Book Review: REBT a Newcomer’s Guide by Matweychuk and Dryden

REBT Newcomer's Guide CoverRational Emotive Behaviour Therapy (REBT) is the main precursor of modern cognitive-behavioural therapy (CBT). (Or the earliest form of CBT, depending on how you look at it.) It was developed in the late 1950s by Albert Ellis, who subsequently wrote dozens of books on the subject. Ellis had a forceful and engaging personality.  In addition to writing textbooks for therapists he wrote some very popular self-help books for a wider audience. He also happens to have referred more often to Stoicism than any other famous figure in the history of psychotherapy. (The now almost forgotten Paul Dubois perhaps comes a close second.)  My own background is in philosophy and CBT, so the relationship between REBT and Stoicism particularly interests me.

In Ellis’ first major publication on what would later become known as REBT, he wrote that its central principle “was originally discovered and stated by the ancient Stoic philosophers”. He meant the REBT principle that emotional disturbances, and associated symptoms, are not caused by external events, as people tend to assume, but mainly by our beliefs and attitudes about such events. Ellis would often teach this principle to therapy clients by showing them a famous quote from the Stoic Handbook of Epictetus: “It’s not events that upset us but our judgments about events.” However, many more references to Stoicism can be found scattered throughout Ellis’ writings. Indeed, even when he makes no explicit mention of Stoicism, traces of its signature ideas can arguably be found in other aspects of REBT theory and practice.

I’ve always felt therefore that Ellis was, quite possibly, more influenced by Stoic philosophy than he actually realized. Perhaps because he read the Stoics quite early in life, as a teenager, he underestimated the extent to which their writings may have inspired various ideas he developed many years later as part of REBT. My first book on Stoicism, The Philosophy of Cognitive-Behavioural Therapy (2010), reviews the parallels between Stoicism and REBT in depth, both in terms of theory and technique. So I won’t be providing another broad survey like that in this short article. Rather I’ll focus on what I think are some notable similarities between the fundamental principles of both Stoicism and REBT.

Rational Emotive Behaviour Therapy: A Newcomer’s Guide

Walter J. MatweychukWalter Matweychuk is an REBT expert who is also very knowledgeable about Stoicism.  Walter gave a talk about their relationship at Stoicon 2017 the international conference for Modern Stoicism. He recently published a neat little introduction to REBT called Rational Emotive Behaviour Therapy: A Newcomer’s Guide (2017). It’s co-authored by Prof. Windy Dryden, a prolific author on REBT and, by my reckoning, the most famous psychotherapist in the UK. Their book is a concise account of REBT for complete newcomers. So it provides a great way for those who are interested in Stoic philosophy to begin learning more about REBT, and I believe they’ll soon grasp the obvious relevance of Ellis’ psychotherapeutic approach to Stoicism.

It starts, naturally enough, by introducing the famous “ABC Model” developed by Ellis. This provides a very simple way to illustrate the difference between healthy (rational) and unhealthy (irrational) ways of responding to any given situation.

A: Activation, meaning you find yourself in a situation or facing certain events about which you draw various inferences
B: Beliefs, you respond by imposing your underlying beliefs on the situation, in this case rigid, irrational demands
C: Consequences, you experience various consequences, particularly emotional distress, but also thoughts and behaviours

For example:

A: I’m giving a presentation at work and someone frowns, so I infer that they think I’m boring
B: I have the inflexible and irrational belief that everyone must find me interesting and if they don’t it’s absolutely awful and unbearable
C: As a consequence, I feel depressed and maybe drink alcohol and distract myself to cope

However, not everyone faced with the same activating event (A) will experience the same emotional consequences (C).  Some individuals might have a more healthy and adaptive response.  Why? Because they have more flexible and rational underlying beliefs (B), akin to preferences rather than rigid demands. This simple model is the foundation stone on which REBT is built. It’s therefore normally taught to clients during the initial orientation (“socialization”) phase of treatment. In more technical terms, it’s used to teach clients a simplified “cognitive” theory of emotion, in which the pivotal elements are their own beliefs (cognitions).

However, when the majority of clients arrive for their first therapy session they tend to talk and think as though certain situations (A) lead directly to emotional distress (C). “She criticized me and that made me feel depressed”, for example. They’re usually missing the cognitive link in the middle, the irrational beliefs (B) that really explain why they’re responding the way that they do. (“People absolutely must not criticize me, because if they do it’s unbearably awful.”)  At first, people often try avoiding or changing the activating event (A), or suppressing the disturbing emotional consequences (C).  However, REBT posits that in most cases the healthiest long-term strategy is to identify the rigid, irrational beliefs that create the emotional response, dispute them, and replace them with flexible, rational beliefs instead.

