Inflammatory Bowel Disease Case Study The patien.docx

Inflammatory Bowel Disease
Case Study
The patient is an 11-year-old girl who has been complaining of
intermittent right lower
quadrant pain and diarrhea for the past year. She is small for her
age. Her physical
examination indicates some mild right lower quadrant
tenderness and fullness.
Studies Results
Hemoglobin (Hgb), 8.6 g/dL (normal: >12 g/dL)
Hematocrit (Hct), 28% (normal: 31%-43%)
Vitamin B12 level, 68 pg/mL (normal: 100-700 pg/mL)
Meckel scan, No evidence of Meckel diverticulum
D-Xylose absorption, 60 min: 8 mg/dL (normal: >15-20 mg/dL)
120 min: 6 mg/dL (normal: >20 mg/dL)
Lactose tolerance, No change in glucose level (normal: >20

mg/dL rise in
glucose)
Small bowel series, Constriction of multiple segments of the
small intestine
Diagnostic Analysis
The child's small bowel series is compatible with Crohn disease
of the small intestine.
Intestinal absorption is diminished, as indicated by the
abnormal D-xylose and lactose
tolerance tests. Absorption is so bad that she cannot absorb
vitamin B12. As a result, she has
vitamin B12 deficiency anemia. She was placed on an
aggressive immunosuppressive
regimen, and her condition improved significantly.
Unfortunately, 2 years later she
experienced unremitting obstructive symptoms and required
surgery. One year after surgery,
her gastrointestinal function was normal, and her anemia had
resolved. Her growth status
matched her age group. Her absorption tests were normal, as
were her B12 levels. Her
immunosuppressive drugs were discontinued, and she is doing

well.
Critical Thinking Questions
1. Why was this patient placed on immunosuppressive therapy?
2. Why was the Meckel scan ordered for this patient?
3. What are the clinical differences and treatment options for
Ulcerative Colitis and Crohn’s
Disease? (always on boards)
4. What is prognosis for patients with IBD and what are the
follow up recommendations for
managing disease?
I want a research paper about “Rational emotive behavior
therapy” by Albert Ellis. I Have uploaded 2 articles, a section
from Albert Ellis’s book, and a review about the book. You
have to use these sources along the paper and if you used
another source please cite them. You have to talk about the
REBT, what is it, how is it used and why some people criticize
it.
Instructions:
· APA format
· It must be 5-7 pages
· Double spaced
· I want it by Tuesday at 6:00 pm.
· You have to use your own word

R
Rational Emotive Behavior Therapy
Windy Dryden
Keywords: rational emotive behavior therapy, rationality and
irra-
tionality, psychological interactionism, active-directive
treatment
Rational Emotive Behavior Therapy (REBT) was founded in
1955 by Albert Ellis, a U.S. clinical psychologist. Originally
trained as a psychoanalyst, Ellis was disappointed at the
results he obtained from this form of therapy and after a
period of experimentation in various therapeutic methods of
the time, he brought together his early interests in a number
of fields to form REBT. These fields included the practical
application of philosophers such as Epictetus, Marcus
Aurelius, and Bertrand Russell who all stressed the impor-
tance of cognition in understanding human affairs
and the work of the early behavior therapists such as John B.
Watson and Mary Cover Jones whose ideas helped Ellis to
overcome public speaking anxiety and fears of approaching
women. Originally, Ellis called his approach Rational
Therapy (RT) because he wanted to emphasize its rational
and cognitive features, but in 1961, he changed its name to
Rational-Emotive Therapy to show critics that it did not neg-
lect emotions. Over 30 years later (in 1993), Ellis renamed
the approach Rational Emotive Behavior Therapy (REBT)
to show critics that it did not neglect behavior.
In 1962, Ellis published Reason and Emotion in
Psychotherapy, a collection of largely previously printed
papers or previously delivered lectures, but which became
a seminal work in the history of psychotherapy. Most of
REBT’s major, present-day features are described in Ellis’s

book, albeit some in embryonic form: the pivotal role of
cognition in psychological disturbance, the principle of psy-
chological interactionism where cognition, emotion, and
behavior are seen as interacting, not separate systems, the
advantages of self-acceptance over self-esteem in helping
clients with their disturbed views of their self, the role that
low frustration tolerance has in perpetuating psychological
disturbance, and the importance of an active-directive thera-
peutic style to name but a few. Present-day features of
REBT not found in this seminal book include its construc-
tivistic and postmodern aspects.
BASIC ASSUMPTIONS
In REBT, rationality is a concept that is applied to a
person’s beliefs. Rational beliefs, which are deemed to be at
the core of psychological health in REBT, are flexible, con-
sistent with reality, logical, and self- and relationship-
enhancing. Irrational beliefs, which are deemed to be at the
core of psychological disturbance, are rigid, inconsistent
with reality, illogical, and self- and relationship-defeating.
In REBT theory (Ellis, 1962, 1994), there are four
types of rational beliefs: flexible preferences (“I want to be
approved, but I don’t have to be”), non-awfulizing beliefs
(“It’s bad to be disapproved, but it isn’t the end of the
world”), high-frustration-tolerance beliefs (“It is difficult to
face being disapproved, but I can tolerate it and it is worth
tolerating”), and acceptance beliefs (e.g., unconditional self-
acceptance [USA]: “I failed to be approved, but I am not
worthless. I am a fallible human being capable of being
approved, disapproved, and treated neutrally,” unconditional
other-acceptance [UOA]: “You disapproved of me, but you
321

are not a bad person for doing so. Rather, you are a fallible
human being capable of good, bad, and neutral deeds,” and
unconditional life acceptance [ULA]: “Life conditions are
really hard for me because of your disapproval, but life is
not all bad. It is a tremendously complex mixture of good,
bad, and neutral events”).
Similarly, there are four types of rational beliefs: rigid
demands (“I must be approved”), awfulizing beliefs (“If
I’m disapproved, it’s the end of the world”), low-frustration-
tolerance beliefs (“I can’t tolerate being disapproved”), and
depreciation beliefs (e.g., self-depreciation: “I am worthless
if I am disapproved,” other-depreciation: “You are a horrible
person if you disapprove of me” and life-depreciation: “Life
is all bad because I have been disapproved”).
REBT advocates an ABC model of psychological dis-
turbance and health. “A” stands for activating event which
can be actual or inferred, “B” stands for belief (rational or
irrational), and “C” stands for consequences of holding a
belief about A and can be emotional, behavioral, and cogni-
tive. Thus, A’s do not cause C’s but contribute to them. B’s
are seen as the prime but not only determiner of C’s.
REBT theory states that holding a rational belief about
an A leads to healthy emotions, functional behavior, and
realistic subsequent thinking, whereas holding an irrational
belief about the same A leads to unhealthy emotions, dys-
functional behavior, and unrealistic subsequent thinking.
REBT theory holds that human beings are capable of
thinking rationally and irrationally. The ease with which we

transform our strong desires into rigid demands, for exam-
ple, suggests that the tendency toward irrational thinking is
biologically based, but can be buffered or encouraged by
environmental contexts (Ellis, 1976). Clients often have the
unfortunate experience of inheriting tendencies toward dis-
turbance and being exposed to their parents’ disturbed
behavior. REBT is optimistic and realistic here. It argues
that if such clients work persistently and forcefully to
counter their irrational beliefs and act in ways that are con-
sistent with their rational beliefs, then they can help them-
selves significantly. However, REBT also acknowledges that
most clients will not put in this degree of effort over a long
period of time and will therefore fall far short of achieving
their potential for psychological health.
ORIGIN AND MAINTENANCE OF PROBLEMS
Paraphrasing the famous dictum of Epictetus, we say in
REBT that people are not disturbed by events but by the
rigid and extreme view they take of them. This means that
while negative events contribute to the development of dis-
turbance, particularly when these events are highly aversive,
disturbance occurs when people bring their tendencies to
think irrationally to these events.
REBT does not have an elaborate view of the origin of
disturbance. Having said this, it does acknowledge that it is
very easy for humans when they are young to disturb them-
selves about highly aversive events. However, it argues that
even under these conditions people react differently to the
same event, and thus we need to understand what a person
brings to and takes from a negative activating event.
People learn their standards and goals from their cul-
ture, but disturbance occurs when they bring their irrational
beliefs to circumstances where their standards are not met

and their pursuit toward achieving their goals is blocked. In
contrast, REBT has a more elaborate view of how distur-
bance is maintained. It argues that people perpetuate their
disturbance for a number of reasons including the following:
(1) They lack the insight that their disturbance is under-
pinned by their irrational beliefs and think instead that it is
caused by events; (2) they think that once they understand
that their problems are underpinned by irrational beliefs, this
understanding alone will lead to change; (3) they do not
work persistently to change their irrational beliefs and to
integrate the rational alternatives to these beliefs into their
belief system; (4) they continue to act in ways that are
consistent with their irrational beliefs; (5) they lack or are
deficient in important social skills, communication skills,
problem-solving skills, and other life skills; (6) they think
that their disturbance has payoffs that outweigh the advan-
tages of the healthy alternatives to their disturbed feelings
and/or behavior; and (7) they live in environments that
support the irrational beliefs that underpin their problems.
CHANGE
REBT therapists consider that the core facilitative
conditions of empathy, unconditional positive regard, and
genuineness are often desirable, but neither necessary nor
sufficient for constructive therapeutic change. For such
change to take place, REBT therapists need to help their
clients to do the following:
● Realize that they largely create their own psycho-
logical problems and that while situations contribute
to these problems, they are in general of lesser
importance in the change process
● Fully recognize that they are able to address and
overcome these problems

