rational emotive behavior therapy

60
Rational Emotive Behavior therapy

Upload: nehabans84

Post on 11-Apr-2017

154 views

Category:

Healthcare


0 download

TRANSCRIPT

Rational Emotive Behavior therapy

Rational Emotive Behavior therapy

Albert EllisEllis was born in Pittsburgh in 1913 and raised in New York City.

He made the best of a difficult childhood by using his head and becoming, in his words, "a stubborn and pronounced problem-solver."

A serious kidney disorder turned his attention from sports to books, and the strife in his family (his parents were divorced when he was 12) led him to work at understanding others.

In junior high school Ellis set his sights on becoming the Great American Novelist.

He planned to study accounting in high school and college, make enough money to retire at 30, and write without the pressure of financial need.

The Great Depression put an end to his vision, but he made it through college in 1934 with a degree in business administration from the City University of New York

Ellis devoted most of his spare time to writing short stories, plays, novels, comic poetry, essays and nonfiction books.

By the time he was 28, he had finished almost two dozen full-length manuscripts, but had not been able to get them published.

He realized his future did not lie in writing fiction, and turned exclusively to nonfiction, to promoting what he called the "sex-family revolution."

At the time Columbia awarded him a doctorate in 1947 Ellis had come to believe that psychoanalysis was the deepest and most effective form of therapy.

He decided to undertake a training analysis, and "become an outstanding psychoanalyst the next few years."

The psychoanalytic institutes refused to take trainees without M.D.s, but he found an analyst with the Karen Horney group who agreed to work with him.

Ellis completed a full analysis and began to practice classical psychoanalysis under his teacher's direction.

By 1955 Ellis had given up psychoanalysis entirely, and instead was concentrating on changing people's behavior by confronting them with their irrational beliefs and persuading them to adopt rational ones.

This role was more to Ellis' taste, for he could be more honestly himself. "When I became rational-emotive," he said, "my own personality processes really began to vibrate.

He published his first book on REBT, How to Live with a Neurotic, in 1957.

Two years later he organized the Institute for Rational Living, where he held workshops to teach his principles to other therapists.

The Art and Science of Love, his first really successful book, appeared in 1960, and he has now published 54 books and over 600 articles on REBT, sex and marriage.

Albert Ellis died of heart and kidney failure July 24, 2007

REBTinterrelation of thought, feeling, and behavior

Human thinking and emotion are not two different processesour thinking, emoting, and acting all interact together

REBT is based on the concept that emotions and behaviors result from cognitive processes

REBT is a philosophically-based, humanistic approach that emphasizes individuals capacity for creating their own self-enhancing and self-defeating emotions.

Ellis borrowed from philosophy. Epictetus, the Stoic philosopher said, People are not influenced by things but their view of things.

REBT holds that an individuals belief system affects whether s/he attains maximum pleasure and self-actualization. Happiness is the goal of all human beings.

REBT is a theory of how people (who want happiness) can inadvertently create personality and emotional disturbance.

REBT seeks to help people understand that it is not past or present events that cause emotional disturbances

It is the individuals belief system about the event, self, others and the world that cause such disturbanceswhat Ellis called irrational beliefs

Theoretical conceptsAccording to REBC theory humans are happiest when they set up importantlife goals and purposes and actively strive to achieve these.

This involves pursuing our valued goals while demonstrating what Alfred Adlercalled social interest a commitment both to helping others achieve theirvalued goals and to making the world a socially and environmentally betterplace in which to live

Responsible Hedonism

REBC theory argues that as humans we are basically hedonistic in the sensethat we seek to stay alive and to achieve a reasonable degree of happiness.

Here hedonism does not mean the pleasures of the flesh but involves the concept of personal meaning; a person can be said to be acting hedonistically when she is happy acting in a way that is personally meaningful forher

REBC theory makes an important distinction between short- and long rangehedonism. We are likely to be at our happiest when we succeed inachieving both our short-term and our long-term goals

Enlightened Self-interestREB counsellors encourage their clients to demonstrate enlightened self-interest (or healthy self-care), which involves putting themselves first most of the time while putting others, and particularly significantothers, a close second.

Enlightened self-interest also sometimes involvesputting the desires of others before our own, particularly when the welfare and happiness of these others are of great importance to them and our. The Basic Principles of Rational Emotive Behavioural Counselling desires are not primary.

Philosophic and Scientific EmphasisREBC theory agrees with the ideas of George Kelly (1955) that we are also scientists and are able to appreciate that our philosophies are basically hypotheses about ourselves, other people, and the world, which need to be tested.

