text:
メイン The Practice of Rational Emotive Behavior Therapy, 2nd Edition
The Practice of Rational Emotive Behavior Therapy, 2nd Edition
Albert Ellis, Windy Dryden
Reissued with a new foreword by Raymond DiGiuseppe, PhD, ScD, St. John's University "New trainees often get the theory of psychopathology; they struggle to get the case conceptualization and the strategic plan. Then they ask themselves. "What do I do now?" Going from the abstractions to the actions is not always clear. The Practice of Rational Emotive Behavior Therapy represents a compilation of years of theoretical and clinical insights distilled into a specific theory of disturbance and therapy and deductions for specific clinical strategies and techniques....The structure of this books focuses on an explication of the theory, a chapter on basic practice, and a chapter on an in depth case study. A detailed chapter follows on the practice of individual psychotherapy. Although the book is not broken into sections, the next four chapters represent a real treasure. The authors focus on using REBT in couples, family, group, and marathons sessions. Doing REBT with one person is difficult to learn. Once the clinician adds more people to the room with different and sometimes competing agendas things get more complicated. These chapters will not only help the novice clinician but also the experienced REBT therapists work better in these types of sessions. So, consider yourself lucky for having picked up this book. Reading it will help many people get better." - From the Foreword by Raymond DiGiuseppe, PhD, ScD, Director of Professional Education, Albert Ellis Institute; Professor and Chair, Department of Psychology, St. John's University This edition, involving a unique collaboration between Albert Ellis and the world's greatest Ellis scholar, Windy Dryden, modernizes Ellis's pioneering theories. The book begins with an explanation of rational emotive behavior therapy as a general treatment model and then addresses different treatment modalities, including individual, couple, family, and sex therapy. The authors have added material new since the book's original edition on teaching the principles of unconditional self-acceptance in a structured group setting. With extensive use of actual case examples to illustrate each of the different settings, and a new brand new foreword by Raymond DiGiuseppe that sets the book into its 21st-century context.
エディション: 2
出版社: Springer Publishing Company
ダウンロード (pdf, 16.29 MB)
Digital Photography Hacks
Derrick Story
74 Seaside Avenue
The Practice of
Rational Emotive
Albert Ellis, PhD, holds MA and PhD degrees in clinical psychology from
Columbia University, and is die founder and President of the Albeit Ellis Institute for Rational Emotive Behavior Therapy in New York Qty. He sees many
clients for individual and group psychotherapy each week at the Institute's
clinic, supervises its therapy and counseling trainees, and each year gives scores
of talks, workshops, intensives, and training sessions in New York, and in many
cities and universities in the United States and throughout the world. He has
published more than 60 books and monographs, over 700 articles, and more
than 150 audio and video cassettes. His well-known books include Sex Without Guilt, Reason and Emotion in Psychotherapy, A Guide to Rational Living, How
to Stubbornly Refuse to Make Yourself Miserable About Anything—Yes, Anything!,
Overcoming Resistance (Springer Publishing Company), and Better, Deeper and
More Enduring Brief Therapy. He has received many honors and awards, including awards for the highest professional and clinical contributions of the American Psychological Association, the American Counseling Association, and the
Association for the Advancement of Behavior Therapy.
Windy Dryden, PhD, is Professor of Counseling at Goldsmiths' College,
University of London. He authored and edited more than 100 books, numerous book chapters and articles, and he has edited 12 book series. Among those
books published by Springer is the first edition of this book The Practice of
Rational-Emotive Therapy, The Essential Albert Ellis: Seminal Writings on Psychotherapy, Overcoming Resistance: Rational-Emotive Therapy With Difficult Clients,
and Doing RET: Albert Ellis in Action. He is a Fellow of the Albert Ellis Institute of Rational-Emotive Behavior Therapy, the British Psychological Society,
the British Associadon for Counseling, and is Consulting Editor of the Journal
of Cognitive Psychotherapy: An International Quarterly (Springer Publishing).
Albert Ellis, PhD
Windy Dryden, PhD
SPRINGER PUBLISHING COMPANY
Copyright © 1997 by Springer Publishing Company, Inc.
No part of this publication may be reproduced, stored in a retrieval
system, or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise, without the prior
permission of Springer Publishing Company, LLC.
Springer Publishing Company, LLC
www.springerpub.com
Production Editor: Pamela Ritzer
Cover design: Mimi Flow
Composition: International Graphic Services
07 08 09 10 / 5 4 3 2 1
13-digit ISBN: 978-0-8261-2216-2 © 2007 Springer Publishing
Company, LLC
Ellis, Albert.
The practice of rational emotive behavior therapy / Albert Ellis,
Windy Dryden.
Contains revised and updated articles previously published.
ISBN 0-8261-5471-9 (HB)
ISBN 0-8261-5472-7 (PB)
1. Rational-emotive psychotherapy. I. Dryden, Windy. II. Title.
[DNLM: 1. Psychotherapy, Rational-Emotive—collected works.
WM 420.5.P8 E47P 1997]
RC489.R3E457 1997
616.89'142-dc20
DNLM/DLC
for Library of Congress
Printed in the United States of America by Berryville Graphics.
1 The General Theory of REST
2 The Basic Practice of REBT
3 A Case Illustration of the Basic Practice of REBT:
The Case of Jane
4 Individual Therapy
6 Family Therapy
7 Group Therapy
Rational Emotive Behavioral Marathons and Intensives
9 Teaching the Principles of Unconditional
Self-Acceptance in a Structured Group Setting
10 The Rational Emotive Behavioral Approach to Sex Therapy
11 The Use of Hypnosis with REBT
How to Maintain and Enhance Your Rational
Emotive Behavior Therapy Gains
Psychotherapy requires a great deal of intellectual knowledge. To become a
successful therapist requires that one reads many books and articles, and listens
to hundreds of hours of lectures and workshops. However, despite all this verbal
intellectual activity, when you close the door and are alone with the client, you
have to act. You have to decide quickly what to say, what to ask, or to remain
inactive. Was that a choice, or did I act passively because I did not know what
to do? After years of training psychotherapists, I have come to view the practice
of psychotherapy more like a motor sport or skill than like an intellectual
activity. However, psychotherapy is a motor skill that rests on a great deal of
knowledge. How do clinicians learn to go from theory to practice? The title
of this book by Ellis and Dryden reflects the action aspects of psychotherapy.
Systems of psychotherapy have a number of parts. First, they provide a
theory of psychopathology that explains how human disturbance develops.
Next, they have a theory of intervention that should follow from the theory of
psychopathology. The strategies proposed from the theory of intervention should
match the mechanisms that are thought to lead to the disturbance. The theory
of interventions usually has two components. The first I will call strategies
and the second techniques. Strategies are the verbal and logical statements that
the clinician hypothesizes to mediate the structure of the disturbed behavior
and emotion in the particular cases. On the basis of the theory and the individual
case, clinicians develop what we call a case conceptualization. A theory must
be fixable enough to explain many individual cases. Based on the case conceptualization, the strategy suggests apian of intervention. It identifies what hypothetical constructs proposed by the theory and case conceptualization require change
to achieve clinically significant improvement for the client. Many theories are
good up to this point. However, they are short on technique. What specific
things do the therapists do or say to implement the strategic plan? New trainees
often get the theory of psychopathology; they struggle to get the case conceptualization and the strategic plan. Then they ask themselves: "What do I do now?"
Going from the abstractions to the actions is not always clear.
The Practice of Rational Emotive Behavior Therapy represents a compilation
of years of theoretical and clinical insights distilled into a specific theory of
disturbance and therapy and deductions for specific clinical strategies and
techniques. Albert Ellis has an immense list of scholarly publications. He is
an impressive intellectual force who is well read in philosophy, anthropology,
and psychology. However, he is first a master clinician. He has focused all
of his incredible knowledge on how to help reduce human suffering one patient
at a time. He has always exemplified the pragmatic scholar. He is one of
those rare people with expansive knowledge who can use his knowledge with
surgical precisions.
The world's greatest Albert Ellis scholar, Windy Dryden from London, joins
Al in this volume. Not only has Windy spent several decades studying Al's
writings, he has spent hundreds, maybe thousands, of hours watching Al do
therapy. Like Al, Windy is most interested in the consistent implementation of
the theory into practice.
The resulting collaboration here is not just a smartly written, clear presentation
of one of the most philosophical theories of psychotherapy, but a very practical
volume as well. They titled this book The Practice of Rational Emotive Behavior
Therapy because both authors are not satisfied for therapists to have only an
intellectual understanding of REBT. Will/can they do it with real clients?
The structure of this book focuses on an explication of the theory, a chapter
on basic practice, and a chapter on an in-depth case study. A detailed chapter
follows on the practice of individual psychotherapy. Although the book is not
broken into sections, the next four chapters represent a real treasure. The authors
focus on using REBT in couples, family, group, and marathons sessions. Doing
REBT with one person is difficult to learn. Once the clinician adds more people
to the room with different and sometimes competing agendas, things get more
complicated. These chapters will help not only the novice clinician but also
the experienced REBT therapists work better in these types of sessions.
So, consider yourself lucky for having picked up this book. Reading it will
help many people (and hopefully yourself) get better.
Raymond DiGiuseppe, PhD, ScD
Director of Professional Education, Albert Ellis Institute
Many excellent books for professionals have been published on rational emotive behavior therapy (REBT), including several of our own (Bernard, 1991;
Bernard & Wolfe, 1993; Dryden, 1994a, 1994b, 1995a, 1995b; Dryden &
DiGiuseppe, 1990; Dryden & Hill, 1993; Dryden & Neenan, 1995; Ellis,
1985c, 1994c, 1996a; Ellis & Grieger, 1986; Walen, DiGiuseppe, & Dryden,
1992; Yankura & Dryden, 1990, 1994). None of these books, however, systematically considers the major way in which REBT is used clinically, such as
its use in individual, group, couples, family, and intensives therapy. Consequently, there is still no volume that systematically reviews the regular practice of REBT.
We have previously written books and articles covering important aspects
of the practice of REBT (Dryden, 1985b; Ellis, 1971a, 1985c, 1993b), but
some of these are outdated and/or out of print. Therefore, in this book we
have revised and updated this previous material, added several chapters on new
REBT formulations, and attempted to produce a volume that will present a
comprehensive picture of the practice of REBT that can be used effectively by
any therapist who wants to employ its important clinical modalities.
Not that this book covers all of REBT Some of the volumes mentioned
above include applications of REBT that are only briefly mentioned here. And
some of its psychoeducational practices—such as its use in workshops, courses,
and rational emotive behavioral training intensives—are barely discussed here.
