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Cogn itive Therapy and Research, VoL 4, No . 4, 1980 , pp . 3 25 -34 0

Ra tional-Em otive Therapy and Cognitive BehaviorTherapy: Similarities and Differenc esAlbert EllisInstitute fo r Rational-Emotive Therapy, New York

General or nonpreferential rational-emotive therapy (RED is synonymouswith cognitive behavior therapy (CBT). Specialized or preferential RET,however, differs from CBT in several ways. Cognitively, it has apronounced philosophic emphasis, includes a humanistic-existentialist out-look, strives for pervasive and long-lasting rather than symptomaticchange, tries to eliminate all self-ratings, stresses antimusturbatory ratherthan antiempirical disputing methods, recognizes the palliative aspects o fcognitive distraction, discourages problem solving that is not accompaniedby changes in clients" basic belief system, and emphasizes secondary aswell as primary symptoms of emotional disturbance. Emotively, it stressesthe discrimination of appropriate from inappropriate emotions, emphasizesmethods of working directly with and on emotions, encourages forcefulemotive interventions, and uses relationship procedures that heavily stressunconditional rather than conditional positive regard. Behaviorally, itfavors penalization as well as reinforcement, is partial to in vivodesensitization and flooding, and makes sure that skill training is donewithin a philosophic framework of trying to help clients make basic changesin their irrational beliefs.Rational-emotive therapy (RET) and cogni t ive behavior therapy (CBT) areboth s imilar and di f ferent ; and to d ispel some of the exis t ing confusion inthis regard (Lazarus, 1979; Ma ho ney , 1979; M eiche nba um , 1979), I shallt ry to present in th is ar t ic le som ething o f a sys temat ic out l ine of the i r mainsimilari t ies and differences. Let me first say what I have tr ied to make clearbe for e (Ell is & Whiteley, 1979): that w hat I call general o r u nprefere ntialRE T is synon ym ous wi th CBT , w hi le what I have ca lled e legant RET, b utwhat m ay be more o bject ively be ca l led preferent ial RE T, d i f ferssignificantly from CB T .in several im por tant respects.

3250147-5916/80/1200-0325503.00/0 1980 Plenum Publishing Corpora t ion

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326 EllisPreferential RET I shall define as that kind of rational-emotive

therapy that RET pract i tioners usual ly prefer to use , par ticular ly withrelatively bright, neurotic, and reasonably well-motivated clients because,they hypo thesize, it is m or e efficient, thoro ughg oing, self-maintaining, andproduc t ive o f "deep" or "pervas ive" persona l i ty change than i s genera lRET. I t i s their therapy of choice, and i t i s a kind of RET that they wil lo f ten choose not to use when res tr icted condi t ions of therap y a nd /o r thelimited resources of clients ma ke it unfeasible o r impractical . Preferen tialRE T is a lways a form of general RET or CB T, bu t the la t ter m ay, and of tendoes , include few aspects of the former . When, in this paper , I refer to RE Twithout any modif ier , I only mean preferential RET; when I refer to CBTand general RET (which, again, I v iew as synonymous) , I mean them asmore generic terms that potentially but not necessarily include preferentialRET. Let me now out l ine some s ignif icant dif ferences between CBT and(preferential) RET under three major headings: cognitive, emotive, and be-havioral differences.

C O G N I T I V E D I FF E R E N C E S B E T W E E N R E T A N D C B TSome of the main cogni t ive d i f fe rences be tween RET and CBT

include the following.Philosophic Emphasis. CBT of course emphasizes cogni t iveprocesses , but i t does not have a specif ic phi losophic emphasis , as RETdoes. Me ichenb aum (1977), one of the leading propone nts of CB T, coversmany techniques, but he significantly omits any stress on a distinctlyphi losophic ou t look . P ET , on the o ther hand , emphas izes tha t hum ans a reborn (as well as reared) as philosophers (Ellis , 1962, 1973a) and that theyare nat ura l scientists (Kelly, 1955), crea tors o f me aning ( Fra nkl , 1966), andusers of rational means to predict the future (Friedman, 1975). One of i tsmain goals, therefore, is to help clients make a profound philosophicchange that will affect their future as well as their present em otio ns and

b e h a v i o r s .To this end, R ET tr ies to help people comprehend and accept severalideas that are sti ll revolu tionary in ou r culture: (1) They largely (thoug h no texclusively) create heir Own em otiona l disturbances b y stron gly believing inabsolutist ic, irrational beliefs. (2) Having a distinct measure of self-deter-minat ion or " free wil l ," they can act ively choose to dis turb or undis turbthemselves. (3) To change, they had better actively work at modifying theirthoughts , feelings, and behav iors . (4) I f they decide to pr ofo un dly changeone major ph i losophy , they may he lp mo di fy many of thei r own emot iona land behavioral reactions. (5) They will usually find a philosophy of

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Rational-Emotive Therapy 327long-range hedonism m ore heal thful and product ive of happiness than oneof short-range hedonism. (6) A scientific rather than than an unscientific,devout ly re l igious , or myst ical ou t look is likely to br ing them greateremotional heal th and sat isfact ion.

As I hav e sho wn (Ellis, 1962, 1971a, 1971b, 1973a, 1973c, 19 74 a) an das Raimy (1975) has emphasized, a l l therapy techniques , when they areeffect ive , probably work because c l ients , wi t t ingly or unwit t ingly, changetheir underlying congitions, ideas, assumptions, or philosophies. RET triesto help them specifically to see wha t are their self-defeating v iews, toquestion and challenge these, and to surrender them for more self-helpingor happiness-producing out loo ks. C BT m ay also include this R ETphilosophic appro ach, but i t ma y not . In RET , i t i s centra l ra ther thanopt ional or per ipheral to personal i ty change.Humanistic Outlook. Not only is RET phi losophical but i t includesthe specif ic exis tent ia l -humanis t ic out look of some other therapeut icschools (Ellis , 1962, 1973a). To some degree, i t incorporates the views ofAlfred Adler , Kurt Goldste in , Karen Homey, Viktor Frankl , Car l Rogers ,and other humanistic theorists. This view sees people as holist ic, goal-directed individuals who have importanc e in the w orld jus t because the y arehum an and alive; i t unco ndition ally accepts them with their l imitations; andit particularly focuses upon their experiences and values, including theirself-actualizing potentiali t ies. At the same time, RET favors ethicalhumanism, the ph i losophy of the Amer ican Humanis t Assoc ia t ion , whichencourages people to live by rules emphasizing hum an interes ts over theinteres ts of inanimate nature , of lower animals, or of any assum ed n aturalorder or dei ty . This out lo ok acknowledges people only as hum an, and in noway as superh uma n or subh um an. I t hypothesizes that devo ut fa i th insuprahuman ent i t ies and powers a lmost a lways leads to poor emotionalheal th an d to decreased long-range happiness . Al though CB T ( l ike behaviortherapy or BT) is usual ly humanis t ical ly or iented, i t does not have to be,while a humanis t ic out look is in t r ins ic to RET.Goals and Purposes. While RET, l ike CBT, is of ten interes ted in ,or at least will sett le for, symptom removal, i t primarily strives for deep-seated emot iona l and behaviora l change . I t works fo r - -bu t , o f course , doesnot a lways aeh ieve- -a remarkably new psycholog ica l set on the par t o f i t sclients that will enable them not only to feel better and be relieved of theirpresent ing symptoms but a lso to br ing a radical ly revised out look to a l lnew, present and future , s i tuat ions that will semiautomatical ly help them tostop disturbing themselves, in the first place, or to quickly undisturbthemselves, in the second place.This new out look or set for which RET strives includes clients 'acquiring philosophies of self-interest , self-direction, toleran ce o f self and

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o the r s , a ccep tance o f un ce r ta in ty , f l ex ib il i ty , s c ien t if i c th ink ing , r i sk -tak ing , an d com m itm en t to v i t a l in te re s ts (E ll is , 1973a, 1979a ). R E Thypo thes ize s tha t i f c l i en ts a ch ieve th i s k ind o f a chang ed pe r spec t ive , th eyw ill m i n i m a l ly c re a t e p r es e n t a n d f u t u re " e m o t i o n a l " p r o b l e m s .

