Reading Temple Grandin Offers a New Perspective on REBT!

I have long agreed with Albert Ellis that his Rational Emotive Therapy (modernized to Rational Emotive Behavior Therapy), is a simple, elegant method for helping clients to learn how to improve their mood and live more comfortably. It is also a derivative of the ancient philosophy of Stoicism. I have worked with individuals and groups for many years, and most people to whom I have introduced REBT easily learn and use this technique for calming their unruly emotions and feeling better. It is not instant. It is not magic. But it really works. As with anything, using REBT well requires practice. 

One of my long-standing puzzles as a therapist has been how CBT (Cognitive Behavioral Therapy) has gained more popularity than REBT as the go-to therapy. There are indeed many books by many authors on each technique. Does CBT work better? Does it have better press? Are there more practitioners? is it easier to teach to therapists in training? Is it easier to teach to clients? 

My take on the above questions is  quite the opposite. I find REBT to be easier to learn, easier to teach, and more effective than CBT. I am trained in both, and, while I learned CBT in school and learned it first, when I studied REBT (Albert Ellis was one of my instructors), I was immediately stuck by how easy it was to learn, to teach, and to put into effect in my own life not to mention those of my clients. So is it the press? Perhaps.

Is a Psychiatric Diagnosis Just Another Name for What You're Feeling? A Rose by Any Other Name.....

The concept of mental illness is at its core about control. When someone is labeled mentally ill, a system including physicians, social workers, and government authorities begins to gain access to her life. People have problems. People have mental or psychological problems. The practice of calling these problems by names reflecting illness and thus putting them into the purview of physicians has been doing harm for decades. It is also demeaning, taking ultimate control from the individual and placing it within their genes or their parents.

I have said it many times and shall say it for as long as I can: there is not a pill for that. Make no mistake, your brain is a biological entity--YOU are a biological entity--thus distress of the mind and emotions are also biological entities, but this does not imply that the only or even the best or even a viable way to solve problems of the mind and emotions is with a pill. The overused "chemical imbalance" theory is dead. On the contrary, psychoactive pills cause chemical imbalances--they change your brain in ways science does not understand, sometimes they alleviate symptoms, but they do not CURE distress.

Thus one danger of calling mental distress a "disease" is that it is then treated as such--you become a patient and you look to a doctor to fix something. This works with appendicitis and broken legs and cancer. It is a fact, however, that not all things clearly within the realm of medical disorders are treatable by medical doctors. In general, there is no treatment for the flu or even the common cold, and physicians are stymied by irritable bowel and migraine. Medical science certainly does not work with depression, anxiety, phobia, PTSD, and the many variations of psychological distress delineated in the various manuals of disease such as the DSM and the ICD, because these are not diseases in the once-commonly understood meaning of the term. These problems do not show demonstrable tissue damage such as a cancer or a stroke, nor do they have symptoms that represent the body fighting a foreign invader, such as cough, fever, runny nose. Rather they have emotions and behaviors as their hallmarks.

Is Mental Illness a Myth?

Have I piqued your interest or accidentally insulted you? I did not make this question up. Thinkers and physicians for many years have wondered the same thing. Mental illness is confusing. It is not diagnosed as is physical illness via tests for microbes, probing for damaged or diseased tissue, nor compiling a list of objectively measurable symptoms. Mental illness is diagnosed via a system of symptom clusters published in one or another manual, the contents of which are agreed upon by scholars in the field. The problems arise when the contents of those manuals change over time, because mental issues are not clear-cut diseases as are physical illnesses. Things are added and subtracted over time--but we could not imagine a time when influenza would stop being called a disease!

Science tries, year after year, to isolate specific markers for mental illness. Tests come and go, but the construct remains elusive. We can objectively test for the flu or cancer or diabetes or a broken leg, but we cannot test in a way that never changes, for depression, schizophrenia, or anxiety. This does not mean that you are not suffering with your problem. It only means in this context, that your problem is mislabeled by being lumped in with physical illness. This is important for many reasons. I hope you are still with me as I elucidate why I, and others like me, believe calling mental problems "diseases" hurts those who suffer with them.

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Unconditional Self-Acceptance vs Self-Esteem: Which one do you want?

"Can you help me to raise my self-esteem?" is one of the most common questions I am asked. The answer I offer is "No, but I can help you to achieve Unconditional Self-Acceptance." While this may sound as if I am being difficult, indeed I am not. The self-esteem movement has not taken humanity in a good direction. Self-esteem is dependent upon achievement, and perhaps just now you are not achieving what you would like to see yourself achieve. This is a trap, because if you are not entirely please with your current performance and this therefore lowers your self-esteem, then how do you raise your self-esteem to encourage yourself to achieve more to your own standards?

Unconditional Self-Acceptance (USA) is not achievement-dependent. USA depends only upon taking a realistic look at yourself and accepting that this is where you are right here, right now in your life, without judgment. Having thus accepted yourself for all of your current traits, good, bad, and neutral, you are in a position to realistically assess what you would like to change about your current behavior. Acceptance is not complacency. Accepting yourself as you are does not mean stopping there, but it allows you to comfortably re-assess without putting yourself down for this lack or that failure. It is what it is, and accepting that without negatively judging yourself, versus judging a given behavior, is what gives you the motivation to alter it.