Humanistic Outlookhumanistic-existential approach to human problems and their solutions

This view conceptualises humans as holistic, indivisible, goal directedorganisms who have importance in the world just because we are human and alive

Two Basic Biologically Based TendenciesRational emotive behavioural theory hypothesises that as humans we have a biologically based tendency to think irrationally as well as a similar tendency to think rationally.

Two Fundamental Human Disturbances1.Ego disturbance relates to the demands that we make about ourselves/others andthe consequent negative ratings that we make when we/others fail to live up to our self-imposed demands

Eg.I may be angry at you because you are acting in a way which I perceive as a threat to my self-esteem.

2. Discomfort disturbance, on the other hand, is more related to the domain of human comfort and occurs when we make dogmatic commands that comfort and comfortable life conditions must exist.

Psychological InteractionismRational emotive behavioural theory states that a persons thoughts, emotions and actions cannot be treated separately from one another. Rather, they are best conceptualised as being overlapping or interacting psychological processes

constructivist counsellingEllis (1989) has argued that in fact REBC is a constructivist counsellingapproach. Thus, REBC theory holds that while people may well be influenced by their culture and family groups to have certain preferences, they construct rigid demands about their preferences

ABC Model

There are, in fact, two different types of A in REBT

Situational A refers to an objective description of what occurred in the situation in which the person disturbed himself

The second is known as the Critical A and refers to the subjective aspect of the situation about which the person disturbed himself. Most frequently, a Critical A involves an inference about what happened in the Situational A.

B stands for beliefs. These are evaluative cognitions or constructed views of the world which are either rigid or flexible and extreme or nonextreme.

When these beliefs are rigid they are called irrational beliefs and take the form of musts, absolute shoulds, have tos, got tos and so on.

awfulising meaning more than 100 per cent bad, worse than it absolutely should be;

(b) low frustration tolerance meaning that your clients believe that they cannot envisage enduring situations or having any happiness at all if what they demand must not exist actually exists

(c) depreciation here your clientswill depreciate themselves, other people, and/or life conditions.

Cant be empirically validated and/or is inconsistent w/ confirmable realityIllogicalBlocks goalsDogmatic instead of flexibleDemand rather than preference(Ellis calls this musturbation)

Hot and cold cognitionsREBT is focused on a particular type of cognitions, appraisal/evaluative or hot cognitions (i.e., rational and irrational beliefs), that are strongly involved in the generation of our feelings.

In a broad sense, REBT admits that B can also include descriptions (e.g., It is a crowded auditorium) and inferences (e.g., I will fail to speak in front of this auditorium) (e.g., cold cognitions; see David, 2003).

These can be represented in our cognitive system by production rules (i.e., if A then do C) and thus, generate mainly behaviors at C. The relations between cold and hot cognitions seem to be bidirectional.

Cognitive Distortions1. ALL-OR-NOTHING THINKING:You see things in black and white categories. If your performance falls short of perfect, you see yourself as a total failure.

2. OVERGENERALIZATION:You see a single negative event as a never-ending pattern of defeat.

3. MENTAL FILTER:You pick out a single negative detail and dwell on it exclusively so that your vision of all reality become darkened, like the drop of ink that discolors the entire beaker of water.

4. DISQUALIFYING THE POSITIVE:You reject positive experiences by insisting they "don't count" for some reason or another. In this way you can maintain a negative belief that is contradicted by your everyday experiences.

5. JUMPING TO CONCLUSIONS: You make a negative interpretation even though there are no definite facts that convincingly support your conclusion. a. Mind Reading:You arbitrarily conclude that someone is reacting negatively to you, and you don't bother to check this out. b. The Fortune Teller Error: You anticipate that things will turn out badly, and you feel convinced that your prediction is an already established fact.

6. MAGNIFICATION (CATASTROPHIZING) OR MINIMIZATION:You exaggerate the importance of things (such as your goof-up or someone else's achievement) or you inappropriately shrink things until they appear tiny (your own desirable qualities or the other fellow's imperfections). This is also called the "binocular trick.

7. EMOTIONAL REASONING:You assume that your negative emotions necessarily reflect the way things really are:"I feel it, therefore it must be true."

8. SHOULD STATEMENTS:You try to motivate yourself with shoulds and shouldn'ts, as if you had to be whipped and punished before you could be expected to do anything. "Musts" and "oughts" are also offenders. The emotional consequence is guilt. When you direct your should statements toward others, you feel anger, frustration, and resentment.9. LABELING AND MISLABELING:This is an extreme form of over-generalization. Instead of describing your error, you attach a negative label to yourself: "I'm a loser." When someone else's behavior rubs you the wrong way, you attach a negative label to him: "He's a goddam louse." Mislabeling involves describing an event with language that is highly colored and emotionally loaded.

10. PERSONALIZATION:You see yourself as the cause of some negative external event which in fact you were not primarily responsible for.