L a c k o f Se lf -R a ti ng o r o f Eg o . R E T d i f f e r s s i g n i f i c a n t l y f r o mb e h a v i o r t h e r ap y , f r o m c o g n it iv e b e h a v io r m o d i f i c a t i o n , a n d f r o m a l m o s ta ll o th e r hum anis t i c -ex i s ten t ia l the rap ie s in tha t i t does n o t e s p o u s e p o s i t i v es e lf - ra t in g : o f c l ie n t s a cq u i r i n g w h a t i s o f t e n c a l le d " s e l f - c o n f i d e n c e " o r" s e l f - e s t e e m . " L i k e t h e s e o t h e r th e r a p i e s , i t e m p h a s i z e s t h e h a r m o fs e l f - d o w n i n g o r s e l f - d i s e s t e e m , b u t i t t a k e s t h e s o m e w h a t s p e c i a l p o s i t i o nt h a t a ll r a ti n g s o r e v a l u a t i o n s o f t h e s e l f t e n d t o b e m i s t a k e n a n di l leg i tima te . I t ho lds , ins tead , tha t a l thou gh peo p le b io log ica l ly and soc ia l lys t r o n g l y t e n d t o r a t e t h e m s e l v e s a s w e l l a s t h e ir a c t s a n d p e f o r m a n c e s , t h e yc a n le a r n t o o m i t t h e f i r s t a n d t o s t ic k o n l y w i t h t h e s e c o n d r a t i n g . T h a t i s,t h e y c a n s e t u p g o a l s a n d v a l u e s a n d t h e n o n l y r a t e w h a t t h e y d o i n t e r m s o fw h e t h e r i t h e l p s t h e m t o a c h i e v e t h e s e g o a l s , w i t h o u t g i v i n g a n y g l o b a lr a t i n g t o t h e i r " s e l v e s " f o r t h e a c h i e v e m e n t o r n o n a c h i e v e m e n t o f s u c hgoa ls (El l is, 1976a ; E l lis & A br ah m s, 1978; E l l is & Grieg er , 1977; E l l is &Harpe r , 1975) .

V a r io u s k in d s o f C B T m i n c l u d i n g t h e t e ch n i q u e s o f G o l d f r i e d a n dD a v i s o n (1 97 6), M a u l t s b y (1 9 7 5 ), M e i c h e n b a u m ( 1 97 7 ), a n d R i m m a n dM a s t e rs 1 9 7 4 / 1 9 7 9 ) - - t e a c h r a t i o n a l co p i n g s t a t e m e n t s , s u c h a s , " I a mg o o d b e c a u s e I e x i s t " o r " E v e n t h o u g h I fa il , I a m still a g o o d p e r s o n . " B u tt h e p h i l o s o p h i c a l r a t i o n a l e f o r h o l d i n g t h e b e l i e f " I a m n e i th e r g o o d n o rb a d , n o r c a n I le g i t im a t e l y r a t e m y s e l f a s a t o t a l p e r s o n a t a ll , e v e n t h o u g hs o m e o f m y tr a it s a r e g o o d ( e ff i ci e n t) o r b a d ( i n e f fi c ie n t ) f o r s o m e o f m ym a i n p u r p o s e s " c a n p r o b a b l y n o t b e s h o w n t o c l i e n t s w i t h o u t a f a i r l ys o p h i s t i ca t e d a n a ly s i s a n d s o c r a t i c - ty p e d i a l o g u e t h a t i s i n d i g e n o u s t o R E T .U se o f H u m o r . C B T , a s w el l a s c e rt ai n o t h e r f o r m s o f t h e r a p y - - s u c ha s F a r re l ly a n d B r a n d s m a ' s (1 97 4) p r o v o c a t i v e t h e r a p y - - m a y i n c lu d eh u m o r , o r r e d u c in g ir r a t i o n a l i d e a s t o a b s u r d i t y , a s a t h e r a p e u t i c m e t h o d .I n p r i n c i p l e , h o w e v e r , R E T h y p o t h e s i z e s t h a t a l m o s t a l l n e u r o t i cd i s t u r b a n c e s t e m s f r o m t a k i n g t h i n g s t o o s e r i o u s l y m f r o m d e m a n d i n g ,c o m m a n d i n g , o r m u s t u r b a t i n g a b o u t o n e ' s g o a l s - - a n d s t a t e s t h a t o n e o ft h e m a i n a n t i d o t e s t o t h is k i n d o f ir r a t io n a l t h i n k i n g i s t h e s t r o n gt h e r a p e u t i c u s e o f a se n s e o f h u m o r . C o n s e q u e n t l y , R E T s tr e ss e s ( t h o u g hd o e s n o t m a n d a t e ) t h e u s e o f h u m o r , i n cl u d in g p a r a d o x i c al i n t e n ti o n ,e v o c a t i v e l a n g u a g e , i ro n y , w i t, c a r t o o n s , a n d r a ti o n a l h u m o r o u s s o n g s(Ellis , 1977a, 1977b).

Ant i m us t urba t ory Techn i ques . C B T p r a c t i ti o n e r s m e . g . , B e c k (1 9 76 ),M a u l t s b y ( 19 7 5) , a n d G o l d f r i e d a n d D a v i s o n ( 1 9 7 6 ) m o f t e n e m p l o ye m p i r i c a l a r g u m e n t s t o s h o w c l i e n t s h o w t o s u r r e n d e r t h e i r m i s p e r c e p t i o n s

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Rational-Em otive Therapy 329of r eal i ty , and even W ol pe (1978) advo ca te s he lp ing c l ien t s to chan ge the i ru n r e al is ti c , a n ti e m p i r i c a l p e r c e p t i o n s . G o i n g b e y o n d t h i s, h o w e v e r , R E Th y p o t h e s i ze s t h a t m o s t a n t i e m p i r i ca l s t a t e m e n t s b y w h i ch p e o p l e d i s t u r bt h e m s e l v e s s t e m f r o m o v e r t o r i m p l i c i t musts: f r o m a b s o l u t i s t i c p r e m i s e st h at h u m a n s bring to m a n y s it u a ti o n s a n d t h a t t h e n a l m o s t c o m p e l t h e m t omispe rce ive the se even ts .

T h u s , i f y o u b e g in w i th th e i r r a ti o n a l p r e m i s e " I must n o t d i ed r a m a t i c a l l y in a n a ir p l a n e a c c i d e n t , " y o u w i ll e a s il y t e n d t o m a k e s e v er a lan t iempi r ic a l conc lus ions , such a s : (1 ) "The re i s a good chance t h a t t h ep lane I f ly in w il l ge t in to an ac c id en t , " (2) " I f I do g e t in an a i r c ra sh , i t w il lbe aw fu l ( tha t i s, m or e than 100070 inco nv en ie n t ) ! " (3) " I can't stand e v e nt h e t h o u g h t o f f l y i n g ! " (4 ) " E v e r y t h i n g c o n n e c t e d w it h a i rp l a n e s - - e v e n ap h o t o o f a p l a n e m i s e x c e p t io n a l ly d a n g e ro u s a n d h o r r i b l e ! " I f , o n t h ec o n t r a r y , y o u st a r t w i t h t h e r a ti o n a l p r e m i s e " I d e f i n it e l y d o n ' t w a n t t o d i ein a n a i rp l a n e c r a sh , b u t i f I d o , I d o ! " y o u w i ll m o s t p r o b a b l y n o t m a k esuch an t iempi r ica l conc lus ions and wi l l e a s i ly s ee tha t the re i s l i t t l e chanceof yo ur ge t t ing k i l l ed in a com m erc ia l f l igh t (E l l is & H arp e r , 1975 ; E l li s &White ley , 1979) .

B e c a u s e i t h y p o t h e s i z e s t h e e x i s t en c e o f u n d e r l y in g musts a n d o f w h a tH o r n e y (1 9 65 ) c al le d " t h e t y r a n n y o f th e s h o u l d s , " R E T n o t o n l y t ri es t or ip up c l i en t s ' an t iempi r ic a l , un rea l i s t i c s ta tements bu t a l so r evea l s andd i s p u t e s t h e u n d e r l y i n g musturbatory p r e m i s e s o u t o f w h i c h t h e s es t a te m e n t s u s u a l l y a r is e . I n t h is re s p e c t , R E T m a y b e s a id t o b e " d e e p e r " o rm o r e " r a d i c a l " t h a n r e la t e d C B T p r o c e d u r e s.

Disputing Techniques. R E T , l i k e C B T , e m p l o y s m a n y c o g n i t i v em e t h o d s , i n c l u d i n g t h e t e a c h in g o f r a t io n a l o r c o p i n g s e l f -s t a te m e n t s ,c o g n i ti v e d i s t r a c t i o n , t h o u g h t s t o p p i n g , b i b l i o t h e r a p y , s e m a n t i c a n a l y s i s,mode l ing , image ry , and p rob lem so lv ing (E l l i s , 1969 , 1976b , 1978b ; E l l i s &Ab rahm s , 1978 ; E l li s & Gr iege r , 1977 ; E l li s & Knau s , 1977). Co ns id e rab lym o r e t h a n C B T , h o w e v e r , i t s p e ci al iz e s i n t w o a c t iv e f o r m s o f d i s p u t in g : (1 )t h e t h e r a p i s t ' s v i g o r o u s l y d i s p u t i n g o r d e b a t i n g c l i e n t s ' i r r a t i o n a l t h i n k i n ga n d ( 2 ) t h e t h e r a p i s t ' s t e a c h i n g c l i e n t s h o w t o d o t h e i r o w n s e l f - d i s p u t i n gand se l f -deba t ing , so tha t they in te rna l iz e the ques t ion ing , cha l leng ing ,s k e p ti c al m e t h o d o f s c ie n c e a n d u s e it to s u r r e n d e r t h e ir p r e s e n t a n d f u t u r eabso lu t i s t i c cogn i t ions (Phadke , 1976) .

