GRAND DELUSIONS

Psychotherapies Without Feeling

by Dr. Arthur Janov

Posted June 2005 on primaltherapy.com

Chapter 13:  The ABCs of RET (Rational-Emotional Therapy):
Holding Back Feelings with Words

Introduction

Rational-Emotive Therapy (RET) was developed in the 1950s by clinical psychologist Albert Ellis. After many years of clinical work using traditional analytic techniques, Ellis saw that this approach did not really work. Years later, looking back on his early years as a psychoanalyst, Ellis recalled that his patients "temporarily felt better from all the talk and attention, but they didn't seem to get better; the insights it took them so long to arrive at didn't change things for them in significant ways." He decided that there had to be a more effective and less time-consuming way to do therapy, one which, incidentally, would give the therapist a more active, "exhortative-persuasive," role.[1] To find that better way, he drew upon "the wisdom of philosophy as well as the most modern psychological advances of our age" to synthesize an analysis of behavior that he could then "present" to the client:

I found that by my presenting a philosophical as well as a psychological analysis the client could enjoy the fruits of two sciences and achieve positive and lasting results from our therapeutic efforts.[2]

Ellis' marriage of psychology and philosophy produced a cognitive-analytic therapy based on the orientation that we create our own neurosis. He was fond of quoting the philosophy of Epictetus, the First Century A.D. Stoic: "What disturbs people's minds is not events but their judgments on events." Events themselves do not bother us, but our thoughts about them do.

From this perspective, external events in which we are involved are almost like mirrors upon which we unwittingly choose to project our own idiosyncratic reactions. When you think someone is treating you badly, it is not true that he is doing anything particularly unpleasant to you. You just think he is. Basically, you have given him that power over you. On the other hand, you can learn to have an entirely different reaction to the same external event; you can rationally decide how to interpret it, which will allow you to respond to the world in a sensible manner.

According to Ellis, we trap ourselves in unpleasant behaviors through the perpetuation of irrational beliefs and unrealistic expectations we have acquired over the years, and choose to hold onto in a "self-defeating" pattern. Emotional disturbance is not a particularly deep-seated problem, but something which goes along with one's ideas and ways of thinking, which although persistent, are eminently changeable. The primary strategy for discarding our irrational beliefs (such as that we deserve to be treated well by others) and unrealistic expectations (such as that those around us should be concerned with our welfare) is known as "disputation," a form of empirical analysis achieved through a formula Ellis devised. Therefore, the way out of our problems involves thinking about our thinking and analyzing our beliefs in order to sort out the rational from the irrational, and then "choosing" to give up the latter.  RET will help you make this better choice, as Ellis explains:

My approach to psychotherapy is to zero in, as quickly as possible, on the client's basic philosophy of life; to get him to see exactly what this is and how it is inevitably self-defeating; and to persuade him to work his ass off, cognitively, emotively and behaviorally, to profoundly change it.[3]

Ellis’ optimistic, individualistic, power-of-positive-thinking view of human experience has had tremendous impact on psychotherapy. As founder (in 1959) and director of the Institute of Rational-Emotive Therapy in New York, Ellis made a controversial name for himself for his liberal views on sex and his groundbreaking work as a sex and marriage therapist. Over time, his theories moved out of the realm of the unconventional into the mainstream. Researchers in cognitive and behavioral psychology carried out studies which ostensibly validated his techniques and gave Rational-Emotive Therapy what passes for scientific credibility. In the 1980's, Ellis received high accolades from the American Psychological Association and was recognized as the "pioneering practitioner and grandfather of cognitive behavior therapy" and for his "profound effect on the professional practice of psychology." The talkative and interactive therapist, the self-analytical patient, and the assigning to patients of cognitive/behavioral homework exercises (to help them learn new ways of thinking and behaving): these are among Ellis' innovative contributions to psychotherapy. In a survey of 800 clinical and counseling psychologists, Ellis was ranked as the second-most influential psychotherapist in history, ahead of Freud himself and trailing only humanist Carl Rogers.[4]

The Nature of Neurosis According to RET

Rational Emotive Therapy’s views are an interesting admixture of judgments and contradiction. On one hand, Ellis contends that man is basically rational or he wouldn't have survived this long. He has an enormous, practical ability to learn. On the other hand, man is quite able, even predisposed, to behave irrationally. The Encyclopedia of Psychology describes Rational-Emotive Therapy's position on our human proclivities: "The capacity to learn includes the capacity to learn nonsense, and...the predisposition to think is very often the predisposition to think crookedly."[5] In fact, according to Ellis, man is born "biologically prejudiced to acquire and retain" neurotic traits:

Children (as well as adults) have inborn tendencies which make it much easier for them to behave badly or neurotically than for them to behave well or sanely. This means that although they are not irrevocably imprinted at birth with specific neurotic characteristics, they are biologically prejudiced to acquire and retain some of these traits; and unless something is actively, directly, and consistently done by their parents and by themselves to counter and thwart these inborn tendencies, they will probably be troubled for the rest of their days.[6]

Ellis is really saying that we are basically irrational, since we have a greater tendency toward neurosis and irrationality than we do toward health. The fact that these tendencies are biologically rooted makes them quite hard to change, but it can be done with a great deal of work and practice ("man is the one animal who can change his inherited characteristics"). The important things for us to do are to first acknowledge that we simply come with these defects, and then set about the task of countering and thwarting them:

The more we face that fact that our children often are born with very strong predispositions to be emotionally disturbed in various ways, the less we shall tend to blame them for their behavior, the less we shall condemn ourselves for making them the way they are, and the more we shall be able to show them that persistent hard work to overcome their biologically predisposed handicaps will be rewarding.

According to Ellis, it is more likely that an abused child grows into a violent adult not because of his actual, day-to-day experiences of being abused, but due to his inherited predispositions. "The anger and violence characteristic of those raised in hostile and aggressive atmospheres may stem from an inherited rather than from an acquired disposition."[7]  He concedes that there exists, "to some degree, a relationship between a person's early training and his or her later conduct," but cautions that "we'd better not view such information as conclusive without further consideration."[8] Decades after first propounding these views, Ellis continued to believe continued to believe that basically all beings have "strong biological tendencies that encourage them to think irrationally, to feel severely disturbed, and to act dysfunctionally."[9] [Italics added]

The contradiction resides in Ellis' view that the environment (in the form of parents and family) can play a significant role in the positive alteration of inborn neurotic tendencies, yet it does not play a significant role in altering inborn tendencies in a negative, neurotic direction. Thus, parents can rest assured; if the child turns out angry and violent, it was preordained. They had nothing to do with it. What's more, if you are a parent, and you are convinced that you screwed up your kid, you are just burdening yourself with irrational ideas.

In his extensive work, Ellis offers many definitions of neurosis and its causes:

It (neurosis) is an unrealistic, immature, and usually self-immolating way of looking at oneself and the world. It is a perfectionistic or grandiose demand...that things occur and people act in a certain way...and it is usually a determined, pigheaded refusal to accept oneself and the world as they are and an asinine insistence that things should, or ought, or must be different from the way they are.[10] [Italics added]

People...do not merely get disturbed from their relationships with their parents and from the teachings of their culture, as psychoanalysis alleges. Nor do they get upset by obnoxious environmental conditions, such as poverty, war, and violence, as many nonpsychoanalytic therapists insist. Rather, they largely -- but not exclusively -- make themselves neurotic. They construct their feelings of insecurity and their low frustration tolerance by their Jehovian demands and commands on themselves, on others, and on the world around them.[11]

This position echoes Fritz Perls' assertion that neurosis is the result of immaturity and retarded personal development. All of us, Ellis writes, are neurotic to some extent; we are "normal neurotics," prone to "needlessly upsetting ourselves," even predisposed to occasional bouts of self-destructiveness. Because we are "born so vulnerable to emotional turmoil," when we are subjected to extreme trauma or loss -- child abuse, rape, the death of people close to us -- we may not be able to avoid becoming "disturbed." But at some point, regardless of the extent of our trauma, we are able to get over it and stop "needlessly upsetting ourselves."[12] The true neurotic is not that way because he has been shaped by his life experiences but because he hasn't asserted control over his thinking. He is a "bigot" who sticks rigidly to his views that things aren't the way they ought to be, a "Jehovian or Hitlerian moralist" who dogmatically clings to his faulty conception of the truth no matter what.

