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It’s perennial: Difference between REBT & CBT???

Posted by Rex Alexander on Fri 15 Sep 17 in REBT & Other therapies compared |

We are pleased to have Dr. Edelstein discuss the differences between REBT and CBT.

Albert Ellis introduced Rational Emotive Behavior Therapy (REBT) in 1955, a radical change from the traditional therapies popular at the time. 

 

It has since spawned a number of offshoots, usually called cognitive-behavioral therapy (CBT). REBT and CBT coincide in a variety of ways. Their core notion affirms human emotions and behavior are predominantly generated by ideas, beliefs, attitudes, and thinking, never by events themselves. Consequently changing one’s thinking leads to an emotional and behavioral change.

There are also major differences between REBT and CBT:
1. REBT addresses the philosophic basis of emotional disturbance as well as the distorted cognitions (the focus of CBT), which makes it more powerful. As you uproot your absolutistic demands, your cognitive distortions get corrected.

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For example, suppose you plan to ask someone for a 2nd date and you’re feeling anxious. You tell yourself: “She didn’t talk or smile much on our first date. I know she’s not interested.” Since there are multiple other explanations for her reserved behavior, which you don’t know by her actions, CBT calls this conclusion “mind-reading” and dismisses it as a cognitive distortion. Instead, REBT looks at the underlying reason you jump to this conclusion, for example telling yourself, “I absolutely need her acceptance and if she rejects me this would be awful, I could not stand it, and proves I’m a loser who’ll never succeed with any woman.” Giving up your dire need for acceptance would not only ameliorate you fears of rejection in future dating situations, but in virtually all interpersonal interactions. Going the CBT route of avoiding mind-reading proves significantly more limited.

REBT posits three core demands fueling cognitive distortions and underlying emotional disturbance:

1.1. “Because I strongly prefer to, I absolutely must do well in life and get the approval of significant others or else I’m no good,”

1.2. “Because I keenly desire it, others absolutely must treat me well or else they’re no good,” and

1.3. “Because I passionately wish it, life absolutely must go well and or else it’s no good.” These demands create anxiety, depression, guilt, anger, resentment, procrastination, and addictions. The simple yet profound philosophic solution involves unconditional acceptance (UA): unconditionally accepting yourself with your flaws, unconditionally accepting others with their great imperfections, and accepting life unconditionally with it’s discomfort, hassles, and unfairness. 

2. REBT highlights the significance of secondary disturbance. Disturbing yourself about your disturbance is often the major factor in life-long (endogenous) depression, severe anxiety, and panic attacks. Most CBT ignores secondary disturbance. For example, you feel anxious about appearing anxious when requesting the date. You are worrying about worrying.

3. REBT presents an elegant solution to the self-esteem problem. It teaches unconditional self-acceptance (USA) rather than any type of self-rating. Most CBT therapists focus on bolstering their clients’ self-esteem by reinforcing some of their positive qualities. This strategy has many pitfalls including having low self-esteem when you do poorly, making invidious comparisons to others, avoiding risk-taking, smug-complacency, and preoccupation with proving, rather than enjoying, yourself.

USA and avoiding the self-rating trap avoids the many problems with self-rating. USA consists of the philosophy of unconditionally accepting yourself as the imperfect human you are whether you do well or poorly, or others love or hate you. If you get fired, for example, rate your job performance as poor, but never overgeneralize to conclude you’re a poor or worthless person. You’re then able to evaluate your deficient (and positive) behaviors to focus on how to improve in the future.

4. REBT is unique among CBT therapies in differentiating between self-destructive, inappropriate negative emotions vs. helpful, appropriate negative ones. Anxiety, depression, and anger are examples of the first type and intense sadness, deep sorrow, great concern, and regret instances of the second.

For example, if you feel slightly anxious about arriving 5-min late, this is an inappropriate negative emotion because, in part, it comes from rigid, absolutistic thinking characterized by demands (musts, shoulds, have tos: “I absolutely must never be late for an appointment”). Alternatively, if you feel intensely sad, you cry, grieve, and mourn over the loss of a loved one, these are appropriate negative emotions. They come from passionate desires and preferences such as, “I strongly wish my lover had not died, how very, very sad and most unfortunate.”