T h i s i s n o t t o s a y t h a t R E T p r i m a r i l y o r e x c l u si v e ly c o n s i st s o f a r g u i n gw i th c li en t s a n d s h o w i n g t h e m h o w t o r a t i o n a l l y a r g u e w i t h t h e m s e l v e s mw h i c h h a s b e e n w r o n g l y im p l i e d b y c ri ti cs s u c h a s L a z a r u s ( 1 97 9 ), M a h o n e y(1974 , 1979) , and Me ichenbaum (1977 , 1979) . Of ten , REP prac t i t ione r sh a rd l y u s e d i s p u t a t i o n m a s w h e n t h e y s e e y o u n g c h i ld r e n, m e n t a l ly r e t a rd e di n d iv i d u al s , o r s e v e r e l y p s y c h o t i c i n d i v i d u a ls w h o a r e h a r d l y a m e n a b l e t oS o c r a t i c - t y p e d i a l o g u e s a n d w h o c a n b e m o r e e f f i c i e n t l y r e a c h e d b y

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teaching them rational coping statements. Whenever feasible, however,RET favors active disputation for several reasons: (1) This is a highlydemocrat ic proc edure that avoids indoctr inating c lients with the therapis t ' s"r ati on al " beliefs. (2) I t helps clients ma ke their own generalizations, whichmay lead to many and more profound emotional and behavioral changes .(3) I t appears to help clients not only achieve but also sustain theirimp rovem ent (thoug h this hypothe sis is yet to be clearlyte sted). (4) I t show sclients how to d ispute the irrationalities of their relatives, fr iends, a ndassociates, and frequently to help these people and the clients ' relationshipswith them (Ellis, 1957/1975, 1973a).

Recognition of Cognitive Palliative Methods. Like CBT, RETemploys many cognitive distraction methods, such as teaching clients to useJacobsen 's (1958) progress ive muscle re laxat ion technique or Benson 's(1975) relaxation response. All these methods work at t imes, help clients totemporar i ly s top worrying, and thereb y faci li ta te behavioral change. RET ,because i t focuses on the philosophies that ofte n underlie cognitive-behavioral meth ods, recognizes how ever that cogni tive dis t raction meth odsare a lmost a lways pal l ia t ive , for they s idetrack people momentar i ly f romtheir self-defeating views instead o f helping the m truly to surren der theseviews. Mo reove r , there is the danger that , in feeling "g o od " or " re l ax ed "as a result of employing cognitive distraction, many clients may stopwork ing at their underlying irrational beliefs and m ay ther efo re preventthemselves f rom making the thoroughgoing changes of which they arecapable . RE T pract it ioners , therefore , use dis tract ion me thod s withcaut ion, som etimes del iberate ly omit them, and encourage c l ients to e mp loythem in addition to more pene t ra t ing and profound methods of cogni t ivebehavior therapy.Problem-Solv ing Methods . CBT impor tan t ly employs prob lem-solving me tho ds of treatm ent (Hale y, 1977; Spivack, Platt , & Shure, 1976;D'Z uril la & Go ldfrie d, 1971), while RET disco urages such problem-s olvingat wh at it calls A (activating experiences in clients' lives) until afteror at leastalong with clients ' work to undermine and change B (their irrational beliefsab ou t wh at is happe ning at A). Thu s, if at point A (activating experience)your partner is giving you a hard t ime, and you are indecisive at point C(emotional and behavioral consequence) abo ut whether or not to leave himor her, a typical CBT solution to this problem will be to have the therapistf igure out w ith you how y ou can change your par tner, reorganize thecondi t ions under w hich you w ork with him or her, form a new par tnershipwith someone else, etc. Instead, RET will f irst explore what you are tell ingyou rse l f - -a t B , your be l ief sys tem wt o m ake you rse l f indecisive, and willturn up such irrational beliefs as "I m u s t make a perfect decision, else I amcontempt ib le ! . . . . I can ' t s tand making a d i sadvantageous dec is ion!" and" I t ' s awfu l i f I lose my par tner comp le te ly !"

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Rational-EmotiveTherapy 331O n c e i t h e l p s y o u t o c l e a r l y s e e a n d t h e n t o d i s p u t e a n d s u r r e n d e r

t h e s e b a s i c i r ra t i o n a l it i e s, R E T t h e n w i ll t r y t o h e l p y o u w o r k o u t a b e t t e rs o l u t i o n t o t h e d i f f i c u l t i e s w i t h y o u r p a r t n e r t h a t e x i s t a t p o i n t A . F o rd i s t u rb e d p e o p l e a lm o s t a l w a y s h a v e , f i r st , p r a ct ic a l p r o b l e m s ( e .g . , " H o wc a n I g e t a l on g b e t t e r w it h m y p a r t n e r ? " ) a n d e m o t i o n a l p r o b l e m s , o rp r o b l e m s a b o u t p r o b l e m s ( e . g . , " H o w c a n I r e f u se t o s e r io u s ly d e p re s s o ra n g e r m y s e l f e v e n i f t h e p r o b l e m w i t h m a y p a r t n e r n e v e r g o e s a w a y ? " ) .W h e r e C B T f r e q u e n t l y c o n c e n t r a t e s o n p ra c t ic a l p r o b l e m s o l vi n g , R E Tm u c h m o r e f r e q u e n t l y f o c u s e s o n s o lv i ng t h e e m o t i o n a l p r o b l e m a b o u t t h ep r a c t i c a l p r o b l e m - - a n d t h e n ( i f r e q u i r e d ) h e l p i n g t h e c l ie n t w i t h t h e o r i g in a ld i f f i c u l t y .

T h e C o n c e p t o f D i s c o m f o r t A n x i e t y . M o s t p s y c h o t h e r a p i e s , i n c l u d in gC B T a n d R E T , d e a l l a rg e l y w i t h c l i e n ts ' e g o a n x i e t y : o n t h e i r d o w n i n gt h e m s e lv e s a s t o t a l h u m a n s w h e n t h e y a c t i n c o m p e t e n t l y a n d / o r a r ed i s a p p r o v e d o f b y s ig n i f i c a n t o t h e r s . R E T , i n a d d i t i o n , m a k e s a sp e c i ale f f o r t t o w o r k w i th c l i en t s ' d i s c o m f o r t a n x i e t y o r l o w f r u s tr a t i o n t o l e ra n c e .D i s c o m f o r t a n x i e ty i s e m o t i o n a l h y p e r t e n s i o n t h a t a ri se s w h e n p e o p l e f e el( I ) t h a t t h e ir li f e o r c o m f o r t i s t h r e a t e n e d , (2 ) t h a t t h e y m u s t n o t f e e lu n c o m f o r t a b l e a n d have t o f ee l a t ease and (3 ) tha t i t i s awfu l o rc a t a s t ro p h i c ( r at h e r t h a n m e r e l y in c o n v e n i e n t o r d i s a d v a n t a g e o u s ) w h e nt h e y d o n ' t g e t w h a t t h e y s u p p o s e d l y m u s t ( E l l i s , 1 9 7 8 b ) .

W h i l e a c t i v e - d i r e c t i v e l y d e a l i n g w i t h e g o a n x i e t y , R E T d e l i b e r a t e l yl o o k s f o r m a n i f e s t a ti o n s o f d i s c o m f o r t a n x e i t y a n d r e v e a ls a n d d i s p u t e s t h ei r ra t i o n a li t ie s t h a t l ie b e h i n d i t. B e c a u s e o f i ts b a s i c p h i l o s o p h y o fl o n g - r a n g e r a t h e r t h a n s h o r t - r a n g e o f h e d o n i s m , i t t e n d s t o b e m o r e s p e c i fi ca n d s t r o n g e r f o e o f l o w f r u s t r a t i o n t o l e r a n c e t h a n a r e m o r e g e n e r a l f o r m so f C B T .

