Rational Emotive Behaviour Education: Student with anxiety - session 2

This 14 year old student has had a reasonable week. He has been aware of how his anxiety has ebbed and flowed in his interactions with others and is monitoring his self-talk. He is very careful about what he says and how he says it and is quick to help and encourage others with enthusiasm. Other students have commented that he is ‘overly helpful and encouraging’ at times and would prefer he ‘relax a bit.’

Counsellor: G’day. How’s it going?

Student: I’m fine. I’ve been thinking about our last chat and I think it’s true that I worry too much about what others think.

Counsellor: You’re not alone, and it’s useful that you have been thinking about your anxiety and what might be causing it. Last time we spoke we talked about ‘needing the approval of others.’ Do you recall?

Student: Yeah. I’ve been thinking a lot about this. I do want to be liked by others. Isn’t it OK to want be liked by everyone?

Counsellor: Can you be liked by everyone? Do you think this is a reasonable expectation to have of others?

Student: I try hard not to offend anyone so shouldn’t they think well of me?

Counsellor: Want and need are interesting ideas. Can you see a difference between the two?

Student: Yes I think need is stronger than want, like you need water to survive but you don’t need to have chocolate. Without water you will die but without chocolate you can still survive!

Counsellor: Well explained. What is the difference between wanting to have others like and respect you and needing others to like and respect you?

Student: I get what you mean. I’m into needing others to like me, like I will die if they don’t! That’s what’s going on with me, that’s why I feel so bad when other people seem not to like me. That’s why I try hard to please them!

Counsellor: I think you are working it out pretty well. You have identified a belief or rule that you have that is not helpful to you because your anxiety is linked to this rule. Do you know what your rule might be?

Student: I have an idea that it’s something to do with my need for others to approve of me. Am I warm?

Counsellor: You are very warm, hot even. Can you begin saying your rule with: ‘I need the ……..

Student: OK. I need the approval of others.

Counsellor: Yes but why?

Student: I need them to like me so I can feel good about myself.

Counsellor: Yes indeed. Well done! And when you don’t get the recognition or approval you ‘need’ how do you feel? And how does this affect your life?

Student: I feel really anxious and I can’t concentrate on anything because I have made someone upset.

Counsellor: Well done! You’re beginning to understand where your anxiety comes from. You have worked out what your feelings and behaviours are connected to. What would that be?

Student: That would be my rule wouldn’t it?

Counsellor: Yes or belief. Tell me what your rule is but instead of beginning with ‘my rule is’ use ‘I believe that’ instead.

Student: OK.  I believe that I need the approval of others for me to feel OK. How’s that?

Counsellor: So who or what is ‘making’ your anxiety?

Student: I think my rule or belief makes my anxiety. Would that be right?

Counsellor: Yes I agree that you have developed a MUST belief. People you like and respect MUST like and respect you but ‘must’ they? Can they?

Student: I’m beginning to understand that I can’t expect everyone I like to like me but it’s hard for me to accept this. But it makes sense.

Counsellor: It might make sense but you have been practicing this MUST rule all your life and it will be difficult to replace it with a healthier more sensible rule.

Student: What would that be?

Counsellor: You might want chocolate but you don’t have to have it. You might want their approval but you don’t have to have it to be OK. How could you express the notion that you might want chocolate but you don’t absolutely need it? Clue - use ‘prefer’ in your sentence!

Student: OK. I would prefer to have some chocolate but I don’t have to have it. I prefer people I like to like me but they don’t have to.

Counsellor: Will you die of you don’t get any chocolate? Will you die if someone you like doesn’t like you? Would it be so awful that you couldn’t stand it?

Student: No I wouldn’t die and I could stand it but I wouldn’t like it, I still wouldn’t like it!

Counsellor: No it would be bad but not so bad that you couldn’t stand it. You can’t always get what you want and that’s true don’t you think? You might not get what you want (them to like you) but you are still OK even if they don’t. We will talk about this further in the next session. Well done.

I had intended to talk about Unconditional Self Acceptance(USA) but I have taken a while to get to this point. The student has shown considerable insight into what he believes (his philosophy) and how this drives his anxiety. Intellectually he understands whats going on, he can talk the talk. But it will be a while and take a lot of hard work before he will automatically walk it. This is called emotional insight and we will continue with this case study in the next post. This is Rational Emotive Behaviour Education at work. Good one Dr. Ellis!

