Stress Counselling: A Rational Emotive Behaviour Approach

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Albert Ellis, Jack Gordon, Michael Neenan & Stephen Palmer

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  • Titles in the Stress Counselling Series

    Ellis, Gordon, Neenan and Palmer, Stress Counselling: A Rational Emotive Behaviour Approach Milner and Palmer, An Integrative Approach to Stress Counselling and Management Palmer and Dryden (eds), Stress Management and Counselling: Theory, Practice, Research and Methodology

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    Foreword

    The main aim of this series is to focus on different approaches to stress counselling and management. It is intended that the books will link theory and research to the practice of stress counselling and stress management. Leading counselling, clinical and occupational psychologists, biologists, counsellors and psychotherapists will report on their work, focusing on individual, group and organizational interventions.

    The books will interest both undergraduate and postgraduate students as well as experienced practitioners in the helping professions, in particular, those who work in the fields of counselling, psychology, psychotherapy, sociology and mental and occupational health.

    StephenPalmer, Centre for Stress Management, London

    Preface

    This book is intended for counsellors, psychotherapists, psychologists, psychiatrists and other members of the helping professions working in counselling, clinical and industrial settings, and others interested in Rational Emotive Behaviour Therapy (REBT), including trainee counsellors from all backgrounds.

    Written by professionals with many years of experience, the book sets out the REBT approach to Stress Counselling. It links the theory of REBT to the practice of Stress Counselling using real and composite case material, and provides people with a conceptual framework and a scientific method of rational thought to help lessen their distress and achieve their personal goals. The nine chapters cover individual counselling as well as group therapy and stress management training in industrial settings.

    The book's comprehensive coverage includes additional material on techniques such as skills training, relaxation methods, hypnosis and biofeedback.

    An Afterword lists addresses of organizations both here and abroad which offer training in REBT and ancillary facilities.

  • Afterword: Training in Rational Emotive Behaviour Therapy

    We believe it is important for the professional development of both trainee and experienced counsellors and therapists to undertake further training to broaden their experience and to keep up to date in the rapidly expanding field of counselling. Training workshops are run by qualified and experienced REBT practitioners and cover a wide range of applications of REBT in counselling, clinical and industrial settings.

    The Albert Ellis Institute for Rational Emotive Behavior Therapy (formerly the Institute for Rational-Emotive Therapy) in New York offers a comprehensive range of services including adult education workshops and multi-session courses, professional training programmes, consulting services for universities, corporations and other organizations, and a bookstore stocking publications and audiovisual materials for professional and educational use.

    If you would like details of training courses in REBT held in England contact:

    • Centre for Rational Emotive Behaviour Therapy

      156 Westcombe Hill

      Blackheath London SE3 7DH

      Tel: 0181 293 4114

      Fax: 0181 293 1441

    • Professor Windy Dryden

      Department of Psychology

      Goldsmiths College

      New Cross

      London SE14 6NW

      Tel: 0171 919 7872

    In the United States the principal centre for training in REBT is The Albert Ellis Institute in New York. They can also provide details of Affiliated Training Centres elsewhere in the United States and in other countries.

    If you would like further information please contact:

    The Albert Ellis Institute for Rational Emotive Behavior Therapy

    45 East 65th Street

    New York

    NY 10021–65–93

    USA

    Tel: (001) 212 5-35-0822

    Canada
    • Centre for Rational-Emotive Therapy

      Kurt Fuerst, PhD

      912–170 Laurier Avenue

      West Ottawa

      Ontario K1P 5-V5

      Canada

      Tel: (001) 613 231-65-5-6

    • Sam Klarreich, PhD

      172 King Street East

      Toronto

      Ontario M5A 1J3

      Canada

      Tel: (001) 416 861–9322

    Australia

    Australian Institute for RET

    118 Balcombe Road

    Mentone

    Victoria 3804

    Australia

    Tel: (0061) 9585-1881

    Germany

    Deutsches Institut für RET und Kognitive Verhaltenstherapie (DIREKT)

    Muellersweg 14

    D-97249 Eisengen

    Germany

    Tel: (0049) 931–8 15 56

    Israel

    Israeli Centre for RET

    27 Gluskin Street

    PO Box 1006

    Rehovot 76470

    Israel

    Tel: (00972) 8 463165

    Italy

    Institute for RET-Italy

    Via G. Trezza, 12

    37129 Verona

    Italy

    Tel: (0039) 45-596993

    France

    Institut Français de Thérapie Cognitive

    55 Passage du Grade Turc

    1400 Caen

    France

    Tel: (0033) 2-31-500149

    Mexico

    Instituto de Terapia Racional-Emotiva de México

    Rincón del Bosque #25

    Colonia Polanco, Mexico DF

    Mexico

    Tel: (0052) 25–53611

    Netherlands

    Institut voor Rationeel-Emotieve Training

    Postbus 316

    2000 AH Haarlem

    Netherlands

    Tel: (0031) 23–5328817

    Finally, the authors would be interested to hear your views and experience of the REBT approach to Stress Counselling and Stress Management. Please write to:

    Albert Ellis at The Albert Ellis Institute, New York

    or to:

    Jack Gordon, Michael Neenan and Stephen Palmer at the Centre for Rational Emotive Behaviour Therapy, London

    (addresses fully listed above).