"The Big Four"(1) Demanding,(2) Awfulizing,(3) Low Frustration Tolerance, and(4) People Rating,

In the ABC framework stands for emotional, behavioural and thinkingconsequences of your clients beliefs about A

3 basic mustsBasic Must No. 1: Demands about Self The first basic must concernsyour clients demands about themselves and is often stated in these terms:I must do well and be approved by significant others and if Im not, thenit is awful; I cant stand it, and I am a damnable person to some degreewhen I am not loved or when I do not do well. These beliefs often lead toanxiety, depression, shame and guilt.

Basic Must No. 2: Demands about Others The second basic must concerns your clients demands about other people, and is often expressed as follows: You must treat me well and justly, and its awful and I cant bear it when you dont. You are damnable when you dont treat me well and you deserve to be punished for doing what you must not do. Such beliefs are often associated with feelings of unhealthy anger, rage, passive-aggressiveness, and acts of violence.

Basic Must No. 3: Demands about the World/Life Conditions The third basic must concerns your clients demands about the world or life conditionsand often takes the following form: Life conditions under which I live absolutely must be the way I want them to be and if they are not, its terrible, I cant stand it, poor me. This belief is associated with feelings ofself-pity and hurt, and problems of self-discipline for example, procrastination and addictive behaviour.

A.Ego Disturbance Demands about Self In this type of disturbance, it is quite clear that the person concerned is making demands about himself and the issue concerns his attitude towards himself. Thus, the major derivative from the demand concerns some variation ofself-depreciation: for example, I must obtain a good degree and if I dont I am no good.

B Discomfort Disturbance Demands about Self Here, the person makes demands about himself but the real issue concerns his attitude towardsdiscomfort: for example, I must obtain a good degree because if I dont, life conditions will be harsh and I couldnt bear that.

C Ego Disturbance Demands about Others Here, the person makes demands about another person, but the real issue concerns his attitude towards himself. A common example of this is found when another persons behaviour serves as a threat to the persons self-esteem and his unhealthy anger about the others behaviour serves to protect his self esteem: for example, You must treat me nicely because if you do not then that proves that I am no good.

D Discomfort Disturbance Demands about Others Here, the person makes demands about others but the real issue discomfort: for example, You must treat me nicely because I couldnt stand life conditions if you do not.

Ego Disturbance Demands about Life Conditions Here, on the surface, the person makes demands about some aspect of life conditions, but the real issue concerns his attitude towards himself: for example, Life conditions must be easy for me because if they are not then thats just proof of my worthlessness.

F Discomfort Disturbance Demands about Life Conditions .This kind of disturbance is a more impersonal form of low frustration tolerance. Itis often seen when a person loses his temper with inanimate objects: for example, My car absolutely must not break down because I couldntstand the frustration if it did.

Distinction between Healthy and Unhealthy Negative Emotions

39

Rational emotive behavioural theory does, however, put forward a more elaborate account of how we perpetuate our psychological disturbance.First, it argues that we do so because we lack three major insights: Psychological disturbance is primarily determined by rigid and extreme irrational beliefs that we hold about ourselves, others, and the world; we remain disturbed by re-indoctrinating ourselves in the present with these irrational beliefs; and the only long-term way of overcoming psychological disturbance is to work against our irrational beliefs and against our tendency to think irrationally and act dysfunctionally.

Secondly, rational emotive behavioural theory holds that we perpetuate our disturbances though our actions and subsequent modes of thought.. When a person thinks irrationally at B about an activating event at A, then I have shown that that person will experience an unhealthy negativeemotion at C. But, the person will also tend to act self-defeatingly at C (behavioural consequence) and think unrealistically at C (cognitive consequence) These behaviours and subsequent modes of thought frequently serve to strengthen the persons conviction in his irrational beliefs at B and in doing so they serve to perpetuate the persons psychological disturbance.

Theory of changeIt states that if clients are to overcome their emotional andbehavioural problems, they need to: (a) acknowledge that they have a problem; (b) identify and overcome any meta-disturbances about this problem; (c) identify the irrational belief that underpins the original problem; (d) understand why their irrational belief is, in fact, irrational(that is, illogical, inconsistent with reality, and will give them poor results in life); (e) realise why the rational alternative to this irrational belief is logical, consistent with reality, and will give them better results; (f) challenge their irrational belief so that they begin to strengthen their conviction in the rational alternative; (g) use a variety of cognitive, emotive, imaginal and behavioural assignments to strengthen their conviction in their rationalbelief and weaken their conviction in their irrational belief; (h) identify and overcome obstacles to therapeutic change using the same sequence as above while accepting themselves for their tendency to construct such obstacles; and (i) keep working against their tendency to think and actirrationally.