Rational Emotive Behavior Therapy and Stoicism – An Interview with Debbie Joffe Ellis

Continuing on with our series of posts on the plenary talks and workshops from Stoicon 2016, we have these reflections by a speaker who gave both a plenary talk and a workshop, Debbie Joffe Ellis.  As the editor of Stoicism Today, I took the opportunity to interview her about her Stoicon 2016 workshop, about Rational Emotive Behavior Therapy (REBT), its affinities with Stoicism, her late husband (Albert Ellis), and her own practice.
GBS: Let’s talk, then, about the workshop.  So you gave a talk and delivered a workshop. How did the workshop go, and what were you focused on primarily?
DJE: The workshop went very well and the room was full with attendees. I focused on presenting the theory, methods & techniques of Rational Emotive Behavior Therapy, its philosophical component, and the fact that it can be more than just an effective evidence based approach – it is also a way of life and living for those who choose to apply it as such. From now on I will refer to Rational Emotive Behavior Therapy as REBT. One of the more powerful aspects of the workshop was giving a live demonstration of the approach, not a role-play, but the ‘real thing’ with a volunteer from the attendees present. When people get to see REBT applied, and observe how enlightening and empowering it can be in just a brief period of time, they can gain a deeper understanding of how impactful, substantive and effective an approach it can be. In the demonstration, which lasted only for about 25 minutes, the volunteer, and those viewing the demonstration, shared that surprising, major and beneficial insights were experienced.
REBT was influenced by the writing of the stoic philosophers. I mention that when I give presentations, whether at gatherings of psychologists or at a gathering like this Stoicon, and Al [Albert Ellis] acknowledged that influence when he spoke and when he wrote about the development of his approach.
There were other influences but some of the main tenets of REBT include ideas seen in Stoic writings, so I pointed that out as I went along in my workshop.  I described the main aspects of REBT and what sets it apart from the other approaches, particularly the cognitive ones, because REBT is the approach that heralded in the cognitive revolution in psychotherapy. Before it came along in the early 1950s, Sigmund Freud was the lord of the psychotherapeutic universe.
My husband was the first one in the field of psychology to so effectively challenge the tenets of psychoanalysis. In so doing, he received criticism and hatred – and was branded as “stupid” and “superficial” and worse than that.  But he continued on with his efforts because he believed so strongly in the efficacy of his approach and the efficiency of REBT. One can rightly say that he applied some of the stoic principles in his choice to not be affected by the barbs of others. He persevered in doing and sharing what he believed was most helpful for most humans, and as a result he succeeded in changing the world of psychotherapy and other fields.
Al saw REBT as not only the way to minimize emotional disturbance, but more than that – to create a life of quality, a life of self-created meaning that contributes not only to one’s self, but to the well-being of other humans and to the environment. REBT is a very holistic approach and way of being. In my view it is the most holistic approach of all the approaches in my field that I know of.
There are some misconceptions and false impressions about REBT. I don’t know if Epictetus or Marcus Aurelius or the other Stoics suffered from such things – because I think their place in history is seen as secure, along with their writings.
My husband wrote his first paper about REBT, which was then just called RT – “rational therapy” – in 1953. It was published in 1955. The Cognitive Therapy approach of Aaron Beck, came out fifteen years later, and he has acknowledged the help of my husband in creating the approach. Beck is part of the University of Pennsylvania, which has done enormous research on CBT, and I think that’s one of the reasons CBT is so well known.  There wasn’t that volume of research done on REBT. Nonetheless, the research done on CBT unsurprisingly supports the premises of REBT because much of CBT is based on the premises of REBT.
Interestingly, some of the misconceptions about REBT include that it came after CBT, or that it’s an offshoot of CBT.  Now there are newer cognitive approaches, some referred to as part of the “Third Wave” of cognitive approaches. One can recognize the components of REBT and Epictetus within them, and sadly, most of them don’t give credit where credit is due.