    References

    (Items marked with a * are mainly self-help materials on REBT.)

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    Dryden, W. (1989) The use of chaining in rational-emotive therapy. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 7 (2), 59–66. http://dx.doi.org/10.1007/BF01246504
    Dryden, W. (1990a) Creativity in Rational-Emotive Therapy. Loughton, Essex: Gale Centre Publications.
    Dryden, W. (1990b) Rational-Emotive Counselling in Action. London: Sage.
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    *Dryden, W. (1994b) Overcoming Guilt. London: Sheldon.
    Dryden, W. (1995a) Preparing for Client Change in Rational Emotive Behaviour Therapy. London: Whurr.
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    *Dryden, W. (1996) Overcoming Anger. London: Sheldon.
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    *Dryden, W. and Gordon, J. (1990a) Think Your Way to Happiness. London: Sheldon.
    Dryden, W. and Gordon, J. (1990b) What Is Rational-Emotive Therapy? A Personal and Practical Guide. Loughton, Essex, England: Gale Publications.
    *Dryden, W. and Gordon, J. (1992) Think Rationally: A Brief Guide to Overcoming Your Emotional Problems. London: Centre for Rational Emotive Behaviour Therapy.
    *Dryden, W. and Gordon, J. (1993a) Peak Performance: Become More Effective at Work. Didcot: Mercury Business Books.
    *Dryden, W. and Gordon, J. (1993b) Beating the Comfort Trap. London: Sheldon.
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    Ellis, A. (1982) Intimacy in rational-emotive therapy. In M.Fisher and G.Striker (eds), Intimacy. New York: Plenum.
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    Appendix 1: REBT Self-Help Form

    Appendix 2: Assignment Task Sheet

    Appendix 3: Techniques for Disputing Irrational Beliefs (DIBS)

    AlbertEllis

    If you want to increase your rationality and reduce your self-defeating irrational beliefs, you can spend at least ten minutes every day asking yourself the following questions and carefully thinking through (not merely parroting!) the healthy answers. Write down each question and your answers to it on a piece of paper; or else record the questions and your answers on a tape recorder.

    • WHAT SELF-DEFEATING IRRATIONAL BELIEF DO I WANT TO DISPUTE AND SURRENDER? ILLUSTRATIVE ANSWER: I must receive love from someone for whom I really care.
    • CAN I RATIONALLY SUPPORT THIS BELIEF? ILLUSTRATIVE ANSWER: No.
    • WHAT EVIDENCE EXISTS OF THE FALSENESS OF THIS BELIEF?

      ILLUSTRATIVE ANSWER:

      Many indications exist that the belief that I must receive love from someone for whom I really care is false:

      • No law of the universe exists that says that someone I care for must love me (although I would find it nice if that person did!).
      • If I do not receive love from one person, I can still get it from others and find happiness that way.
      • If no one I care for ever cares for me, which is very unlikely, I can still find enjoyment in friendships, in work, in books, and in other things.
      • If someone I deeply care for rejects me, that will be most unfortunate; but I will hardly die!
      • Even though I have not had much luck in winning great love in the past, that hardly proves that I must gain it now.
      • No evidence exists for any absolutistic must. Consequently, no proof exists that I must always have anything, including love.
      • Many people exist in the world who never get the kind of love they crave and who still lead happy lives.
      • At times during my life I know that I have remained unloved and happy; so I most probably can feel happy again under unloving conditions.
      • If I get rejected by someone for whom I truly care, that may mean that I possess some poor, unloving traits. But that hardly means that I am a rotten, worthless, totally unlovable individual.
      • Even if I had such poor traits that no one could ever love me, I would still not have to down myself as a lowly, bad individual.
    • DOES ANY EVIDENCE EXIST OF THE TRUTH OF THIS BELIEF?

      ILLUSTRATIVE ANSWER:

      No, not really. Considerable evidence exists that if I love someone dearly and never am loved in return that I will then find myself disadvantaged, inconvenienced, frustrated, and deprived. I certainly would prefer, therefore, not to get rejected. But no amount of inconvenience amounts to a horror. I can still stand frustration and loneliness. They hardly make the world awful. Nor does rejection make me a turd! Clearly, then, no evidence exists that I must receive love from someone for whom I really care.