S e c o n da r y S y m p t o m s o f D i stu r ba n c e. T h e t h e o r y o f R E T s a ys t h a tn o t o n l y d o p e o p l e t e l l t h e m s e l v e s b a s i c i r r a t i o n a l b e l i e f s ( B ) a b o u t t h ea c t i v a t i n g e x p e r i e n c e s ( A ) i n t h e i r l i v e s a n d t h e r e b y b r i n g o n d i s t u r b e de m o t i o n a l a n d b e h a v i o r a l c o n s e q u e n c e s ( C ) , b u t b e c a u s e h u m a n s h a v e ap r o n o u n c e d b i o s o c i al t e n d e n c y t o o b s e r v e a n d e v a l u a te v i r tu a l ly e v e r y t h in gi n t h e i r l iv e s, i n c l u d i n g t h e i r e m o t i o n a l r e a c t i o n s , t h e y a l s o se e , t h i n k a b o u t ,a n d a p p r a i s e th e i r d i s t u r b e d f e e li n g s a n d b e h a v i o r s - - a n d i n t h e p r o c e s s o fmus t urba t i ng a b o u t th e ir p r i m a r y s y m p t o m s t h e y o f t e n c re a t e se c o n d a r ys y m p t o m s , o r d i s tu r b a n c e a b o u t d i s tu r b a n c e ! T h u s , b y te ll in g y o u r s e l f , " Im u s t s u c ce e d a t t h is t a s k ! " y o u c a n m a k e y o u r s e l f a n x i o u s, a n d b yc o n v i n c in g y o u r s e l f , " I s h o u l d n o t m a k e m y s e l f a n x i o u s , " y o u c a n p r o d u c et h e s e c o n d a r y s y m p t o m o f a n x i e t y a b o u t a n x i e ty . Y o u m a y a ls o , a t t i m e s ,p r o c e e d t o a t h i r d l ev e l: m a k e y o u r s e l f a n x i o u s a b o u t b e i n g a n x i o u s a b o u tb e i n g a n x i o u s !

R E T , m o r e s o t h a n C B T , s p e c if ic a l ly l o o k s f o r s e c o n d a r y a n d t e r t ia r ys y m p t o m s o f d i s t u r b a n c e , s h o w s c li en ts h o w t h e y c r e a te t h e s e s y m p t o m s ,

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a n d i n d ic a te s w h a t t h e y c a n d o t o e l i m i n a te p r i m a r y , s e c o n d a r y , a n dt e r ti a r y s y m p t o m s . E s p e c i a ll y i n t h e c a s e o f s er i o u s p h o b i a s , s u c h a sa g o r a p h o b i a , RE T w o r k s w i t h o r ig i n a l f ea r a n d , e s p e ci a ll y , t h e f e a r o f f e a r :t h e h o r r o r a b o u t the or igina l fear (El l i s , 1979a) .Selec t iv i ty o f Techniques . L i k e C BT , R E T is e x c e p t i o n a l ly e le c ti c i ni ts m e t h o d s o f t r e a tm e n t , a n d a l t h o u g h i t f a v o r s c o g n i t io n , i t a l s o t ri es t oe n c o u r a g e p e r s o n a l i ty c h a n g e t h r o u g h e m o t i v e a n d b e h a v i o r a l m e t h o d s :r e co g n i z in g t h a t i f p e o p l e f o r c e t h e m s e l v e s t o a c t a n d / o r f ee l d i f f e r e n t ly ,t hey f requ en t ly will b r i ng ab ou t cogni t ive m od i f i ca t i on (E l li s , 1968, 1970a ,1 97 9b ; W o l f e & Br a n d , 1 97 7). R E T , h o w e v e r , h y p o t h e s iz e s t h a t e f f i c i encyis a n im p o r t a n t a s p e c t o f t h e r a p y a n d t h a t , t o a c h i e v e m a x i m u m e f f i c a c ya n d m i n i m u m h a r m w i t h th e i r cl ie n ts , th e r a p i s ts h a d b e t t e r e m p l o y ah igh ly sel ec ti ve ra the r t han an i nd i sc r imina t i ve ly ec l ec ti c use o f va r iou sm e t h o d o l o g i e s .

F o l l o w i n g it s p h i l o s o p h y o f t h e r a p e u t i c e f f i c ie n c y , RE T f a v o r s in v i v od e s e n s it iz a ti o n a n d f l o o d i n g h o m e w o r k a s s ig n m e n t s , a n d h y p o t h e s i z es t h a tt h e y w ill u s u a ll y r e s u lt i n m o r e p r o f o u n d a n d l a st in g p h i l o s o h i c c h a n g e sthan wi l l, s ay , imagina l a n d /o r g radu a l de sen s i t iz a t i on . I t a l so min imizest h e u s e o f c a th a r si s a n d a b r e a c t i o n o f a n g e r b e c a u s e it a ss u m e s t h a t t h e s et e c h n i q u e s h e lp p e o p l e i m m e d i a t e ly f e el b e t t e r b u t u l t im a t e l y g e t w o r s e b ye n c o u r a g i n g t h e m t o c o g n i t iv e l y r e a f f i r m a p h i l o s o p h y o f o u t r a g e w h i let h e y a r e " r e l e a s i n g " t h e ir a n g e r .R E T a l so a v o i d s th e u s e o f t r a n s p e r s o n a l , m y s t ic a l , a n d r e li g io u st e c h n i q u e s b e c a u s e , a g a i n , t h e s e m e t h o d s m a y s o m e t i m e s h e l p s o m e c l ie n tst o l iv e " b e t t e r " w i t h t h e ir d i s t u r b e d t h i n k i n g b u t a t t h e s a m e t i m e i n te r f e r ew i t h t h e f u l l d e v e l o p m e n t o f f l ex i b le , o p e n , a n d s c ie n ti fi c a t t i t u d e s - - w h i c h ,a c c o r d i n g t o RE T , a r e c o r e c h a r a c te r is t ic s o f o p t i m u m a n d s u s t a in e dmen ta l hea l t h (E l li s , 1970b , 1972). R ET , t hen , b ecau se o f i ts ba s i ca s s u m p t i o n s a b o u t w h a t r e a l l y c o n s t i t u t e s e m o t i o n a l h e a l t h a n dd i s t u r b a n c e , i s m o r e s e l e c t i v e i n c h o o s i n g t h e r a p e u t i c m e t h o d s t h a n i sg e n e r a l CBT . ( L e t m e n o t e , i n p a s s i n g , t h a t o n e o f t h e m a i n d i f f e r e n c e sb e t w e e n RE T a n d L a z a r u s ' s ( 1 9 7 6 ) m u l t i m o d a l t h e r a p y i s t h a t t h e l a t t e rs o m e w h a t c o m p u l s i v el y u s es a ll th e m a i n t e ch n i q u e s i n t h e B A S I C I D m o d e lwi th v i r t ua l l y a ll cl ien t s a ll o f t he t ime , whi l e R ET m or e se l ect ive ly use ss o m e o f t h e s e CBT t e c h n i q u e s w i th s o m e o f t h e c li en t s s o m e o f th e t i m e . )

E M O T IV E D I F F E R E N C E S B E T W E E N R E T A N D C B T

I n p r i n c i p l e , RE T a l m o s t i n v a r i a b l y e m p l o y s e m o t i v e a n d b e h a v i o r a lm e t h o d s o f p s y c h o t h e r a p y , a n d h a s a lw a y s d o n e s o . B e c a u s e i t u n u s u a l lye m p h a s i z e s c o g n i t i v e - r a t i o n a l m e t h o d s , a n d i s s o m e w h a t d i f f e r e n t i n t h i s

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Rational-Emotive Therapy 333r e s p e c t f r o m m o s t o t h e r f o r m s o f t h e r a p y , I o r i g i n a l l y c a l l e d i t R T o rra t iona l th e rap y (E l l is , 1957 , 1957 /1975 , 1958), bu t I soon chan ged th i s toR E T o r ra t ional -emot ive t h e r a p y w h e n I r e al i ze d t h a t t h e o r ig i n a l n a m e w a slead ing c r i t ic s to s ee i t on ly ( r a the r th an in g rea t mea sure ) in r a t iona l t e rm s(E l li s & H arp e r , 1961).

