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Journal of Rational-Emotive & Cognitive-Behavior Therapy, Vol. 23, No.

2, Summer 2005 ( 2005)


DOI: 10.1007/s10942-005-0008-8
Published Online: August 6, 2005

CAN RATIONAL-EMOTIVE BEHAVIOR


THERAPY (REBT) AND ACCEPTANCE AND
COMMITMENT THERAPY (ACT) RESOLVE
THEIR DIFFERENCES AND BE INTEGRATED?
Albert Ellis
Albert Ellis Institute, New York

ABSTRACT: Rational-Emotive Behavior Therapy (REBT) is a pioneering


form of Cognitive Behavior Therapy (CBT). Acceptance and Commitment
Therapy (ACT) is part of the new wave of CBTs. In this article, I discuss the
papers of Ciarrochi, Robb, and Godsell, and of Ciarrochi and Robb, who pro-
pose that REBT and ACT can be quite suitably integrated, and the paper of
Steven Hayes, the originator of ACT and of Relational Frame Theory, who is
skeptical about the feasibility of Ciarrochi, Robb, and Godsell’s proposals. My
own view is that ACT and REBT significantly overlap in their theory and
practice and that they can be successfully integrated if both therapies make
some changes.

KEY WORDS: acceptance and commitment therapy; cognitive behavior


therapy; psychotherapy; rational-emotive behavior therapy.

In two papers in this issue, Ciarrochi, Robb, and Goodsell and


Ciarrochi and Robb have nicely shown how Rational-Emotive Behav-
ior Therapy (REBT) and Acceptance and Commitment Therapy (ACT)
have several distinct differences as well as similarities and how these
two new cognitive behavior therapies (CBTs) might successfully be
integrated. In a thoughtful paper discussing Ciarrochi, Robb, and
Godsell’s suggestion, Steven Hayes (2005) summarizes the outcome
studies of ACT and is concerned about the effects of REBT and CBT’s
focusing on the content of dysfunctional beliefs and the role of
logical–empirical challenges to beliefs.

Author correspondence to Albert Ellis, Ph.D., Albert Ellis Institute, 45 East 65th Street, New
York, NY 10021, USA; e-mail: aiellis@aol.com.

153  2005 Springer Science+Business Media, Inc.


154 Journal of Rational-Emotive & Cognitive-Behavior Therapy

Let me now comment on these three papers and give my views on


integrating ACT with REBT and CBT. However, just as I was about
to finish my comments, Guilford Press sent me the manuscript of a
new book edited by Steven Hayes, Victoria Follette, and Marsha
Linehan, Mindfulness, Acceptance, and Relationship: Expanding the
Cognitive Behavioral Tradition (2005). I was asked to review this
book and possibly endorse it and I shall favorably do so.
The book contains 13 chapters by many outstanding cognitive
behavior therapists who have also recently added to conventional
CBT, just as Hayes and his associates have done, and have cited
some innovative theories and techniques of their own. Some of the
chapters are by the editors, Hayes, Linehan, and Follette; and other
chapters are by well-known CBT practitioners, including Zindel Se-
gal, John Teasdale, Robert Kohlenberg, T.D. Borkovec, G. Terence
Wilson, and G. Alan Marlatt.
These authors and their collaborators all largely favor Hayes’ ACT
and his Relational Frame Theory (RFT), but they also add some ori-
ginal theoretical concepts and cognitive behavioral techniques. They
all believe that their innovative methods can definitely be integrated
with ACT and RFT without much difficulty. I agree with them—as
does Steven Hayes.
The interesting question is: Since most of the innovative therapies
in his edited book, Mindfulness, Acceptance, and Relationship, in-
clude much less metacognition, which is at the basis of mindfulness,
and distinctly less emphasis on acceptance than REBT has done for
years, I wonder why Steve favors integrating the CBT therapies in
this book with ACT but is much more unwilling to consider integrat-
ing it and REBT. Let us see!
I shall first make the important point that REBT has distinct dif-
ferences with Beck’s (1976) cognitive therapy (CT) and with conven-
tional CBT, and that Hayes often mentions REBT in the same breath
with these other two forms of treatment. Formerly, all REBT was
similar to Beck’s cognitive therapy and many other cognitive behav-
ior treatments. Thus, they all mostly followed the ABCs of REBT.
They all held that when Activating Events or Adversities (A) occur
to people and they experience emotional-behavioral disturbances as
Consequences (C), their Beliefs (B) lead to or ‘‘cause’’ C and therefore
they would better change them to ‘‘rational’’ or preferential instead
of ‘‘irrational’’ and absolutistic Beliefs (Ellis, 1957, 1962). When peo-
ple believe (B), ‘‘I wish I performed well,’’ and they are not success-
ful, they usually have the ‘‘healthy’’ or ‘‘helpful’’ feelings of sorrow,
Albert Ellis 155

disappointment, and frustration and continue trying to succeed.


