Stoicism and Rational Emotive Behaviour Therapy by Walter J. Matweychuk

This post is the transcript of Dr. Walter J. Matweychuk’s presentation at the STOICON 2017 conference in Toronto, Canada. Video recording of this talk and others are available in the Stoicon 2017 Resources site.
I am a clinical psychologist who was drawn to begin to study Stoic philosophy a few years ago to better understand the pioneering form of cognitive behavior therapy (CBT). That distinct and pioneering approach to CBT is named Rational Emotive Behavior Therapy (REBT). REBT’s creator was Dr. Albert Ellis, a very well-known American clinical psychologist who parted company with the Freudian approach to psychotherapy way back in 1955. Dismayed by the inefficiency of psychoanalytical psychotherapy, which he had been formally trained in, Ellis turned to his lifelong passion for philosophy to create a more effective psychotherapy. Albert always said that his brainchild was an amalgamation of ancient and modern philosophy which heavily borrows from Stoic philosophy.
I had the pleasure of being formally trained by Ellis, and I practice REBT in an outpatient clinic at the University of Pennsylvania in Philadelphia. Every day I use this philosophical approach to psychotherapy on a wide range of clinical problems with people of various backgrounds, educational levels, and degrees of functional impairment. Over the course of my 27-year career, I have witnessed the way clients and patients come to help themselves using REBT. I have seen how people who diligently work at understanding and implementing the core principles of REBT come to liberate themselves. These people learn how not to disturb themselves when they encounter various types of adversity which renders them more effective at changing whatever they can change when facing difficult problems common to the human condition. I assume that anyone who is interested in Stoic philosophy, who uses Stoic philosophy to help themselves through the journey of life, will also very much like and benefit from learning REBT. REBT largely overlaps with Stoic philosophy and can be a very useful compliment to the practicing Stoic. My goal today is to introduce to the core principles of REBT using the words and quotations of Epictetus.
When Ellis departed from psychoanalysis in 1955, his new practical approach to psychotherapy was game-changing. Unlike other cognitive behavioral therapies that followed in its wake and were primarily developed in the confines of academia, REBT was established in the rough and tumble streets of Manhattan in New York. Ellis was a private practitioner who worked from dawn to dust helping people with multiple problems that were often quite challenging. Over his long life, it is estimated that Ellis had over 180,000 hours of face to face clinical contact helping people and he wisely turned to philosophy to find answers to their problems and for his personal strength, meaning, and happiness.
Epictetus taught that:

“It is not events that disturb people, but it is their judgments concerning them.” Enchiridion 5. He then goes on to add “So make a practice at once of saying to every strong impression: ‘An impression is all you are, not the source of the impression.’ Then test and assess it with your criteria, but one primarily: ask, ‘Is this something that is, or is not, in my control?’ And if it’s not one of the things that you control, be ready with the reaction, ‘Then it’s none of my concern.’” Enchiridion 1(5).

Consistent with Stoic philosophy REBT argues that adversity in and of itself is insufficient to produce maladaptive, self-defeating emotional disturbance. In REBT emotional disturbance is defined as emotional and behavioral reactions that are self-defeating, unhealthy, and undermine our primary goals of survival and happiness. Ellis argued that all other goals and values were subsumed under these two overarching goals.
Ellis presented the relationship between our tacit attitudes and the subsequent emotional and behavioral reactions we display when we encounter adversity using what came to be known as the ABC theory of emotional disturbance.
Before introduction to REBT theory, people will often wrongly believe that their emotional upset is a result of encountering adversity. People will attribute adversity, assigned the letter (A), as the direct cause of their Consequential Emotional and Behavioral Reactions which I will here assign the letter (C). Ellis in keeping with Stoic Philosophy showed people that is not adversity (A), but our Basic Attitudes at point (B), in the ABC model which largely produce our consequential emotional and behavioral reactions (C).
REBT distinguishes between healthy and unhealthy negative emotions. It is important to note that healthy negative emotions are not to be erased or eliminated. The experiencing of healthy negative emotions in the face of adversity is good and self-helping and result when our desires, wishes, wants, and preferences are undermined by the presence of adversity. Healthy negative emotions result in motivation that leads to productive action to change what can be changed.
There are essentially eight healthy negative emotions which include concern, sadness, remorse, disappointment, sorrow, productive anger, relationship preserving jealousy, and productive, motivating envy. In contrast to these healthy negative emotions are eight unhealthy and self-defeating negative emotions which are anxiety, depression, guilt, shame, hurt, unproductive anger, relationship interfering jealousy, and unproductive, self-disturbing envy.
The primary characteristic of unhealthy negative emotions is that they are self-defeating. These negative feelings interfere with a person’s ability to live well with that which cannot be changed. They also undermine effort to improve things. Unhealthy negative emotions often lead to excessive behavior (e.g., aggressive behavior) or lead to self-defeating avoidance and escape behavior that is unhealthy such as excessive use of alcohol, sex, exercise, or procrastination. Most importantly unhealthy negative emotions are likely to interfere with a person experiencing some degree of happiness in the presence of unchangeable adversity.
By contrast, the essential characteristics of healthy negative emotions are that they provide us important feedback that what we value, want, desire, and prefer is not occurring. These feelings motivate us to change what can be changed and to get more of what we want and less of what we do not want. Healthy negative emotions do not undermine our efforts to achieve our goals and allow us to live well with adversity when it cannot be changed. Essentially despite the presence of negative emotion which is associated with being blocked or obstructed by adversity the individual can still have some degree of happiness despite the presence of adversity. Learning how to experience some degree of happiness despite the presence of adversity is an important skill to cultivate because the human condition is such that new problems manifest themselves throughout our lifespan. If we do not learn how to have some degree of equanimity or happiness despite the never-ending parade of problems that occur in life we are likely to have a pretty dismal existence.
Epictetus said:

 “Remember that you are an actor in a play, the nature of which is up to the director to decide. If he wants the play to be short, it will be short, if he wants it long, it will be long. And if he casts you as one of the poor, or as a cripple, as a king or a commoner – whatever the role assigned, the accomplished actor will accept and perform it with impartial skill. But the assignment of roles belongs to another. (Enchiridion 17)

Epictetus also said,

“Don’t hope that events will turn out the way you want, welcome events in whichever way they happen: this is the path to peace.” Enchiridion 8

Inspired by Epictetus, REBT also encourages acceptance. We are very precise in our definition of what it means to accept things. In our view, acceptance means to acknowledge that something exists which is against our goals & values and that it would be preferable for this particular reality not to exist. However, in REBT we acknowledge that it does not logically follow to conclude that the negative reality must not exist. Furthermore we in REBT encourage firm determination to change the existing negative conditions if they can be changed and to have determination to adjust constructively with conditions that cannot be changed.
Epictetus taught:

 “It is not events that disturb people, it is their judgments concerning them. Death, for example, is nothing frightening, otherwise it would have frightened Socrates. But the judgment that death is frightening – now that is something to be afraid of. So when we are frustrated, angry or unhappy, never hold anyone except ourselves – that is, our judgments – accountable.”

In REBT we emphasize what is called the Principle of Emotional Responsibility. Like Epictetus quoted above, we teach that humans largely disturb themselves about adversity. Emotional disturbance does not happen to us. We are not victims of misfortune so much as victims of our rigid and extreme attitudes we hold towards what other people do to us and what fate throws our way. In REBT we argue the individual nearly always has some degree of emotional choice in how he reacts to adversity.
As a result of this view the REBT psychotherapist will challenge the person experiencing emotional disturbance with questions such as “How are you angering yourself about your colleague’s misbehavior?” or “What attitude could you adopt to help you respond productively to this adversity and to live well despite its continued existence in your life?”. Leading REBT psychotherapist Dr. Windy Dryden restates Epictetus’s famous dictum this way, “It is not events that disturb people, it is their rigid and extreme attitudes concerning them.”
Epictetus taught:

“Remember, it is not enough to be hit or insulted to be harmed, you must believe you are being harmed. If someone succeeds in provoking you, realize that your mind is complicit in the provocation…” Enchiridion 20

In REBT we teach this idea of complicity in our self-defeating emotional reactions by introducing to the client the ABC model of emotional disturbance. This framework helps the client see that their rigid and extreme attitudes, assigned the letter B, come between adversity, assigned the letter A, and their emotional and behavioral reactions, assigned the letter C. Prior to REBT therapy clients will think “My colleague made me angry because he absolutely should cooperate with me on this project!” This statement shows that the client’s model of emotion is that A (adversity) directly leads to C (emotional and behavioral consequence). The client sees himself as a victim of misfortune.
In REBT therapy we teach that healthy emotional reactions are the consequence of relinquishing rigid and extreme attitudes towards adversity and replacing them with flexible and non-extreme, healthy attitudes towards it. So the individual is encouraged to adopt a position such as “I wish my colleague would cooperate with me on this project, but he does NOT HAVE to cooperate with me. I will choose a healthy attitude towards his uncooperative behavior and then take steps to influence him to cooperate to whatever extent I can.” As a result of this flexible attitude towards a negative state of affairs, the individual will lead to healthy, productive negative feelings of disappointment, sorrow, concern and\or productive anger.
Ellis held that all humans are born and reared to hold, to greater or lesser extent, rigid and extreme attitudes. Fortunately, Ellis taught that humans also were born and reared to hold flexible and non-extreme attitudes. In his view irrational, self-defeating attitudes and rational, self-helping attitudes are part of the human condition and both are rooted in our biology. This view, therefore, implies that we will never eliminate the irrationality that lurks within us. We can greatly reduce the intensity, frequency, and duration of its expression in our lives but we will always remain fallible, humans despite having the potential for significant growth and self-actualization.
Epictetus emphasized that