But the professional who wants to use REBT in its most popular clinical modes
will find them described in detail in this book. While we do not expect it to
replace other REBT writings, we hope that it significantly and usefully supplements them.
ALBERT ELLIS, PuD
The Qenerol Theory
of REBT
In this first chapter we discuss the general theory underpinning the practice
of REBT. First, we put REBT in historical context and trace some of its major
influences. Second, we outline REBT's major theoretical concepts. Third, we
put forward an expanded version of REBT's well-known ABC framework.
Fourth, we consider REBT's perspective on the nature of psychological disturbance and health. Fifth, we elaborate this theme by detailing REBTfc viewpoint on how psychological disturbance is acquired and perpetuated. Finally,
we outline the REBT general theory of therapeutic change.
THE HISTORICAL DEVELOPMENT OF REBT
I (AE) founded rational emotive behavior therapy (REBT) in 1955 when I was
a New York clinical psychologist, having begun my career in the helping professions in the early 1940s. As a result of research I was doing at that time for
a massive work to be entitled The Case for Sexual Liberty, I gained a local reputation for being an authority on sexual and marital relationships. I was consulted by my friends on their sexual and relationship problems and discovered
that I could be successful in helping them with these problems in a short
period of time. I decided to pursue formal training in clinical psychology after
discovering that there were no formal training possibilities then offered in sex
and marital counseling. After getting a PhD degree in clinical psychology, I
chose to be trained in psychoanalysis, believing then that it was the deepest
and most effective form of psychotherapy available. I decided on this course
Parts of this chapter were adapted from Dryden and Ellis (1986) and W. Dryden and A. Ellis,
"Rational-Emotive Therapy," in K. S. Dobson (Ed.), Handbook of Cognitive-Behavioral Therapies;
New York: Guilford, 1987 (used by permission) and have been previously published in The Nurse
Practitioner: The American Journal ofPrimary Health Care, /2(7)July 1987.
The Practice ofREBT
of action because my experiences as an informal sex-marital counselor had
taught me that disturbed relationships were really a product of disturbed persons "and that if people were truly to be helped to live happily with each other
they first had better be shown how they could live peacefully with themselves"
(Ellis, 1962, p. 3).
I initially enjoyed working as a psychoanalyst, partly because it allowed me
to express both my helping and problem-solving interests. However, I became
increasingly dissatisfied with psychoanalysis as an effective and efficient form
of treatment. In the early 1950s, I began to experiment with different forms
of therapy, including psychoanalytkally oriented psychotherapy and eclecticanalytic therapy. But although I became more effective with my clients, I
remained dissatisfied about die efficiency of these methods. During this period
of experimentation I returned to my lifelong hobby of reading philosophy to
help me with my search for an effective and efficient form of therapy. One of
the major influences on my thought at that time was the work of the Greek
and Roman Stoic philosophers (e.g., Epicurus, Epictetus, and Marcus Aurelius). They emphasized the primacy of philosophic causation of psychological
disturbances—a viewpoint mat was not popular in America in the 1950s—and
deemphasized the part played by psychoanalytic psychodynamic factors. This
view was also largely promoted by several ancient Asian philosophers, especially Confucius, Lao-Tsu, and Gautama Buddha. In essence, these ancient
philosophies, which stated that people are disturbed not by things but by their
view of things, became the foundation ofREBT, and this perspective (following my pioneering formulations) remains at the heart of present-day cognitive-behavioral approaches to psychotherapy.
Major Philosophical Influences
Apart from ancient philosophy, present-day REBT owes a philosophical debt
to a number of other sources that have influenced its development. Immanuel
Kant's writings on the power (and limitations) of cognition and ideation
strongly impressed me, and the work of Spinoza and Schopenhauer was also
important in this respect. Philosophers of science, such as Popper (1959,
1963), Russell (1965), and Bartley (1984), were also influential in helping me
see that all humans develop hypotheses about the nature of the world. Moreover, these philosophers stressed the importance of testing the usefulness of
such hypotheses rather than assuming that they are necessarily helpful. The
practice ofREBT goes along in many respects with the logicoempirical methods of science (Ellis, 1962, I979d). REBT also stresses the flexibility and antidogmatism of the scientific method and opposes all dogmas, just as science
does, and it holds that rigid absolutism is one of the main cores of human disturbance (Ellis, 1983a). Also, REBT in some ways predated and in other ways
endorses some of the views of postmodernism (Ellis, 1994c, 1996a, 1996b).
The General Theory ofREBT
Although the philosophy ofREBT is at variance with devout religiosity, in
one respect Christian philosophy has been most influential. REBT's theory of
human value (which will be discussed later) is similar to the Christian viewpoint of condemning the sin but forgiving the sinner (Ellis, 1991b, 1991c,
1994c; Hauck, 1991; Mills, 1993; Powell, 1976). Due to its stand on self-acceptance and its bias against all forms of human rating, REBT allies itself with the
philosophy of ethical humanism (Russell, 1950,1965), which opposes the deification and devil-ification of humans. Since REBT considers that humans are at
the center of their universe (but not of the universe) and have the power of
choice (but not of unlimited choice) with regard to their emotional realm, it
has its roots in the existential philosophies of Heidegger (1949) and Tillich
(1977). Indeed, REBT has a pronounced humanistic-existential outlook (Ellis,
1973,1991c, 1994c, 1996a).
I was also influenced, particularly in the 1960s, by the work of the general
semanticists (e.g., Korzybski, 1933). These theorists outlined the powerful
effect that language has on thought and the fact that our emotional processes
are heavily dependent on the way we, as humans, structure our thought by the
language we employ.
Major Psychological Influences
In developing REBT, I (AE) have similarly been influenced by the work of a
number of psychologists. I received a training analysis from an analyst of the
Karen Horney school, and Horney's (1950) concept of the "tyranny of the
shoulds" was certainly an early influence on my emphasis on the primacy of
absolute, dogmatic evaluative thought in the creation and maintenance of
much psychological disturbance.
The work of Adler was important to the development ofREBT in several
respects. Adler (1927) was the first great therapist to really emphasize inferiority feelings—while REBT similarly stresses self-rating and the ego anxiety to
which it leads. Like Adler and his Individual Psychology, REBT also emphasizes
people's goals, purposes, values and meanings. REBT follows Adler in regard to
the use of active-directive teaching, the stress placed on social interest, the use
of a holistic and humanistic outlook, and the employment of a highly cognitivepersuasive form of psychological treatment (Ellis, 1991b, 1991c, 1996a).
Although REBT was originally termed Rational Psychotherapy, it has always
advocated the use of behavioral methods as well as cognitive and emotive techniques in the practice of therapy. Indeed, I (AE) utilized the methods advocated
by some of the earliest pioneers in behavior therapy (Dunlap, 1932; M. C. Jones,
1924; Watson & Rayner, 1920), first, in overcoming my own early fears of
speaking in public and approaching women, and second, in the active-directive form of sex therapy that I practiced in the 1940s and 1950s. This behavioral active-directive emphasis remains prominent in present-day REBT.
The Practice of REST
In its 40 years of existence, REBT has been practiced in various therapeutic modalities (individual, group, marital, and family), by many kinds of helping professionals (e.g., psychologists, psychiatrists, social workers), and with a
variety of client populations (e.g., adults, children, the elderly) suffering from
a wide range of psychological disorders. Apart from its use in counseling and
psychotherapy, rational emotive behavioral principles have been applied in
educational, industrial, and commercial settings. A recent development has
been the applicadon of REBT to public education in the form of 9-hour intensive workshops. In this respect it is playing a significant role in the field of preventive psychology. REBT is practiced throughout the world, and there are
REBT institutes, or centers, in the United States, France, Italy, West Germany, Holland, Australia, England, Mexico, Israel, and India. It is thus a wellestablished form of cognitive-behavioral therapy.
MAJOR THEORETICAL CONCEPTS
REBT is based on a set of assumptions that stress the complexity and fluidity
of human beings. Given this fundamental view of human nature, REBT uses
the following theoretical concepts.
Goals, Purposes, and Rationality
According to REBT theory, humans are happiest when they establish important life goals and purposes and actively strive to attain these. It is argued that,
in establishing and pursuing these goals and purposes, human beings had better mind the fact that they live in a social world and that a philosophy of selfinterest, where a person places him or herself first, also implies putting others
a close second. This is in contrast to a philosophy of selfishness, where the
desires of others are neither respected nor regarded. Given that humans will
tend to be goal-directed, rational in REBT theory means "that which helps
people to achieve their basic goals and purposes, whereas 'irrational' means
that which prevents them from achieving these goals and purposes" (Dryden,
1984c, p. 238). Thus, rationality is not defined in any absolute sense but is relative in nature.
Humanistic Emphasis
REBT does not pretend to be "purely" objective, scientific, or technique-centered but takes a definite humanistic-existential approach to human problems
and their basic solutions. It primarily deals with disturbed human evaluations,
emotions, and behaviors. It is rational and scientific but uses rationality and
science to enable humans to live and be happy. It is hedonistic, but it espouses
Tbt General Theory ofREBT
long-range instead of short-range hedonism so that people may achieve the
pleasure of the moment and of the future and may arrive at maximum freedom and discipline. It hypothesizes that probably nothing superhuman exists
and that devout belief in superhuman agencies tends to foster dependency
and increase emotional disturbance. It assumes that no humans, whatever
their antisocial or obnoxious behavior, are damnable nor subhuman. It particularly emphasizes the importance of will and choice in human affairs, even
though it accepts the likelihood that some human behavior is partially determined by biological, social, and other forces (Bandura, 1986; Ellis, 1973,
1988,1994c, 1996a).
The Interaction of Psychological Processes
and the Place of Cognition
REBT theory has, from its inception, stressed an interactive view of human
psychological processes. Cognitions, emotions, and behaviors are not experienced in isolation and often, particularly in the realm of psychological disturbance, overlap to a significant degree. Recently, REBT has stressed the inferential nature of activating events and has shown how events (or more correctly,
how we perceive events) again interact with our cognitive evaluations, emotions, and behaviors (Ellis, 1994c, 1995a). This point will be amplified in the
section tided "The Revised ABCs ofREBT."