GBS: You know, I’m looking right here at Beck’s Cognitive Theory and the Emotional Disorders. I’m just reading through the index and there are of course a number of references to Ellis, but there is only one reference in the entire book to Epictetus. So what I think I’d like to ask is this:
With Ellis there is a much more clear lineage drawn out to Stoic philosophy as well as, like you pointed out, to many other sources that he’s synthesizing. We see people like Donald Robertson, for example, who is a cognitive behavioral therapist and is very cognizant of how Stoicism and that come together. Do you think that there is perhaps a chance that as Cognitive Behavior Therapy developed, it lost some of that connection to some of the inspirations of your husband?
DJE: I do think there is a good chance that is the case. Sadly, I am learning that in some colleges these days students of psychology or counseling study CBT, and REBT is barely presented. They are deprived of much valuable knowledge if they don’t learn about REBT and don’t learn its influences. They also miss out by not learning about the immeasurable influence REBT has had on the theories they do study.
Some speakers and writers about CBT and other approaches under the cognitive umbrella have recommended that a person distances themselves in some way from their thoughts.
REBT, more than substantially urging people to simply have objective awareness as much as possible about their thoughts, goes a lot deeper. It says, rather than distance oneself from the unhealthy thoughts, identify them.  Identify them really clearly, and as you do so, identify elements within them that are irrational, because one of the main premises of REBT is that when we think in an irrational way in response to adversity, we create unhealthy emotions.  And when we think in rational, healthy ways about the same adverse happenings, then we create and experience healthy and non-debilitating emotions.
So REBT says don’t distance yourself, identify the thoughts instead, and then come up with a healthy new beliefs. I’m not saying Cognitive Behavior Therapy doesn’t advise doing that – but what I have observed is that in REBT the means to do so are much more specific, more precise and we learn the ways to dispute irrational beliefs logically and pragmatically and realistically.
GBS: So with having emotional responses that are more productive, is it safe to say that REBT envisions the emotions as playing an important role in motivating us to do what’s good for us – or what’s good for others? So, that if we didn’t feel those things, there would be something lacking or less effective?
DJE: I love the way you put that question. Yes, most definitely. Another thing that REBT offers that I haven’t seen so much in the other cognitive approaches, is that it does teach us the difference between what is called healthy, negative emotions and unhealthy, negative emotions – negative not meaning bad, but meaning not pleasant, not joyful, not happy. So when you think in rational ways in approach to adversity, the healthy negative emotions created could do as you suggested, and would possibly motivate us to do what we can to create a beneficial change or at least to avoid doing anything that would cause destructive or debilitating outcomes.
Healthy negative emotions include concern instead of unhealthy anxiety and panic that debilitate, NOT motivate. Other healthy emotions are sadness and grief rather than their debilitating counterpart of unhealthy depression. Depression debilitates – whereas sadness and grief, experienced for example if someone we love dies, or for some – when they don’t get the outcome they want in a political election, do not debilitate, and often motivate one to take productive action. Fueled by those healthy feelings we might be more likely to consider, “What, if anything, can I do about this situation?” If someone creates despondency rather than sadness, they are less likely to reflect on what they might do that could be productive in the circumstance.
Another example would be healthy anger versus unhealthy rage. When we communicate in a rational way, from a place of healthy anger – about something we consider unfair, unjust, or worse – we are able to choose what we do or say. We don’t impulsively lash out or act in self-defeating ways. Healthy anger allows us to acknowledge that something is bad or unjust, and yet, we are able to think and speak rationally and avoid behaving in rash ways that may harm or thwart our purpose. On the other hand, rage often ends up creating outcomes that do not support our goals and can create much destruction.
The final example of healthy vs unhealthy negative emotions that I’ll mention here is that of experiencing healthy regret, which allows us to reflect and potentially avoid the possibility of repeating a behavior that was not good or productive. The unhealthy emotional counterparts of regret are shame and guilt, which can paralyze and have us feel and believe that we’re worthless. We damn ourselves, which can inhibit us from learning and moving forward in productive ways, and that then often creates added unhealthy emotions of depression and/or anxiety. REBT repeatedly reminds us that each of us has worth, simply because we exist. We may act in good or bad ways, but that doesn’t make us good or bad people. We are living beings, with worth, who can act in a variety of ways. Hopefully we choose to act in more life-enhancing and respectful ways than otherwise, but for those who don’t, their worth isn’t diminished despite any bad and disturbed behaviors. That assertion has frequently been a controversial aspect in REBT!
