Cognitive · 1955
Rational Emotive Behaviour Therapy (REBT)
Emotional disturbance is maintained when preferences turn into absolutist demands, and it changes as rational beliefs and unconditional acceptance develop.
Rational Emotive Behaviour Therapy (REBT) is a philosophical and active cognitive behavioural approach which holds that emotional and behavioural consequences do not derive directly from events but from the evaluative beliefs through which a person interprets them. The A-B-C model identifies the activating event, the beliefs and the consequences, and places at the clinical centre the absolutist demands directed at oneself, at others or at life. From those demands derive awfulising, low frustration tolerance and the global condemnation of the person, of others or of the world, which intensify unhealthy negative emotions such as anxiety, depression, anger, guilt or shame. Ellis distinguishes two basic forms of disturbance that can combine: ego disturbance, organised around demands for achievement and approval whose frustration is experienced as a threat to one's worth, and discomfort disturbance, organised around demands for comfort, ease and certainty whose frustration is experienced as unbearable. Intervention combines logical, empirical, pragmatic and semantic disputing, rational emotive imagery, exposure, shame-attacking exercises, behavioural rehearsals, between-session assignments and training in unconditional acceptance. Its aim is to replace demands with firm but flexible preferences, transform disturbing emotions into healthy negative emotions, and consolidate a life philosophy that allows more effective action even when frustration, uncertainty, error, rejection or loss persist.
Theory of change
A person changes when they identify and weaken the absolutist demands that generate disturbance, strengthen rational preferences and practise them cognitively, emotionally and behaviourally until they become a stable life philosophy.
Core ideas
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Evaluations mediate between adversity and disturbance
REBT holds that an adversity may produce real pain, loss or difficulty, but that intense emotional disturbance depends largely on the evaluative beliefs the person inserts between the event and their response. The A-B-C model does not deny context or the influence of facts; it explains why the same event can elicit sadness, concern or adaptive annoyance in one person and depression, paralysing anxiety or destructive rage in another. (Ellis, 1962; Ellis & Dryden, 1997).
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Absolutist demands organise irrational beliefs
The principal forms of disturbance are organised around demands directed at the self, others or life: I must perform perfectly and be approved of, others have to treat me as I wish, and life conditions ought to be easy, fair and favourable. These demands turn legitimate desires into absolute necessities and constitute the core from which awfulising, low frustration tolerance and global condemnation derive. (Ellis, 1994; DiGiuseppe et al., 2014).
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The therapy distinguishes healthy from unhealthy negative emotions
REBT does not aim to eliminate all distress or replace it with optimism. It seeks to transform unhealthy, disproportionate and blocking negative emotions into healthy negative emotions that retain sensitivity to loss or danger while facilitating coping, learning and action. Sadness, concern, sorrow and adaptive annoyance are compatible with flexible preferences; intense depression, anxiety, guilt, shame and rage are usually fed by rigid, totalising evaluations. (Ellis & Dryden, 1997; Dryden & Bond, 1994).
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Unconditional acceptance replaces the global rating of the self
REBT holds that globally evaluating a person as worthless, valuable, bad or superior is an excessive inference that confuses concrete acts with the totality of a human being. Unconditional self-acceptance makes it possible to acknowledge errors, limitations and harms without deriving from them a total verdict on one's own worth, and it is complemented by unconditional acceptance of other people and of life, without approving harmful behaviour or giving up on changing it. (Ellis, 1994; Ellis & Dryden, 1997).
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Low frustration tolerance can be trained
Low frustration tolerance does not simply describe suffering in the face of something difficult, but the belief that discomfort is unbearable, intolerable or incompatible with continuing to function. REBT works with it through reappraisal, exposure and assignments that make it possible to learn that an experience can be unpleasant, unfair or painful and, at the same time, bearable and manageable. Change is verified when the person stops organising their behaviour around immediate relief. (Ellis & Dryden, 1997; DiGiuseppe et al., 2014).
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Lasting change requires cognitive, emotive and behavioural practice
An intellectual grasp of a belief's irrationality does not guarantee that the person will act differently when they feel threatened again. REBT combines verbal disputing, rational emotive imagery, rehearsals, exposure, shame-attacking exercises and between-session assignments in order to weaken the old philosophy and strengthen the new one in the contexts where it is actually activated. (Ellis, 1994; Maultsby & Ellis, 1974; DiGiuseppe et al., 2014).