“We must undergo a hard winter training and not rush into things for which we haven’t prepared.” Discourses 1.2.32

Like Epictetus, Ellis argued that humans can train themselves, through much work and practice, to detect, challenge, and relinquish rigid and extreme attitudes that underpin emotional disturbance. He emphasized deliberate effort at adopting healthy, self-helping flexible and non-extreme attitudes. He also warned that because our self-defeating rigid thinking was biologically rooted we need to guard against backsliding as we can easily return to previous counterproductive ways of thinking, emoting, and behaving. Here again the way to prevent backsliding through work and practice of rational thinking, emoting and behaving, much like Epictetus advocated.
Unlike other modern cognitive-behavioral psychotherapies that have followed REBT, I argue that REBT is both a philosophy and a system of psychotherapy. As psychotherapy, it teaches people to question and relinquish their rigid and extreme attitudes and to adopt flexible and non-extreme attitudes. As a philosophy, it suggests values to live by which I will cover towards the end of today’s presentation.
Epictetus taught that “Learning that does not lead to action is useless.” Discourses 1.29.35 REBT also encourages the active study and use of the rational attitudes discussed in the psychotherapy session. To this end, clients are encouraged to reflect on their rigid and extreme attitudes when they are in their home environment to help themselves when they disturb themselves between sessions. We encourage clients to study REBT and to gain a firm understanding of its core ideas through home study that can take the form of reading self-help books on REBT or listening to instructional audio on REBT like those found at my website REBTDoctor.com. Like Epictetus we want the client to live and act in a way consistent with REBT philosophy and to forcefully dispute their rigid attitudes when disturbed, to practice through repetition healthy, rational attitudes, and to strive to live in harmony with them when the going of life gets rough!
The theory of REBT holds that four attitudes are responsible for nearly all non-psychotic emotional disturbance. One attitude is primary, and three derive from it and are secondary. Ellis humorously named the core attitude “musturbation” but also referred to it as “Demandingness.” He argued that absolutistic, rigid, dogmatic, anti-scientific attitudes were at the core of emotional disturbance. These attitudes can be expressed in different ways with words like (absolutely) must, (absolutely) should, (absolutely) have to, and (absolutely) need to. Ellis taught clients to assume that just about all their dogmatic musts fell under three major headings as follows:

1. “I absolutely must perform well on important projects and be approved of by significant people or else I am an inadequate and unlovable person!”
2. “Other people, particularly those I have cared for and treated well, absolutely must treat me kindly and fairly, or else they are rotten individuals who deserve to suffer!”
3. “The conditions under which I live absolutely must be easy, unfrustrating, predictable, secure, and enjoyable or else the world’s an awful place, I can’t stand it, and I’ll never be happy!”

From these three musts at the core of emotional disturbance, three extreme secondary attitudes arise. These derivative attitudes are:

1. It is awful, terrible, the end of the world (Awfulizing)
2. It is intolerable, unbearable, I cannot stand it (Discomfort Disturbance)
3. The Devaluation of self, others, life (Disturbance related to Human Worth

REBT teaches that if rigid attitudes are the core of disturbance, then flexible attitudes are at the center of emotional health. The characteristics of these healthy flexible attitudes are that they are empirically valid, logical and promote adaptation to the circumstances of life. They are typically expressed with words like want, wish, prefer, and desire. For example, in reference to the previously mentioned individual who has been angering himself over a colleague’s uncooperative behavior in the workplace, this man could move towards greater tolerance and emotional equanimity by holding the attitude “I want and strongly prefer that my colleague cooperate with me on this project, but it does not follow that he absolutely must cooperate with me on this project.”
As for the three derivatives non-extreme attitudes that derive from this healthy attitude of desiring and preferring cooperation from one’s colleague, those attitudes would be:

1. It is bad, undesirable, inconvenient, etc. but not awful, terrible or the end of the world that I do not have his cooperation on this project.
2. My colleague’s lack of cooperation is uncomfortable but not unbearable, intolerable, or something I cannot survive and live with as I do this project.
3. My colleague is doing a bad deed by not cooperating with me but is not a bad person. His bad behavior is proof he is a fallible human, not proof he is a bad human. I can unconditionally accept him as a person while strongly condemning and never liking his bad, uncooperative behavior.

