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Rational Emotive Behavior Therapy:
Philosophy and Application
Mark S. DeBord, LCSW, LLC
www.markdebord.com
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Rational Emotive Behavior Therapy
proposes that psychological disturbance is largely
created and maintained through irrational
philosophies consisting of internal absolutistic
demands. This therapy strives to produce sustained
and profound cognitive, emotive, and behavioral
change through active, vigorous disputation of
underlying irrational philosophies and the
development of rational alternatives.
Sacks, Susan Bendersky. Rational emotive behavior therapy: disputing
irrational philosophies. Journal of Psychosocial Nursing and Mental Health
Services. (May 2004) Vol. 42 Issue 5.
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Epictetus in 1st Century A.D. People are
disturbed not by things, but by the views
which they take of them.
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Objectives1.Participants will discuss the philosophical
underpinnings of REBT.2.Participants will understand and be able to
use the ABC model of REBT as a core component of therapy.
3.Participants will consider how REBT is used to address a variety of disorders/ clinical presentations.
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REBT Philosophy Epistemology theory of knowledge (search for the
truth)
Dialectics art of reasoning art of logical thinking
Survival and enjoyment are valued (REBT
encourages long range hedonism vs. short-term)
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Sub-Values1. Self-interest may give of themselves to some degree for
others, but not completely
2. Social-interest protecting rights of others helps us survive
together
3. Self-direction it is best to assume responsibility for ourselves
vs. demanding that we have excessive support from others
4. Tolerance allowance for our self and others to be wrong or
make mistakes
5. Flexibility rigidly held beliefs get in the way of happiness
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Sub-Values6. Acceptance of uncertainty the world is fascinating and full
of probability and chance; absolute certainties do not exist. Order is helpful, but complete predictability is not possible nor necessary.
7. Commitment people are generally happier when vitally absorbed in something outside themselves a creative interest and/or significant interpersonal involvement
8. Self-acceptance unconditional self-acceptance (USA) is more conducive to satisfactory life vs. a constant demand to prove ones self/ measure / rate Ellis was against rating ones self at all, but in favor of rating behaviors. A person is too complex to be given a global evaluation.
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Sub-Values9. Risk-taking emotionally healthy people are willing to take
risks and live life as adventure whether more conservative or
risky
10. Realistic expectations healthy people do not strive for what
is not possible we cannot get all we want
11. High frustration tolerance lump it when you dont get what
you want do what you can, accept the rest
12. Self-responsibility avoid blaming others - take responsibility
for the solution by being responsible for your own thinking,
emotions and behaviors
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REBT Philosophy Epistemology theory of knowledge (search for the
truth)
Dialectics art of reasoning (Gift from God) art of
logical thinking
Survival and enjoyment are valued(REBT
encourages long range hedonism vs. short-term)
Will and choice of an individual is important
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REBT does not teach self-discovery,
but rather self-construction. REBT
views the client not as an entity to
be found, but one who is an ever developing being.
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REBT Philosophy Epistemology theory of knowledge (search for the
truth)
Dialectics art of reasoning (Gift from God) art of
logical thinking
Values survival and enjoyment (REBT encourages
long range hedonism vs. short-term)
Will and choice of an individual is important
Ethics treating others well (contrary to what some
think, REBT is not blindly hedonistic, it does recognize
that when you treat others well, it increases the
likelihood of being treated well)
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REBT Principles Cognition is the most important proximal
determinant of human emotion.
Irrational thinking is a major determinant of
emotional distress.
The best way to conquer distress is to change
irrational thinking.
Multiple factors impact ones emotions (biology,
genetics, environment, culture, etc.), but humans
have a tendency to think both rationally and
irrationally. It may be that there are short-term
benefits from irrational thinking.
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REBT Principles Emotions have purpose. Negative emotions, in
particular, tend to be a cue that there is something wrong much like physical pain lets us know there is something wrong.
Although people may have developed dysfunctional patterns of thinking in reaction to experiences or education, the reason people continue in their dysfunctional thinking patterns is continued indoctrination/ rehearsal and refusal to challenge them.
People can change those dysfunctional thinking patterns, but it generally takes persistent, active practice to think in alternative fashion one of the ways to cement the new belief is to act on the belief act as if..