5. REBT maintains that all anger, having a commanding and condemning, dictatorial philosophic core, some form of “others absolutely must treat me well or else they’re no good,” is unhelpful, feels bad, and sometimes quite destructive. It teaches individuals effective assertiveness and other appropriate alternatives to anger. CBT views some anger as healthy and appropriate. Although CBT teaches assertiveness, it fails to address the philosophic root of anger.

For the above reasons and others the duration of REBT therapy tends to be briefer than CBT.

https://www.psychologytoday.com/blog/the-three-minute-therapist/201703/5-major-differences-between-rebt-cbt

 

 

Michael R. Edelstein, Ph.D.
Clinical Psychologist
415-673-2848 (24/7)
htttp://ThreeMinuteTherapy.com
drmedelstein.threeminutetherapy@gmail.com

Dr. Edelstein conducts in-person, phone, and Skype REBT.

Author of Three Minute Therapy
Features help for anxiety, depression,
relationships, panic attacks and addiction


 

© 2017, Rex Alexander. All rights reserved.

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6 Comments

  • Jimmy says:

    Jimmy sez: Dear Dr Edelstein,

    Excellent summary. Thank you

    In Ellis’ last book, which he wrote with Dr Joffe-Ellis, he agreed with you when he said that the number one difference between REBT and CBT was UA (which is why I think the name should be changed to REBUT (he changed it to REBT from RET when he added Behaviorism – and REBUT is a lot easier to remember and apropos)).

    Please excuse my nit picking: Please permit me to question your modifiers: “intense”, “deep”, and “great” in regards to sorrow, etc. To my mind, these are irrational, exaggerating modifiers. I feel that it would be better to use the word, “appropriate”. Of course, you may hold a different view of the intensity of these modifiers. You do not go anywhere near this far, but allow me to add a bit of humor:
    “When I use a word,” Humpty Dumpty said in rather a scornful tone, “it means just what I choose it to mean — neither more nor less.”
    “The question is,” said Alice, “whether you can make words mean so many different things.”
    “The question is,” said Humpty Dumpty, “which is to be master – – that’s all.”

    While Carroll uses exaggeration humor, Korzybksi is scientific:
    “Since Einstein and the newer quantum mechanics, it has become increasingly evident that the only content of ‘knowing’ is of a structural character.

    “The only link between the verbal and objective world is exclusively structural, necessitating the conclusion that the only content of all ‘knowledge’ is structural. Now structure can be considered as a complex of relations, and ultimately as multi-dimensional order. From this point of view, all language can be considered as names for unspeakable entities on the objective level, be it things or feelings, or as names of relations. In fact, even objects could be considered as relations between the sub-microscopic events and the human nervous system. If we enquire as to what the last relations represent, we find that an object represents an abstraction of a low order produced by our nervous system as the result of a sub-microscopic events acting as stimuli upon the nervous system.”

    Again, thanks for this “great” synopsis on REBT vs. CBT!!!

    May I forward this?

    jimmy

    • Rex says:

      Fri 15 Sep 2017, 11:01 am

      Hi Guys,

      The discussion regarding the similarities and differences between REBT and CBT continues. Dr. Edelstein responds to Dr. Riggenbach.


      MICHAEL SEZ: It’s very good to hear from you, Jeff. I’m pleased to learn you enjoy the discussion. I have more!

      Here’s your response and my rejoinder.

      I’d love to get further push-back from you.

      Dr. Jeff B. Riggenbach, http://jeffriggenbach.com, response to my comparison of REBT to CBT:
      1. CBT(as I was taught by Beckian folks it and teach it myself) would definitely identify the distortion of mind reading, but would also elicit the function of the distortion as well as the underlying belief and the connection and the false attribution connecting the two (“if i don’t get tbis date it means I am unlovable or have no value, etc)
      2. CBT definitely identifies & attacks “secondary disturbance.” I have entire role plays in my training dealing with worry about worry as well as panic about panic attacks.
      3. CBT would teach self acceptance as well as identify components of the belief and work to broaden what kinds of things one values and create evidence based upon those value related components (that would increase “esteem”)
      4. this just sounds like a semantic distinction…CBT would identify continuums of emotions in different “feelings families” (ie anger… maybe 1 is “annoyed” and 10 is “enraged” and clients identify a feeling word for each open point on the continuum… the more extreme/intense the feeling, the more unhealthy (or “destructive” we might call it
      5. CBT teaches that although anger is Understandable in many situations it is rarely helpful

      I’m pleased to see Dr. Riggenbach’s version of CBT includes some REBT notions. Here are some differences he overlooks.