Thus, someone who has sexual difficulties, such as impotence, frigidity, or avoidance of sex due to what has been called "performance anxiety," is basically the victim of his own perfectionistic perceptions. He has a silly "tendency to exaggerate the significance of things," based on his illogical "fears of failure," not to mention his irrationally "dire need to feel approved and loved."[13] The person who shies away from sex because he fears sexual rejection or ridicule, and who opts for masturbation or peeping is just self-destructively stubborn. He and the neurotics like him are "much more disturbed than they have to be because they simply will not accept themselves as fallible, incessantly error-prone humans."[14]

As I think I have shown in my psychotherapeutic practice during the last twenty years, these severely disturbed individuals (the "true" neurotics) can, with much prodding and guidance, think considerably better about themselves and their surroundings than they usually do; but they seem to have great difficulty in doing so; and are almost allergic to continuing to think straight for any period of time. Given proper guidelines, and practically being forced to follow them for a while, they can gradually be trained to become more consistent and straight-thinkers. But what a job it is to teach them.  And how they usually resist![15]

The "proper guidelines" to get over the "allergy" of crooked thinking Ellis refers to are contained within an involved system of behavioral analysis -- which is really cognitive analysis -- aimed at achieving the "training in straight thinking" that is his answer to neurosis.

The ABC's of RET

Ellis refers to the principles underlying this new analysis of behavior as the ABC's of RET. The ABC's constitute a kind of formula that anyone can apply to figure out how to change their negative behavior. The formula is itself unchanging; only the elements of one's behavior change. Thus, anger might be the problem today; depression or grief tomorrow; and fear and anxiety next week. By taking the problematic emotional response -- the anger, fear, or depression -- and passing it through the formula, a solution can almost invariably be found.

Of the formula's elements, A is the Activating Event -- the immediate experience that triggered the emotional response. B is the Belief System used to evaluate or judge the experience. C is the Emotional Consequence of the experience -- the anger, frustration, fear, anxiety, or depression -- as well as the "behavioral consequence." D stands for Disputing, which you must do with the irrational belief underlying your disturbing emotional response. Finally you arrive at E, which is the Cognitive Effect of having gone through all of the above. E is the solution in the form of a New Philosophy. It enables you to respond differently to A (the activating event), which in turn changes C (the emotional consequence and resulting behavior). Whew!

Although there are five components to Ellis' ABC chain, the most pivotal link is point B -- the belief system. He contends that what we feel (C) in any given situation (A) is a result of what we think and believe (B), so that changing B automatically changes C:

One of the main RET hypotheses states that you seem to feel what you think or expect to feel -- and not what you actually do experience. You prejudice your feelings about something with your views of what you believe you should feel. Moreover, although RET fully admits the transactional nature of human thoughts and feelings, it holds that in most cases -- not all -- your thoughts remain paramount over what we call feelings. Therefore, you can more quickly, easily, and importantly change your thinking than you can change your thinking by modifying your feelings.[16]

B is thus the focal point of RET. Irrational beliefs generate irrational behavior, which Ellis defines as anything that interferes with one's goal of happiness. A belief is labelled irrational when it results in what he calls self-destructive emotional responses (such as irritation, rage, and so on). A rational belief, by contrast, will help keep the individual emotionally composed, will help him get along with others, and will keep him on the track toward his own happiness and goal-fulfillment.

Well, let's take an example.  You are at work when your boss unexpectedly reprimands you for not doing a report in the right way. But you actually did the report in the way you have always done it. You try to explain this to the boss, but he won't listen, and stalks impatiently out of your office. You are left feeling angry and depressed. What to do about it?

Ellis says that you don't have to feel angry or depressed. While you can't control how your boss treats you, you can control how you react to his treatment. How? Bring in the ABC's.

You know that A (the activating event) is the unfair reprimand you received from your boss. You know that C (the emotional consequence) is the feeling of anger, anxiety, even outrage, you are currently experiencing. And you know from your RET training that the pivotal element in getting from point A to point C is at point B -- your belief system.

So you examine your beliefs about this particular situation. According to Ellis, the rational response (rC) (the response you did not have) would be a feeling of disappointment and discomfort. The rational belief (rB) determining this relatively cool response would be something to the effect that your boss should not treat you the way he did. But you do not have your emotions under control. Instead, you are sitting and stewing in anger. Meanwhile, the boss has refused to hear you out fairly, and there is nothing you can do about it. Thus, your anger is self-defeating; it is inappropriate and irrational. Since he won't listen to you, there's no point in sitting and stewing. It's a corrosive, impotent emotion which certainly won't help you accomplish anything constructive at the office and might even be driving up your blood pressure.

To figure out why you are sitting and stewing, you must locate the irrational belief (iB) that is fueling your irrational response or consequence (iC) of anger. This is done through the application of objective and rational analysis:

In locating your iBs (irrational beliefs) we use the method of logical, empirical checking, designed to discover any illogical, nonempirical ideas you might hold at B (your belief system). By putting the case into the RET framework, an RET clinician can discover your rBs (rational beliefs) and iBs (irrational beliefs) simply through a knowledge of your feelings and behavior at both points A (activating event) and C (emotional consequence).[17]

You now realize that you are stewing in anger because you believe that your boss' treatment of you was unjust and awful; that not only is it wrong for him to behave that way toward you, but that he is a terrible person for having done so. In your RET training you learned that such beliefs are irrational because they inappropriately equate a person's actions with his worth as a total person. In Ellis' words:

This failure to separate a person from his action implies that only an (x) person can act (x), and that all (x) acts must get performed by (x). Further, and more specifically, any person who does anything that any other person deems bad or unjust must be a bad person. If a good person performs good acts, then he can never do anything bad, for he is a good person and capable of only good acts. If a bad person performs bad acts, he can never do anything good, for he is a bad person and can perform only bad acts...(Thus) a simple rule of thumb for discerning the difference between rB (rational belief) and iB (irrational belief) in your Belief System is: Beliefs remain rational so long as they do not extend an evaluation of the action into an evaluation of the person.[18]

Now that you've recognized the irrationality of your response by discovering the irrationality of your belief, you can change your belief to something more sensible. Okay, the boss reprimanded me, this is something I should expect to happen now and then, and although I don't like it, it's just part of the nature of things. Once you have reinterpreted this interaction -- reconceptualized it from an outrageous confrontation to a minor to-be-expected conflict -- you will feel better.

What Come First, Feelings or Beliefs?

In his 1977 book How to Live With -- and Without -- Anger, Ellis entitles his chapter on the ABCs of RET "How You Create Your Own Anger."  The chapter on rational and irrational beliefs is entitled "The Insanity of Anger."  What he is basically saying is that thoughts (otherwise known as ideas or beliefs) create feelings.  Whether people generate these thoughts consciously or unconsciously, they "teach themselves to use these thoughts to evoke emotions."[19]  The emotion itself does not exist independent of thoughts or ideas; it is the product of them.

Before taking a more detailed look at Rational-Emotive Therapy's perspective on neurotic belief systems and how to alter them, I would like to comment upon Ellis' idea that our feelings stem from our beliefs rather than the other way around.

There is no doubt that emotional problems can easily appear to stem from beliefs.  Take the notion that it is useless to rely on anyone.  A person armed with this attitude never asks for help, never develops lasting friendships and loyalties, and keeps too much to himself.  He may therefore find it more difficult to achieve his purposes, is miserably alone, and never discovers how helpful and encouraging others can be.  He has an assumption about the world which, when he acts by it, helps to keep the world the way he sees it.