When, however, they believe (B) ‘‘I have to perform well and I am
worthless when I don’t,’’ they often make themselves disturbed—that
is, experience anxiety, depression, and worthlessness.
REBT and CBT both say that people have the choice about disturb-
ing themselves and they can change unhealthy Beliefs to healthy
ones and undisturb themselves. In the original A, B, Cs of REBT,
what happens to people at A (their environment) is important, since
A · B = C. So both A and B affect C (emotional-behavioral Conse-
quences); and since people’s Beliefs (Bs) and their temperaments are
biologically as well as environmentally learned and conditioned, they
disturb themselves as a result of their heredity and their environ-
ment. So they can lessen their disturbances by changing either A or
B. Because A (their environment) is often unchangeable, people can
still lessen their disturbances and increase their happiness by engag-
ing in Disputing (D) their Irrational Beliefs (IB’s) and making them
more preferential or flexible and less absolutistic and rigid.
Emotional and behavioral dysfunctioning, the original REBT the-
ory said, were largely—not completely—correlated with people’s abso-
lutistic, rigid, inflexible, unrealistic, perfectionistic, grandiose
insistences instead of their flexible preferences.
This original ABC version of REBT has been largely incorporated
into Aaron Beck’s (1976) CT and many of the other cognitive behavior
therapies (CBTs). But it was soon added to in important ways in
REBT. First, I began emphasizing that Beliefs (Bs) were not merely
cognitive, but also included emotions and behaviors. Thus, the Belief
‘‘I must perform well or else I am worthless!’’ includes a forceful,
strong emotional element (‘‘I am determined that I must perform
well!’’) and also includes a powerful action tendency (‘‘I’d better push
myself to perform well, to ward off feelings of worthlessness!’’).
Similarly, REBT holds that emotions are not merely feeling states
but also include important cognitive and behavior aspects; and that
behaviors are not merely actions but also include thinking and emo-
tional factors (Ellis, 1962). According to this expanded theory of
REBT, human disturbances do not merely follow from (or are
‘‘caused’’ by) Irrational Beliefs (IBs) but follow from a combination of
dysfunctional thoughts–feelings–behaviors. Yes, all three working
integrally together.
If this is so, then REBT practitioners had better show their clients
that they can think–feel–act themselves into unhealthy Consequences
(Cs) when unfortunate Adversities (A) occur in their lives or they can
156 Journal of Rational-Emotive & Cognitive-Behavior Therapy

to a considerable degree constructively choose to think–feel–act ratio-


nally or functionally and experience healthy negative feelings (e.g.,
sadness or regret) and healthy negative actions (e.g., sensible attempts
to withdraw from Adversities). As a result of this theorizing, REBT has
been a constructivist therapy for many years and includes in its prac-
tice a good many different kinds of ‘‘thinking,’’ ‘‘feeling,’’ and ‘‘behavior’’
methods, which integratively interact with one another and counter-at-
tack people’s dysfunctioning. In this respect, it is rather different from
Beck’s CT and from many of the other CBTs. Therefore, I have changed
its name from the original RT and RET to REBT.
As Ciarrochi, Robb, and Godsell (2005) have noted, REBT still ac-
tive-directively and quite consciously Disputes (D) clients’ IBs realis-
tically and logically, but it also heavily stresses functional Disputing:
‘‘If you continue to believe the shoulds and musts that you now hold,
where will this kind of thinking–feeling–action get you? Will it lead
to your achieving more of your goals and values-or less?’’
Although REBT still is similar to Beck’s CT in several respects, it
is radically different in that it is much more philosophic. As a recent
discussion between me and Padesky and Beck (Ellis, 2004b; Padesky
& Beck, 2004) shows, Beck emphasizes empirical formulations and
information processing in CT, while I strongly emphasize profound
and fundamental philosophical change—which includes a philosophy
of feeling and of behaving functionally (Ellis, 2001a, b, 2003, 2004a).
In particular, REBT especially includes clients’ (and therapists’)
acceptance and commitment, and has been doing so years before ACT
was formulated by Hayes and his collaborators (Hayes, Stroshal,
&Wilson, 1999). In fact, Jacobson (1992), who used to be an almost
exclusive behavior therapist, gives me credit for adding acceptance to
the field of therapy in my seminal book, Reason and Emotion in Psy-
chotherapy (1962), and Marsha Linehan did a study of REBT with
Marvin Goldfried in the 1970s and may have been influenced by it
when she formulated Dialectical Behavior Therapy for clients with
borderline personality (Linehan, 1993). Many of the other recent
innovators in CBT have also been influenced by REBT’s acceptance
and commitment philosophy.
Let me briefly summarize the main REBT techniques of commit-
ment that are taught at the Albert Ellis Institute and recommended
to all therapists who want to practice modern-day REBT. I still theo-
rize that people mainly (not exclusively) disturb themselves by taking
their normal preferences for success and approval and destructively
escalate them into absolutistic shoulds and musts.
Albert Ellis 157