A s I n o t e d i n t h e p r e v i o u s s e c ti o n o f t h is p a p e r , R E T i s n o t m e r e l y ap r a g m a t i c a p p r o a c h t o t h e r a p y t h a t e m p l o y s a n y a n d all t ec h n i q u e s t h a t" w o r k " o r t h a t g i v e g o o d , t e s te d re s u lt s; i t is a l s o a p h i lo s o p h i c s y s t em o rt h e o r y o f h u m a n n a t u r e a n d o f p e r s o n al it y c h a n g e - - a n d a s l o n g a s t h ist h e o r y s e em s v a l i d , R E T p r a c t i ti o n e r s l a rg e ly ( t h o u g h , I h o p e , n o t r ig i d ly )f o l l o w it i n t h e i r w o r k w i t h c li en t s. S o m e o f t h e m a i n t e n et s o f t h i s t h e o r yf o l l o w . ( 1 ) H u m a n s d i s t u r b t h e m s e l v e s f o r b i o l o g i c a l a s w e l l a s s o c i a l o re n v i r o n m e n t a l r e a s o n s : b e c a u s e t h e y a re n a t u r a l l y a n d e a si ly p r e d i s p o s e d t ot h i n k c r o o k e d l y , e m o t e i n a p p r o p r i a t e l y , a n d b e h a v e d y s f u n c t i o n a l l y i nr e g a r d t o t h e i r o w n g o a l s a n d v a l u e s . ( 2 ) O n c e t h e y a c q u i r e o r i n v e n ti r r a ti o n a l t h i n k i n g , t h e y s t r o n g l y an d f o r c e f u l ly h o l d o n t o i t, a n d h a v e g r e a td i f f i cu l ty in g iv ing i t up . (3) Because the i r cogn i t ions , a f fec t s , and ac t ionss i g n i fi c a n tl y i n t e ra c t a n d t r a n s a c t w i th e a c h o t h e r , o n l y a m u l t i f a c e t e dc o g n i t i v e - e m o t i v e - b e h a v i o r a l a p p r o a c h t o t h e r a p y i s l i k e l y t o h e l p t h e mo v e r c o m e t h e ir n e u r o t ic s y m p t o m s , t o m a i n t ai n e m o t i o n a l h e a lt h , a n d t os i g n i f i c a n t l y p r e v e n t t h e m f r o m d i s t u r b i n g t h e m s e l v e s a g a i n i n t h e f u t u r e .(4 ) E m o t i o n a l m a t u r i t y a n d b e h a v i o r a l e f f i c a c y l a rg e l y c o n s i s t o f w i s h in g ,wan t ing , and p re fe r r ing se l f - chosen , ind iv idua l i s t i c goa l s r a the r than ab-so lu t i s t i c a lly need ing , nece s s i t a ting , o r m us tu rba t in g ab ou t those goa l s . (5 )E f f i c i e n t - - m e a n i n g q u i c k e r , s i m p l e r , l o n g e r - l a s t i n g , a n d m o r e t h o r o u g h -g o i n g - - m e t h o d s o f p e r s o n a l it y c h a n g e ar e u s u a l ly p r e f e ra b l e t o l es se f f i c ie n t m e a n s . B e c a u s e o f i ts b e in g b a s e d o n s u c h t h e o r ie s a s t h e s e - - m o s to r a ll o f w h i c h , o f c o u r s e , m a y s u b s e q u e n tl y b e r ev is ed o r a b a n d o n e d - -R E T f a v o r s c e r ta i n e m o t i v e t e c h n i q u e s a n d d i s f a v o r s o t h e r e m o t i v em e t h o d s o f t h e r a p y w h i l e C B T i s l es s s e le c ti v e i n th i s r e s p e ct . F o r e x a m p l e :

Di scr im i na t ing App ropr i a t e f ro m I nappropr ia t e Em ot i ons . R E Te s p e c i a l l y d i s c r i m i n a t e s b e t w e e n n e g a t i v e e m o t i o n s l i k e s o r r o w , r e g r e t ,f r u s tr a t io n , a n d a n n o n y a n c e , w h i ch f o ll o w f r o m p e o p l e ' s n o t g e t ti n g w h a tt h e y desire a n d w h i c h m o t i v a t e t h e m t o t r y t o c h a n g e f o r t h e b e t t e r a nu n d e s i r e d o r o b n o x i o u s s i t u a t i o n , a n d n e g a t i v e e m o t i o n s l i k e d e p r e s s i o n ,p a n i c , r a g e , a n d f e el in g s o f i n a d e q u a c y , w h i c h ( it h y p o t h e s i ze s ) f o l l o wf r o m p e o p l e ' s n o t g e t t in g w h a t t h e y i r ra t i o n a ll y t h i n k t h e y need o r m u s thave a n d w h i c h i n t e r f e re w i t h t h e i r c o n s tr u c t i v e m o t i v a t i o n a n d a c t i o n a n du s u a l l y s a b o t a g e t h e i r d e s ir e s. U n l i k e m a n y C B T a n d e x p e r ie n t ia lp r a c t i t i o n e r s , r a t i o n a l - e m o t i v e t h e r a p i s t s d o n o t a c c e p t a n e m o t i o n a s" g o o d " m e r e l y b e c a u s e it e x is t s, is g e n u i n e , a n d h a s a c e r ta i n d e g r e e o fi n t en s i ty . I n s t e a d , R E T s p e c if i ca l ly d e f in e s " h e a l t h y " e m o t i o n s i n t e r m s o f

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c l ie n ts ' g o a ls a n d v a l u e s , a n d n o t a b s t r a c t l y in t h e ir o w n r i gh t . T h u s m a n yf o ll o w e r s o f C B T m e . g . , B e c k ( 1 9 7 6 ) - - t h i n k o f d e p r e ss i o n a s e x t re m es a d n e s s, a n d v i e w b o t h i n t e n s e sa d n e s s a n d d e p r e s s io n a s h a r m f u l s y m p -t o m s . B u t R E T s e es d e p r e s se d p e o p l e as c o m m a n d i n g t h a t t h ei r e x t r e m es a d n e ss ( w h i c h m a y b e b a s e d o n a r ea l l o ss , a n d t h e r e f o r e q u i t e l e g i ti m a t e )m u s t no t ex is t and a s the reb y i ll eg i t ima te ly ma k ing them se lves depre s sed . I tc o n s e q u e n t l y t ri es t o h e l p s u c h i n d i v i d u a l s r e m a i n a p p r o p r i a t e l y s a d b u ts u r r e n d e r th e i r i n a p p r o p r i a t e , s e l f -d e f e a t i n g f e el in g s o f d e p r e s s i o n .

D i r e c tl y W o r k i n g w i th a n d o n E m o t i o n s . L i ke C B T , R E T u s es m a n ye v o c a t i v e -e m o t i v e e x e rc i se s t h a t g i v e c l ie n t s a n o p p o r t u n i t y t o a c k n o w l e d g e ,g e t i n t o u c h w i t h , w o r k o n , a n d c h a n g e t h e i r f e e li n gs f r o m i n a p p r o p r i a t e t oa p p r o p r i a te o n e s . It p a rt i cu l a r ly e m p l o y s m y v e r s io n o f M a u l t s b y ' sra t iona l -em ot ive image ry (M aul t s by , 1971, 1975; M au i t sb y & E l l is , 1974),w h e r e cl ie n ts a r e a s k e d t o i n t en s e l y i m a g i n e o n e o f t h e w o r s t p o s s i b l e t h i n g st h a t c o u l d h a p p e n , t o l e t t h e m s e l v e s s t r o n g l y f e e l a n x i o u s , d e p r e s s e d , o ra n g r y , a n d t o d i r e c t l y w o r k o n c h a n g i n g t h e s e f e e l i n g s t o t h o s e o f s o r r o w ,d i s a p p o in t m e n t , o r a n n o y a n c e . I t a l so , m u c h m o r e t h a n d o e s C B T , c r ea t e sand use s som e enco un te r and m ara tho n te chn iqu es (E l li s , 1977c; E l li s &W hi te ley , 1979 ; W ol f e & Bran d , 1977).

A t t h e s a m e t i m e , R E T a v o i d s m a n y e m o t i v e p r o c e d u r e s , s u c h a sR e i c h i a n , g e s t a l t , b i o e n e r g e t i c , a n d p r i m a l t e c h n i q u e , t h a t s o m e C B Tp r a c t i t io n e r s - - e . g ., P a l m e r ( 1 9 7 3 ) - - u s e b e c a u s e t h e s e p r o c e d u r e s o f t e nh e l p ex a c e r b a t e r a t h e r t h a n a m e l i o r a t e f e el in g s t h a t R E T v i e w s asi n a p p r o p r a t e - - s u c h a s a n g e r a n d " s e l f - e s t e e m . "

R e l a t i o n s h i p P r o c e d u r e s . R E T , C B T , a n d a l m o s t a l l o t h e r f o r m s o fp s y c h o t h e r a p y i n v o lv e s o m e k i n d o f r e l at i o n sh i p b e t w e e n t h e th e r a p i st a n dc li e n ts , b u t R E T t e n d s t o b e m o r e s e le c ti v e t h a n C B T i n t h is r e s p e c t a n de m p h a s i ze s t h e t h e r a p i s t ' s a c c e p t i n g r a t h e r t h a n g i vi n g w a r m t h o r a p p r o v a lt o c li en t s a n d s tr es se s, t e a c h i n g t h e m t h e p h i l o s o p h y o f s e l f -a c c e p t a n c e .A l t h o u g h R E T p r a c t it i o n e r s c a n , i f t h e y w i s h , g iv e t h e ir c li e nt s e m p a t h y ,s y m p a t h y , w a r m t h , a n d e v e n l o v e, t h e y t e n d t o d o s o w i th e x t r e m e c a u t i o n :recogn iz ing tha t the the r ap i s t ' s expre s s ion o f the se f ee l ings can ea s i lyb a c k f i r e a n d h e l p c l i e n t s t h i n k t h a t t h e y a r e " g o o d p e o p l e " b e c a u s e th et h e r a p i st a p p r o v e s o f o r l o v e s t h e m . C l i e n ts t h e r e b y t e n d t o a c q u i r ec o n d i t i o n a l r a t h e r t h a n u n c o n d i t i o n a l s e l f - ac c e p t a n c e t h a t R E T f a v o r s .