 Ellis would counsel him to change his assumptions.  But it's not so easy.  Such assumptions are based upon real experience.  He may never have been helped by his parents and has learned not to expect it.  The idea is driven by a feeling, and not vice versa. There is ample evidence in the neurologic literature that feelings can be organized below the level of conscious awareness, lower than the ideational processing mechanisms of the cortex.  Ellis neglects all of the recent research on the blocking mechanisms in the brain that keep feelings and thoughts apart.  The child has feelings long before he has words to describe them.  A number of feelings do not get transferred to the left hemisphere thought processes early on because the connecting pathways along the corpus collosum which bridge the two brain hemispheres are not fully developed until the age of ten.  So when Ellis says that the person must change his assumptions about the world he neglects the fact that behavior is based on feelings, not simply on assumptions.

Say someone assumes that women are dangerous because his whole history with his mother was dangerous.  He doesn't just "assume" women are dangerous.  And no matter how hard he tries to change this "assumption," he is fighting against a relentless undercurrent.  To change matters he has to change his feelings.  To change his feelings he has to have contact with them throughout his history.  In short, he has to reach back into history for the origins of his feelings.

Where else would we get our assumptions from if not history? They are certainly not acquired like so much mental dust from the philosophical atmosphere.  Furthermore, they serve an important purpose.  They make our feelings harmonious with our ideas.  Could one imagine having feelings that were in contradistinction to one's ideas?  It would be most uncomfortable.  The attempt at harmony is an attempt at balance, albeit neurotic balance.  All of these neurotic assumptions, and Ellis assumes they are neurotic and need changing, symbolize the Pain so that the person need not face it.

A person who was abandoned by a parent when little may feel alienated and worthless.  Later, if the one he loves and needs leaves him, the unconscious reasoning or assumption would be that it must be because he deserves to be left.  This may subsequently generalized into a number of philosophical positions:  that people cannot be relied upon; that being a loner is virtuous; that he is intrinsically unlovable, etc.  But aiming therapy exclusively at such attitudes is to mistake the rim of the target for its center. The early abandonment is the center, and it must be brought into consciousness if the influence it exerts on all facets of the person's life is to fade. 

Ellis apotheosizes the disconnection of feelings and ideas, implying that the former don't count nearly as much as the latter. To watch films of his therapy one sees what an intellectual process it is for him.  He is busy telling the patient all about the assumptions he is carrying around that have to change.  The patient nods and Ellis goes on lecturing.  He is the center of wisdom and power in the therapy.  It is unconsciously a basic distrust of the patient.

Ellis maintains that "you create your own anger philosophically."[20]  I could not disagree more.  As Nietzsche rightly pointed out, philosophy tends to be "a species of involuntary and unconscious autobiography."  This seems to me to be true whether we are speaking of philosophy on the grand scale or everyday personal catchphrases.  The generalization that "There is no use in relying on anyone" is an historical account, a statement of actual experience, before it converts to the assumption.  Someone who says that they cannot rely on anyone has clearly had the experience of being let down by another.  If the idea is held tenaciously, then it indicates that he was probably let down by someone vitally important to his well-being early in life.  He then acquires the attitude that people will let him down.  The point is he is prophesying something that has already occurred.  The emotion is a response not only to a present situation but also an echo of past hurt. 

How does the person feel who constantly predicts that everyone will fail him, and who repeats these sentences to himself interminably?  Miserably alone.  Helpless and hopeless.  In other words, the belief brings him back to the very feeling which prompted the belief.

There are those, like Ellis, who claim that the emotion does not exist without the thought, and that you can liberate yourself from emotions such as suspicion and loneliness by replacing your conventional way of thinking with a more positive one.  There are also those who argue that once our loner has experienced the loyalty and dependability of others (or at least understood that it can be found), he will start to mend his mistaken philosophical ways.  Though this can happen, it is unlikely.  Because firstly, he will not cultivate such people, and secondly, he will distrust the experience no matter how it proceeds and will find other conclusions to uphold his underlying feeling of distrust.  Such conclusions might be:  "They are only helping me because they want something;" or "It'll never last -- they'll do something in the end to show that they can't be relied on;" or "They don't know what I'm really like.  Once they find out, it's all over."  There will be a strong tendency to undermine such developments in order to return himself to the past which preoccupies him.  At this point receiving what he never had may be more painful than struggling for it.

     In any case, you do not erase history anymore than you erase part of your physiology, which is where history is lodged.  If you live in your "head" you might imagine that behavior is driven by ideas.  That is because you are out of touch with your feelings and cannot imagine that they motivate you.  Even if the ideas are altered by a therapist, the feelings are still there.  Now what? Better repression, more disconnection, less being in touch with oneself.  Is that progress?  Is behavior the be-all and end-all of therapy.  If you are a Behaviorist it is.  There is no notion of feelings, consciousness or unconsciousness in their schema.  No notion, in short, of the total human being.

An individual can feel a certain way without the belief or behavior to support it, but he wouldn't believe and behave as he does without the feeling to direct him.  RET arbitrarily detaches the idea from the feeling which infuses it.  Primal Theory recognizes that they are all of a piece.  It goes through the idea to the feeling, which when felt often leads to the spontaneous evaporation of the idea.

Take the mystical notion of aliens coming to take a person to a strange land, something we have seen.  Do you attempt to dissuade her or dissuade any paranoid from her ideas?  You can talk yourself blue in the face doing that.  It is clearly not a matter of ideas. The woman above felt alienated.  She imagined that the aliens were outside of her instead of inside.  Once she felt (over and over again) the alienated feelings inside of her, the delusions left. If we were to take just her ideas as though they sprung from the air and tried to convince her that there were no aliens, we would be fighting against her history and her physiology.

Whereas we look to the past for the source of a patient's present feeling states, thought patterns, and belief systems, Ellis hews strictly to the present.  He explains that insight is the key to RET, but he is quick to differentiate between what he calls RET insight and insight according to classical theory.  In RET, the focus is on the present situation, and the insights achieved by the application of its methods are insights about present irrational beliefs.  According to Ellis:

Insights about one's childhood or distant past prove of little or no service in facilitating adequate "working through" of a client's problems...Granted the influences of your parents, teachers, religious leaders, and environment may greatly contribute to your growth and formation, yet you'd better realize that although these factors significantly influence development, they by no means remain fixed and unchangeable.[21]

Thus an animal phobia can be better treated by locating the pertinent irrational beliefs underlying it than by attempting to trace it back to childhood trauma.  In fact, dwelling on those past traumas only serves to reinforce the fear.  "What happened ten or twenty years ago," Ellis maintains, "has little or no value now. It happened.  The past remains fixed and unchangeable while you may affect the present and future by your own actions."[22]

Ellis does recognize the complete dependency and need that characterizes childhood.  He also recognizes that children are "at the mercy of" their elders, and that they have "little or no choice in their somewhat helpless situation."  As adults, however, "we can seriously question the degree to which our childhood experiences influence us."  He cites how in adulthood we may easily differ with our parents in regard to religious convictions, political viewpoints, social and cultural values, professional preferences, and so forth.  This, to Ellis, proves the primary assumption upon which RET is based.

"The responsibility to change your life," Ellis says, "involves your willingness to separate yourself from the childish concept that your parents still have responsibility for your actions and attitudes today.  And it also involves your attending to your present and future situations, not to your infantile ones."[23]  Thus, we have the ability to make conscious choices every day.  We, not our parents or others, are the agents of the choices we make.  We can mold our thoughts, beliefs, and feelings as if they were so much putty.  And if we do not get to work on them, we are basically the architects of our own unhappiness.

What Ellis forgets is that the childish concept that a child should be loved is not neurotic, not then and not now.  The unloved child still resides in the person and directs his actions now.   Ellis' view is most undynamic, shallow and phenotypic, a therapy of appearances.  He deals with presenting symptoms, eradicates the symptoms -- feeling hurt because someone was mean -- and imagines that effective treatment has taken place.