Given this interactional view, it is true, however, that REBT is most noted
for the special place it has accorded cognition in human psychological processes, particularly the role that evaluative thought plays in psychological
health and disturbance. One of REBT's unique contributions to the field of
cognitive-behavior therapy lies in its distinction between rational, and irrational Beliefs. Rational Beliefs are evaluative cognitions of personal significance that are preferential (i.e., nonabsolute) in nature. They are expressed
in the form of "desires," "preferences," "wishes," "likes," and "dislikes." People experience positive feelings of pleasure and satisfaction when they get
what they desire and experience negative feelings of displeasure and dissatisfaction (e.g., sadness, concern, regret, annoyance) when they do not get what
they desire. These negative feelings (the strength of which is closely related
to the importance of the desire) are regarded as healthy responses to negative
events and do not significantly interfere with the pursuit of established or new
goals and purposes. These Beliefs, then, are "rational" in two respects. First,
they are flexible, and second, they do not impede the attainment of basic goals
and purposes.
Irrational Beliefs, on the other hand, differ in two respects from Rational
Beliefs. First, they tend to be absolute (or dogmatic) and are expressed in the
form of rigid "mustV "should's," "ought's," "have-to's," etc. Second, they lead
to negative emotions that largely interfere with goal pursuit and attainment
The Practice ofSEBT
(e.g., depression, anxiety, guilt, anger). Healthy Beliefs strongly tend to underlie functional behaviors, whereas unhealthy Beliefs underpin dysfunctional
behaviors such as withdrawal, procrastination, alcoholism, and substance abuse
(Ellis & Knaus, 1977; Ellis, Mclnerney, DiGiuseppe, & Yeager, 1988; Ellis &
Velten, 1992).
Two Basic Biological Tendencies
Unlike most other theories of therapy, which stress the impact of significant
life events on the development of psychological disturbance, REBT theory
hypothesizes that the biological tendency of humans to think irrationally and
dysfunctionally has a notable impact on such disturbance. Its view that irrational and dysfunctional thinking is heavily determined by biological factors
(always interacting with influential environmental conditions) rests on the
seeming ease with which humans think crookedly and the prevalence of such
thinking even among people who have been "rationally" raised (Ellis, 1976a).
While I (AE) have acknowledged that there are social influences operating
here, I have also noted that even if everybody had had the most rational
upbringing, virtually all humans would often irrationally change their individual and social preferences into absolutistic demands on (a) themselves, (b)
other people, and (c) the universe around them (Ellis, 1985a, 1988,1994c).
The following constitutes evidence in favor of REBT's hypothesis of the
biological basis of human irrationality:
1. Virtually all humans, including bright and competent people, show evidence of major human irrationalities and self-defeatism.
2. Virtually all me disturbance-creating irrationalities (absolutistic shoulds and
musts) mat are found in our society are also found in just about all social and
cultural groups that have been studied historically and anthropologically.
3. Many of the self-destructive behaviors that we engage in, such as procrastination and lack of self-discipline, go counter to the teachings of parents, peers, and the mass media.
4. Humans—even bright and intelligent people—often adopt new irrationalities after giving up previous ones.
5. People who vigorously oppose various irrational behaviors often fall prey
to these very irrationalities. Atheists and agnostics exhibit zealous and
absolutistic philosophies, and highly religious individuals act immorally.
6. Insight into irrational thoughts, feelings, and behaviors helps only partially
to change them. For example, people can acknowledge that drinking alcohol in large quantities is harmful, yet this knowledge does not necessarily
help them abstain from heavy drinking.
7. Humans often fall back to self-defeating habits and behavioral patterns
even though they have often worked hard to overcome them.
The General Theory of REST
8. People often find it easier to learn self-defeating than self-enhancing
behaviors. Thus, they very easily overeat but have great trouble following
a sensible diet.
9. Psychotherapists who presumably should preferably be good role models
of rationality often act irrationally in their personal and professional lives.
10. People frequently delude themselves into believing that certain bad experiences (e.g., divorce, stress, and other misfortunes) can never happen to
them (Ellis, 1976a, 1979e, 1994c).
However, REBT holds that humans have a second constructivist biological
tendency, namely, to exercise the power of human choice and to work toward
changing their dysfunctional thinking and acting. Thus, they have (1) the ability to see that they make themselves disturbed by the irrational views they
bring to situations, (2) the ability to see that they can change their thinking,
and, most important, (3) the ability to actively and continually work toward
changing this thinking and behaving by the application of cognitive, emotive,
and behavioral methods. While REBT theory asserts that humans have a
strong biological tendency to think dysfunctionally (as well as functionally), it
holds that they are by no means slaves to this tendency and can transcend
(although not fully) its effects. In the final analysis, then, the REBT image of
the person is quite an optimistic one (Dryden, 1994a, 199Sb, 1995c;.Ellis,
1973,1994c, 1996a; Ellis & Bernard, 1983,1985; Kelly, 1955;Mahoney, 1991).
Two Fundamental Human Disturbances
According to REBT, humans easily make absolute demands on themselves, other
people, and the world. However, if these demands are more closely investigated, they can be seen to fall into two major categories of psychological disturbance: ego disturbance and discomfort disturbance (Ellis, I979a, 1980a,
1994c, 1996a).
In ego disturbance a person makes demands on self, others, and the world;
and if these demands are not met in the past, present, or future, the person
becomes disturbed by damning "self." As I (WD) have shown, self-damnation
involves (1) the process of giving my "self" a global negative rating and (2)
"devil-ifying" my "self as being bad or less worthy (Dryden, 1984b). The
rational and healthy alternative to self-damnation is unconditional self-acceptance (USA), which involves refusing to give one's "self a single rating
(because it is an impossible task due to one's complexity and fluidity and
because it normally interferes with attaining one's basic goals and purposes)
and acknowledging one's fallibility.
In discomfort disturbance or low frustration tolerance (LFT), the person
again makes demands on self, others, and the world that are related to dogmatic commands that comfort and comfortable life conditions must exist.
The Practice of REBT
When these demands are not met in the past, present, or future, the person
feels disturbed and tends to mvfulize and create I-can't-stand-it-itis. Tolerating
discomfort in order to aid goal attainment and long-range happiness is the
healthy and rational alternative to demands for immediate gratification.
Thus, as will be shown later, self-acceptance and a high level of frustration
tolerance are two of the main cornerstones of the rational-emotive image of
the psychologically healthy human being (Ellis, 1979e, 1994c, 1996a).
THE REVISED ABCS OF REBT
When REBT was originally established, I (AE) employed a simple ABC assessment framework to conceptualize clients' psychological problems (Ellis, 1962).
In this schema, "A" stood for the Activating event, "B" represented a person's
Belief about that event, and "C" denoted the person's emotional and behavioral responses, or Consequences, to holding the particular Beliefs at "B." The
major advantage of the ABC framework lay in its simplicity. However, its simplicity was also a disadvantage in that important distinctions between different types of cognitive activity were glossed over (Wessler & Wessler, 1980). It
is important to note that different REBT therapists use different expanded
versions of the original ABC framework (cf. Ellis, 1985c; Wessler & Wessler,
1980). There is thus no absolutely correct way of conceptualizing clients' problems according to such an expanded schema. What is presented below is one
version of the revised ABC framework (Ellis, 198Sb, 1994c).
Activating Events or Activators (A's) of Cognitive,
Emotional, and Behavioral Consequences (C's)
The REBT theory of personality and personality disturbances begins with
people trying to fulfill their Goals (G's) in some kind of environment and
encountering a set of Activating events or Activators (A's) that tend to help
them achieve or block these Goals. The A's they encounter usually are present or current events or their own thoughts, feelings, or behaviors about these
events, but they may be embedded in memories or thoughts (conscious or
unconscious) about past experiences. People are prone to seek out and
respond to these As because of (1) their biological or genetic predispositions,
(2) their constitutional history, (3) their prior interpersonal and social learning, and (4) their innately predisposed and acquired habit patterns (Ellis,
1976a, 1979e, 1983b, 1994c).
Afc (Activating events) virtually never exist in a pure or monolithic state; they
almost always interact with and partly include B's and C's. People bring themselves (their goals, thoughts, desires, and physiological propensities) to A!s.
Beliefs about Activating Events
According to REBT theory, people have almost innumerable Beliefs (B's)—
cognitions, thoughts, or ideas—about their Activating events (Afc); and these
B's importantly exert strong influences on their cognitive, emotional, and
behavioral Consequences (C's). Although A% often seem to directly "cause" or
contribute to C's, this is rarely true, because B's normally serve as important
mediators between A5s and C's and therefore more directly "cause" or "create"
C's (Bard, 1980; Ellis, 1962,1994c, Goldfried & Davison, 1994; Grieger &
Boyd, 1980; Wessler & Wessler, 1980). People largely bring their Beliefs to A;
and they prejudicially view or experience A's in the light of these biased Beliefs
(expectations, evaluations) and also in the light of their emotional Consequences (C's). Therefore, humans virtually never experience A without B and
C, but they also rarely experience B and C without A.
B's take many different forms because people have many kinds of cognitions.
In REBT, however, we are mainly interested in their rational Beliefs (RBs),
which, we hypothesize, lead to their self-helping behaviors, and in their irrational Beliefs (IBs), which, we theorize, lead to their self-defeating (and societal-defeating) behaviors. We can list some of the main (but not the only) lands
of B's as follows:
Nonevaluative Observations Example: "(I see)... the man is walking."
Such observations do not go beyond the available data. They are nonevaluative because they are not relevant to our goals. When such observations are
relevant to our goals, they become evaluative; for example, when the man walking is my father, who has just recovered from a car accident. The evaluative
aspects of such "evaluative observations" are often implicit—for example, "(I
am pleased that)... the man is walking."
Nonevaluative Inferences Example: "The man who is walking is going to
the post office." Such cognitions are called "inferences" because they go beyond
the available data. All we are able to observe in this example is a man walking
in a certain direction. Although he is proceeding in the direction of the post
office, he may or may not be "going to the post office." As such, inferences may
be viewed as hypotheses about our observations that may or may not be correct. These inferences are nonevaluative when they are not relevant to our
goals. When such inferences are relevant to our goals, they become evaluative—
for example, when the man who may be going to the post office will bring us
back our birthday parcels (if indeed he does make such a visit). The evaluative
aspects of such "evaluative inferences" are again often implicit—for example,
"(it is good that)... the man who is walking is going to the post office."
It is helpful to realize, for assessment purposes, that inferences are frequently chained together (Moore, 1983) and that it is often important to find
the most relevant inference in the chain, that is, the one that overlaps with
the person's "musturbatory" evaluations (i.e., events that are dogmatic in
nature and couched in the form of must's, should's, ought's, and have-to's, etc.)
Thus, if a client reports experiencing anger at his wife for forgetting the shopping, shopping may not actually be the "event" that triggers his anger-producing evaluations. The inference chain may be revealed thus: wife forgets
shopping -» I will mention this to her -» she will nag me -»I won't be able
to watch the football game on TV in peace. Any of these inferences may trigger anger-creating evaluations, and it is often important to involve clients as
fully as possible in the assessment process by asking questions to help them
provide reliable information concerning their most relevant inferences in particular chains.