Why do they do so? Because that is their biosocial nature.


As Alfred Korzybski (1933) brilliantly pointed out, people often sen-
sibly generalize (‘‘I failed a few times and I may easily fail again’’)
and they frequently exaggeratedly overgeneralize (‘‘Therefore I am a
failure’’). Korzybski (1933) wisely noted that just about all the people
on earth are both sane and unsane. He held, as does Steven Hayes
(Hayes et al., 1999), that they are disturbed because they are lan-
guage-creating animals, and their using language and symbols (as
other animals do not do), helps them resort to both generalization
and overgeneralization. So in Korzybski’s form of psychotherapy, gen-
eral semantics, they are specifically shown how they create inaccu-
rate overgeneralizations, mistake a map for a territory, and can be
taught to prevent themselves from thinking–feeling–acting in that
disturbing way. REBT, among other techniques, favors general
semantics methods (Ellis, 1962, 2001b) and agrees that just about all
people are often irrational and unsane—including therapists (Ellis,
1976)!
Prophylactically and therapeutically, REBT strongly and cogni-
tively–emotionally–behaviorally promotes three major forms of accep-
tance. It hypothesizes that when people overtly or implicitly hold
unrealistic and inflexible demands, they frequently create three
destructive forms of nonacceptance: (1) ‘‘Since I have failed to per-
form well and be approved by significant others as I absolutely must,
it is not good and I am also no good, worthless.’’ People put down
their behaviors and their total selves; and they create, as Korzybski
said, the is of identity, which leads to self-downing. (2) ‘‘Since other
people don’t treat me kindly and fairly, as they absolutely must not,
they are rotten people who deserve to be punished.’’ Clients (and oth-
ers) then make themselves hostile and antisocial. (3) ‘‘Since the world
and conditions in my community are frequently bad and frustrating,
as they absolutely must not be, my life has unnecessary hassles and
misfortunes, and that is awful and terrible, and almost totally bad.’’
People, with this nonaccepting philosophy, create awfulizing and low
frustration tolerance.
Based on this theory of clients’ (and other people’s) self-chosen non-
acceptance, REBT postulates that self-rating (‘‘I am good or bad’’),
other-rating (‘‘You are good or bad’’) do not create all human distur-
bance, but very possibly create most of it.
Contemporary (or latter day) REBT, unlike Beck’s CT and most of
the other CBT’s, uses every possibly means of helping clients to think-
ingly–emotionally–actively solidly make three major acceptances: (1)
158 Journal of Rational-Emotive & Cognitive-Behavior Therapy