    • WHAT ARE THE WORST THINGS THAT COULD ACTUALLY HAPPEN TO ME IF I DON'T GET WHAT I THINK I MUST (OR DO GET WHAT I THINK I MUST NOT GET)? ILLUSTRATIVE ANSWER: If I don't get the love I think I must receive:
      • I would get deprived of various possible pleasures and conveniences.
      • I would feel inconvenienced by having to keep looking for love elsewhere.
      • I might never gain the love I want, and thereby continue indefinitely to feel deprived and disadvantaged.
      • Other people might down me and consider me pretty worthless for getting rejected – and that would be annoying and unpleasant.
      • I might settle for pleasures other than and worse than those I could receive in a good love relationship; and I would find that distinctly undesirable.
      • I might remain alone much of the time; which again would be unpleasant.
      • Various other kinds of misfortunes and deprivations might occur in my life – none of which I need define as awful, terrible, or unbearable.
    • WHAT GOOD THINGS COULD I MAKE HAPPEN IF I DON'T GET WHAT I THINK I MUST (OR DO GET WHAT I THINK I MUST NOT GET)?
      • If the person I truly care of does not return my love, I could devote more time and energy to winning some-else's love – and probably find someone better for me.
      • I could devote myself to other enjoyable pursuits that have little to do with loving or relating, such as work or artistic endeavors.
      • I could find it challenging and enjoyable to teach myself to live happily without love.
      • I could work at achieving a philosophy of fully accepting myself even when I do not get the love I crave.
    © 1974, Institute for Rational-Emotive Therapy. Revised 1994.

    You can take any one of your major irrational beliefs – your shoulds, oughts, or musts – and spend at least ten minutes every day, often for a period of several weeks, actively and vigorously disputing this belief. To help keep yourself devoting this amount of time to the DIBS method of rational disputing, you may use operant conditioning or self-management methods (originated by B.F. Skinner, David Premack, Marvin Goldfried, and other psychologists). Select some activity that you highly enjoy that you tend to do every day – such as reading, eating, television viewing, exercising, or social contact with friends. Use this activity as a rein-forcer or reward by ONLY allowing yourself to engage in it AFTER you have practiced Disputing Irrational Beliefs (DIBS) for at least ten minutes that day. Otherwise, no reward!

    In addition, you may penalize yourself every single day you do NOT use DIBS for at least ten minutes. How? By making yourself perform some activity you find distinctly unpleasant – such as eating something obnoxious, contributing to a cause you hate, getting up a half-hour earlier in the morning, or spending an hour conversing with someone you find boring. You can also arrange with some person or group to monitor you and help you actually carry out the penalties and lack of rewards you set for youself. You may of course steadily use DIBS without any self-reinforcement, since it becomes reinforcing in its own right after a while. But you may find it more effective at times if you use it along with rewards and penalties that you execute immediately after you practice or avoid practicing this rational-emotive method.

    Summary of Questions to Ask Yourself in DIBS
    • WHAT SELF-DEFEATING IRRATIONAL BELIEF DO I WANT TO DISPUTE AND SURRENDER?
    • CAN I RATIONALLY SUPPORT THIS BELIEF?
    • WHAT EVIDENCE EXISTS OF THE FALSENESS OF THIS BELIEF?
    • DOES ANY EVIDENCE EXIST OF THE TRUTH OF THIS BELIEF?
    • WHAT ARE THE WORST THINGS THAT COULD ACTUALLY HAPPEN TO ME IF I DON'T GET WHAT I THINK I MUST (OR DO GET WHAT I THINK I MUST NOT GET)?
    • WHAT GOOD THINGS COULD I MAKE HAPPEN IF I DON'T GET WHAT I THINK I MUST (OR DO GET WHAT I THINK I MUST NOT GET)?

    Disputing (D) your dysfunctional or irrational Beliefs (iBs) is one of the most effective of REBT techniques. But it is still often ineffective, because you can easily and very strongly hold on to an iB (such as, ‘I absolutely must be loved by so-and-so, and it's awful and I am an inadequate person when he/she does not love me!’). When you question and challenge this iB you often can come up with an Effective New Philosophy (E) that is accurate but weak: ‘I guess that there is no reason why so-and-so must love me, because there are other people who will love me when so-and-so does not. I can therefore be reasonably happy without his/her love.’ Believing this almost Effective New Philosophy, and believing it lightly, you can still easily and forcefully believe, ‘Even though it is not awful and terrible when so-and-so does not love me, it really is! No matter what, I still need his/her affection!’

    Weak, or even moderately strong, Disputing will therefore often not work very well to help you truly disbelieve some of your powerful and long-held iBs; while vigorous, persistent Disputing is more likely to work.

    One way to do highly powerful, vigorous Disputing is to use a tape recorder and to state one of your strong irrational Beliefs into it, such as, ‘If I fail this job interview I am about to have, that will prove that I'll never get a good job and that I might as well apply only for low-level positions!’