Ellis always saw his approach as being, in a sense, philosophical because it targets very fundamental beliefs. Indeed, often it could be described as an attempt to transform our underlying “philosophy of life” by disputing irrational beliefs and adopting more rational ones instead. Socrates was arguably the first person to really introduce the notion that rationally disputing our beliefs about what’s good or bad could be construed both as doing philosophy and also as a sort of psychological therapy.  He liked to quote Homer, saying that it was the business of philosophy, not to speculate about the heavens, as previous thinkers had done, but to investigate “Whatso’er is good or evil in a house”, by asking questions of practical significance to our daily lives.  It was the Stoics, though, who really developed this therapeutic aspect of Socratic philosophy the most.

The ancient Stoics actually had a similar three-stage model to Ellis but their emphasis was slightly different. For instance, Epictetus describes this process:

A: There’s an event, such as being caught in a storm at sea, that automatically triggers certain reflexive emotional reactions (propatheiai) and automatic thoughts (phantasiai), such as feelings of anxiety and seasickness, etc.
B: We respond with the belief, or rather value judgement (hupolepsis), that what is happening is intrinsically bad and harmful to our very nature
C: Our initial thoughts and feelings then escalate into a full-blown irrational desires or emotions (called “passions”) and we become excessively upset about the situation

For Stoics, it’s therefore a specific kind of value judgement that’s the root cause of emotional disturbance, and certain behavioural problems in life. For simplicity, we could describe it as judging things outside of our direct control to be strongly good or bad. However, they actually based their therapeutic approach on a more subtle qualitative distinction between two different types of value judgement: one which causes distress and one which does not. They had to introduce jargon to express this, making a distinction between judging something to be supremely “good” (agathos) or “bad” (kakia) versus merely assigning a lighter kind of value (axia) to it for the purposes of planning future actions.

The Stoics believed that only our own character should be judged supremely “good” or “bad”, making these terms synonymous with “virtue” and “vice” respectively. Everything external to our character or acts of will is at best lightly “preferred” or “dispreferred”, advantageous or disadvantageous, but not truly “good” or “bad” in this strong sense.  We can articulate this distinction between something being “good” versus merely “preferred” in several ways because the Stoics employed several definitions of the “good” and a variety of arguments to support their theory. One is that the “good”, in this key technical sense, is synonymous with what is truly beneficial for us, and the “bad” with what is genuinely harmful.

We may rationally value some external things over others, such as preferring wealth over poverty, as long as we don’t actually confuse the value of such things with our supreme good or what is ultimately beneficial for us in life. Money might be useful or advantageous, according to the Stoics, but it’s not really the goal of life.  Likewise, poverty might be a disadvantage that we prefer to avoid but in itself it doesn’t necessarily ruin our life.  Assigning so much value to external advantages such as wealth or status, as if they were a “life or death matter”, is a recipe for neurosis, and the Stoics believed that it was also the root cause of certain vices, i.e., of immoral or antisocial behaviour and even crimes.  In their view, external advantages like having wealth, good looks, or friends, merely gives us more opportunity or control over external events in life.  Whether that’s ultimately good or bad, though, depends on how we use it.  Political tyrants have immense wealth and power but, observed the ancient Stoics, that merely gives them more opportunity to exercise folly and vice.  We go wrong, the Stoics say, when we’re duped into believing that fame, wealth, and other external advantages in life, are somehow more important than wisdom and virtue.

There’s another interesting way of expressing the Stoic qualitative distinction between what is supremely good (or beneficial) and the lighter value placed on externals such as health, wealth, and reputation. They believed that unhealthy passions (desires and emotions) are not only irrational but also excessive. They overreach themselves by demanding that they get what they want despite the fact that their aim is to get (or avoid) external things beyond our direct control. Nothing, say the Stoics, is truly under our direct control except our own will, or our ability to choose one thing over another (prohairesis). It’s therefore madness, or simply irrational and unphilosophical, to desire things in this demanding way.