F o r c e f u l E m o t i v e I n t e rv e n t i o n s. B e c a u s e i t t h e o r iz e s t h a t h u m a n s a r ef o r th e m o s t p a r t b i o l o g i c a l l y p r e d i s p o s e d t o d i s t u r b t h e m s e l v e s a n d t op e r p e t u a t e t h e ir o w n d y s f u n c t i o n a l t h i n k i n g , e m o t i n g , a n d b e h a v i n g , a n dt h a t t h e y h a v e e n o r m o u s d i f f ic u l t y i n c h a n gi n g a n d k e e p in g c h a n g e d t h e irs e l f- d e f e a ti n g e m o t i o n a l r e a c t i o n s , R E T h o l d s t h a t i t i s o f t e n i m p o r t a n t f o rt h e r ap i s ts t o u s e a g r e a t d e a l o f f o r c e o r v i g o r i n i n t e r r u p t i n g t h e i r c l i e n t s 'p h i l o s o p h i e s a n d b e h a v i o r s ( E l l i s , 1 9 7 9 b ) . C o n s e q u e n t l y , R E T e m p l o y s

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Rational-EmotiveTherapy 335u n u s u a l l y s t r o n g r a t i o n a l c o p i n g s t a t e m e n t s t h a t h a v e a p o w e r f u l e m o t i v equa l i t y , and i t use s d rama t i c exe rc i se s , such a s i t s f amous shame-a t t ack ing exe rc i se s , to i nduce m any c l ien t s t o f l o od t hem se lves wi th po s i t i veor nega t i ve fee l ings t ha t m ay be t he rapeu t i ca l l y use fu l (E l li s, 1974b; E l li s &A b r a h m s , 1 97 8). C B T m a y , o f c o u rs e , e m p l o y th e s am e k i n d o f f o r c e f u le m o t i v e p r o c e d u r e s u s e d in RE T , b u t it t e n d s t o d o s o le ss o f t e n a n d t o d os o o n p r a g m a t i c r a t h e r t h a n t h e o r e ti c a l g r o u n d s .

B E H A V I O R A L D IF F E R E N C E S B E T W E E N R E T A N D C B TB o t h C B T a n d R E T i n c lu d e a w i d e r a n g e o f b e h a v i o r a l p r o c e d u r e s - -

i n f a c t , a l m o s t a l l t h e c o m m o n m e t h o d s t h a t a r e u s e d i n g e n e r a l b e h a v i o rt h e r a p y ( BT ) . Be c a u s e , h o w e v e r , o f th e s a m e k in d o f t h e o r e t i c a l a n dp h i l o s o p h i c a s s u m p t i o n s m e n t i o n e d i n t h e p r e v i o u s s e c t io n s o f t h i s a r t ic l e,RE T i s o n c e a g a i n m o r e s e l ec ti v e t h a n C BT i n t h is c o n n e c t i o n . T h u s i te m p h a s i z e s r e l a t i v e l y f e w b e h a v i o r a l m e t h o d s w h i l e i g n o r i n g o r d e -e m p h a s i z i n g s o m e o f t h e o t h e r s :

Reservations About Operant Conditioning. A l t h o u g h R E T o f t e nut i li zes op era nt con di t io nin g (El li s , 1969, 1973b; Ell is & A br ah m s, 1978) , i tt a k e s a s o m e w h a t s k e p t i c a l v i e w o f t h e e f f e c t i v e n e s s o f s o c i a lr e i n f o r c e m e n t , a n d e s p e c ia l ly o f k i n d a n d e n c o u r a g i n g w o r d s f r o m t h et h e ra p i s t w h e n c li en t s d o t h e " r i g h t " t h in g . F o r i f I, a s y o u r t h e r a p i s t , k e e pt elli ng y o u , " T h a t ' s g r e at ! " o r " I l i ke t h a t ! " w h e n y o u c a r r y o u t y o u r R E Th o m e w o r k a s s i g n m e n t s , y o u m a y s t a r t t o d o t h e m m a i n l y f o r m e a n d t h ep r a i se I g i v e y o u ra t h e r t h a n f o r t h e ir i n t ri n s ic r e w a r d s . M o r e o v e r , y o u m a yf a ls e ly c o n c l u d e , " B e c a u s e I a m d o i n g s o w e l l a t th i s t h e r a p y a n d b e c a u s eD r . E llis li k es m e f o r c a r r y in g i t o u t s a ti s fa c t o r il y , I a m a g o o d p e r s o n ! "Y o u m a y t h e r e b y g iv e y o u r s e l f c o n d i t io n a l r a th e r t h a n u n c o n d i t i o n a lp o s i ti v e r e g a r d o r a c c e p t a n c e , a n d f e el b e t t e r b u t r e m a i n b a s i c a ll y a sd i s t u r b e d a s e v e r .A c c o r d i n g t o R E T th e o r y , m o s t p e o p l e - - a n d , e s p ec ia ll y , m o s ts e r io u s l y d i s t u r b e d p e o p l e m a r e a l r e a d y , b e c a u s e o f th e i r b i o l o g i c a l n a t u r eand t he i r soc i a l ( r e in forcement ) upbr ing ing , too r e i n f o r c e a b l e , tooc o n d i t i o n a b l e , a n d too s u g g es ti bl e. T h e y m u c h t o o e a si ly d o t h e " r i g h t "t h i n g s f o r t h e w r o n g r e a s o n s . R E T , t h e r e f o r e , i s o n e o f t h e f e w b e h a v i o rthe rap i e s t ha t consc ious ly t ry t o he lp c l i en t s acqu i re a ba s i c ph i l osophico u t l o o k t h a t m a k e s th e m m a x i m a l ly n o n d e p e n d e n t , i n d i v id u a l is t ic , a n dn o n c o n f o r m i s t . A l t h o u g h i t o f t e n ( f o r p r a c t i c a l p u r p o s e s ) a d o p t sSkinne r i an me thods , i t a l so re t a ins a fundamenta l i nd iv idua l i s t i c -h u m a n i s t i c o u t l o o k t h a t e n c o u r a g e s c l i e n t s t o b e l e s s c o n d i t i o n a b l e b yout s ide ( soc i a l ) i n f l uences and more se l f -condi t i onab l e and se l f -con t ro l l i ng .

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336 EllisI n th i s re s p e c t , it i s a g a i n m o r e s e l e c t iv e i n i t u s e o f t e c h n i q u e s t h a n s o m e o ft h e o th e r m o d e s o f C B T t e n d t o b e .