GBS: Let’s move on to talking about the session itself. You said that you had volunteers – or, maybe I’m mistaking it – either one volunteer or perhaps multiple ones – and you worked through some things in a very transformative way in the session itself.
DJE:  I had only one, because the workshop was only 90 minutes and the demonstration – you know, often I plan for it to be around 15-20 minutes when I only have 90 minutes, but this one was very compelling and things were being revealed, so there was only one – and it lasted about 25 minutes.
It’s not appropriate for me to give the name of the person, or to say anything to identify him or her. One of the things that I request in such a workshop is that in order to help such a person who bravely volunteers to feel safe enough to disclose what is going on for them and what their issues are to a room of people is a level of confidentiality. I request permission to talk at a later time about some of the issues that may emerge if doing so can help others, but also commit to not identifying that person nor transgressing the promise of privacy.
One of the reasons I do these live demonstrations (and when I ask for volunteers, I emphasize the need for them to share real issues and real problems, not engage in role-playing) is that they can provide deep and beneficial insights to one and all present. When real issues have been presented, I’ve never had non-productive demonstrations! The beauty of being and witnessing someone being real, authentic and open to considering the REBT principles and encouragement, is that when transformation happens in 15-20, or even 25 minutes, it certainly gives the person experiencing the session directly, and the viewing audience members, concrete evidence that when we change our thinking, we can change our emotions.
So in the case of the person who volunteered at Stoicon, and I won’t say whether the person was male or female, they brought up an issue related to relationships, and in a short period of time, through identifying their irrational beliefs, and questioning them, this person was able to see things differently and able to challenge their original beliefs. They could then clearly see that those former beliefs they were so convinced of weren’t universal truths! In fact, some of them were not true at all! Their restrictive unhealthy feelings changed to healthy ones, right there and then!
What REBT reminds us to do is to focus on what is possible, even when certain elements in our situation are realistically negative, so that we get to consider a broader perspective. In the demonstration not only did the person willingly participate, they appeared to be highly motivated to change, and that always helps. This person was determined to help themselves to suffer less, and in addition to following my guidance as we identified irrational beliefs, they willingly disputed some of those premises, which seemed gospel truth before reflecting and realizing such notions were far from fact or truth.
So in 25 minutes there was kind of a “WOW!” and the person who volunteered expressed great gratitude. Many of the attendees who came up later to share feedback said, “WOW!” In that short period of time – to identify the self-defeating thoughts, challenge them, broaden the perspective, realize what is realistic and factual, and deciding on clear goals to focus on going forward – this person transformed their emotions.  A pretty good use of time and effort I’d say! Some critics of REBT accuse it of being too general. I don’t think so!
GBS: No, no –it’s very interesting – and one of the things I was going to ask you in particular that you started to touch on is:  With the audience… do they end up – to some degree – saying, “Oh – I have this sort of issue as well.”  Or do they respond affectively to doing this?  It seems there would be quite a number of different reactions people might have.
DJE: Well, the answer to your question is an unequivocal “Yes”, and “Yes!” Many of the people who view live demonstrations say, “I can relate to that. I have something similar going on, or similar enough.” And then others, who may not have that specific, let’s say, relationship or other issue, still have the tendency to think in irrational ways and make themselves unnecessarily emotionally disturbed in other scenarios.  So even though they may not relate to the same exact circumstance that was explored in the demonstration, they learn from watching the way I and the volunteer hone in on identifying the irrational beliefs, the way they are disputed, and the way we then come up with effective, rational healthy beliefs.
And then, what is very important to keep in mind, and what I emphasize the importance of in any workshop I give, is that for most people to maintain any benefit from an epiphany or realization that occurs during a workshop or the like, requires more than just gaining the new understanding. For most people, the awareness of the change and the ability to make it long-lasting, requires effort, ongoing effort. Homework. REBT offers cognitive, emotive and behavioral forms of homework. An example of a cognitive one might be the person reading and focusing on the healthy new beliefs that were created in response to identifying and disputing the toxic ones. Those toxic beliefs may have been there for decades and decades, depending on the age of the person, and until REBT they often viewed them as universal truths rather than realistically as unhealthy, irrational beliefs that burdened and restricted them. Usually homework is to be done for at least 30 days.