Irrational Beliefs and Neurosis

RET says that adult emotional problems stem almost invariably from one of three major irrational belief systems. All three systems revolve around the concept of should or must by which we upset and devalue ourselves and others. Ellis terms this process of stubborn self-denigration "musturbation." He then provides an outline of "the whole system of the irrational beliefs that contribute to or 'cause' emotional disturbances." Each of the three major irrational ideas has a number of corollaries or sub-ideas.

Irrational Idea No. 1 -- "I must do well and win approval of others for my performances or else I will rate as a rotten person." This accounts for the self-hating and self-depreciating end of the emotional spectrum. Ellis explains the logical progression from the idea to the feeling of worthlessness and self-destruction:

Once you believe this idea, as almost all people in all parts of the world seem to, you may then somewhat "logically" conclude: "If I do rate as a rotten or inferior person, I view my life as awful and might as well begin to give serious consideration to the idea of my own self destruction." This, of course, leads to strong feelings of depression, anxiety, and overall worthlessness.[24]

There are some eleven corollaries under Irrational Idea No. 1. One corollary, for example, is: "I must understand the nature and secrets of the universe to live happily in it." Another: "I must find a high degree of order, certainty, or predictability in the universe around me in order to feel comfortable and to perform adequately." Ellis believes that these obsessive ways of thinking account for a wide diversity of feelings and problems we experience.

Irrational Idea No. 2: "Others must treat me considerately and kindly and in precisely the way I want them to treat me. If they don't, society and the universe should severely blame, damn, and punish them for their inconsideration."

Irrational Idea No. 3: "The world (and the people in it) must arrange conditions under which I live so that I get everything that I want when I want it. And further, conditions must exist so that I don't get what I don't want. Moreover, I usually must get what I want quickly and easily." Here is one of this idea's thirteen corollaries: "I must remain a helpless victim of anxiety, depression, feelings of inadequacy, and hostility unless the conditions that cause my unhappiness change and allow me to stop feeling disturbed."

Once you have accomplished the pivotal act of discovering your irrational beliefs, you must then carry out the second most pivotal act of disputing them. After all, what's knowledge without action? It is not enough to recognize the problematic beliefs as irrational in a generic sense. Rather, you must really nail down, really elucidate, really reason through the specific points of illogic and irrationality in the belief. But you are not left totally on your own in this next endeavor. Ellis again provides a framework for this part of the RET method in the form of "three major insights or understandings that will help you dispute irrational beliefs."

Insight No. 1 is a really recapitulation of the RET position that our beliefs constitute the single most influential factor in how we feel and behave. The insight is that you can therefore change those beliefs -- no matter how or when you may have acquired them -- and feel better.

Insight No. 2 contains two key RET points: (1) We sustain our emotional problems by mentally repeating and reiterating our irrational beliefs to ourselves; and (2) Epictetus' idea that it is our view of an unpleasant event, not the event itself, that makes it unpleasant for us. Under the first point Ellis explains:

RET teaches that you carry on your early acquired...irrational beliefs by your own repetition of these ideas in your mind and your continued acting upon them. You seem to do this automatically or "passively" but if you look more closely you will see that you actively keep indoctrinating yourself with irrational Beliefs. Inappropriate Emotional Consequences remain in existence because you continue to maintain irrational philosophies or beliefs from which they stem, and you continue to feel emotions such as anger, anxiety and depression at C because you either consciously or unconsciously keep reiterating your irrational Beliefs to yourself.[25]

He notes that children have a limited ability to recognize irrationality in the "teachings" given to them by their parents. But as adults we are fully equipped to do so. The fact that many of our negative emotions operate differently in us as adults than they did during our childhood indicates to Ellis that early conditioning is not the sole factor. Rather it is our own "constant repetition of the early acquired doctrines" that is the prime culprit in today's difficulties.

   Ellis makes it sound as if a neurotic's repetition of unhealthy ideas is voluntary.  Not only does this seem to contradict Ellis' own theory of genetic predetermination, but it leaves me wondering why anyone would knowingly seek to make themselves suffer.  His almost glib assertions about a specific inherent neurotic inclination display either a loss of theoretical stamina or a taste for working upside down. 

   One can't help suspecting that, having found it difficult to nail down causality, Ellis opted instead for a cause which is beyond either sensible argument or informed support.  It is too biologically profound and obscure to investigate, so we had better turn our attention to the current manifestations of these tendencies.  In his keenness to do something about neurosis, Ellis has decided that the underlying cause is too difficult to do anything about -- which in effect allows him to invent an easier cause.  We choose to be neurotic.  Possibly because it is easier to remedy something chosen, he makes choice the key, so that attaining health becomes a matter of making new decisions.  If that were true, we would put the world to rights in no time.  But of course, it isn't. As Ellis himself admits, it is devilishly hard to get people to make the "right" choices.  I believe it is because, in the fashion of Canute, RET seeks to hold back the waves with words.

Ellis says that doctrines and teachings are what neurotics repeat. It is hard to believe that Ellis actually purports to reduce all experience to a matter of indoctrination or teaching. Is a beating at the hands of a drunken father a doctrine? Is sudden abandonment by a mother a mere teaching? Are impatience, indifference, neglect, rejection, humiliation, contempt and abuse conceptually received? No doubt the child learns a lesson, but surely to call these and lesser miseries mere doctrines is to demonstrate a one-dimensional view of human existence. Neurosis is laid down as experience, not as ideas.

No child suffering any of the injuries listed above shows signs of having registered a doctrine. They feel bad. Although there are gradations to their reactions, ranging from mild neurosis to psychosis, they are all reacting to being hurt. They have been affected, not instructed.

Can you imagine anyone going around repeating sentences to himself ad nauseam? Do you repeat sentences to yourself over and over again? Is that what makes you depressed or anxious? Or do panic attacks suddenly arise, seemingly stemming from nowhere, and certainly having nothing to do with exhortative sentences? Do you suddenly wake up apprehensive or depressive long before you've shaken the cobwebs out of your head to be able to form sentences?

If beliefs result from experiences, which they often do, such beliefs serve to keep the Pain in check while at the same time obliquely expressing it. You can in fact watch the progression from Pain to belief. This is what often happens, for example, in the born-again experience. It is nearly axiomatic that people suddenly "find God" at the time when they are closest to their Pain. They feel so badly, so naked and vulnerable in the face of their Pain that the Pain conjures up the specter of an omniscient Being who will watch over and protect and love them -- who will in effect save them from their Pain.

Neurosis is a reflexive reaction to too much Pain; it is not something which is considered and chosen. The whole biologic system deviates from normal. The thyroid is affected, as is the stress hormone levels and the neurotransmitter output. Neurosis is global. Neurosis is a compromise for the sake of survival. Ellis would have us believe that we opt for sickness or health as a result of some evolutionary whimsy. In fact, a biologic systems "opts" for neurosis because it serves a survival purpose: to protect us from overwhelming Pain and keep us alive.

A child must repress the memory of her father doing things to her or her mother going out the door never to return. Is the child hurt by incest only because she has the wrong philosophy about what to expect from a father? Or is it a devastating experience that is rarely conscious later on? Young children do not have the physiologic wherewithal to sit around making choices. They react.

The matter of secondary gain in neurosis partly confuses this issue. In other words, a person not only "benefits" from the basic repression which allows him to survive the Pain, but he often finds that his symptoms bring external rewards. For instance, a chronic complainer not only keeps the Pain at bay, but gains attention and the efforts of concerned friends seeking to remove the cause for complaint. Ellis might interpret this as voluntary neurosis. Certainly the patient is partly responsible for its continuation if he fails to do something about it, once he has recognized it as such. He may decide that he is more comfortable in the half-world of neurosis than he would be in an emotionally-naked encounter with his Pain. But even that decision is prompted by Pain.

