Rational Emotive Behaviour Therapy in a Nutshell

Michael Neenan, Windy Dryden

• Publisher: SAGE Publications Ltd
• Year: 2010
• Print ISBN: 9780857023322, 9780857023315
• eBook ISBN: 9781446244654
• Edition: 2
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Rational Emotive Behaviour Therapy in a Nutshell provides a concise overview of a popular therapeutic approach, starting with the ABCDE Model of Emotional Disturbance and Change.

Written by leading REBT specialists, Michael Neenan and Windy Dryden, the book goes on to explain the core of the therapeutic process:

- Assessment

- Disputing

- Homework

- Working through

- Promoting self-change.

As an introduction to the basics of the approach, this updated and revised edition of Rational Emotive Behaviour Therapy in a Nutshell is the ideal first text and a springboard to further study.

ONE

The Distinctive Features of Rational Emotive Behaviour Therapy

We are often asked what are the similarities and differences between rational emotive behaviour therapy (REBT) and cognitive behaviour therapy (CBT). While this seems like a reasonable and straightforward question, we actually find it problematic and difficult to answer. The reason we find the question problematic is this. We consider cognitive behaviour therapy (CBT) to be a therapeutic tradition comprising a number of specific approaches, of which REBT is but one. Thus, when we are asked to compare and contrast REBT with CBT, it is like being asked to compare and contrast an orange (a specific piece of fruit) with fruit (a general category).

Thus, rather than compare REBT (a specific CBT approach) with CBT (a general therapeutic tradition), we prefer to outline what makes REBT distinctive within the CBT tradition. So, in this opening chapter, we will discuss fifteen of REBT’s distinctive theoretical features and fifteen of its distinctive practical features. So, when you have read the following thirty distinctive features of REBT, you should have a good idea about what makes REBT distinctive within the therapeutic tradition of CBT. Note that we are not saying that these thirty features are unique to REBT and only to REBT. Rather, we are saying that, taken together, these features outline the distinctiveness of REBT.

Before we undertake our task, it is worth saying that REBT is the oldest of the extant specific CBT approaches, being established by Albert Ellis (1913–2007) in the late 1950s. It is thus over fifty years old, and while it is still developing, what appears in this book are its key ideas described in a nutshell!

The distinctive theoretical features of REBT

In this section, we will outline REBT’s major distinctive theoretical features.

Postmodern relativism

REBT espouses postmodern relativism, which is antithetical to rigid and extreme views and holds that there is, in all probability, no absolute way of determining reality. Note that we have said ‘in all probability’ here, for had we said that there is no absolute way of determining reality, then this would have been an absolute statement, antithetical to REBT theory.

REBT’s position on human nature

All approaches to counselling and psychotherapy are based on explicit or implicit ideas about human nature. In selecting a schema to outline REBT’s views of human nature we have chosen Hjelle and Ziegler’s (1992) ‘basic assumptions’ approach, which puts forward nine continua on which REBT and other approaches can be located with respect to their position on this issue. We have spelt out this position in Table 1.1.

Table 1.1 Description of the nine basic assumptions concerning human nature and REBT’s position on these continua

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• Freedom – Determinism

How much internal freedom do people have and how much are they determined by external and internal (e.g. biological) factors?

REBT’s position: Moderate emphasis towards the freedom end of the continuum

• Rationality – Irrationality

To what extent are people primarily rational, directing themselves through reason or to what extent are they guided by irrational factors?

REBT’s position: Mid-range between the two. People have the capacity to be both rational and irrational. They have to work harder to be rational than irrational

• Holism – Elementalism

To what extent are people best comprehended as a whole or to what extent by being broken down into their constituent parts?

REBT’s position: Moderate emphasis towards holism end of the continuum

• Constitutionalism – Environmentalism

To what extent are people the result of constitutional factors and to what extent are they products of environmental influences?

REBT’s position: Strong emphasis towards the constitutionalism end of the continuum

• Changeability – Unchangeability

To what extent are people capable of fundamental change over time?

REBT’s position: Moderate emphasis towards the changeability end of the continuum

• Subjectivity – Objectivity

To what extent are people influenced by subjective factors and to what extent by external, objective factors?

REBT’s position: Strong emphasis towards the subjectivity end of the continuum

• Proactivity – Reactivity

To what extent do people generate their behaviour internally (proactivity) and to what extent do they respond to external stimuli (reactivity)?

REBT’s position: Strong emphasis towards the proactivity end of the continuum

• Homeostasis – Heterostasis

To what extent are humans motivated primarily to reduce tensions and maintain an inner homeostasis and to what extent are they motivated to actualize themselves?

REBT’s position: Mid-range between the two

• Knowability – Unknowability

To what extent is human nature fully knowable?

REBT’s position: Moderate emphasis towards the unknowability end of the continuum

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Source: Hjelle and Ziegler, 1992

REBT’s distinctive ABC model

Most approaches to CBT outline an ‘ABC’ meditational model when the person’s responses at ‘C’ to an event at ‘A’ are mediated by their thoughts and/or beliefs (B) about the event. This view is articulated in Epictetus’s oft-quoted dictum: ‘Men are disturbed not by things, but by their views of things’. Now, different CBT approaches have different versions of this ABC model and in Chapter 2 we will outline REBT’s distinctive ‘Situational ABC’ model which highlights key inferential aspects of ‘A’ and argues that ‘C’ can be emotive, behavioural and cognitive in nature. It also stresses that ‘ABCs’ are best understood within a situational context.

Rigidity is at the core of psychological disturbance

REBT argues that a defining characteristic of humans is that we have desires. We want certain things to happen and other things not to happen. However, we also a have a strong tendency to transform these desires into absolute musts, shoulds and oughts, etc. When we hold rigid beliefs of this nature, we disturb ourselves. Thus, in REBT, rigidity is seen as being at the core of psychologically disturbed responses to adversity.

