Beating Backsliding – Dr. Walter Matweychuk
Rational Emotive Behavior Therapy, REBT, is a very useful therapeutic approach for achieving emotional and behavioral change. REBT works when people work at it. However, it is not unreasonable to expect and prepare in advance for backsliding. Expecting the possibility of backsliding after achieving therapeutic gains is an understandable stance to take when one observes the human condition. Research has shown that people who quit cigarette smoking and remain abstinent for ten years have tried and failed four or five times before learning how to remain abstinent from smoking for a ten-year period. In the same vein Alcoholics Anonymous, which has a few useful aphorisms worthy of note teaches its members to “Try fail, try fail, try succeed.” It conveys that people who have problems with alcohol can succeed in overcoming its grip, but it may take multiple efforts to learn how to do this.
Backsliding is not limited to people who use REBT with addictions. People who overeat can lose weight, but it will take effort and experimentation over time to learn how to maintain their new weight and not slowly creep back into eating larger portions when under stress. Even without stress, people find it hard to consistently eat healthy portion sizes and make healthy food choices in our obesogenic environment. Those of us who exercise know that it is sometimes easy to fall out of the routine of regular exercise when life gets busy. Another example of having to guard against backsliding is the case where students who have had problems with procrastination and who have made progress in addressing their academic procrastination return to their procrastinating and perfectionistic ways. People with anger problems, social anxiety and phobias will make therapeutic gains either on their own or with the help of an REBT psychotherapist but they also need to remain vigilant and continue to do what helped them change in the first place or else they will quickly backslide into well-established patterns of anger or anxiety-based avoidance and passivity. I hope you now are convinced that backsliding, lapsing and relapsing, whatever you may call the problem of losing your therapeutic gains is, unfortunately, part of the human condition.
Patients often experience a period of emotional upset in response to backsliding. They will commonly depress themselves, shame themselves, guilt themselves and feel hopeless after making changes and noticing that those changes are not enduring. Some patients will wrongly conclude that the presence of backsliding indicates that they cannot change and will never achieve long-lasting behavioral and emotional change. I teach these patients that this conclusion is not necessarily a valid conclusion. I build into my REBT psychotherapy from nearly the outset that it is the human condition to make both emotional and behavioral changes only sometimes to find those changes dissipate and old well-established patterns of behaving and emoting re-emerge. Backsliding and relapse may occur when we are under stress or when multiple events occur to distract us or otherwise prevent us from taking time to do what has been working in the first place to produce those hard-earned emotive and behavioral gains. What I have observed is that people, fallible humans, fatigue and discontinue doing what has been helping them. They stop rehearsing rational thinking; they stop taking time to do an ABC analysis of emotional upset, they stop listening to REBT audio found on REBTDoctor.com and stop refreshing their REBT skills and forget how to think, feel, and behave rationally. People stop working at REBT. They stop helping themselves.
I have found that a patient’s reaction to backsliding is often evidence of low discomfort tolerance attitudes and beliefs that require successful REBT treatment. It is as if the patient falsely believes that one makes a therapeutic change and it absolutely should be maintained without any effort on an ongoing basis. The truth of the matter is that humans can and do make emotional, behavioral and cognitive changes BUT because we are fallible humans, we will backslide. To assist these patients, I address their low discomfort tolerance attitudes and beliefs about maintaining behavioral gains. I teach the REBT philosophy of unconditional self-acceptance and unconditional life-acceptance. Unconditional self and life-acceptance are a choice a patient can make. You choose to accept yourself unconditionally even when you backslide. You surely will never like the tendency we all have to backslide, but you always can choose to accept yourself despite possessing this unwanted tendency. You accept that life often involves taking eight steps forward and two backward. Such relapsing and backsliding are too bad, but it is never the worst thing in the world NOR is it unbearable unless you are addicted to heroin and backslide and overdose. Death by overdose is sad, dramatic evidence that the backsliding was truly unbearable. Here the addict relapses and uses an amount of heroin they once were able to tolerate but now after a period of abstinence they no longer can tolerate that same amount, and they overdose and stop breathing. However, thankfully backsliding does not usually produce truly unbearable conditions. In most instances of backsliding we regain weight, stop exercising, start procrastinating, stop asserting ourselves and upset ourselves BUT we do not die from any of these steps backward because they are not truly unbearable no matter how disappointing they may be.