Use of Penalization. A l t h o u g h c o n s i d e r a b l e r e s e a r c h t e n d s t o s h o wt h a t r e i n f o r c i n g p e o p l e f o r t h e i r " g o o d " b e h a v i o r w o r k s b e t t e r t h a np e n a l iz i n g t h e m f o r t h e i r " p o o r " b e h a v i o r ( S k in n e r , 1 9 71 ), I h a v e n o tf o u n d t h i s t o b e c o n s i s t e n t ly t ru e i n c l in i c a l p r a c t i c e - - e s p e c i a l l y w i t h a d u l tD . C . ' s ( d i f f i c u l t c u s t o m e r s ! ) w h o s e d e g r e e o f e m o t i o n a l d i s t u r b a n c e , a n de s p e c ia l ly t h ei r a b y s m a l l y l o w f r u s t r a t i o n t o l e r a n c e , a l m o s t f o r c e s t h e m t og o f o r i m m e d i a t e p l e a s u r e s r a t h e r t h a n l o n g - t e r m g a i n s . R E T p r a c t i c e h a sd i s c o v e r e d t h a t t h e s e in d i v i d u a l s o f t e n d o n o t a l t er th e i r d y s f u n c t i o n a lb e h a v i o r un l e ss t h e y g i v e t h e m s e l v e s a n i m m e d i a t e a n d s o m e w h a t d r a s t icp e n a l t y i m m e d i a t e l y a f t e r r e p e a t i n g t h i s b e h a v i o r . T h u s i n v e t e r a t e s m o k e r sf r e q u e n t l y w o n ' t s t o p s m o k i n g i f , s a y , t h e y r e i n f o r c e t h e m s e l v e s w i t hd e li c io u s f o o d e v e ry t im e t h e y d e s is t f r o m s m o k i n g - - f o r t h e y f in d , f o rp h y s ic a l a n d p s y c h o l o g ic a l r e a s o n s , c ig a r e tt e s s o " r e w a r d i n g " t h a t t h e f o o dd o e s n ' t p r o v e t h a t r e i n f o r c e a b l e . B u t i f t h e y s e v e r e ly p e n a l i z e t h e m s e l v e se v e r y s in g le t im e t h e y s m o k e - - s a y , b y b u r n i n g a $ 1 0 0 b i ll ( a n d l i g h ti n g u pt h e c i g a r e t t e w i t h i t ! ) - - t h e y u s u a l l y s t o p s m o k i n g q u i t e q u i c k l y !O n t h e b a s is o f t h e se a n d m a n y s im i l ar o b s e r v a t io n s c o n c e r n in gp e o p l e ' s lo w fr u s t r a ti o n t o l e r a n c e , R E T t h e o r y s t a te s t h a t h u m a n sf r e q u e n t l y v i g o r o u s l y h o l d t o a n d g i v e i n t o ir r a t i o n a l i d e a s , s u c h a s t h e i d e at h a t t h e y c a n h a r m l e s s l y g e t a w a y w i t h s m o k i n g , a n d t h a t h i g h ly f o r c e f u le m o t i v e - b e h a v i o r a l i n t e r v e n t i o n , s u c h a s t h e i r g i v i n g t h e m s e l v e s s t i f fi m m e d i a t e p e n a l t i e s w h e n e v e r t h e y i n d u l g e i n d y s f u n c t i o n a l a c t i v i t i e s , i so f t e n r e q u i r e d t o h e l p d e p r o p a g a n d i z e t h e m r e g a r d i n g t h e s e i r r a t i o n a l i t i e s .W h e r e a s C B T a n d B T , t h e r e f o r e , t e n d t o e m p h a s i z e b e h a v i o r a lr e i n f o r c e m e n t m e t h o d s , R E T m o r e o f t e n u t i l i z e s s e l f - p e n a l i z a t i o n .In Vivo Desensitization. B T a n d C B T t o d a y o f t e n u s e in v i vo d es en -s i t i z a t i o n r a t h e r t h a n W o l p e ' s s y s t e m a t i c d e s e n s i t i z a t i o n , w h i c h i s l a r g e l yd o n e i m a g i n a t iv e l y ( E m m e l k a m p , K u i p e r s , & E g g e r a a t , 1 97 8; W o l p e , 1 95 8,1 97 3). R E T , h o w e v e r , h a s a l w a y s f a v o r e d i n v iv o d e s e n si ti z in g h o m e w o r kass ignme nt s an d do es so m or e t han g enera l C BT (E l l is , 1962, 1979b). Th et w o m a i n h o m e w o r k a s s ig n m e n t s u t il iz e d i n R E T f o l lo w . (1 ) P e o p l e w h on e e d l e s s ly f e a r t o d o c e r t a i n t h i n g s - - s u c h a s r id e i n e l e v a t o r s o r e n c o u n t e rm e m b e r s o f th e o t h e r s e x - - a r e u r g e d t o d o s o m a n y t im e s , a n d p r e f er a b ly ina s h o r t p e r i o d o f t i m e . ( 2 ) C l i e n t s w h o h a v e l o w f r u s t r a t i o n t o l e r a n c e a n dw h o c o p o u t o f d i f fi c u l t si t u at i o n s i n o r d e r t o f ee l b e t t e r - - e . g . , q u i tu n p l e a s a n t j o b s o r r e f u s e t o v i si t d i f f i c u l t r e l a t i v e s - - a r e e n c o u r a g e d t o s t a yi n th e s e s i tu a t io n s u n t il t h e y o v e r c o m e m u c h o f th e i r l o w f r u s t r a t io nt o l e ra n c e o r d i s c o m f o r t a n x i e t y - - a n d t h e n , p e r h a p s , t o l e av e t h e s es i t ua t i ons .Flooding or Implosive Therapy. B e c a u s e o f i t s a s s u m p t i o n t h a td r a m a t i c i n t e r r u p t i o n o f c l i e n ts ' i rr a t i o n a l b e l i e f s i s o f t e n m o r e e f f e c t iv e

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Rational-EmotiveTherapy 337than gradual and less dramatic interruption of these beliefs, RET tendsmuch more than CBT to favor flooding or implosive therapy. It encouragesdisturbed individuals to engage, suddenly, implosively, and repetitively, in"dangerous" or "phobic" behaviorwnot merely to desensitize themselvesto the " pa in " of undergoing this kind of action but also to impinge on theirirrational ideas that they c a n ' t perform this behavior, that it will des t roythem if they do, that it is to o painful to bear, etc.

Sk i l l Tra in ing Procedures . Both RET and CBT employ a good manyskill training procedures, such as the teaching of assertion training, personalrelating, and sex proficiency, but RET also emphasizes the limitations ofskill training when it is used mainly in its own right and does not include abasic change in clients' irrational beliefs (Ellis, 1977d). RET practitioners,when using skill training, strongly emphasize people's first surrenderingtheir basic irrationalities (especially, horror of failure and dire need forothers' approval that blocks their acquiring assertion training, sex, andother skills) and then learning the skills themselves (Lange & Jakubowski,1976; Wolfe & Fodor , 1975, 1977). The RET approach in this respect has adifferent emphasis from that used by most other CBT practitioners(Liberman, King, DeRisi, & McCann, 1977; Masters & Johnson, 1970).

CONCLUSIONI have tried to outline in this article some of the major differences

between cognitive behavior therapy (CBT) or general RET, which I see assynonymous, and specialized or preferential RET, and to outline thesomewhat distinct theory and practice of the latter form of psychotherapy. Ihave by no means covered all the possible differences between these twooverlapping methods of therapy but have concentrated on the importantones that currently come to my mind. One of my main hypotheses is that thesystematic use of CBT or general RET will be more effective for moreclients more of the time than any form of treatment that exclusively stressescognitive, emotive, or behavioral methods. But I also hypothesize thatRET, when defined as it is in this paper and when used in its preferentialform, will also prove more effective than CBT (or than general RET) formore clients more of the time. Virtually no studies have yet been done totest this hypothesis, and it will be interesting to see what the outcome ofsuch studies will be.

REFERENCE SBeck, A. T. Cognitive therapy and the emotional disorders. New York: International Uni-

versities Press, 1976.

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338 El l isBens on , H . The relaxation response. New York: Mor row, 1975.D ' Zur i U a , T . , & G o l d f r ied , M . P r ob l em s o l v i ng and behav i o r m o d i f i ca t i on . Journal of Ab-normal Psychology, 1971 , 78, 10%126.E llis , A . O u t com e o f em pl oy i ng t h r ee t echn iques o f p s ycho t he r apy . Journal of Clinical Psy-chology, 1957, 13, 334-350.El li s, A. Ho w to l ive wi th a "n eu ro t i c . " New Y ork: Cro w n, 1 975 (Rev. ed . ) . (O r ig inal lypubl i shed, 1957. )E l li s, A . Ra t i on a l p s ycho t he r apy . Journal of General Psychology, 1958 , 59, 35-49.El l is , A. R eason and emo t ion in psycho therapy. New Y ork: L yle Stuar t ; Ci t adel Press , 1962.El li s, A . W hat r ea l ly causes therapeu t i c change? Voices, 196 8, 4(2) , 90-97.E l li s, A . A cogn i ti ve app r oach t o behav i o r t he r apy . International Journal of Psychiatry,1969, 8, 896-900.El li s, A . T he co gni t ive e l emen t in exper i ent i a l an d re l a t ionship p sycho therapy. ExistentialPsychiatry, 1970, 28, 35-52. (a)El l is , A. Th e case agains t r e l ig ion . Mensa Bulletin, 1970, No. 38, 5-6. (b)El l is , A. Theory and practice o f rational-emotive psychotherapy, Cassette rec ordin g. Ne w

York: Ins t i tu t e for Ra t ional Liv ing , 197 1. ( a)El l is , A. Growth through reason. Pa l o A l t o : Sc i ence and Behav i o r Books ; H o l l yw ood :W ilshire Books , 197 1. (b)E ll is , A . W ha t does t r ans pe r s ona l p s ycho l ogy have t o o f f e r t o t he a r t an d s c ience o f p s ycho-t he r apy? Voices, 19 72 , 8(3), 10-20. (Revised vers io n: Rational Living, 1973 , 8 ( 1 ) ,20-28.)El l is , A. Humanistic psychotherapy: The rational-emotive approach. N e w Y o r k : C r o w n ;M cG r aw - H i l l Pape r backs , 1973 . ( a)E l li s, A . A r e cog n i ti ve behav i o r t he r apy and r a t i ona l t he r apy s y nony m o us ? Rational Living,1973, 8(2), 8-1 1. (b)E l li s, A . M y ph i l o s ophy o f p s ycho t he r apy . Journal of Contemporary Psychotherapy, 1973, 6 ,13-18. (c)El l is , A. Cog ni t ive aspects of a breact ive therap y. Voices, 19 74 , 10(1), 48-56. (a)El l is , A. How to stubbornly refuse to be ashamed of anything. Casset t e r ecording. New York:Ins t i tu t e for R at iona l Liv ing , 1974. (b)El l is , A. RET abolishes most of the human ego. N ew Y or k : I n s t i t u t e f o r Ra t i ona l L i v i ng ,1976. (a)EU .is, A . Resea rch i n cogn i t i ve behav i o r t he r apy . I n D . M e i chenba um , M . M ahoney , M .G ol d f r i ed , A . T . Beck, A . E l li s, F . K anf e r , & P . W ach t e l , Cognitive behavior therapyresearch. Cassett e r eco rding. New York: In s t i tu t e for R at ion al Liv ing , 1977; El l i s , A .Fun as psychotherapy. Cas s e t t e r eco r d i ng . N ew Y or k : I n s t i t u t e f o r Ra t i ona l L i v i ng ,1977. (Also: Rational Living, 1977, 12(1), 2-6.) (a)El l is , A. .4 garland of rational songs. Son gboo k and cas se tte r eco r d ing . N ew Y or k : I n s t i t u t efor Ra t ional Liv ing , 197 7. (b)El l is , A. How to live with--and without--anger. New York: R ead er ' s Diges t Pres s, 1977. ( c)E l l is , A . Sk i l l t r a i n ing i n couns e l i ng and ps ycho t he r apy . Canadian Counsellor, 197 7, 12(1),30-35. (d)El l is , A. Cognitive techniques of sex therapy. Cas s e t t e r eco r d i ng . W as h i ng t on , D . C . :A m er i can A s s oc ia t i on o f Sex Educa t o r s , C ouns e l o r s and The r ap i s t s, 1978 . (a )El l is , A. Discomfort anxiety: A new cognitive-behavioral construct. Casset t e r ecording. NewY or k : B M A aud i o t apes , 1978 . ( b )E l l i s , A . A no t e on t he t r ea t m en t o f ago r aphob i cs w i t h cogn i t i ve m od i f i ca t i on ve r s usp r o l onge d expos u re in vivo. Behaviour Research and Therapy, 1979, 17, 162-164. (a)E l l is , A . The us e o f f o r ce i n p s ycho t he r apy . Journal oJ Contemporary Psychotherapy, 1979,10, 83-97. (b)E l l i s , A . , & A br ahm s , E . Brief psychotherapy in medical and health practice. N e w Y o r k :Spr inger , 1978.El l is , A . , & Grieger, R. Handbook of rational-emotive therapy. N ew Y or k : Sp r i nge r ,1977.