Rational Emotive Behaviour Education: Student with Anxiety 1

This student feels anxious over something that has happened. He asked another student if he had a problem (are you Ok? Can I help?). This was misinterpreted (what do you mean I have a problem?) and he responded aggressively. The student was taken aback and then began to mull over the response he received. He asked a trusted teacher if the esteem in which he was held by other teachers was now diminished. The teacher said not in any way but the student remained preoccupied and went to see the counsellor outlining what had happened and how best to deal with the situation.

In the counsellors office

Student: I am concerned about how a student responded to me. I am caring and I didn’t intend to offend him when I asked him how he felt and if I could help. I am worried that he thinks I intended to offend him. I want to be a nurse one day; everyone knows I like to help.

Counsellor: So you asked him if he had a problem and he didn’t appreciate the questions. He felt annoyed. Is that right?

Student: Yes and I don’t understand why he felt that way. Anyone who knows me would say that I am caring and I am genuine when I ask how someone is.

Counsellor: You are caring and considerate of others generally and you are known for this. One individual has interpreted your intentions in a negative way and you feel upset and worried about this.

Student: Yes I do. I asked Mr S. if the other teachers would think less of me because I have offended someone. I am worried about this.

Counsellor: Using the Emotional Thermometer how would you rate the intensity of how you feel? How strong is your worry?

Student: It is around 9/10.

Counsellor: That’s strong. How often do you feel like this and for how long?

Student: Most of the time I feel anxious about things.

Counsellor: How does this affect your day-to-day life? Does it help you achieve your goals or get in the way?

Student: I can’t focus on what I have to do.

Counsellor: That would be stronger than concern or worry. Do you know what anxiety is?

Student: Yes I do.

Counsellor: From what you tell me you feel anxious a lot of the time because you want everyone to like you and you think it would be terrible if anyone thought badly of you. You really care about what others think of you.  Do you think you care too much? Do you need other people to approve of you for you to feel OK?

Student: How did you know that?

Counsellor: The belief that ‘I am OK only if others think I am’ is an unhealthy belief because it stops you from working towards your goals. You feel nervous and worried a lot of the time (unhealthy negative feelings) because you think it would be terrible if anyone knew you made mistakes or didn’t seem to approve of you.

Student: This stops me from being successful because I can’t concentrate on my work because I feel very worried a lot of the time! I worry too much about what others think of me but I can’t seem to stop doing this.

Counsellor: You have the tendency to believe that everyone must like you because you are a likeable and caring person and others should recognise this. Is this fair to say?

Student: Yeah. I just can’t handle it. What can I do?

Counsellor: We will look at your belief that you need everyone’s approval to be OK and why this is keeping you anxious. We will work on this next time we meet. In the meantime remind yourself that you don’t need other peoples approval to be OK. You can prefer it but you don’t need it.

Rational Emotive Behaviour Education is the application of Rational Emotive Behaviour Therapy principles and practices in the classroom and across the school. When a student comes to see the counsellor she already knows that thinking, feeling and behaving are connected. She knows about rational and irrational thinking; how ‘musturbatory’ beliefs stop her from achieving success. She has been introduced to the Emotional Thermometer and the Catastrophe Scale as aids that can help her. The student is therefore prepared to explore unsettling personal emotional issues using to Dr. Albert Ellis’ ABC Theory of Emotional Disturbance. We will continue to explore this student’s anxiety in the next blog post, Rational Emotive Behaviour Education: Student with Anxiety 2. 

Musting Oughting and Shoulding

‘Musturbation’ is a term coined by Dr Albert Ellis to describe absolutist, black and white thinking/believing. Musturbatory thinking according to Rational Emotive Behaviour Therapy theory is the kind of thinking that gives rise to extreme frustration anger and depression. This kind of thinking drives the unhealthy choices we are teaching our students about. The following habits of thinking are musturbatory:


• I absolutely must get what I want (or not get what I don’t want)

• Significant others must treat me well and do my bidding

• Life should be easy

If these absolutist demands are not being met then:

• Life is so awful and I can’t stand it! It sucks!

