Thirty-four years ago, at the end of my interview for gaining entry into the REBT training fellowship, Albert Ellis asked me if I had any questions for him. I then asked, “What is the weakest aspect of REBT?” In asking this question, I exposed my youthful grandiosity. My master plan was to attempt to improve upon his work through my own future research. I needed to know from the source where was the weakest link in his psychotherapeutic theory. Albert Ellis answered and said, “It is perfect logic. It works, but it is just that some people do not use it.” I was a little surprised by this answer. As I studied REBT and used it with my patients and on myself, I came to understand what he meant. Let me explain.
What is REBT?
REBT is a theory of how a human can effectively respond to life’s adversities. It offers explanations, but its emphasis is on teaching you how to cope with adversity and how to change something within yourself to address life’s difficulties. It does explain how you come to experience emotional and behavioral disturbance. That explanation is that you demand that life, others, and even yourself be as you think they absolutely should be. It explains how to free yourself of your self-created emotional disturbance. That explanation is to develop flexible and non-extreme attitudes towards adversity. It also explains why it is so hard to do this. That explanation is that all of us are fallible humans, and we have two competing natural or biological tendencies. One tendency is to defeat ourselves with rigid and extreme attitudes that are inconsistent with scientific thinking. The other tendency is to solve our problems and cope with life’s adversities with flexible and non-extreme thinking consistent with scientific thinking. REBT explains that we are imperfect beings. Often, the self-defeating side of our nature is a stronger force. Adding to the biological predisposition to think in rigid and extreme ways, we have practiced these self-defeating attitudes and behaviors for a long time. Lastly, we are sometimes encouraged by others to think in these rigid and extreme ways. Therefore, we find it hard to change our attitudes and behaviors because of our nature and the extensive length of time we have practiced our self-defeating rigid and extreme attitudes and behaviors. One piece of evidence supporting Ellis’s argument for the biological predisposition of our self-defeating attitudes, emotions, and behaviors is that after having achieved therapeutic progress, humans often “naturally” backslide and go back to responding to life in our well-practiced, self-defeating ways of responding. All of us experience some degree of backsliding in some area of our lives that we have changed. It is not uncommon to hear a patient report losing weight to gain it back, quitting smoking only to resume it, overcoming shyness, and then resorting to unassertive, anxious behavior. Others who struggle with procrastination and perfectionism make headway only to later backslide into avoidance behavior and perfectionistic behavior. Ellis noted that patients all too often report that they stopped doing what worked. This tendency to stop doing what is working to change a self-defeating behavior is in and of itself evidence of our human imperfection. One patient told me a humorous way of putting this tendency people have to stop doing what works. He said, “In my business, we used to say, ‘The solution we implemented worked so well we stopped using it.’”
Basic Assumptions of REBT
REBT starts with the assumption that humans cannot perfect themselves, certainty cannot be found, and utopias do not exist. REBT also confidently asserts that “REBT works if people do and keep doing the work.” This proclamation is valid for REBT but probably is true of many other forms of psychotherapy and even other forms of therapy. Physicians lament that medications work to manage an illness, but many patients stop using them or do not even fill some prescriptions. Physical therapists report that patients will improve their range of motion, functional mobility, or pain levels during a course of physical therapy. However, when the course of physical therapy ends many of the patients discontinue the home exercises required to maintain the physical therapy gains. Physical impairment inevitably returns without the ongoing effort to maintain the therapeutic physical gains. Sadly, these are examples of our human fallibility and tendency to go back to the idea it is too hard to continue to do what works.
REBT is damn good therapy. It will help you to change self-defeating behavior and emotional reactions. It will help you to improve your response to other people. It will help you stick to your long-term goals. It will help you live better with your limitations and to learn to accept yourself unconditionally. It will help you live with adversity and uncertainty. When people tell me, as one patient recently mused, “I have been wondering if I should continue with sessions, that is if REBT works sufficiently well to remain in therapy,” My response was to ask her if she was doing self-therapy daily. Was this patient taking responsibility for making therapy work by doing what is required between sessions? I define self-therapy as:
1. Reading about REBT ideas and strategies or listening to my audios in order to develop an accurate understanding of them
2. Reflecting on how to implement REBT ideas and strategies
3. Identifying one’s rigid and extreme attitudes and then challenging them using a worksheet or at the very least doing it in their head
4. Using their iPhone, making a digital recording of REBT consistent flexible and non-extreme attitudes they want to adopt and then listening to the recording (and then making a new recording the following day)
5. Teaching other people REBT ideas if these others are open to hearing about REBT
6. Getting out of their comfort zone and trying new behaviors consistent with their therapeutic goals
7. Practicing rational emotive imagery
8. Attending my demonstrations on Saturdays and studying how REBT is applied to a wide range of problems to appreciate its versatility and to appreciate how they are not alone in finding REBT challenging to implement
Just as a person would take a medication every day, you need to think about, rehearse, and implement daily REBT-based ideas and self-management strategies to change in some way. Then you have to continue to make efforts to maintain therapeutic progress. If you are using REBT and not getting results, it is essential to ask yourself if you are doing your part. Are you pushing yourself to think, act and feel in healthy but unfamiliar ways? Are you hoping for spontaneous change or are you working and practicing resisting years of self-defeating thinking and behavior? If not, why are you not pushing yourself? Are you holding a demand that therapeutic progress absolutely should come easily and quickly? Perhaps you have made progress, but you have the idea that you absolutely should not have to work on maintaining those gains. If this is your attitude, I advise you to question it and relinquish it. Is this a realistic way of thinking given what you know about human nature? Just as you will get rusty in a foreign language you once learned to speak well if you stop speaking and reading that language, you will lose therapeutic gains in REBT if you do not use REBT for the rest of your life. This has to be done because that biological predisposition cannot be removed from inside of you. You can lessen your irrational, self-defeating side, but you cannot eradicate it. You will be better off if you simply accept this fact of life. If you are disappointed by your progress, are you demanding that you somehow achieve perfection? You cannot perfect yourself, and even if you practiced REBT every day, you will still occasionally display self-defeating emotions and behaviors. That is the human condition. You had better accept this. With REBT you can greatly reduce the frequency, intensity, and duration of such slips, but they will occur. Perhaps you are disappointed because you have not learned how to accept aspects of life you do not like. If you are not good at philosophical acceptance, you had better double down on this goal. Fallible humans do not want to accept the inevitable disappointments, losses, and frustrations of life. Fallible humans quickly demand that things not be as they sometimes are. Our rigid and extreme attitudes prevent us from accepting things we do not like and cannot change. If this sounds a little like you, my best advice is to work on cultivating your ability to accept those things you do not like and cannot change. There is no magic therapy. There are no perfect solutions. Different paths and choices typically have trade-offs. I sometimes say, “Pick your poison.” There are no superhumans, no utopias, and there is no certainty. There is no effort-free therapy. REBT is an efficient and effective therapy if you work hard at it and commit to doing what it takes to maintain and extend your progress for the rest of your life. That, in my view, is the bottom line.