    Figure out several Disputes to this iB and strongly present them on this same tape. For example: ‘Even if I do poorly on this interview, that will only show that I failed this time, but will never show that I'll always fail and can never do well in other interviews. Maybe they'll still hire me for the job. But if they don't, I can learn by my mistakes, can do better in other interviews, and can finally get the kind of job that I want.’

    Listen to your Disputing on tape. Let other people, including your therapist or members of your therapy group, listen to it. Do it over in a more forceful and vigorous manner and let them listen to it again, to see if you are disputing more forcefully, until they agree that you are getting better at doing it. Keep listening to it until you see that you are able to convince yourself and others that you are becoming more powerful and more convincing.

    Additional copies of this pamplet are available from the

    INSTITUTE FOR RATIONAL-EMOTIVE THERAPY

    45 East 65th Street, New York, NY 10021–6593

    Tel (001) (212) 535-0822 Fax (001) (212) 249-3582

    Call for ordering information.

    Appendix 4: How to Maintain and Enhance Your Rational Emotive Behaviour Therapy Gains

    AlbertEllis

    If you work at using the principles and practices of rational emotive behavior therapy (REBT), you will be able to change your self-defeating thoughts, feelings, and behaviors and to feel much better than when you started therapy. Good! But you will also, at times, fall back – and sometimes far back. No one is perfect and practically all people take one step backwards to every two or three steps forward. Why? Because that is the nature of humans: to improve, to stop improving at times, and sometimes to backslide. How can you (imperfectly!) slow down your tendency to fall back? How can you maintain and enhance your therapy goals? Here are some methods that we have tested at the Institute for Rational-Emotive Therapy in New York and that many of our clients have found quite effective.

    How to Maintain Your Improvement
    • When you improve and then fall back to old feelings of anxiety, depression, or self-downing, try to remind yourself and pinpoint exactly what thoughts, feelings, and behaviors you once changed to bring about your improvement. If you again feel depressed, think back to how you previously used REBT to make yourself undepressed. For example, you may remember that:
      • You stopped telling yourself that you were worthless and that you couldn't ever succeed in getting what you wanted.
      • You did well in a job or in a love affair and proved to yourself that you did have some ability and that you were lovable.
      • You forced yourself to go on interviews instead of avoiding them and thereby helped yourself overcome your anxiety about them.

        Remind yourself of thoughts, feelings, and behaviors that you have changed and that you have helped yourself by changing.

    • Keep thinking, thinking and thinking rational beliefs (rBs) or coping statements, such as: ‘It's great to succeed but I can fully accept myself as a person and enjoy life considerably even when I fail!’ Don't merely parrot these statements but go over them carefully many times and think them through until you really begin to believe and feel that they are true.
    • Keep seeking for, discovering, and disputing and challenging your irrational beliefs (iBs) with which you are once again upsetting yourself. Take each important irrational belief – such as, ‘I have to succeed in order to be a worthwhile person!’ – and keep asking yourself: ‘Why is this belief true?’ ‘Where is the evidence that my worth to myself, and my enjoyment of living, utterly depends on my succeeding at something?’ ‘In what way would I be totally acceptable as a human if I failed at an important task or test?’

      Keep forcefully and persistently disputing your irrational beliefs whenever you see that you are letting them creep back again. And even when you don't actively hold them, realize that they may arise once more, bring them to your consciousness, and preventively – and vigorously! – dispute them.

    • Keep risking and doing things that you irrationally fear – such as riding in elevators, socializing, job hunting, or creative writing. Once you have partly overcome one of your irrational fears, keep acting against it on a regular basis. If you feel uncomfortable in forcing yourself to do things that you are unrealistically afraid of doing, don't allow yourself to avoid doing them – and thereby to preserve your discomfort forever! Often, make yourself as uncomfortable as you can be, in order to eradicate your irrational fears and to become unanxious and comfortable later.
    • Try to clearly see that difference between appropriate negative feelings – such as those of sorrow, regret, and frustration, when you do not get some of the important things you want – and inappropriate negative feelings – such as those of depression, anxiety, self-hatred, and self-pity, when you are deprived of desirable goals and plagued with undesirable things. Whenever you feel over-concerned (panicked) or unduly miserable (depressed) acknowledge that you are having a statistically normal but a psychologically unhealthy feeling and that you are bringing it on yourself with some dogmatic should, ought, or must. Realize that you are invariably capable of changing your inappropriate (or musturbatory) feelings back into appropriate (or preferential) ones. Take your depressed feelings and work on them until you only feel sorry and regretful. Take your anxious feelings and work on them until you only feel concerned and vigilant. Use rational-emotive imagery to vividly imagine unpleasant activating events before they happen; let yourself feel inappropriately upset (anxious, depressed, enraged, or self-downing) as you imagine them; then work on your feelings to change them to appropriate emotions (concern, sorrow, annoyance, or regret) as you keep imagining some of the worst things happening. Don't give up until you actually do change your feelings.
    • Avoid self-defeating procrastination. Do unpleasant tasks fast – today! If you still procrastinate, reward yourself with certain things that you enjoy – for example, eating, vacationing, reading, and socializing – only after you have performed the tasks that you easily avoid. If this won't work, give yourself a severe penalty – such as talking to a boring person for two hours or burning a hundred dollar bill – every time that you procrastinate.
    • Show yourself that it is an absorbing challenge and something of an adventure to maintain your emotional health and to keep yourself reasonably happy no matter what kind of misfortunes assail you. Make the uprooting of your misery one of the most important things in your life – something you are utterly determined to steadily work at achieving. Fully acknowledge that you almost always have some choice about how to think, feel, and behave; and throw yourself actively into making the choice for yourself.
    • Remember – and use – the three main insights of REBT that were first outlined in Reason and Emotion in Psychotherapy (Ellis, 1962):

