Professionally speaking, I’m a provider of care for mental, emotional, and behavioral health (collectively “behavioral health”). To be specific, I’m a Rational Emotive Behavior Therapy (REBT) practitioner.
This psychotherapeutic modality falls under the umbrella of cognitive behavior therapy (CBT). In general, CBT focuses on patterns of thinking and believing which influence how people further think or believe, feel (emotions or bodily sensations), and behave.
Specifically, REBT theory uses the ABC model to illustrate how when Activating events (“Actions”) occur and people maintain irrational Beliefs about the events, these unhelpful assumptions – and not the actual occurrences – are what create unpleasant cognitive, emotive, bodily sensation, and behavioral Consequences.
In particular, there are four predominate irrational beliefs which people use: demandingness, awfulizing, low frustration tolerance, and global evaluations. Addressing these, the ABC model incorporates Disputation of unhelpful assumptions in order to explore Effective new beliefs.
From a psychological standpoint, people disturb themselves using a Belief-Consequence (B-C) connection. Of course, this isn’t to suggest that in the context of the naturalistic or physical world there is no Action-Consequence (A-C) connection.
As an example, if you eat pepper X (Action), your mouth may experience a burning sensation (Consequence). Still, if you unhelpfully Believe, “That shouldn’t have happened to me,” then you’ll likely disturb yourself into a sorrowful disposition (Consequence).
Thus, I help people to stop upsetting themselves through use of B-C connections, though I can’t fully resolve their A-C connections. If there were a mathematical formula for the ABC model, it would be something like: Action + Belief = Consequence ÷ Disputation = Effective new belief.
Furthermore, this helpful psychotherapeutic modality uses the technique of unconditional acceptance (UA) to relieve suffering. This is accomplished through specific use of unconditional self-acceptance, unconditional other-acceptance, and unconditional life-acceptance.
Additionally, foundational components incorporated into REBT relate to Stoicism—a philosophical practice valuing four virtues (wisdom, courage, temperance or moderation, and justice) as a means of achieving eudemonia (a life well-lived) and humanism—the process of healing oneself.
As well, REBT is influenced by existentialist principles—essentially positing that each of us will inevitably die and that we can search for purpose and meaning as a method of living a well-lived existence. Importantly, all of these techniques require frequent (and I mean daily) practice.
I’ve found that most people with whom I interact use “mental health” and “behavioral health” synonymously. This is unsurprising, being that people within the wellness field often use one term as an analogue for the other. One source addresses the distinction between these concepts thusly:
Unsurprisingly, behavioral health has more to do with the specific actions people take. It’s about how they respond in various scenarios. Two people who are experiencing similar emotions may react in very different ways. Mental health, on the other hand, has more to do with thoughts and feelings. It’s pretty specific to biological factors that influence our mental state.
From an REBT perspective, I don’t dispute that biological factors may influence the mental state of people. Still, I propose that the B-C connection does more than merely influence this condition; it serves as a causal link between an action and a self-disturbed consequence.
It’s worth noting that one source adds in regard to the mental versus behavioral health distinction, “Mental health is a subset of behavioral health, but behavioral health encompasses a broader range of conditions that affect a person’s behavior, such as substance abuse, addiction, and eating disorders.”
Whereas major depressive disorder, generalized anxiety disorder, or histrionic personality disorder may present with internalized characteristics which aren’t readily detectable from an external point of view, substance abuse, eating disorders, and other conditions which carry a behavioral component may be identifiable by others.
The former relates to mental illness or disorders and is generally understood in the context of mental health. However, the latter and former terms are both enveloped in the term behavioral health. Now, how one goes about treating or managing features of these symptoms is a separate matter altogether.
Some psychotherapists, perhaps working within a mental health framework, strive to help clients feel better. This process entails listening to an individual’s expressed thoughts and beliefs in order to achieve catharsis—the process of releasing, and thereby providing relief from, strong or unpleasant emotions.
Unlike that approach to care for mental, emotional, and behavioral health, REBT practitioners aim to help people get better rather than to merely feel better. Expanding upon this concept, one REBT source states:
When considering therapy, the goal is to help one realize unhelpful patterns of thinking and behaving, and developing new ways of coping. This may include asking people to face what they are most distressed about, sit with uncomfortable emotions, and practice behavioral changes. Yes, this may take more time than offering solutions and providing reassurance, but if we aren’t uncomfortable, why change? That is why we have our social supports to help us feel better, and we have REBT to help us get better.
Facing distressful situations, sitting with discomfort, and practicing behavioral changes are all action-based intervention strategies. Yes, even deliberately sitting with discomfort qualifies as action-oriented effort, because it requires exertion of action not to passively opt for escapism.