unconditional self-acceptance (USA). This means that you fully accept


yourself whether or not you succeed at important tasks and whether
or not you are approved by significant people. (2) Unconditional other-
acceptance (UOA). This means that you fully accept (though not nec-
essarily like) all other humans—similar to Alfred Adler’s (1964) social
interest—whether or not they act fairly and competently. (3) You
unconditionally accept life (ULA). This means that you fully accept
life whether or not it is fortunate or unfortunate and do your best to
discover and enjoy its personally selected satisfactions and pleasures
(Ellis, 2001a, b, 2002, 2003, 2004a; Ellis and Harper, 1997).
One more important aspect of REBT is today emphasized. I discov-
ered soon after I created REBT that clients (and other people) not
only destructively demand that they succeed in important tasks, be
treated ‘‘rightly’’ by others, and live under what they consider as
‘‘good’’ conditions. To make matters worse, they also, when they up-
set themselves with their demandingness, berate themselves for mak-
ing themselves anxious, depressed, and raging. They insist, ‘‘I must
not be anxious and depressed!’’—and thereby make themselves more
anxious and depressed. They also insist, ‘‘Others must not be dis-
turbed!’’—and thereby make themselves more hostile to others. They
also insist, ‘‘I must not have low frustration tolerance (LFT)!’’ and
thereby have low frustration tolerance for their LFT. Not always, of
course; but quite frequently. REBT therefore goes out of its way to
show them these destructive secondary disturbances; and, of course,
to fully accept themselves and others with their self-upsetting. They
then achieve a thoroughgoing thinking–feeling–acting philosophy of
acceptance (Ellis, 2001b, 2002, 2003, 2004a).
REBT also stresses (but not demands) commitment to therapy if
you desire lastingly change. I have been saying for many years,
‘‘There are many insights that REBT can give you, but three are
most notable: (1) You do not only get disturbed by people and events.
You also frequently disturb yourself about them. So much of your dis-
turbance results from your self-upsetting. (2) You usually began dis-
turbing yourself in your early childhood. But you remain anxious,
depressed, and raging today because you keep inventing your strong
and persistent shoulds, oughts, and musts to which you habituated
yourself in your earlier life. (3) Today, your destructive thinking–feel-
ing–acting propensities and habits are usually so engrained that
there is probably no way but continual work and practice—yes, stea-
dy work and practice—to minimize and to alleviate them. Tough!—
but you may well have to often put on your thinking–feeling–doing
Albert Ellis 159

caps for the rest of your life (Ellis, 1962, 2002). No rest for the weary!
Then you look for many creative enjoyments!’’ (Ellis, 1962, 1994).
From what I have just said, it should be reasonably obvious that
the critics of REBT, including Steve Hayes (2005) often wrongly per-
ceive it as almost obsessed with irrational and illogical Beliefs. Some
sloppy followers of REBT and some practitioners of forms of CBT
may be in that camp. But hardly up-to-date REBTers. They fre-
quently show clients how to find and Dispute (D) their IBs and to ar-
rive at Effective New Philosophies (E), otherwise known as Rational
Coping Beliefs. Fine. That, as many empirical studies and an im-
mense amount of clinical evidence have shown, is enormously effec-
tive in helping people (Lyons & Woods, 1991). REBT can frequently
be effective in from 1 to 10 sessions. It also works with practically all
kinds of severe personality disorders, and with people with psychotic
disorders. Of course, REBT doesn’t significantly help all disturbed
people; but it does remarkably well with most of them—if their thera-
pists induce them to commit themselves to working at it. It therefore
requires a dedicated, committed therapist who uses good relating
skills—just as ACT does.
However! competent REBT practitioners do much more than teach
people how to find and Dispute their destructive thinking. They also
try to persuade their clients, in several cognitive, emotional, and
behavioral ways, to consciously take and profoundly imbibe a philoso-
phy of both acceptance and commitment. They strongly present these
important therapeutic goals to their clients. To accomplish this, they
frequently take on several roles and can serve as teachers, preachers,
propagandists, persuaders, and encouragers. As far as I can see, ACT
practitioners do something similar. For example, they often teach
Mindfulness to clients; give them metaphors, analogies and fables,
stories, puzzles, and other presentations just as REBT practitioners
do; and even, though they deny using direct cognitive methods, use
more active-directive teaching than many other therapists—such as
Rogerian, Reichian, and Gestalt therapists.
REBT also stresses teaching clients to focus on their goals and val-
ues—as pointed by several reviewers. And it uses evaluation—which
is a cognitive technique that involves language—not only to assess
whether a therapeutic method works; but it also explores clients’
evaluations of their goals and their demands about these goals. Thus,
clients usually have the goal of succeeding in an important endeavor,
and their rational evaluation is something like, ‘‘I really wish to suc-
ceed and gain approval. That would be good.’’ But their irrational
160 Journal of Rational-Emotive & Cognitive-Behavior Therapy

