Understanding Emotional Problems and their Healthy Alternatives

The REBT Perspective

Windy Dryden

• Verlag: Routledge
• Jahr: 2021
• ISBN:
  9781000460735
• Auflage: 2
• Thema: Psicología
• Thema: Asesoramiento psicoterapéutico

Rational Emotive Behaviour Therapy (REBT) is an approach to counselling and psychotherapy rooted in the CBT tradition, and one that has a distinctive perspective on emotional problems.

Understanding Emotional Problems and their Healthy Alternatives provides an accurate understanding of the REBT perspective on eight major emotional problems for which help is sought and their healthy alternatives:

? anxiety and concern

? depression and sadness

? shame and disappointment

? guilt and remorse

? unhealthy anger and healthy anger

? hurt and sorrow

?unhealthy jealousy and healthy jealousy

? unhealthy envy andhealthy envy.

Rather than discussing treatment methods, Windy Dryden encourages the reader tounderstand these problems accuratelyand suggests that doing so will provide a firm foundation for effective treatment. This new edition, updated throughout, reflects the increased interest in helping clients work towards 'healthy negative emotions'.

Understanding Emotional Problems and their Healthy Alternatives will be essential reading for therapists, both in training and in practice.

Part 1

Anxiety and concern

Chapter 1

Understanding anxiety

10.4324/9781003203483-2

In this chapter, I will make some general observations about anxiety before discussing more specific areas of this disabling emotion. In the following chapter, I will do the same for concern which in REBT is considered to be the healthy alternative to anxiety.

General points about anxiety

In this section, I will discuss:

• The role of threat in anxiety.
• The role of a general anxiety-creating philosophy comprising four general rigid and extreme attitudes in general anxiety.
• The role of specific rigid and extreme attitudes towards specific threats in specific instances of anxiety.

In order to feel anxious a person needs to think that they are about to face a threat

In order to feel anxious a person needs to think that they are about to face some kind of threat. Without making a threat-related inference, the person won’t feel psychologically anxious.

There are two different kinds of threats that a person may experience: threats to ego aspects of their personal domain and threats to non-ego aspects of their personal domain. As Aaron T. Beck (1976) noted in his book Cognitive Therapy and the Emotional Disorders,¹ the personal domain includes anything that a person holds dear. So when a person faces an ego threat, they are facing a threat to something that they hold dear, which has an impact on their self-esteem (e.g. they think that they might fail an examination, and if they did they would consider themself to be a failure). When a person faces a non-ego threat, they are again facing a threat to something that they hold dear, which this time does not have an impact on their self-esteem (e.g. they think that they might feel sick and they contend that they cannot bear experiencing such a feeling).

It is important to note that a threat does not have to be real for a person to feel anxiety. The important point here is that the person themself considers the threat to be real.

A general anxiety-creating philosophy (GAP) underpins general anxiety

While locating a threat is a necessary condition for a person to feel anxious, it is not sufficient for the person to feel anxious. Some people, for example, as we will see, feel concerned rather than anxious about the possibility of facing a threat. In order to experience anxiety about the real and imagined threats in their life, a person needs what I call a ‘general anxiety-creating philosophy’ (GAP).

There are four ingredients to such a philosophy, which I will review one at a time.

Ingredient 1: A rigid attitude

The first ingredient of a GAP is known as a rigid attitude.

When a person holds a rigid attitude towards threats, they first assert that they prefer that such threats do not exist in the first place nor occur in the second. I call this a ‘shared preference’ component because this is present in both their rigid attitude and, as we will see in Chapter 2, their flexible attitude. Then, they add an ‘asserted demand’ component to this preference: ‘I would prefer that these threats do not exist or occur and therefore they must not do so.’²

For example, Sally is generally anxious about going for a health check and identifies a threat in that category (i.e. discovering that she is ill). Sally’s preference is as follows: ‘I would much prefer not to be ill’, to which she adds her asserted demand: ‘…and therefore I must not be ill’. By demanding that she must not be ill, Sally experiences the following consequences:

Emotional consequences

Sally experiences anxiety.

Thinking consequences

Sally’s subsequent thinking is skewed and very distorted. She is so preoccupied with the possibility that she is ill that she excludes the possibility that she may be well and all she can think about concerns illness. In other words, Sally has tunnel vision that serves to sustain her anxiety.

Behavioural consequences

Sally’s behaviour is characterised by avoidance. She avoids going for health checks. This will have the effect of reinforcing her extreme awfulising attitude (to be discussed presently) that it would be absolutely horrible to be ill. If it wasn’t horrible, she reasons, she wouldn’t avoid going for health checks.

I will discuss the thinking and behavioural consequences of anxiety-related rigid/extreme attitudes more fully later in the chapter.

Rigid attitudes would make sense if they actually removed the possibility of facing a threat. Thus, if by demanding that she must not be ill, Sally removed the possibility of being ill, then making this demand would make sense. However, making demands has no such effect on reality. They don’t magically remove the possibility of threats existing.

Ingredient 2: An awfulising attitude

The second ingredient of a GAP is known as an awfulising attitude. When a person holds such an attitude, they first assert that it would be bad for these threats to exist and to occur. I call this a ‘shared evaluation of badness’ component because this is present in both their awfulising attitude and, as we shall see in Chapter 2, their non-awfulising attitude. Then, they add an ‘asserted awfulising’ component to this evaluation of badness: ‘It is bad for these threats to happen and it would therefore be horrible, awful, terrible or the end of the world for these threats to exist in the first place and for them to occur in the second place.’³

Here the person converts their sensible, non-extreme conclusions – e.g. in Sally’s case that it would be bad or unfortunate to be ill – into illogical extreme conclusions – therefore it would be absolutely dreadful or the end of the world to be ill.

