Tuesday, 24 March 2009

Rational emotive behaviour therapy .ellis.albert

In 1953 Albert Ellis expounded his theory of Rational Behavior Therapy, later this became known as Rational Emotive Behavior Therapy as Ellis recognised the importance of emotion in his theory.

The fundamental proposition of REBT is that much of our psychological, emotional and behavioral problems are caused by our holding irrational beliefs (IB's). REBT proposes that humans have an innate capacity for both rational and irrational thinking. Irrational beliefs prevent goal attainment, lead to inner conflict (frustration, anxiety and depression), conflict with others (anger) and low self esteem. Rational beliefs lead to attainment of goals and greater self acceptance, acceptance of others and positive self-regard. Irrational beliefs are likely to be illogical, based on limited evidence and assumptions, absolutistic and inflexible. Rational beliefs are more flexible, based in reality and logical.

Ellis states that events alone do not cause a person to feel depressed, angry, or anxious. Rather, it is one’s beliefs about the events which contributes to unhealthy feelings and self defeating behaviors. In other words it is not what is happening that disturbs us but the thoughts that we have and the things that we tell ourselves about what is happening that causes us to feel disturbed. Such a disturbed individual can take this irrationality a step further and become disturbed about our disturbances. For example, feeling guilty about being angry is a disturbance about a disturbance.

Often, these irrational beliefs take the form of extreme or dogmatic 'musts', 'shoulds', or 'oughts'; they contrast with rational and flexible desires, wishes, preferences and wants. The presence of extreme philosophies can make all the difference between healthy negative emotions (such as sadness or regret or concern) and unhealthy negative emotions (such as depression or guilt or anxiety). For example, after experiencing a loss one person's philosophy might take the form: "It is unfortunate that this loss has occurred. It is sad that it has happened, but it is not awful, and I can continue to function." Another's might take the form: "This absolutely should not have happened, and it is horrific that it did. These circumstances are now intolerable, and I cannot continue to function." The first person's response is apt to lead to sadness, while the second person may be well on their way to depression.

It is important to note that REBT maintains all individuals have it within their power to change their beliefs and philosophies profoundly, and thereby to change radically their state of psychological health. Albert Ellis has suggested three fundamental core philosophies that cause disturbance, all irrational beliefs fit within either of these philosophies:

Beliefs about self:
“I must be thoroughly competent, adequate, achieving, and lovable at all times, or else I am an incompetent worthless person." This belief usually leads to feelings of anxiety, panic, depression, despair, and worthlessness.

Beliefs about other people:
“Other significant people in my life, must treat me kindly and fairly at all times, or else I can’t stand it, and they are bad, rotten, and evil persons who should be severely blamed, damned, and vindictively punished for their horrible treatment of me." This leads to feelings of anger, rage, resentment, and vindictiveness.

Beliefs about the world:
"Things and conditions absolutely must be the way I want them to be and must never be too difficult or frustrating. Otherwise, life is awful, terrible, horrible, catastrophic and unbearable." This leads to low-frustration tolerance, self-pity, anger, depression, and to behaviors such as procrastination, avoidance, and inaction.

Just as there are three fundamental irrational philosophies (see above) there are contrasting rational philosophies, they are.

Beliefs about self;
“I am a fallible being, I have my good points and bad points, there is no need for me to be perfect, despite my good and bad points I am no less worthy and no more worthy than any other person”

Beliefs about others;
“other people may treat me unfairly from time to time, there is no reason why people must be fair at all times, people who treat me unfairly are no less and no more worthy than any other person”

Beliefs about life;
“life does not always work out the way I would like it to, there is no reason why life must always be the way I want it to be, life is not always pleasant but it is very rarely unbearable.”

Because the irrational beliefs are viewed as the source of psychological disturbance the goal of REBT is to change the irrational beliefs to more rational ones. REBT takes a directive and educational approach to therapy in which the therapist teaches the client how to identify and challenge irrational thinking and how to think in more rational and flexible ways. Rational Emotive Behaviour Therapy teaches the client to identify, evaluate, dispute, and take action against their irrational self- defeating beliefs, thus helping the client to not only feel better but to get better and to stay better. This is a contrast to problems solving approaches in which the focus is on the immediate problems and solving those problems. In such an approach the individual is not changing the way they respond to events and so when problems arise in the future they are not as well equipped to cope with their problems.

REBT uses a model known as the A-B-C model, this outlines in very simple terms the process and theory of REBT. In the A-B-C model, A is the Actuating event, B is the Belief about the event and C is the consequence. A client may come to therapy feeling disturbed about something that has happened; they will explain that their disturbance is caused by what happened (event A). REB Therapist will work with the client to demonstrate how their disturbance (Consequence C) is not caused by the event (A) but by the belief (B) about what happened.

A crucial part of the REBT is in teaching the connection between the Belief and the Consequence. Understanding this connection shows that it is not the event at A but it is the belief about the event that causes distress. The event at (A) is likely to be something that is not changeable; however the belief (B) is changeable. Changing the belief about the event liberates the individual from the distress (consequence C).

Once the therapist has established the A-B-C and has educated the client to the connection between B and C the REBT moves on to step D of the ABC model. During step D the therapist engages the client in discussions about their irrational beliefs with the intention of changing the irrational beliefs. At this point the therapist is taking a directive role in challenging the client to evaluate their thinking processes and to explore new ways of thinking. If the client is able to realize that their currently held beliefs are irrational and that alternative rational beliefs are more productive and emotionally stable, the client will adopt the new belief and let go of the old beliefs.

REBT has been criticized for its confrontational apporach, not all people cannot accept having their beliefs questioned and may feel like they are being attacked. Ellis himself has said that he practiced the Rogerian principle of unconditional positive regard in his therapy but he also administered “tough love” in disputing with clients. Much of this confrontational style came from Ellis' personality and other practitioners may not be so harsh with their clients.

As with all models of psychotherapy, REBT does not work for everyone. Ellis had his own explanation for why REBT sometimes failed. He suggested that people who claim to putting the principles of REBT to use where doing no such thing. In other cases people just did not want the direct advice that Ellis dispensed. For such clients that are not able to handle the Ellis way of doing therapy, there are other therapeutic approaches which focus on the cathartic expression of feelings or the exploration and solution of problems.

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