● Understand that their problems stem largely from
irrational beliefs
● Detect their irrational beliefs and discriminate
between them and their rational beliefs
● Question their irrational beliefs and their rational
beliefs until they see clearly that their irrational beliefs
are false, illogical, and unconstructive while their
rational beliefs are true, sensible, and constructive
322
● Work toward the internalization of their new
rational beliefs by using a variety of cognitive
(including imaginal), emotive, and behavioral
change methods while refraining from acting in
ways that are consistent with their old irrational
beliefs
● Extend this process of challenging beliefs and using
multimodal methods of change into other areas of
their lives and to commit to doing so for as long as
necessary
SKILLS AND STRATEGIES
REBT therapists see themselves as good psychological
educators and therefore seek to teach their clients the ABC
model of understanding and dealing with their psychologi-
cal problems. They stress that there are alternative ways of

addressing these problems and strive to elicit their client’s
informed consent at the outset and throughout the therapeu-
tic process. If they think that a client is better suited to a dif-
ferent approach to therapy, they do not hesitate to effect a
suitable referral.
REBT therapists frequently employ an active-directive
therapeutic style and use both Socratic and didactic teaching
methods. However, they vary their style from client to client
(Dryden, 2002). They often begin by working with specific
examples of identified client problems and help their clients
to set healthy goals. They employ a sequence of steps in
working on these examples that involves using the ABC
framework, challenging beliefs, and negotiating suitable
homework assignments with their clients. Helping clients to
generalize their learning from situation to situation is explic-
itly built into the therapeutic process as is helping clients to
identify, challenge, and change core irrational beliefs which
are seen as accounting for disturbance across a broad range
of relevant situations.
A major therapeutic strategy involves helping clients to
become their own therapists. In doing this, REBT therapists
teach their clients how to use a particular skill such as chal-
lenging irrational beliefs, model the use of this skill, and
sometimes give the clients written instructions on how to
use the skill on their own (Dryden, 2001). Constructive
feedback is given to encourage the refinement of the skill.
As clients learn how to use the skills of REBT for them-
selves, their therapists adopt a less active-directive, more
prompting therapeutic style in order to encourage them to
take increasing responsibility for their own therapeutic
change.
REBT may be seen as an example of theoretically
consistent eclecticism in that its practitioners draw on pro-

cedures that originate from other therapeutic approaches,
but do so for purposes that are consistent with REBT theory
(Dryden, 1995). REBT therapists are selective in their eclec-
ticism and avoid the use of methods that are inefficient,
mystical, or of dubious validity. REBT therapists have their
preferred therapeutic goals for their clients, i.e., to help them
to change their core irrational beliefs and to develop and
internalize a set of core rational beliefs. However, they are
ready to compromise these objectives when it becomes clear
that their clients are unable or unwilling to change their core
irrational beliefs. In such cases, REBT therapists help their
clients by encouraging them to change their distorted infer-
ences, to effect behavioral changes without necessarily
changing their irrational beliefs or to remove themselves
from negative activating events (Dryden, 1995).
The fact that REBT therapists are theoretically consis-
tent in their eclecticism and are prepared to make compro-
mises with their preferred therapeutic strategy shows that
they are informed by REBT theory, but are flexible in their
implementation of it in the consulting room. Since flexibil-
ity is a key concept in REBT, good REBT therapists in being
therapeutically flexible demonstrate that they practice what
they preach.
RESEARCH EVIDENCE
There is quite a lot of research indicating that psycho-
logical disturbance is correlated with irrational beliefs, but
studies indicating that these beliefs are at the core of distur-
bance have yet to be carried out. Most scales that measure
irrational and rational beliefs are deficient in one respect or
another and there is a need to develop a scale with excellent
psychometric properties.

Numerous studies on the effectiveness of REBT have
been carried out and various meta-analyses of REBT out-
come studies have been conducted which have come to dif-
ferent conclusions about the effectiveness of REBT.
Well-controlled trials of REBT need to be done with clinical
populations, employing well-trained REBT therapists who
can be shown to adhere to a properly designed REBT adher-
ence scale. Work is currently in progress to design such an
adherence scale.
FUTURE DIRECTIONS
The future of REBT was considered a number of years
ago in a survey of the then membership of the International
Training Standards and Review Committee of the Albert
Ellis Institute (Weinrach et al., 1995). Of the nine members
of this committee, seven were basically optimistic about
REBT’s future and two were relatively pessimistic. Since
I was one of the most pessimistic, I would like to explain
the major source of my pessimism. My prediction is that in
323
the future there will be increasing emphasis on empirically
supported therapies (ESTs) in our field and REBT in its spe-
cific form will fail to meet the criteria of an EST. Indeed,
REBT is not even mentioned in Lyddon and Jones’s (2001)
edited text on the empirically supported cognitive therapies.
There are no academic centers of excellence where the
empirical study of REBT is being conducted and as I noted
in a previous section there is no well-validated therapist
adherence or competency scale to determine that REBT

will be correctly and competently delivered in any future
efficacy studies.
Having said that, I do think that REBT’s ideas will
continue to be incorporated into generic CBT and will have
their impact in future psychological education programs to
which they are particularly suited. As such, REBT concepts
will be alive and well but perhaps not under the rubric of
REBT. Whether future authors acknowledge REBT as their
source is debatable. But as Ellis reminds us, if this does not
happen, it would be bad, but it would not be awful.
REFERENCES
Dryden, W. (Ed.). (1995). A rational emotive behaviour therapy
reader.
London: Sage.
Dryden, W. (2001). Reason to change: A rational emotive
behaviour
therapy (REBT) workbook. Hove: Brunner-Routledge.
Dryden, W. (Ed.). (2002). Idiosyncratic rational emotive
behaviour
therapy. Ross-on-Wye: PCCS Books.
Ellis, A. (1962). Reason and emotion in psychotherapy.
Secaucus, NJ: Lyle
Stuart.
Ellis, A. (1976). The biological basis of human irrationality.
Journal of
Individual Psychology, 32, 145–168.
Ellis, A. (1994). Reason and emotion in psychotherapy. Revised
and

updated edition. New York: Birch Lane Press.
Lyddon, W. J., & Jones, J. V., Jr. (Eds.). (2001). Empirically
supported cog-
nitive therapies: Current and future applications. New York:
Springer.
Weinrach, S. G., Ellis, A., DiGiuseppe, R., Bernard, M.,
Dryden, W.,
Kassinove, H., Morris, G. B., Vernon, A., & Wolfe, J. (1995).
Rational
emotive behavior therapy after Ellis: Predictions for the future.
Journal of Mental Health Counseling, 17, 413–427.
Rehabilitation Psychology
Timothy R. Elliott and Warren T. Jackson
Keywords: physical disability, rehabilitation, counseling,
cognitive–
behavioral therapy
The rate of permanent disability has increased steadily over
the years, accompanying the aging of our population,
increasing rates of survival from severe physical trauma,
and the precipitous rise of debilitating, incurable chronic
disease. Considerable evidence attests that people who
possess adaptive social–cognitive characteristics typically
experience a more optimal adjustment following disability
than persons who have deficits in these characteristics (for a
comprehensive overview on this field, see Frank & Elliott,
2000). These characteristics are essential in adhering to
self-care regimens, preventing further complications and
enhancing quality of life. CBT has great potential in pro-
moting adjustment, well-being, and personal health among
persons with disabling conditions. Cognitive–behavioral

interventions are the most promising and widely accepted
treatments in rehabilitation psychology.
Thus, the great variety of patient and family needs in
rehabilitation and community settings provides a wonderful
opportunity for application of virtually all CBT approaches:
behavior management, learning theory as it applies to
didactics and patient education, cognitive techniques that
inform psychoeducational interventions, and empirically
supported CBT protocols for specific disorders and adjust-
ment difficulties. In rehabilitation settings, CBT may be
conceptualized in its broadest form.
VARIED APPLICATIONS
Types of Injury/Illness
The successful practitioner of CBT must have familiar-
ity with all of the different disorders that are commonly
encountered in various rehabilitation settings. Disorders
may be classified as central neurologic (stroke, head
trauma), peripheral neurologic (spinal cord injury, Guillian–
Barré syndrome), orthopedic (fractures, joint replacements),
medical (major surgery, chronic metabolic illness), psychi-
atric (schizophrenia, mental retardation), and combined.
Substance use disorders are considered elsewhere in this
volume; however, they are certainly prevalent in rehabilita-
tion settings (alcohol abuse, therapeutic dependence on pain
medication) and often these disorders contribute to the onset
of a disability and to the development of preventable sec-
ondary complications following disability (e.g., ER visits,
infections, skin ulcers).
Treatment Settings
There has been a definite trend over the past 15 years

for rehabilitation resources to be reallocated from the
traditional inpatient postacute setting to outpatient and
home-based programs. In addition, new initiatives such
as telehealth approaches are being developed to augment
324
Humanism, in both concept and philosophy, is encased in a
literature that is predominantly abstract. As with most
philosophical matters, it is difficult to translate its concepts into
tangible day-to-day action steps. Rational emotive behavioral
tharapy (REBT) provides perhaps the best and most detailed
method for translating humanist concepts into humanist
behavior.
That rational emotive behavior therapy (REBT) is deeply rooted
in philosophy has been a central theme in the writings of its
founder, Albert Ellis, from the beginning (Ellis, 1962) to the
present (Ellis, 1996). It casts an unusual combination of
stoicism and hedonism into the context of rigorous scientific
thinking and largely utilizes Socratic dialogue to help
individuals examine old beliefs, and then proactively adopt new
or modified beliefs that make up a more realistic and effective
philosophy of life.
Although focusing primarily on the relief of emotional distress
and the alteration of dysfunctional behavior, REBT's
fundamental tenets are equally applicable to all aspects of
human experience. Thus, although some critics may scoff at
REBT procedures as emphasizing "just semantics," it is
important to note that all human experience exists only within
the context of semantics: A tree is a"tree" only within this
domain (Johnson, 1946; Korzybski, 1933). Beyond that realm,
as no meaning exists outside of it, there are no means by which
humans can experience anything in a way that could at all be
considered human. All experience is experience only in terms of