I teach that disturbing one’s self over backsliding will NEVER assist one in curtailing their backsliding. Take careful note of this important point. Many people wrongly believe that by upsetting themselves over backsliding that is a necessary and helpful thing to do in response to the acknowledgment of backsliding. I show them that disappointment, concern, and displeasure with backsliding are healthy and helpful negative feelings to experience. These feelings are self-helping because they both acknowledge the relapsing but are motivating and help us to resume the work necessary to restart therapeutic change. These feelings result from rational attitudes such as:
1. I wish I did not backslide, but sadly I have, and the universe permits this as I do not have to in an absolute sense maintain my therapeutic gains no matter how desirable that would be.
2. Backsliding is very disappointing but not the bloody end of the world, in 99% of the cases. Only when backsliding results in immediate death can we say it is truly unbearable.
3. Resuming the use of REBT methods and ideas may be uncomfortable but far from unbearable and well worth doing and tolerating. REBT works when I choose to work at implementing it!
4. The fact that I have taken a few steps backward is proof that I am a fallible human, NOT lesser as a human. I will unconditionally accept myself but not my backsliding because backsliding can have pernicious effects on my long-term well-being.
Reader note that feelings of shame, depression, anxiety, anger, and guilt are unhealthy and self-defeating and are what we in REBT considered to be an avoidable emotional disturbance. It is important that you see that disturbing oneself at the initial sign of backsliding, often also called lapsing and relapsing, will only maintain the backsliding instead of initiating determined effort to curtail it.
In addition to low discomfort tolerance attitudes, people may rate themselves due to their backsliding leading to shame, guilt, anxiety or depression. Rating oneself for backsliding leads to self-downing and will lead to hopelessness, despair, and inactivity. Backsliding is bad but you, the person doing the backsliding, is never a bad person. You are an organism in evolution. You are changing and no behavior, no matter how crucial to your personal goals, is a measure or a proxy for your human worth.
To successfully address your backsliding, you need to think differently about it. In REBT to think differently, you need to examine your attitudes ABOUT your backsliding and your attitudes leading to and maintaining your backsliding. To this end, I encourage you to question those crucial self-defeating attitudes you hold. The process of reflection in REBT is known as disputing your irrational attitudes and beliefs. For example, to begin challenging those self-disturbing attitudes underpinning your backsliding consider these questions:
1. Where is it written that change must occur linearly with no starts and stops, lapses and relapses? The sensible answer to this question is that no law of the universe dictates that change absolutely must be enduring and easily or effortlessly maintained. Accept this. Change is NOT a one and done affair.
2. Does it help me to hold the attitude that change must not require continued effort? The self-helping answer is that it NEVER helps to demand that change NOT require continued effort.
3. What attitudes towards backsliding are true and helpful? Therapeutic gains are difficult to maintain but not impossible when one works at the maintenance of gains and accepts it is necessary. Unfortunately, all humans are at risk of backsliding. The sensible approach to backsliding is to unconditionally accept oneself so that one fully and non-defensively acknowledge backsliding and then to reject it NOT oneself. By doing so, one can immediately make an effort to address one’s backsliding.
I also point out to my patients that humans learn through experience. Doing and re-doing is the way we learn. We are natural scientists and natural experimenters. The thing to do is to see that when humans keep after their goals and do not upset themselves when they backslide they continue to try and try again. By repeatedly working at a goal, we very often learn how to achieve the goal. What often makes the difference between goal achievement and ultimate goal failure is if we continue to try and figure out how to succeed at the goal. Grit, which is the capacity to work passionately at your goals over long periods of time, is facilitated by rational attitudes towards the struggle. REBT builds true GRIT and helps you keep after yourself and helps you to keep making the effort that ultimate goal achievement requires. Use Rational Emotive Behavior Therapy to address your emotional reaction to backsliding and see what I mean!