Some people who view a demonstration respond:  “I can strongly relate and I’m going to do what you suggested to the volunteer!” Others simply learn more about how to apply the approach to their own situation.
GBS: That’s quite a range…
DJE: Yes. That’s why I love what I do. I love sharing this because it’s not complicated – it’s quite common-sense – and for people who are motivated to change, it’s not…difficult, it just takes effort. Persistence, some patience, and ongoing effort.
GBS: You know, it strikes me that that’s another place where Rational Emotive Behavioral Therapy differs from, say, Freudian depth psychology, or other approaches as well, because you could actually do a demonstration of it.  If someone is going to be psychoanalyzed, it could be years of going to the therapist before something would come out of it.  It’s not going to be that immediate – getting at something that somebody else could look at from the outside and say, “I think maybe that would work for me, too.”
DJE: You just identified the reason my husband created his approach! He was trained in psychoanalysis – in his day and age when studying psychology one didn’t have a choice. Al studied it and was practicing it. He observed that for some people he worked with who were undergoing psychoanalytic therapy, they might have felt better and gained some insights, but they weren’t actually getting better, and they weren’t learning how to take responsibility for the creation of their emotions. They continued to think in the ways that created their emotional disturbances in the first place.
Al wanted to help as many people as possible in his life-time and beyond to learn that we, if we’re not cognitively impaired, do have the power to create our own emotional destinies. We may not have such power to control many of our circumstances – but certainly we have a choice in how we think about them, in how we react and respond, and feel about them. And so, exactly what you said, unlike the long-term nature of most psychoanalytic approaches…. REBT is a magnificent short-term therapy for many people, and the more motivated a person is to change, and the more they make effort, their more likely they will achieve their therapeutic goals efficiently and effectively.
Whether a person is receiving REBT therapy, or applying the principles themselves in self-help mode, one can ask -how quickly are they going to experience change, and lasting change at that? The answer is – the more they do, do, do, the more effectively and substantially they change, change, change!
So, you hit on one of the core differences between REBT and some other cognitive approaches, and the approaches of Freud and others who came after him in the psychoanalytic field. Do we want to have tools that will help us creating healthy behavior, and minimize emotional suffering and maximize enjoyment in what would take less time for many clients in all probability?  Stoic philosophy influenced Al’s own philosophy of life and living, and his approach of REBT reminds us of the importance of using the mind in constructive ways. Life contains suffering and loss, and in order to maximize joy, we had best not create and add unnecessary suffering and pain through thinking in unproductive and self-defeating ways.
GBS: So it seems that cultivating autonomy of the person who is engaging in the therapy is a core value.
DJE: Yes. Exactly – it is a core value. And it’s not just about focusing on ‘me being me’, but also about having social interest and caring about the well-being of others, helping others, and also being sensitive to the environment and not being destructive. REBT encourages us to do what we can to prevent or change any changeable human-made destruction that is going on. So it’s very holistic, as I said earlier, a core premise is that we’d best be aware of how we create our own meaning, our own emotions, our own behaviors and let’s choose the healthy ways of life and being in the world and with others, and let’s also help others whenever possible. When we help others it contributes to greater self-awareness, choice and a sense of empowerment. When we help other people, it helps us to help ourselves. In the spirit of credit where credit is due, I do want to mention that one of the people who also influenced Al was Alfred Adler who – in his approach to psychology also encouraged social interest. Adler had some components in his approach that were more aligned with psychoanalysis, but in terms of social interest and some other components of his theory, my husband did appreciate Adler’s work.
GBS: So there’s something, to go back to Stoicism, like the Stoic conception of cosmopolitanism, and extending affection outward from the people that we’re very close to, to wider and wider circles to all humanity, or all rational beings – and maybe we’ll find out some day that dolphins are rational, or elephants are rational in the sense the Stoics meant – and it seems there is something very similar to that in REBT.