one's semantics, cumulatively referred to as one's philosophy of
life and segmentally as specific beliefs.
So far as we know, the universe contains no inherent meanings
for humans to seek and discover: It just is. Whatever is
discovered has meaning constructed for it by human beings
(Wittgenstein, 1958). Although there may be considerable
agreement among humans as to the meaning applied, that does
not mean that the applied meaning has some or even any degree
of accuracy relative to how the universe "is." There seem to be
relatively few meanings applied to, or constructs developed
about, the universe that are certain. Einstein himself somewhere
observed that to the extent we practice science, we are certain
of nothing, and that to the extent we are certain of anything, we
are not practicing science.
Thus, the body of knowledge each human being accrues
comprises of constructed meanings, only a few of which are the
individual's own. The rest are to various degrees imposed by
others, whose meanings were likewise imposed by previous
others. Most such meanings, for example definitions, beliefs,
and values, are not simply passed on objectively from
generation to generation as items to consider. They are
presented as inherently truthful and transmitted via a
propagandistic route involving emotionally charged and one-
sided presentations when we are in a young and vulnerable
state: We are told exactly what to think rather than being taught
how to think. Schachtel (1957) has described this process most
eloquently:
Everything is new to the newborn child. His gradual grasp of
his environment and of the world around him are discoveries
which, in experiential scope and quality, go far beyond any
discovery that the most adventurous and daring explorer will
ever make in his adult life... Education and learning, while on
the one hand furthering this process of discovery, on the other
hand gradually brake and finally stop it completely. There are
relatively few adults who are fortunate enough to retain some of
the child's curiosity, his capacity for questioning and for

wondering. The average adult "knows all the answers," which is
exactly why he will never know even a single answer. He has
ceased to wonder, to discover. He knows his way around, and it
is indeed a way around and around the same conventional
pattern in which everything is familiar and nothing cause for
wonder. It is this adult who answers the child's questions and in
answering, fails to answer them, but instead acquaints the child
with the conventional patterns of his civilization, which
effectively close up the asking mouth and shut the wondering
eye. (p. 17)
As each individual human being traverses from day to day his or
her actuarial existence of approximately 27,759 days (76 years),
that journey is an effective one depending on the philosophy of
life the individual uses while engaging what has been referred
to as our brief cheating of nonexistence (Ellis & Harper, 1975).
Optimal effectiveness means behavior that maximizes the
enjoyment and satisfaction one derives throughout the full
course of one's existence. It tends to be best accomplished by a
full engagement with the process of living, that is, fully
extending oneself in challenging, growth-enhancing activities
and largely avoiding passive, too comfortable inaction (Ellis &
Harper, 1975). Moreover, it is an engagement neither delimited
nor complicated by attempts to impose various magical,
unscientific, and otherwise illogical meanings on it. It is the
manner of approaching that engagement and not the final
success of the engagement that allows happiness and
satisfaction to characterize one's existence.
REBT, with its central focus on how each individual can
enhance his or her ability to secure maximum quality in living,
works diligently to provide each person with a method by which
self-defeating emotions and behaviors are avoided and life-
enhancing emotions and behaviors are fostered. This method
works to eliminate or restructure those beliefs that restrict or
sacrifice one's own personal power (over self, not others) in
one's life. This, in fact, is the essence of REBT's humanism -
personal empowerment to pursue one's existence unbridled by

propagandistic, magical, supernatural, or other nonsensical
beliefs handed down by others, either past or present. It
encourages individuals to think their own thoughts and to do so
based on reason, logic, and the scientific method, all with a goal
of securing the greatest amount of happiness, satisfaction, and
joy in a universe that promises nothing and couldn't care less.
As we humans become more adept at ridding ourselves of
magical and supernatural notions, we find that life begins to
become rather simple (although obviously not easy--simple does
not mean easy), because we then have only two things to
identify and contend with in our pursuit of maximum joy and
minimum pain not just today, but throughout our entire
existence. The first thing to discover and then to accept fully is
"what's so," which is best exemplified by noting that water is
wet and rocks are hard. It is important to note forthwith that
what's so as used here is not meant to convey the idea of some
absolute knowledge, but only that the bulk of all reasonable
current evidence indicates it to be relatively so. Although some
might, perhaps even validly, quibble over whether 2 plus 2
actually equals 4 or that water really is wet, evidence suggests
that, at least for now, we would best make our decisions and
live our lives in accordance with the probable and relative
validity of these ideas. As Johnson (1946) has noted, however,
"We can be sure that 2 - 2 in principle but not in a horse trade.
The next oyster is not the same as the last oyster if you have
just eaten twenty-seven oysters" (p. 187).
What's so (or more accurately stated: What seems to be so,
given current abundant evidence) provides an important
foundation for the second thing to identify and then implement,
which is "what works." If we are not clear about what's so, it is
difficult to determine what works. For example, if your spouse
is a drunk, do not expect your spouse to be sober because that is
just not what's so. The relativity of "drunk" does not matter
greatly; more or less drunk more or less of the time is not the
issue. What works is to expect what's so, which is a drunken
spouse. In other words, develop plans based on the knowledge

that your spouse is more likely to be drunk than sober. It is
simple, until you start to insist that your spouse ought not drink,
that it is awful to have a drunk around, that you shouldn't have
to put up with such a terrible person, that you must not be
frustrated by having plans disrupted by a drunken spouse, and
so on. What works takes into account what's so and largely
eliminates the futile whining over the inevitable
disappointments and frustrations that occur in one's life.
REBT's message is simple:
Stop all of your whining;
Go get a plan.
Accept what you can't change;
Change what you can!
The primary dysfunctional emotions (anger, anxiety,
depression) that humans experience derive directly from a
refusal to acknowledge what's so in this universe and by
ignoring what works. Thus, when one believes that one must
perform in a manner that justifies one's existence and that earns
one a place of worthwhileness on the planet, and furthermore
that one could not possibly accept oneself otherwise, one is
doomed to depression. Why doomed? What's so is that humans
are imperfect, fallible, mistake-making beings possessing no
possibility of performing well at all times in all places. They
inevitably screw up! Moreover, they don't get to pick their
screw ups, and they often do so at the most inopportune times.
Tough! That's just what's so. What works is to accept the
inevitability of mistakes and, while working to correct them if
possible, to refuse to rate either one's self or one's
worthwhileness. Human fallibility alone rigs that rating system
so as to do one in--inevitably. To do otherwise would be the
equivalent of sending one's car to the junk yard because it gets a
flat tire or because a spark plug misfires.
Similarly, when one insists that other humans perform
according to one's own dictates and declares them to be rotten
people unless they do so, one is doomed to a life of anger. But
again, because these are fallible human beings, not angels and

certainly not perfect, they are inevitably going to be wrong at
times. Therefore, they have an inherent right to be wrong
(although that obviously does not mean that it is right to be
wrong or that consequences are not in order). Condemning them
simply does not work. What does work is to accept the fact that
humans screw up and then to develop plans that take into
account their proneness to mistakes.
Likewise, demanding that life go the way one wants and
insisting that one just cannot stand things going otherwise
dooms one to intractable anxiety. The consequent thought,
"what if .... "that then dominates one's mind creates an ever
present sense of impending catastrophe, which certainly
presents some problems for experiencing the happiness and
satisfaction that life seems really to be all about. What works is
to accept the unpredictable nature of life on this planet and to
resign oneself to the fact that, not just at some point but at
many points, chance is going to get us. After all, considering
that we reside on a planet with about 6 billion screw ups, it is
nothing short of amazing that things work as well as they do! It
makes no more sense to complain about our bad circumstances
than it does to whine over the fact that water is wet. What does
work is to accept the misfortunes that occur in our lives, which
are mostly out of our control, while diligently focusing on what
is virtually always within our control: The way we choose to
think about those negative things.
Inasmuch as we usually have not been taught the principles of
how to think, it is often difficult to recognize when our thinking
becomes illogical. After all, we believe what we believe
because it is true, not because it is untrue. The absolute nature
of this truth supports an unquestioning allegiance to it, a
process about which Adolph Meyer (in Johnson, 1946)
observed, "What ails most people is not that they are ignorant
but that they know too much that isn't so. For such people, the
better part of further learning is forgetting and forgetting of
well-learned misinformation and inefficiency is not easy as a
rule" (p. 48).

Much of what we believe to be true does not conform either to
what's so or to what works. Moreover, much of what seems to
be true is also either irrelevant or nonsensical. Students, for
example, often complain that a subject is difficult, homework is
time-consuming, and a teacher is dull, thereby justifying not
wanting to go to school. Even if these contentions are accurate,
they are not relevant. What is relevant is doing what is
necessary to get the grade that will get the credit to add on to
the final number of credits that are required to graduate, which
is the ultimate goal. This idea becomes more evident when
considering the swimmer who is 20 feet under water and
running out of air. It may be true that the swimmer is tired,
cold, and not feeling like swimming to the surface. The only
thing actually relevant, however, is getting to the surface. There
is no fairy godmother or any other force in the universe
available to provide the swimmer with a time-out until he or she
feels like swimming to the surface. Life stays simple when our
thinking stays relevant.
One of the more common complaints one hears as a therapist is,
"If only I had been better..." or"If I had been good enough ....
"indicating that some unfortunate event would then not have
occurred. This is a very deceptive way of thinking because it is
indeed true, as stated; it is also nonsensical. "If only I had been
good enough as a parent, my child would never have done those
bad things" is a true statement. It is also a true statement that
"If only I had been good enough, there would never have been a
Gulf War." If you are good enough, you can jump over the
moon. A true statement, if only you were good enough.t The
way in which such statements are constructed make them
deceptively true while camouflaging their nonsensical nature.
There is a hidden implication, moreover, that the person ought
to have some superhuman power and otherwise is to be
degraded as inferior instead of being more logically viewed as
simply, and fallibly, human.
REBT might be called the most humanistic of all therapies in
that its central focus is on placing personal power back in the