Flexibility is at the core of psychological health

As we mentioned above, we have desires as humans. However, if we recognize that we don’t have to get what we want and we don’t have to be spared of what we don’t want, we will not disturb ourselves about the adversities that we face. Thus, in REBT, flexibility is seen as being at the core of psychologically healthy responses to adversity.

Extreme beliefs are derived from rigid beliefs

As we pointed out above, rigid beliefs are at the core of psychologically disturbed responses to adversity. REBT theory also holds that three extreme beliefs are derived from such rigidity in the face of adversity. These are known as: awfulizing beliefs, discomfort intolerance beliefs and depreciation beliefs. We will discuss these in Chapter 2.

Non-extreme beliefs are derived from flexible beliefs

As we pointed out above, flexible beliefs are at the core of psychologically healthy responses to adversity. REBT theory also holds that three non-extreme beliefs are derived from such rigidity in the face of adversity. These are known as: non-awfulizing beliefs, discomfort tolerance beliefs and acceptance beliefs. We will also discuss these in Chapter 2.

Distinction between unhealthy negative emotions (UNEs) and healthy negative emotions (HNEs)

As we discussed above, when we face adversity, we have a choice. We can either make ourselves disturbed about this adversity or we can respond in psychologically healthy ways. Depending on what we disturb ourselves about, the emotional component of such disturbance can be expressed in one or more of the following unhealthy negative emotions: anxiety, depression, guilt, shame, hurt, unhealthy anger, unhealthy jealousy and unhealthy envy. These unhealthy negative emotions (or UNEs) are deemed to stem from irrational (i.e. rigid and extreme) beliefs. These UNEs may vary in intensity according to the strength of the person’s irrational beliefs.

When we respond healthily to the same adversities, we still experience negative emotions, but these emotions will be healthy in their effects. In REBT, these are known as healthy negative emotions (or HNEs) and are as follows: concern, sadness, remorse, disappointment, healthy anger, healthy jealousy and healthy envy. They are deemed to stem from rational (i.e. flexible and non-extreme) beliefs. These HNEs may also vary in intensity according to the strength of the person’s rational beliefs.

Explaining why clients’ inferences are highly distorted

In clinical practice you will encounter situations where your clients will disclose highly distorted inferences (e.g. ‘I will become a bag lady’; ‘I will lose complete control of myself’; ‘I am having a heart attack’). In other approaches to CBT, these tend to be treated as other less highly distorted inferences are and are subject to empirical enquiry. While this can also be done in REBT, in this form of CBT such highly distorted inferences are conceptualized as cognitive consequences of irrational beliefs, and before they are targeted for intervention the irrational beliefs that spawn them are questioned first.

Position on human worth

REBT has a unique perspective on the issue of human worth, which is particularly relevant to problems of self-esteem (where judgements of the worth of self are salient) and unhealthy anger (where judgements of the worth of others are often made). REBT’s view is that as humans are constantly in flux and are highly complex, we cannot legitimately be assigned a single, global judgement or rating that completely accounts for us. Consequently, the REBT alternative is to unconditionally accept humans as fallible, complex and changeable, but to give legitimate evaluations to our rateable aspects (e.g. our behaviour, thoughts, etc.).

REBT’s view is that, like self-actualization, unconditional acceptance of self and others is something to strive for, not to attain once and for all.

Distinction between ego and discomfort disturbance and health

REBT argues that there are two major personal domains in which people experience emotional problems: the ego domain (in which problems revolve around a person’s lack of self-esteem) and the discomfort domain (in which problems are about anything else). When Ellis (1979a, 1980a) first introduced this distinction, he was referring to two different types of anxiety: ego anxiety (experienced when the person held an irrational belief about a threat to her self-esteem) and discomfort anxiety (experienced when the person held an irrational belief about a threat to her sense of comfort).

Since then, these terms have been applied much more widely than to anxiety so that when a person holds a demand and self-depreciation belief about an adversity, she is said to experience ego disturbance and when, in the face of the adversity, she holds a demand and any irrational derivative belief other than a self-depreciation belief, she is said to experience discomfort disturbance.

Also, when the person holds a flexible, non-dogmatic preference and a self-acceptance belief in the face of an adversity, the person is said to experience ego health and when she holds a flexible, non-dogmatic preference and any rational derivative belief other than a self-depreciation belief in the face of an adversity, she is said to experience discomfort health.

Focus on meta-emotional disturbance

While other animals may be said to experience symptoms consistent with psychological disturbance, only we humans appear to have the ability to disturb ourselves about our disturbances. In REBT this is known as meta-emotional disturbance (Dryden, 2009) or secondary disturbance (Walen et al., 1992), and REBT therapists have long since emphasized the early assessment and treatment of this form of disturbance and the need to give clinical priority to it over the person’s primary disturbance when its existence impedes the person from dealing effectively with the latter.

The biological basis of human irrationality

Most other approaches to CBT are based on social learning theories which stress that psychological disturbance occurs as a result of faulty learning. REBT, on the other hand, argues that there is a strong biological basis to psychological disturbance. Thus, for example, independent of their learning history, people seem to find it very easy to transform their preferences into rigid demands, particul...

Table of contents

• Cover Page
• Title
• Copyright
• Contents
• Preface
• Acknowledgement
• 1 The distinctive features of rational emotive behaviour therapy
• 2 The REBT ‘Situational ABC’ model
• 3 Assessment
• 4 Disputing
• 5 Homework
• 6 Working through and promoting self-change
• Appendix 1 Thinking distortions and their realistic alternatives
• References
• Index