• People who behave shitily are shits!

• When I behave shitily I am a shit!

Musturbators will blame others and events for how they feel e.g. I only got an A- (perfectionistic leanings – I must be perfect), maths makes me angry (life must be easy), she didn’t let me join and she’s/life’s a shit (people/life must treat me fairly)

Karen Horney said:

‘Try to eliminate the word ‘should’ from your vocabulary …but try doing so without replacing ‘should’ with ‘ought’ or ‘you’d better’.

When people tell me I should, ought or must do something I am inclined not to want to do it. If an e mail uses language like should, ought or must I am inclined to ignore it or to bin it.

Our musturbating students don’t know they are doing this and Rational Emotive Behaviour Education is about teaching and modelling behaviour that reflects healthy habits of thinking (philosophies).

Self-Acceptance and the Resilient Child

Unconditional Self Acceptance (USA) is a habit of thinking that the resilient person has constructed over a lifetime. It is deeply held and is reflected in the behaviour and demeanor of the individual. You will observe the self-accepting person try new things readily, not being overly concerned about the prospect of failure, as she knows failing doesn’t equate with ‘being’ a failure. You will notice a self accepting person experience rejection philosophically, again understanding rejection or disapproval of others doesn’t render her a ‘reject’. USA affords the individual a degree of ‘psychological immunity’ to adversity. We all experience rejection, failure and challenges and it is the resilient person who is better placed to deal with these in a healthy way. Dr. Albert Ellis, creator of Rational Emotive Behaviour Therapy, encourages us to help our younger people to develop the capacity to ride the hard knocks successfully, to work through problems, to hang tough and believe that things can work out. Jonas Salk (developer of the polio vaccine) is on record as having said that he would be interested in researching ways of psychologically immunising children and how this could enhance their physical well being. There is a large body of evidence that supports the link between mental well being and physical health, so USA is very important in promoting emotional and physical well being. Specifically individuals who unconditionally accept themselves experience sadness, disappointment, concern or annoyance rather than depression, anger or anxiety in the event of difficult circumstances. Conversely those whose self worth is tethered to how well they do at tasks or how much they are esteemed by significant others are prone to depression and other emotional and behavioural dysfunction. If you want more information on USA please refer to earlier posts. The remaining discussion will focus on some ideas we can use to help others who may have issues with self worth. Tell your students, yourself and anyone who’ll listen that:

·      Thinking feeling and behaving are intertwined, interlinked. In other words when we experience emotions they are attached to our thinking (perception, interpretation of events) and our choices of action (behaviour).

·      Helpful habits of thinking help us and unhelpful habits of thinking (believing) hinder us.

·      USA is a helpful (true) habit of believing i.e. ‘I believe I am always worthwhile even if you don’t or if I do badly at a task.’

·      Conditional Self Acceptance (CSA) is an unhelpful (untrue) habit of thinking i.e. ‘I’m only worthwhile if you think so and when I do well at important tasks.’

·      Always give feedback that is behaviour and not person based, i.e. ‘you did that well’ rather than ‘good girl!’

·      No one is good or bad but they are always worthwhile. They are human beings not human doings! I.e. 'doing' good is not 'being' good and 'doing' bad is not 'being' bad.

These ideas will help your children develop the belief that ‘my value is not diminished by rejection or failure. What I think about me is more important than how others may view me. I can fail at something but never am I a failure and I can be rejected but never am I a reject.’

Remind yourselves daily of this truism bequeathed us my the late Dr. Albert Ellis who said:

'Unconditional self-acceptance is the basic antidote to much of your depressed self-downing feelings.'

USA is a rational belief well worth cultivating.

The Universe Don't Give a Shit!

