Rationality and Pluralism

The selected works of Windy Dryden

Windy Dryden

• Publisher: Routledge
• Year: 2013
• Print ISBN:
  9780415813778
• eBook ISBN:
  9781135089610
• Topic: Psicología
• Subtopic: Salud mental en psicología

Leading psychologist, lecturer, and author Windy Dryden has compiled his most valuable writings on Rational Emotive Behaviour Therapy from the last thirty five years. This collection reveals the thinking, concepts and practical experience that have made Dryden one of the most respected and cited REBT authorities of our time.

Dryden has authored or edited over 195 books and established Europe's first Masters in REBT. While his primary allegiance remains with REBT, he has published extensively on CBT and the wider issues of psychotherapy.

Dryden's pluralistic perspective on REBT comes through in such seminal pieces as:

• The therapeutic alliance in rational-emotive individual therapy
• Compromises in rational-emotive therapy
• Adapting CBT to a broad clientele
• Unconditional self-acceptance and self-compassion

CHAPTER 1

RATIONAL EMOTIVE BEHAVIOUR THERAPY

(Albert Ellis, 1913–2007)

C. Feltham and I. Horton (Eds) (2012) The Sage handbook of counselling and psychotherapy. London: Sage (pp. 298–301)

As this volume of selected works is structured around my publications in the area of Rational Emotive Behaviour Therapy (REBT), a therapeutic approach which is best placed within the cognitive-behavioural tradition of counselling and psychotherapy, I decided to begin the collection with this piece. The article serves as a basic introduction to and overview of REBT which sets the rest of the book in context.

Brief History

Rational emotive behaviour therapy (REBT) was founded in 1955 by Albert Ellis, an American clinical psychologist who had become increasingly disaffected with psychoanalysis in which he trained in the late 1940s. Originally the approach was called rational therapy (RT) because Ellis wanted to emphasize its rational and cognitive features. In doing so, Ellis demonstrated the philosophical influences (largely Stoic) on his thinking. In 1961 he changed its name to rational-emotive therapy to show critics that it did not neglect emotions, and over 30 years later (in 1993) Ellis renamed the approach yet again, calling it rational emotive behaviour therapy to show critics that it did not neglect behaviour.

In 1962 Ellis published Reason and Emotion in Psychotherapy, a collection largely of previously published papers or previously delivered lectures, but which became a seminal work in the history of psychotherapy. Most of REBT’s major present-day features are described in this book: the pivotal role of cognition in psychological disturbance; the principle of psychological interactionism where cognition, emotion and behaviour are seen as interacting, not separate, systems; the advantages of self-acceptance over self-esteem in helping clients with their disturbed views of their selves; and the importance of an active-directive therapeutic style, to name but a few.

Albert Ellis died in 2007 after an unfortunate period during which he was in dispute on a number of issues with the institute that continues to bear his name. Despite this, the legacy that Ellis left REBT and the wider field of psychotherapy is untarnished and unquestioned.

REBT is practised all over the world and has many different therapeutic, occupational and educational applications. However, it tends to live in the shadow of Beck’s cognitive therapy, an approach to cognitive-behaviour therapy which has attracted a greater number of practitioners and is more academically respectable.

Basic assumptions

Rationality is a concept that is normally applied to a person’s beliefs. Rational beliefs, which are deemed to be at the core of psychological health, are flexible or non-extreme, consistent with reality, logical, and both self and relationship enhancing. Irrational beliefs, which are deemed to be at the core of psychological disturbance, are rigid or extreme, inconsistent with reality, illogical, and both self and relationship defeating.

There are four types of rational belief: non-dogmatic preferences (‘I want to be approved of, but I don’t have to be’); non-awfulizing beliefs (‘It’s bad to be disapproved of, but it isn’t the end of the world’); discomfort tolerance beliefs (‘It is difficult to face being disapproved of, but I can tolerate it’); and acceptance beliefs (e.g. self-acceptance, ‘I can accept myself if I am disapproved of’; other acceptance, ‘You are not horrible if you disapprove of me’; and life acceptance, ‘Even though this tragedy happened, life is not all bad and comprises good, bad and neutral events’).

Similarly, there are four types of irrational belief: rigid demands (‘I must be approved of’); awfulizing beliefs (‘If I’m disapproved of, it’s the end of the world’); discomfort intolerance beliefs (‘I can’t tolerate being disapproved of’); and depreciation beliefs (e.g. self-depreciation, ‘I am worthless if I am disapproved of’; other depreciation, ‘You are horrible if you disapprove of me’; and life depreciation, ‘Life is all bad because this tragedy happened’).

REBT advocates a situational ‘ABC’ model of psychological disturbance and health. ‘A’ stands for adversity, which occurs within a situation and can be actual or inferred. ‘A’ represents the aspect of the situation that the person focuses on and evaluates. ‘B’ stands for belief (rational or irrational). ‘C’ stands for the consequences of holding a belief about A and can be emotional, behavioural and cognitive. Thus, ‘As’ do not cause ‘Cs’ but contribute to them. ‘Bs’ are seen as the prime but not the only determiners of ‘Cs’.

Holding a rational belief about an ‘A’ leads to healthy emotions, functional behaviour, and realistic and balanced subsequent thinking. Holding an irrational belief about the same ‘A’ leads to unhealthy emotions, dysfunctional behaviour, and unrealistic subsequent thinking that is highly skewed to the negative.

REBT’s view of human nature is realistic. Humans are seen as having the potential for both rational and irrational thinking. The ease with which we transform our strong desires into rigid demands suggests that the tendency towards irrational thinking is biologically based, but can be buffered or encouraged by environmental contexts.

