Dogma, REBT and Mental Health - a case study circa 1961

I was about six and the parish priest walked into the room. His vestments swirled around him as we all rose in deference to this holiest of holy messenger of God. The air wafted over us as he passed, stopping to settle in the middle of the front of the class. He was like a giant in black robes as he towered over us all, his large golden crucifix hanging from around his white dog collar, adding to his mystique and the drama of the situation.

“Give me the child until he is seven and I’ll give you the man." St 

Francis Xavier

My teacher, sister Mary explained that Father Pat was here to talk about heaven and hell and how we could be good people; how we could win over God's favour via good deeds and how the sacraments of confession and communion would ensure we could enter the gates of heaven one day. I felt quite scared and my fear continued to grow as he began his talk in his Irish brogue...

... 'Sure isn't it true that the good Lord has given us free will? D'ya know what that means?' He answered his own question and we just sat in awe as he expounded on how it was our job to do this and to think that. I was told what to believe as decreed by the priests and nuns as I continued my indoctrination in the absolutes of the dogma of the Catholic version of Christianity. I was a sinner and it was God who would forgive my sins and deliver me from all that was bad and evil!

For the wages of sin is death, but the free gift of God is eternal life in Christ Jesus our Lord. Romans 6:23

The priest continued in earnest. He had with him a sheet of blotting paper and a fountain pen. He emptied a small amount of ink onto the sheet. The ink slowly spread outwards from its epicentre and his godliness declared, 'this is your soul when ye are born. It is already stained by original sin. When ye are baptised your sin is forgiven. Such is the power of God!' (he made the sign of the cross and looked heavenward).

He then pointed to the right side of the room (our left) as a representation of heaven; where good people go, who think and act in accordance with the word of God. To his left was hell. This is where we would go if we didn't repent our sins; eternal fire and damnation awaited those of us who were sinners, those who blasphemed and swore, who told lies and had bad unhealthy (carnal) thoughts and imaginings.

He proceeded to empty a larger amount of ink onto the blotting paper. The stain radiated from where it was placed on the white paper. When it stopped the priest declared that a significant sin would have been made to make such a blemish. He motioned towards 'hell' and stopped. He said, 'this is a venial sin. Your soul still has divine grace but it is dirty and needs cleaning! God forgives us all!' Things would be fine if we repented our sins and paid the appropriate penance. So off to confession we could go and all would be OK again.

The priest became animated and his voice more shrill as he emptied the entire contents of the pen onto the blotting paper! He walked to the left of the room and as the ink stain spread on the paper he got closer to 'hell.' 'This is your soul when ye commit a mortal sin. Sure this is when God is most unhappy with ye. Ye are in grave danger of not going to heaven!'

By way of illustration of the concept of sin and its consequences Father Pat had hit the proverbial on the head. The class of six year olds sat in silent terror as Sister Mary thanked the priest and invited us all to pay close attention to what the 'good' father had said to us. 'Remember that God is watching you. He is everywhere!' she reminded us as the priest left the room as dramatically as he had entered. Whoosh and he was gone.

That thirty minute session above all others at junior school had impacted me in ways I would never imagine, consciously and unconsciously. The teaching of dogma (a set of principles laid down by an authority as incontrovertibly true) leaves an impressionable young person constrained (controlled) by these 'absolute truths' that govern our very existence. What were these truths that could not be questioned? How could these impact on ones mental health and well being?

• The idea that we are born to serve and adore an omnipotent being who made us in his image and lives in heaven. 

• That he is aware of our every action and thought. That heavenly privileges can be withdrawn if and when we sinfully transgress the rules of the dogma laid down. 

• That we are told we must love our neighbour as ourselves and that should we ever covet our neighbours possessions (material and otherwise) in thought or in deed would constitute a sin that would invite the wrath of the vengeful God that we were all taught to fear. 

I did unto others until I resented them with a passion. I learnt to seek the approval of all and sundry because in pleasing others I was pleasing God. I lost my own identity in placing others well being above my own mental health. I would expect others to do likewise for me and felt angry when they didn't (why should they?). I learnt to be judgemental - people should/ought/must think/act as I do according to the rules (again why should they?). The propaganda had worked and I was in the thrall of the dogma that I had inherited. My absolute beliefs were rusted onto to my subconscious and I had all the answers! So I thought.

Fortunately I happened upon the work of the Stoic philosophers, Bertrand Russell, Christopher Hitchens and Albert Ellis who were all singing from the same hymn sheet. An opinion is just that and doesn't constitute fact.