When Sally holds an awfulising attitude and she thinks of going for health checks, for example, she tells herself that if she was ill, nothing could be worse than this, and if it did happen, absolutely no good could possibly come from such an eventuality.

Ingredient 3: An unbearability attitude

The third ingredient of a GAP is known as an unbearability attitude. When a person holds such an attitude, they first assert that it would be a struggle for them to bear the existence and occurrence of such threats. I call this a ‘shared struggle component’ because this is present in both their unbearability attitude and, as we shall see in Chapter 2, their bearability attitude. Then they add an ‘unbearability’ component to this struggle: ‘It is a struggle for me to bear the existence and occurrence of these threats and therefore I couldn’t bear them.’⁴

Thus, Sally’s anxiety is underpinned by her unbearability attitude that it would be unbearable for her to be ill. When she holds this attitude, she pictures herself crumpled up in a heap on being told that she is ill and thinks that she will lose the capacity for happiness if she were ill.

Ingredient 4: A self-devaluation attitude

As mentioned above, there are two basic forms of anxiety: ego anxiety, where a person makes themself anxious about a threat to their self-esteem, and non-ego anxiety, where they make themself anxious about threats to things that do not involve self-esteem. In the latter type of anxiety, non-ego anxiety, a person generally holds a rigid attitude and then either an awfulising attitude or an unbearability attitude is most dominant in their thinking. Putting this diagrammatically we have:

Non-ego anxiety = Threat to non-ego aspect of personal domain × rigid attitude + awfulising attitude or unbearability attitude

In ego anxiety, a person generally holds a rigid attitude and a self-devaluation attitude, as shown below:

Ego anxiety = Threat to ego aspect of personal domain × rigid demand + self-devaluation attitude

When a person holds a self-devaluation attitude, they first evaluate negatively some aspect of themself or what happened to them. I call this a ‘shared negatively evaluated aspect’ component because this is present in both their self-devaluation attitude and, as we shall see in Chapter 2, their unconditional self-acceptance attitude. Then they add an ‘asserted global negative evaluation of self’ component to this ‘shared negatively evaluated aspect’ component: ‘It is bad if these threats exist and occur and if they do this proves that I am a failure, less worthy or unlovable.’⁵

For example, Norman is anxious about receiving disapproval (a general category of events that, if they happened, would result in him lowering his self-esteem). Thus, receiving disapproval is, for Norman, an ego threat. Now if we add Norman’s rigid attitude and self-devaluation attitude to this threat, we have: ‘I must not be disapproved of and if I am this proves that I am an unlikeable person.’

When a person is anxious in specific situations, they focus on a specific threat and practise a specific version of their general anxiety-creating philosophy

When a person holds a GAP, doing so increases the chances of identifying threats in their environment. This tendency to locate threats to their personal domain is characteristic of a person who experiences general anxiety. If a person only identified such threats when they actually existed, they would still make themself anxious, but wouldn’t do so very often. To make themself anxious regularly and frequently, a person tends to be very sensitive to threats to their personal domain. GAPs sensitise a person to the possibility of threat in the absence of objective evidence that such threats actually exist. Let me explain how holding a GAP influences a person’s ability to identify threats in their environment.

Norman (whom we met above) holds the following GAP: ‘I must be approved by new people that I meet and if I’m not it proves that I am unlikeable.’ Since Norman holds this attitude, he will become preoccupied with the possibility that new people will not like him and will think that he is unlikeable, unless he is certain that they will like him. This preoccupation will involve Norman tending to do the following:

• He will tend to overestimate the chances that a new group of people won’t approve of him and underestimate the chances that they will approve of him (overestimating the probability of disapproval).
• He will tend to think that if they do disapprove of him, they will disapprove of him greatly, rather than just mildly or moderately (overestimating the degree of disapproval).
• He will tend to think that all or most of those present will disapprove of him rather than the more realistic situation where some might disapprove of him, others might approve of him and yet others might be neutral towards him – assuming that he doesn’t have crass social habits that will objectively antagonise all or most people he has just met (overestimating the extent of disapproval).

In summary, when a person holds a GAP about approval, for example, they will overestimate the probability, degree and extent of the opposite happening (i.e. being disapproved) in their environment. GAPs lead a person to become oversensitive to threat.

So far I have discussed the role that general anxiety-creating philosophies play in making a person oversensitive to threat in their environment. Once the person has identified a specific threat in a specific environment, they will then hold a specific version of their GAP to make themself anxious in that specific situation. Let’s take Norman’s example again. He holds a GAP that I discussed above, namely: ‘I must be approved by new people that I meet and if I’m not it proves that I am unlikeable.’ Now let’s further assume that Norman goes to a party where there are people that he doesn’t know and his host is about to introduce him to these people. Norman’s GAP will immediately lead him to focus on the threat in this situation: ‘These specific people will not like me.’ This is known as an inference. An inference is a hunch about reality that can be correct or incorrect, but a GAP leads a person to think of it as a fact.

Having focused on this specific threat, Norman needs to hold a specific version of his GAP. In this case, it is: ‘These peop...