‘What is it, Passion, that you want? Tell me this.’
‘What I want, Reason? To do everything I want.’
‘A royal wish; but tell me it again.’
‘Whatever I desire I want to happen.’ – Cleanthes

That’ll be an irrational, rigid type of demand then. By contrast, the philosophical attitude aspired to by Stoicism would require embracing the fact that our desires can always be thwarted by external events. Epictetus actually tells his Stoic students that there’s only one thing that they should rigidly demand in life, that they refrain from voluntarily engaging in vice, because that’s always, by definition, within their power to accomplish.

Epictetus called the first stage of training in Stoicism the “Discipline of Desire and Aversion”, which he says is the most urgent for his students to master. It’s basically the Stoic therapy of the passions. He says it boils down to the doctrine that irrational passions are fundamentally due either to being thwarted in getting what we desire or in getting what we seek to avoid in life (Discourses, 3.2). The frustration of certain desires, he says, is necessarily the cause of emotional disturbance, genuine misfortune, sorrow, lamentation, and even envy. He’s clearly talking about a particular type of desire that’s intolerant of being thwarted or remaining unfulfilled. He addresses this demanding quality of unhealthy desires at the very beginning of the Stoic Handbook:

Remember that [this type of] desire contains in it the profession (hope) of obtaining that which you desire; and the profession (hope) in aversion (turning from a thing) is that you will not fall into that which you attempt to avoid: and he who fails in his desire is unfortunate; and he who falls into that which he would avoid, is unhappy. If then you attempt to avoid only the things contrary to nature which are within your power, you will not be involved in any of the things which you would avoid. But if you [rigidly] attempt to avoid disease or death or poverty, you will be unhappy. Take away then aversion from all things which are not in our power, and transfer it to the things contrary to nature [i.e., irrational and unhealthy] which are in our power. (Handbook, 2)

Nevertheless, he adds that his students are to refrain from passionately desiring wisdom and virtue for the time being, in this strong sense, because that would be setting their sights too high at the beginning of their education in philosophy. He concludes by explaining that instead of employing this demanding, passionate form of desire and aversion his students should instead employ a light preference in selecting one external goal over another.

Moreover, Epictetus ends this passage by saying that even when pursuing things lightly in this way, Stoics should also remember to do so “with exceptions”. The meaning of this is usually lost in translation but he’s actually using a Stoic technical term: hupexhairesis. This is often translated as “with a reserve clause”. It means something very specific: undertaking our actions while calmly accepting that they might be thwarted. In plain English, the Stoic reserve clause is like saying: “I want to do xyz but if I don’t succeed, that’s not the end of the world.” Sometimes the “reserve clause” is expressed by qualifying desires and intentions with the clause: “if nothing prevents me”, “Fate permitting” or “God Willing”. Epictetus and other Stoics would also imagine specific setbacks thwarting their desires, which they practised accepting with equanimity and indifference. It seems to me that the addition of the “reserve clause” might be compared to what REBT means by holding “flexible” as opposed to “rigid” beliefs about what we want in life. It’s the subtle knack of being able to say “I want this but if I don’t get it – so what? – it’s not the end of the world” rather than “I must have this!”

REBT likewise shows clients that their irrational beliefs (B), in the form of rigid demands, are the key to their problem and that’s what the therapy focuses on helping them to change.

Note that failing to gain what we value is insufficient for emotional disturbance. REBT does not target unfulfilled values; rather it targets rigid attitudes that suggest the values we have absolutely must be fulfilled. Flexible attitudes specify a preference for what is valued and explicitly negate a demand for it. (p. 16)

For example, they might turn the rigid demand “I absolutely must succeed in valued areas of my life” into the flexible preference “I would prefer to succeed in valued areas of my life but do not have to do so.” In REBT it’s assumed that the strength of a desire alone isn’t what makes it into a rigid demand but nevertheless very strong desires are more likely to mutate into rigid demands.  This distinction can be compared to the one made thousands of years earlier by the Stoics: between the sort of excessive desires or aversions that inevitably cause emotional disturbance when frustrated and the sort of light preferences that seamlessly adapt themselves to being thwarted.

REBT also distinguishes between three domains in which people hold such beliefs: about themselves, other people, or life in general.  Stoicism actually employed exactly the same distinction.  The early Stoics apparently began by employing a twofold distinction between internal and external nature, or ourselves versus the rest of the world.  (This is probably the origin of Epictetus’ famous “dichotomy of control”, which distinguishes what is up to us, our own actions, from everything else.)  However, at least by the time of Marcus Aurelius, this had evolved into a threefold distinction between ourselves, the rest of humankind, and the universe (or nature) as a whole.

