Overcoming Worry with REBT

Rational Emotive Behavior Therapy (REBT) is a tough-minded approach to emotional well-being, and this spirit of tough-mindedness attracts some people to it. In generic cognitive behavior therapy, the therapist guides the patients to test the validity of their worrisome thoughts, assessing the probability that adversity will occur. REBT, a distinct form of cognitive behavior therapy, prefers an entirely different tactic. This piece aims to show you how to manage anxious thoughts using the empowering approach preferred by REBT.

People worry and experience ruminative anxiety in response to a threat to their or a significant other’s future comfort (non-ego worry) or self-esteem (ego-worry). People often worry about their or significant other’s health, finances, job security, relationship status, acceptance by others or institutions, and safety. One way of approaching worry is to challenge the idea that the adverse threat will come to pass. Generic CBT prefers this approach and tries to show the individual that the dreaded event may not occur. A generic CBT therapist will be inclined to point out that one might be engaging in the fortune teller error and is assuming a threat will come to pass when, in fact, there is a certain probability that the threat will not be something the individual will have to face. Some people will take comfort in this reassurance. Often, this will be their reassuring strategy when a friend or family member attempts to comfort you about something. They might say, “You worry too much, that won’t happen; you always think the worst.”

The approach above has some merit to it. People worry themselves sick over events that never materialize; when this happens, they sometimes magically believe that worrying about the threat played a role in the adversity not occurring. Shortly after, their minds find a new threat to dwell on and worry about. Some people feel anxiety when they have nothing to worry about. They make themselves anxious by assuming they have missed a threat, have let their guard down, and are, therefore, more vulnerable to danger. People can be pretty creative in disturbing themselves; this is a prime example of such creativity!

The probabilistic approach favored by friends and family and offered as a first line of attack by generic CBT therapists is similar to pulling a dandelion flower without targeting its root system. In little time, the dandelion grows its flower back. Rational Emotive Behavior Therapy is rooted in philosophy and prefers to target the root system of worry, namely the rigid and extreme attitudes that underpin worry. REBT aims to liberate an individual and build confidence that if the worst-case scenario occurs, the individual will be capable of withstanding it. 

Below are a few worrisome thoughts and their associated underpinning rigid and extreme attitudes: 

I might fail the test. I must not fail the test. I would be a failure. (ego-worry)

This symptom means I have cancer. I must not have cancer. I could not bear the surgery and post-operative treatments and their side effects. (non-ego worry)

My partner’s inattention means they no longer love me. I need certainty that they continue to love me and will never leave me for another. I cannot face life without them. (non-ego worry) If they leave me, I would be lesser of a person. (ego-worry)

My daughter might not get into the school of their choice. She must get the opportunity to go to their preferred university. It would be unbearable to watch her face rejection and suffer the pain of deprivation. (non-ego worry)

I might outlive the money I have saved. I need certainty that I will not outlive my money and will be financially safe. It is awful to face financial stress and the deprivation that would go along with not having enough money to last me until I die. (non-ego worry)

Empower Yourself by Adopting A Healthy Attitude towards that Which You Fear

In REBT, we prefer not to run from the inference that the worst-case scenario will not come to pass. We encourage our patients to face their worst fears head-on and empower them. This path can be a tough sell, but in the end, it works best. The toughminded approach of examining your rigid and extreme attitudes about the worst-case scenario is a far more empowering antidote for worry. We wish to help you get past this worry and to help you get healthier more fundamentally. We desire to induce a profound philosophical change that will enable you to increase confidence in your ability to handle challenging circumstances and savor the moment. It is not that the spirit of the REBT philosophy is pessimistic. The philosophy of REBT is optimistic towards human resilience and realistic towards life. Although this may be the more difficult way to address the problem, it is empowering because sometimes the worst-case scenario in life occurs. Furthermore, if you believe “something must not happen,” you will be vulnerable to that dreaded event. We are prisoners of every “must not” we hold because the hand of fate may not comply with our demands for comfort, safety, and approval.

Another argument I make for REBT being an optimistic but realistic philosophy towards life is that we believe a person can have some happiness even when adversity that “must not exist” and “cannot be changed” occurs. This assumption is one reason I have stuck with this philosophy of life for 34 years of clinical practice. I have always known REBTers to be a happy bunch. I remember when I was in training at the Institute, laughter, songs, and parties, with no heavy drinking, were not uncommon occurrences. Dr. Ellis showed and modeled a spirit that happiness was still possible in an unfair and challenging world.