evaluation of this goal may be, ‘‘I must succeed or else it is terrible
and I’m worthless!’’ Their irrational or musturbatory evaluations are
radically different from their functional evaluations of their goals. So
REBT practitioners point out this difference, and show clients how
one kind of goal evaluation is helpful and another kind of goal evalu-
ation is unrealistic and unhelpful. In this way, REBT is probably
more focused on evaluation of goals than is ACT.
Hayes (2005) cites several studies where, without addressing the
content of dysfunctional thinking, ACT gets excellent therapeutic re-
sults. What he seems to mean is that ACT doesn’t directly address
the clients’ dysfunctional Beliefs, such as, ‘‘Because I failed at this
important project, that is awful and my failing makes me an incom-
petent person, a failure.’’ But in several ways, it indirectly contradicts
them. It shows, by stories, metaphors, coping statements, in vivo
desensitization, and other cognitive behavioral techniques that your
therapist accepts you with your failings; that your friends and loved
ones do so, too; that many people don’t consider you a total failure;
that people who fail (like Lincoln for example) can finally succeed;
that you can accept yourself no matter how many times you fail; that
it isn’t the end of the world to fail; that you can relax and not focus
on your failures; that you can enjoy many other things, etc.
In other words, ACT both explicitly and implicitly presents several
philosophies of acceptance that help you to believe that failing doesn’t
make you a worm and is not catastrophic and awful.
Now the interesting thing is that REBT uses a number of cogni-
tive, emotive, and behavioral techniques that ACT also uses to help
change your self-downing and awfulizing outlooks, but it consciously
teaches them directly and indirectly with everyday language and
with stories and metaphors. It analyzes the language of clients (as
Korzybski’s general semantics does) and does so quite openly and
didactically; but it also uses realistic and logical Disputing of your
IBs.
Why does REBT logically and realistically Dispute your dysfunc-
tional ideas, feelings, and actions? Because REBT (and some other
CBTs) have found, in contradiction to ACT, that Disputing the con-
tent of what you think not only works, but works remarkably well in
most (though hardly all) cases. It is effective, very often, in from 1 to
10 sessions. What is more, active Disputing of IBs is effective in self-
help form, through books, handouts, cassettes, lectures, workshops,
intensives, courses, etc. REBT direct teaching has helped millions of
people prophylactically and therapeutically.
Albert Ellis 161

Hayes (2005) states that ACT, theoretically and philosophically, ‘‘is


a contextual behavioral therapy which seeks rapid changes in the
function of cognition and emotion, rather than what RFT suggests
would be the more difficult and error-prone task of changing their
content. That is quite different from traditional CBT, and the data so
far seem to bear this out.’’
Hayes may be largely right about the advantages of ACT over tra-
ditional CBT; but as I indicated at the beginning of this article, tradi-
tional CBT is far from being the same as REBT. So let me now show
how his statement does not understand what REBT today is.

(1) In many ways REBT is a contextual behavior therapy. It clearly


holds that people’s Beliefs about Adverse events often (not always)
help create disturbed Consequences (thoughts, feelings, and ac-
tions) because they interact to do so. The REBT ABC theory clearly
says that A · B = C. So the environmental context is definitely ta-
ken into account. Thus, if you fail one test (at A) you may conclude
(at B), ‘‘It’s only one failing and I probably will succeed the next
time.’’ You will probably therefore have the healthy emotional Con-
sequence (C) of disappointment about your performance. But if you
fail several tests in a row (A) you often (not always) will have the
unhealthy behavioral Consequence (C) of anxiety and depression
because you tell yourself (B), ‘‘I’ll never succeed and am a total fail-
ure.’’ Both Rational and Irrational Beliefs occur—of course—in
some context, which influences them.
(2) ACT, notes Hayes (2005) ‘‘seeks rapid changes in the functions of
cognition and emotion, rather than what RFT suggests would be
the more difficult and error prone task of changing their content.’’
Fine. But REBT analyzes two different functions of cognitions:
First, a helpful function, ‘‘I don’t like this failing. I wish that I usu-
ally succeed, but I can stand it if I don’t and still be reasonably
happy.’’ Second, an unhelpful content, ‘‘Because I hate failing, I
absolutely must not fail and am a worthless person if I do!’’ By
showing clients how different are these two functions of cognitions,
it helps them keep the first and reduce the second.

