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Rational emotive behavior therapists will listen while you whine about your mother, but in the final analysis, they put you at the center of the universe, largely responsible for your own actions and feelings.
ABC's. Rational Emotive Behavior Therapy places the responsibility for a person's fate squarely upon his or her own shoulders. It is one's irrational beliefs (B) that cause "traumatic" experiences (A) to result in neurosis.
The REBT therapist leads a client to attack his or her irrational beliefs by disputing them (D). Once the client's attack has been successful, he or she is free to establish sensible beliefs and appropriate behavior which are psychologically healthy effects (E).
From any conventional viewpoint, Ms. P needed no therapy at all. She had just been offered an exceptionally good job. High-level men had sought her company after her husband's death. She had no problems with her 18-year-old daughter, who was adjusting well to an out-of-town college. Yet, she came to me in an extreme state of panic.
She slept little and fitfully, and vacillated about accepting the new job. These were recent, and she thought surface, manifestations of her anxiety. More important, she was afraid of failing on any job, although she had never failed. She believed her husband had lost interest in her before his death, though he had never shown signs of disinterest. And she felt inadequate sexually, despite her sexual partners' protestations about their inadequacies rather than about hers.
Instead of feeling better, in the light of her recent business and social successes, and after what she called "three highly successful years" of psychoanalysis, she was becoming considerably more anxious and disturbed.
Her previous analyst, a woman well trained in Freudian and Sullivanian methods, had guided her to believe that the basis of her disturbance was her attitude toward men. She had "learned" through psychoanalysis that she had vainly sought her father's love when she was a child, but had never succeeded in weaning him away from his much greater and obsessive interest in her older brother. Consequently, she unconsciously hated men. She had resolved this problem by forcing herself to compete compulsively with males, to win out over them in the business world. But she had felt it too dangerous to compete with them sexually, since they were always better at having orgasms than she. So she had retreated, according to her analyst, to extravaginal stimulation instead of intercourse.
Awareness of the psychoanalytic explanations for her disturbance was not enough for Ms. P. She decided that her analysis was not progressing, and in desperation decided to try rational emotive behavior therapy (REBT).
REBT, which I originated in 1955, goes further than orthodox psychoanalysis and classical behavioristic approaches. It places humans at the center of the universe and gives them considerable responsibility for their own fate. It is partly their choice to make or to refuse to make themselves neurotic. Although REBT's basic theory of human personality has strong roots in biological and environmental assumptions, it holds that the individual himself can, and usually does, significantly intervene between his environmental input and his emotional output, and that therefore he -- and, of course, she -- has, potentially, a good amount of control over what he feels and does.
REBT uses a simple ABC approach to human personality and its disturbance. The therapist usually begins with C, the upsetting emotional Consequence that the client has recently experienced. Typically, she has been rejected. This rejection can be called A, the Activating Experience, which the person wrongly believes directly causes C, her feelings of anxiousness, worthlessness, and depression. The client learns that by itself an Activating event (A) in the outside world does not cause or create any feelings or emotional Consequence (C). For if it did, the therapist explains, then virtually everyone who gets rejected would have to feel just as depressed as the client, Ms. P. But since this is hardly true, C is largely caused by some intervening variable, which is the individual's Belief system (B).
When rejection occurs, the healthy individual has a mainly healthy or rational set of negative beliefs: "Isn't it unfortunate that I was rejected. I will suffer real losses or disadvantages by this rejection. Now, how can I be accepted by this person in the future, or by some other person who will probably bring me almost as much joy?" These Beliefs are rational or useful because they increase a person's happiness and minimize his pain, and they are related to observable, empirically provable events.
If the individual held rigorously to his (or her) rational Belief about being rejected, he or she would experience profound feelings at point C, but they would not be those that accompany an irrational set of Beliefs: anxiousness, worthlessness and depression. Instead, he would have feelings of disappointment, frustration and annoyance. His feelings would then be quite healthy or appropriate to the Activating experience or event, since they would motivate him to try to change his life so that he would be accepted in the future and, hence, enjoy himself more.
Ms. P's Beliefs were irrational. If one assumes that she had failed to win her father's love because of his obsessive interest in her older brother, it becomes important to know why she had made those grim facts of life all-important and why she had insisted on letting them affect her for so long. Other females have fathers who favored their older brothers, but unlike Ms. P, they all do not unconsciously hate men forever and compulsively compete with them. A crucial question therefore was: What was her fundamental Belief system or philosophy of life, which she had brought to and derived from her unsuccessful attempts to get her father's love?