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Core Irrational Belief Demandingness
oFrustration Intolerance choosing short-term comfort or pain avoidance
oHuman Worth Ratings thoroughly judging ourselves or others based on too little information and ignoring potential
oAwfulizing/ catastrophizing: un-survivable
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Assumption
People generally want to be reasonably happy and/or content and disturbing emotions and behaviors interfere with that goal.
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Modern Philosophical
InfluencesBeara, Vladan. The Contribution of REBT in Addressing the Givens of Existence. Journal of Rational Emotive Cognitive Behavior Therapy (2015) 33:179-197.
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Existentialism Existentialists focus on the individual in the world
There is no meaning to be found, only that which
we give it. The meaninglessness also encompasses
the amorality or unfairness of the world and it is only
when we ourselves see this and experience the
pain that comes from facing the meaninglessness
that we can begin to live authentically.
Existence means that individuals are independently
acting and responsible, conscious beings. Existence
has to do with self-making/ constructing. Existence
is free and uncertain.
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Victor Frankl - Logotherapy
Teaches that human freedom is not
freedom from the conditions of the world,
but free to form an attitude toward the
conditions of the world.
REBT is in agreement and encourages
people to accept the very things that they
often unacceptable.
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Irvin Yalom 4 Ultimate Concerns
1. Death
2. Freedom and Responsibility
3. Existential Isolation
4. Meaninglessness of Life
Confront by deep personal reflection that results in
adopted beliefs (assignment of meaning) about these
concerns that lead to a more adaptive, productive,
and satisfying life or one more full of anxiety and
dread.
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Jean Paul Sartre How do we make sense or make peace with the
fact that other people so often act stupidly,
irresponsibly, sneaky, mean, envious, unwilling to
help, etc.? At a certain point the task is to accept
that other people are fallible and imperfect. But
then we have to face the same in ourselves.
Finally, we have to face the conflict with God or the
universe. How do we make sense or make peace
with God for making the world as it is?
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REBT thought REBT teaches clients how to use a strong
preferential rather than imperative; to
unconditionally accept self, others and the world.
This is important as we often want to believe that
people are basically good, that there is meaning in
the world and it is benevolent, that there is justice,
and there is predictability. Where this does not
match with our reality, suffering results and we do
not like suffering!
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Facing Death Yalom death anxiety is the mother of all religions.
Martin Heidegger once one is born, they are old enough to die and the awareness of that mortality gives value to life such that we shift to a higher state of mindfulness and authenticity.
Seneca no man enjoys the true taste of life but he who is willing and ready to abandon it.
Facing death makes us appreciate life.
Dealing with death carries a great potential for traumatization, but also a potential for post-traumatic growth.
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Viktor FranklThere are no certainties.
We are not free from condition: biological,
environmental, psychological or social.
We are free to take a stand as to how we will respond
to these conditions. The happier people were the
ones who reached out to help their fellow human.
(Mans Search for Meaning Viktor Frankl 1945)
(Happiness Is. Shawn Christopher Shea - 2005)
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Facing Freedom and Responsibility
Existential angst is a negative feeling
arising from the experience of human
freedom and responsibility, while despair
is generally defined as a loss of hope to
be what one defined ones self to be.
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REBT thoughtAlthough many attempt to deny responsibility,
there is a general assumption that
responsibility for ones self is a precondition of
therapeutic change.
Unwanted events may have an important role
in how we feel, but the disturbance comes
from our present cognitions, beliefs and
assigned meaning we give those unwanted
events.
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IBs vs. RBs Associated with Freedom and Responsibility
1. that there is an invariably right, precise and perfect solution to human problems and that it is awful if this perfect solution is not found is. REBT teaches that there is no human perfection and no human certainty.
2. that one must be competent, adequate and achieving in all important aspects or else he or she is an inadequate, worthless person. REBT teaches that all of us can and do easily fail.
3. that if there is no absolute certainty in life, then one cannot and must not face life responsibilities and difficulties and that it is easier to avoid them. REBT teaches that just because there is no absolute certainty, humans still have responsibility to make decisions. Actually avoiding being active in our own lives can lead to even greater suffering. It is like being at sea being tossed by the waves without having our rudder and engines at work to navigate our course. Quest for certainty is futile. There are no perfect solutions. It is in the discomfort that we have the opportunity to grow.
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Facing Existential Isolation
Yalom: Interpersonal isolation (loneliness);
intrapersonal isolation (do not understand or may
even deny parts of ourselves); and existential isolation
(separation from others and the world as a whole).