As an alternative to worry, REBT offers healthy concern as a realistic option. Healthy concern lacks the ruminative qualitative that is part of anxiety. With healthy concern, we will likely do whatever we can to prepare for a threat without overpreparation, which worry sometimes brings on. Overpreparing is a waste of time, energy, and other resources. With healthy concern, we also will be better able to appreciate the probability that the adverse event will or will not occur. Like our non-REBT cbt colleagues, we hope for the best but psychologically prepare for the worst. This stance is REBT-rooted confidence in our ability to face life’s challenges.

Now let us examine REBT’s healthy attitudes that you are encouraged to adopt as an antidote to worry:

Worrisome thinking: I might fail the test. I must not fail the test. I would be a failure. (ego-worry)

REBT’s Healthy attitude: It is true I might fail the test or not do as well as I like. I wish to do well on the test and will study hard. No evidence supports the idea that I must not fail the test. The universe allows humans to fall short of their goals. I have occasionally failed tests in life, and there is always some probability I will do so again. Failing would prove I am an imperfect human, not a failure. I will use my non-ruminative concern to focus on studying, not the possible outcome of failing. Failing will not make me a failure.

Worrisome thinking: This symptom means I have cancer. I must not have cancer. I could not bear the surgery and post-operative treatments and their side effects. (non-ego worry)

REBT’s Healthy attitude: I might be facing the fight of my life. I do not want cancer, but sooner or later, I will have to address some serious medical problems. It would be hard and uncomfortable to face surgery but not unbearable. If the doctor recommends surgery, it is worth doing because if I avoid surgery, my chances of successfully addressing this cancer are far lower. As for the post-operative treatments, to the extent they are uncomfortable, that is too bad. A therapy that is challenging to tolerate is not equal to unbearable. I could withstand the side effects of post-operative treatment. If this is the fight of my life, I am committed to fighting the good fight with REBT’s realistic philosophy. It is good that fate introduced me to REBT, which I have used throughout my life! I can run from adversity, but I cannot hide. Sooner or later, I will face challenging tests in life. I am up for the challenge, even if I would rather not face it. 

Worrisome thinking: My partner’s inattention means they no longer love me. I need certainty that they continue to love me and will never leave me for another. I cannot face life without them. (non-ego worry) If they leave me, I would be lesser of a person. (ego-worry)

REBT’s Healthy attitude: I want certainty that my partner’s inattention does not indicate they no longer love me and will never leave me, but do not (absolutely) have to have it. Certainty in life does not exist; only probability exists. It would be tough to face life without my partner if they left me, but it is not something I could not learn to do. I managed to survive before I met them and even enjoyed life a bit during this pre-relationship time. My life is far more enjoyable with them, but I still could survive and have some happiness without them. If they were to leave me, that would not make me lesser of a person. It would prove that I lost their love. I will not define human value based on a fallible human’s love. I will accept myself even if they decide to leave me for another. It will also help always to remember that good can come from bad. 

Worrisome thinking: My daughter might not get into the school of their choice. She must get the opportunity to go to their preferred university. It would be unbearable to watch her face rejection and suffer the pain of deprivation. (non-ego worry)

REBT’s Healthy attitude:  My daughter might not get into the school of their choice. I hope she gets the opportunity to go to their preferred university, but sadly, there is nothing in the universe that dictates she must get what she wants. It would be hard to watch her face rejection and suffer the pain of deprivation, but it would not be unbearable. I will encourage her to accept this deprivation if it occurs and strive to make the most of whichever school grants her admission. Life has setbacks, and she will face one sooner or later. I want to encourage her to learn the art of succeeding despite setbacks.

Worrisome thinking: I might outlive the money I have saved. I need certainty that I will not outlive my money and will be financially safe. It is awful to face financial stress and the deprivation that would go along with not having enough money to last me until I die.

REBT’s Healthy attitude: I hope not to outlive the money I have saved, but I do not need certainty that I will be financially safe. I did the math, and there is a reasonable probability that the money I saved will be sufficient to last me to death. It is challenging to consider the stress and deprivation that would follow if I had insufficient funds, but if that happened, I would have to find a way to get by. Dwelling on the possibility of insufficient funds will not grow my money but will lessen the quality of my life. I will keep reminding myself that I did what I could over the years, and the money I have is the money I have. Now, get back to living.

Summary

Although it is tempting not to think about your great fears in life, I encourage it. Rather than seeking a psychologically cheap reassurance that your worst fear may not come to pass, think of all the reasons why you could bear that worst-case scenario. Keep at it till you get there. This path will take work and courage, but by doing this psychological work, you will develop confidence that will free you to enjoy your life.