The universe doesn’t care about you, it’s not for or against you, it just doesn’t give a shit. Albert Ellis

There are many quotes that Albert Ellis left us to ponder and this one’s a cracker! You can imagine him talking to the regular Friday night crowd at the (now fake) Albert Ellis Institute. He would demonstrate his ABC Theory of Emotional Disturbance to help volunteer clients gain insight into what was causing their emotional and behavioural disturbances. He would listen carefully to his client protest about how unfair this or that was and that if only life wasn’t so hard he could be happy. He would ‘cherchez le should’ listening intently for the tell-tale signs suggesting that his client believed the world owed him easy passage through life. Dr Ellis would challenge the belief that this or that shouldn’t have happened and that life was so unfair! ‘It happened therefore it should have happened. Yes it was unfortunate but not so awful that you can’t stand it! You can’t change what happened but you can change how you think about what happened.’ Ellis would invite his client to examine the veracity of his errant beliefs and to reconsider them in the light of the evidence and to replace them with healthy preferences. As the workshop ended his client would have something to work with on his onward journey, the audience members would leave well informed and heartily entertained and Dr Ellis would retire to his room and no doubt continue to work on his writing assignments! In my role as school counsellor I work with students who believe that life should be easy and that it isn’t fair when they are required to do something they don’t like. How do I know this? Often they will articulate exactly how they feel. ‘That teacher pisses me off because she wants me to do a science experiment with some kids I don’t like.’ He would be according to Albert Ellis unhappily ‘musturbating’, demanding that he must get what he wants. But mostly their behaviour and accompanying anger tell me what they believe, what their philosophy of life is. According to Ellis’ ABC Theory of Emotional Disturbance 'it’ doesn’t make the student angry but it's their expectation that they shouldn’t have to do 'it' that causes them grief! It is the false belief, constructed over time and practiced daily that ‘life should be easy and it is awful when it doesn’t give me what I must have!’ Try and tell a student that he or she is making his/her anger and aggression and not the teacher and she will look at you as if you are nuts. I talk often with colleagues about students who draw most on teacher time and school resources in terms of intervention and support. We agree that most of these students blame someone or something for how they feel and behave. We have found Ellis’ REBT to be a very useful tool to help them learn about the link between thinking feeling and behaving through Rational Emotive Behaviour Education. Students learn about the Catastrophe Scale and how often the belief that a problem is bigger than it is relative to others will cause emotional upset not the event or problem itself and that it is not so awful that it cannot be tolerated. They also learn how extreme negative and unhealthy emotions are driven by irrational musturbatory beliefs. At our school we are applying REBT principles in daily practice through Rational Emotive Behaviour Education. We are systematically challenging the errant view that strength of feelings and behaviours are made by other people and events and we teach that it is the individuals own personal irrational philosophical beliefs that determine largely how they feel and act! For those students who blame their teachers, the weather and others for how they feel and act we are using Ellis’ wise advice, that the world doesn’t give a shit about us and it doesn’t owe us anything so we’d better start taking responsibility for our own actions and emotions.

Giulio wrote this!

RESEARCH: Acceptance of Self and Others among Children: Implications for Bullying in Schools

This soon to be published research paper by Dr. Ken Rigby and Giulio Bortolozzo explores the attitudes of 212 middle school students towards themselves and others. As hypothesised, acceptance of self was significantly correlated with low levels of victimization and acceptance of others with low levels of bullying.

The intention of this post is to explore the implications of these findings for schools and teaching practice and suggest strategies (Rational Emotive Behaviour Education) to address bullying in our schools. But before that, a cautionary note!

A study by Dr Ken Rigby (Uni SA) and Peter Smith (Goldsmith College, London) reveal that 75 per cent of reports obtained from 27 countries (between 1990 and 2009) indicate a significant drop in student reported bullying and only 11 per cent reported an increase in occasional bullying.

In a recent article (Bullying going down, not up, Adelaide Advertiser, June 10th) Rigby reminds us that whilst the public perception may be that bullying is on the rise, the evidence suggests otherwise. Rigby believes that this perception:

‘… is due to the considerable raising of alarm about bullying and its effects over the past 15 years or so, and the increase in the reporting of serious incidents."

He goes on to say that:

"Stressing the serious effects of bullying is one understandable way of getting attention to the problem. Unfortunately doing so distorts the picture and takes attention from the many positive things that can be done, and are being done around the world, to address the problem more effectively."

Habits of Thinking and Victim Behaviour

# Unconditional Self-acceptance (USA) is the belief that self worth is not given to or bestowed on us by someone or something. It is given that a person is worthwhile because she exists and not because someone deems her so! This healthy (self helpful, rational) belief enables us to deal effectively with difficult situations (emotionally and behaviourally).