An alternative way of understanding the philosophy of REBT is that through the adaptation of flexible and non-extreme attitudes the individual to adopt a philosophy of unconditional self-acceptance (USA), unconditional other acceptance (UOA), and unconditional life acceptance (ULA).
Epictetus taught:

 “If you are ever tempted to look for outside approval, realize that you have compromised your integrity. So be satisfied just being a philosopher, and if you need a witness in addition, be your own; and you will be all the witness you could desire.” Enchiridion 23

In my view this quotation is similar to REBT’s view of unconditional self-acceptance.
Epictetus goes on to say:

“We use labels like ‘thief’ and ‘robber’ in connection with them, but what do these words mean? They merely signify that people are confused about what is good and what is bad. So should we be angry with them, or should we pity them instead?” Discourses I.18.13

In this quote I think we see Epictetus teaching a view of others that is highly consistent with REBT’s view of unconditional other-acceptance.
Epictetus also teaches:

“Don’t hope that events will turn out the way you want, welcome events in whichever way they happen: This is the path to peace.”Enchiridion 8

I think this view by Epictetus is very close to REBT’s concept of unconditional life-acceptance.
Earlier I pointed out that unlike other cognitive behavioral therapies which followed it, REBT has and articulates specific philosophical values. Ellis argued that by striving to adopt these values a human would be moving towards emotional well-being and self-actualization. Here you see REBT going beyond the treatment of emotional disturbance and pointing the way towards emotional health and life satisfaction. Depending on your definition of what constitutes a philosophy, one could argue that it is the articulation of these guidelines that makes REBT more than a psychotherapy and perhaps a philosophy. These values include:

1. Self-interest (enlightened self-interest)
2. Social interest
3. Self-direction
4. High frustration and discomfort tolerance
5. Flexibility in thinking, open to change, unbigoted
6. Acceptance of Uncertainty
7. Commitment to creative and meaningful pursuits
8. Scientific thinking
9. Self, Other and Life Acceptance
10. Calculated Risk-taking
11. Long-range hedonism (hedonic calculus)
12. Nonutopianism & nonperfectionism related to self, others, and life
13. Self-responsibility for own emotional disturbance

(REBT’s Principle of Emotional Responsibility)
Time does not allow me to point out the overlap between most REBT’s values for emotional well-being and those found within Stoic philosophy. I have already attempted to point out how discomfort tolerance, self/other/life acceptance, and the Principle of Emotional Responsibility can be seen in the quotations of Epictetus. I would show how REBT’s value for long-range hedonism is consistent with the words of Epictetus as shown in this quote:

 “As with impressions generally, if you get an impression of something pleasurable, watch yourself so that you are not carried away with it. Take a minute and let the matter wait on you. Then reflect on both intervals of time: the time you will have to experience the pleasure, and the time after its enjoyment that you will beat yourself up over it. Contrast that with how happy and pleased you’ll be if you abstain. If the chance to do the deed presents itself, take extra care that you are not overcome by its seductiveness, pleasure, and allure. Counter temptation by remembering how much better will be the knowledge that you resisted.” Enchiridion 34

I would like to close my presentation today by asserting that you consider adding REBT to your study of Stoicism. I believe that REBT is very consistent with many of the teachings of Stoic philosophy. I attempted to use Epictetus’s own words to support my view. I will add that like Stoicism, REBT is a tough-minded philosophy that holds up well when your worst nightmare or adversity occurs. I think REBT can help you as you strive to live virtuously as a fallible human in a challenging world.
For those of you who are mental health professionals or involved in philosophical coaching my recently published book, Rational Emotive Behavior Therapy – A Newcomer’s Guide may be useful to you if you wish to go beyond today’s presentation. For those of you who are not mental health professionals but wish to learn more about how you can use REBT in your life you may want to go to my website REBTDoctor.com. There you will find a number of audios and videos you can listen to at no charge. Finally, Ellis was a prolific writer of self-help literature and here a couple of three of the many titles that might be useful to you in learning to apply REBT to your problems of everyday living include:

1. How to Make Yourself Happy and Remarkably Less Disturbable (A. Ellis)
2. How to Stubbornly Refuse to Miserable About Anything, Yes Anything! (A. Ellis)
3. How to Control Your Anger Before It Controls You(A. Ellis)

Thank you for your attention.
Walter Matweychuk is a clinical psychologist and REBT practitioner.  He teaches for New York University, maintains the website, REBTDoctor.com and is the co-author of Rational Emotive Behavior Therapy: A Newcomer’s Guide.