will I use to rate or measure my individual worth.”
It might seem that a philosophy of USA would necessarily lead to complacency, but this is far from the truth. In USA, motivation in fact shifts away from the quick hits of “proving oneself”, or being “egoistic”, or showing a “better” or “greater” value than others as a means to regulate self-esteem and towards fearlessly facing deficiencies, correcting them to achieve goals and values, and the enjoyment of life. Ellis described such an outlook as long-range hedonism. As Ellis wisely noted,
“Well adjusted people tend to seek both the pleasures of the moment and those of the future and do not often ask for future pain to get present gain. They seek happiness and avoid pain, but they assume they will probably live for quite a few years and that they had better think of both today and tomorrow and not obsess themselves with immediate gratification.”
Ellis further recognized that even though the self is unique in many ways, it is also an extension of society and culture. Much of our thoughts, feelings, and behaviors are significantly influenced (and sometimes even created) by the environment. Personhood thus includes “socialhood”. Moreover, we are endowed with social instincts which dictate that individual ways of living must coalesce with societal standards. As such, Ellis believed that USA naturally extended to unconditional other acceptance (UOA) which might be likened to the Christian philosophy of loving the sinner but not his sins.
As a practical matter, UOA becomes necessary once it is recognized that we live in a social community and had better treat others fairly for the sake of our own happiness and survival. Equally important, however, is recognition that when we rate and label others, we often become resentful towards them. Therefore, we decide to accept the unfairness in the wrongful behavior of others and allow the emotions of healthful sorrow and disappointment without experiencing unhealthy anger. Though we may appraise the performance of others, we should refrain from damning them intrinsically. Applying the philosophy of UOA, we give to others what we have hopefully given to ourselves — thorough acceptance notwithstanding failings and virtues.
The final prong of the philosophy of unconditional acceptance as described by Ellis is that of unconditional life acceptance (ULA). Applying ULA means that when things go wrong in our lives over which we have little or no control — for example a loved one passing away, disabilities, or natural disasters — we can strongly dislike these adversities and do our best to rectify them, yet still accept them when they cannot be presently rectified, and hopefully have the wisdom to see the difference. There is a clear difference between liking adversities (which is difficult, if not impossible, to do) and accepting them, which is still difficult but doable. The goal is to develop what Ellis calls High Frustration Tolerance (HFT) as opposed to the often self-defeating Low Frustration Tolerance (LFT). It is a life philosophy that is best summarized by a prayer written by Reinhold Neihbur in the 1950′s:
Grant me the serenity, to accept the things I cannot change;
The courage to change the things I can; and
The wisdom to know the difference.
The Nuts and Bolts of REBT
Even though the arguments for adopting the philosophy of unconditional acceptance are compelling, it would be very difficult to suddenly cast aside entrenched notions of self-esteem building in favor of a vastly different philosophical approach to life. To aid in this endeavor of self-improvement, Ellis created Rational Emotive Behavioral Therapy (REBT) which provides a practical framework for effecting the necessary deep philosophical change.
A. The Three Levels of Thinking
Though Ellis’ therapeutic approach includes behavioral and emotive techniques (which are discussed below), the focus of REBT is on changing cognitive processes. Specifically the individual system of beliefs is targeted for restructuring. According to REBT theory, individuals think on three levels: a) Inferences; b) Evaluations; and c) Core Beliefs. These are described by REBT practitioner Wayne Froggatt as follows:
Inferences. In everyday life, events and circumstances trigger off inferences about what is “going on” — that is, we make guesses about what we think has happened, is happening, or will happen. Inferences are statements of ‘fact’ (or at least what we think are the facts — they can be true or false) . . . In REBT . . . [inferences] are regarded as significant only in the sense that they provide a window to the evaluative thinking.
Evaluations. More significantly from the REBT perspective, in addition to making inferences about things that happen, we go beyond the ‘facts’ to evaluate them in terms of what they mean to us. Evaluations are sometimes conscious, and sometimes beneath awareness.
Core Beliefs. Guiding a person’s inferences and evaluations are their underlying, general core beliefs . . . these are the rules that guide how people react to the events and circumstances in their lives.