Insight 1 for students: Self-acceptance is a (healthy) belief. It is deeply held and is expressed in the way we behave and feel in day-to-day life. It is not connected to how well we do at something or how others view us. The belief that when we do good/bad we are not good/bad is an important insight to have. Doing and being are different ideas! This healthy belief is a protective factor against bullying.

As Jonas Salk (creator of the polio vaccine) replied to Martin Seligman (psychologist/author) when asked what he would do if he were a young scientist today:

‘I'd do immunisation. But instead of doing it physically, I'd do it psychologically.'

Dr. Albert Ellis (creator of Rational Emotive Behaviour Therapy) would say that teaching unconditional self-acceptance, ‘psychologically immunises’ students against the scourge of undue anxiety, depression and other emotional disturbance.

# Conditional Self-Acceptance is the belief that self worth is given to or bestowed on us by someone. It is a belief that a person is worthwhile only when someone deems her so! This unhealthy (self defeating, irrational) belief stops us from dealing effectively with difficult situations (emotionally and behaviourally) and may put us at risk of being bullied.

Insight 2 for students: Conditional self-acceptance is an unhealthy belief. It is a deeply held belief that gives rise to depression and anxiety because of the individuals need for the approval of others. Because we believe we are only worthwhile when others ‘tell’ us so we are at great risk because there is the reality that others we may like, may not like us.

Conditional acceptance of self is the belief that that we are only worthwhile when significant others deem us so or when we do well at something. This, Ellis reminds us, is self-esteem the ‘worst sickness known to man or woman!’ (See previous posts)

Our research says that many students who have constructed the irrational belief that their worth depends on others (Serious Approval Dependence SAD) may be prone to bullying. Why? They may believe that they deserve it and signal that they are not confident through their behaviour: e.g. withdrawn, passive. These behaviours will be accompanied by e.g. fear, anxiety, and depression.

Habits of Thinking and Bully Behaviour

# Unconditional acceptance of others equates with respect and tolerance. This is a healthy habit of thinking/behaving, which accommodates a range of qualities and characteristics observed in other people. When we hold this belief we accept that others are worthwhile irrespective of how they behave. Whilst having such an attitude we retain the right to choose whom we would like to associate with. We can for instance decide not to associate with a particular other for a disagreeable quality she may have but we do not then decide she is totally bad and treat her disrespectfully!

Insight 3 for students: Unconditional acceptance of others is a healthy habit of thinking. It means we are made up of an infinite number of qualities and characteristics and we cannot be defined according to any particular one of them e.g. if we do a ‘bad’ thing (steal a pencil) we are not totally bad. Conversely if we do something ‘good’ (feed the cat) we are not totally good. We can dislike an aspect of another’s personality or behaviour and choose not to associate with them but we respect them as fellow human beings of intrinsic worth.

# Conditional other acceptance equates with disrespect for others. This is an unhealthy habit of thinking. It drives intolerance towards others behaviours and qualities which we may find different, disagreeable, quirky etc. It allows some people in some situations to hurt others because they are ‘different’ ‘not normal’ etc who ‘deserve to be punished.’

Insight 4 for students: Conditional acceptance of others is an unhealthy habit of thinking. When we think like this we act inappropriately towards others because we tend to judge someone’s total being according to a behaviour or characteristic we may not like or approve of. It is quite ok to judge the behaviour as ‘bad’ but not the person.

A whole school approach to teaching these concepts through Rational Emotive Behaviour Education will do the following:

• Reinforce healthy attitudes and beliefs already held by resilient students
• Begin to challenge the unhealthy attitudes and beliefs held by vulnerable students and to help them build new healthy habits of thinking
• Help students understand that what they believe is connected to how they feel and behave

If students accept themselves unconditionally, they will understand that what people think of them is not as important as what they think/believe about themselves. They will tend not to depend on the approval of others and will therefore be less affected by any unfair and hurtful attention. They will be more self assured and assertive.

The research (Bortolozzo, Rigby) strongly supports the teaching of Rational Emotive Behaviour Therapy/Education as an effective anti bullying strategy especially in regard to helping those students who may be at risk of being bullied.

There are many REBT based resources available to teachers. I have written two resources People and Emotions for primary and secondary students and Have a Go Spaghettio! for early childhood learners. Anyone who would wish to purchase a copy can contact me via this blog site. You can visit www.rebtnetwork.org for additional information and resources.