The error-prone liability of REBT’s analyzing the content of


unhelpful cognitions sometimes arises when clients think, ‘‘Since my
therapist has shown me that my thoughts are irrational and unhelp-
ful, I must not have them and it’s awful if I do!’’ This, as Hayes has
noted (Hayes et al., 1999), is an error that REBT disputing may
encourage. Yes, it may, but it usually doesn’t. Moreover, REBTers
162 Journal of Rational-Emotive & Cognitive-Behavior Therapy

are keenly aware of this possible musturbatory error, usually quick-


ly find it, and help their clients Dispute their musts about their
musts and surrender them to preferences.
Hayes and I often tell clients the same parable in this respect: ‘‘A
king didn’t want his daughter to marry a prince who had passed all
the tests he had been given that made him eligible to marry her. So
he said to his wise men, ÔFind a test that the prince can not pass or
off goes your heads!’ After much anxious planning, the king’s wise
men found a test that the prince could not pass—namely, ÔDon’t
think of a pink elephant for twenty minutes.’ Because, of course, in
trying desperately to not think of a pink elephant, the prince had to
think of one and therefore failed the test.’’
I deliberately tell my clients this parable, to show them that if they
were the prince and told themselves, ‘‘I absolutely mustn’t have any
must!’’ that Irrational Belief will paradoxically add to their must
about thinking about an elephant. So absolutistic musts and musts
about musts are, paradoxically, destructive. REBT therefore warns
clients about them and thereby doubly Disputes the content of dys-
functional musts. (Incidentally, as I also show my clients, if the
prince wants to pass the test and marry the princess, he could delib-
erately think of a white elephant and use other distraction tech-
niques in order to pass it.)
This parable, I think, really shows that clients can irrationally
musturbate about any therapy technique, no matter how good it usu-
ally is. Thus, they can take the ACT and the REBT technique of
acceptance, and tell themselves, ‘‘I absolutely must follow the philoso-
phy of acceptance, otherwise I am no damned good!’’ They therefore
reinforce their nonacceptance. Since ACT doesn’t consciously look for,
find, and actively Dispute clients’ dysfunctional musts about their
own therapeutic efforts, I would say that it omits one of the most
useful therapeutic methods.
REBT also points out that in using some distraction techniques
that Hayes at times recommends, some clients do not see the error
of their thinking and therefore change it. Thus, when they use
mindfulness training, they dispassionately observe their thinking,
think about it, see that it easily leads them into needless worry
and obsession, and therefore decide that it is dysfunctional and de-
cide to let go of it or change it to more functional thinking and do-
ing. Just as they consciously and unconsciously plague themselves
with musts, they now consciously and/or unconsciously ‘‘let go’’ of
these musts. Acceptance includes implicit and explicit philosophic
Albert Ellis 163

change, such as, ‘‘I no longer have to give into and follow my wor-
risome thoughts. I am able to let go of them.’’
Steven Hayes notes that ACT was more effective with halluci-
nated psychotic clients when compared to treatment as usual
(TAU). I can well believe it was, because it used acceptance meth-
ods to help these clients accept themselves with their hallucina-
tions—meaning, accept themselves without blame. This is exactly
what REBT does with clients with psychosis. It assumes that their
hallucinations (and other bizarre behavior) are partly biologically
caused and are not like the IBs of clients with neurosis. It therefore
often does not try to change the hallucination—which may not stem
from their making their preferential desires into demands—but it
stresses teaching hallucinating people USA—unconditional self-
acceptance. They may then retain or even increase their psychotic
thoughts or perceptions, and still not damn themselves for having
them. Good ACT—but also good REBT!
The same thing goes for people with addictions, severe personal-
ity disorders, and practically all the difficult clients that seem to
be successfully treated with ACT. It is not absence of Disputing of
the content of their dysfunctional beliefs that ACT used with them.
It is mainly ACT’s helping them to fully accept themselves with
their dysfunctional perceptions, emotions, and actions. This is pre-
cisely what happens in REBT practice in addition to sometimes
Disputing the content of their IBs. Hayes lightly acknowledges
REBT’s very strong philosophy of unconditional acceptance. But
then he implies that it is not a crucial REBT concept and practice.
It damned well is!
Hayes, in answering Ciarrochi and Robb, says, ‘‘It is not clear to me
why we must be attached to logical–empirical challenging.’’ He forgets
that REBT challenges IBs in cognitive, emotive, and behavioral ways,
and that logical–empirical challenging is only one of these several
ways. REBT also says that it is preferable to challenge IB’s—not that
we must.
Hayes doubts that REBT would target the thought, ‘‘life is wonder-
ful’’ along with the thought, ‘‘life is awful.’’ How wrong he is! Both
thoughts, according to REBT (and to Alfred Korzybski) are irrational
overgeneralizations, are unrealistic, and may easily be harmful to
people.
Hayes is unaware of studies showing that REBT in a few hours is
effective. Actually, there are over 200 outcome studies of REBT, most
164 Journal of Rational-Emotive & Cognitive-Behavior Therapy