      Insight No. 1: You largely choose to disturb yourself about the unpleasant events of your life, although you may be encouraged to do so by external happenings and by social learning. You mainly feel the way you think. When obnoxious and frustrating things happen to you at point A (activating events), you consciously or unconsciously select rational beliefs (rBs) that lead you to feel sad and regretful and you also select irrational beliefs (iBs) that lead you to feel anxious, depressed, and self-hating.

      Insight No. 2: No matter how or when you acquired your irrational beliefs and your self-sabotaging habits, you now, in the present, choose to maintain them – and that is why you are now disturbed. Your past history and your present life conditions importantly affect you; but they don't disturb you. Your present philosophy is the main contributor to your current disturbance.

      Insight No. 3: There is no magical way for you to change your personality and your strong tendencies to needlessly upset yourself. Basic personality change requires persistent work and practice – yes, work and practice – to enable you to alter your irrational beliefs, your inappropriate feelings, and your self-destructive behaviors.

    • Steadily – and unfrantically! – look for personal pleasures and enjoyments – such as reading, entertainment, sports, hobbies, art, science, and other vital absorbing interests. Take as your major life goal not only the achievement of emotional health but also that of real enjoyment. Try to become involved in a long-term purpose, goal, or interest in which you can remain truly absorbed. For a good, happy life will give you something to live for; will distract you from many serious woes; and will encourage you to preserve and to improve your mental health.
    • Try to keep in touch with several other people who know something about REBT and who can help go over some of its aspects with you. Tell them about problems that you have difficulty coping with and let them know how you are using REBT to overcome these problems. See if they agree with your solutions and can suggest additional and better kinds of REBT disputing that you can use to work against your irrational beliefs.
    • Practice using REBT with some of your friends, relatives and associates who are willing to let you try to help them with it. The more often you use it with others, and are able to see what their iBs are and to try to talk them out of these self-defeating ideas, the more you will be able to understand the main principles of REBT and to use them with yourself. When you see other people act irrationally and in a disturbed manner, try to figure out – with or without talking to them about it – what their main irrational beliefs probably are and how these could be actively and vigorously disputed.
    • When you are in rational-emotive individual or group therapy try to tape record many of your sessions and listen to these carefully when you are in between sessions, so that some of the REBT ideas that you learned in therapy sink in. After therapy has ended, keep these tape recordings and play them back to yourself from time to time, to remind you how to deal with some of your old problems or new ones that may arise.
    • Keep reading REBT writings and listening to REBT audio and audiovisual cassettes, particularly Humanistic Pyschotherapy (Ellis); A Guide to Personal Happiness (Ellis and Becker); A New Guide to Rational Living (Ellis and Harper); Overcoming Procrastination (Ellis and Knaus); Overcoming Depression (Hauck); and A Rational Counseling Primer (Young). Keep going back to the REBT reading and audiovisual material from time to time, to keep reminding yourself of some of the main rational-emotive findings and philosophies.
    How to Deal with Backsliding
    • Accept your backsliding as normal – as something that happens to almost all people who at first improve emotionally and who then fall back. See it as part of your human fallibility. Don't feel ashamed when some of your old symptoms return; and don't think that you have to handle them entirely by yourself and that it is wrong or weak for you to seek some additional sessions of therapy and to talk to your friends about your renewed problems.
    • When you backslide look at your self-defeating behavior as bad and unfortunate; but work very hard at refusing to put yourself down for engaging in this behavior. Use the highly important REBT principle of refraining from rating you, your self or your being but of measuring only your acts, deeds, and traits. You are always a person who acts well or badly – and never a good person nor a bad person. No matter how badly you fall back and bring on your old disturbances again, work at fully accepting yourself with this unfortunate or weak behavior – and then try, and keep trying, to change your behavior.
    • Go back to the ABCs of REBT and clearly see what you did to fall back to your old symptoms. At A (activating event), you usually experienced some failure or rejection once again. At rB (rational belief) you probably told yourself that you didn't like failing and didn't want to be rejected. If you only stayed with these rational beliefs, you would merely feel sorry, regretful, disappointed, or frustrated. But when you felt disturbed again, you probably then went on to some irrational beliefs (iBs), such as: ‘I must not fail! It's horrible when I do!’ ‘I have to be accepted, and if I'm not that makes me an unlovable worthless person!’ Then, after convincing yourself of these iBs, you felt, at C (emotional consequence) once again depressed and self-downing.
    • When you find your irrational beliefs by which you are once again disturbing yourself, just as you originally used disputing (D) to challenge and surrender them, do so again – immediately and persistently. Thus, you can ask yourself, ‘Why must I not fail? Is it really horrible if I do?’ And you can answer: ‘There is no reason why I must not fail, though I can think of several reasons why it would be highly undesirable. It's not horrible if I do fail – only distinctly inconvenient.’ You can also dispute your other irrational beliefs by asking yourself, ‘Where is it written that I have to be accepted? How do I become an unlovable, worthless person if I am rejected?’ And you can answer: ‘I never have to be accepted, though I would very much prefer to be. If I am rejected, that makes me, alas, a person who is rejected this time by this individual under these conditions, but it hardly makes me an unlovable, worthless person who will always be rejected by anyone for whom I really care.’