The fact that an opinion has been widely held is no evidence whatever that it is not utterly absurd.  Bertrand Russell

A persons worth is not tethered to how others think of her nor to her successes or failures. I learnt that thinking in absolutes stopped me from considering other philosophical views. I moved from the fixed inflexible thinking of the governed and subservient; from an absolutist to a free thinker. I began to question what I had been told to be irrefutable. I had started to develop independence of thought; to think for myself!

In REBT (Rational Emotive Behaviour Therapy) terms I shifted from believing that I must always be perfect and achieve my goals. That people I like must like me. That the world should give me what I want. If none of these demands were satiated it was the greatest travesty of justice! (because it shouldn't be that way!). I felt out of whack a lot of the time because I wasn't thinking straight!

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

I instead learnt to accept that I would sometimes (often) not hit the mark (and the sun still rose in the morning). I understood that everyone can't see me as I would like them to regard me (I chose to prefer this was the case). I learnt that the world/life doesn't take into account my personal needs and sensibilities and it is how I responded to events that mattered (I preferred things to go well but didn't demand that they should). 

This is a continuing journey and I subscribe to the philosophy of Albert Ellis who said:

The best years of your life are the ones in which you decide your problems are your own. You do not blame them on your mother, the ecology, or the president. You realise that you control your own destiny.

REBT, Growth Mindset and Rational Emotive Behaviour Education

REBT holds that our response to happenings/events, are linked to the habits of thinking or thinking rules that we have constructed over time. We can as a result of our social learning conclude certain things about our nature and capabilities. These can indeed be fixed and Albert Ellis talked about the debilitating effects of rigid, inflexible and immutable thinking habits that cause severe emotional suffering like anxiety, depression anger and shame. When gripped by such extreme emotional disturbance/turmoil the individual is in a sense unable (incapable) of acting in what we may consider constructive and progress/goal orientated ways. Fixed mindset predicts fixed outcomes. As these fixed thinking rules remain and continue to be practiced their truth is unchallenged; they are absolute. Can they be changed? Yes they can but with a lot of work!

According to Dweck: 'In a fixed mindset students believe their basic abilities, their intelligence, their talents, are just fixed traits. They have a certain amount and that’s that ... In a growth mindset students understand that their talents and abilities can be developed ...They don’t necessarily think everyone’s the same ... they believe everyone can get smarter if they work at it.' (Morehead 2012).

Ellis' ABC Theory explains how irrational beliefs (B) can be challenged at (D) - Disputation of Irrational Beliefs (DiBs). The first task of the educator/mentor/counselor is to alert the student/client to the relationship of B to C where B = beliefs, C = emotional behavioural consequences of A = the activating event). Refer here Thinking Feeling Doing (The ABC Theory of Emotional Disturbance) for more on this.

Growth Mindset Continuum ©Giulio Bortolozzo

The above diagram is my take on Growth Mindset as it is promoted and developed by Albert Ellis' ABC Theory of Emotional Disturbance. This model is delivered to teachers students and parents via the successful Rational Emotive Behaviour Education program adopted by several schools in South Australia. The aim is to alert students to the notion:

• that THINKING FEELING and BEHAVING are linked (Intellectual Insight)
• that Fixed Mindset Thinking (Irrational) is self defeating
• of actively and persistently challenging Fixed Mindset Thinking to change it to Growth Mindset Thinking (Emotional Insight)

Learning and success is linked to how we view (believe about) ourselves, others and life in general. The irrational beliefs of  'I am dumb/incapable' can be said to be fixed i.e. this is 'me', my 'nature' my 'lot in life'. The belief that 'I need the approval of others' to be happy and successful can also be regarded as a fixed idea about self in relation to others. And the belief that when things get tough one automatically defaults to the idea that it is not worth trying because of the 'fixed' construct that 'I am incapable/can't' (learned helplessness) anyway!

Ellis would say, I believe, that a fixed mindset is one which is comprised of irrational (stops us from pursuing our goals) thinking rules. The headset as outlined above will render the individual anxious (I don't want to risk failure) and/or depressed (people will think I'm dumb) and ashamed (I shouldn't be so dumb. I'm a loser!) What chance then for this person to progress and grow?

'Fixed mindset people dread failure, feeling that it reflects badly upon themselves as individuals, while growth mindset people instead embrace failure as an opportunity to learn and improve their abilities.' http://www.edutopia.org 

Help students become aware of their destructive fixed mindset (irrational) thinking rules. Challenge the veracity of such dogmatically held beliefs with a view to deconstructing them and replacing them with more rational (self/other helpful) thinking rules i.e. a growth mindset that will help thrive even through the adversity of failure, rejection and change. This is being successfully done in South Australian schools through the Rational Emotive Behaviour Education program!

Growth Mindset, Happier Kids!