I began to teach Ms. P the ABC's of rational emotive behavior therapy and to show her why psychoanalysis, which had concentrated on A and C, but not on B, may have given her a misleading or highly superficial explanation of her disturbance.
As we probed, Ms. P began to see that her depression was not a direct result of her father's rejection, but was a consequence of her system of Beliefs. Her C responses, or Consequences, were not caused by her father's favoring her brother but by her own mediation processes, or what she thought about this favoritism.
She actually gave herself those Consequences by choosing to create certain value assumptions, or Beliefs. She had chosen these Beliefs early in life, and she still clung to them. I explained that she continued to demand that her father (and virtually all males) be devoted to her, and that she would not free herself from anxiety and hatred until she gave up her childish demands.
Although she was able to see, on theoretical grounds, that Activating events do not cause emotional Consequences in people unless their Beliefs about these events are strongly positive or negative, Ms. P did not feel comfortable with this idea. Her strong conviction, shared by most people, that emotions arise directly from experiences, helped block her acknowledgment of this REBT hypothesis. Also, her ardent allegiance to her previous analyst and to the analytic theory that current events are determined by past history helped increase her blocking. During our fifth season, the therapeutic tide turned. Ms. P started to cry. She told me about her father's death a year ago and about the unveiling of his headstone that was to take place at his grave the following Sunday. I asked why she was crying depressedly, since her father's death, at the age of 55, was a great loss that she could healthily grieve about but was it "awful" and "horrible," so that she could not enjoy anything again? She answered that the unveiling made it utterly final: "I still value his love highly, and it's very unfortunate that I'll never in any way be able to get it now."
I demurred. I thought there was more to it than that. If she thought the loss of his love was only quite unfortunate, she would feel very sad -- but not depressed, as she seemed to be.
"Yes," she agreed. "To be honest, when I was crying there, I was also feeling depressed. And I guess I still am, whenever I fully face the fact that he's gone, gone forever, and that I'll never get from him the love I always craved."
"And that makes you -- ?" I asked, in typical REBT fashion.
"A rotten person! A no-good, low-down, rotten person, whose own father never could, and now never will, love her!"
My hunch and my persistence had paid off. Ms. P clearly saw that there was something much more than the loss of her father's love that bothered her and caused her depression -- namely her profound Belief that she was worthless for losing that love. That turned the therapeutic tide. From that moment she acknowledged that she was the main cause of her emotional disturbance and that her Beliefs about her father and herself were self-defeating.
Ms. P's new insight did not end her therapy. REBT has two main purposes. The first is to show the emotionally disturbed person how irrational Beliefs create dysfunctional Consequences. The second, and in some ways the more important, is to teach the individual how to Dispute (D) in order to change or surrender these irrational Beliefs. REBT overlaps significantly with various "insight" therapies, including Freudian psychoanalysis and Adlerian individual psychology, in regard to the first of these two purposes, but it tends to deviate radically from them on the second. REBT espouses forceful, philosophic and behavioristic attacks on the individual's self-sabotaging Belief system.
If the therapist succeeds in leading the individual to Dispute his irrational Beliefs about himself and the world, the client then proceeds to E, new and better-functioning Effects. The therapist encourages the client to adopt new philosophies of living, thus reducing feelings of anxiety. Eventually, the client will almost automatically stop creating anxiety when he undergoes frustrating Activating experiences.
Ms. P realized that it was not her early childhood experiences that created panic about her new job offer, depression about the supposed loss of her dead husband's love, and feelings or worthlessness about her sexuality. I then helped her see the main irrational Beliefs that caused her symptoms. Paraphrased, there were:
To help Ms. P give up these self-deprecating ideas, I first used an REBT approach. I showed her that her irrational Beliefs about needing competency, love, and freedom from panic, were unrealistic, illogical, and self-destructive.
Most people tend to believe several irrational ideas. They hold to these ideas with dreadful results in terms of their emotions and behaviors. As far as I have been able to determine, these beliefs are usually forms of absolutism. They consist of unqualified demands and needs, instead of preferences or desires. Consequently, they are unrealistic and self-defeating.
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