      1. CBT fails to appreciate the power and influence of demands in emotional disturbance. In many presentations of CBT “should statements” are seen as only one of 10 cognitive distortions, rather than the overriding philosophy to be addressed by the therapist. CBT’s “10 Cognitive Distortions” is a point in fact. In addition, as Dr. Riggenbach illustrates in his comment, when CBTers mention the underlying philosophic problem thinking, they discuss the derivative of the demand, “I am unlovable and I have no value” rather than the demand that creates it, in this case “I absolutely must be accepted by significant others or else I’m unlovable.”

      2. I have never seen a chapter devoted to secondary disturbance in a CBT book, even though it frequently is the larger issue in an individual’s emotional disturbance. When clients overcome this, it’s not unusual for their Primary Disturbance to significantly diminish or disappears entirely.

      3. Much of CBT includes self-acceptance as a sub-heading under positive or “authentic” self-esteem. In his book The Six Pillars of Self-Esteem, Nathanial Branden recommends having self-esteem, which includes self-acceptance as only one of the pillars. In Feeling Good: the New Mood Therapy, David Burns has a section titled “Specific Methods for Boosting Self-Esteem.” REBT recommends abolishing self-esteem not boosting it.

      4. Dr. Riggenbach sees negative emotions on “continuums.” Here he illustrates the CBT therapist’s failure to recognize the universe of difference between appropriate and inappropriate negative emotions. The difference is a matter of kind, not degree. Appropriate negative emotions come from preferences whereas inappropriate ones are functions of demands. It’s hardly “a semantic difference.”

      5. Here Dr. Riggenbach again demonstrates an important difference. He states, anger “is rarely helpful.” REBT sees anger as never helpful (with the exception of an artificially created situation, such as being offered $100 dollars for getting angry). As I explain in my book, if in the rare case a show of anger would motivate another individual to do better, a pretense of anger would do fine.


      Thank you everyone for participating in this discussion. Additional comments are welcome.

  • Dr. Edelstein says:

    Dr. Edelstein sez:
    Hi Jimmy,

    I appreciate your kind words.

    Thank you for reminding me of UA, which I neglected to include. I plan to revise the article to do so. Great point!

    Yes, please send it far and wide!

    Warm regards, Michael

  • Rex says:

    Rex sez: Hi Michael and Jimmy,

    Thanks for excellent posts. I will add these to REBT Info, if that’s OK with you.

    It is an understatement to say that Korzybski is dense. But I think his contribution is very important. We are lucky to have access to some of the “old guys” from the Institute of General Semantics, but they seem reluctant or unable to explain some of the concepts in an understandable way and, surprisingly, seem (at least in my experience in dealing with them) overly-touch when some of the basic concepts are challenged. “Curse of knowledge”? That’s a pity because with that attitude and the naturally dense nature of GS, it is going precisely nowhere. Sigh!

    One thing I have been wrestling with (Michael? Jimmy? Anybody?) is that Ellis, et al may have skipped over a basic stage in AK’s “Structural Differential,” his model of how we construct or “abstract” our individual experience which is much deeper than the “ABC” model. Ellis and other CBT guys describe a linear process: 1) There is an event at “A”. 2) We have a belief about it at “B”, 3) which determines our emotional consequence or result at “C.” Nothing new there, but GS (to the extent that I understand it, which is admittedly quite limited) seems to say that there is an emotional response BEFORE “B.” There is the activating event, and then our perception of it, and in this context, “perception” includes a lot more stuff than images, sounds, tactile sensations, etc. It is non-verbal, but still includes lots of “evaluations,” feelings, emotions, etc. So, it is from this “soup” of non-verbal or pre-verbal “impressions” that we then have beliefs about which determines the quality or nature of the emotional “consequence.”

    If it sounds like I don’t know what I am talking about, that may not be very far from the truth. :o{ AK’s basic text is 900 words! So far I have only been able to read the “Reader’s Digest” version. But that’s a start. Happily, I don’t think that this “debate” effects the way REBT is applied. But it is nonetheless quite interesting from a purely existential, ontological standpoint.