of them 10 sessions or less, that show its effectiveness (DiGiuseppe,


Terjasen, Rose, Doyle, & Vidalakis, 1998).
Hayes (2005) admits ‘‘that changing the content of client thought is
not anathema to ACT or RFT. Indeed, ACT itself includes such ef-
forts.’’ Ah, indeed it does! ACT, as I noted above, consistently does
Disputing and reframing. But where REBT does so both directly and
indirectly, ACT obsessively-compulsively sticks to using only indirect
and presumably nonverbal methods of challenging dysfunctional
thoughts, feelings, and actions. As Hayes rightly says, since both
REBT and ACT methods often work, we can do empirical studies to
discover which work best and which have more disadvantages.
ACT also employs a good many verbal language methods and then
claims that it does not really do so. I also think that it indirectly em-
ploys the technique of Disputing IBs by helping clients to arrive at
what REBT calls Effective New Philosophies (E).
Thus, when clients believe, ‘‘I must succeed at work or love, or else
I am an incompetent, worthless person,’’ REBT asks these Disputing
(D) questions and actively-directively encourages these more func-
tional answers of Effective New Philosophy (E):

(1) Realistic Disputing (D): ‘‘Why must you succeed? Where is it writ-
ten that you have to? Would a strong preference to succeed be bet-
ter than your must?’’ Answer or Effective New Philosophy (E): ‘‘I
clearly don’t have to succeed, though it would be preferable. My
need to succeed is only written in my nutty head. Of course, a
strong preference to succeed would be more sensible than my
demanding that I do so.’’
(2) Logical Disputing (D): ‘‘Does it logically follow that if I don’t suc-
ceed, my failing will make me an incompetent, worthless person?
Does my failing make me be or become a total failure?’’ Answer or
Effective New Philosophy (E): ‘‘No, failing makes me a person who
failed this time, not an incompetent or worthless person who will
always fail. No, I (and anyone else) can’t become a total failure be-
cause I would then have to fail at everything all the time.’’
(3) Functional Disputing (D): ‘‘Where will it get me if I think in this
unrealistic and illogical way?’’ Answer or Effective New Philosophy
(E): ‘‘It will get me nowhere, except anxious and self-downing.’’ Dis-
puting: ‘‘Will it help me or make me happier?’’ Answer or Effective
New Philosophy (E): ‘‘It damned well won’t.’’

REBT employs this kind of Disputing to help clients see: (1) That
they create their thinking errors. (2) That they can choose to think
Albert Ellis 165

differently if they fail and get rejected by others—can choose to feel


sorry and disappointed instead of anxious and depressed. (3) That
they can also similarly think dysfunctionally about many other fail-
ures, rejections, and adversities. (4) That their dysfunctional think-
ing-feeling-behaving practically always follows when they turn
healthy preferences into dysfunctional demands. (5) That in the fu-
ture they can continue to see their destructive cognitions–emotions–
behaviors and work hard at Disputing them until their common auto-
matic thoughts habitually tend to be minimal and to be replaced by
rational coping philosophies. So REBT hypothesizes that actively,
determinedly, and persistently Disputing IBs is a hell of a good way
to minimize them, therapeutically and prophylactically. It consciously
aims, by this and many other cognitive–emotional–behavioral tech-
niques, to help clients ‘‘Feel Better, Get Better, and Stay Bet-
ter’’—which is the title of one of my best-selling books (Ellis, 1994,
2001a).
And ACT? As far as I can see, its goals and purposes are quite sim-
ilar to those of REBT—to help clients clearly see that their usual
ways of thinking, feeling, and acting frequently are dysfunctional and
that therefore they had better fully acknowledge this and see pre-
cisely how they delude themselves and needlessly make themselves
suffer.
At the same time that they see how mistakenly and inefficiently
they behave, they had better not blame themselves for their self-
defeating behaviors but totally accept themselves with their dysfunc-
tions and then actively seek alternate, more functional ways of living.
To do this, they had better actively commit themselves to using
ACT’s potentially helpful methods. If these are some of ACT’s main
goals and purposes, I can only say that they are quite similar to RE-
BT’s—which has tried to implement them for many years before ACT
was invented (Ellis, 1962).
Let me finally give my general impressions of ACT and RFT. I lar-
gely favor what they say and do—but think that they have several
important omissions. ACT is definitely a form of cognitive behavior
therapy, with some unusual emphasis and techniques. It rightly
emphasizes the role of human language in disturbance and notes
that people most probably would not seriously disturb themselves if
they had no language. This sounds accurate, except for psychotic and
other biological-based disorders. Although regular and symbolic lan-
guage has many great advantages, it also helps create emotional dis-
turbances. Hayes (2005) says that ACT ‘‘is the only behavior therapy
166 Journal of Rational-Emotive & Cognitive-Behavior Therapy