Positive Preferential Evaluations Example: "I prefer people to approve of
me" or "I like people to approve of me ... (but they do not have to)." These
cognitions are termed "positive preferential evaluations" because (1) they are
flexible and nonabsolute (statements like "but they do not have to" are rarely
stated but are implicit in such cognitions), and (2) they refer to what the person evaluates as positive—"people approving of me." They are often termed
"rational" in REBT theory because they tend to aid and abet a person's basic
goals and purposes.
Let us assume that a man who holds the Belief "I prefer people to approve
of me" observes a group of people laughing and infers that they are laughing
•with him. This person may conclude the following based on the positive preferential evaluation that he likes approval and the inference that they are laughing with him:
"(I presume)... they think I am funny."
"(I presume)... they like me."
"(I presume)... their liking me has real advantages."
These cognitions are all positive, nonabsolute inferences because (1) they
go beyond the available data, (2) they are relevant to the person's goal (he is
getting what he values), and (3) they are not held with absolute conviction.
"My ability to make them laugh is good."
"It's pleasant to hear them enjoy themselves."
The latter are both positive, nonabsolute evaluations because this man is
appraising his ability to make them laugh and their pleasure at laughing in a
positive but relative manner.
Positive Musturbatory Evaluations Example: "I must have people approve
of me." Such cognitions are termed "positive musturbatory evaluations"
The General Tktory ofBEBT
because they are absolute and dogmatic and they refer to what the person evaluates as positive in a devout manner. They are often termed "irrational" in
REBT theory in that they tend to impede and inhibit a person from achieving his or her other basic goals and purposes.
Let us again assume that a group of people are laughing with a man and presumably like him. He may conclude the following based on his positive musturbatory evaluations. Thinking errors are categorized in parentheses:
"I am a great, noble person!" (overgeneralization)
"My life will be completely wonderful!" (overgeneralization)
"I deserve to have only fine and wonderful things happen to me!"
(demandingness and deification)
These are all positive, absolute evaluations. The evaluations of T and die
world are positive and grossly exaggerated.
"I am sure they will always like me." (delusions of certainty)
"I am convinced that I will always please them." (delusions of certainty)
The latter are both positive, absolute inferences because (1) they go beyond
the data at hand, (2) they are positively relevant to the person's goal, and (3)
they are held with absolute conviction.
Negative Preferential Evaluations Example: "I prefer people not to disapprove of me ..." or "I dislike people disapproving of me ... (but there's no
reason why they must not disapprove of me)." These cognitions are termed
"negative preferential evaluations" because, once again, (1) they are flexible
and nonabsolute (statements like "but therefc no reason why they must not..."
are also rarely stated but are again implicit in such Beliefs); and (2) they refer
to what the person evaluates as negative—"people disapproving of me." They
are also termed "rational" in REBT theory because they tend to aid and abet a
person's basic goals and purposes.
This time let us assume that a man who holds the Belief "I prefer people
not to disapprove of me" observes a group of people laughing but infers that
they are laughing at him. This man may conclude the following based on the
negative preferential evaluations:
"(I presume) ... they think I am stupid."
"(I presume)... they don't like me."
"(I presume) ... that their not liking me has real disadvantages."
These are all negative nonabsolute inferences because (1) they go beyond
the data at hand, (2) they are relevant to the person's goal (he is getting what
he dislikes), and (3) they are not held with absolute conviction.
This man may further conclude:
"It's unfortunate that they are laughing at me."
"It would be bad if I have some unfortunate trait,"
These are both negative, nonabsolute evaluations. The evaluations of his
"situation" and of his "unfortunate trait" are negative and nondevout (i.e., not
absolutistic).
Negative Musturbatory Evaluations Example: "I must not have people disapprove of me." Such cognitions are termed "negative musturbatory evaluations" because (1) they are absolute and dogmatic and (2) they refer to what
the person evaluates as negative in a devout manner. They are further examples of irrational Beliefs in that they tend to impede the achievement of a person's basic goals and purposes.
If we assume again that a group of people are laughing at a man and presumably disapprove of him, he may conclude the following based on the above
negative musturbatory evaluations. Again, the categories of thinking errors are
listed in brackets.
"I am an incompetent, rotten person!" (overgeneralization, self-downing)
"My life will be completely miserable!" (overgeneralization, awfulizing)
"The world is a totally crummy place!" (overgeneralization, awfulizing)
"I deserve to have only bad or good things happen to me!" (demandingness and damnation)
"This is awful, horrible, and terrible!" (awfulizing)
"I can't bear it!" (I-can't-stand-it-itis)
These are all examples of negative absolute evaluations. The people and
things appraised are all evaluated in a negative and grossly exaggerated manner.
"I will always act incompetently and have significant people disapprove
of me." (overgeneralization)
"They know that I am no good and will always be incompetent." (non
sequitur, jumping to conclusions, mind reading)
"They will keep laughing at me and will always despise me." (non
sequitur, jumping to conclusions, fortune-telling)
"They only despise me and see nothing good in me." (focusing on the
negative, overgeneraiization)
"When they laugh with me and see me favorably, that is only because they
are in a good mood and do not see that I am fooling them." (disqualifying the positive, non sequitur, phonyism)
"Their laughing at me and disliking me will definitely make me lose my
job and lose all my friends." (catastrophizing, magnification)
"They could only be laughing because of some foolish thing I have done
and could not possible be laughing for any other reason." (personalizing, non sequitur, overgeneralizadon)
The above seven are all examples of negative absolute inferences because
(1) they go beyond the data at hand, (2) they tend to sabotage the person's goal,
and (3) they are held with absolute conviction.
Consequences (C's) of Activating Events (A's)
and Beliefs (B's) about A's
C's (cognitive, affective, and behavioral Consequences) follow from the interaction of A's and B's. We can say, mathematically, that A x B=C, but this formula may actually be too simple, and we may require a more complex one
to express the relationship adequately. C is almost always significantly
affected or influenced but not exactly "caused" by A, because humans naturally react to some degree to stimuli in their environments. Moreover, when
A is powerful (e.g., a set of starvation conditions or an earthquake), it tends
to affect C profoundly.
When C consists of emotional disturbance (e.g., severe feelings of anxiety,
depression, hostility, self-deprecation, and self-pity), B usually (but not always)
mainly or more directly creates or "causes" C. Emotional disturbance, however, may at times stem from powerful A!s—for example, from environmental
disasters such as floods or wars. Emotional disturbance may also follow from
factors in the organism—for example, hormonal, disease, or biochemical factors—that are somewhat independent of, yet may actually "cause" C's.
When strong or unusual A5s significantly contribute to or "cause" C's or
when physiological factors "create" C's, they are usually accompanied by contributory B's too. Thus, if people are caught in an earthquake or if they experience powerful biological changes and they "therefore" become depressed,
their As and their physiological processes probably are strongly influencing
them to create irrational Beliefs (IB's), such as, "This earthquake shouldn't have
occurred! Isn't it awful! I can't stand it!" These IB's, in turn, add to or help create their feelings of depression at C.
C's usually consist of feelings and behaviors but may also consist of thoughts
(e.g., obsessions). C's (Consequences) that follow from AJs and B's are virtually
never pure or monolithic but also partially include and inevitably interact with
A and B. Thus if A is an obnoxious event (e.g., a job refusal) and B is, first, a
rational Belief (e.g., "I hope I don't get rejected for this job!") as well as, second, an irrational Belief (e.g., "I must have this job! I'm no good if I don't get
it"), C tends to be, first, healthy feelings of frustration and disappointment and,
second, unhealthy feelings of severe anxiety, inadequacy, and depression.
So A x B-C. But people also bring feelings (as well as hopes, goals, and
purposes) to A. They would not keep a job unless they desired or favorably
evaluated it or unless they enjoyed some aspect of it. Their A therefore partially includes their B and C. The three, from the beginning, are related
rather than completely disparate.
At the same time, people's Beliefs (B's) also partly or intrinsically relate to
and include their Afe and their C's. Thus, if they tell themselves, at B, "I want
to get a good job," diey partly create the Activating event at A (going for a job
interview), and they partly create their emotional and behavioral Consequences
at C (feeling disappointed when they encounter a job rejection). Without their
evaluating a job as good they would not try for it nor have any particular feeling about being rejected.
A, B, and C, then, are all closely related, and none of them tends to exist
without the other.
THE NATURE OF PSYCHOLOGICAL
DISTURBANCE AND HEALTH
Psychological Disturbance
Rational emotive behavioral theory, then, posits that at the heart of neurotic
disturbance lies the tendency of humans to make devout, absolutistic evaluations of the perceived events in their lives. As has been shown, these evaluations are couched in the form of dogmatic "must's," "should's," "have to's,"
"got to's," and "ought's." We hypothesize that these absolutistic cognitions are
at the core of a philosophy of devout Beliefs that is a central feature of much
human emotional and behavioral disturbance (cf. Ellis, 1991b, 1991c, 1995a).
These Beliefs are deemed to be irrational in REBT theory in that they usually
(but not invariably) impede and obstruct people in the pursuit of their basic
goals and purposes. Absolutist must's do not invariably lead to psychological
disturbance because it is possible for a person to devoutly believe "I must succeed at all important projects," have confidence that he or she will be successful in these respects, and actually succeed in them and thereby not experience
psychological disturbance. However, the person remains vulnerable in this
respect because there is always the possibility that he or she may fail in the
future. So although on probabilistic grounds REBT theory argues that an
absolutistic philosophy will frequently lead to such disturbance, it does not
claim that this is absolutely so. Thus, even with respect to its view of die nature
of human disturbance REBT adopts an antiabsolutistic position
REBT theory goes on to posit that if humans adhere to a philosophy of
"musturbation" they will strongly tend to make a number of core irrational
conclusions that are deemed to be derivatives of these "must's." These major
derivatives are viewed as irrational because they too tend to sabotage a person's basic goals and purposes.
The first major derivative is known as "awftilizing." This occurs when a perceived event is rated as being more than 100% bad—a truly exaggerated and
magical conclusion that stems from the Belief: "This must not be as bad as it is."
The second major derivative is known as "I-can't-stand-it-itis." This
means believing that one cannot experience virtually any happiness at all,
under any conditions, if an event that "must" not happen actually occurs or
threatens to occur.
The third major derivative, known as "damnation," represents a tendency
for humans to rate themselves and other people as "subhuman" or "undeserving" if self or other does something that they "must" not do or fails to do something that they "must" do. "Damnation" can also be applied to world or life
conditions that are rated as being "rotten" for failing to give the person what
he or she "must" have.