Extreme Attitudes

This newcomer’s guide also covers three common “extreme attitudes”, which REBT believes are derived from rigid demands.

  1. Extreme awfulizing
  2. Discomfort intolerance
  3. Extreme devaluation

These also have parallels in the Stoic literature, although for the Stoics, as we’ve seen, the root cause of suffering is the belief that external things, which are not entirely up to us, are supremely good or bad. Sometimes, to be fair, it’s difficult to separate these sort of toxic attitudes as they’re very closely intertwined. For that reason, the difference in emphasis between Stoic therapy and REBT is arguably less significant than what they have in common. Both approaches agree that broadly-speaking a nexus of irrational, evaluative, demanding beliefs are at the core of our emotional distress.

Awfulizing

REBT holds that extreme “awfulizing” attitudes often derive from rigid demands. For example, if I believe “People must treat me with respect” then as a consequence I may also have an extreme attitude that says “It’s awful when people don’t treat me with respect.” What’s meant by “awful” is defined as:

  1. Nothing could conceivably be worse in terms of this situation
  2. It’s worse than what we’d normally think of as 100% bad – it’s off the scale
  3. Absolutely no good can be derived from something as intrinsically bad as this
  4. There’s no way to transcend something this awful by responding constructively to it

The opposing attitude in REBT consists of asserting that the situation may be bad but it’s not awful, e.g., “It’s bad when I don’t succeed in valued areas of my life but it’s not awful”. We might also say “I don’t like it but it’s not the end of the world.”

As we’ve seen, the Stoics view rigid, irrational desires as the corollary of irrational value judgments. The two things are basically synonymous. What Ellis meant by awfulizing can be compared to what the Stoics meant by someone judging an external event to be supremely “bad” and “harmful”, in their special technical sense. This involves the belief that some external misfortune is so bad that it harms our fundamental interests, striking at the very core of our being. The Stoics believe this attributes a form of extreme “badness” to external events that they simply cannot possess: only the corruption of our own character, by folly and vice, can actually ruin our lives in this way.

To paraphrase one of their metaphors: imagine a set of scales with folly and vice on one side. No matter how many external misfortunes we pile up on the other side, it should never be enough to tip the scales. The form of “badness” attributable to external misfortune, no matter how severe, is inherently inferior and qualitatively different from the sort of “badness” possessed by our own descent into inner wretchedness. In plain English, both Stoicism and REBT agree that much of our emotional disturbance is caused by the belief that apparent misfortunes in life are not only “bad”, in the ordinary sense, but terrible or awful in an exaggerated and disproportionate sense. It’s right off the scale, in fact, and the Stoics would say that’s because it makes the error of conflating two different sorts of value.

Discomfort Intolerance

REBT believes that many problems are due to the belief that discomfort is unbearable, which causes people to feel overwhelmed and give up prematurely when perseverance is required. Tolerance of discomfort happens to be essential to most psychotherapy, though. For example, treatment for many forms of anxiety requires repeatedly confronting our fears, which is impossible without a willingness to accept and tolerate a certain amount of emotional discomfort. Put crudely, we usually have to be willing to step outside of our comfort zone in order to achieve significant changes. In fact, discomfort intolerance can be a severe handicap in many areas of life. When we tell ourselves “I can’t bear it”, we’re usually wrong. It’s often just fear or laziness speaking. We can bear a lot more than we tend to assume.

The Stoics remind themselves of this quite frequently. One of the recurring themes in The Meditations of Marcus Aurelius is the claim that we are, by nature, capable of bearing more discomfort than we realize. For example, Marcus tells himself not to overwhelm his mind with exaggerated worries but to divide troubling events into small parts and focus on one aspect at a time. I call this the Stoic technique of “Depreciation by Analysis.” When we calmly ask ourselves “What is there about this particular aspect that’s actually unbearable?” we come to realize how absurd that question is because there’s almost always a way to cope.