    Always feel free to contact me with any questions or if there is anything I can do to be helpful.

    Cheers,

    Rex
    Khon Kaen, Thailand
    rextutor@gmail.com

    http://REBTinfo.com
    http://www.SecularRecovery.com
    http://www.ChiangMaiForum.net
    http://www.KhonKaenForum.net
    http://www.MindBodyThailand.com

  • Rex says:

    Hi Guys,

    Dr. Jeff B. Riggenbach, http://jeffriggenbach.com, a (Beckian) CBT guy has kindly given permission to republish his response to Dr. Edelstein comparison of REBT to CBT.

    JEFF: 1. CBT(as I was taught by Beckian folks it and teach it myself) would definitely identify the distortion of mind reading, but would also elicit the function of the distortion as well as the underlying belief and the connection and the false attribution connecting the two (“if i don’t get tbis date it means I am unlovable or have no value, etc)

    2. CBT definitely identifies & attacks “secondary disturbance.” I have entire role plays in my training dealing with worry about worry as well as panic about panic attacks.

    3. CBT would teach self acceptance as well as identify components of the belief and work to broaden what kinds of things one values and create evidence based upon those value related components (that would increase “esteem”)

    4. this just sounds like a semantic distinction…CBT would identify continuums of emotions in different “feelings families” (ie anger… maybe 1 is “annoyed” and 10 is “enraged” and clients identify a feeling word for each open point on the continuum… the more extreme/intense the feeling, the more unhealthy (or “destructive” we might call it

    5. CBT teaches that although anger is Understandable in many situations it is rarely helpful

    REX: Are you familiar enough with REBT to share what you see to be the most essential difference(s) between REBT and (Beck)CBT? BTW, OK if I add your comments to the http://REBTinfo.com

    JEFF: I have my ideas based upon only some basic training and a one day conference with Dr. Ellis himself, but cant say I feel sufficiently educated on RET as I am with CBT … would hate to make false assumptions about a different approach.

  • Rex says:

    Tue 22 Aug 2017, 11:06 am


    REX SEZ: Apologies. It would have been better if the individuals involved in this discussion had posted their own content. However, I feel it is interesting and important enough to paste them here. Not every comment is included, and am paraphrasing where I think it is more helpful. Feel free to correct me if I get it wrong or misrepresent anything. Hope it is not too confusing.


    REX SEZ: Jimmy has a lot to say and apparently very strong feelings that REBT is superior to CBT, and that REBT is unfairly categorized as a “subset” of CBT. He also does not like the CBT emphasis on inferences compared to REBT’s emphasis on evaluations.

    On a personal note, I learned REBT style and CBT style simultaneously. Although I have come to prefer the way REBT refrains from “beating around the bush” and gets right to the heart of the matter, I find both valid and useful situationally, but that is the subject of a much longer article It was only much later that I became more familiar with the distinctions between the two, but I never found those distinctions to be any big deal, certainly nothing to rouse my passions over! I see them as more of a stylistic preference than anything else. So, it still surprises me how much passion this “debate” stimulates in (some) others. If there are any good studies out there suggesting otherwise, I would be eager to see them.


    Sun 20 Aug 2017, 7:45 am

    Hi Jimmy, all,

    > JIMMY: I strongly object to nacbt.org calling REBT a subset of CBT.

    REX: While “possibly” incomplete or misleading, REBT as a subset of CBT seems like a factual statement to me. How would you prefer it be stated or described? [a subset cannot be larger than it’s parent set]

    JIMMY: telling people to question whether they are mind reading is an unnecessary delay that can be dwelled on

    REX:One of the important, perhaps the most important distinctions between REBT and (Beck)CBT is the CBT emphasis (although not exclusive emphasis) on inferences compared to the REBT emphasis on evaluations and core beliefs. Needless to say, most or nearly all of the REBT guys share your opinion, hence their preference for REBT over CBT. I wold presume that vice versa would be true for CBT guys. Comparing the efficacy of focus on inferences vs. evaluations is a useful and interesting debate, but one which is unlikely to result in anything more than opinion.

    Cheers,

    Rex

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