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.
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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.
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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.
Dr. Edelstein conducts in-person, phone, and Skype REBT.
Author of Three Minute Therapy
Features help for anxiety, depression,
relationships, panic attacks and addiction
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Originally posted 2017-09-15 00:00:57.