8/3/2019 RET vs CBT

15/16

R a t i o n a l - E m o t i v e T h e r a p y 3 39E l l is , A . , & H a r p e r , R. A. A guide to rational living. E n g l e w o o d C l i f f s , N e w J e r s e y : P r e n ti c e -Hall , 1961.E l l i s , A . , & H a r p e r , R. A. A new guide to rational living. E n g l e w o o d C l i f f s , N e w J e r s e y :P r e n t i c e - H a l l ; H o l l y w o o d : W i l s h i r e B r o o k s / C o l e , 1 9 7 9 .El l i s , A . , & Knans , W. Overcoming procrastination. N e w Y o r k : I n s t i t u t e f o r R a t i o n a lLiv ing , 1977.El l i s, A . , & W hi te ley , J . M. (Eds . ) . Theoretical and empirical foundations of rational-emotive therapy. Mo n t e r e y , C a l i f o r n i a : B r o o k s / C o l e , 1 9 7 0 .E m m e l k a m p , P . M. G . , K u i p e rs , A . C . M . , & E g g e r a a t , J . B . C o g n i t i v e m o d i f i c a t i o n v e r su sp r o l o n g e d e x p o s u r e in vivo: A c o m p a r i s o n w i t h a g o r a p h o b i c s a s s u b j e c t s . BehaviourResearch and Therapy, 1978 , 16, 33-41.Fa r r e l ly , F . , & B r a n d s m a , J . Provocative therapy. M il lb rae , Ca l i fo rn ia : Ce le s t i a l Ar t s , 1974 .F r a n k l , V . E . Man's search for meaning. N e w Y o r k : W a s h i n g t o n Sq u a r e P r e s s, 1 9 6 6 .F r i e d m a n , M . Rational behavior. C o l u m b i a , So u t h C a r o l i n a : U n i v e r s it y o f So u t h C a r o l i n aPress , 1975.G o l d f r i e d , M. R . , & D a v i s o n , G . S . Clinical behavior therapy. N e w Y o r k : H o l t , R i n e h a r t &

Wins ton , 1976 .H a l e y , J . Problem-solving therapy. San Franc i sco : Jo ssey -Bass , 1977 .H o m e y , K . Collected writings. N e w Y o r k : N o r t o n , 1 9 6 5 .J a c o b s e n , E . You must relax. N e w Y o r k : Po c k e t B o o k s , 1 9 5 8 .Kelly, G. The psychology of personal constructs. N e w Y o r k : N o r t o n , 1 95 5.L a n g e , A . , & J a k u b o w s k i , P . Responsible assertive behavior. Cha m pa ign , I l l ino i s : Re -search Press , 1976.L a z a r u s , A . A . Multimodal therapy. New York : Sp r inge r , 1976 .L a z a r u s , A . A . A c r i t i q u e o f r a ti o n a l - e m o t i v e t h e r a p y . I n A . E l li s & J . M. W h i t e le y ( e d s. ),Theoretical and empirical foundations of rational-emotive therapy. Mo n t e r e y ,C a l i f o r n i a : B r o o k s / C o l e , 1 9 7 9 .L i b e r m a n , R . P . , K i n g , L . W . , D e R i s i , W . J . , & M c C a n n , M . Personal effectiveness.Ch am pa ign , I l l ino i s : Resea rch Press , 1977.M a h o n e y , M . Cognition and behavior modification. Cambr idge , Massachuse t t s : Ba l l inge r ,1974.M ahoney , M . A c r i t i ca l ana ly s is o f r a t ion a l -em ot ive theo ry and p rac t ice . In A . E l l i s & J . M .Whi te ley (Eds . ) , Theoretical and empirical foundations of rational-emotive therapy.Mo n t e r e y , C a l i f o r n i a : B r o o k s / C o l e , 1 9 7 9 .M a s t er s , W . H . , & J o h n s o n , V . E . Human sexual inadequacy. Bos ton : L i t t l e , Brown , 1970 .M a u l ts b y , M . C . , J r . R a t i o n a l e m o t i v e i m a g e r y . Rational Living, 1971, 6(I) , 24-27 .Ma u l t s b y , M. C . , J r . Help yourself to happiness. N e w Y o r k : I n s t i t u t e f o r R a t i o n a l L i v i n g ,1975.Ma u l t s b y , M . C . , J r . , & E ll is , A . Technique for using rational emotive imagery. N e w Y o r k :In s t i tu te fo r Ra t iona l L iv ing , 1974 .Me i c h e n b a u m , D . Cognitive behavior modification. N e w Y o r k : P l e n u m , 1 97 7.M e i c h e n b a u m , D . D r . E l l i s , p l e as e st a n d u p . I n A . E l l is & J . M . W h i te l e y (E d s . ), Theoreticaland empirical foundations of rational-emotive therapy. Mo n t e r e y , C a l i f o r n i a :B r o o k s / C o l e , 1 9 7 9 .Pa l m e r , R . D . D e s e n s i t i z a t i o n o f t h e f e a r o f e x p r e s s i n g o n e ' s o w n i n h i b i t e d a g g r e s s i o n :Bioene rge t ic a s se r t ive t echn iques fo r behav io r the rap i s t s . Advances in BehaviorTherapy, 197 3, 4, 241-253.P h a d k e , K . M . Bull fighting: A royal road to mental health and happiness. U n p u b l i s h e dm a n u s c r i p t , B o m b a y , 1 9 7 6 .R a i m y , V . Misunderstandings o f the self. Se l f Franc i sco : Jo ssey -Boss , 1975 .R i m m , D . C . , & Ma s t e r s , J . C . Behavior therapy. New Y ork : Acad emic Press , 1979 (Rev . ed . ) . Orig inal ly publ ished , 1974.)Sk inne r , B . F . Beyond freedom and dignity. N e w Y o r k : K n o p f , 1 9 7 1 .Sp i v a c k , G . , P l a t t , J . , & Sh u r e , M. Theproblem solving approach to adjustment. Sa n F r a n -c isco: Jossey-Bass , 1976.

8/3/2019 RET vs CBT

16/16

3 4 0 E l l i s

W o l f e , J . L . , & B r a n d , E . ( E d s .) . Tw enty years o f rat ional therapy. N e w Y o r k : I n s t i t u t e f o rRa t iona l L iv ing , 1977 .W o l f e , J . L . , & Fo d o r , I . G . A c o g n i t i v e - b e h a v i o r a l a p p r o a c h t o m o d i f y i n g as s e rt i veb e h a v i o r i n w o m e n . Counseling Psychologist, 1975, 5(4), 45-52.W o l f e , J . L . , & Fo d o r , I . G . M o d i f y i n g a s s er t iv e b e h a v i o r i n w o m e n : A c o m p a r i s o n o f t h r e ea p p r o a c h e s . Behavior Therapy, 197 7, 8, 567-574.W o l p e , J . Psychotherap y by reciproca l inhibition. St a n f o r d , C a l i f o r n i a : S t a n f o r d U n i v e r s i t yPress , 1958.W o l p e , J . The practice o f behavior therapy (2nd ed . ) . New York : Pe rgamon , 1973 .W o l p e , J . C o g n i t i o n a n d c a u s a t i o n i n h u m a n b e h a v i o r a n d i t s t h e r a p y . AmericanPsychologist, 1978 , 33, 437-446.