When Students Are Our Teachers

Teachers beginning their careers will be challenged in their practise when situations present that require strength and resilience. One of a couple of things I will offer when asked is not to allow the fear of the disapproval of students thwart their resolve to establish their authority as classroom leader.

Why doesn't she like me? He doesn't seem to respond to my manner/style of teaching etc. Whilst these might prompt opportunities for reflection and review they don't need to become major 'crises of confidence.' Unless this is allowed to happen of course. As Eleanor Roosevelt once said: 

What we believe about ourselves is reflected in our behaviour and in how we feel when presented with difficult situations. Unconditional self acceptance is a kind of psychological buttress against the negative views and opinions that others may have of us. So suggestion number one for new educators: take ideas, opinions, advice on board but don't let them define you. What we believe about ourselves is less likely to be compromised. Our buttress isn't breached. For more on self acceptance visit:

Albert Ellis and REBT 

The second piece of advice I will offer is this; be aware of our personal prejudices about students. As we can't expect that all others must like/respect/admire us (though we may healthily prefer this) it is true that we may not have altogether positive views of others. I have heard colleagues over the years say that they 'can't seem to warm to this student and this effects how I relate to her.' This is an important insight to acknowledge and it can have positive outcomes if we determine to find 'a way in' to connecting with that child. 

Accepting self and accepting others are valuable attitudes to cultivate and educators who practise this by and large relate more effectively to their students. Those students who otherwise may be marginalised are eventually, in most cases won over!

A Girl Called Sharon - when 'being good' is self defeating!

I believe that our emotional and behavioural dysfunction is linked to the philosophies we have constructed over time and which we practise and reinforce unconsciously. Albert Ellis and others assert that our anger, anxiety and other emotional ills are constructed ergo they can be deconstructed.

“If you are distressed by anything external, the pain is not due to the thing itself, but to your estimate of it; and this you have the power to revoke at any moment.” Marcus Aurelius

 

Marcus Aurelius

Why does Sharon feel so sad and aggrieved? Where does her own personal beliefs come from? This fictitious account of Sharon's early learning might shed some light on this.

Little Sharon was taught that she should always use her manners and that others should too. If she waved to someone who waved at her ‘that was good’, she was a ‘good girl’ to do this. Her parents said ‘good girl.’ Her parents would say how rude it was when others didn’t show the same standard of manners and that they should always be well mannered. Sometimes her dad would say how terrible it was that people weren’t as well-mannered as they should be.

At school Sharon tried very hard to be ‘good’ at all times.  Sometimes she would ask the teacher, ‘am I a good girl?’  She would try hard to get stickers and she felt bad when the teacher was angry about something.  She thought it was her fault.

When she was in high school she worked hard to be liked by others. She would buy things for her friends and offer to do things for them. If they seemed unhappy she would worry that she had done something bad. If she wasn’t included she felt very sad and thought no one liked her.

When she was an adult she found she often felt angry when people didn’t do what she thought they should do.  She would help people, buy them things and go out of her way to do for others. Instead of feeling good she felt bad.

‘Why don’t they do things for me,’ she would think. ‘Why don’t they buy things for me? Shouldn’t they treat me the same way? Perhaps I should try harder,’ and then they will like me and think I’m cool. Perhaps I’m not trying hard enough.’

Years later.

When she was driving in town one day another driver let her in and Sharon waved to her. The other driver didn’t wave back and she felt the anger rise inside her…  

  

Sharon with a friend

Mental Health Education - rational emotive behaviour education

Children are constructing their own views on things (philosophies) making meaning from what they see and hear in their interactions with others and the world. The conclusions they draw may be helpful or unhelpful (rational or irrational) – their ‘thinking rules.’ (unconscious/unaware)

Behaviour management is not individualised – what philosophies do those children hold (constructed)? Do they know them? How do they effect emotional and behavioural responses to situations? What can they learn/relearn that will help them?

One size fits all – assumes that:

• Children know how to behave
• They have all been exposed the same learning/experiences
• They therefore should know how to behave
• If they don’t behave appropriately they should be punished (because they should Know better) – This will not be the articulated position of the teacher/parent/other (they too may be unaware of their own constructed philosophies!)

This is a short term fix at best but it will:

• Not make sense to the child (doesn’t factor in what ‘thinking rules’ they have constructed)
• Children are blamed/judged on their behaviour
• Children believe they are ‘bad’
• Social and emotional problems – anxiety, depression, anger, shame
• Can’t engage in learning – ‘I’m bad/stupid/worthless/dumb.’