Do not disturb yourself by picturing your life as a whole; do not assemble in your mind the many and varied troubles which have come to you in the past and will come again in the future, but ask yourself with regard to every present difficulty: ‘What is there in this that is unbearable and beyond endurance?’ You would be ashamed to confess it! And then remind yourself that it is not the future or what has passed that afflicts you, but always the present, and the power of this is much diminished if you take it in isolation and call your mind to task if it thinks that it cannot stand up to it when taken on its own. (Meditations, 8.36)

By focusing on the here and now, and one aspect at a time of a larger situation, Stoics learn to cope with even the most challenging misfortunes in life. Marcus, like other Stoics, also frequently asks himself what “virtue” or coping ability nature has given him that he could use to deal with the situation he faces. This is related to the Stoic emphasis on studying role models and learning coping strategies from them, which Marcus does extensively in Book One of The Meditations. One way of increasing our appraisal of our ability to cope with adversity and tolerate discomfort is by reminding ourselves how other people have managed to cope with similar situations.

Devaluation and Acceptance

REBT holds that a great deal of emotional disturbance is caused by beliefs rigidly deprecating oneself, other people, or life in general. This is typical in clinical depression but it can manifest in many other types of emotional problem as well. These extreme attitudes are interpreted as derivatives of rigid demands. For example, someone who rigidly believes “You must not ignore me” may conclude “You are a bad person if you do ignore me.” The essence of this attitude is a global rating of negative value. Something is judged to be bad as a whole, whereas in reality most things have a mixture of positive and negative qualities. It’s a form, therefore, of over-generalization. REBT recommends that these attitudes should be replaced with more flexible ones that actively refrain from attaching a global negative rating to oneself, other people, or life in general.  Even better, we should learn to accept ourselves and others unconditionally even if we object to specific attitudes or behaviours.

This sort of extreme negative evaluation is similar to what the Stoics mean by judging externals, including life as a whole or other individuals, to be bad in the strong sense described above. Epictetus actually says that when you fail to distinguish between things that are up to you and things that are not, and invest too much importance on the latter, as a consequence “you will lament, you will be disturbed, you will blame both gods and men”, i.e., railing against life in general (Handbook, 1). The Stoics repeatedly warn us not to indulge in judging other people to be “good” or “bad” in the strong sense they’re concerned with, similar to a global rating of value.

Epictetus says that someone who is uneducated in philosophy blames other people, someone who is partially educated blames himself, and someone who has completed his education blames neither himself nor others (Handbook, 5).  Human nature is fundamentally something sacred to the Stoics because, despite our flaws, our very nature contains the seeds of wisdom  and virtue, the potential for good.  Rather than condemning themselves others in this global deprecating sense, therefore, the Stoics encourage us to view our many passions and vices as, ultimately, being irrational mistakes made by beings that are fundamentally capable of doing good as well as evil.

Conclusion

There are many more comparisons we could make between REBT and Stoicism.  For example, one of the methods of Socratic disputation employed in REBT, known as “functional disputation”, involves evaluating the consequences, emotional and otherwise, of holding rational versus irrational beliefs.  That’s very similar to one of the most common methods cited by the Stoics, which involved comparing the consequences of living rationally versus those of being ruled by unhealthy passions, i.e., desires and emotions based on irrational beliefs.  The Stoics often allude to this through the shorthand method of stating the paradox that irrational fears typically do us more harm than the things of which we’re afraid – highlighting the harmful consequences of irrational beliefs.  Anger, they say, does us more harm than the person with whom we’re angry ever could, because it poisons our very character with temporary madness.

I’ve only been able to touch briefly on some similarities between REBT and Stoicism here. So I’ve focused on some of the key similarities in their conceptualization of emotional disturbance because that’s of absolutely fundamental importance, underlying as it does most of the other concepts and techniques employed in both approaches. As I mentioned at the beginning, my book The Philosophy of CBT attempts to provide a fairly comprehensive overview of the similar concepts and techniques found in REBT and Stoicism. So, in particular, if you’re interested in looking at the practical therapeutic techniques that go with the theory described above that would be worth reading.

However, this newcomer’s guide by Matweychuk and Dryden explains the core techniques of REBT more thoroughly, in plain English, in a way that I think will be of interest to those studying Stoic philosophy. For anyone looking for a quick introduction to REBT, it’s perfect in that respect because it’s very concise and yet covers the key concepts of the approach very well.

The Stoic Handbook

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One thought on “Book Review: REBT a Newcomer’s Guide by Matweychuk and Dryden”

  1. If people are really interested in another precursor to CBT and/or REBT — please look into the works of Dr. Abraham Low. In the late 1930’s around the time that AA was getting started, Dr. Low developed the Recovery Method Techniques. https://recoveryinternational.org
    Wonderful, helpful techniques.

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