hands of the individual human being. Given the nature of the
universe, one does not control events to any significant degree.
What one does have the power to control, but all too often
relinquishes, is the power over one's own thinking. Personal
power is relinquished when one uses a way of thinking that
involves such notions as "should," "must," "can't stand," "need,"
"awful," and the like. In such thinking, the power resides in the
concept, as choice does not exist for the person within the
context of such absolutes. There are no alternatives for such
ideas: "Must" means only must, nothing less and nothing
different, and if what "must be" isn't, only catastrophe can
ensue. Even when the person generates the must from within,
power is handed over to the concept and removed from the
person. Likewise, "can't stand" and "should" transfer power
outside the person. If one defines any event in terms of "can't
stand," then one becomes at the effect of that event and without
personal power relative to it. Personal power is retained when
one's thinking involves such notions as "better if," "don't like,"
"prefer," "misfortune," and the like. In such thinking, the person
has choice and is not dominated by absolute concepts. One can
define any event in terms of both "don't like" and "can stand,"
thereby retaining personal power in deciding how to deal with
it.
In everyday life, these two ways of thinking boil down to an
issue of ownership. After all, humanism is all about ownership
residing in the person. When we hold absolute ideas such as
should and must, these ideas "own" us, that is, they take away
our power to choose and lead us into the self-defeating process
of reacting from emotion instead of according to a thoughtful,
well-constructed proactive plan. They rob us of our humanity,
and by using them we virtually sign over a deed to our own
being. One of the more intriguing stories to come out of the
inhumanity of war is that of the soldier who, while living under
extremely hostile POW conditions, retained a tiny bit of food
from each meager meal and offered it to any visitor to his cell,
including his captors. He chose to retain his civility under

inhumane conditions, thus exhibiting a self-mastery that
transcended circumstances: Nothing owned him.
A more subtle way that we humans relinquish ownership of
ourselves resides in the manner in which we resist both internal
and external forces. One of the things that seems to be what's so
in our universe is that whatever we resist tends to persist or
even strengthen. Muscles gain strength when provided with
resistance. If we resist wakefulness by trying to go to sleep, we
become more awake. If we resist a thought by trying not to
think it--pink elephants, for example--the more we have the
thought. What we are doing is passing ownership to what we
resist. Similarly, the more we think about a pain and focus on it,
the worse it gets: the pain comes to own us. Another example is
our reaction to the anger someone expresses toward us. We get
angry and respond in kind, which only begets greater anger on
their part.
Whatever we do not resist tends to go away or to change, a
process that may be likened to "mental judo." Instead of
resisting, we use the energy of the external thrust to turn things
to our advantage. Thus, in the face of anger, the rational and
humanistic response might be: "Thank you for the feedback and
for being interested enough to share it. I understand your
concerns. Is there anything else about me that bothers you? I'm
interested in what you have to say." As a genuine response to
anger, mental judo provides the greatest chance for two human
beings to get destructive emotions out of the way, acknowledge
what's so, and get down to the business of what works.
Given how dangerous absolute, demanding thoughts are to us,
they might be termed "red light" thoughts. Associating a red
light to such thoughts serves as a reminder to stop immediately,
examine the thought, and then alter it to one that does not
relinquish one's personal power and render one the victim of
circumstances. We own ourselves when we train ourselves to
think in terms of preferences and opinions and limit ourselves
to the safety of such "green light" thoughts as prefer and better
if.

Refer to the two columns in Table 1. Cover the "green light"
column and look only at the "red light" column. When seen in a
group all at once, one becomes acutely aware of how extreme
and overwhelming these ideas are. Johnson (1946) described it
as "language going all out" (p. 190). Now cover the red light
column. In seeing the green light thoughts all together, one idea
is suggested immediately: "If I dislike it this much, I'd better
get a plan and try to change it if I can."
An exercise that has helped many clients to diminish almost
immediately their dysfunctional emotions and retain their
personal power regardless of circumstances involves doing
vigorous self-talk that accepts and reinforces green light
thoughts while actively disputing red light thoughts. Moving
back and forth between columns and down the list, it might go
something like this:
He shouldn't act like... Wait! He shouldn't? Who says? Granted
it would work better (reinforce green light or RGL) if he didn't
do that, but does that really mean he shouldn't (challenge red
light or CRL)? I certainly don't like it and wish he acted
differently (RGL), but that doesn't mean I can't stand it or that
he must be different (CRL). Even if it would be better if he
didn't do that (RGL), there is no reason he must act differently
(CRL). It would only be nice if he did, and I would prefer it
(RGL). It clearly is not necessary, and I don't need it(CRL). I
don't have to have what I want (CRL). Yes, it is unfortunate if I
don't get what I want (RGL), but that isn't awful (CRL). It is
clearly not terrible that I get disappointed in not always getting
what I desire (CRL). Such misfortune hardly constitutes a
catastrophe (CRL). I can live without what I want (CRL). Even
if his behavior is bad, that doesn't make him a bad person
(CRL). So the important thing is to figure out how I can
influence or help him to change. Being terribly upset over his
behavior and condemning him doesn't work and leaves me
feeling miserable.
Clients can be taught this exercise, often in the first session,
and frequently get excellent results even before they know much

about REBT principles and practices and certainly before they
gain a deep philosophical grasp of its concepts. While
encouraging themselves to accept realistically what's so, they
also prompt themselves to think in terms of what works.
Red light thinking results in intense emotion, which disrupts
communication and sets up conflict. Instead of open discussion
guided by objective inquiry and mutual respect, the real issue
becomes one of power. The issue at hand becomes less the focus
of the interaction than does such person-oriented issues as being
right, winning, dominating, justifying, and the like. As a
dimension, power has at one end aggressive and at the other end
passive. It pits one person against another, which does not work
well at home or at work because when one is made to lose there
is usually a strong urge to get back at the winner; everyone
eventually loses. Even if one wins regularly over one's spouse,
for example, the best life becomes that of a life lived with a
loser!
REBT techniques enable one to stay off the power dimension
and, instead, engage any topic on the effort dimension. On this
dimension, which runs simply from low to high in terms of the
effort one chooses to devote to the issue, two human beings can
work side by side to reach a solution to a conflict or issue
without there having to be a loser. Because neither person can
ever be the problem, the solution is win-win. The effort
dimension is distinctly humanistic in that personal power is
retained by each person, and the solution is a function of two
humans working together without any imposition of external
forces or of the supernatural.
The distinct characteristics associated with working on the
power dimension make it clear why productive communication
becomes virtually impossible. The goal is to win or at least to
avoid losing. The need to dominate the "opponent" leads to an
antagonistic approach and often supports being mean and
manipulative in trying to assure winning. Communication, on
the other hand, is enhanced by the characteristics associated
with work on the effort dimension, where the desired outcome is

win-win. Here the focus is on the problem and the goal is to
find a solution. Each person is treated with respect and the
interaction is based on kindness and honesty. The distinctions
between these dimensions are noted in Table 2.
For REBT therapists, the primary area of work in the power
versus effort domain is the tendency for individuals to
personalize the actions of others. For most people, both major
and minor insults, slights, and attacks of whatever sort are taken
as personally meaningful, for example, being called a name says
something about oneself. Such a reaction, of course, brings the
power dimension into play and communication is immediately
disrupted. REBT employs two approaches to dispel the idea that
such incidents are personal in any way.
First, name-calling has no magical power in the sense that a
name actually makes the person anything. Upsetting oneself
over being called a name calls for a belief in magic in the sense
that one might become whatever the name indicates, for
example, being called an SOB might actually make one an SOB.
Most clients readily get rid of this concern when instructed to
imagine that all people in their city believe with all their heart
and soul and then shout in unison "(client) is a dandelion" while
at the same time observing their body for any signs of physical
change. They realize quickly that a name is nothing more than
an expression of dislike, which may be unpleasant but is hardly
catastrophic.
Second, a clear understanding of REBT's well-known ABC
paradigm makes it clear that nothing is personal. If A is the
event, B is the meaning placed on the event, and C is the
emotional consequence, then A does not cause C. One always
has a choice as to the B that is used in regard to A. Therefore,
all that anyone can do is provide the client with an A. Few
clients have any difficulty understanding ABC when applied to
their own experiences. It is equally important, however, that
clients understand that other people have their own ABC's and
that all the client can do is provide others with an A. Other
people are responsible for their own B's, which have nothing to

do with the client and, hence, are never personal. When another
person has a given B, they have to respond with the consequent
C. That response may indeed have an effect on the client in
various ways, but it is not personal in that it only says
something about the other person's B and nothing about the
client. Consider that at a certain altitude, temperature, and
humidity it must rain. If one is.present at that point, one gets
wet, but there is nothing personal in a rainstorm. Likewise,
there is nothing personal in another person's B, and such a
realization enables the client to move from the power dimension
to the effort dimension.
It is particularly impressive to observe the outcomes of power
versus effort work accomplished within a family setting. The
first step is to help the family define (create conceptually) a
context for family life that is agreed upon by all family
members and that provides each member full participation and
personal benefits. Such a context usually is defined as one in
which each member has maximum opportunity for personal
growth and individuality in a safe and supportive environment,
that is, an environment in which each member knows that
acceptance, support, and encouragement will be forthcoming
from other family members even when---or perhaps more
especially when--one behaves as a fallible human being. Any
behavior coming from the power dimension will damage the
agreed upon context, whereas any work on the effort dimension
most likely will enhance it.
By transcending immediate self-interest, which calls for
eliminating any red light thoughts, the individual helps create a
setting that enhances long-term self-interest. Each family
member can best be assured of getting the most (but probably
not all) of what he or she wants by working diligently to help
other family members get what they want. Working to get only
what one wants for oneself constitutes a power dimension
approach virtually guaranteeing that each family member will
then be only for himself or herself. Taking a family of four, for
example, when one member is for three, the likelihood will be

that the three members will be for the one. (Perhaps the Three
Musketeers were onto something with their famous motto: One
for all and all for one!)Within the family context, everyone
loses if any one person wins as well as if any one person loses.
Therefore, striving to win (power dimension) ensures losing,
which makes for a powerful double-bind: The only way to win
is to help other family members win (effort dimension).
The one area providing the greatest difficulty for getting off the
power dimension involves issues of morality. Nothing seems to
have greater power to destroy humane behavior by energizing
the power dimension to its fullest. Moral standards are by
definition grounded in righteousness, goodness, and truth. They
are considered by their proponents as emanating from some
universal code. Violating these standards, then, violates
universal law, which justifies the righteous wrath that adherents
wreak on the "immoral" person. The fallacy in this thinking is
that behavior is equated with the person, so that individuals are
then judged as either worthless or worthwhile depending on how
their behavior conforms to the laws any given group has decided
are universal. The righteous, of course, are not constrained by
humane principles in their treatment of the unrighteous because
the latter are viewed as less than human or as unworthy of being
treated as such. From a moral standpoint, the end goal of
achieving absolute conformity justifies any means, however
devious, dangerous, or deathly.
Hill (1976) and Craft and Hill (1991) have described some
distinctions to be made between moral standards and ethical
standards that demonstrate the latter to be far more forgiving of
human misbehavior and that allow for greater objectivity and
goal-directed problem solving (see Table 3).
Ethically, behavior is simply correct or incorrect based on
existing knowledge or agreement, with no universals being
invoked. Behavior based on what's so and what works is
considered ethical, and it involves, essentially, being true to
oneself while not harming others. When behavior is not ethical,
the behavior is the focus instead of the person, and the remedy