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Secondary disturbance amplifies suffering
Many people not only suffer an initial emotion but condemn themselves for feeling it: they become anxious about being anxious, ashamed of their shame or depressed about not having improved sooner. REBT analyses this second level as a new A-B-C and disputes the demands that turn a human reaction into evidence of personal failure, which reduces the self-referential escalation of distress. (DiGiuseppe et al., 2014; Dryden & Neenan, 2015).
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The therapist teaches rational emotive self-therapy
The ultimate aim is for the person to be able to detect their demands autonomously, debate them, formulate rational beliefs and expose themselves to the experience they previously avoided. The patient is not positioned as the passive recipient of corrections, but as an active learner of a practical philosophy they can apply to future adversities, relapses and life decisions. (Ellis, 1962; Ellis & Dryden, 1997).
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Rationality combines logic, evidence and usefulness
A rational belief is not defined by being pleasant, agreeable or morally approved, but by its logical coherence, its compatibility with the available evidence and its functional consequences for facing reality. This criterion makes it possible to recognise objective problems and intense desires without turning them into absolute demands, catastrophes or global condemnations. (Ellis, 1962; DiGiuseppe et al., 2014).
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Ego disturbance and discomfort disturbance are two distinct targets
Ellis proposed distinguishing two cores of disturbance that require specific disputing. In ego disturbance, the person makes performance and approval conditions of their worth and globally condemns themselves when they fail or are rejected; the central work is unconditional self-acceptance. In discomfort disturbance, they demand that life, their emotions or their effort be comfortable and bearable, and treat frustration as unbearable; the central work is raising frustration tolerance. Both usually coexist and feed one another: low frustration tolerance makes it easier for the person to become disturbed about being disturbed, so that overlooking the discomfort domain explains many therapeutic blockages and relapses. (Ellis, 1979/1980, in Ellis & Grieger, 1986; Ellis & Dryden, 1997; Ellis & Ellis, 2011).
Influences
- Stoic and Epicurean philosophy (Epictetus, Marcus Aurelius, Epicurus)
- Adler and Horney (individual and social psychoanalysis)
- Orthodox psychoanalysis (initial training and critique)
- Behaviourism (Watson) and personal constructs (Kelly)
- American pragmatism (Dewey) and epistemology (Russell, Popper)
- General semantics (Korzybski)
Key references
- Ellis, A. (1957). Rational psychotherapy and individual psychology. Journal of Individual Psychology, 13, 38–44.
- Ellis, A. (1962). Reason and Emotion in Psychotherapy. Lyle Stuart.
- Ellis, A. (1994). Reason and Emotion in Psychotherapy: Revised and Updated. Carol Publishing Group.
- Ellis, A., & Dryden, W. (1997). The Practice of Rational Emotive Behavior Therapy. Springer Publishing Company.
- DiGiuseppe, R., Doyle, K. A., Dryden, W., & Backx, W. (2014). A Practitioner’s Guide to Rational-Emotive Behavior Therapy. Oxford University Press.
- Dryden, W., & Neenan, M. (2015). Rational Emotive Behaviour Therapy: 100 Key Points and Techniques. Routledge.
- Maultsby, M. C., Jr., & Ellis, A. (1974). Techniques for Using Rational-Emotive Imagery. Institute for Rational-Emotive Therapy.
- Dryden, W., & Bond, F. W. (1994). Reason and emotion in psychotherapy: Albert Ellis. British Journal of Psychiatry, 165(1), 131–135.
- David, D., Lynn, S. J., & Ellis, A. (Eds.). (2010). Rational and Irrational Beliefs: Research, Theory, and Clinical Practice. Oxford University Press.
- Ellis, A., & Grieger, R. (Eds.). (1986). Handbook of Rational-Emotive Therapy (Vol. 2). Springer Publishing Company. [Ed. esp.: Manual de Terapia Racional-Emotiva, Vol. 2, Desclée de Brouwer, 1990].
- Ellis, A. (1980). Discomfort anxiety: A new cognitive-behavioral construct. Rational Living, 14–15.
- Ellis, A., & Ellis, D. J. (2011). Rational Emotive Behavior Therapy. American Psychological Association.
- Chávez Icaza, A. L. (2015). Albert Ellis (1913–2007): la vida y obra de un terapeuta cognitivo. Revista de Psicología (UCSP), 5(1), 137–146.
- Albert Ellis Institute. (s. f.). About Albert Ellis, Ph.D.
- Albert Ellis Institute. (s. f.). Our Mission and History.
- Academy of REBT. (s. f.). The History of Rational Emotive Behavior Therapy.