REBE is a long term approach to mental health/well being. It:

• Alerts students to their ‘thinking nature.’
• Helps them identify what they believe and why and how this relates to how feel and behave
• Empowers them to monitor emotions, check thinking, recalibrate – is this as big a problem as I believe it is?
• Helps them to challenge and change destructive personal philosophies that are not based in fact and which cause them (selves) grief
• Reduces the incidence of major mental health conditions like depression and anxiety

The REBE in Schools Program

• Recognises the dignity of the person (no shame job)
• Is teacher/student/parent friendly
• Is based on well tested psychological principles (REBT)
• Recognises students as constructivists – ‘Depression is by and large constructed therefore it can be deconstructed.’ Albert Ellis
• Is systematic, relentless, comprehensive and effective in its mission
• Is highly cost effective
• Is home grown

An Anxious Adolescent - part 3

The student continues to explore the idea that events don’t cause our extreme ill feelings but rather it is our interpretation or thinking about them that does. The belief we are worthwhile only when others do is an errant philosophical view and our student is beginning to realise that his unrealistic demand that others MUST like him to be likeable is doing him a disservice.

In the counselling office in a school in South Australia

Counsellor:   You say that you feel anxious when you think you have ‘offended’ someone. Is that fair to say?

Student:  Yes I want people to be happy. I hate it when they feel bad because of me.

Counsellor:  It would appear that you believe you are responsible for how others feel. You say you ‘made him upset.’ Would that also mean that you believe others ‘make you upset?’

Student:  Yes. People can make me upset and I can upset others.

Counsellor:   I want to talk about a ‘must’ rule that people make over time. It is a rule that is not a helpful one to have.

Student:  What do you mean? Do I have a must rule? I don’t think I do.

Counsellor:   What do you think about the rule ‘people must like me or I’m no good?’

Student:  I’m not sure what you mean. Where does this rule come from?

Counsellor:  OK instead of using the word ’rule’ replace it with ‘belief.’  Say ‘I believe I’m OK only when people think I am.’ (Student repeats statement). A belief is a strongly held view about something that we believe is true.

Student:  Why do I believe this? Where does it come from?

Counsellor:   You have learnt this from an early age. You have learnt that you are only ‘good’ if others think you are ‘good.’ When someone disapproves of aspects of your personality or something you do you don’t just feel disappointed you feel really anxious and sad. Someone or something is not ‘making’ you anxious but your ‘thinking rule’ your ‘must belief’ is!

‘It's lack of faith that makes people afraid of meeting challenges, and I believed in myself.’ Muhammad Ali 

Student:  Do you mean that my belief that that kid I was talking about ‘must like me and think I am a good person’ is what is causing my anxiety?

Counsellor: Yes exactly! Your belief (that you believe is true) is making you anxious because you don’t get what you must have and that it is really awful that you don’t. You think you need the acceptance of others to be worthwhile!

Student:  Isn’t it normal to want other people to like me? I try very hard to be liked.

Counsellor:  We may want to be liked and admired by others but really needing others’ attention and admiration to ‘make’ us feel worthwhile and accepted is an unhealthy MUST rule. That is ‘people must like us for us to feel good about ourselves.

Student:  OK I am getting the hang of this. Other people who might disapprove of my behaviour don’t cause my anxiety but my must belief does. I think ‘he must think I am a good person.’ Is that right?

Counsellor: Yes, well done. Not only must he approve of you but it is so awful that you can’t stand it when he doesn’t!  You must get what you want and when you don’t you feel highly anxious and very unhappy.  You will maintain your anxiety as long as you believe your MUST belief/rule.

Student:  How do I change my unhelpful rule? How can I learn to manage my extreme worry?

Counsellor: The antidote to ‘I must have the approval of others for me to feel OK’ is Unconditional Self-Acceptance (USA). It means ‘I accept myself, warts and all even when I stuff up, even when someone disapproves of me in some way!’ This is a healthy rule/belief because you remain in control. You remain healthily concerned but not so anxious that you can’t focus on your work.

Student:  So when someone thinks I have done something bad I’m not bad, is that what you are saying? 

Counsellor:  Yes you are always worthwhile no matter what, even when you screw up or someone rejects you. When you asked someone if they had a problem and he mistook what you said and showed annoyance towards you it did not in any way take away your value. You are only worthless if you believe you are and you believe you are when you believe ‘I MUST have the approval of others to be worthwhile.’

Student:  I get what you mean.

Counsellor:  Practise believing ‘I prefer others to approve of me but they don’t have to. I accept myself no matter what. I can handle this.’

Student:  I’ll do that. Thanks. 

''I don't have to be what you want me to be.'' Muhammad Ali

An Anxious Adolescent - part 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 effect 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 what’s 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!