involves a change in the behavior. It is important to note that
when the person becomes the target, ethical violations have
been converted into moral issues, thereby justifying punishment
(meaning damnation) of the person and not just penalizing the
behavior (Ellis, 1994). From an ethical standpoint, the person is
accepted as human and fallible regardless of mistakes. The
action toward the person involves only penalization. The ethical
viewpoint promotes tolerance for self, for others, and for the
world.
Self-mastery and tolerance, then, seem to be central elements in
humanist philosophy, in REBT, and in effective living. When
the individual is mastered by red light thoughts, or is dominated
by magical, supernatural or illogical beliefs, it is virtually
impossible to recognize and engage what works. Consider, for
example, the almost universal cry of the rebelling adolescent,
"It's a free country, isn't it?" The idea that freedom involves
doing what one wants seems to violate what's so in the universe.
True freedom is derived from the individual's capacity to choose
to do what he or she does not want to do in order to enhance the
chances of getting more of what is desired in the long run. Red
light thinking undermines such personal freedom because one
cannot stand waiting and must have what one wants
immediately.
In his in-depth study of optimal personality functioning, Coan
(1974) identified one central characteristic as the key to the
optimal personality: flexibility. The optimally functioning
person could bring to the world that which the world required.
When spontaneity was called for, the person could produce
spontaneity. When orderliness and structure were called for,
they too could be produced. The optimally functioning
personality, then, is in a continual "dance with the world" and
does not demand that the world be only the way one sees it or
wants it to be. Such a person is aware of the relativity of
meanings and would readily grasp the profundity of Johnson's
(1946) observation"To a mouse, cheese is cheese. That is why
mousetraps are effective" (p. 192). (Cheese is also bait.) He or

she attempts to implement what works within the context of
what's so and does not use magical, unscientific, supernatural,
or other nonsensical notions. This person recognizes and fully
accepts the idea that happiness and life satisfaction ultimately
are all up to the individual human being and nothing else, that
is, they are not a function of life circumstances.
Inasmuch as the central thrust of REBT is toward enabling
optimal functioning in each human being without resorting to
anything outside the person, which leaves each person fully
accountable for both the process and outcome of his or her own
existence, it would be difficult to find a better example of
humanism in action than that of Rational Emotive Behavior
Therapy.
TABLE 1
A "Red Light-Green Light" System for Managing Emotions
Green Light Thoughts Red Light Thoughts
Would work better if Should be
Don't like Can't stand
Wish Must be
Be better if Got to be
Nice Necessary
Prefer Need
Want Have to have
Unfortunate Awful
Disappointing Terrible
Misfortune Catastrophe
Desire Can't live without
Bad behavior Bad person
TABLE 2
Power Versus Effort in Human Interaction
Interaction Power Effort

Focus Person Problem
Poles Passive to Aggressive Low to High
Goal Win/Avoid losing
Solution
Attitude Antagonism Respect
Style Mean/Manipulative Kind/Honest
Outcome Win/Lose Win/Win
TABLE 3
Views of Behavior and Misbehavior From a Moral System
Versus That of an Ethical System
PART I
System of Morals
Focus Moral Immoral
Attitude Toward:
Behavior Good Bad
Righteous Evil
Saintly Sinful

Attitude Toward:
Person Worthwhile Worthless
Innocent Guilty
Noble No Good
Action toward: Praise Punishment
Integrate Excoriation
with moral Exclusion
cult
PART II
System of Ethics
Focus Ethical Unethical
Attitude Toward:
Behavior Right Wrong
Correct Mistaken
Saintly Approval Disapproval
Attitude Toward:
Person Human Human

Innocent Falible Falible
Acceptance Acceptance
Action toward: Approval Penalization
Tolerance Tolerance
of differences of differences
REFERENCES
Coan, R. (1974). The optimal personality: An empirical and
theoretical analysis. New York: Columbia University Press.
Craft, B., & Hill, L. (1991, November 15). Beyond morality.
Presented at the Annual Conference of the American Counseling
Association Western Region, Jackson Hole, Wyoming.
Ellis, A. (1962). Reason and emotion in psychotherapy. New
York: Lyle Stuart.
Ellis, A. (1994). Reason and emotion in psychotherapy. (Rev.
ed.). New York: Birch Lane Press.
Ellis, A. (1996). The humanism of rational emotive behavior
therapies and other cognitive behavior therapies. The Journal of
Humanistic Education and Development, 35, 60-87.
Ellis, A., & Harper, R. (1975). A new guide to rational living.
North Hollywood, CA: Wilshire.
Hill, L. (1976). Rational behavioral counseling in the vocational
rehabilitation process. Doctoral dissertation, University of
Sarasota.