A person's choice to remain sick does not mean that choice is the essence of the sickness. A sick choice is based on sickness, not on choices. Likewise, the choice to become healthy is important but in itself it is not the agent of change. It merely enables that agent. What I often note about therapies such as RET, which is essentially decision therapy, is how does one make the decision to make the decision not to be neurotic, when not being able to make a decision is part of the neurosis?

After Ellis explains his second point -- it is our view of an unpleasant event, rather than the event itself, that makes us feel unpleasant -- he points out that we often cannot remember the details of what happened, yet we continue to be upset. We can see this clearly in the case of something or someone who upset us a long time ago. The specifics of what happened are lost to our memory, so we must therefore be repeating the original irrational beliefs in order to sustain the original irrational emotions over such a long period:

Unless you continually repeat to yourself your irrational beliefs and thus vigorously throw yourself into holding onto them and perhaps even acting aggressively while holding them, you almost certainly do not give the incident much thought after a reasonably short period of time. Your ongoing, or sustained, view of that original (situation)_- rather than the (original) conditions themselves - keeps you upset.[26] [Italics original]

Here again Ellis is saying that outer experience has no intrinsic reality. Instead, it is what we make of it, nothing better, nothing worse. According to Ellis, even psychotics suffer solely as a result of their "invention" of traumas that were never really so traumatic. The guy walking down the street shouting at imaginary tormentors -- his thinking is just a little off, that's all. He's still overreacting to past incidents the basically ephemeral nature of which he was and is too irrational to perceive.

Insight No. 3 is the call to arms. Ellis counsels that changing our irrational beliefs, and the disturbed feelings and behaviors they generate, requires a "great deal of work and practice." For no matter how aware we are of our irrational beliefs, no change will occur until we take action and dispute them. He further explains that beliefs vary in intensity, "and unless you Dispute your (irrational beliefs) powerfully, you stand a good chance that they will gain a controlling influence in a situation."[27] And a final caution: "Remember, the more powerfully and consistently you dispute (at point D) your anxiety-creating or anger-producing (irrational beliefs), the sooner you will dispel them."[28] Toward this end, Ellis next attempts to help the reader develop the needed skills for Disputing.

As noted earlier, skill in disputing means taking an irrational belief and putting it through the rigors of logical analysis. Ellis uses a hypothetical example in which a friend has withdrawn from a living agreement, leaving you with no roommate and less money. You react with anger and rage. You put your anger through the RET mill and discover that there are several irrational beliefs underlying it. One of these is: "He (your friend) should not, must not treat me unfairly." Ellis then proceeds to suggest how one might dispute the irrational viewpoint. His analysis goes on at considerable length, but an excerpt is sufficient to provide a taste of the process:

"Granted that he has dealt with me unfairly and that virtually everyone in our society would agree that he has, what evidence exists, however, that he ought not abuse me in this unfair manner?" If we approach this question from the point of social morality, one might say that if the people in general ignored the oughts and shoulds of its social, moral, and ethical standards, their society could not survive as a civilized unit. Yet morality doesn't actually determine what ought or should exist; it merely establishes definitions or guidelines with regard to either right or wrong. In other words, civilized morality states that one had better act "properly" rather than "improperly" and goes on to dictate that otherwise bad results will accrue. If bad results occur by someone's actions, the members of a society may feel impelled -- because of civilized morality --to lay some sanctions against the transgressor in order to persuade him or her to act otherwise in the future.[29]

Two pages later, Ellis arrives at the desired rational belief needed to properly dispute the above irrational belief. It reads: "Although it would seem desirable to get treated fairly at all times, and although social rules declare it advisable for people to act fairly to me, no universal law exists, no reason commands I must get treated fairly." Once one can accept this viewpoint, anger fades into mere rational disappointment. The logical recognition that there is no universal law or power requiring you to be treated fairly reinstates your emotional equilibrium.

What Ellis has discovered is a giant rationale for keeping real hurt away.  What if expecting decent treatment is not neurotic?  What if expecting love is not neurotic?  If you weren't loved he is going to help you think it wasn't and isn't necessary. RET will provide a rationale for whatever the situation. Have rationale: will travel. Don't expect anything and you won't be hurt.  Is that a way to lead a life...giving up hopes, aspirations, and desires to avoid suffering?   It is fine for those urban types who live in their heads and can develop intellectual rationales.  But for those less sophisticated?  What do they do? Here again, science takes a back seat while the therapist elevates his neurosis to the level of a theory.

To analyze what might make you angry in a situation in to gain insight is all well and good -- but only up to a point. The idea that we ought to be treated in certain ways and not in others can have an objective validity in the here and now. It may also be a throwback to the early-life situation in which we have needs that parents are biologically obliged to fulfill. Failure in this area leaves us with the feeling of unfairness, of being let down. A gap opens up between what is biologically imperative and what we actually receive, between natural expectation based on instinct and the social realities affecting fulfillment of that expectation.

What we should have or what we ought to have implies not having or not having had. When someone in our current life lets us down, we are opened to the history of being let down. That history may not have been resolved; it exacerbates our current reactions. We are reminded (consciously or unconsciously) of what was our due compared to what was our lot. The answer is not to objectively think one's anger away, but to feel one's way through the anger, to feel its early context. Otherwise, if it were confined to the present, it wouldn't be neurotic. What makes for overreactions in the present is the historical weight added to it. Without that baggage there would be no neurotic reaction, simply real reactions to real events.

But in telling us what we should believe and think and feel, Ellis is again the repository of reality. He decides what a proper reaction is, and the patient is left to follow his directions.

No good is achieved, however, by exerting strenuous efforts to agree with someone else's so-called rational viewpoint. Being talked out of one's feelings is the quickest path to confusion and tension. Turning oneself into a student of universal law has little to do with personal therapy. The individual feels angry. So be it. In his anger lies the reason for it, and in the Pain beneath it lies his means to becoming truly reasonable.

What would Ellis do with someone who spent three years in a concentration camp?  Is it neurotic on the part of the victim because he expected to be treated fairly and fed three times a day? Is it just his attitudes that need changing?  Or was his life destroyed by confinement, lack of privacy, dignity, kindness?  Was his life ruined by daily threats of death and of watching others march to their deaths?  It is not a matter of philosophy.  It is a matter of humanity.

RET does make an attempt to deal with feelings, but only as a window into the beliefs that supposedly generate them, which in turn the therapist is supposed to modify through insistent "rational" exhortation, as if "appropriate" thinking and feeling were something you teach rats in a cage how to do properly. Ray Di Giuseppe, director of training and research at the Institute for Rational-Emotive Therapy, explains that RET focuses on trying "to help patients get in touch with their feelings... because that's when, as therapists, we learn what their irrational beliefs are. We teach them how to modify the quality of their feelings so they don't get knocked over by them. It's the distinction between feeling sadness and depression...We teach people to take out the self-destructive nature of the emotion so they can function in the world."[30]

On the one hand Di Giuseppe says that it's important to feel, but on the other there is the attempt to change feelings, to convince people to feel differently than they do. Agreement with a viewpoint belonging to another does not mean the anger or other emotion fades. It only means it has been repressed.

Are adherents of RET aware of Liebenskind's experiments at UCLA administering inescapable footshocks to rats periodically. They began to feel helpless and hopeless and developed tumors. Was this because they were repeating the wrong sentences over and over to themselves? Or was it that they underwent experiences that they could not predict or control and which finally made them sick?