Although REBT holds that "awfulizing," "I-can't-stand-it-itis," and "damnation" are secondary irrational processes in that they tend to stem from the philosophy of "must's," these processes can sometimes be primary (Ellis, 1983b,
1994c, 199Sa). Indeed, Wessler (1984) has argued that they are more likely to
be primary and that "must's" are derived from them. However, the philosophy
of "mustfs," on the one hand, and those of "awfulizing," "I-can't-stand-it-itis,"
and "damnation," on the other, are in all probability interdependent processes
and often seem to be different sides of the same "cognitive" coin (Ellis, 1994c).
REBT notes that humans also make numerous kinds of illogicalities'when
they are disturbed (Ellis, 198Sc, 1994c). In this respect, REBT agrees with
cognitive therapists (Beck, Rush, Shaw, & Emery, 1979; Burns, 1980) that such
cognitive distortions are a feature of psychological disturbance. However,
REBT theory holds that such distortions almost always stem from the "must's."
Some of the most frequent of them are
1. AU-or-none thinking: "If I fail at any important task, as I must not, I'm a
total failure and completely unlovable!"
2. Jumping to conclusions and negative non sequiturs: "Since they have seen me
dismally fail, as I absolutely should not have done, they will view me as an
incompetent worm."
3. Fortune-telling; "Because they are laughing at me for failing, as I absolutely
should not have done, they will despise me forever."
4. Focusing on the negative: "Because I can't stand things going wrong, as they
must not, I can't see any good that is happening in my life."
5. Disqualifying the positive: "When they compliment me on the good things
I have done, they are only being kind to me and forgetting the foolish
things that I absolutely should not have done."
6. Allness and neverness: "Because conditions of living ought to be good and
actually are so bad and so intolerable, they'll always be this way and I'll
never have any happiness."
7. Minimization: "My good shots in this game were lucky and unimportant.
But my bad shots, which I absolutely should never have made, were as bad
as could be and were totally unforgivable."
8. Emotional reasoning: "Because I have performed so poorly, as I absolutely
should not have done, I feel like a total nincompoop, and my strong feeling proves that I am no damned good!"
9. Labeling and overgeneralization: "Because I must not fail at important work
and have done so, I am a complete loser and failure!"
10. Personalizing: "Since I am acting far worse than I absolutely should act and
they are laughing, I am sure they are only laughing at me, and that is
ffwfull"
11. Phonyism: "When I don't do as well as I ought to do and they still praise
and accept me, I am a real phony and will soon fall on my face and show
them how despicable I am!"
12. Perfectionism: "I realize that I did fairly well, but I absolutely should have done
perfectly well on a task like this and am therefore really an incompetent
person!"
Although REBT clinicians at times discover all the unrealistic and illogical
Beliefs just listed—and a number of others that are less frequently found with
clients—they particularly focus on the unconditional "should's," "ought's," and
"must's," that seem to constitute the philosophic core of irrational beliefs that
lead to emotional disturbance. They hold that if they do not get to and help
clients surrender these core Beliefs or underlying schemas, die clients will most
probably keep holding them and create new irrational derivatives from them.
REBT practitioners also particularly look for "awfulizing," "I-can't-standit-itis," and "damnation," and they show clients how these almost invariably
stem from their "must's" and can be surrendered if they give up their absolutistic demands on themselves, on other people, and on the universe. At the
same time, rational emotive behavior therapists usually encourage their clients
to have strong and persistent desires, wishes, and preferences, and to avoid
feelings of detachment, withdrawal, and lack of involvement (Ellis, 1972a,
1973, 1985c, 1991c, 1994c, 1996a).
More important, REBT holds that unrealistic and illogical beliefs do not
in themselves create emotional disturbance. Why? Because it is quite possible for people to unrealistically believe, "Because I frequently fail, I always
do"; and it is possible for them also to believe illogically, "Because I have frequently failed, I always will." But they can, in both instances, rationally conclude, "Too bad! Even though I always fail, there is no reason why I must
succeed. I would prefer to, but I never have to do well. So I'll manage to be as
happy as I can be even with my constantly failing." They would then rarely
be emotionally disturbed.
To reiterate, the essence of human emotional disturbance, according to
REBT, consists of the absolutistic "must's" and ''must not's" that people think
The General Theory of REBT
about their failure, about their rejections, about their poor treatment by others,
and about life's frustrations and losses. REBT therefore differs from other cognitive-behavioral therapies—such as those of Bandura (1986), Beck (1976),
Goldfried & Davison (1994), Janis (1983), Lazarus (1989), Mahoney (1991),
Maultsby (1984), and Meichenbaum (1992)—in that it particularly stresses
therapists looking for clients' dogmatic, unconditional "must's," differentiating them from their preferences, and teaching them how to surrender the former and retain the latter (Bernard, 1991; Dryden, 1994a, 1995b, 1995c; Ellis,
1962,1985c, 1994; Ellis & Becker, 1982; Ellis & Harper, 1975; Grieger &
Woods, 1993; Phadke, 1982; Walen, DiGiuseppe, & Dryden, 1992).
If the philosophy of musturbation is at the core of much psychological disturbance, then what philosophy is characteristic of psychological health? REBT
theory argues that a philosophy of relativism or "desiring" is a central feature
of psychologically healthy humans. This philosophy acknowledges that humans
have a large variety of desires, wishes, wants, preferences, and so forth; but if
they refuse to escalate these nonabsolute values into grandiose dogmas and
demands, they will become less psychologically disturbed. They will, however,
experience healthy negative emotions (e.g., sadness, regret, disappointment,
annoyance) when their desires are not fulfilled. These emotions are considered to have constructive motivational properties in that they both help people
to remove obstacles to goal attainment and help them to make constructive
adjustments when their desires cannot be met.
Three major derivatives of the philosophy of desiring are postulated by
rational emotive behavioral theory. They are deemed to be rational in that they
tend to help people reach their goals or formulate new goals if their old ones
cannot be realized.
The first major derivative of desiring, rating or evaluating badness (or antiawfulizing), is the rational alternative to "awfulizing." Here, if a person does
not get what she wants, she acknowledges that this is bad. However, because
she does not believe "I have to get what I want," she contains her evaluation
along a 0%-100% continuum of badness and therefore does not rate this situation as "awful"—a rating that is placed on an exaggerated level. In general,
when the person adheres to the desiring philosophy, the stronger her desire,
the greater her rating of badness will be when she does not get what she wants.
The second major derivative of desiring is known as tolerance and is the
rational alternative to "I-can't-stand-it-itis." Here the person (1) acknowledges
that an undesirable event has happened (or may happen), (2) believes that the
event should empirically occur if it does, (3) rates the event along the badness
continuum, (4) attempts to change the undesired event or accepts the "grim"
reality if it cannot be modified, and (5) actively pursues other goals even
though the situation cannot be altered.
The third major derivative, known as acceptance, is the rational alte ative
to "damnation." Here the person accepts herself and others as fallible humans
who do not have to act other than they do and as too complex and fluid to be
given any legitimate or global rating. In addition, life conditions are accepted
as they exist, People who have the philosophy of acceptance rally acknowledge
that the world is highly complex and exists according to laws that are often
outside their personal control. It is important to emphasize that acceptance
does not imply resignation. A rational philosophy of acceptance means that
the person acknowledges that whatever exists empirically should exist but does
not absolutely have to exist forever. This prompts the person to make active
attempts to change reality. The person who is resigned to a situation usually
does not attempt to modify it.
REBT theory also puts forward a number of criteria of psychological health.
These include the following:
1. Self-interest: Sensible and emotionally healthy people tend to be primarily interested in themselves and to put their own interests at least a little above
the interests of others. They sacrifice themselves to some degree for those for
whom they care but not overwhelmingly or completely.
2. Social interest: Social interest is usually rational and self-helping because
most people choose to live and enjoy themselves in a social group or community. If they do not act morally, protect the rights of others, and abet social survival, it is unlikely that they will create the kind of world in which they
themselves can live comfortably and happily.
3. Self-direction: Healthy people tend mainly to assume responsibility for
their own lives while simultaneously preferring to cooperate with others. They
do not need or demand considerable support or succoring from others, though
they may prefer and work for this.
4. High frustration tolerance: Rational individuals give both themselves and
others the right to be wrong. Even when they intensely dislike their own and
others' behavior, they refrain from damning themselves or others, as persons,
for unacceptable or obnoxious behavior. People who are not plagued with
debilitating emotional distress tend to go along with St. Francis and Reinhold
Niebuhr by changing obnoxious conditions they can change, accepting those
they cannot, and having the wisdom to know the difference between the two.
5. Flexibility: Healthy and mature individuals tend to be flexible in their
thinking, open to change, and unbigoted and pluralistic in their view of other
people. They do not make rigid, invariant rules for themselves and others.
6. Acceptance of uncertainty: Healthy men and women tend to acknowledge
and accept the idea that we seem to live in a world of probability and chance
where absolute certainties do not and probably never will exist. They realize
that it is often fascinating and exciting and definitely not horrible to live in this
kind of probabilistic and uncertain world. They enjoy a good degree of order
The General Theory of 'REBT
but do not demand to know exactly what die future will bring or what will happen to them.
7. Commitment to creative pursuits: Most people tend to be healdiier and happier when they are vitally absorbed in something outside themselves and
preferably have at least one powerful creative interest, as well as some major
human involvement, that diey consider so important that they structure a good
part of their life around it.
8. Scientific thinking: Nondisturbed individuals tend to be more objective,
realistic, and scientific than more disturbed ones. They are able to feel deeply
and act concertedly, but they tend to regulate their emotions and actions by
reflecting on them and evaluating their consequences in terms of the extent to
which they lead to the attainment of short-term and long-term goals.
9. Self-acceptance: Healthy people are usually glad to be alive and accept
themselves just because they are alive and have some capacity to enjoy themselves. They refuse to measure their intrinsic worth by their extrinsic achievements or by what others think of them. They frankly choose to have
unconditional self-acceptance (USA), and they try to avoid rating themselves—
their totality or their being. They attempt to enjoy rather than to prove themselves (Ellis, 1973, 1995a; Ellis & Harper, 1975; Hauck, 1991; Mills, 1993).
10. Risk-taking: Emotionally healthy people tend to take a fair amount of
risk and to try to do what they want to do, even when there is a good chance
that they may fail. They tend to be adventurous but not foolhardy.