Johnson, W. (1946). People in quandaries. New York: Harper.
Korzybski, A. (1933). Science and sanity. San Francisco:
International Society of General Semantics.
Schachtel, E. (1957). On memory and childhood amnesia. In P.
Mullahy (Ed.), A study in interpersonal relations: New
contributions to psychiatry. New York: Evergreen.
Wittgenstein, L. (1958). The blue and brown books: Preliminary
studies for the philosophical investigations. New York: Harper.
~~~~~~~~
By Larry K. Hill
Larry K. Hill is in private practice in Rock Springs, Institute for
Rational Emotive Behavior Therapy, he is a certified supervisor
and trainer in REBT. Correspondence regarding this article
should be sent to Larry K. Hill, 1209 Hi//top Drive, Rock
Springs, WY 82901-5818.
Book Review
The Practical Therapist Series
Impact Publishers
This is a series of books devoted to teaching

skills and techniques in a variety of therapeutic
approaches. Many of these books will appeal to
counselling psychogists around the world and it
appears that there will be additional books
published in the series. So far I have received
four books. Rather than review each book sepa-
rately, I’ll mention each one brie� y and com-
ment more generally on the series.
The � rst I received was Rational Emotive
Behaviour Therapy (1998) by Albert Ellis, PhD
and Catharine MacLaren, MSW. This is basic-
ally vintage Ellis although it is updated with
comparisons with other recent theoretical ap-
proaches. I am familiar with many of Dr Ellis’s
earlier writings and, although the concepts are
similar, there are enough differences, both in
form and examples, to make this book worth
reading as well. Essentially it is Ellis in part
responding to his critics over the years and
further re� ning his concepts. Besides the theory
chapters, there are separate chapters on REBT
assessment, cognitive techniques, emotive/ex-
periential techniques, behavioural techniques,
and the integration of REBT with other

systems. As an illustration of the updating men-
tioned earlier, there are now distinctions made
among various types of disputing. The integra-
tion chapter predictably implies that REBT
comprehensively includes other systems and
was there � rst. But it’s a good read and either
a good � rst introduction or an updated refresher
to REBT. There are numerous clinical snippets
and a few examples of therapist-client dialogues.
The second book is Metaphor in Psychother-
apy (1998) by Henry T. Close, ThM. It has
been heavily in� uenced by the reframing,
story-telling, and utilization techniques of
Milton Erickson. Stylistically it tends to ramble
but it is easy to read and engrossing. Many of
the chapters are organized around a central
metaphor (e.g. the ‘Slimy green monster;
a story addressing children’s phobias’). But
is isn’t always apparent what problem or con-
cerns the metaphors are addressing. Other
chapters discuss such topics as metaphor and
reframing, drama and metaphor, and medita-
tion and fantasy. The book is short on examples

of client problems (other than the metaphors
themselves) and therapist-client dialogue is al-
most non-existent. Its primarily a discussion
book and the reader will have to think about
how to use these metaphors (or any metaphors)
in therapy. But its style makes it very approach-
able although the organization is not clear. But
many of Erickson’s works read this way—it just
requires a little more effort from the reader.
The third book is Creative Therapy with
Children and Adolescents (1999) by Angela Hob-
day, MSc and Kate Ollier, Mpsych. This is a
British book and indeed is labelled, ‘A British
Psychological Society Book’. This one is very
tightly organized and highly speci� c in tech-
nique; indeed, its really a detailed therapy man-
ual. The introduction sets the stage by
describing topics such as the organization of
the book, the format of the sessions, the setting,
materials needed, and general tips for working
with children. The remainder of the chapters
describe very speci� c and age-graded exercises
for different purposes and how to implement
them. The topics covered are; getting to know

you, feelings, increasing motivation to change,
becoming less stressed, learning new skills, im-
proving coping skills, coming to terms with loss,
understanding my family, promoting positive
self-esteem and reviewing progress. There are
even many illustrations but no client examples
or therapist-client dialogue. Even I, with no
background in working with children, could
likely implement many of the strategies. But it
might not be wise if I did so; ‘a little learning is a
dangerous thing’.
The fourth is Integrative Brief Therapy, Cog-
nitive, Psychodynamic, Humanistic and Neuro-
behavioural Approaches (1999) by John
Preston, PsyD. Because of the complexity of
the approach, it is more dif� cult to summarize
this book in a short space. What Dr Preston has
Counselling Psychology Quarterly ISSN 0951–5070 print/ISSN
1469–3674 online # 2000 Taylor & Francis Ltd
http://www.tandf.co.uk/journals
Counselling Psychology Quarterly, Vol. 13, No. 3, 2000, pp.
321 – 322

done is to touch on a large number of thera-
peutic approaches—including all of those in the
title and development approaches as well as
such concepts as the mentally healthy individual
and handing resistance. Although he references
many writers from each tradition, he provides
his own ideas on these topics, often by boxes
illustrating key concepts. Thus, an enormous
amount of material is covered in one book.
Because of its sheer scope, however, concepts
come and go with great rapidity and it isn’t
always clear how they � t together or how one
might create therapeutic strategies derived from
them. This is re� ected in the individual chapters
which are often quite short. The book is light as
well on case examples and therapist-client illus-
trative dialogue. Nevertheless, it’s an impressive
integration of many approaches and the inclu-
sion of often-neglected topics such as resistance
and the newer neurobiological model is com-
mendable. I personally found it very interesting
and informative.

So what are my impressions of the series? I
have served as Associate Editor of a similar
practically-oriented book series (‘Counselling in
Practice’, Sage) so I am familiar with the prob-
lems inherent in an undertaking of this magni-
tude. There is generally a tension between
allowing individual author variation (resulting
in dissimilar books and sometimes customer
disappointment) and forcing each book into a
Procrustean Bed and thereby reducing creativ-
ity. This series tends toward the former. There
is considerable variation in the practical nature
of the books I have examined so far—with some
including numerous examples and other relying
primarily on conceptual discussion. The books
also vary considerably in length, from a high of
305 to a low of 166 pages. The organizational
structure is not common across the books and it
appears that the individual authors were not
given a template to follow. What is similar
across these four books, however, is the read-
ability and conceptual level as well as the high
degree of creativity found in every volume. They

are appropriate for advanced undergraduate–
masters level courses as well as practicing thera-
pists who wish to acquaint themselves with
new concepts and techniques. They are very
readable and should pose no problems in
intelligibility.
I look forward to other volumes in this
series and would recommend them to students
and therapists who wish to broaden their
knowledge base in an enjoyable way.
E. Thom as Dowd
322 Book Review
Section:
PRACTICE AND APPLICATION
Rational emotive behavior therapy (REBT) is one of the main
humanistic psychotherapies. It shows how people, in an all-too-
human manner, create a large part of their emotional
disturbances and also have the ability to uncreate them. It is a

theory of personality and of therapy that emphasizes emotional
health and self-actualization for individuals and for the social
group in which they choose to live. It avoids devotion to any
kind of magic and supernaturalism. It especially emphasizes
unconditional selfacceptance (USA), antiabsolutism,
uncertainty, and human fallibility, and tries to combine
scientific flexibility and rigor with an existentialist-humanist
approach. This article is adapted from Ellis (1994b), and Ellis
(1972a).
In his article "Humanistic Psychology," in Raymond Corsini's
Encyclopedia of Psychology, M. Brewster Smith (1994) pointed
'out that secular humanism is "a neglected version of humanistic
psychology," and showed that where Pascal and Kierkegaard
defined the religious version of existentialism, Shakespeare,
Montaigne, Nietzsche, Sartre, and other thinkers "proposed a
mundane, Godless humanism, also existentialist in its concern
with the responsibility entitled by human selfconsciousness" (p.
158). Smith also contrasted the somewhat irreconcilable
perspective of causal and interpretive understanding in
psychological science and argued that "for the distinctly human
world, interpretation and causal explanation must somehow be
joined... Indeed, the only satisfactory science of human
experience and action must be one on which the hermeneutic
interpretation plays a central part conjoined with causal
explanation" (p. 158).

Quite a problem! Secular humanism, which is in many ways
opposite to the religious, mystical, and spiritual humanism that
seems to have largely prevailed during the last decade in the
Association for Humanistic Psychology (AHP), as well as in the
Division of Humanistic Psychology of the American
Psychological Association, and, to a certain extent in the
Association of Humanistic Education and Development
(AHEAD), tries to be quite existential, social,
phenomenological, and even postmodernistic. But it also does
its best to be rigorously (not rigidly) empirical, naturalistic,
relativistic, and scientific (Clark, 1992; Kurtz, 1973, 1985;
Stein, 1985). On the other hand, transpersonal psychology, the
dominant theme in recent AHP publications, often claims to be
scientific because it uses some of the methods of science, but
actually is often dogmatic and absolutist (Ellis, 1972b, 1985;
Ellis & Yeager, 1989; Kurtz, 1986). I could go on at great
length showing what I think are the evils of transpersonal and
mystical humanism--including that they are actually
antihumanistic. But I have already done this elsewhere (Ellis &
Schoenfeld, 1990; Ellis & Yeager, 1989), so let me focus on
what secular humanism is and how it specifically applies to
rational emotive behavior therapy (REBT).
Secular humanists see men and women as unique individuals
who almost always choose to live in a social group. They are
individuals in their own personal right but also are--and had

better be--social creatures who try to live together peacefully,
fairly, and democratically. Even their discrete "personality," as
Sampson (1989) noted, is also a social product. Secular
humanists fully acknowledge people to be human--that is, very
limited and fallible--and in no way are they either superhuman
(more than human) or subhuman (less than human). They all
seem to have good and bad behaviors and traits; but, as
Korzybski (1933) pointed out, they are not what they do.
The personalities of men and women are an ongoing, ever-
changing, constructing and reconstructing process. Once they
set up goals and purposes, which as humans they invariably
seem to do, their acts and deeds are measurable or ratable but
they, themselves, their essence, their being are too complex and
changeable to be given any global rating or report card. We
consequently have no accurate or meaningful way of deifying or
damning them. They are not good or bad, they merely exist. If
they choose to continue to exist and to enjoy their existence,
then again some of their acts are good because they aid their
goals and some of their behaviors are bad because they sabotage
these goals. People's goals and purposes cannot be assessed
scientifically or objectively because, as individuals, they can
choose from a wide variety of goals, none of which (except by
arbitrary definition) can be assessed as unconditionally good or
bad. But once they pick a certain goal (e.g., succeeding at work,
love, or psychotherapy) it can often be scientifically or

empirically determined whether (a) they actually achieve it, and
(b) they achieve the results they wanted by achieving it.
Secular humanists, in other words, favor certain values such as
human life and well-being, but do not claim that these values
are absolutely good or bad. If their goals are viewed as good, it
can be scientifically shown that they can or cannot be achieved
and whether their achievement actually brings about the results
the valuers desired. The meanings or purposes people subscribe
to are largely chosen (or adopted from others). But whether
their actions to reach these goals (which are largely chosen)
will actually lead to their achievement can be scientifically
determined by looking for a cause-effect relationship.
Secular humanists acknowledge that humans have the human
ability to imagine, fantasize, and strongly believe in all kinds of
superhuman entities and powers such as gods, angels, spirits,
and fairies, and that, in fact, they often create meaning and
explanations for anything they do not fully understand.
Therefore, they impatiently and cavalierly invent such
supernatural entities and forces. But, along with Popper (1985),
humanists contend that unless these spirits and forces are in
some way empirically falsifiable, any imaginative person can
invent an infinite number of them. Moreover, many of these
fantasized creations are contradictory to other supernatural
fantasies. The existence of any and all of them is never
impossible but is highly improbable. Belief in such spirits may

of course help some people to overcome some of their emotional
problems (such as anxiety) or behavioral problems (such as
addiction to alcohol). But devout belief in improbable gods and
spirits often creates its own difficulties, such as dependency,
