Addiction A-Z

Rational emotive behavior therapy

Rational emotive behavior therapy (also known as “Rational Emotive Therapy” or REBT for short) is a type of psychotherapy along the same lines as cognitive behavioral therapy (CBT). It was developed by psychologist Albert Ellis back in the 1950s. In fact, although psychiatrist Aaron Beck is credited with the development of CBT, Dr. Ellis is often referred to as the “grandfather” of CBT because of his groundbreaking work in this area of clinical psychology.

Rational emotive behavior therapy is based on the idea that irrational thoughts and beliefs are at the root of troubling emotions and dysfunctional behaviors. When we overreact to situations and lose perspective due to faulty expectations or distorted beliefs, it can cause serious problems in our lives, including interpersonal difficulties, psychological distress, and self-destructive behavior. Ellis believed these irrational thoughts and beliefs are learned, and as such, can be unlearned. His approach to treatment emphasizes taking personal responsibility, challenging and eliminating self-defeating thoughts and behaviors, and finding and choosing more rational and realistic ways of looking at ourselves as well as the world around us. Doing those things is the key to making positive changes.

The goals of REBT include:

  • Increasing your awareness of thoughts and beliefs that are irrational, negative, and unrealistic
  • Understanding their impact on your emotions and behavior
  • Learning new skills that enable you to cope with challenging situations in a healthy manner

History of REBT

As mentioned above, rational emotive behavior therapy was developed by Dr. Albert Ellis, an American psychologist. Dr. Ellis, like most psychologists in his time, was trained in psychoanalysis. Psychoanalysis has its roots in the theories of Sigmund Freud. Psychoanalytical treatment focuses heavily on the impact of early childhood experiences and the role of unconscious thought processes in the development of psychiatric disorders. It’s an insight-oriented, long-term approach to treatment. One of Dr. Ellis’ primary frustrations with psychoanalysis was that progress (of therapy clients) was often painfully slow.

This prompted Ellis to develop REBT, which was originally called “rational therapy”. During that same time period (the 1950s), another revolutionary but similar approach to treatment known as “cognitive therapy” was being developed by Dr. Aaron Beck, an American psychiatrist. Veering away from traditional psychoanalytical theory’s emphasis on unconscious processes, both cognitive therapy and REBT focused on conscious thoughts – and more specifically, on distorted and irrational thoughts and beliefs – and how they caused psychological distress.

Of course, Ellis’s concepts were initially dismissed by the vast majority of psychologist and psychiatrists. However, by the early 1980s they had become highly respected. They have been widely used by many mental health professionals ever since.

Throughout his impressive career, Ellis published hundreds of articles and over 75 books related to his work in clinical psychology. Many of his books, such as How to Stubbornly Refuse to Make Yourself Miserable about Anything: Yes, Anything and How to Make Yourself Happy and Remarkably Less Disturbable were written as self-help books for the lay person.

Ellis received several prestigious rewards honoring his work in clinical psychology. He also founded the Albert Ellis Institute in 1959. Based in New York City, it’s known around the world for the training and research it provides in the field of clinical psychology.

Basic Premise of REBT

The underlying premise of REBT is that irrational beliefs (which are often learned in childhood) don’t persist automatically. In other words, their ongoing presence requires some type of maintenance. REBT focuses on changing the underlying pattern of thinking – our flawed philosophical perspective – that continues to support these beliefs and perpetuate the problems in our lives.

The process of change in REBT is scientific in nature, as it encourages therapy clients to challenge or “test” the rationale of their thoughts. They learn to do this by self-observation (of the connection between their thoughts, feelings, and behaviors), and then challenging the reality of their thoughts and beliefs on an ongoing basis.

Irrational and distorted beliefs:

  • Trigger negative, distressing emotions that lead to unhealthy, problematic behaviors
  • Make it difficult or impossible to achieve your goals and live the life you desire
  • Cause you to make unreasonable and negative judgments about yourself, others, and the world
  • Lead to a distorted perception of reality

Key Tenets of REBT

Two of the most well-known tenets in rational emotive behavior therapy are “the three musts” – fundamental beliefs that are at the core of almost every irrational thought – and Ellis’ famous “ABC model”.

The Three Basic “Musts” (Fundamental Core Beliefs)

One of the key tenets of REBT is the three fundamental “musts” – the unrealistic demands we place on ourselves, others, and the world. In order to make positive changes in your life, it’s imperative that you first identify your personal musts, which are always some variation of the following:

1 – I MUST be competent, lovable, adequate, good, and always win or else I’m worthless, incompetent, and / or unlovable. (This faulty core belief plays a major role in depression, hopelessness, panic and anxiety, despair, low self-esteem, difficulties being assertive, feelings of worthlessness, guilt, and shame.)

