When You Don't Know Where to Turn / A Self-Diagnosing Guide to Counseling and Therapy

by Steven J. Bartlett

But, like any habits, these mental (or cognitive) habits can be broken. Cognitive therapy attempts to do this.

Ellis called his own approach rational-emotive therapy. By this, he acknowledged that people have both rational and emotional dimensions. Their emotions and thoughts (cognitions) are so thoroughly intertwined that they cannot be clearly separated. Yet mental evaluations and ideas are given so much power that cognitive habits are responsible for emotional responses. It is thinking that makes it so.

Rational-emotive therapy is the most widespread approach to cognitive therapy, so we will examine Ellis's approach in some detail.

The main technique of rational-emotive therapy, and of cognitive therapy in general, is to focus clients' attention on their belief systems, their views about what "should" and "ought" to be, their cognitive "filters" through which they interpret, in a semiautomatic way, the world around them. If the "activating event" is a failure or a rejection, for example, a client's rational belief system will lead to feelings of regret, sorrow, disappointment, or annoyance; if an individual's beliefs are irrational, on the other hand, he or she may instead feel depression, worthlessness, futility, and severe anxiety. For rational-emotive therapy, emotional good health depends on the rationality of the way a person receives and interprets events.

WHAT RATIONAL-EMOTIVE THERAPY IS LIKE

Therapy usually begins with individual sessions. Once clients have learned how to identify mental habits that create disturbing emotions, therapy is sometimes continued in groups, where new attitudes and forms of behavior can be practiced in a kind of microcosm of the larger world. Rational-emotive therapy that is done in a group context is not, however, "group therapy," since the therapist's focus is on individual styles of thinking, not on relationships among members of the group.

During therapy, clients are very quickly challenged to give evidence for their irrational beliefs. The rational-emotive therapist will openly and ruthlessly oppose the foolish absolutes that clients express and make it clear how they are upsetting themselves emotionally by insisting on such nonsense. It is not considered essential that the therapist be a kind, warm, supportive person. In fact, rational-emotive therapy encourages therapists to show their impatience with irrational beliefs that cannot be defended empirically or logically. Once clients are shown that many of their beliefs cause them misery and disappointment, they are asked to dispute—silently, in their own minds—their irrational beliefs whenever they find the old habits taking over. It takes time to extinguish old habits; it doesn't happen overnight. Clients need patience and tenacity to oppose their old reflexes and replace them with rational, realistic beliefs.

An hour a week in rational-emotive therapy is really, then, like a tutorial session with a teacher. The client-students talk about their feelings; the therapist criticizes underlying irrational beliefs and makes it clear to the clients what a rational response would be. Then the clients are asked to practice applying rational beliefs on their own, outside of therapy. Gradually, a more rational way of looking at things takes the place of the old habits.

AN EXAMPLE

Joan Hendley is single, twenty-nine years old, and assistant manager of a bank. She has come to Dr. Kovac because of chronic depression, a sense of low self-worth, and feelings of insecurity and anxiety. Lately, she has begun to drink heavily and regularly feels the need to use sleeping tablets.