Clients often have the unfortunate experience of inheriting tendencies towards disturbance and being exposed to their parents’ disturbed behaviour. REBT is optimistic and realistic here. It argues that if such clients work persistently and forcefully to counter their irrational beliefs and act in ways that are consistent with their rational beliefs, then they can help themselves significantly. However, REBT also acknowledges that most clients will not put in this degree of effort over a long period of time and will therefore fall far short of achieving their potential for psychological health.

Origin and maintenance of problems

People are disturbed not by events but by the rigid and extreme views that they take of them. This means that while negative events contribute to the development of disturbance, particularly when these events are highly aversive, disturbance occurs when people bring their tendencies to think irrationally to these events.

REBT does not have an elaborate view of the origin of disturbance. Having said this, it does acknowledge that it is very easy for humans when they are young to disturb themselves about highly aversive events. However, it argues that even under these conditions people react differently to the same event and thus we need to understand what a person brings to and takes from a negative activating event. People learn their standards and goals from their culture, but disturbance occurs when they bring their irrational beliefs to circumstances where their standards are not met and their pursuit of their goals is blocked.

REBT has a more elaborate view of how disturbance is maintained. It argues that people perpetuate their disturbance for a number of reasons including the following:

• They lack the insight that their disturbance is underpinned by their irrational beliefs and think instead that it is caused by events.

• They wrongly think that once they understand that their problems are underpinned by irrational beliefs, this understanding alone will lead to change.

• They do not work persistently to change their irrational beliefs and to integrate the rational alternatives to these beliefs into their belief system.

• continue to act in ways that are consistent with their irrational beliefs.

• They lack or are deficient in important social skills, communication skills, problem-solving skills and other life skills.

• They think that their disturbance has payoffs that outweigh the advantages of the healthy alternatives to their disturbed feelings and/or behaviour.

• They live in environments which support the irrational beliefs that underpin their problems and they think that as this is the case they cannot do anything to help themselves.

Change

REBT therapists consider that the core facilitative conditions of empathy, unconditional acceptance and genuineness are often desirable, but neither necessary nor sufficient for constructive therapeutic change. For such change to take place, REBT therapists need to help their clients to do the following:

• realize that they largely create their own psychological problems and that while situations contribute to these problems, they are in general of lesser importance in the change process

• fully recognize that they are able to address and overcome these problems

• that their problems stem largely from irrational beliefs

• detect their irrational beliefs and discriminate between them and their rational beliefs

• question their irrational beliefs and their rational beliefs until they see clearly that their irrational beliefs are false, illogical and unconstructive while their rational beliefs are true, sensible and constructive

• work towards the internalization of their new rational beliefs by using a variety of cognitive (including imaginal), emotive and behavioural change methods

• refrain from acting in ways that are consistent with their old irrational beliefs

• extend this process of challenging beliefs and using multimodal methods of change into other areas of their lives and to commit to doing so for as long as necessary.

All this is best done when effective REBT therapists develop, maintain and suitably end a good working alliance with clients (Dryden, 2009). This involves:

• therapists and clients having a good working bond

• therapists and clients sharing a common view of the determinants of the latter’s problems and how these can best be addressed

• therapists and clients working towards agreed goals

• therapists and clients executing agreed tasks designed to facilitate goal achievement.

Skills and strategies

REBT therapists see themselves as good psychological educators and therefore seek to teach their clients the ABC model of understanding and dealing with their psychological problems. They stress that there are alternative ways of addressing these problems and strive to elicit from their clients informed consent at the outset and throughout the counselling process. If they think that a client is better suited to a different approach to therapy, they do not hesitate to effect a suitable referral.

REBT therapists frequently employ an active-directive counselling style and use both Socratic and didactic teaching methods. However, they vary their style from client to client. They begin by working with specific examples of identified client problems and help their clients to set healthy goals. They employ a sequence of steps in working on these examples which involves using the situation ally based ABC framework, challenging beliefs and negotiating suitable homework assignments with their clients.

Helping clients to generalize their learning from situation to situation is explicitly built into the counselling process. So too is helping clients to identify, challenge and change core irrational beliefs which are seen as accounting for disturbance across a broad range of relevant situations.

A major therapeutic strategy involves helping clients to become their own therapists. In doing this, REBT therapists teach their clients how to use a particular skill such as challenging irrational beliefs, model the use of this skill, and sometimes give the clients written instructions on how to use the skill on their own. Constructive feedback is given to encourage the refinement of the skill. As clients learn how to use the skills of REBT for themselves, their therapists adopt a less active-directive, more prompting therapeutic style in order to e...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Preface
• Acknowledgements
• 1. Rational emotive behaviour therapy
• 2. Past messages and disputations: the client and significant others
• 3. Rational-emotive therapy and eclecticism
• 4. Rational-emotive therapy and cognitive therapy: a critical comparison
• 5. Language and meaning in RET
• 6. Vivid methods in rational-emotive therapy
• 7. The therapeutic alliance in rational-emotive individual therapy
• 8. Compromises in rational-emotive therapy
• 9. Self-disclosure in rational-emotive therapy
• 10. Reason and emotion in psychotherapy: thirty years on
• 11. Rationality, outrageous ideas and sensitivity
• 12. Understanding persons in the context of their problems: a rational emotive behaviour therapy perspective
• 13. My idiosyncratic practice of REBT
• 14. How rational am I? Self-help using rational emotive behaviour therapy
• 15. REBT’s situational ABC model
• 16. The personal therapy experiences of a rational emotive behaviour therapist
• 17. Resilience and rationality
• 18. The importance of choice in therapy: from the perspective of a, hopefully flexible, CBT practitioner
• 19. Albert Ellis and rational emotive behavior therapy: a personal reflection
• 20. Adapting CBT to a broad clientele
• 21. Dealing with procrastination: the REBT approach and a demonstration session
• 22. Unconditional self-acceptance and self-compassion
• Index