B. Irrational Thinking
The primary purpose of REBT is to identify patterns of irrational thinking, and to replace those thoughts (beliefs) with rational thinking. In general, irrational beliefs:
- Block persons from achieving their goals; create extreme emotions that persist, distress, and immobilize; and lead to harmful behaviors;
- Distort reality (misinterpretations of what is happening — not supported by the available evidence); and
- Contain illogical methods of evaluation.
As previously noted, unlike many other cognitive-behavioral approaches which focus on inferential thinking, REBT places much emphasis on challenging irrational core and evaluative beliefs. Ellis proposed that there are a small number of irrational core beliefs underlying most unhelpful emotions and behaviors. These are:
- I need love and approval from those significant to me — and I must avoid disapproval from any source.
- To be worthwhile as a person I must achieve, succeed at whatever I do, and make no mistakes.
- People should always do the right thing. When they behave obnoxiously, unfairly or selfishly, they must be blamed and punished.
- Things must be the way I want them to be, otherwise life will be intolerable.
- My unhappiness is caused by things outside my control — so there is little I can do to feel any better.
- I must worry about things that could be dangerous, unpleasant or frightening — otherwise they might happen.
- Because they are too much to bear, I must avoid life’s difficulties, unpleasantness, and responsibilities.
- Everyone needs to depend on someone stronger than themselves.
- Events in my past are the cause of my problems — and they continue to influence my feelings and behaviors now.
- I should become upset when other people have problems, and feel unhappy when they are sad.
- I shouldn’t have to feel discomfort and pain — I can’t stand them and must avoid them at all costs.
- Every problem should have an ideal solution — and it’s intolerable when one can’t be found.
Additionally, Ellis identified the irrational evaluative thought processes which are woven into the 12 Irrational Core Beliefs and which exist independently. These are:
Demandingness. Demandingness refers to the way people hold unconditional “shoulds” and absolutistic “musts” — believing that certain things must or must not happen, and that certain conditions (eg. success, love, or approval) are absolute necessities. Notoriously referred to by Ellis as musturbation, it can be directed inwardly (demands made upon oneself), and outwardly (demands made upon others and the universe). Demandingness is at the core of most irrational thinking.
Catastrophising. Catastrophising includes awfulising and discomfort intolerance (a/k/a ‘can’t-stand-it-itis’). Characterized by words like “awful”, “terrible”, and “horrible”, awfulising occurs when we exaggerate the consequences of past, present, or future events. Often following awfulising is discomfort intolerance (low frustration tolerance) which is based upon the idea that one cannot bear some circumstance or event (often leading to the demand that it not be so).
People-Rating. Produced by the previously discussed principles of conditional self-esteem, people-rating involves the overgeneralization that the total value or worth of oneself or of another can be determined by evaluation of narrow, specific traits and behaviors — e.g. “I did a bad thing, therefore I am a bad person”.
C. The ABC’s of REBT
Ellis illustrates his theory of cognition utilizing what is known as the ABC Model of REBT where ‘A’ represents the activating event and the inferences as to what is happening; ‘B’ represents the evaluative beliefs that follow the inferences; and ‘C’ represents the emotional and behavioral consequences which follow the inferences. Froggatt gives the following example of the A x B = C formulation:
A. Activating Event — What Happened:
Friend passed me in the street without acknowledging me.
A’. Inferences about what happened:
He’s ignoring me. He doesn’t like me.
B. Beliefs about A:
I am unacceptable as a friend, so I must be worthless as a person (Evaluation).
C. Emotional and Behavioral Consequences:
There are two important conclusions to be drawn from this formulation. First, ‘A’ does not cause ‘C’; it triggers ‘B’ which then gives rise to ‘C’. Second, these sorts of ABC cognitive episodes do not stand alone, but often run in chains wherein ‘C’ becomes the ‘A’ for another episode. In the above example, the troubled individual might interpret his isolating behavior as weak, and then engage in self-downing (this sort of secondary disturbance is discussed below in more detail).