In any case, REBT is an active-directive form of CBT in which I listen intently to expressed thoughts and beliefs as a means of recognizing patterns of self-disturbance. Yet, that’s merely the starting point of the helping process.
Disputation of irrational beliefs is action-focused. Likewise, employing the technique of UA requires effort. Moreover, the single most important element of personal change doesn’t result from in-session intervention strategies, though is realized through the process of homework.
As an example, if client X reports experiencing shame about running outside in the daytime, because of how she perceives her body, all the talking that occurs in a session will do very little about her practicing REBT techniques by actually applying these tools in the real world.
Therefore, homework negotiated between client X and I may relate to a shame-attacking exercise whereby she goes for an outdoor run in the daytime while practicing REBT techniques on her own. Preferably, she will go for several runs of this sort and in different locations.
This is where the behaviorism component of REBT comes into play. The late psychologist who developed REBT, Albert Ellis, once stated of his approach to behavioral health care:
I added all kinds of behavioral and emotional techniques that I took from others or made up to include in REBT. Like my famous shame-attacking exercise, which I made up because I said right at the beginning in 1956 in my first paper, ‘Thinking goes with feelings and behaviors. Feeling goes with thinking and behaviors. Behavior goes with thinking and feeling.’ All three! That’s the way humans are. So REBT includes a great many thinking, feeling and behavioral methods.
By behaviorally challenging her mentally-formed beliefs which impact her emotions and actions, client X can desensitize herself to the experience of running in front of other people. Although she still may not like how she looks, she can invariably tolerate and accept the activity of running in the daytime. Ellis also stated:
We have a whole host of behavioral techniques where we get people to do what they are afraid of, do public speaking, go for job interviews, approach members of the same or opposite sex. And we also give them reinforcements and penalties.
These techniques stem from behaviorists such as John B. Watson, B. F. Skinner, Ivan Pavlov, Joseph Wolpe, and others. Nevertheless, Ellis was clear about how he approached REBT versus how classic behaviorists regarded human behavior when he stated:
We also believe, as part of [REBT] and practice, in the educative aspects of psychotherapy. [REBT] doesn’t exactly follow the usual medical model of disturbance, which essentially holds that emotional problems consist of diseases or aberrations, curable by an outside person’s (a therapist’s) authoritarianly telling people what they have to do to improve. Nor does it follow the somewhat similar conditioning model (held in common by both psychoanalysts and classical behaviorists), which claims that humans get made disturbed by early influences, and that they therefore have to get restructured or reconditioned by an outside, parentlike therapist who somehow forces them into new patterns of behaving.
It follows, instead, the humanistic, educative model which asserts that people, even in their early lives, have a great many more choices than they tend to recognize; that most of their “conditioning” actually consists of self-conditioning; and that a therapist, a teacher, or even a book can help them see much more clearly their range of alternatives and thereby to choose to reeducate and retrain themselves so that they surrender most of their serious self-created emotional difficulties.
Given this clarification, REBT serves as a method of getting better rather than merely feeling better. Noteworthy, it’s the process of getting that takes aim at behavior. In essence, people learn how to get out of their own way through the experience of self-empowerment.
Herein, I’ve addressed the distinction between care for mental health and behavioral health. Specifically, I’ve described how Rational Emotive BEHAVIOR Therapy – a form of CBT – is used to help people get better regarding their behavioral health needs.
If choosing to seek treatment or management of symptoms, or to merely learn how to improve your level of functioning and overall quality of life, I look forward to helping to along your path. Although self-improvement of this sort may be an uncomfortable process, perhaps you’ll benefit from actively empowering yourself to get better.
If you’re looking for a provider who works to help you understand how thinking impacts physical, mental, emotional, and behavioral elements of your life—helping you to sharpen your critical thinking skills, I invite you to reach out today by using the contact widget on my website.
As a psychotherapist, I’m pleased to help people with an assortment of issues ranging from anger (hostility, rage, and aggression) to relational issues, adjustment matters, trauma experience, justice involvement, attention-deficit hyperactivity disorder, anxiety and depression, and other mood or personality-related matters.
At Hollings Therapy, LLC, serving all of Texas, I aim to treat clients with dignity and respect while offering a multi-lensed approach to the practice of psychotherapy and life coaching. My mission includes: Prioritizing the cognitive and emotive needs of clients, an overall reduction in client suffering, and supporting sustainable growth for the clients I serve. Rather than simply helping you to feel better, I want to help you get better!
Deric Hollings, LPC, LCSW
References:
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