11. Long-range hedonism: Well-adjusted people tend to seek both the pleasures of the moment and those of the future and do not often court future pain
for present gain. They are hedonistic, that is, happiness-seeking and painavoidant, but they assume that they will probably live for quite a few years and
that they had therefore better think of both today and tomorrow and not be
obsessed with immediate gratification.
12. Nonutopianism: Healthy people accept the fact that Utopias are probably
unachievable and that they are never likely to get everything they want and to
avoid all pain. They refuse to strive unrealistically for total joy, happiness, or
perfection or for total lack of anxiety, depression, self-downing, and hostility.
13. Self-responsibility for own emotional disturbance: Healthy individuals tend
to accept a great deal of responsibility for their own disturbance rather than
defensively blame others or social conditions for their self-defeating thoughts,
feelings, and behaviors.
Distinction between Healthy and
Unhealthy Negative Emotions
Rational emotive behavioral theory argues that people can hold rational and
irrational Beliefs at the same time. They can easily transmute their desires into
demands. Thus, I may rationally believe "I want you to love me" and simultaneously believe that "since I strongly want you to love me, you must do so."
Thus, it is important for therapists to discriminate between their clients' rational and irrational Beliefs. When such distinctions are made, it is easier to distinguish between helpful and unhelpful negative emotions. Healthy negative
emotions are deemed to be associated with rational Beliefs and unhealthy negative "emotions with irrational Beliefs. In the following, the healthy negative
emotion is listed first.
1. Concern verms anxiety. Concern is an emotion that is associated with the
Belief, "I hope that this threat does not happen, but if it does, it would be
unfortunate," whereas anxiety occurs when the person believes, "This threat
absolutely must not happen, and it would be awful if it does."
2. Sadness versus depression. Sadness is deemed to occur when the person
believes, "It is very unfortunate that I have experienced this loss, but there is
no reason why it should not have happened." Depression, on the other hand,
is associated with the Belief "This loss should not have occurred and it is terrible that it did." Here, when the person feels responsible for the loss, he will
tend to damn himself: "/ am no good," whereas if the loss is outside the person's control, he or she will tend to damn the world/life conditions: "It is terrible." As shown earlier, REBT theory holds that it is the philosophy of
masturbation implicit in such evaluations that leads the person to consider that
he will never get what he wants, an inference that leads to feelings of hopelessness. Example: "Because I must always get the things I really want and did
not get it this time, I'll never get it at all. It's hopeless!"
3. Regret versus guilt. Feelings of regret or remorse occur when a person
acknowledges that he has done something bad in public or private but accepts
himself as a fallible human being for doing so. The person feels badly about
the act or deed but not about himself because he holds the belief, "I prefer not
to act badly, but if I do, too bad!" Guilt occurs when the person damns himself as bad, wicked, or rotten for acting badly. Here, the person feels badly
about both the act and his "self because he holds the belief, "I must not act
badly, and if I do it's awful and I am a rotten person!"
4. Disappointment versus shame/embarrassment. Feelings of disappointment
occur when a person acts "stupidly" in public and acknowledges the stupid act
but accepts herself in the process. The person feels disappointed about her
action but not with herselfbecms& she prefers but does not demand that she act
well. Shame and embarrassment occur when the person recognizes that she
has acted "stupidly" in public and then condemns herself for acting in a way
that she absolutely should not have done. People who experience shame and
embarrassment often predict that the watching audience will think badly of
them, in which case they tend to agree with these perceived judgments. Thus,
they often believe that they absolutely need the approval of these others. Shame
can sometimes be distinguished from embarrassment in that the public "prat-
fall" is regarded by the person as more serious when she feels shame. However, both emotions involve self-denigration.
5, Annoyance versus anger. Annoyance occurs when another person disregards an individual's rule of living. The annoyed person does not like what the
other has done but does not damn him or her for doing it. Such a person tends
to believe, "I wish the other person did not do that, and I don't like what
he/she did, but it does not follow that he/she must not break my rule." In
anger, however, the person does believe that the other absolutely must not
break the rule and thus damns the other for doing so. REBT holds that it is
healthy to be angry at another's acts but not at the person for acting badly.
It should be noted that rational emotive behavioral therapists do not generally target healthy negative emotions for change during therapy because they
are deemed to be Consequences of rational thinking (Crawford & Ellis, 1989;
Ellis, 1994c, 1996a).
ACQUISITION AND PERPETUATION OF
Rational emotive behavioral theory does not put forward an elaborate view
concerning the acquisition of psychological disturbance. This partly follows
from the hypothesis that humans have a distinct biological tendency to think
and act irrationally but it also reflects the REBT viewpoint that theories of
acquisition do not necessarily suggest therapeutic interventions. REBT holds
that humans' tendencies toward irrational thinking are biologically rooted, but
it also acknowledges that environmental variables do contribute to psychological disturbance and thus encourage people to make their biologically influenced demands (Ellis, 1976a, 1979e, 1994c). Thus, parents and culture usually
teach children which superstitions, taboos, and prejudices to abide by, but they
do not originate their basic tendency toward superstitiousness, ritualism, and
bigotry (Ellis, 1991b, 1994c, 1995a).
Rational emotive behavioral theory also posits that humans vary in their disturbability. Some people emerge relatively unscathed psychologically from
being raised by uncaring or overprotective parents; others emerge emotionally damaged from "healthier" child-rearing regimens. In this respect, REBT
claims that individuals with serious aberrations are more innately predisposed
to have rigid and crooked thinking than are those with lesser aberrations and
that consequently they are likely to make lesser advances. Thus, the REBT
theory of acquisition can be summed up in the view that as humans we are not
disturbed simply by our experiences; rather, we bring our ability to disturb
ourselves to our experiences (Ellis, 1976a, 1994c, 1995a),
Although rational emotive behavioral theory does not posit an elaborate
view to explain the acquisition of psychological disturbance, it does deal more
extensively with how such disturbance is perpetuated. First, people tend to
maintain their psychological problems by their own naive theories concerning the nature of these problems and to what they can be attributed. They lack
what REBT calls REBT Insight No. 1: that psychological disturbance is often
primarily determined by the absoJutistic Beliefs that people hold about negative life events (B determines C). Rather, they consider that their disturbances
are mainly caused by these situations (A causes C). Because people make incorrect hypotheses about some of the major determinants of their problems, they
consequently attempt to change A rather than B. Second, people may have
Insight No. 1 but lack REBT Insight No. 2: that people remain disturbed by
reindoctrinating themselves in the present with their absolutistic Beliefs.
Although they may see that their problems are largely determined by their
Beliefs, they may distract themselves and thus perpetuate their problems by
searching for the historical antecedents of these Beliefs instead of directing
themselves to change them as currently held. Third, people may have Insights
No. 1 and No. 2 but still sustain their disturbance because they lack REBT
Insight No. 3: that only if they diligently work and practice in the present as
well as in the future to think, feel, and act against their irrational beliefs are
they likely to change them and make themselves significantly less disturbed.
People who have all three insights clearly see that they had better persistently
and strongly challenge their destructive beliefs cognitively, emotively, and
behaviorally to break the perpetuation of the disturbance cycle. Merely
acknowledging that a Belief is irrational is usually insufficient to effect change
(Ellis, 1962,1979e, 1994c, 1996a).
REBT contends that a major reason that people perpetuate their psychological problems is that they adhere to a philosophy of 'law frustration tolerance (LFT)
(Ellis, 1979a, 1980a). Such people believe that they must be comfortable and thus
do not work to effect change because such work involves experiencing discomfort. They are short-range hedonists in that they are motivated to avoid shortterm discomfort, even though accepting and working against their temporary
uncomfortable feelings would probably help them to reach their long-range
goals. Such people rate cognitive and behavioral therapeutic tasks as too painful,
even more painful than the psychological disturbance to which they have
achieved some measure of habituadon. They prefer to remain with their "comfortable11 discomfort rather than face the change-related discomfort that they
believe they must not experience. Maultsby (1984) has argued that people often
back away from change because they are afraid that they will not feel right about
it. He calls this the "neurotic fear of feeling a phony" and actively shows clients
that these feelings of "unnaturalness" are natural concomitants of relearning.
Another prevalent form of LFT is "anxiety about anxiety." Here, individuals
believe that they must not be anxious and thus do not expose themselves to anxiety-provoking situations because they might become anxious if they did so—an
experience they would rate as "awful." As such, they perpetuate their problems
and overly restrict their lives to avoid experiencing anxiety.
Anxiety about anxiety constitutes an example of the clinical fact that people
often make themselves disturbed about their disturbances. Having created secondary (and sometimes tertiary) disturbances about their original disturbance,
they become preoccupied with these "problems about problems" and thus find
it difficult to get back to solving the original problem. Humans are often very
inventive in this respect. They can make themselves depressed about their
depression, guilty about being angry (as well as anxious about their anxiety),
and so on. Consequently, people often had better tackle their disturbances
about their disturbances before they can successfully solve their original problems (Ellis, 1979a, 1980a, 1993,1994c, 1996).
REBT theory endorses the Freudian view of human defensiveness in
explaining how people perpetuate their psychological problems (A. Freud,
1937). Thus, people maintain their problems by employing various defense
mechanisms (e.g., rationalization, avoidance) that are designed to help deny
the existence of these problems or to minimize their severity. The REBT view
is that these defenses are often used to ward off self-damnation tendencies and
that under such circumstances, if these people were to honestly take responsibility for their problems, they would tend to severely denigrate themselves for
having them. In addition, these defense mechanisms are also employed to ward
off discomfort anxiety, because if such people admitted their problems, they
would rate them as "too hard to bear" or "too difficult to overcome."
I (AE) have noted that people sometimes experience a form of perceived payoff for their psychological problems other than avoidance of discomfort (Ellis,
1979e). The existence of such payofis serves to perpetuate these problems. Thus,
a woman who claims to want to overcome her procrastination may avoid tackling the problem because she is afraid that should she become successful she
might then be criticized by others as being "too masculine," a situation she would
evaluate as "awful." Her procrastination serves to protect her (in her mind) from
this "terrible" state of affairs. I (WD) have noted that "rational emotive behavior therapists stress the phenomenological nature of these payoffs, i.e., it is the
person's view of the payoff that is important in determining its impact, not the
events delineated in the person's description" (Dryden, 1984c, p. 244).
Finally, the well-documented "self-fulfilling prophecy" phenomenon helps to
explain why people perpetuate their psychological problems. Here, people act
according to their evaluations and consequent predictions and thus often elicit
from themselves or from others responses that they then interpret in a manner
that confirms their initial hypotheses. Thus, a socially anxious man may believe
that other people would not want to get to know "a worthless individual such as
I truly am." He then attends a social function and acts as if he were worthless,
avoiding eye contact and keeping away from others. Unsurprisingly, such social
behavior does not invite approaches from others, a lack of response that he interprets and evaluates thus: "You see, I was right. Other people don't want to know
me. I really am no good."