Ellis' demonstrations on the skill of disputation of irrational belief are informative. In essence, patients are told to roll up their sleeves and be prepared to do battle indefinitely with these demons:

Until you go through these ABCs...many, many times, until you do them vigorously, strongly, and powerfully, and until you practice them over and over again, you will tend to sink back into your irrational beliefs and into your inappropriate Consequences. Only with continual practice will you probably uproot your iBs (irrational beliefs) thoroughly, and even then, never for all time to come. You will often tend to regress into your former habits; all humans do. No one can ever expect to attain perfection at all times, yet by using the RET methods, you will always use your ability to recognize your iBs and iCs (irrational consequences) and you will have the process for debating and disputing them at hand so you may rid yourself of them as they recur.[31]

If your iBs and your iCs keep recurring, surely you cannot be rid of them.  Ellis' methods evoke images of desperate attempts to keep the lid on a powerfully sprung jack-in-the-box by applying heavier and heavier ropes of so-called logic and reason.  It all sounds exhausting, the tension increasing with every new dispute undertaken.  Neurosis is the result of an overload of information called Pain, and yet Ellis seems to want to tax the poor brain with even more to do.  It is not enough that it is already battling away.  It now has to examine itself according to foreign lights, unravelling intricate spools of logic and learning sophisticated methods of debate with itself.  It amounts to acquiring a great tangle of intellectual clutter.  Rather than producing "elegant solutions," as Ellis claims to do, the unhappy neurotic is further confined by a baffling though more refined maze of thought.  He is invited to jog through the labyrinth of Ellisian dogma until I fear he collapses in a heap, or lets out a scream of frustration.

Critique: A Primal View

Albert Ellis' theory is based on three false assumptions.

His first false assumption is that thoughts remain paramount over feeling such that you can change your feelings by changing your thinking. This implies some kind of cortical superiority whereby thought processes would have a regulating, neurological dominance over feeling processes. In actuality, thoughts (plus the belief systems they constellate) and feelings are organized in different areas of the brain. And the gating mechanisms can disconnect them so that messages, no matter how important, do not travel to where they should go.

It is possible through surgery of the prefrontal cortex to disconnect feelings completely from ideas. Or by cutting the corpus collosum to block the transfer of information from one hemisphere to another. One can eliminate the awareness of Pain by severing the orbitofrontal pathways such that one's ideas about one's Pain contradict the actual physical state of pain. The person who is in great physical pain now is able to deny it. The disconnected person who is still in Pain may say that he wants to quit drugs, and he really does. But he can't because his body dictates his behavior. He is compelled to quell the Pain.

The second false assumption is that ideas are necessary to sustain an emotional response. In attempting to explain why neurotics stay anxious and upset over even trivial events, Ellis concludes that it is because of repeated ideas. But what is "repeated" is not ideas, thoughts, or sentences. We now know that neural circuits of engraved traumatic events reverberate continuously throughout the limbic system, altering hormone output, changing blood sugar, constricting blood vessels, and so on. In Ronald Melzack's experiments with dogs, for instance, a single electronic "zap" to the limbic system produced continuous, long-term neurological reverberations. The experiments were designed to show that single events can result in long-lasting effects. Emotional events in human beings are also stored in the limbic system. The effects of these events are engraved subcortically and continue to reverberate whether or not any sentences are repeated subconsciously. Clearly dogs have no neurologic equipment for such conceptualizations as Ellis suggests, yet the circuits continued to reverberate.

The third false assumption is closely entwined with the second. Ellis not only contends that ideas are necessary to sustain an irrational (neurotic) response, he also contends that an "unconscious rehearsing of statements" must also occur. Thus we continually repeat our irrational beliefs to ourselves, even vigorously throwing ourselves into holding onto them. How incredibly tiring. There wouldn't be time for anything else in life. Here again Ellis demonstrates a surprisingly narrow comprehension of the nature of experience, reducing it to the domain of thought by viewing it as the sole sustainer and sculptor of how we feel.

From this perspective, the person who experienced a near-miss auto accident two hours ago is still shaking and unnerved not because of the unsettling nature of the experience itself, or because the near miss brings up feelings from the past, but merely because he is saying to himself something to the effect of, "Oh, my heavens! How terrible it would have been if that car had hit me!" If he can just put a cork on the internal chatter, his heart will stop thumping, he will stop trembling, and he will be able to get on with his life.

The problem with this notion is one of contradiction. Ideas are processed cortically, on the third level of consciousness. Unconscious ideation is a contradiction in terms. However, you can have feelings which are unconscious, because feelings are processed subcortically. Thus, triggered by the near-miss auto accident are reverberating circuits of feelings. Something like a near-miss auto accident can activate these circuits so that unconscious memories suddenly become conscious.

 Memories of being chased and beaten by a brother or father, memories of fighting parents, memories of first-grade bullies -- all can be triggered by experiences in the present. Whatever sentences accompany the experience are merely extensions -- not agents -- of it. The experience of nearly being killed in an auto accident is an experience of severe trauma. It is not a cognitive utterance.

Ultimately, there is no reality, no rational, in Rational Emotive Therapy. When Ellis states, "We do not suffer from the shock of our experiences -- the so-called trauma -- but we make out of them just what suits our purposes,"[32] he is saying that no event is intrinsically traumatic. But how, according to Ellis, does a child twist real catastrophes -- violent fighting between parents, beatings and humiliations (let us not forget the epidemic proportions of child abuse in this country), rejection, indifference, pressure, and the like -- to "suit" his purposes? Why would a child have such miserable purposes to begin with? Why would a child want to neuroticize experiences if they had been truly healthy ones in the first place? Where do these "purposes" come from? What prior forces shape the purposes for which we use or invent trauma to suit ourselves?

Neurosis is a profound biologic state, an alteration of one's total physiology, not a mental issue. A person suffers when he spends the first ten years of his life in three or four foster homes. There are not too many interpretations for all the traumas he goes through -- except Pain. He later goes to a RET therapist and is told that perhaps he shouldn't have expected love in the first place. Perhaps the stability he requires now is an illusion and isn't really necessary. And the patient agrees, and says over and over again, "I don't need stability. It's an illusion." Is it? Or is it a real need based on history? The infant doesn't interpret his trauma; he suffers it.

Ellis contends that sentences are the realities. I contend that Pain is the reality, and that sentences may arise out of feelings in order to justify and rationalize them. The foster child mentioned above will not become neurotic because of his attitudes toward the foster homes, but because of the very real heartache, rejection, and abandonment, because of the very real lack of warmth and kindness and belonging he has experienced.

Ellis says that we determine the meanings we give to situations. In reality, however, the meaning one assigns to a situation in the present is not a deliberately chosen one, but one that reflects unconscious processes at work. It reflects how one feels about the situations. Meaning is the last element in the neural hierarchy of perception. It follows feeling -- neuro-embryologically, and therefore, psychologically. Ideas are meant to pinpoint and make sense out of sensations and feelings. Ideas were the last to develop in evolution and follow the lower levels which developed hundreds of millions of years previously.

Ellis implies that we are all basically self-destructive in that we choose our neurosis. We are anxious because we perversely insist on telling ourselves the wrong things. We get something out of being neurotic, and the therapist's job is to craftily discern what we are getting from our behavior -- attention, hostility, affection, concern, rejection, or whatever it is we neurotically desire. The people in est some years ago extended Ellis's ideas so that even a young child was responsible for his own neurosis.

  I have seen hundreds of patients who have said everything in the book to themselves to get over their problems, but nothing worked. Indeed, that is their terrible frustration; no matter how hard they tried, nothing worked to quell the Pain. Ellis contends that the patient is responsible for making his own life, and that he must simply choose to feel good. In other words, the patient is now being made to feel anxious and guilty about being anxious! He's just being "pigheaded," and it's his fault.

This is a harmful oversimplification of the concept of self-responsibility. Of course, as adults we are the only ones who can undo our Pain, and in that sense we are responsible for it. But Ellis treats self-responsibility with a kind of superficial flippancy, implying self-destructive intentionality on the part of the patient if he doesn't get well. The patient is then left with the disturbing implication that if Ellis' theories and therapy don't work for him, he must have some hidden, masochistic desire for them not to work. "We are in pain because we want to be" is really a remake of the puritan viewpoint that bad things happen to us because we are sinful. Such attitudes make healing impossible. You cannot heal without feeling the Pain of the wound, and according to Ellis, feeling the Pain of the wound means you want to be hurt.