dogma, bigotry, pollyannaism, and wars with nonbelievers.
Secular humanists are, almost by definition, relativists,
skeptics, and nondogmatists (Clark, 1992). Though many of
them, such as Ayer (1936), used to be logical positivists, they
now mostly realize that logical positivism in some respects is
itself not falsifiable, so they have revised it (Bartley, 1984;
Popper, 1985). Although they do not tend to be radical or
devout deconstructionists, they do tend to favor the more
moderate kind of postmodernism espoused by Levin (1991). As
Levin noted, this kind of postmodernism has given up
modemism's near-sacred "assumptions about certainty in
knowledge, faith in absolute systems, totalities and unities."
And, he stated, "postmodernism recognizes ambiguities,
indeterminacies, undertones and overtones, complexities,
uncertainties, tensions, interactions, exchanges, equivocations"
(pp. 251-252). This kind of thinking is favored by today's
secular humanism.
What is called "humanistic psychotherapy" and counseling tends
to consist of (a) existential encounters between therapists and
their clients (Frankl, 1959; May, 1969; Rogers, 1961; Yalom,
1990), (b) experiential and body-oriented exercises (Perls,

1969), and (c) transpersonal therapy (Grof, 1984; Tart, 1975;
Walsh & Vaughan, 1980). The first two of these methods have
often proven useful and even the third one has shown, at times,
that it helps some people, though I still think that on the whole
it does more harm than good (Ellis, 1994a, 1996; Ellis &
Abrams, 1994; Ellis & Yeager, 1989).
The one form of therapy that has been most neglected by many
humanist therapists is cognitive-behavioral therapy, perhaps
because its main proponents have largely been secular
humanists. Thus, Alfred Adler (1926, 1927) was a pioneering
cognitive therapist as was George Kelly (1955), both of whom
were secular humanists. I started to do rational emotive
behavior therapy (REBT), the first of the popular cognitive-
behavior therapies, in 1955 (when I had read Adler but not
Kelly) and I followed a secular humanist model, which I largely
derived from several philosophers, including Epictetus,
Epicurus, John Dewey, George Santayana, Bertrand Russell, and
Alfred Korzybski (Ellis, 1957, 1962, 1985, 1988; Yankura &
Dryden, 1994).
Today's cognitive-behavior therapy was originally derived from
REBT but also went its own way and followed, to some extent,
the computer-oriented aspects of the cognitive revolution in
psychology. Consequently, it sometimes became sensationalist,
mechanistic, and rationalist, instead of, as REBT has always
tried to be, existentialist and philosophic. Thus, some of the

cognitive-behavioral therapies, such as those of Beck (1976),
Maultsby (1984) and Meichenbaum (1977), used empirical
disputing of irrational beliefs and added to them positive
affirmations, as originally proposed by Coue (1923). But they
included little of the philosophical flavor of REBT.
REBT, as noted above, is quite humanistic, but abjures spiritual,
religious, and mystical overtones and implications. Its secular
humanistic origins lead to some of the following theories and
practices.
CONSTRUCTIVlSM
Like Kelly's theory of personal constructs, and in some ways
more so, REBT is highly constructivist. It holds that although
humans largely learn their goals, standards, and values from
their family and their culture, they construct, yes, create, most
of their emotional disturbances. For, unlike rats and guinea
pigs, they take their strong desires and preferences, and they
raise and propel them into Jehovian, absolutist musts, shoulds,
and demands. Thus, when people want and prefer to succeed at
school, work, or love, they frequently insist and command, "At
all times and under all conditions I must, I have to succeed!"
Because their self-constructed musts are often unrealistic and
often impossible to achieve, they do not merely (as
psychoanalysis and behavior therapy claim) get disturbed or
acquire disturbances. More important, says REBT, they make

themselves upset-consciously and unconsciously construct their
musts and the emotional and behavioral disturbances that stem
from these imperatives (Dryden, 1994a, 1994b, 1995; Ellis,
1973, 1988, 1991a, 1991b, 1994a; Ellis & Dryden,
1990;Yankura & Dryden, 1994).
PHENOMENALISM
REBT, with Epictetus and several other ancient philosophers,
holds that it is not things and events that upset us but our view
of these Activating Events (A's). Unfortunately A's influence
us, but our B's (Beliefs) about these A's largely bring about
disturbed C's (Consequences), such as anxiety and depression.
Therefore, to undisturb ourselves, we can proceed to D-to
actively and forcefully Dispute our self-defeating, musturbatory
B's. The ABCD Theory of emotional disturbance and how to
change it is unusually phenomenalistic.
The ABC's of REBT also stress the meanings and interpretations
people give to events and to results rather than the events and
results in themselves. Thus, being thwarted at point A may
mean a horrible hassle to one person and mean an adventurous
challenge to another. Also, feeling anxious at point C may be
viewed as awful and terrible by one individual, who thereby
creates her or his own great anxiety about anxiety and makes
himself or herself doubly or triply disturbed. But another person
may view this same kind of anxiety as "damned inconvenient"

and may make real efforts to understand and to cope with it.
REBT tries to help people look at the meanings and
interpretations they give to events and results and, especially, to
their own possibilities of creating new meanings and
interpretations. It focuses not merely on people's gruesome past
and present but also on their possibilities for the future (Ellis,
1991 a, 1991 b).
EXISTENTIAL CHOICE
Unlike most other therapies, REBT holds that people, even
though they may not be fully aware of this, largely choose their
dysfunctional core philosophies and lifestyles. Consciously and
unconsciously, they mainly train themselves to feel panicked,
depressed, self-hating, and enraged, rather than get conditioned
to feel these ways. They are biologically and socially
predisposed to needlessly upset themselves, usually from
childhood onward, to create dysfunctional thoughts, feelings,
and behaviors; and they hardly have complete free will. But
they still have a significant degree of choice, and they therefore
can almost always choose to think, feel, and behave in less
disturbed and more fulfilling ways.
SELF-FULFILLMENT AND LONG-RANGE HEDONISM
REBT theorizes that people will not greatly enjoy or fulfill
themselves when they make themselves distinctly disturbed, so

it first helps them to significantly reduce their disturbances. It
favors hedonism and fulfillment and tries to help people become
less disturbed and happier. However, because immediate
gratification-like excessive drinking--may easily lead to
harmful results, REBT favors long-range rather than short-range
hedonism.
UNCONDITIONAL SELF-ACCEPTANCE
Like person-centered therapy (Rogers, 1961), REBT accepts
people unconditionally, whether or not they perform well or are
likeable. But it also actively teaches them how to
unconditionally accept themselves (and others). It shows them
they can choose to fully accept themselves, no matter what they
do, just because they choose to do so. It also shows them a more
elegant philosophical solution in which they refuse to rate
themselves and their totality at all, and only rate what they do
and do not do (Berne, 1972; Ellis, 1973, 1985, 1988, 1994a;
Ellis & Dryden, 1990, 1991; Hauck, 1991; Mills, 1993).
FLEXIBILITY AND ALTERNATIVE SEEKING
While helping people to give up their dogmatic, rigid shoulds
and musts, REBT also shows them how to look for other
alternative solutions and pleasures. As they work to change
their absolutist demands, they see the wide world for what it is-
a place with many possible knowledges and adventures. They

learn and teach themselves that either/or rules are often
unnecessary and that all kinds of possibilities ("both/and" or
"and/also") can be made to occur (Crawford, 1988; Ellis, 1962,
1985, 1994a, 1996; FitzMaurice, 1994; Korzybski, 1933).
PROFOUND PHILOSOPHICAL CHANGE
Like the other cognitive-behavior therapies, REBT helps people
to give up their unrealistic, anti-empirical attributions and
inferences, such as, "Because he frowned, I am sure he thinks I
acted badly, he hates me, and he knows I am a real loser!" It
shows them how to dispute and challenge these misperceptions
and false Beliefs. But it also looks beyond them to people's
absolutist demands by which they often create their
mispcrception. Such as, "He absolutely must, and at all times,
approve of me. And because he frowned this time--as he must
not!--that proves that I acted badly, that he hates me, and that
he knows I am a real loser!" Instead of just getting to people's
disparate dysfunctional cognitions, REBT tries to help them get
to their basic, core philosophies from which these spring, and to
show them how to actively dispute them until they make a
profound philosophic change. As they make this change, they
may change their basic patterns of dysfunctional thinking and
automatically and tacitly tend to think more rationally in the
future.

INDIVIDUALITY AND SOCIALITY
Although REBT has been part of the human potential movement
since the 1960s, REBT practitioners have tried to avoid its
excesses by helping people see that they choose to live in a
social group and that they are interdependent with this group.
An essential part of people's lives is group living and their
economic, ecological, political, and other happiness depends on
the well-functioning of their community. While they had better
not be too self-sacrificing and other-directed, they had also
better not be too self-indulgent and self-centered. The principle
of both/and, rather than either/or, is important. Active
democratic participation in community affairs rather than self-
centered isolation will usually help oneself and one's social
group. REBT tries to help each individual in a family,
community, or other system understand and healthfully change
himself or herself. But it also stresses the importance of
improving and changing the system in which all humans
interdependently live (Ellis, 1985, 1991a, 1994a; Ellis &
Dryden, 1991, 1997).
THERAPEUTIC ENCOUNTER
REBT consists of a therapeutic encounter between the client and
the therapist in the course of which the therapist may not
personally like or want to befriend all clients but cares very
much about helping them overcome their emotional behavioral

problems and lead happier lives. Like their clients, therapists
and counselors are humans in their own right and are not blank
screens, nor are they purely objective. They may therefore
reveal a good deal of themselves to clients and have human
relationships with them, but still take care to be responsible
professionals and not get personally involved with their clients.
REBT practitioners clearly show clients their shortcomings and
disturbances, but always try to accept them as people, to give
them unconditional acceptance no matter how badly they
perform, and never to condemn them for their poor behaviors.
But in addition to giving and modeling what Rogers (1961) calls
unconditional positive regard to their clients, REBT
professionals actively-directively teach them how to give it to
themselves. For REBT holds that most clients easily and
naturally damn themselves as well as their dysfunctional
thoughts, feelings, and actions, and that unless they are
specifically taught the humanistic philosophy of self-
acceptance, they are not likely to devise it and work for it
entirely on their own. REBT, therefore, is collaborative and
instructive, supportive and active-directive. It uses the
therapeutic relationship as a vehicle to show clients how to
relate to one human, the therapist, and therefore to be able to
relate better to others. But it also teaches a large number of
cognitive, emotive, and behavioral methods that clients can use
to help themselves function in their intrapersonal, interpersonal,

and community relationships (Ellis, 1973, 1985, 1994a, 1996;
Ellis & Harper, 1997; Franklin, 1993; Hauck, 1991; Mills,
1993).
EMOTIONAL AND BEHAVIORAL METHODS OF REBT
Although I once over-optimistically thought that people could
logically and rationally be convinced to change their
dysfunctional feelings and behaviors, I soon realized that they
very often hold on to their musts, misperceptions, and
misleading inferences and attributions very strongly, and they
persistently habituate themselves to self-defeating emotions and
actions. So, from the start, I incorporated into REBT many
forceful, emotive-evocative methods (such as my famous
shameattacking exercises). I also, right from the start, favored
in vivo desensitization, implosive deconditioning, and the use
of reinforcements and penalties with many of my clients. In
addition, REBT uses active Disputing by clients of their
irrational Beliefs, but also uses a number of other cognitive
methods, such as self-help reports, coping self-statements, and
bibliotherapy, in its wide-ranging therapeutic armamentarium.
So REBT is far from being an intellectual or rationalist therapy,
but is truly rational-emotive, strongly behavioral, and in many
ways one of the most integrarive of modem therapies (Ellis,
1985, 1988, 1994a, 1996).
Humanistic psychotherapy, in my view and that of REBT, is the

study of the whole individual for the purpose of helping people
live a happier, more self-actualizing, and more creative
existence. It completely accepts them with their human
limitations; it particularly focuses on and uses their experiences
and their values; it emphasizes their ability to create and direct
their own destinies; and it views them as holistic, goal-directed
individuals who are important in their own right, just because
they are alive, and who (together with their fellow humans)
have the right to continue to exist and to enjoy and fulfill