In conclusion, REBT theory holds that people "naturally tend to perpetuate
their problems and have a strong innate tendency to cling to self-defeating,
habitual patterns and thereby resist basic change. Helping clients change, then,
poses quite a challenge for REBT practitioners" (Dryden, 1984c, pp. 244-245).
THE THEORY OF THERAPEUTIC CHANGE
We have argued that the rational emotive behavioral view of the person is basically an optimistic one: although it posits that humans have a distinct biological tendency to think irrationally, it also holds that they have the constructive
capacity to choose to work toward changing this irrational thinking and its selfdefeating effects.
There are various levels of change. REBT theory holds that the most elegant and long-lasting changes that humans can effect are ones that involve
philosophic restructuring of irrational Beliefs. Change at this level can be specific or general. Specific philosophic change means that individuals change
their absolutistic demands ("must's," "should's") about given situations to rational relative preferences. General philosophic change involves people adopting
a nondevout attitude toward life events in general.
To effect a philosophic change at either the specific or general level, people
are advised to
1. First, realize that they create, to a large degree, their own psychological
disturbances and that although environmental conditions can significantly
contribute to their problems they are usually of secondary consideration in
the change process.
2. Fully recognize that they do have the ability to significantly change their
own disturbances.
3. Understand that emotional and behavioral disturbances stem largely from
irrational, absolutistic, dogmatic Beliefs.
4. Detect their irrational beliefs and discriminate them from their rational
5. Dispute these irrational beliefs, using realistic, logical, and heuristic methods and by feeling and acting against them.
6. Work toward the internalization of their new, effective Beliefs by employing a number of cognitive, emotive, and behavioral methods of change.
7. Continue this process of challenging irrational Beliefs and using multimodal methods of change for the rest of their lives.
When people effect a philosophic change at B in the ABC model of REBT,
they often are able to spontaneously correct their distorted inferences of reality (overgeneralizations, faulty attributions, etc.). However, they can often ben-
efit from challenging these distorted inferences more directly, as REBT has
always emphasized (Ellis, 1962,1971a, 1973, 1994c, 1996a; Ellis & Harper,
1961a, 1961b) and as Beck (Beck et al., 1979) and other cognitive therapists
have also stressed (Maultsby, 1984; Meichenbaum, 1992).
Although rational emotive behavioral theory argues that irrational beliefs
are the breeding ground for the development and maintenance of inferential
distortions, it is possible for people to effect inferentially based changes without making a profound philosophic change. Thus, they may regard their inferences or "automatic thoughts" as hunches about reality rather than facts, may
generate alternative hypotheses, and may seek evidence and/or carry out experiments that test each hypothesis, They may then accept the hypothesis that
represents the "best bet" of those available.
Consider a man who thinks that his co-workers view him as a fool. To test
this hypothesis he might first specify their negative reactions to him. These
constitute the data from which he too quickly draws the conclusion, "They
think I'm a fool." He might then realize that what he has interpreted to be
negative responses to him might not be negative. If they seem to be negative,
he might then carry out an experiment to test the meaning he attributes to his
co-workers' responses. Thus, he might enlist the help of a colleague whom he
trusts to carry out a "secret ballot" of odiers' opinions of him. Or he could test
his hunch more explicitly by directly asking them for their view of him.
As a result of these strategies this person may conclude that his co-workers find some of his actions foolish rather than considering him to be a complete fool. His mood may lift because his inference about the situation has
changed, but he may still believe, "If others think I'm a fool, they're right, I
am a fool and that would be awful." Thus, he has made an inferential change
but not a philosophic one. If this person were to attempt to make a philosophic change, he would first assume that his inference was true, then address
himself to his evaluations about this inference and hence challenge these if
they were discovered to be irrational (i.e., musturbatory evaluations). Thus,
he might conclude, "Even if I act foolishly, that makes me & person with foolish behavior, not a foolish person. And even if they deem me a total idiot, that
is simply their view, with which I can choose to disagree." REBT therapists
hypothesize that people are more likely to make a profound philosophic
change if they first assume that their inferences are true and then challenge
their irrational Beliefs, rather than if they first correct their inferential distortions and then challenge their underlying irrational Beliefs. However, this
hypothesis awaits full empirical inquiry.
People can also make direct changes of the situation at A (Activating event).
Thus, in the example quoted above, the man could leave his job or distract
himself from the reactions of his colleagues by taking on extra work and devoting himself to that. Or he might carry out relaxation exercises whenever he
comes in contact widi his co-workers and thus distract himself once again from
their perceived reactions. Additionally, the man might have a word with his
supervisor, who might then instruct the other workers to change their behavior toward the man.
When we use the REBT model to consider behavioral change, it is apparent that a person can change his or her behavior to effect inferential and/or
philosophic change. Thus, again using the above example, a man whose coworkers view him as a fool might change his own behavior toward them and
thus elicit a different set of responses from them that would lead him to reinterpret his previous inference (behavior change to effect inferential change).
However, if it could be determined that they did indeed consider him to be a
fool, then the man could actively seek them out and show himself that he could
stand their disapproval and that just because they think him a fool does not
make him one. He would thus learn to accept himself in the face of people's
views while exposing himself to their negative reactions (behavior change to
help effect philosophic change).
While REBT therapists prefer to help their clients make profound philosophic changes at B, they do not dogmatically insist that their clients make such
changes. If it becomes apparent that clients cannot or will not, at any given time,
change their irrational Beliefs, then REBT therapists endeavor to help them
either to change A direcdy (by avoiding the troublesome situation or by behaving differently) or to change their distorted inferences about the situation.
In the next chapter we build upon these theoretical underpinnings and consider the basic practice ofREBT.
The Basic Practice of REBT
In this chapter we outline the basic practice of REBT. First, we consider
aspects of the therapeutic relationship between clients and therapists in REBT.
Second, we deal with issues pertaining to inducting clients into REBT and
assessing their problems in REBT terms. Third, we specify basic treatment
strategies in REBT. Fourth, we specify the major treatment techniques that
are employed during REBT. Fifth, we note a number of obstacles that emerge
in the process of REBT and how they might be overcome. Finally, we distinguish between preferential and general REBT (or cognitive-behavior therapy
[CBT]) and specify their differences.
THE THERAPEUTIC RELATIONSHIP
REBT is an active-directive form of psychotherapy in that therapists are active
in directing their clients to identify the philosophical source of their psychological problems and in showing them they can challenge and change their
irrational musturbatory evaluations. As such, REBT is an educational form of
therapy. I (AE) have sometimes conceptualized the role of the effective REBT
therapist as that of an authoritative (but not authoritarian!) and encouraging
teacher who strives to teach his or her clients how to be their own therapists
once formal therapy sessions have ended (Ellis, 1979c, 1994d, 199Sa, 1996a).
Therapeutic Conditions
Given the above role, REBT therapists strive to unconditionally accept their
clients as fallible human beings who often act self-defeatingly but are never
Parts of this chapter were adapted from Dryden and Ellis (1986) and W. Dryden and A, Ellis,
"Rational-Emotive Therapy," in K, S. Dobson (Ed.), Handbook of Cognitive-Behavioral Therapies;
New York: Guilford, 1987 (used by permission), and have been previously published in The Nurse
Practitioner. Tht American Journal of Primary Health Ctrt, 12(7), July 1987.
essentially bad (or good). No matter how badly clients behave in therapy, the
REBT therapist attempts to accept them as people but will frequently, if appropriate, let them know his or her reactions to the client's negative behavior
(Ellis, 1973,1994c, 1996a, I996b; Woods & Ellis, 1996).
In our role as therapists we strive to be as open as therapeutically feasible
and will not hesitate to give highly personal information about ourselves should
our clients ask for it, except when we judge that clients would use such information against themselves. REBT therapists often disclose examples from their
own lives concerning how they experienced similar problems and, more important, how they have gone about solving these problems. Thus, they strive to
be therapeutically genuine in conducting sessions.
REBT therapists tend to be appropriately humorous with most of their clients
because they think that much emotional disturbance stems from the fact that
clients take themselves and their problems, other people, and the world too
seriously. They thus strive to model for their clients the therapeutic advantages of taking a serious but humorously ironic attitude to life. They endeavor,
however, not to poke fun at the clients themselves but at their self-defeating
thoughts, feelings, and actions (Ellis, I977b, 1977c, 1981,1987b). In the same
vein, and for similar purposes, REBT therapists tend to be informal and easygoing with most of their clients. However, REBT opposes therapists unethically indulging themselves in order to enjoy therapy sessions at their clients'
expense (Ellis, 1985c, 1996a, I99<5b).
REBT therapists show their clients a special kind of empathy. They not only
offer them "affective" empathy (i.e., communicating that they understand how
their clients feel) but also offer them philosophic empathy (i.e., showing them
that they understand the philosophies that underlie these feelings).
Thus, with certain modifications, they agree with Rogers's (1961) views concerning therapist empathy, genuineness, and unconditional positive regard. However, REBT therapists are wary of showing the vast majority of their clients
undue warmth. If REBT practitioners get really close to their clients and give
them considerable warmth, attention, caring, and support, as well as unconditional acceptance, then these therapists run two major risks (Ellis, 1982a, 1985a),
The first major risk is that therapists may unwittingly reinforce their clients'
dire "needs" for love and approval—two irrational ideas that are at the core of
much human disturbance. When this happens, clients appear to improve because
their therapists are indeed giving them what they believe they must have. They
begin to "feel better" but do not necessarily "get better" (Ellis, 1972a, 1991a,
1994c, 1996a, 1996b). Their "improvement" is illusory because their irrational
philosophies are being reinforced. Because they seem to improve, their therapists have restricted opportunities to identify these ideas, to show them how they
relate to their problems, and to help them challenge and change them. Consequently, although such clients are helped by their therapists, they are now shown
how they can help themselves and are thus vulnerable to future upset.
The Basic Practice of REST
The second major risk is that therapists may unwittingly reinforce their
clients' philosophy of low frustration tolerance (LFT) or discomfort disturbance.
Clients with LFT problems "almost always try to seek interminable help from
others instead of coping with life's difficulties themselves. Any kind of therapy
that does not specifically persuade them to stop their whining and to accept
responsibility for their own happiness tends to confirm their belief that others
must help them. Close relationship therapy is frequently the worst offender in
this respect and thereby may do considerable harm" (Ellis, 1982a, p. 206).