DJE: I believe that dolphins, elephants and other creatures on our remarkable planet operate within states of consciousness and thinking that as yet few, if any, humans can even imagine. There are countless documented accounts of such creatures behaving in altruistic ways, demonstrating compassion, play, humor, kindness, and experiencing grief. Such experiences are unlikely to be stimulated by the primitive fight-or-flight part of their brains! Yes, it will be fascinating if we can learn more about the way these noble animals think. In the meantime I fervently hope that more humans learn to respect and appreciate all forms of life, not only their fellow-humans.
GBS: I imagine you’ve been doing these sorts of workshops and demonstrations for a number of years – and you saw your husband doing them as well.  Is there something that you’ve learned over the course of doing this over and over and over again…?
DJE: I guess one of the first and easiest answers that pops to mind, as I mentioned to you earlier, is that the more motivated a person is to make ongoing efforts in order to create beneficial changes, the more likely it is that they will change. There is a psycho-educational component to REBT – people are taught to help themselves and not rely on the therapist or teacher of the approach. When I give workshops, whether they’re the 90-minute ones, like I did at Stoicon, or when I do half-day or all-day workshops, one of the things I continue to notice is that on occasions someone may volunteer for the demonstration, and then they want me to do most of the work, and/or they have an expectation that the impact of their years of unhealthy thinking and feelings should be easy to change. On occasion someone may want me to agree with them when they’re blaming other people for their own misery – and they soon discover that (for their good) they won’t get that from me!
I remind them that yes, I don’t suggest that they deny or excuse it as okay when behavior from others is brutal or insensitive, and it is important to face and accept reality. REBT doesn’t distort or repress facts, nonetheless people have a choice of either thinking they’re victims and to consequently feel depressed, unworthy, and/or enraged at the wrong-doer, OR of acknowledging that this or that rotten thing happened but that they can choose to acknowledge and recognize that: (1) they survived, and (2) that when people act in very bad ways, it’s not necessarily because they’re totally evil – but because they are thinking in disturbed ways.
And rather than putting energy into damning such people, it’s better for individuals to put more energy into thinking, “Yes, they did a bad thing but I choose to focus on the fact that I survived. I can unconditionally accept myself and focus on what I can do in this circumstance. I can stubbornly refuse to continue to create and feel unhealthy emotions that eat away at me, and don’t change the past. I choose to focus on what is good in the here and now, and to dispute any thoughts that create emotions that rob me of life, vitality, greater joy and wellbeing.”
Something I have observed over the years is that the people who get the most out of REBT are those who are willing to put the most effort into thinking, feeling and acting differently after they learned what they learned from the workshop or the lecture.
And then another thing I’ve observed over the years is how many people believe similar irrational beliefs until they recognize the harmful consequences of doing so and are willing to dispute them. Two major REBT components that I want to highlight – that are presented in REBT are 1) the identification of three core irrational beliefs from which a multitude of others come and also, 2) the emphasis that REBT has on the importance of unconditional acceptance that the other cognitive behavioral processes do not emphasize as much.
So, firstly, the three core irrational beliefs are: First, “I must do well and be approved or loved by other people.” Secondly, “You must treat me well and act the way I think you should.” And finally, “Life should be fair and just.”
The unconditional part of REBT is seen in its urging of us to make effort to experience more often and deeply the components of unconditional self-acceptance (USA); unconditional other acceptance (UOA); and unconditional life acceptance (ULA). Accepting doesn’t mean liking – and it doesn’t mean indifference – and it doesn’t mean neutrality in terms of behavior or in seeking consequences for those who have performed bad actions. It means accepting reality, human fallibility (our own and that of others), and remembering that we have resilience and can choose to make efforts to cope successfully when bad things happen.
For example, if someone has treated me very badly, REBT would remind me to work on having unconditional other acceptance of them. That doesn’t mean liking what they did – and if they acted in brutal ways, it would be abnormal for me to like such behavior. It doesn’t mean unconditional other acceptance tends towards an attitude of not doing anything about bad stuff. No way!  REBT would encourage a person to take action if it seems that could be constructive.