    • Keep looking for, finding, and actively and vigorously disputing your irrational beliefs which you have once again revived and that are now making you feel anxious or depressed once more. Keep doing this, over and over, until you build intellectual and emotional muscle (just as you would build physical muscle by learning how to exercise and then by continuing to exercise).
    • Don't fool yourself into believing that if you merely change your language you will always change your thinking. If you neurotically tell yourself, ‘I must succeed and be approved’ and you sanely change this self-statement to, ‘I prefer to succeed and be approved,’ you may still really be convinced, ‘But I really have to do well and have got to be loved.’ Before you stop your disputing and before you are satisfied with your answers to it (which in REBT we call E, or an effective philosophy), keep on doing it until you are really convinced of your rational answers and until your feelings of disturbance truly disappear. Then do the same thing many, many times – until your new E (effective philosophy) becomes hardened and habitual – which it almost always will if you keep working at arriving at it and re-instituting it.
    • Convincing yourself lightly or ‘intellectually’ of your new effective philosophy or rational beliefs often won't help very much or persist very long. Do so very strongly and vigorously, and do so many times. Thus, you can powerfully convince yourself, until you really feel it: ‘I do not need what I want! I never have to succeed, no matter how greatly I wish to do so!’ ‘I can stand being rejected by someone I care for. It won't kill me – and I still can lead a happy life!’ ‘No human is damnable and worthless – including and especially me!’
    How to Generalize from Working on One Emotional Problem to Working on other Problems
    • Show yourself that your present emotional problem and the ways in which you bring it on are not unique and that virtually all emotional and behavioral difficulties are created by irrational beliefs (iBs). Whatever your iBs are, moreover, you can overcome them by strongly and persistently disputing and acting against these irrational beliefs.
    • Recognize that you tend to have three major kinds of irrational beliefs that lead you to disturb yourself and that the emotional and behavioral problems that you want to relieve fall into one of these three categories:
      • ‘I must do well and have to be approved by people whom I find important.’ This iB leads you to feel anxious, depressed, and self-hating; and to avoid doing things at which you may fail and avoiding relationships that may not turn out well.
      • ‘Other people must treat me fairly and nicely!’ This iB contributes to your feeling angry, furious, violent, and over-rebellious.
      • ‘The conditions under which I live must be comfortable and free from major hassles!’ This iB tends to create your feelings of low frustration tolerance and self-pity; and sometimes those of anger and depression.
    • Recognize that when you employ one of these three absolutistic musts – or any of the innumerable variations on it that you can easily slide into – you naturally and commonly derive from them other irrational conclusions, such as:
      • ‘Because I am not doing as well as I must, I am an incompetent worthless individual!’ (Self-damnation).
      • ‘Since I am not being approved by people whom I find important, as I have to be, it's awful and terrible!’ (Awfulizing).
      • ‘Because others are not treating me as fairly as nicely as they absolutely should treat me, they are utterly rotten people and deserve to be damned!’ (Other-damnation).
      • ‘Since the conditions under which I live are not that comfortable and since my life has several major hassles, as it must not have, I can't stand it! My existence is a horror!’ (Can't-stand-it-itis).
      • ‘Because I have failed and got rejected as I absolutely ought not have done, I'll always fail and never get accepted as I must be! My life will be hopeless and joyless forever!’ (Overgeneralizing).
    • Work at seeing that these irrational beliefs are part of your general repertoire of thoughts and feelings and that you bring them to many different kinds of situations that are against your desires. Realize that in just about all cases where you feel seriously upset and act in a distinctly self-defeating manner you are consciously or unconsciously sneaking in one or more of these iBs. Consequently, if you get rid of them in one area and are still emotionally disturbed about something else, you can always use the same REBT principles to discover your iBs in the new area and to eliminate them there.
    • Repeatedly show yourself that it is almost impossible to disturb yourself and to remain disturbed in any way if you abandon your absolutistic, dogmatic shoulds, oughts, and musts and consistently replace them with flexible and unrigid (though still strong) desires and preferences.
    • Continue to acknowledge that you can change your irrational beliefs (iBs) by rigorously (not rigidly!) using the scientific method. With scientific thinking, you can show yourself that your irrational beliefs are only theories or hypotheses – not facts. You can logically and realistically dispute them in many ways, such as these:
      • You can show yourself that your iBs are self-defeating – that they interfere with your goals and your happiness. For if you firmly convince yourself, ‘I must succeed at important tasks and have to be approved by all the significant people in my life,’ you will of course at times fail and be disapproved – and thereby inevitably make yourself anxious and depressed instead of sorry and frustrated.
      • Your irrational beliefs do not conform to reality – and especially do not conform to the facts of human fallibility. If you always had to succeed, if the universe commanded that you must do so, you obviously would always succeed. And of course you often don't! If you invariably had to be approved by others, you could never be disapproved. But obviously you frequently are! The universe is clearly not arranged so that you will always get what you demand. So although your desires are often realistic, your godlike commands definitely are not!
      • Your irrational beliefs are illogical, inconsistent, or contradictory. No matter how much you want to succeed and to be approved, it never follows that therefore you must do well in these (or any other) respects. No matter how desirable justice or politeness is, it never has to exist.

