In 1953, New York psychologist Dr. Albert Ellis looked at the state of psychoanalytic theory and asked, “Where’s the evidence?” That simple question, combined with Ellis’s determined hard work in the face of the ridicule and scorn of psychoanalysts, launched a paradigm shift in psychology—one that transformed mainstream therapy from a mysterious, almost mystical, experience into a cognitive and behavioral process that can be studied using the tools of the scientific method. This effort launched the cognitive revolution in psychotherapy.
While cognitive behavior therapy is widely accepted today, the workbegun by Albert Ellis in 1953 continues. Before his death on July 24, 2007, he asked a group of trusted colleagues to continue his efforts. One of his goals was to ensurethat reason, science, and rationality would remain top priorities in the evolution of psychotherapeutic techniques. Among that trusted group of colleagues was Dr. Paul Kurtz,chairman of the Center for Inquiry.
Reason Emerges from the Darkness of Unreason
Like most therapists of the middle twentieth century, Ellis had practiced psychoanalytic methods. Growing doubtful of the vague and scientifically untestable principles of the various forms of Freudian psychoanalysis, he decided to change the way he, as a therapist, interacted with his clients.
Ellis taught his clients to become skeptics—to question the sanctity of their most cherished beliefs, to critique their thoughts and emotions, to work actively at changing, and to pay attention to a basic idea once expressed by William James, the founder of American psychology:by changing your thinking, you can change your life.
These ideas were hardly new. In 1905, Swiss psychiatrist Paul Dubois wrote a book titled The Psychic Treatment of Nervous Disorders, in which he described a method of reducing needless mental suffering through a process he called “the education of reason.”
The idea of educating reason came from antiquity. Socrates, Aristotle, and Plato emphasized reason as the best hope for humankind. Like the philosophers who came before him, Dubois trainedpeople to apply reason to undermine irrational views involved in their persistent and needless emotional distresses. Unfortunately, his work was overshadowed by Freud’s psychoanalytic movement, which probed the mysterious area of the unconscious in search of repressed memories of early childhood trauma.
The fact that Freud’s theory was unsupported by evidence did not hinder its ultimate acceptance by mental health professionals. For decades, psychoanalysis enjoyed the favor of therapists, artists, intellectuals, and writers—a factor that helped cement into the public mind the image of the analyst’s couch as both an icon and a cliché. This iconic status allowed the mysterious processes on the couch to enjoy dominance over other, scientifically testable theories of mental disturbance. But cracks in the system started to appear in the late 1940s. One studyshowed that institutionalized mental patients who underwent analysis had a recovery rate lower than the spontaneous recovery rate. The time was ripe to get back to reason.
Techniques of Rational Therapy Take Shape
In 1955, Ellis began calling himself a “rational therapist.”He based his distinctively humanistic approach on scientific methods of inquiry conveyed through an educational model emphasizing the development of reason and the testing of propositions through action. Starting with the ancient wisdom of the Stoic philosopher Epictetus, who said it is not events that disturb people but their interpretation of events,he then adopted ideas from Socrates, Epicurus, Aurelius, Kant, Schopenhauer, and Russell. He was also influenced by Eastern philosophers such as Confucius, Lao-Tsu, and Buddha. Indeed, according to Ellis, philosophers rather than psychologists exerted the lion share of influence on the development of his psychotherapy.
Ellis drew also from the work of Alfred Korzybski, who advocated empirical inspection of the facts of individual situations before making generalizations. Such critical thinking guards against the unwitting inference to vague and misleading abstractions and overgeneralizations, including either/or thinking. This dichotomous thinking can lead to the fallacy of contingency worth: here, one defines oneself as either worthwhile or worthless, without determining the options that lie in between.
For more than fifty years, Ellis worked eighteen hours each day developing, testing, and writing about rational therapy. As he experimented, he refined and expanded rational therapy, changing its name twice along the way. Today, the therapy Ellis created is known as “rational emotive behavior therapy,” or more popularly by its initials, REBT. The rational system Ellis nurtured is now the bedrock foundation for other mainstream approaches, including cognitive therapy and cognitive-behavioral therapy.
The techniques of REBT are based on applying the tools of critical thinking and methods of scientific inquiry to the problems of our daily lives. Unfortunately, the teaching and honing of critical-thinking skills is rarely a high priority in elementary and secondary education. As a result, undiscerning students are vulnerable to faulty thinking and lack the reasoning skills to avoid superstitious, antiscientific thinking and to rationally assess such ideas as alien abductions, astrology, extrasensory perception, false memories, guardian angels, ghosts, and spiritualism. Still, reasoning skills can be taught and profitably learned.
