Psychology: Essential Thinkers, Classic Theories, and How They Inform Your World - Andrea Bonior 2016

Albert Ellis
Psychotherapy
The Canon

BORN 1913, Pittsburgh, Pennsylvania

DIED 2007, New York City, New York

Educated at the City University of New York and Columbia University

BIG IDEA

Albert Ellis began his adult life with a career in business administration and a dream of being a writer—a somewhat unlikely start to becoming one of the most influential psychologists of all time—but what started him on the latter path was his interest in theories of sexual relationships, which led him to put together a collection of essays, The Case for Sexual Liberty. As more and more people sought his advice after the publication of that book, he discovered that he really enjoyed counseling people. He became an enthusiastic disciple of psychoanalysis and was accepted into a psychoanalytic training program without first earning a medical degree—a rarity at the time—and then went on to get a doctorate in psychology. After a few years in practice, however, he lost faith in some of the principles of psychoanalysis, and by 1957 he had written the book How to Live with a Neurotic and established what he called rational therapy, which eventually morphed into rational-emotive behavior therapy (REBT).

REBT is indeed quite different from psychoanalysis. The therapist in psychoanalysis tends to be rather passive, but an REBT therapist is encouraged to be active and to directly challenge a patient’s unrealistic beliefs. REBT involves directly confronting patients’ self-defeating patterns, helping them readjust their thinking and transform their cognitions into healthier, more adaptive ways of approaching the world. What Ellis established became the forerunner of cognitive therapy.

He also helped bridge the gap between psychotherapeutic treatment and scientific experimentation. Therapists were still overwhelmingly psychoanalytic, and experiments were still overwhelmingly behaviorist. By introducing more concrete, measurable techniques, Ellis became a pioneer in the search for quantifiable, empirically validated outcomes in psychotherapy.

REBT, in Ellis’s words, has three components: A, B, and C, for activating experiences, beliefs, and consequences, respectively. Activating experiences are the circumstances that trigger an emotional reaction in someone: a trauma, a breakup, a stressful work environment. Beliefs are the thought systems that we develop as a result of our experiences; such thoughts are often self-sabotaging and irrational, and they are often responsible for our unhappiness. And consequences are often negative emotions—loneliness, anxiety, hopelessness—that arise from our beliefs.

Ellis emphasized that it is not the activating experiences themselves but rather our beliefs about them that actually cause our unhappiness and long-term patterns of dysfunction. Where treatment comes into play has to do with D and E: the therapist’s disputing of such beliefs, and the therapist’s help in encouraging the patient to work toward the more positive effects of a new and healthier belief system. As for irrational beliefs themselves, Ellis identified many common ones. The most commonly damaging ones, he posited, are those that involve a perfectionistic attitude about how competent one must be, the conviction that others are terrible people if they don’t always treat one considerately, and the demand that the world make one happy at all times. The therapist’s job is to persistently question such beliefs. Four questions commonly come up:

”Is there evidence for this belief?

”Is there evidence against it?

”If you stop having this belief, what is the worst thing that can happen?

”If you stop having this belief, what is the best thing that can happen?

The therapist and the patient hash it out, and the patient gradually comes to understand the contradictions within such beliefs and adopts a more rational approach. Though Albert Ellis believed in the importance of self-acceptance, his objective approach extended to the very notion of the self—he was not interested in more transcendent or actualized versions of the self, such as those that humanistic therapy tended to espouse.

Ellis’s early interest in sexual theory never went away, and throughout his career he continued to write and conduct research on human sexual behavior. His 1958 book Sex Without Guilt is thought to be one catalyst of the American sexual revolution of the 1960s. He allowed his beliefs to evolve along with the times, gradually adopting a more accepting philosophy around same-sex relationships. His criticism of some of the effects of religion—especially as he felt some religious beliefs led to guilt and agitation—was another area in which he clashed occasionally with more conservative cultures.

Ellis himself seemed larger than life, with a rather abrasive though personable style in the therapy room, a further departure from previous styles of psychotherapy (but one that need not be a component of cognitive interventions). For the last 40 years of his life, he taught popular Friday seminars on therapeutic techniques, sometimes lacing them with profanity in a no-nonsense, humorous, confrontational way. In many respects, he was the anti-Freud: direct, action-oriented, and demystifying, believing that therapy shouldn’t have to take years, and that it should be confrontational, transparent, make sense, and quit beating around the bush. He wrote more than 70 books that were accessible and aimed at laypeople, such as How to Stubbornly Refuse to Make Yourself Miserable About Anything—Yes, Anything.

THEN WHAT?

Ellis’s techniques were a clear forerunner, along with Aaron Beck’s work, of cognitive therapy and later cognitive behavioral therapy. Through a long career that continued until he died, when he was just short of 94 years old, Ellis was arguably the psychologist most responsible for moving therapy techniques into the realm of shorter-term, “face your problems” types of interventions. This had a tremendous impact on the public outside the therapy room as well, in terms of shaping cultural beliefs about self-help.

WHAT ABOUT ME?

It is easy at first glance to assume that REBT and its descendants merely tie a pretty bow around your life, encouraging you to look on the bright side or ignore adverse things that are happening. On the contrary, REBT is based on the premise that life will not always be fair and that some acceptance of negative things is necessary in order for you to become happier. So adversity is most definitely acknowledged. But an REBT therapist—or a good friend employing its techniques—will help you look at adversity in a different light, paving the way for you to become more optimistic and autonomous in actually being able to deal with it.

Let’s imagine the case of a disheartening medical diagnosis. You find out that you have diabetes, and the significant lifestyle changes that will be required—along with the implications of having such an illness—are bringing down your mood and making you hopeless. REBT would urge you not to ignore your diagnosis or put yourself in denial with a vague “Everything will be okay.” It would encourage you to face your diagnosis in a realistic, autonomous way. After a session or two of REBT, you might regard your diagnosis as a wake-up call and determine to work with your doctor to find specific strategies to help you not only cope with diabetes but also improve your overall health. This is not pie-in-the-sky thinking or avoiding the reality of the diagnosis. You would experience an improvement not only in your mood but also in your ability to move forward and cope with the challenge at hand.

Larger-scale beliefs can also be identified and challenged through these types of interventions. Ellis illuminated meaningful connections between particular beliefs and particular moods, and he worked with his patients to help them identify the antecedents and consequences of their behavior in systematic ways so that they could avoid sliding down the slippery slope from irrational thoughts to a depressed mood. Later cognitive therapists adopted Ellis’s discoveries and techniques, such as the use of mood journals and logs of automatic thoughts. Albert Ellis understood that the more rigid and maladaptive we are in our beliefs, the more we defeat ourselves, and the higher the price we pay. What he gave his fellow psychotherapists was the gift of a blueprint for challenging irrational, maladaptive beliefs.