Unconditional self-acceptance provides you with power; the power to change. The reverse of USA is NOT self-hatred; it is simply denial. Thus, if you have not yet achieved USA, this simply means you have not yet given yourself a good, hard look and accepted each and every part of you: looks, behaviors, thoughts, and feelings. Some of these are malleable, and some are fixed. You cannot change your height, but you can change your mood or how you react to your failure to make that golf shot or your tendency to eat late in the evening. You begin with completely accepting that unfavored behavior and examining the thoughts that drive it. With this non-judgmental approach, it is much easier to take on the challenge of making difficult changes.

The Powerlessness of Getting Angry

"He makes me sooo mad."
"That really pisses me off."
"I can't stand it when you do that."

We often think of anger as a powerful emotion--anger makes us red in the face, we feel a surge of power, our voices get loud. What we fail to notice is that the perception of power is vastly different from the experience of power. When you are angry, you are not in control. You are powerless over what you feel, and often feel powerless over your reactions. This is not power, but its opposite, powerlessness, loss of control, and weakness. When you are not in control of your reaction to a situation, you are indeed weak. The presentation of anger may serve to decoy the person or situation about which you are angry, it presents a loud and blustery front, but it takes away your power to regain control of the most important variable: yourself.

Ah, but since it appears that people, things, and situations MAKE us angry, how do we avoid becoming angry and thus maintain control? By following the famous ABCs of Rational Emotive Therapy. A is an Activating event--it is what we complain about that has "made" us angry--a fact of experience. C is the Consequence we create--behavior(s) and/or emotion(s). Which leaves B out of its place between A and C. B is the Belief or set of beliefs, whether conscious or unconscious, that is the true cause of C. Generally the beliefs that cause anger are irrational.

To illustrate: a man tromps your toes quite hard in a crowded elevator. Your initial reaction of pain is a normal, automatic one. The next reaction (emotional C), anger, and possibly the shout (behavioral C) "hey, look where you are going", is mediated by your beliefs that "he should be more careful", "he should look where he is going", "he should have waited for the next car", etc. Then you notice the white-tipped cane--the man is blind. Your anger is replaced by compassion, perhaps a lingering annoyance that no one in front helped him enter safely, a touch of shame for being angry at a blind man, etc. Thus the anger was NOT caused by your toes having been stepped on, but by the thoughts generated by your related beliefs. The anger, thus created, can be eliminated once the belief system is altered either by new knowledge ("he is blind"), or by a conscious choice as in this next example:

Your daughter is very late getting home one Saturday evening. You are frustrated that she is missing her curfew once again. You are getting angry, and thinking about how you will discipline her when she finally shows up. You feel yourself coming to a boil, and the words "grounded for life" and "never go out with those people again" bounce around in your brain. Eventually, you realize that losing sleep, pacing the floor, and planning the expected late-night ambush will do little to solve the problem of her frequent tardiness, but will result in her becoming correspondingly angry at you and creating a stalemate on the issue of improved behavior. You create a plan to deal with her in the morning, and head off to bed, your anger having turned to disappointment, and your self-control reasserted. You even manage to get some sleep, which your worried daughter, having created her own defensive, angry stance, ("where is the expected, unreasonable parental ambush?") is not able to achieve.

Success--you have managed your irrational thoughts ("that girl must respect the house rules", "I can't stand having a child who disobeys", "what a bad daughter I have"). By changing your thoughts into calmer ones ("it is a shame she has made another poor choice", "I need a plan to help her understand that if she is living here, there are rules she must follow", "children test the patience of parents; I remember that from when I was her age, but it will make for a happier household if she learns to cooperate".), you regained control over your emotions and behaviors. Changing your thoughts from demands and name-calling into preferences and facts helped you to calm yourself and create a plan. You put yourself back in control of both you and the situation.

Getting from anger to calm is a process. It begins, in the language of RET, with D, a Dispute: "Is it really true that she must respect the rules, or is that just my unreasonable demand of a teenager?", "It is not true that I cannot stand her behavior", "She can be unruly, but she is not all bad"). Following your dispute, you arrive at a new approach, the reasonable beliefs that will allow you to sleep, as in the example above. E is that Effective new belief or philosophy. And F is your new behavior and emotions: getting a night of good sleep and dealing calmly with the teen in the morning ("Honey, we need to talk about your curfew"). You win and so does she. Having a calm parent helps her to remain open to learning and improving.

Whenever you find yourself thinking "(he/she/that)makes me sooo mad", you have given away your personal power. To maintain power and control, change your thoughts so that you can be understandably upset, disappointed, concerned, confused, etc., without losing control over your reactions and thus, the situation. Rational Emotive Behavior Therapy, developed by Albert Ellis, can help you learn to prevent anger and maintain control. Empower yourself!