It should be noted, however, that while the above formulation retains much practical truth, even Ellis’ own view of the ABC’s evolved over time. Specifically, Ellis stated:
“I still retain this formulation, but realize that A, B, and C are more complicated than they first appear. First, they include aspects of and interact with each other; second, B, in particular does not merely include the individuals Belief System, but also includes integral aspects of his/her emotional and behavioral system.”
Notwithstanding these concessions and other psychological complexities, the focus of cognitive-behavioral therapy in general, including REBT, remains consciously disputing irrational beliefs as a means to achieve healthy behavioral and emotional effects.
D. The Process of Change
Cognitive Techniques in REBT
Ellis notes that Belief Systems include both functional or rational beliefs (RBs) and dysfunctional or irrational beliefs (IBs). RBs are usually expressed as preferences or wishes (“I want to perform well and be approved by significant others else my behaviors are faulty”) as opposed to IBs which tend to include absolutistic musts, shoulds, and demands (“I must perform well and have to be approved by significant others or I am a worthless person!”). The primary method of effecting change through REBT involves learning to Dispute irrational beliefs. The process of Disputing (D), as described by Ellis, involves asking and answering a series of questions:
- Realistic Disputing. “Why must I perform well? Where is it written that I must be approved by others?” Answer: “There is no evidence that I must or have to, but it would be highly preferable if I did.”
- Logical Disputing. “Does it follow that if I perform badly and lose the approval of others that it will make me an inadequate person?” Answer: “No, it will only make my deeds inadequate; but my performance is not me nor my total personhood.
- Pragmatic Disputing. “What results will I get if I believe that I absolutely must always perform well and always be approved by significant others?” Answer: “I will make myself anxious and depressed.” “Do I want to get these results?” Answer: “No!”
The result of the process of disputing (and other techniques) is the development of what Ellis calls Effective New Philosophies (E) which give rise to healthy emotions and behaviors (C’s). Keep in mind, however, that not all unpleasant emotions are seen as dysfunctional in REBT, nor are all pleasant emotions seen as functional. As Froggatt notes, the aim of REBT is not so-called “positive thinking”, but rather having “realistic thoughts, emotions and behaviors that are in proportion to the events and circumstances an individual experiences.”
Emotive-Behavioral Techniques in REBT
REBT evolved through the years to include more emphasis on emotive and behavioral techniques as Ellis’ own understanding of the importance of these processes likewise evolved. Even though REBT retains a prominent focus on changing cognition, Ellis rather emphatically stated that if people wanted to effect self-helping consequences
“they had better work on their Believing-Emoting-Behaving and not merely their Believing. More specifically, they had better vigorously and forcefully (that is, emotively) change their dysfunctional B’s; and at the same time, they forcefully and persistently feel and act against them.”
As such, in addition to cognitive methods such as Disputing, Ellis promoted several emotive and behavioral techniques in a multimodal approach to self-improvement. The best known of these techniques are Rational Emotive Imagery and Shame-Attacking Exercises.
Rational Emotive Imagery. Ellis observed that “REBT notably recognizes healthy and unhealthy feelings when people react to some unfortunate Adversities (A’s). It considers consequent feelings of sorrow, regret, frustration, and annoyance as healthy or self-helping; and it sees anxietizing, depressing, and raging as unhealthy or self-sabotaging . . . keenly sorrowing and regretting about a serious loss is not considered to be having an unhealthy emotional problem . . . [one should be] concerned about, say, losing a job or acquiring poor physical health because lack of such concern may lead to poor results.” A practical method for distinguishing healthy and unhealthy emotions and for learning to change destructive emotions to self-helping ones is found in a technique which Ellis and Maultsby describe as Rational Emotive Imagery (REI).
In REI, a past or anticipated “bad event” is imagined vividly. The circumstances are considered in great detail. Conversations are imagined. Actions are visualized. The situation is recreated or allowed to unfold entirely in the mind’s eye. The most extreme negative emotions are allowed to flow forth and are felt thoroughly and completely without fear or hesitation. The mental recreation is expanded and continued until the emotional reaction has become as disturbing as possible. After the unhealthy emotions are felt for a few minutes, shift focus to quickly and consciously change the feelings from disturbed to merely unpleasant. For example, change them from anxiety and depression to regret and disappointment. Ellis believed that with sustained practice through REI, automatic unhealthy emotional reactions can be replaced with healthy emotional reactions.