        Although the scientific method is not infallible or sacred, it efficiently helps you to discover which of your beliefs are irrational and self-defeating and how to use factual evidence and logical thinking to rid yourself of them. If you keep using scientific analysis, you will avoid dogma and set up your hypotheses about you, other people, and the world around you so that you always keep them open to change.

      • Try to set up some main goals and purposes in life – goals that you would like very much to reach but that you never tell yourself that you absolutely must attain. Keep checking to see how you are coming along with these goals; at times revise them; see how you feel about achieving them; and keep yourself goal-oriented for the rest of your days.
      • If you get bogged down and begin to lead a life that seems too miserable or dull, review the points made in this pamphlet and work at using them. Once again: if you fall back or fail to go forward at the pace you prefer, don't hesitate to return to therapy for some booster sessions.

    Appendix 5

    Appendix 6: An Introduction to Rational Emotive Behaviour Therapy

    MichaelNeenan

    Rational Emotive Behaviour Therapy (REBT) was founded in 1955 by an American psychologist, Albert Ellis. Ellis believed, like some ancient philosophers, that it is not so much events, circumstances or other people that directly cause our emotional problems but rather our beliefs and attitudes about these situations that largely determine how we think and feel. For example, three people lose their jobs: the first becomes depressed because he believes he is now worthless; the second becomes angry because he believes he should have been promoted rather than sacked; the third is happy because he never liked the job and can now pursue new opportunities. The same event for each person but three very different emotional reactions; in each case, it is the individual's beliefs about losing his job that primarily shapes his emotional response.

    Ellis has identified two kinds of beliefs which are at the core of our emotional responses to various situations. The first kind are rational beliefs which are flexible and adaptable to life events. These beliefs come in the form of wishes, wants, hopes, preferences, desires. Rational beliefs are seen as logical, realistic, practical, goal-orientated and encourage the individual to strive for a philosophy of self-acceptance as a fallible human being.

    The second kind are irrational beliefs which are inflexible and dogmatic and come in the form of absolute musts, shoulds, have tos, got tos, oughts – demands and commands we make on ourselves, others and the world and, when not met, can lead to ‘awful’ consequences (the imagined worst that could happen to us) including self-damnation and self rejection. Irrational beliefs are seen as illogical, unrealistic and bring undesirable practical consequences; in effect, they cause considerable emotional unhappiness and can block us from achieving our goals in life.

    In REBT, irrational beliefs are targeted for disputing in order to reduce or remove an individual's emotional disturbance (as will be described later, only certain kinds of negative emotional states are seen as unhealthy or self-defeating). REBT provides a model, ABC, to show how this is achieved by emphasizing the relationship between beliefs and emotions.

    © Michael Neenan
    Multiple copies of this page may be made by the purchasing institution or group only.
    AActivating EventGiving a speech to a group of people.
    BBeliefs (Irrational)I must not make mistakes or bore people. If I give a poor speech, I will be a complete failure. People will laugh at me and that would be awful. I couldn't bear to be despised or ridiculed.
    CConsequences: Emotion BehaviourAnxiety Visible agitation and lack of concentration on the speech.

