“Secondary disturbance” is not secondary in signifance.

Posted by Rex Alexander on Fri 17 Nov 23 in Acceptance, Basics, Depression, Disputing, ULA, UOA, USA |
We have been having some great discussions lately over at the REBT-CBT Forum Yahoogroup.  Thm raised an honest and important question and was kind enough to allow me to re-post it here.  Thanks, Thm!  His question and my response follows. Your follow-up comments and questions are encouraged and welcomed.

  From Thm @ . . .

Would anyone mind drafting a disputation for being ashamed about being depressed? My colleague just went on sick leave due to depression, and I noticed that I felt a bit of contempt for her because of that. Then I felt ashamed of myself for my lack of understanding. I am depressed myself and just barely managing to work. I guess I imagine that if I did not feel shame about being depressed my work ethic would somehow fall apart and I would give up making much effort. I don’t really think that makes much sense, so I feel ashamed of being so irrational. I also imagine that colleagues would feel the same lack of regard for me as I felt for my colleague if I were unable to keep working. That may be realistic enough, but the thought makes me feel acutely ashamed.

I think I “should” be able to write a decent disputation myself, but have not been getting around to it, and so I am a bit ashamed of that, too.”



Hi Thm, All,

Thanks for sharing this.  Sounds like a bummer-and-a-half!  May I add it to my blog, please?  I think a lot of people would benefit.

I hate to disappoint you, but what you have not very exotic or even very interesting from an REBT perspective.  Just meat & potatoes, garden variety REBT 101.

Shame usually results from attacking your self, your essence, your identity in a global way.  Dr. Ellis referred to it as “rating” or “downing”   In it’s simplest form, when you decide that you are a “bad person” or any of a bizillion variations on that them, you probably will feel shame.  To the extent that you harangue yourself about it, you may feel very great shame.  This can lead to all kinds of other problems and issues.  This is usually referred to as “self esteem” and a great many self-help books are dedicated to relieving low self-esteem.  REBT-CBT usually avoids the whole quagmire of “low self” esteem, and focuses instead on “Unconditional Self Acceptance”  abbreviated as USA (also UOA, and ULA for “Unconditional Other Acceptance”, and “Unconditional Life Acceptance.”).    The easiest way to acquire USA is to stubbornly refuse to call yourself names, and the easiest way to accomplish that  is to choose a concept of self that is difficult or impossible to rate. Never rate your SELF, your essence, your identity based upon your behavior.


Guilt (healthy regret) kept in perspective can often be useful
and helpful if it results in a change in behavior. Shame is
self-downing, “rating,” an attack on your self, your “essence.”


Guilt is usually the result of rating your BEHAVIOR in an unhealthy or irrational way.

So, it goes like this:

I must not feel depressed
Perhaps:  It’s terrible and awful, and I can’t stand feeling depressed.
And as I feel depressed, as I absolutely must not, I am a shit!

You undoubtedly have your own language for “shit.”  There is a long, long laundry list of ways to put oneself and others down, but not matter what flavor of language, it all boils down to some kind of global label expressing the concept “I am no damn good!”    Sometimes that attack is primarily on one’s (or another’s) intelligence (Idiot! Stupid!  Retard!), Sometimes on sexuality or gender (faggot, bitch, cunt, bastard, wimp, sissy).  Sometimes on competence (useless, incompetent).  Sometimes on success and achievement success (failure, fuck up, loser, bum, slacker).  Sometimes on industry and energy levels (lazy,sloth, slacker) .  Many of these “may” be rational or appropriate descriptions of some behavior (notice I said “may”) which we then magically expand to color our or another’s total essence and identify.  We put a drop of yell-slacker food coloring into the glass of clean water, and the en tire glass of water not takes on the essence of “slacker.”

It seems to me that people who are depressed SHOULD feel depressed.  After all, how else would you expect a depressed person to feel?  That is not to say that you should like it or that it is a healthy or desirable situation, but obviously if you are making yourself depressed, that is precisely the way you SHOULD feel . . . until you challenge your nutty thinking and replace it with thinking that helps you emote in ways which are more positive and pleasant, and in turn behave in ways that are more rewarding and help you get more of what you want and less of what you do not want . . . which will in turn improve your thinking, which will improve your emoting  which will improve your behavior . . . and so on.

I get this one a lot:  I get depressed and I make it worse by telling myself :  “Rex, since you are supposed to be this hot shit REBT buy, you shouldn’t get depressed, and if you do get depressed, you should be able to wiggle your nose and snap out of it!”

Usually, I don’t have to do much disputing and replacing because as soon as I identify this pattern of thinking, I recognize it as an “old friend”  (yeah, right!) and see that it is patently absurd.

As to contempt for your friend, you are applying the nutty thought that your friend SHOULDN’T be depressed, and because he is, he is unworthy.

Do you have an evidence whatsoever the proves you absolutely must not be depressed?  Or that because you are, you are some kind of nogoodnick?




Being depressed may be unpleasant, and while it would obviously be better not to be depressed, there is absolutely no reason what you should not be depressed.  However, if you want to do something about it, you can by

1.  First relinquishing your “darling shoulds” as we have been discussing here.

2.  Recognize that even though you are depressed, it does not make you a bad person . . . or even a depressed person.  It is perfectly rational to unconditionally accept your self (and your friend’s self)  whether you are depressed or not.

3.  Get involved with a program of recovery which may include things such as

  • Therapy, support group,
  • Combating the “urge to do nothing” and keeping busy.
  • Think positively
  • Possibly do some service or volunteer work or other good deeds for others to encourage you to get “outside of yourself” and outside of your own head.  Service to others is both an ancient and modern antidote to depression, and remains one of the most effective, especially when done within  a comprehensive program of recovery.
  • Keep a healthy lifestyle; diet, exercise, supplements, participating in activities that bring you pleasure (forcing yourself if you have to).
  • Do some DAILY disputing and replace (ABC or Three Column) even if you don’t feel like it, even if you don’t think you are doing it very well.
  • Do you Burns depression inventory a couple of times a week and graph or chart your progress
  • This may take awhile.  Be patient.  Be persistent.  Keep putting one foot in front of the other .
  • Accept progress without demanding “perfection. 
  • Get the “Feeling Good Handbook” and work some of the exercises every day.  You can get a used copy for $1 buck on Amazon or Abebooks.com .

This should give you a starting place.  Please check in and let us know how you are doing.  I have approached this in a sloppy “shotgun” sort of way, so if you have an specific questions or anything to add which you think might help us be more helpful, do not hesitate to ask.


Khon Kaen, Thailand



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Originally posted 2013-12-07 03:57:31.

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