Rational emotive behavior therapy (REBT), previously called rational therapy and rational emotive therapy, is an active-directive, philosophically and empirically based psychotherapy, the aim of which is to resolve emotional and behavioral problems and disturbances and to help people to lead happier and more fulfilling lives.
REBT posits that people have erroneous beliefs about situations they are involved in, and that these beliefs cause disturbance, but can be disputed and changed.
History
Rational emotive behavior therapy was created and developed by the American psychotherapist and psychologist Albert Ellis, who was inspired by many of the teachings of Asian, Greek, Roman and modern philosophers. REBT is a form of cognitive behavioral therapy (CBT) and was first expounded by Ellis in the mid-1950s; development continued until his death in 2007. Ellis became synonymous with the highly influential therapy. Psychology Today noted, "No individual—not even Freud himself—has had a greater impact on modern psychotherapy."
REBT is both a psychotherapeutic system of theory and practices and a school of thought established by Ellis. He first presented his ideas at a conference of the American Psychological Association in 1956 then published a seminal article in 1957 entitled "Rational psychotherapy and individual psychology", in which he set the foundation for what he was calling rational therapy (RT) and carefully responded to questions from Rudolf Dreikurs and others about the similarities and differences with Alfred Adler's individual psychology. This was around a decade before psychiatrist Aaron Beck first set forth his "cognitive therapy", after Ellis had contacted him in the mid-1960s. Ellis' own approach was renamed Rational Emotive Therapy in 1959, then the current term in 1992. Marcus Aurelius, Epictetus, Zeno of Citium, Chrysippus, Panaetius of Rhodes, Cicero, and Seneca, and early Asian philosophers Confucius and Gautama Buddha. In his first major book on rational therapy, Ellis wrote that the central principle of his approach, that people are rarely emotionally affected by external events but rather by their thinking about such events, "was originally discovered and stated by the ancient Stoic philosophers." Ellis illustrates this with a quote from the Enchiridion of Epictetus: "Men are disturbed not by things, but by the views which they take of them." Ellis noted that Shakespeare expressed a similar thought in Hamlet: "There's nothing good or bad but thinking makes it so." Ellis also acknowledges early 20th century therapists, particularly Paul Charles Dubois, though he only read his work several years after developing his therapy.
REBT is then applied as an educational process in which the therapist often active-directively teaches the client how to identify irrational and self-defeating beliefs and philosophies which in nature are rigid, extreme, unrealistic, illogical and absolutist, and then to forcefully and actively question and dispute them and replace them with more rational and self-helping ones. By using different cognitive, emotive and behavioral methods and activities, the client, together with help from the therapist and in homework exercises, can gain a more rational, self-helping and constructive rational way of thinking, emoting and behaving.
One of the main objectives in REBT is to show the client that whenever unpleasant and unfortunate activating events occur in people's lives, they have a choice between making themselves feel healthily or, self-helpingly, sorry, disappointed, frustrated, and annoyed or making themselves feel unhealthily and self-defeatingly horrified, terrified, panicked, depressed, self-hating and self-pitying. By attaining and ingraining a more rational and self-constructive philosophy of themselves, others and the world, people often are more likely to behave and emote in more life-serving and adaptive ways.
A fundamental premise of REBT is that humans do not get emotionally disturbed by unfortunate circumstances, but by how they construct their views of these circumstances through their language, evaluative beliefs, meanings and philosophies about the world, themselves and others. This concept has been attributed as far back as the Stoic philosopher Epictetus, who is often cited as utilizing similar ideas in antiquity.