A common criticism of me and my husband in relation to unconditional other-acceptance is heard when people say, “How can you say to someone who has been raped or abused – or their family has been killed – to have unconditional other acceptance?” Well, REBT doesn’t say it’s easy, but reminds us that if we don’t make such effort, we will continue to suffer for the rest of our lives. We will continue to carry bitterness and hatred and rage and, from a holistic perspective, it’s well known that this creates physical illness.  There is a lot of research proving that. We make ourselves sick, emotionally and often physically. And it doesn’t do any good. So, how do you accept someone unconditionally when they’ve done a horrible thing to you?
Well, here is what REBT recommends. If we are willing to consider the fact that if any one of us had the abuser’s genetic makeup, if any one of us had been brought up the way they had, if any one of us had similar experiences as those that they had in their young and adult lives, if we believed what they believed, and finally, if any one of us was thinking what that person was thinking when they did whatever ugly act they did – then we probably would have done the same thing. A person who commits brutality is brain damaged – and I don’t say that sarcastically: I say it literally. A person with a healthy brain and mind does not rape and murder.
Thinking in that way doesn’t take the abusive person off the hook. A person who has been abused and yet chooses to work on forgiveness and unconditional acceptance will be more likely to respond to the atrocious acts in a steady, calm and productive way than the person who immerses himself or herself in rage or in bitterness. And finally, on this point, we know that it is humanly possible. There are plenty of examples that show it is possible, where a person who has been abused has chosen not to hate the perpetrator. There are people who, in the past, knew someone who had been a murderer of someone close – and could sincerely feel and say, “We forgive him. We forgive him.”
GBS: Absolutely.
DJE: And another thing that REBT emphasizes that other cognitive approaches may not disagree with, but they don’t emphasize it as much, is the power of gratitude. As I did mention earlier, REBT reminds us to focus on what still is good – especially during the brutal chapters of our lives. I wrote an article about just that in the Journal of Spirituality in Clinical Practice, published by the American Psychological Association, in March, 2015.
GBS: I think the only school that I see that has a similar emphasis on gratitude is the positive psychology people – but they tend to approach it in a very different way.
DJE: You are correct in that and, to his credit, Marty Seligman, who is considered the father of positive psychology, has often acknowledged the tremendous influence Al’s work had on his own.
GBS: That makes sense. This is going to get back a little bit more into ancient philosophy – but Cicero, who is a Stoic of sorts, but who disagrees with them on some key things. For example, about grief, he says the Stoics don’t acknowledge it the way they should.
He calls gratitude the mother of all the virtues, which is an interesting departure. And that gets quoted a lot – but then nobody reads the rest of the Cicero work that it comes from. But he seemed to have thought that it was really central and that without it there is something lacking to these other good dispositions.
DJE: I agree with that. And so does REBT.  Gratitude doesn’t dilute any of the other dispositions you mention – it enriches lives. When we live with a sense of awe and wonder, we bring upliftment to everyday life – even in mundane circumstances!  There is plentiful, and growing, research on the positive impact on the cardiac health of people who practice gratitude and who experience awe and wonder in their lives. REBT has from the get-go asked people to focus on that which is awesome and wonderful.
Al wasn’t about encouraging people to live a nice, neutral life that was devoid of any suffering. He encouraged people to live an intentional life, to work towards experiencing greater joy and tranquility, and to accept the probability that life would contain some loss and suffering. He also taught us how to focus on the positives in life and not elevate healthy sadness and grief into states of debilitating emotional suffering when adversities were experienced. He encouraged people to live lives infused with moral and ethical preferences and choices. REBT is largely about creating the healthy emotions when times are tough, whilst at the same time being mindful of allowing the experience of awe, wonder and gratitude for the opportunity to live this human life to infuse our awareness and enrich our minds, bodies and spirits.
Dr. Debbie Joffe Ellis is a licensed Australian psychologist, licensed New York MHC, and adjunct professor at Columbia University TC. She presents and teaches in her home city of New York, throughout the USA and across the globe.  You can watch the videorecording of her plenary speech at Stoicon 2016 here.