Ellis' outlook toward the results of his own therapy is as tough-minded and insouciant as his view of neurosis. He pushes patients toward "more elegant solutions" even when they resist, and if those elegant solutions don't work, then "tough!"

Ellis is no doubt saying to himself, "No one says I have to succeed all the time; and if I don't, too bad." I wonder what the patient is saying. Is she saying, "No one says therapy has to succeed, and if it doesn't, too bad!"? Or is she saying, "I have led a miserable life. This is my last chance. If I don't succeed I don't want to live anymore"?

Obviously, Ellis is using his own therapy on himself by using strings of words to alleviate or circumvent any possible feelings of failure. For him the grim reality that patients change only moderately in his therapy is not something to feel badly about. And if he does feel badly about it for a moment, better to exhort and persuade himself that he is succumbing to sentimental irrationality.

If they choose not to get better, it is simply "tough!" And that about sums up the leitmotif of Ellis's therapy -- be tough, develop excuses or rationales for your behavior because nothing really matters -- not even love. You don't need love; you just think you do. Change your thoughts and presto! your need disappears.

Converting Personal Experience into a Therapy

Ellis is as tough on himself as he is on his patients. Here is a sampling of his Marine-style therapy applied personally:

Today, if I had a public speaking phobia, I would still force myself to give many talks in a row -- as I did during my twentieth year. But I would also work very hard at giving up the belief that I must impress others with my speaking and that my life would turn into a holy horror if I did not. And I would furthermore work at giving up several concomitant feelings of shame.[33]

Ellis believes that you have to give up your feelings and force yourself into action in order to function. What he doesn't realize is that the reason force is necessary -- not to mention the hard work and practice he so often refers to -- is because giving up feelings amounts to giving up parts of oneself. Such psychological amputations do indeed require force.

We must spur ourselves into action, is Ellis' view. In fact, he seems to regard action and aggression as the highest goals of therapeutic achievement. Not surprisingly, Ellis himself had learned as a young man to combat fear and shyness with action and boldness. Ellis' example regarding public speaking is actually an oblique reference to the fears against which he had effectively "desensitized" himself long before. According to a 1988 portrait of Ellis in Psychology Today, at age 19, in order to overcome his "terror" of speaking before a political group to which he belonged he devised a number of "shame-attacking" exercises for himself, and repeatedly forced himself to speak up in public forums as often as possible, until he no longer felt uncomfortable doing so. He later forced himself to overcome his fears of talking to women by striking up conversations with dozens of them in a park in New York. Recalling this self-imposed "exercise," Ellis asserts:

According to learning theory and strict behavior therapy, my lack of rewards should have extinguished my efforts to meet women. But I realized that throughout this exercise no one vomited, no one called a cop and I didn't die. The process of trying new behaviors and understanding what happened in the real world led me to overcome my fear of speaking to women."[34]

This worked for Ellis; why not assist others achieve a similar growth? Ellis has extrapolated from his own personal life a philosophy and a mindset which he believes is universally applicable. His position implies that if you are more passive and reflective, if you act less and introspect more, then you are less adapted to the world. Ellis is blind to the "doer" neurosis where action is used as a defense, and where passivity (inaction) would really be a step toward health. No need to introspect, reflect on one's self and one's feelings, get out and DO! His adage seems to be, "If you are active and functioning, then you are fine." But the truth is that most doer neurotics are terrified of being without activity. They cannot passively relax because they are too busy using action to run from what is inside. They stay on the move because to stop might mean to have to feel certain things they are terrified to confront.

This is one reason why Ellis' action approach is one-dimensional and lopsided: it does not allow for individual differences, for introversion-extroversion predispositions, or for the inwardly oriented life.

Again, Ellis has it backwards. He has not paid attention to neurology. In the order of the development of the brain, sensations come first, then emotion, and finally ideas. This is true in the evolution of the species as well as in the life of each individual. Ideas are a much later development than feelings, neurologically speaking. And why do these ideas persist? Why do they plague us despite all our awareness and self-analyses? They do so because the continuity of human existence is based on feelings, not on passing thoughts.

Feelings shape our attitudes, and childhood traumatic feelings are the only way to account for the continuity of irrational ideas. Our ideas and concepts emerge out of sensation and feeling in order to express, differentiate, and symbolize them. These ideas can endure unchanged for a lifetime. This is not because they are being rehearsed, but because they are reverberating below the level of conscious-awareness untouched by new ideas.

Ellis' error grows out of his belief that neurosis is a set of ideas separate from the total state of the person. In actuality, children can be neurotic long before they develop ideas. A one-year-old child who hasn't developed the cortex to formulate ideas can still be very neurotic. He may have allergies, colic, eating problems, sleep problems, or other such ailments as a consequence of his repressed Pain. He may be a headbanger, a constant whiner, or unduly hyperactive. The infant is beset by these problems not because he is rehearsing irrational ideas -- but because he is agitated by Pain.

    The clearest illustration of my point is found in the case of psychotics with delusional ideation who are given particular painkillers, and who then change their ideas and irrational thoughts immediately without any discussion whatsoever taking place.  I discussed in another work the delusion of a young woman who thought someone in Europe was sending messages to her through her television set, a common delusion.  Tranquilizers, which work on lower brain centers, not on thought centers, diminished the delusion.   This again indicates the fact that ideas are derived from lower-level neurological processes, and are altered when those processes are altered.

The dialectic of neurosis pertains: when we feel our own past reality, our current unreality disappears. When we do not feel our past, the current unreality remains. When someone is forced to be "real and logical" in the present, he is bound to remain neurotic and irrational -- not only because he is forced to adopt somebody else's idea about reality which has no relevance to his own physiology, but also because he is now deprived of the direct tie between old feelings and current ideation. Even though that current ideation is "irrational," it is his ideation, his neurotic synchrony. To overlay it with the therapist's ideation is to make it only more inaccessible.

Feeling and ideation are a unity. Irrational ideas persist when feelings are buried, which is why they seem irrational; the context is missing. The point is that the ideas make perfect sense once they are reconnected to the past. The delusion in one of my patients, "I caused the war!" dissipated when she felt that she caused the war between her parents when she witnessed a violent argument at the age of five when her father left the house permanently. Without that context, which took weeks of feeling to reach, her ideas would seem totally paranoid. Should we have convinced her that there was no war so she couldn't possibly have caused it? There was a war, only it occurred thirty years earlier. The fight was about her and her upbringing.

Ellis makes much of the "desire" to change. But how do you get someone to feel that desire? In some types of neurosis, loss of desire is precisely the problem: the person doesn't desire to do anything. A serious depressive cannot be coaxed into desiring to feel better. Desire rides on feeling and on physiology, not thought, which is why feeling remains the inroad to desire. There are physiologic factors to take into account. If one is deficient in interleukin II, deficient in thyroid and is anemic, one doesn't have the energy to desire anything except rest. These factors can be altered early on by trauma, skewing the physiology toward the "hypo" or undersecretion mode. Thereafter, trying to do anything is a great effort.

Forcing a patient to desire to do something -- even when that something is wanting to feel better -- is putting the cart before the horse. It is asking the patient to get over some of his neurosis in order to get over the rest of his neurosis. If it were that easy, he could just as easily go all the way and get over all of his neurosis. It's the "get over it" school of psychology.

RET and Childhood Neurosis

One might reasonably assume that Ellis' system of cognitive behavioral analysis is applicable only to adults. It turns out, however, that he also uses it on children to show them how they create their own neurotic problems through irrational ideas, and how they can choose more logical ways of perceiving the world, so that they can stop being plagued by "stupid, ineffectual and self-defeating behavior."