    From the REBT viewpoint, B not A primarily causes C. Beliefs are not treated as facts but as assumptions which can be shown, to varying degrees, to be true or false and therefore open to challenge and change. The client is encouraged to weigh the evidence for and against her beliefs. The aim is to construct through disputing (D) a rational and effective (E) belief system not only to tackle the problems brought to therapy, but also to achieve a more profound philosophical change in her life (if the latter goal is sought by the client).

    In order to test the effectiveness of the new rational beliefs, client and therapist negotiate which tasks or homework assignments the client will carry out between therapy sessions. These tasks enable clients to develop greater confidence and responsibility in facing their problems as well as demonstrating that what happens outside of therapy is more important than what happens inside it. With the ABC example, the client's task would be to give another speech in order to challenge her irrational or self-defeating beliefs.

    AActivating EventGiving a speech to a group of people
    BBeliefs (Rational)I sincerely hope I do not make mistakes or bore people but there is no reason why I absolutely must not do so. If I do, too bad.
    If I give a poor speech it means I've failed in this particular area but it doesn't mean I'm a failure as a person. I can still accept myself for failing and learn how to deliver a better speech.
    If people did laugh at me it might be difficult to cope with but hardly awful. It's me that's introducing the horror into an unpleasant situation.
    I certainly wouldn't like to be despised but I could bear it. Public ridicule may well give me a chance to strengthen my self-acceptance as well as increase my ability to tolerate uncomfortable situations.
    CConsequences:
    EmotionConcern
    BehaviourMore relaxed and focused on the speech.

    In the above example, if the client sticks with her rational beliefs and thereby makes herself only concerned, not anxious, she is more likely to give a good speech rather than a poor one.

    © Michael Neenan
    Multiple copies of this page may be made by the purchasing institution or group only.

    With regard to feelings, REBT does not aim to eliminate all emotional states – thinking, feeling and behaving constructively are equally important; instead, REBT seeks to distinguish between unhealthy and healthy negative emotions. Unhealthy negative emotions such as anxiety, depression, guilt, anger, shame, hurt, cause considerable emotional distress and produce self-defeating behaviour which blocks us from achieving our goals. Irrational beliefs create unhealthy emotions.

    Healthy negative emotions and alternatives to those just listed are, respectively, concern, sadness, remorse, annoyance, regret, disappointment and, whilst signalling some degree of emotional upset, act as a stimulus to tackle self-defeating behaviour in order to reach our goals. Rational beliefs produce healthy emotions.

    As can be seen from this introduction, REBT expects clients to work hard to identify, challenge and change their irrational beliefs and carry out homework tasks. Because of this emphasis, REBT employs a collaborative relationship between client and therapist. The ultimate aim of therapy is for the client to learn the principles and practices of REBT for present and future problem solving; in essence, to become his or her own counsellor.

    Author's note:

    The purpose of the Introduction is to provide a handout for clients, students, trainers and any other interested parties. In the ABC example, I have deliberately avoided teasing out the clinically relevant part of the A (also known as the Critical A) in order to keep the introduction relatively straightforward. Please do not disturb yourselves about my lack of theoretical purity.

    Appendix 7: Stress Mapping

    A stress map is a visual means of representing the sources of stress in your life. The central box represents yourself and the other boxes represent people you are in contact with. The other boxes can represent other potential stressors, too, such as new computers or internal demands you place on yourself, e.g. perfectionist beliefs.

    Complete the boxes and then rate the amount of stress each other potential stressor can cause you on a scale of 1 to 10, where 10 represents high levels of stress. Place the score next to the appropriate stressor. Then ask yourself how much stress you may cause the other people on your stress map. Also note these scores down.

    Once the exercise is completed, note down any insights that you may have gained from undertaking stress mapping.

    © Albert Ellis, Jack Gordon, Michael Neenan and Stephen Palmer 1997
    Multiple copies of this page may be made by the purchasing institution or group only

    Appendix 8: Big I/Little i Diagram

    Appendix 9: Irrational Belief: Cost-Benefit Form

    N.B. An irrational belief consists of a rigid and unqualified must, should, have to, got to, ought and a derivative which is usually awfulizing, I-can't-stand-it-itis (LFT) or damnation of self and/or others.

    © Albert Ellis, Jack Gordon, Michael Neenan and Stephen Palmer 1997
    Multiple copies of this page may he made by the purchasing institution or group only.

    Appendix 10: Rational Belief: Cost-Benefit Form

    N.B. A rational belief consists of a flexible preference, wish, want, desire and a derivative which is usually de-awfulizing, I can stand it (HFT) or acceptance of self and/or others.

    © Albert Ellis, Jack Gordon, Michael Neenan and Stephen Palmer 1997 Multiple copies of this page may be made by the purchasing institution or group only.

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