These are some of the latest publications by Dr. Ken Rigby, which can be sourced at http://www.kenrigby.net/

Ken Rigby (2010) Bullying Interventions: Six basic approaches. Camberwell: ACER Press
Ken Rigby (2009) Bullying in Schools: Six Methods of Intervention (the DVD): Loggerheads.
Ken Rigby (2010) Addressing School bullying: Education Queensland
Australian Government report on the Method of Shared Concern by Rigby and Griffiths
Responding to school bullying: a resource for teachers

Rational Emotive Behaviour Therapy- a new book by Dr. Albert Ellis and Dr. Debbie Joffe Ellis

Dr Ellis’ latest work is a book called Rational Emotive Behaviour Therapy. Co authored by his wife Dr Debbie Joffe Ellis, it is part of the Theories of Psychotherapy Series, edited by Jon Carlson and Matt Englar-Carlson and published by the American Psychological Association.

This gem comes hot on the heels of Dr Ellis' autobiography All Out! which was published in 2010, with contributions by Dr. Debbie Joffe Ellis.

Ellis created REBT and developed it, promoted it and practiced it until his death in 2007. REBT is often said to be an offshoot or subsidiary of CBT but as this publication reminds us, REBT is the original cognitive therapy. Indeed Ellis is regarded as the father of REBT and the grandfather of CBT by those in the know.

Dr. Ellis’ motivation was to provide useful information to the general public on issues relating to mental health, offer a model (ABC Theory of Emotional Disturbance) that could explain why people feel and behave as they do and suggest strategies that they could use and practice in their lives.

Of course the ABC model is used the world over by mental health practitioners to support people in their desire to address their behavioural and emotional disturbance and to attain positive mental health.

Ellis challenged the psychoanalytic establishment and weathered the criticism and ostracism of those who wanted to preserve the elite status of the role of therapist. Ellis in time understood that psychoanalysis was a long and drawn out process, much too focused on past events and though the client may have felt better it didn’t necessarily mean she got better in the longer term.

As Ellis said:

‘Many psychoanalysts refused to let me speak at their meetings. They were exceptionally vigorous because I had previously been an analyst and they were very angry at my flying the coop.’

Ellis met this petulance with his usual wit and intellect and forged ahead anyway! He practiced what he taught and as he unconditionally accepted himself he declared:

‘By not caring too much about what people think, I'm able to think for myself and propagate ideas, which are very often unpopular. And I succeed.’

Ellis surely put the ‘REBT cat’ amongst the ‘psychoanalytic pigeons’ and the field of psychotherapy was challenged and transformed for good and for the better!

The book contains much for the layperson and the practitioner alike and remains true to the Ellis’ philosophy of helping people to help themselves. A DVD accompanies the book, which illustrates the therapeutic application of REBT.

Drs. Albert Ellis and Debbie Joffe Ellis acknowledge early in the book those who give and have given due recognition to his influence on their work. For instance William Glasser has respectfully given Dr Ellis due regard. Unfortunately others who have benefitted greatly by his work have not been so considerate.

Drs Ellis and Debbie Joffe Ellis again reinforce the importance of teaching children in schools from a very early age the basic principles and practices of REBT. Students and teachers would benefit greatly by understanding the link between thinking, feeling and behaving. The ‘wisdom of the ages’ ring long and loud through Ellis’ work. Consider the words of Epictetus in around 100 AD:

‘Events don’t make us act and feel as we do but it is our interpretation (appraisal) of those events that cause us to do what we do and feel what we feel.’

Helping people explore and understand this philosophy and apply it in their lives through Ellis’ ABC Theory is achieved in seven clearly written and informative chapters, which cover the life and work of Dr Ellis. Dr Debbie Joffe Ellis as co author continues to help spread the 'gospel of St Albert' widely and most successfully! The book talks about:

REBT History
REBT Theory
The REBT process
Future Directions of REBT

This book is a great reference for teachers and mental health practitioners alike and will be enjoyed by anyone who is interested in their own personal development. Indeed, a book for everyone!

Well done Drs Albert Ellis and Debbie Joffe Ellis on this wonderful REBT resource!