Heidegger: We are birthed into the world alone and
we exit alone. There are times in life when one
experiences de-familiarization ones role or situation
changes to the degree that one no longer feels at
home in the world many phases of life require
adjustments/ redefining in life.
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Facing Existential Isolation
This feeling of aloneness drives us to connect and to be a part.
Unfortunately, we will connect with many things to end that discomfort that may make the long-term consequences worse. But it can also draw us to God and to other worthy pursuits.
But make no mistake, even that does not make a way to avoid suffering, it only makes a way for more meaning and the hope in the suffering.
If we are able to acknowledge our isolated situations and confront them with resoluteness and authenticity, we will be able to turn lovingly toward others.
A relationship at its best involves individuals who relate to one another in a need-free fashion.
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Facing Existential Isolation
Camus: Isolation must be experienced before it can be overcome/ transcended. It is the ability to recognize the discomfort of aloneness and overcome the longing to flee, that allows us to mature, accepting that existential isolation.
Believing in a deity that loves us, that takes care of us, that has a plan for us and will never abandon us probably has a potential to diminish the sense of existential isolation. This likely also prompts us to reach out and engage other people who are participating in the same experience. If in nothing else, this binds us together.
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REBT: IBs associated with isolation:
1. that the world should be and must be different
than it is including feeling isolated/ lonely
2. the world owes us something and should not,
must not frustrate us, especially unnecessarily
it should and must provide a sense of comfort
and refuge
3. we should and must have a sense of familiarity/
belonging
4. there is a dire necessity to be loved or
approved by virtually every significant person
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REBT: RB associated with isolation:
We would do better to accept that we
may at times be alone in the world and
may find ourselves in unfamiliar territory,
but we are still responsible to self-make
by making choices and redefine our
purpose and meaning as life
circumstances change.
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Facing MeaninglessnessJung: the principle aim of psychotherapy is not to transport one to an impossible state of happiness, but to help him to acquire steadfastness and patience in the face of suffering.
Frankl: Humans seem to require meaning. Without it, we tend to be distressed (The Search for Significance Robert McGee). Jung was in agreement who said that neurosis must be understood as a suffering soul which has not discovered its meaning.
Frankl: Life can be made meaningful by what we contribute (work or creativity); what we take (experiences, sensations) and the stand we take on the destiny that is our reality (tragedies, unfortunate events). Life until its very end is meaningful ..
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Just World HypothesisMelvin J. Lerner: We are deeply threatened by the
possibility of bad things being able to randomly
happen to us. Humans want predictability.
When people experience trauma, they often
want to make sense of the traumatic event by
understanding what happened, how it happened
and why it happened.
At the very least, they want to find personal
significance in the event or gain something for
their present life from the experience.
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REBT Thought
REBT would ask what kind of life would have
meaning for you. It seems that crises of
meaning are inherent to the normal process of
maturation. Crises of meaning are a threat, but
they also represent a chance for obtaining a
new quality of life and wisdom.
Life is difficult!
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Session Structure1.brief check on current emotional status
2.review homework
3.set goals for the session
4.assessment of self-defeating (irrational)
beliefs using the ABC model
5.disputation
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Session Structure6. rational alternatives
7. problem-solving and skill building
8. review salient points of session
9. assignment/ agreement on homework
10.client feedback
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REBT General Goal
Acceptance of self, others, and situation are general goals of REBT while working to improve our situation and increase our capacity/ efficacy.
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ABC Model of REBT
Activating Consequence
Event
Situations
Emotionaland
Behavioral reactions
Irritation, disappointment vs. anger, depression,
guilt, anxiety
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ABC Model
Activating Belief Consequence
Event System
Situations
I wish I desire I prefer
Preference not met
I Must have PreferenceI must
You must The world must
Positive Emotional/ Behavioral reaction
Negative Healthy Reaction
Negative Unhealthy Reaction
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Cognitions are wired into various schemas in order
that we might more efficiently function. Therefore,
often our thoughts are functionally unconscious
although may be accessible to the conscious. This is
actually adaptive until we run into difficulties where
the schema no longer works for us then it pays to
analyze the thinking and processes we are using to
approach life in order that we might formulate new
schemas/ patterns of interacting and interpreting the
world such that we can better reach our goals and
get along more fluidly/ satisfactorily.
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Insights1. Our thinking/belief system has a tremendous influence on
how we react to an event or experience (feelings and
behavior).