A-B-C-D-E-F Model
In REBT, clients usually learn and begin to apply this premise by learning the A-B-C-D-E-F model of psychological disturbance and change. The following letters represent the following meanings in this model:
:thumb|438x438pxA Adversity
:B Beliefs about adversity
:C Emotional consequences
:D Disputations to challenge beliefs about adversity
:E Effective new rational beliefs
:F New feelings
The A-B-C model states that it is not an A, adversity (or activating event) that cause disturbed and dysfunctional emotional and behavioral Cs, consequences, but also what people B, irrationally believe about the A, adversity. A, adversity can be an external situation, or a thought, a feeling or other kind of internal event, and it can refer to an event in the past, present, or future.
The Bs, irrational beliefs that are most important in the A-B-C model are the explicit and implicit philosophical meanings and assumptions about events, personal desires, and preferences. The Bs, beliefs that are most significant are highly evaluative and consist of interrelated and integrated cognitive, emotional and behavioral aspects and dimensions. According to REBT, if a person's evaluative B, belief about the A, activating event is rigid, absolutistic, fictional and dysfunctional, the C, the emotional and behavioral consequence, is likely to be self-defeating and destructive. Alternatively, if a person's belief is preferential, flexible, and constructive, the C, the emotional and behavioral consequence is likely to be self-helping and constructive.
Through REBT, by understanding the role of their mediating, evaluative and philosophically based illogical, unrealistic and self-defeating meanings, interpretations and assumptions in disturbance, individuals can learn to identify them, then go to D, disputing and questioning the evidence for them. At E, effective new philosophy, they can recognize and reinforce the notion no evidence exists for any psychopathological must, ought or should and distinguish them from healthy constructs, and subscribe to more constructive and self-helping philosophies. This new reasonable perspective leads to F, new feelings and behaviors appropriate to the A they are addressing in the exercise.
Psychological dysfunction
One of the main pillars of REBT is that irrational and dysfunctional ways and patterns of thinking, feeling, and behaving are contributing to human disturbance and emotional and behavioral self-defeatism and social defeatism. REBT generally teaches that when people turn flexible preferences, desires and wishes into grandiose, absolutistic and fatalistic dictates, this tends to contribute to disturbance and upset. These dysfunctional patterns are examples of cognitive distortions.
Irrational beliefs
REBT proposes four core irrational ways of thinking that create suffering:
- Demands: The tendency to demand success, fair treatment, and respect (e.g., I must be treated fairly).
- Awfulizing: The tendency to consider adverse events as awful or terrible (e.g., It's awful when I am disrespected).
- Low Frustration Tolerance (LFT): The belief that one could not stand or tolerate adversity (e.g., I cannot stand being treated unfairly).
- Depreciation: The belief that one event reflects the person as a whole (e.g., When I fail it shows that I am a complete failure).
Core beliefs that disturb humans
Ellis has suggested that humans take the above distorted ways of thinking and created three core beliefs or philosophies that humans tend to disturb themselves through:
REBT differs from other clinical approaches like psychoanalysis in that it places little emphasis on exploring the past, but instead focuses on changing the current evaluations and philosophical thinking-emoting and behaving in relation to themselves, others and the conditions under which people live.
