When people come for REBT psychotherapy, it is clear that we are teaching and encouraging them to adopt healthier ideas. An incomplete list of those ideas includes:
- Unconditional self-acceptance
- Unconditional other-acceptance
- Unconditional life acceptance
- Emotional responsibility
- Long-term hedonism
- Self-Direction
- Calculated risk-taking
- The role of healthy negative emotions
- Uncertainty tolerance
It is equally or perhaps more important that patients go beyond learning new ideas and understand the primary change process that REBT attempts to teach them. I refer to the process as learning to dispute your rigid and extreme attitudes. There is significant variability as to how well different people understand and use this skill. Those who get skilled at it do far better and take considerably more from REBT than those who only learn new ideas that they call to mind from time to time. Many people resist spending time at home engaging in this process. It isn’t easy to learn. It requires some time and the expenditure of mental energy. At first, people may not see themselves doing this type of self-therapy well. They quit practicing disputing and fail to get good at doing it. Not doing the work to learn this disputation process is a big mistake!
My goal is to help people learn to do this challenging process and to do it regularly as self-therapy. I have given considerable thought to teaching this process to both REBT psychotherapists in training and to patients who come to me for psychotherapy. REBT is a form of self-help, and learning to help yourself with REBT should preferably involve learning this process.
The below outline aims to teach a person how to use this primary change process of REBT. I have attempted to break the cycle down into stages or steps a person can do at home in the service of changing those rigid attitudes that lie at the core of their emotional disturbance. Remember that what underpins unhealthy emotions and behavior is a rigid attitude towards yourself, others, or life conditions. This premise is a fundamental tenet of REBT. The goal of disputing it is to identify, refute, and replace these self-defeating attitudes.
Identification stage:
Look for your demand, your rigid, absolutistic attitude that lies at the core of your emotional disturbance. Dr. Ellis frequently said to his patients to “Look for the should look for the must. You cannot be a shit without a should!” Let me be clear that you are only looking for absolutistic shoulds, have to’s, and musts. There are conditional, probabilistic, and preferential ideas using these words that are harmless examples of sound reasoning. Here are three examples:
- Conditional should: If you wish to be fit, you should regularly exercise.
- Probabilistic should: I heard the weather report, and it should start snowing later tonight.
- Preferential should: You preferably should learn to dispute your rigid attitudes, so you derive maximum benefit from this practical philosophy.
Do target your absolutistic shoulds, absolute have to’s, and absolute musts:
- I absolutely have to perform well.
- You absolutely have to treat me nicely.
- The world absolutely should be easy.
Disputation of the rigid attitude stage:
- Examine the functional impact of the rigid attitude. – Is this rigid attitude negatively impacting me? How is it negatively impacting me?
- Seek evidence that supports the rigid attitude. Where is the evidence for my absolute should, my absolute must? If no evidence supports it acknowledge this and acknowledge what you prefer, what you wish would happen, or desire.
Creation of a healthy attitude stage:
- Create a healthy, flexible alternative attitude. Express that healthy attitude as a wish and negate the demand for this wish (e.g., I want to have certainty that I will remain healthy, but I do not absolutely have to have an assurance that I will remain healthy. I want his love, but I do not absolutely have to have his love.)
Disputation of healthy attitude stage:
- Examine the functional impact of the flexible attitude. – Will the flexible attitude impact me in a good way? If I hold this flexible attitude, how will it impact me in a good way? Is there a functional downside to this healthy attitude?
- Find evidence that supports the validity of the flexible attitude.
Address doubts, reservations, and objections to the adoption of the healthy attitude stage:
- Step back and resolve doubts, reservations, and objections to adopting the flexible attitude.
Rehearsal with Implementation stage:
- Rehearse the flexible idea. The goal of this rehearsal is to have the explicitly rehearsed idea to be automatic and internalized. Hopefully, by rehearsing the flexible attitude it will become the new default reflexive attitude in your mind that you bring to future adversity.
- Now commit to living consistently with the flexible attitude and continue to rehearse it. Use the healthy attitude or lose it.
Remember the bottom-line lesson of REBT: No matter how strongly I want something, I never absolutely have to have it. Remember, as the strength of my desire increases, it is easier for my mind to jump to the erroneous conclusion that I absolutely must have it. However, it is still false to think that because I want something very strongly, I absolutely have to have it, absolutely should get it, absolutely must get it. Ask yourself, “Can I live with not getting what I strongly want? Answer: Yes, and I still can have some happiness, although not quite as much as I would have if I could get what I strongly want. Much of life involves learning to accept what you cannot change and still have some happiness. Remember what you can nearly always change – your attitude towards adversity!”