with its own comprehensive research program into the nature of hu-
man language and cognition.’’ I agree with his point and congratulate
ACT devotees for doing this. They can teach REBT and all cognitive-
stressing therapists some important points.
However, Hayes and his associates often imply that it is common
language itself that people use to upset themselves and that by
avoiding it and by using metaphorical language, therapists reach
people better. I doubt this. Yes, the kind of language used in ACT
definitely can work—and Hayes has listed several studies where it
quickly works. But language itself doesn’t seem to ‘‘cause’’ distur-
bance while some kinds of internal language—which REBT special-
izes in investigating, much more than ACT does—have been shown
in hundreds of studies to be significantly more prevalent in emotion-
ally anguished than in nonanguished people. Before REBT was in-
vented, personality inventories like the MMPI were shown to fairly
accurately diagnose various kinds of psychological functioning, and
they still do. Some of these scales, like the famous Beck Depression
Inventory, are part of the regular CBT movement that Hayes thinks
ACT is mightily different from. Other personality inventories, such
as the MMPI, show that the content of people’s dysfunctional Beliefs
are often highly correlated with their thinking, emotional, and behav-
ioral disorders and can be usefully analyzed by therapists who use
CBT and other forms of therapy. These personality inventories seem
to have been used in several of the outcome studies of ACT and help
make these studies more effective.
Why Hayes is allergic to consciously finding and Disputing dys-
functional Beliefs in addition to his indirect ACT methods is still
something of a mystery to me. Yes, language helps people improperly
create disturbances. But language, in the form of consciously think-
ing about thinking and thinking about thinking about thinking
(meta-thinking), may be one of the most effective antidotes to emo-
tional and behavioral disturbances (Ellis, 2001b, 2002). I think that
ACT indirectly uses powerful persuasive language similar to REBT.
But instead of directly challenging clients to think differently by Dis-
puting their IBs, it indirectly teaches them to adopt an Effective New
Philosophy in a number of ways. Thus, it teaches clients to evaluate
how effective is their thinking, emoting, and behaving. It highlights
and explains why conventional thought is often dysfunctional. It pro-
vides clients with what REBT calls rational coping statements. It
shows clients how to be more purposive. It encourages them to have
a spiritual attitude meaning, to question their self-centeredness and
Albert Ellis 167

have distinct social interest. It encourages flexible thinking, emoting,


and acting.
Are these and other indirect methods of interrupting clients’ dys-
functional thinking–feeling-and acting inefficient or bad? Not at all!
Steven Hayes presents evidence that they work, and, as I say above,
REBT also uses practically all of them, and has done so for a number
of years (DiGiuseppe & Muran, 1992; Ellis, 1973, 1994). But REBT
also uses considerable active-directive Disputing of destructive Be-
liefs, to which Steven Hayes is opposed. Because REBT does most of
what ACT does and because it vigorously Disputes disturbing IBs, too,
I naturally think that it is more effective than ACT. But that remains
to be experimentally shown. Meanwhile, I definitely think, as Ciarro-
chi, Robb, and Godsell nicely say in their papers (2005), that REBT
can productively be integrated with ACT. Let’s try it and see!
Hayes (2005) concludes his article with ‘‘Effectiveness, not just logic,
is the issue.’’ Agreed! He recommends that if defusing and direct expe-
rience replace disputation and if believing in-context replaces belief,
REBT and ACT may be integrated. Fine. REBT, unlike some other
CBTs, has always included defusion, direct experiencing, and believ-
ing-in-context. But it also effectively includes empirical and logical dis-
putation of dysfunctional beliefs. Therefore, I hypothesize, it is more
likely to be both quickly and profoundly effective than ACT. Not only
can it be integrated with ACT as it is practiced today, but I think that
ACT would benefit by adding some of the REBT forms of logical and
empirical Disputing to its methods. Again, let us experiment and see.

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