themselves. This concept of humanistic psychotherapy and
counseling includes both an ethical and a scientific orientation.
Humanistic psychotherapy and counseling is an important
offshoot of humanistic psychology; but it has often gone off
into its own idiosyncratic realms and has been particularly
preoccupied, in recent years, with experiential, nonverbal, and
physical approaches to personality change. It has assumed that
modem man has become too intellectualized, technologized, and
unemotional, hence alienated and dehumanized. It has,
therefore, proposed itself as a corrective experiential force to
make up for the lapses of classic behaviorism and orthodox
psychoanalysis. In this respect, it has made notable
contributions to psychotherapy and to the actualizing of human
potential.
However, humans do not live by emotional (and by highly
emotionalized) bread alone. They are remarkably complex,

cognitive-emotive-behaving creatures. Of their main traits, their
high-level ability to think about their thinking is probably their
most unique and most "human" quality. If, therefore, people are
effectively working against their strong individual and societal
tendencies to dehumanize themselves, they would do better to
learn to vigorously use some of the highest level thinking and
metathinking of which they are innately capable but which they
easily neglect and avoid (Piatelli-Palmarini, 1994).
The cognitive-behavioral therapies are in the vanguard of those
methods that can be effectively used to preventively and
psychotherapeutically help humanization. Because I am the
founder and leader of one of the best known cognitive schools,
namely, rational emotive behavior therapy or REBT, let me
briefly describe this system and try to show why it, like similar
cognitive schools, is one of the most revolutionary humanistic
psychotherapies ever practiced.
Unlike the orthodox psychoanalytic and the classical
behavioristic psychologies, REBT squarely places humans in the
center of the universe and of their own emotional fate, and
gives them almost full responsibility for choosing to make or
not to make themselves seriously disturbed. Although it weighs
biological and early environmental factors as quite important in
the chain of events that lead to human disorganization and
disorder, it holds that, nonetheless, individuals themselves can,
and usually do, significantly intervene between their

environmental input and their emotionalized output, and
therefore have an enormous amount of potential control over
what they feel and what they do. Moreover, when they
unwittingly and foolishly make themselves disturbed by
devoutly believing in irrational and dysfunctional assumptions
about themselves and others, they can almost always make
themselves undisturbed again, and can often do so within a
relatively short time by using rational-emotive procedures.
Although I first discovered that individuals with neurotic
feelings and behaviors usually have a dozen major irrational
Beliefs (iB's) that strongly encourage their self-defeating
conduct, I later realized that these iB's, and dozens of others
that people commonly hold, can be placed under three main
headings:
1. "I absolutely must perform important tasks well and be
approved by significant others, or else I am an inadequate,
pretty worthless person!" Result: Severe feelings of anxiety,
depression, and demoralization, often leading to severe
inhibition.
2. "Other people, especially my friends and relatives, truly must
treat me kindly and fairly, or else they are rotten, damnable
people!" Result: Severe feelings of anger, rage, fury, often
leading to fights, child abuse, assault, rape, murder, and
genocide.
3. "The conditions under which I live absolutely must be

comfortable, unhassled, and enjoyable, or else it's awful, I can't
stand it, and my life is hardly worth living!" Result: Severe
feelings of low frustration tolerance, often leading to
compulsion, addiction, avoidance, inhibition, and phobic
reactions (Ellis, 1988, 1994a).
All three of these major self-sabotaging philosophies include
absolutistic, grandiose shoulds, oughts, and musts. This kind of
masturbation is decidedly all-too-human (because all of us often
put ourselves in its throes) but it is also pronouncedly
inhumane. REBT and most of the other cognitive behavior
therapies humanistically fight against this inhumanity. They
teach people how to dispute and challenge their grandiose musts
and how to replace them with strong realistic, but still very
human, preferences.
REBT uses an A-B-C method of viewing human personality and
personality disturbance. When I am trying to help people, I
usually begin with C, the upsetting emotional Consequence that
they have recently experienced. Typically, they have been
rejected by someone (which I call A, the Activating
experience), and then feel anxious and worthless, and feel that
A, their being rejected, has caused or depressed them at C. They
wrongly believe that C, their feelings of anxiety, worthlessness,
or depression, stem directly from A, and they may even overtly
voice this belief by saying something like, "He rejected me and
that made me depressed."

I quickly try to show these clients that A does not directly cause
C; that an Activating Event or Adversity in the outside world
does not, by itself, create any feeling or emotional Consequence
in their head and gut. For if this were true, then virtually
everyone who gets rejected would have to feel just as depressed
as the client does, and this is obviously not the case. C, then,
must at least partly be caused by some intervening variable, or
by B: the individual's Belief system. Normally, when people are
rejected at A they have two distinct Beliefs: one that is sensible
or rational and another that is irrational. Their rational Belief
(rB) generally is as follows: "Isn't it unfortunate that they
rejected me! I will suffer real losses or disadvantages by their
rejection, and that is too bad. Now, how can I get them to
accept me in the future; or, if I cannot, how can I get accepted
by some other quality people who will probably bring me the
kind of joy I would receive if they had not rejected me." This
latter Belief is rational because it (a) is designed to increase
people's happiness and minimize their pain and (b) is consonant
with observable reality. For it can easily be seen, by the people
themselves and by others, that it is unfortunate to be rejected by
someone they care for; that they will suffer real losses or
disadvantages by their rejection; and that they probably can find
another person who will accept them and bring them the kind of
joy they would have received had they not been rejected by the
first person.

If these individuals held rigorously to their rational Beliefs
about being rejected and did not go an iota 'beyond them, they
would usually experience pronounced feelings at point C
(emotional Consequences), but not those of anxiety,
worthlessness, or depression. Instead, they would have feelings
of disappointment, sorrow, regret, frustration, and annoyance.
Their feelings would then be quite appropriate to the Activating
experience or event, because these would motivate them to try
to change their lives so that they would in the future be
accepted as desirable companions and hence enjoy themselves
more.
Humans, however, are biologically and sociologically prone to
think magically at point B, and to have self-defeating or
irrational Beliefs (iBs) in addition to their rational ones.
Consequently, my clients will usually conclude: "Isn't it awful
that they rejected me! I am less worthwhile because they have
done so! No desirable person will probably ever accept me! I
should have done a better job of getting them to accept me, and
I deserve to bepunished for being so inept!" These Beliefs are
highly irrational because (a) they are almost certain to decrease
clients' happiness, maximize their pain, and prevent them from
fulfilling their desires in the future; and (b) they are related to
magical, empirically unvalidatable and unfalsifiable hypotheses
for which there is not, nor probably ever can be, any substantial
evidence.

When a man hypothesizes that it is awful (or terrible or
horrible) that he has been rejected by a woman he desires, he is
really contending (a) that it is exceptionally inconvenient for
him to be rejected and (b) that it must not be as inconvenient as
it actually is. Although the first of these statements is
verifiable, the second one really is not. It implies that he should
not, ought not, must not be inconvenienced when he doesn't
want to be; that there is a law of the universe that posits that his
wishes have to be satisfied, and that he can't stand living in a
world where he is seriously deprived. But these are all
absolutist and grandiose propositions that have little basis in
reality and that he has foolishly created in his head. Awfulness
is really a devil that he invents and with which he then plagues
himself. Inconveniences and disadvantages clearly exist, but
awfulness and terribleness are made-up monsters and demons.
When a woman hypothesizes that she is worthless because a
preferred person has rejected her, she again resorts to an
unvalidatable and unfalsifiable hypothesis. For the conclusion
that she is worthless means (a) that her life has somewhat less
worth or value now that she has lost the person she wants and
(b) that it has and will forever after have no value. Although,
again, the first of these propositions may well be true, the
second proposition cannot really be proven or disproven, but it
is merely definitional. For how, except by definition, can it be
shown that she, a very complex and evolving human being, is

and will always be of no value whatever because one preferred
person has rejected her? Even if she never wins a desirable
partner, she could normally do many other enjoyable things
during her lifetime and therefore bring considerable value to her
life.
When a man hypothesizes that no desirable person will ever
accept him because the one he now prefers has rejected him, he
again is stating an unprovable assumption. For if he keeps
trying, he has a high probability of eventually winning a valued
partner, as long as he does not so seriously affect and deflect
himself by his foolish self-fulfilling prophecy that he cannot
possibly win one.
When a man concludes, "I should have done a better job of
getting this woman to accept me; and I deserve to be punished
for being so inept!" he is holding several magical and
unverifiable propositions:
1. He claims not only that it would have been better if he had
convinced the woman to accept him, but also that he should and
ought to have done what would have been better. But how can
he ever substantiate his absolutist should and ought?
2. He strongly implies that he is a louse, a no-good person for
not inducing the preferred woman to accept him. But how could
he ever become a totally bad person just because he has done
some mistaken or inefficient acts?
3. He insists that because he has been inept in gaining the

acceptance of this woman (a) he will be penalized or deprived
by her loss, and (b) he deserves, by some inalterable law of the
universe, to be condemned, damned, and punished forever.
Although point (a) can be verified, point (b) is a dog-matic,
faith-backed hypothesis that can probably never be
substantiated or falsified.
In many ways, then, people's irrational Beliefs (iB's) are
magical, and they are much more likely to lead to more harm
than good. The more they devoutly and uncritically hold them,
the more they will almost inevitably feel anxious, worthless,
and depressed. These feelings, moreover, will usually sabotage
rather than help them solve their original problem--namely, how
to win the acceptance of the person they prefer or of someone
somewhat equivalent to this person.
As a rational emotive behavior therapist, I talk with these
disturbed individuals and quickly show them that A (their
Activating experiences or events) do not directly cause C (their
dysfunctional emotional Consequences), but that they
themselves partly create these poor Consequences by
absolutistically and unscientifically convincing themselves at
point B, of several highly irrational Beliefs. I then lead them on
to point D, which consists of vigorously Disputing their
irrational Beliefs. I show them how to question and challenge
these Beliefs by asking themselves (a) "Why is it awful that the
person I greatly prefer rejected me?" (b) "How am I pretty

worthless because he or she has refused me?" (c) "Where is the
evidence that no desirable person will probably ever want me?"
(d) "Why must I have done a better job of getting him or her to
accept me?" (e) "By what law do I deserve to be punished or
damned for being so inept?"
If people feel anxious, worthless, and depressed about being
rejected but succeed in Disputing (at point D) their irrational
Beliefs (iBs) about themselves and the world, they then proceed
to E, a new Effective Philosophy. First, they have a new
cognitive Effect (cE, which amounts to a restatement, in a more
generalized form, of their original rational Beliefs or rBs).
Thus, they will tend to conclude the following:
1. "It is not awful, but merely very inconvenient and
disadvantageous for this preferred person to reject me."
2. "Although, for the present, my life may be less enjoyable, or
worth less than it would have been had he or she accepted me, I
am never a worthless individual, unless I foolishly define
myself as one."
3. "There is of course no evidence that no desirable person will
ever accept me; in fact, it is likely that in the future one will."
4. "There are many reasons why it would have been better had I
done a good job of getting this person to accept me, but there is
no reason why I absolutely should or ought to have done such a
good job."
5. "There is no law that says that I deserve to be punished or

Inflammatory Bowel Disease Case Study The patien.docx

Inflammatory Bowel Disease Case Study The patien.docx

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