12 January 2022
This blog is about an apparent conflict found between the premises of Rational Emotive Behavioural Therapy (REBT) and Dialectical Behavioural Therapy (DBT). Specifically, as described by an astute attendee of SMART Recovery, REBT states that a change in thinking leads to a change in actions. DBT states that one cannot think herself into new ways of acting; she can only act herself into new ways of thinking. So, which is right? Both, I believe.
Having just completed my theories of counselling psychology course, the first footing that needs examining comes from BETA, an abbreviation for the four most fundamental bases of theory in psychology (Seligman & Reichenberg, 2014). BETA stands for Behaviour, Emotion, Thought, and Action, the premise being that (at least) one of these is at the root of most theories.
A revealing fact, about our apparent contradiction, is the history of Albert Ellis’s REBT. That theory began under the name of Rational Therapy in the 1950s. From this alone, we can infer that it falls under the “T” or thought-based theories. It was aimed at people suffering self-doubts, anxiety, and depression. The fundamental premise is that how we think affects how we feel and act.
In 1961, Rational Therapy morphed into Rational Emotive Therapy and in 1993 morphed again into REBT, its present iteration. “As practiced today, REBT emphasizes thoughts, but views emotions, behaviours, and thoughts as intertwined and inseparable. To maximize success, treatment must attend to all three” (Seligman & Reichenberg, 2014, p. 274).
DBT began as a behavioral therapy for the benefit of those experiencing the symptoms of Borderline Personality Disorder (BPD) and chronic suicidality (Seligman & Reichenberg, 2014). The briefest description of BPD states that it “...is a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity” (DSM 5, p. 645). Working backward, impulsivity indicates challenges with emotions, attention, and self-regulation resulting in an often-changing focus. Instability in affect means one’s feelings are changing frequently and without apparent cause. It is hardly surprising that if your behaviour and attention are all over the place and your emotions feel random, you would question your self-image (who am I?) which might lead to unstable relationships. My intuition is that a person with BPD might feel victimized by her own unrelentingly moving consciousness i.e., it never slows down long enough to focus well on one thing.
So, how effective is REBT likely to be for a person whose mind is in constant motion? For REBT to work, one must 1. Audit one’s own thoughts, 2. Analyze those thoughts breaking them into, 3. Activating event, Consequence, and then implicit Belief while then, 4. Gathering evidence for or against that belief so that you can then, 5. Dispute the belief and rectify your thinking. Now imagine doing that if you are so frustrated that the pain of living is overwhelmingly negative; so negative that you are regularly thinking of taking your own life. That is what Marcia Linehan (1993, Seligman & Reichenberg, 2014) was dealing with. Her goal was to help regulate the emotions and behaviours of those suicidal BPD patients.
Albert Ellis’s goal was to regulate the negative self-talk and thinking of those suffering anxiety, depression, and low self-esteem. Which is why I believe both approaches, though apparently contradictory, can be effective. It’s all about who is being helped and what their current issues are. In simpler terms, you do not put regular gasoline into an electric or diesel car engine or as the British say, horses for courses, meaning each type of horse has a favoured mode fostering well-spiritedness.
Dan Chalykoff is working toward an M.Ed. in Counselling Psychology and accreditation in Professional Addiction Studies. He writes these blogs to increase (and share) his own evolving understandings of ideas. Since 2017, he has facilitated two voluntary weekly group meetings of SMART Recovery.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Seligman, L. & Reichenberg, L.W. (2014). Theories of counseling and psychotherapy: Systems, strategies, and skills (4th ed.). Pearson.
Well said, Dan! Love the horse analogy. A smattering of both can’t hurt, right? The “who” and the “what issues” matter most in trying to help your LO or yourself. Perhaps the premises conflict could be reevaluated to a modern day thinking of, “making the best of both worlds”!
Thanks for reading and commenting, Trish. Yes, I think it’s all about the recipient. If it doesn’t work, move on to something that does work.
Thanks so much for this Dan.
You make complicated theories into a logical and simplified process which has aided me greatly.
Thanks for this so much…..lots to think about and absorb as I continue to work on my understanding of recovery and how these principles apply to me.
You’re an amazing teacher, sir!!
Thanks for that, Nancy. I do try to reduce the concepts to digestible portions. If that’s working, the writing’s working. Thanks for reading and commenting.
An interesting read. I believe both are helpful. My own thoughts about BPD is that it’s a label and basically a dysregulation of emotions. When you start to peal back the layers I have found that there is always trauma/dysfunctional family dynamics that influence and mold individuals into this type of emotional dysregulation. I love DBT as a therapy, it offers so much hope and understanding as to what happened to you.
Great post!!
I like your comment about the label, Linda. All diagnoses are approximate categorizations. It’ll probably take me a decade or more of practice before I can weigh in on the accuracy of all the psychological/psychiatric labels we throw around. Much more important to treat the person and not the phenomenon affecting that person. Thanks for reading and commenting.