We can also learn—and many wholeheartedly accept—from sources such as friends, family, teachers, and the media a variety of irrational ideas that lead to needless emotional distress. For example, Ellis outlined three common beliefs that underlie human disturbance: demands about ourselves, other people, or the world. He called these irrational claims The Three Basic Musts.
- I must do well and win the approval of others or else I am no good.
- Other people must treat me exactly the way I want them to treat me. If they don’t, they are no good and they deserve to be condemned and punished.
- I must get what I want, when I want it; and I must not get what I don’t want or I can’t stand it.
According to Ellis, this form of demanding is a major trigger for emotional disturbance. To help derail such anti-empirical thinking, Ellis taught his clients and other therapists to ask, “Where is the evidence that the universe and other people must conform to my demands?”
Ellis coined the colorful word MUSTurbation to describe the human tendency to turn strong preferences into irrational musts. He discovered that eliminating the demands while retaining the preferences leads to less-disturbed thinking, feeling, and behavior.
People can and do needlessly distress themselves through adopting different forms of irrational thinking. For example, depressive thinking can include ideas of helplessness, hopelessness, and self-pity. Effectively addressing depressive thoughts correlates with relief from depression and measurable changes in brain structure associated with changes in thinking. When examining such distortions, one may find an irrational must, such as “I must stop this thinking and must stop feeling depressed.”
The application of skeptical inquiry and the scientific method, which Carl Sagan called “the fine art of baloney detection,” provides an antidote to irrational demands. It works as well for evaluating irrational ideas that drive cognitive and emotional disturbances as it does for claims of the paranormal.
Baloney detection reduces the effect that an irrational belief has on a person’s life. Some irrationality has little bearing on quality of life, such as believing that grasshoppers can hear at frequencies that they really cannot hear. But some forms of irrationality can be harmful. Ellis considered a belief irrational and harmful if it:
- blocks people from achieving their goals, creates extreme emotions of distress that persist or immobilize the person, or leads to behavior that harms oneself, others, and one’s life in general;
- misinterprets reality;
- contains illogical ways of evaluating oneself, others, and the world.
REBT practitioners challenge their clients to look for evidence to support unsound and harmful irrational beliefs and to test the assumptions behind them. Invariably, as with claims of the paranormal, the evidence for such irrational beliefs is in short supply. When clients recognize their beliefs as irrational, REBT therapists encourage them to adopt flexible and nondogmatic alternative views. For example, instead of clinging to the anxiety-provoking idea that they absolutely must not be rejected by anyone, clients are encouraged to question whether rejection is catastrophic.
In addition to teaching clients to think critically,REBT practitioners advocate humanistic values that increase the probability of living a healthy and happy existence. They include:
- The goal of happiness. Rational individuals seek happiness whether they are alone or with others, in groups or in intimate relationships. They prefer to be well informed; they look for rewarding work; and they make the most of leisure time.
- Long-range hedonism. Emotionally healthy people balance the pleasure of the present with the prospect of future pleasure. They avoid engaging in potentially harmful short-term pleasures (e.g., heavy drinking) that are likely to lead to long-term problems (e.g., cirrhosis).
- Acceptance of mortality. Given that this is the only life we can be sure we’ll have, it makes sense to enjoy it as much as possible.
- Self-direction. Rather than primarily rely on government, a deity, or others to provide a life direction, rationally healthy individuals tend to set and pursue their own enlightened goals.
- Acceptance of uncertainty. Life offers few guarantees. Mature people know that predicting the future is unreliable at best and fraudulent at worst. They accept that they live in a world of probability and rarely upset themselves over life’s uncertainties.
- Commitment to creative pursuits. Rational people tend to throw themselves into creative pursuits that they consider purposeful and meaningful.
- Enlightened self-interest. Rational people pursue their own happiness and at times, though not always, put their own interests ahead of the interests of others.
- Social interests. Rational people work toward creating their preferred communities and relationships. Accordingly, they act ethically and protect the rights of others.
- Flexibility. Ellis claimed that “musts” are a human invention. Psychologically healthy andhappy people strive to be pluralistic and nondogmatic in their outlook.