Shame-Attacking Exercises. Shame implies a self-downing condemnation — a regret that has been internalized and then expanded to become a negative global rating of oneself. As a means to counter the self-destruction caused by shame, Ellis proposed a method of in vivo desensitization referred to as shame-attacking exercises, which he described as follows:
“[The individual does] something that they consider ‘shameful,’ risk rejection by others for doing it, and show themselves even when they do get rejected they can have a non-upsetting philosophy and attitude. ‘Too bad. It’s not awful that I was disapproved for doing this shameful act, and I can still live and be happy!’”
Obviously, the chosen act should not be something that could bring harm to oneself or others, but merely something silly that might attract negative attention. Common examples of suitable exercises include shouting out the prices of various items in a grocery store, or wearing odd clothing in public. The point of the exercise is to practice adopting a viewpoint of slight regret (even humor) at the rejection of others, instead of one of shame.
E. Secondary Disturbances
One of the more important elements of REBT is the recognition what Ellis calls secondary disturbances. In his practice, Ellis observed that his clients had often upset themselves by making irrational demands about their being upset. Simply put, people tend to create anxiety about being anxious, depression about being depressed, obsess about their obsessions and so on. In effect, a person who experiences primary situational anxiety from an event like boarding a subway car will often make matters worse by telling himself something like this: “I must not panic! It’s awful to panic! I am a weakling and failure for having these panic attacks. Others will see that I am panicking and that would be terrible!” Another common secondary disturbance is guilt — for example, people with anger problems may down themselves for having difficulty controlling their rage. The unfortunate result is a cascading effect wherein the primary and secondary disturbances build upon and reinforce each other. Inasmuch, REBT places strong emphasis on addressing secondary disturbances as a means to gain access to and change the primary disturbances.
F. REBT Homework Assignments
Unlike many other forms of “discussion therapy”, REBT is designed to be brief and it is geared towards teaching clients how to help themselves in the future rather than spending years in therapy rehashing the past and searching in vain for magical epiphanies. As such, clients are given practical “homework assignments” which allow real-world implementation of REBT principles. Change through REBT only comes through diligent effort and repeated practice, and therefore requires some level of discipline and desire to do the necessary work.
Aside from the above-described emotive-behavioral techniques of REI and Shame-Attacking that might be given as homework, cognitive homework often includes completing forms which allow the individual to see in black and white the ABCs (and DEs) of their own thinking. In addition, because REBT is largely an educational psychology, individuals are encouraged to take advantage of the many self-help books, pamphlets and documents available which have been authored by Ellis and a number of other credible REBT practitioners.
When Albert Ellis broke with his Freudian psychoanalytic training and created REBT, one must wonder whether or not he was aware of the profound impact he would have upon the practice of mental health. Based upon one survey of American and Canadian psychologists, Ellis was ranked the second most influential psychotherapist in history (Carl Rogers ranked first in the survey; Sigmund Freud ranked third). Most significant, however, is the fact that REBT is much more than an interesting “theory”. Indeed, repeated clinical studies through the years have confirmed that individuals can experience significant improvement in mental health through application of the principles of REBT. Furthermore, the practical application of REBT is not complex nor does it require application of esoteric therapeutic approaches. On the contrary, it is a direct method of self-improvement that is readily accessible to anyone who wishes to make the effort to change. Though not without its limitations — limitations freely acknowledged by Ellis himself — REBT is ultimately a philosophy of personal empowerment and a path to psychological well-being.
Ellis, Albert, Overcoming Destructive Beliefs, Feelings and Behaviors: New Directions for Rational Emotive Behavior Therapy, Prometheus Books (New York 2001).
Ellis, Albert, The Myth of Self-Esteem: How Rational Emotive Behavior Therapy Can Change Your Life Forever, Prometheus Books (New York 2005).
Froggatt, Wayne, A Brief Introduction to Rational Emotive Behavior Therapy (2005).