However, since REBT is flexible and is against the formulation of absolute,
dogmatic therapeutic rules, it does recognize that under certain conditions
(e.g., where a client is extremely depressed, accompanied by powerfiil suicidal
ideation), distinct therapist warmth may be positively indicated for a period of
time (Ellis, 198Sa).
Therapeutic Style
I (AE) recommend that REBT therapists adopt an active-directive style with
most clients and a particularly forceful version of that style with some very disturbed and resistant clients (Ellis, 1979, 1985c, 1996a, 1996b). However, not
all REBT therapists concur with this view. Some recommend a more passive,
gentle approach under specific or most conditions with clients (e.g., Young,
1984). Eschenroeder (1979) notes that it is important to ask in REBT, "Which
therapeutic style is most effective with which kind of client?" (p. 5). In the same
vein, recent proponents of eclectic forms of therapy argue that style of therapeutic interaction had better be varied to meet the special situations of individual clients (Beutler, 1983; Lazarus, 1989). This is a scantily researched area
in REBT, but it may be best for REBT therapists to avoid (1) an overly
friendly, emotionally charged style of interaction with "hysterical" clients, (2)
an overly intellectual style with "obsessive-compulsive" clients, (3) an overly
directive style with clients whose sense of autonomy is easily threatened, and
(4) an overly active style with clients who easily retreat into passivity. This line
of reasoning fits well with the notion of flexibility that REBT therapists advocate as a desirable therapeutic quality. Varying one's therapeutic style in REBT
does not mean departing from the theoretical principles on which the content
of therapy is based. As Eschenroeder (1979) points out, in REBT, "there is no
one-to-one relationship between theory and practice" (p. 3).
Personal Qualities of Effective Rational
Emotive Behavioral Therapists
Unfortunately, no research studies have been carried out to determine the personal qualities of effective REBT therapists. REBT theory, however, does put
forward a number of hypotheses concerning this topic (Ellis, 1978a, 199Sc,
The Practice of WET
1996a, 1996b), but it is important to regard these as both tentative and awaiting empirical study.
1. Because REBT is a fairly structured form of therapy, its effective practitioners are usually comfortable with structure but flexible enough to work in
a less structured manner when the need arises.
2. REBT practitioners tend to be intellectually, cognitively, or philosophically inclined and become attracted to REBT because the approach provides
them with opportunities to fully express this tendency.
3. Because REBT is often to be conducted in an active-directive manner,
effective REBT practitioners are usually comfortable operating in this mode.
Nevertheless, they have the flexibility to modify their interpersonal style with
clients so that they provide the optimum conditions to facilitate client change.
4. REBT emphasizes that it is important for clients to put their therapyderived insights into practice in their everyday lives. As a result, effective practitioners of REBT are usually comfortable with behavioral instruction and
teaching and with providing the active prompting that clients often require if
they are to follow through on homework assignments.
5. Effective REBT therapists tend to have little fear of failure themselves.
Their personal worth is not invested in their clients' improvement. They do
not need their clients' love and/or approval and are thus not afraid of taking
calculated risks if therapeutic impasses occur. They tend to accept both themselves and their clients as fallible humans and are therefore tolerant of their
own mistakes and the irresponsible acts of their clients. They tend to have, or
persistently work toward acquiring, a philosophy of high frustration tolerance,
and they do not get discouraged when clients improve at a slower rate than
they desire. Thus, effective practitioners tend to score highly on most of the
criteria of positive mental health outlined in chapter 1, and they serve as
healthy role models for their clients.
6. REBT strives to be scientific, empirical, antiabsolutistic, and undevout
in its approach to people's selecting and achieving their own goals (Ellis, 1978a,
1994c, 199Sa, 1996a, 1996b). Thus, effective practitioners of REBT tend to
show similar traits and are definitely not mystical, antiintellectual, or magical
in their beliefs.
7. REBT advocates the use of techniques in a number of different modalities (cognitive, imagery, emotive, behavioral, and interpersonal). Its effective
practitioners are thus comfortable with a multimodal approach to treatment
and tend not be people who like to stick rigidly to any one modality.
Finally, I (AE) note that some REBT therapists often modify the preferred
practice of REBT according to their own natural personality characteristics
(Ellis, 1978b). Thus, for example, some therapists practice REBT in a slowmoving, passive manner, do little disputing, and focus therapy on the relation-
The Basic Practice ofREBT
ship between them and their clients. Whether such modification of the preferred practice ofREBT is effective is a question awaiting empirical enquiry.
INDUCTING CLIENTS INTO REBT
When clients seek help from REBT therapists, they vary concerning how
much they already know about die type of therapeutic process they are likely
to encounter. Some may approach the therapist because they know he or she is
a practitioner of REBT; others may know nothing about this therapeutic
method. In any event it is often beneficial to explore clients' expectations for
therapy at the outset of the process. Duckro, Beal, and George (1979) have
argued that it is important to distinguish between preferences and anticipations when expectations are assessed. Clients' preferences for therapy concern
what kind of experience they want, whereas anticipations concern what service they think they will receive. Clients who have realistic anticipations for
the REBT therapeutic process and have a preference for this process require,
in general, far less induction into this process than clients who have unrealistic anticipations of the process and/or preferences for a different type of therapeutic experience.
Induction procedures, in general, involve showing clients that REBT is an
active-directive structured therapy oriented to discussing clients' present and
future problems and one that asks clients to play an active role in the change
process. Induction can take a number of different forms. First, therapists may
develop and use a number of pretherapy role induction procedures, in which a
typical course ofREBT is outlined and productive client behaviors demonstrated (Macaskill & Macaskill, 1983). Second, therapists may give a short lecture at die outset of therapy concerning the nature and process ofREBT. Third,
therapists may employ induction-related explanations in die initial therapy sessions, using client problem material to illustrate how these problems may be
tackled in REBT and to outline the respective roles of client and therapist.
ASSESSMENT OF CLIENTS' PROBLEMS
The next stage of therapy concerns assessment. Assessment of the kind and
degree of emotional disturbance of clients is held to be important in REBT
for several reasons:
• To determine how seriously disturbed clients are, so that therapists can
see how likely they are to benefit from any form of therapy, including
REBT and so that they can also decide which REBT techniques (of the
many possible ones that are available) may be most suitably employed
(and which techniques avoided) with each particular client under the conditions in which he or she may be expected to live.
• To determine—or at least guess with a fair degree of accuracy—how difficult clients are likely to be, how they will probably take to the main
REBT procedures, and how long psychotherapy with each of them is
likely to be required.
• To discover which type of therapist involvement (e.g., a more or less active
or a more or less passive and supportive kind) is likely to help the individual client.
• To discover what types of skill deficiencies clients have and what kinds of
training (either in the course ofREBT or outside therapy) they might
best undertake to remedy some of their skill deficiencies. Thus, on the
basis of this assessment, certain kinds of skill training, such as assertiveness, social skills, communication, or vocational training, may be recommended for specific clients.
REBT practitioners are at liberty to use all kinds of assessment procedures
but generally favor the type of cognitive-behavioral interventions described in
Kendall and Hollon (1980). They tend to take a dimmer view of diagnostic
procedures such as the Rorschach and other projective techniques than they
do of more objective personality questionnaires and behavioral tests, largely
because the former often have dubious validity, incorporate questionable psychoanalytic and psychodynamic interpretations, and usually are not particularly applicable to effective treatment processes.
Together with many other REBT practitioners, we take the view that
although assessment interviews and some standard diagnostic tests may at
times be useful in exploring clients' disturbances, perhaps the best form of
assessment consists of having several REBT sessions with the client. Some of
the advantages of this kind of therapy-oriented assessment are as follows:
1. In the course of such an assessment procedure, clients can get to work
almost immediately on their problems, can gain therapeuticatly while being
assessed, and can be helped to suffer less pain, hardship, and expense while
undergoing treatment.
2. The preferable techniques to be used with different clients are often best
determined mainly through experimenting with some of these techniques in
the course of the therapeutic process. Although the use of standard personality tests, such as the Minnesota Multiphasic Personality Inventory (MMPI),
may help the therapist start off with some REBT methods rather than other
methods with a given client, only by actually experimenting with certain specific methods is the therapist likely to see how the client reacts to them and
consequently how they had better be continued or discontinued.
3. Assessment procedures divorced from ongoing psychotherapy (such as
giving a whole battery of tests prior to beginning therapy) may be iatrogenic
for a number of clients. During this testing process, especially if the assessment procedures are long-winded and take some time to complete, clients may
imagine "horrors" about themselves that lead them astray and make it more
difficult for them to benefit from therapy.
4. Certain conventional assessment procedures—for example, the Rorschach and Thematic Apperception Test (TAT)—may wrongly predict problems, symptoms, and dynamics that many clients do not really have and may
help lead their therapists up the garden path and away from more scientifically
based evaluations.
5. Clients sometimes take diagnoses obtained from complicated assessment
procedures as the gospel truth, feel that they have thereby received a valid
"explanation" of what ails them, and wrongly conclude that they have been
helped by this "explanation." REBT assessment procedures, including using
therapy itself as an integral part of the assessment process, primarily focus on
what clients had better do to change rather than emphasize clever diagnostic
"explanations" of what ails them.
Because REBT is strongly cognitive, emotive, and behavioral, it assesses not
only clients' irrational Beliefs but also their inappropriate feelings and their
self-defeating behaviors. The usual REBT assessment process almost always
Clients are helped to acknowledge and describe their unhealthy negative
feelings (e.g., anxiety, depression, anger, and self-hatred), and these
are clearly differentiated from their healthy negative feelings (e.g.,
disappointment, sadness, frustration, and displeasure).
They are led to acknowledge and delineate their self-defeating behaviors
(e.g., compulsions, addictions, phobias, and procrastination) rather
than to overemphasize idiosyncratic but nondeleterious behaviors
(e.g., unusual devotion to socializing, sex, study, or work).
They are asked to point out specific Activating events in their lives that
tend to occur just prior to their experienced disturbed feelings and
behaviors.
Their Rational Beliefs that accompany their Activating events and that
lead to undisturbed Consequences are assessed and discussed.
Their Irrational Beliefs that accompany their Activating events and that
lead to disturbed Consequences are assessed and discussed.
Their Irrational Beliefs that involve absolutistic "must's" and grandiose
demands on themselves, others, and the universe are particularly
determined.
Their second-level Irrational Beliefs that tend to be derived from their
absolutist^ "should's" and "must's"—that is, their "awralizing," their
"I-can't-stand-it-itis," their "damning" of themselves and others, and
their unrealistic overgeneralizations—are also revealed.
Their Irrational Beliefs that lead to their disturbanc