- Acceptance of Reality. Albert Ellis’s Three Dimensions of Acceptance includes unconditional self-, other-, and life-acceptance. Human beings are incurably fallible. The rational individual accepts human fallibility and the vagaries of life. Acceptance does not mean acquiescence and does not preclude taking highly assertive initiatives; it means taking reality as it comes. Unconditional self-, other-, and life-acceptance separate REBT from other cognitive-behavior therapies that do not include this guiding philosophy.
- Risk-taking. People who are relatively free of rigid views are more inclined to step outside their comfort zones and try new experiences. While they prefer to avoid failure, they accept it as part of life.
- High frustration tolerance/non-utopianism. Life is full of hassles. Instead of whining about life’s frustrations, the rational individual heeds the maxim of Reinhold Niebuhr to develop the courage to change what can be changed, the serenity to accept what can’t, and the wisdom to know the difference.
- Emotional responsibility. Rational people embrace healthy emotions as a blend of thoughts, feelings, and actions. They may rightly hold others accountable for untoward actions but don’t blame them for causing their own emotional distress. Instead of saying, “It makes me mad,” or “She upset me,” they take responsibility for their thoughts,feelings, and actions.
Psychotherapies Can Be Empirically Validated
The 1949 Boulder Conference on Clinical Psychology recommended training Ph.D. psychologists as researcher-practitioners. Ellis followed this model. He identified conditions associated with human disturbance and health and defined the concepts so they could be empirically tested, relying on evidence instead of conjecture. He directly and indirectly helped train thousands of counselors and psychotherapists to think empirically.
Today, REBT remains guided by the view of philosopher of science Karl Popper: a theory that can’t be tested is useless. When a theory is disconfirmed, a more accurate theory is sought and again tested. This process is repeated until confirmations are established and adopted based on the evidence.
Cognitive and behavioral methods such as REBT now dominate psychotherapy, replacing psychodynamic therapies that rely largely on Freudian premises. This dominance arose partially because the research supported its efficacy. But the change from pseudoscientific methods to those with empirical support was largely due to the emergence of managed care.
Insurance companies directed their dollars toward evidence-based methods. But that doesn’t mean the battle between scientifically validated psychotherapeutic methods and pseudoscience is over. Techniques and theories such as rebirthing and energy therapies still enjoy favor with the public and, sometimes, with the press.
Can Self-help Really Help?
The term self-help has a tendency to raise the hackles of the skeptically minded. Somuch absurdity falls under the category of self-help that a self-respecting critical thinker may give anything carrying that label a wide berth. For example, Jennifer Niesslein’sbook Practically Perfect in Every Way recounts the author’s two years of consulting self-help gurus whose advice included encouraging her to walk around her house clapping her hands into corners to disperse stagnant energy and seeking out “the guardian spirit of the house and . . . the spirits of earth, air, fire, and water.”
Skeptics may be surprised to learn that practitioners consider REBT a self-help therapy. Ellis’s readers find his books an effective, inexpensive way to get better at their own pace and on their own initiative.
Ellis emphasized the importance of incorporating rational thinking into the habits of daily life. Superficially knowing about REBT or any other type of critical thinking system is easy. Becoming emotionally and behaviorally involved in applying these skills to one’s life takes personal effort and practice. That’s one of the reasons REBT is called self-help. The only behavior we can control or change is our own.
It may help to have consistently ethical role models and teachers who not only represent an understanding of the concepts but who practice them in their daily lives. Ellis acted as such a role model for the therapists he trained and for his many clients. Still, he emphasized the importance of applying one’s own efforts toward self-change without relying on gurus or psychics.
Research indicates that by reading self-help materials (bibliotherapy) people can overcome many forms of emotional distress, if the approach taken in those materials is cognitive- and behavior-based. For example, several meta-analyses suggest that a subgroup of people with depression, anxiety, perfectionism, and substance abuse make significant progress through reading about and applying evidence-based cognitive and behavior techniques.
Starting with his 1957 rational emotive therapy book, How to Live with a Neurotic, Albert Ellis spearheaded the use of bibliotherapy. Throughout his writings, he took the strong position that ridding oneself of troublesome symptoms was often insufficient. Instead, he emphasized what he saw as a more elegant approach that involved making profound changes in attitude and life philosophy. Readers learned to reduce the negatives in their lives and increase the positives. Rational readings help augment this direction.