Disturbances
REBT sees disturbances as caused by characteristics of a person, rather than a particular past event;
<blockquote>Almost all (neurotic clients) have innate tendencies to take their strong desires and preferences (which they learn and which they also have biological predispositions to construct) and to escalate them into unrealistic, illogical, absolutist demands and to thereby disturb themselves when these rigid imperatives are not fulfilled.</blockquote>
Other insights
Other insights of REBT (some referring to the ABCDEF model above) are:
<blockquote>Insight 1 – People seeing and accepting the reality that their emotional disturbances at point C are only partially caused by the activating events or adversities at point A that precede C. Although A contributes to C, and although disturbed Cs (such as feelings of panic and depression) are much more likely to follow strong negative As (such as being assaulted or raped), than they are to follow weak As (such as being disliked by a stranger), the main or more direct cores of extreme and dysfunctional emotional disturbances (Cs) are people's irrational beliefs—the "absolutistic" (inflexible) "musts" and their accompanying inferences and attributions that people strongly believe about the activating event.</blockquote>
<blockquote>Insight 2 – No matter how, when, and why people acquire self-defeating or irrational beliefs (i.e. beliefs that are the main cause of their dysfunctional emotional-behavioral consequences), if they are disturbed in the present, they tend to keep holding these irrational beliefs and continue upsetting themselves with these thoughts. They do so not because they held them in the past, but because they still actively hold them in the present (often unconsciously), while continuing to reaffirm their beliefs and act as if they are still valid. In their minds and hearts, the troubled people still follow the core "masturbatory" philosophies they adopted or invented long ago or ones they recently accepted or constructed.</blockquote>
<blockquote>Insight 3 – No matter how well they have gained insights 1 and 2, insight alone rarely enables people to undo their emotional disturbances. They may feel better when they know, or think they know, how they became disturbed, because insights can feel useful and curative. But it is unlikely that people will actually get better and stay better unless they have and apply insight 3, which is that there is usually no way to get better and stay better except by continual work and practice in looking for and finding one's core irrational beliefs; actively, energetically, and scientifically disputing them; replacing one's absolute "musts" (rigid requirements about how things should be) with more flexible preferences; changing one's unhealthy feelings to healthy, self-helping emotions; and firmly acting against one's dysfunctional fears and compulsions. Only by a combined cognitive, emotive, and behavioral, as well as a quite persistent and forceful attack on one's serious emotional problems, is one likely to significantly ameliorate or remove them, and keep them removed.</blockquote>
Intervention
As explained, REBT is a therapeutic system of both theory and practice; generally one of the goals of REBT is to help clients see the ways in which they have learned how they often needlessly upset themselves, teach them how to "un-upset" themselves and then how to empower themselves to lead happier and more fulfilling lives. with the efficacy of REBT demonstrated across a range of sports.
REBT also has many interfaces and applications through self-help resources, phone and internet counseling, workshops & seminars, workplace and educational programmes, etc. This includes Rational Emotive Education (REE) where REBT is applied in education settings, Rational Effectiveness Training in business and work-settings and SMART Recovery (Self Management And Recovery Training) in supporting those in addiction recovery, in addition to a wide variety of specialized treatment strategies and applications.
Efficacy
REBT and CBT in general have a strong and substantial research base to verify and support their psychotherapeutic efficiency and their theoretical underpinnings. Meta-analyses of outcome-based studies reveal REBT to be effective for treating various psychopathologies, conditions and problems.
In general REBT is arguably one of the most investigated theories in the field of psychotherapy and a large amount of clinical experience and a substantial body of modern psychological research have validated and substantiated many of REBTs theoretical assumptions on personality and psychotherapy.
Ellis himself later in life accepted that REBT was not universally effective; "I hope I am also not a devout REBTer, since I do not think it is an unmitigated cure for everyone and do accept its distinct limitations."
Limitations and critique
The clinical research on REBT has been criticized by both supporters and detractors. For instance, originator Albert Ellis has on occasion emphasized the difficulty and complexity of measuring psychotherapeutic effectiveness, because many studies only tend to measure whether clients merely feel better after therapy instead of them getting better and staying better.
Ellis has himself in very direct terms criticized opposing approaches such as psychoanalysis, transpersonal psychology and abreactive psychotherapies in addition to on several occasions questioning some of the doctrines in certain religious systems, spiritualism and mysticism. Many, including REBT practitioners, have warned against dogmatizing and sanctifying REBT as a supposedly perfect psychological panacea. Prominent REBTers have promoted the importance of high quality and programmatic research, including originator Ellis, a self-proclaimed "passionate skeptic". He has on many occasions been open to challenges and acknowledged errors and inefficiencies in his approach and concurrently revised his theories and practices.
Mental wellness
As would be expected, REBT argues that mental wellness and mental health to a large degree results from an adequate amount of self-helping, flexible, logico-empirical ways of thinking, emoting and behaving.