Ellis points out that a parent probably won't be able to spot truly disturbing behavior until the child is at least four years of age because, after all, childhood behavior is generally "bizarre":

It is exceptionally difficult to tell whether a child...is predisposed to neurotic behavior during his first four years because so much of his behavior during that time is, at least from an adult standpoint, relatively bizarre and "childish" that it is still too early to see very clearly whether he is headed in a truly aberrant direction.[35]

Once a child has outgrown most of the bizarre and childish behavior of early childhood, you can then begin to detect neurotic predispositions. One main sign can be found in the area of self-depreciation. Neurotic children, Ellis explains, subscribe to two major irrational beliefs. The first one is: "It is a dire necessity for a human being to be loved or approved by virtually every significant person in his life." In discussing this "irrational" need for love, Ellis takes the rather surprising view that love isn't all that necessary:

Granting...that most children have to be helped and approved to some considerable degree before they begin to accept and value themselves even when they have done many wrong deeds, there is certainly no evidence that youngsters have to be greatly loved if they are to get along reasonably well.

Most children can hardly be given love and adoration by all their associates and relatives; and since only a small percentage of children seem to turn out to be exceedingly self hating as a result of this dearth of unalloyed approval, we may justifiably conclude that this kind of total acceptance is hardly a requisite for mental health, and that the lack of it does not automatically send each "deprived" youngster into the doldrums.[36]

Now that we have "justifiably concluded" that a goodly amount of love and acceptance is hardly necessary, let us look at the second irrational belief which leads the believing child down the path of further neurosis: "One should be thoroughly competent, adequate, and achieving in all possible respects if one is to consider oneself worthwhile."[37] Ellis explains that once a child has set up such a premise for himself, he is setting up ("inventing") failures and catastrophes such that "he will sooner or later end up by considering himself worthless and will make himself distinctly neurotic.[38]

Ellis' general attitude toward neurotic children is well summarized by his evaluation of John, an 11-year-old patient. John had been plagued by school phobias and other assorted irrational fears all of his young life. He was terrified of going to school, afraid of being assaulted by other boys, worried about becoming ill, scared that he would cut himself with a knife, and so forth. If he managed to overcome one fear or obstacle, another would turn up in its place. For instance, if he started off with a fear of doing spelling one week -- and conquered that -- then the next week he would have a fear of doing geography. Ellis evaluates:

John's case epitomizes the fact that certain children are enormous catastrophizers who actively seek conditions to worry and fret about. Some do so mutedly and manage to get through the normal happenings of their existence with too much tenseness, but without dramatic upheavals. Others, like John, seek such conditions dramatically and wind up by having school phobias, excruciating nightmares...psychosomatic upsets, and various other manifestations of intense, irrational fear.

Most children, of course, are much more afraid of various people, things, and events than are average adults. But a minority of youngsters are pathologically afraid of innumerable things, or immensely afraid of a few; and these children have to be somehow disabused of their anxiety-creating philosophies of life if they are to live comfortably and if they are to give their parents peace.[39]

Children do not have "anxiety-creating philosophies of life" which they must be "disabused" of. They have physiological imprints of Pain acquired through actual lived events. The more catastrophic these events, the more catastrophizing is the child's behavior. The kind of choices one is capable of making as an adult are very different from those made as a child or infant. The adult may reflect, consider, weigh alternatives, examine options, analyze motives, and speculate on outcomes. The child's repertoire is much more limited because his brain simply cannot do the same work. He cannot put so much intellectual distance between action and reaction, between experience and response. He cannot choose to be neurotic, as Ellis suggests, in the same way that an adult can be prefer one philosophy over another or even welcome some nurturing magical presence into his life. A child's choices are not really choices at all in the sense that full cognitive deliberations are not his to call upon.

  Ellis seems to believe that children are aware of their neurotic "choices" -- hence calling them choices at all. But if a degree of awareness is essential to choice, then Ellis is out of order; children are overtaken by neurosis long before the capacity of conceptual awareness is fully operational. If Ellis studied electroencephalography he would know that the cortex and its rationality aren't fully functional until puberty. It is then that ideas have some chance against feelings.

Furthermore, no therapy can be called child therapy when its aim is to "give their parents peace." Children are unruly, phobia-ridden, or intractable for reasons directly related to the parents themselves. To manipulate, cajole, or threaten the child into behavior that merely gives his parents peace is to enforce psychological prostitution upon him. He is being asked to deny his own integrity, to deny the validity of what he experiences, by exchanging his Pain for a philosophy that suits his parents' needs.

This is not child therapy.  It is child abuse.

Ellis believes that we all have genetic tendencies to be irrational -- to be hostile, envious, blaming, etc.  The Primal view of man is not based on such negative suppositions because we have observed human beings experiencing the very depths of their Pain, and we have seen that hostility and blame, and most negative emotions, are reactions to hurt and deprivation.  They are not basic tendencies and do not exist in the absence of Pain.

Ellis' view is a twist again on the Freudian and religious notion that we are basically bad or evil (read, irrational) and have to be corralled into good behavior.  I believe it is the opposite.  We are "made bad."  We are made hostile by deprivation of need, by abuse, and neglect.  Of course, the capacity to be hostile exists in everyone, and will continue to exist as a survival mechanism as long as the capacity to inflict deprivation and injury exists.  Viewing hostility or irrationality as an inherited trait, however, only serves to perpetuate neurosis as the accepted condition of mankind.

I believe we are born eminently rational.  There is no one quite so perceptive and real as a child untrammeled by Pain.  Pain deviates our whole system including our psyche.  When my patients relive early Pain, they return to rationality.  Their perceptions change and are no longer warped.  Ellis does not understand that neurosis is a survival mechanism.  He does not understand that humans become irrational precisely because their basic heredity has been denied.

According to RET, the solution to the problem of neurosis lies in developing a "good philosophy of life."  Having a philosophy, however, is not one of our basic needs.  Getting our needs fulfilled is basic.  Without feeling, basic need remains deprived.  When fulfillment occurs, a "good philosophy of life" does not have to be developed.  It is simply lived.

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[1]_See Claire Warga, "You Are What You Think." Psychology Today, Sept. '88, pp. 54-58.

[2]Albert Ellis. How to Prevent Your Child From Becoming A Neurotic Adult (New York: Crown Publishers), 1966, p. 4.

[3]Quoted in Psychology Today, op. cit., p. 58.

[4]Psychology Today, op. cit., pp. 54-58.

[5]Raymond J. Corsin, Ed., Encyclopedia of Psychology, Vol. 3. (New York: John Wiley & Sons, 1984), p. 207.

[6]Ellis, op. cit., p. 4.

[7]Ibid., p. 49.

[8]Ibid., p. 48.

[9]See Albert Ellis' column, "Making Ourselves Neurotic," in The Humanist, March\April, 1992, pp. 43-44.

[10]How to Prevent Your Child From Becoming a Neurotic Adult, op. cit., p. 19.

[11]The Humanist, op. cit., p.43.

[12]Ibid., p. 43.

[13]Albert Ellis, "Are Gays and Lesbians Emotionally Disturbed?" The Humanist, Sept.\Oct. 1992, pp. 33-35.

[14]Psychology Today, op. cit., p. 58.

[15]Ibid., p. 21.

[16]How to Live With -- and Without -- Anger, Ibid., p. 20.

[17]Ibid., p. 19.

[18]Ibid., p. 21-22.

[19]Ibid., p. 19.

[20]Ibid., p. 8.

[21]Ibid., p. 300.

[22]Ibid., p. 31.9

[23]Ibid., p. 32.

[24]Ibid., pp. 39-46.

[25]Ibid., p. 51.

[26]Ibid., p. 54.

[27]Ibid., p. 55.

[28]Ibid., p. 55.

[29]Ibid., pp. 67-68.

[30]Psychology Today, op. cit., p. 57.

[31]Ibid., pp. 70-71.

[32]Arthur Burton, What Makes Behavior Change Possible?. (New York: Brunner/Mazel, 1976), p. 191.

[33]Ibid., p. 188.

[34]Psychology Today, op. cit., p. 56.

[35]Ellis, How to Prevent Your Child From Becoming Neurotic, op. cit., p. 12.

[36]Ibid., p. 23.

[37]Ibid., p. 24.

[38]Ibid., p. 27.

[39]Ibid., pp. 38-39.