2 – Other people (particularly important people in my life) MUST always treat me with kindness and fairness; exactly how I want them to. Anyone who doesn’t do this is a bad person and deserves to be punished for how terribly he / she treated me. (This irrational “must” can lead to passive-aggressive behavior, hostility, rage, vindictiveness, and violent behavior.)

3 – I MUST always get what I want when I want it; not getting what I want would be terrible, awful, and unbearable. (This irrational core belief often leads to procrastination, feeling sorry for oneself, inability to tolerate frustration, avoidance, loss of motivation, and addictive behavior. It can also contribute to anger, hopelessness, and depression.)

Each of these “musts” involves making unrealistic demands and having unreasonable expectations on self, others, and the world. In REBT, these irrational core beliefs are disputed, paving the way for more rational and realistic ways of thinking about self, others, and the world.

The ABC Model 

Ellis created the “ABC Model” to help his clients understand how their misinterpretation of external events – and their tendency to blame those events for their problems – contributes to their unhappiness. This model also illustrates the connection between thoughts, feelings, and behavior.

  • A stands for the “activating event” – something that occurs in one’s environment (e.g. someone doesn’t return your phone call, you don’t get the promotion you’d been hoping for, etc.)
  • B stands for your belief about (or interpretation / misinterpretation of) the event
  • C stands for the consequences of the belief (the emotional response it elicits)

In REBT, the root of people’s psychological problems lies within the irrational belief or misinterpretation of the events that occur in their lives.

Following is an example of the ABC’s:

  • A – Sam asks Susan to the prom, but Susan turns him down (this is the activating event)
  • B – Sam interprets Susan’s rejection as evidence that he’s unlovable and unworthy, and therefore, why would any girl want to go out with him (this is his irrational belief / misinterpretation of the event)
  • C – Sam feels depressed, sad, and angry at life in general (this is the consequence of his irrational belief)

An alternative to B and C in the above scenario might be:

  • B – Sam believes Susan said no because she’s stuck up
  • C – Sam feels angry and resents Susan for turning him down

Either way, the situation leads to negative feelings – depression, anger, resentment – and unhealthy behaviors, such as going out and getting drunk to drown his sorrows (in the first scenario) or spreading rumors about Susan to get back at her for turning him down (in the alternative scenario).

What Sam didn’t know is that Susan turned him down because her parents won’t allow her to date any boys that aren’t Jewish, and Sam isn’t Jewish. Susan didn’t explain that to him when she turned him down because she’s embarrassed by her parent’s rules, which she feels are overly strict.

All too often, people go through life misinterpreting events, jumping to erroneous conclusions, and clinging to deeply-rooted irrational beliefs that cause problems in their lives and make them miserable. REBT helps people understand that it’s B – their irrational belief – and not A – the external, activating event – that causes C – the undesirable consequence. When people begin to fully grasp this, they are able to start taking responsibility for their problems rather than blaming other people or events.

Techniques and Strategies Used in REBT

Rational emotive behavior therapists use a variety of techniques to help their clients make positive changes in their lives. The techniques fall into three categories: cognitive, emotive, and behavioral.

Cognitive techniquesThe cognitive methods employed by REBT therapists are geared to identify and change faulty beliefs. They include:

  • Disputing and challenging irrational beliefs (e.g. challenging the belief that life should always be fair, and when it’s not, it’s horrible and unbearable)
  • Looking for evidence that either supports or disproves your irrational beliefs and erroneous assumptions (e.g. identifying past successes in a client who believes she’s a total failure)
  • Changing one’s self-talk (e.g. rewording self-deprecating statements to ones that are self-supporting and empowering)
  • Thought stopping involves learning to interrupt and halt irrational or negative thoughts as soon as they appear, rather than dwelling on them and allowing them to negatively impact your emotions. Therapists may demonstrate this in a therapy session by shouting “stop!” in order to interrupt a client who’s exhibiting a negative stream of thought during the conversation.
  • Reframing involves looking at a situation or event from a different (and more positive) perspective (e.g. a client considering the possibility that he wasn’t promoted simply because someone else was better suited to the position, rather than because the boss doesn’t like him or because life is always unfair and nothing ever goes his way)

Emotive techniques – As the term suggests, emotive techniques help clients better understand the relationship between their negative emotions with various events and the faulty beliefs associated with them. They include:

  • The use of humor helps clients take a step back and laugh at themselves as they begin to recognize how foolish and preposterous their faulty beliefs (and reactions based on them) are.
  • Role playing allows clients to rehearse scenarios and practice new skills, while continuing to address any negative emotions and distorted beliefs associated with those situations.
  • Shame-attacking exercises help clients becomes more accepting of themselves while letting go of the shame they may feel about particular thoughts, feelings, or behaviors

Behavioral techniques – Behavioral techniques help clients learn to replace old dysfunctional and ineffective behaviors with new behaviors that are more effective and constructive. They include:

  • Homework assignments allow clients to practice new skills in between therapy sessions, and then discuss them with the therapist in the following session
  • Relaxation techniques (e.g. progressive muscle relaxation, deep breathing exercises, meditation, guided imagery) enable clients to calm themselves down when they feel stressed or anxious
  • Systematic desensitization involves step-by-step (systematic) exposure to anxiety-provoking thing or situation while using relaxation techniques to stay calm and relaxed
  • Journaling allows clients to process their thoughts, feelings, and subsequent behaviors (and what they’ve learned in therapy) between sessions by writing them down in a private journal
  • Risk-taking exercises allow clients practice what they’ve learned in therapy in situations that will be a bit challenging
  • Learning more about one’s disorder (e.g. depression, social phobia, etc.) by reading about it (also known as bibliotherapy)

Other techniques and strategies may also be used by REBT therapists.

Disorders, Issues, and Conditions That Can Benefit from REBT

Rational emotive behavior therapy has been used effectively in the treatment of a wide range of psychological problems, specific mental health disorders, and other conditions and issues, including (but not limited to) the following:

  • Depression
  • Suicidal thoughts
  • Low self-esteem
  • Recovery from sexual abuse
  • Panic attacks / panic disorder
  • Generalized anxiety disorder
  • Posttraumatic stress disorder
  • Social phobia (social anxiety disorder)
  • Specific phobias
  • Obsessive-compulsive disorder
  • Compulsive behaviors
  • Eating disorders
  • Autism spectrum disorders
  • Behavioral problems in children and adolescents
  • Substance abuse and dependence
  • Porn addiction
  • Gambling addiction
  • Grief and loss
  • Impulsivity and impulse control disorders
  • Personality disorders
  • Marital problems
  • Relationship issues
  • Family conflict
  • Anger issues
  • Chronic or severe stress
  • Somatic complaints
  • Chronic pain
  • Coping with health issues (e.g. a psychiatric disorder, chronic physical illness or condition, physical disability)
  • Insomnia
  • Social skills deficits
  • Performance anxiety (e.g. public speaking, taking tests)
  • Difficulties being assertive
  • Stuttering
  • Aggressive behavior
  • Procrastination
  • Excess guilt
  • Self-sabotage
  • Managing major life transitions

Benefits of REBT

There are many benefits to rational emotive behavior therapy. They include:

  • You learn to take responsibility for how you feel, react, and behave in response to situations and events
  • You learn to identify and monitor any irrational thoughts and beliefs, including the impact they have on your feelings and actions
  • You can apply what you’ve learned in REBT in all areas of your life
  • You learn how to essentially be your own therapist in future situations that are challenging or distressful
  • You learn how to stop negative thoughts in their tracks so that you don’t get stuck in a downward spiral that can lead to emotional distress and unhealthy behavior
  • You learn to let go of unrealistic expectations of yourself, others, and the world, and adapt more a healthier, more realistic perspective
  • You learn how to genuinely accept yourself
  • Your relationships improve as you learn to be less reactive, not jump to conclusions or assume the worst, and develop more realistic expectations of others
  • You learn to tolerate frustration and set-backs with more grace and ease
  • You learn to stop relying on others’ perceptions, attitudes, behaviors, and opinions for validation of your worth

Advantages of REBT

There are many advantages to REBT compared to many other types of psychotherapy, including the following:

  • It’s a relative short-term treatment; most REBT clients require only 10 to 20 therapy sessions to accomplish their treatment goals
  • It’s a very action-oriented type of treatment
  • Homework assignments allow you to practice what you’ve learned in between sessions, which helps reinforce what you’ve learned
  • The therapy process encourages you to quickly become self-reliant rather than inadvertently fostering a dependence on the therapist
  • It gives clients useful, practical tools in addition to insight into their problems
  • Substantial research over the years has shown that REBT is a highly effective treatment for a wide range of psychiatric disorders and other psychological issues
  • It’s practical; the techniques and concepts of REBT are relatively easy to understand, learn, and apply
  • It’s cost-effective because of its short-term nature
  • It can be used with individuals, groups, couples, and families

Finding an REBT Therapist

If you’re interested in working with a therapist who uses rational emotive behavior therapy as his or her primary treatment approach, the best place to start is the website of the Albert Ellis Institute. The institute’s website can be found at AlbertEllis.org. There is a “find a therapist” link at the top of the home page, which allows you to do a search for an REBT professional in your area. You can narrow your search based on specific disorders (e.g. PTSD, depression, phobias), specific issues (e.g. child abuse, stage fright, relationships), and other specialty areas (e.g. executive coaching, parenting, neuropsychology, adolescents, women).

Although there is no “one size fits all” when it comes to psychotherapy, rational emotive behavior therapy is one of the most widely-researched and effective treatment approaches being used today. It’s an excellent form of therapy for anyone who is truly willing to challenge, reconsider, and change the way they look at things that may be causing problems for them and preventing them from living a richer, more fulfilling life.

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