REBT in Action
REBT involves teaching people how to dispute irrational thinking, change unhealthy behaviors, and become more skeptical, scientific, and creative. Since Ellis mainly worked with a population of emotionally upset individuals, his first step was to help them get over their immediate distress.
He developed an ABC technique to help clients organize and change irrationally harmful thoughts, feelings and actions:
- Astands for Adversity or Activating event.
- Bstands for the Beliefs about the event. (Some can be rational, some irrational.)
- Cstands for emotional or behavioral Consequences.
Adversity can be anything the person views as disturbing, such as a nightmare, depressed mood, haunting thought, or job loss. The Belief about the adversity is the central part of the formula, creating the emotional and behavioral Consequences.
For example, getting caught in stalled traffic and missing an important meeting can prove both inconvenient and frustrating. But people can give themselves added stress if they tell themselves, “I can’t stand getting caught in traffic. This should not happen to me. I can’t stand this pressure.”An ABC analysis, combined with corrective actions,can lead to a dramatic reduction in the emotional distress this type of thinking evokes.
Ellis’s ABC system also has D and E components. The D stands for Disputing irrational or self-defeating beliefs. The E stands for new cognitive, emotive, and behavioral Effects. The following example illustrates how the ABCDE model works to alleviate worry because a friend is late for a luncheon date.
Adverse event. A friend is forty-five minutes late for a luncheon date.
Irrational beliefs. What if something terrible happened? I’m sure something terrible happened. (Images come to mind of a bloodied friend in a tangled wreck with the jaws of life tearing at the vehicle door.)
Emotional and behavioral consequences. Anxiety, hand-wringing, pacing the floor.
Disputing irrational belief.: Where is the evidence that something terrible happened? Sample response: there is none. Sample conclusion: it would be wise to work to accept the idea that my fearful thoughts are probably not the same as facts.
Effects. A new rational view: the friend may have gotten a late start or gotten caught in traffic. A new rational conclusion: since the reason for the delay is unknown, it’s best to suspend judgment until I know the facts. Emotional result: a calmer outlook based upon a suspension of judgment about what could have happened.
In some situations, our level of worry may be the only variable we can control. By reducing it, we can lessen emotional distress and the physiologically stressful consequences that go with it. REBT does not claim to eliminate all unpleasant emotion; rather, it seeks to teach people how to stop becoming unduly upset or allowing their emotions to spiral out of control.
Some distresses, such as public-speaking anxiety, can involve both challenging the worried thinking and engaging in the feared situation. Ellis used behavioral homework assignments to expose the individual to the feared situation in a helpful way. Exposure research suggests that guided efforts in facing needless fears helped to minimize or eliminate them.
A key element of REBT is practice. Learning to dispute self-defeating or irrational thinking habits is a skill. Like any other skill, it improves with repetition. Homework assignments provide opportunities for practice in clear thinking. This can help decrease irrational thinking and increase opportunities to experience the breadth of emotions from healthy sorrow to joy.
In the end, the value of Dr. Albert Ellis’s work cannot be calculated by a building appraisal or a bank account. His work’s value is better determined by his network of trained REBT practitioners and supporters, the flexibility of REBT to evolve in the future, and the countless people who have increased their health and happiness through working to develop an educated reason. These are the true accomplishments of this revolutionary thinker. His legacy will continue into the twenty-first century and beyond.
- Dubois, Paul. The Psychic Treatment of Nervous Disorders. Translated by Smith Ely Jelliffe and William A. White. Sixth edition. New York: Funk and Wagnalls, 1909.
- Ellis, Albert. “What Is Rational–Emotive Therapy (RET)?” In A. Ellis and M.E. Bernard (Eds.), Clinical Applications of Rational–Emotive Therapy, pp. 1–30. New York: Plenum, 1985.
- ———. Feeling Better, Getting Better, Staying Better. Atascadero, California: Impact Publishers, 2001.
- ———. The Case Against Religion: A Psychotherapist’s View. Austin: American Atheist Press, 1980.
- ———. Reason and Emotion in Psychotherapy. Secaucus, New Jersey: Citadel, 1962.
- Knaus, William. The Cognitive Behavior Workbook for Depression. Oakland, California: New Harbinger, 2006.
- Niesslein, Jennifer. Practically Perfect in Every Way My Misadventures through the World of Self-Help—And Back. New York: G.P. Putnam’s Sons, 2007.