2. Regardless of how we came to our belief system (think the
things we do), we keep that belief system alive by repeating
the thoughts to ourselves and acting upon them; thus,
reinforcing them and refusing to challenge their validity and
effectiveness.
3. To change disturbed feelings and behaviors, change the
thinking and practice practice practice!
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REBT
Thinking irrationally is the human condition. We are all born with a tendency to think irrationally and rationally self-defeatingly and in our self-interest.
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REBT
Our emotional and behavioral
responses are largely caused/
affected by our conscious and
unconscious evaluations,
interpretations and philosophies.
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Distinction between healthy and
unhealthy negative emotions
Concern vs. anxiety
Sadness vs. depression
Remorse vs. guilt/ shame
Annoyance/ irritation vs. anger/ rage
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Development of an EmotionDevelopment of Emotional and Behavioral Reactions 05/30/2010 Mark S. DeBord, LCSW
Issue/ Event/ Situation
Perception is
Good!
Is
G
Emotional Result
Is Pleasant!
Perception is
Bad!
Perception is
Bad!
What a catastrophe!
This is
unovercomeable!
What a
Loser!
I cant stand this!
Emotional Pain:
anxiety, guilt,
anger, and
depression.
Ineffective Behaviors:
aggression, inactivity,
distancing, worry, self-loathing
As bad as this may be, blessings
and good remain - now and in
future possibilities!
Although I dont like it when I
do, everyone makes mistakes.
As bad as this may be and as
much as I dont like it, I can
stand it and God can handle it!
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Emotional Pain:
concern, remorse,
irritated and sad.
Effective Behaviors: problem-solving, ask
for change, plan for similar events,
connect with others, learn, make choices
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Disputation Strategies
Cognitive philosophical persuasion by way of
Socratic questioning and/ or didactic dialogue
Emotive Rational Emotive Imagery forceful
expression of the rational alternative
Behavioral bibliotherapy, exposure, response
prevention, role play, journaling, acting as though
giving advice to a friend
Functional examining whether or not the thought
or belief works over the long-run
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Should, Ought, Must(Red Flag Words?)
Indications of IBs are often seen in words such as
should, ought and must.
The challenge is to differentiate between what is
advisable vs. what is mandatory!
Therapists new to REBT may find themselves seeking
these words and disputing those statements
indiscriminately which is generally confusing for the
client and may lead to an alliance rupture.
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Replacement/ Alternative Rational Beliefs
It is not enough just to do away with the irrational
belief, but we want to replace it with a rational
alternative.
The alternative belief is to negate the must, affirm the
desire, counter the FI/ catastrophizing/ self-
denigration/ other-denigration; and develop a
behavioral (solution-focused/ problem-solving)
strategy to get more of your desire/ preference met
and accept what is not yet realized.
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Clients often want: The situation to change.
A perfect solution.
A guaranteed outcome upon making a thought-out decision.
A solution without effort.
To avoid discomfort of any kind.
Others to act differently.
Others to see things the way you or even most people see things.
The world to give them what they want or at least more of what they want.
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Homework Homework has always been a big part of
REBT to assist with the continued recovery
and application of therapy outside the
sessions.
However, people often do not do it! If you
ask about it each time without judgement, it
implies that it is important at least
important enough for you to ask about it.
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Problem-solving/ Solution-focused
Following disputation, problem-solving and skill
building become the focus with much ebb and flow to
assist with the overall application and prompting of
behavioral change.
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Discontinuation of Services
When client achieves goals and/or is able to be own
therapist using the bibliotherapy and other techniques
taught in treatment.
When there is a change in level of distress (Likert
Scale/ PCOMS/ other outcome measure), a change
in behavior, reports of others, ability to accurately
complete self-help forms, etc. Client perception most
importantly.
Booster sessions may be helpful.
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Random thoughts in conclusion
Cannot keep thoughts from crossing our minds, but we
certainly can do something with them once they do.
Basically REBT is a psycho-educational model that teaches
clients to be their own therapists/ how to manage their
emotions and behaviors.
Get and use feedback. Allow clients voice to be heard.
Negotiate with them.
Insight (how one gets to a place) may be nice and even
helpful, but without learning how to change the beliefs or
learning a new helpful thought, it may not be enough.
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Q&AMark S. DeBord, LCSW, LLC
212 Cypress Street
West Monroe, LA 71291
318-381-9070
www.markdebord.com
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