Dealing with Emotional Problems Using Rational Emotive Behaviour Therapy (REBT) [2 ed.] 1032542551, 9781032542553

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Dealing with Emotional Problems Using Rational Emotive Behaviour Therapy (REBT): A Practitioner’s Guide

In this practical companion to the client manual, Windy Dryden draws on Rational Emotive Behaviour Therapy (REBT) –​an approach that focuses on identifying, examining and changing the rigid/​extreme attitudes that largely determine emotional and behavioural issues –​to encourage people to deal with their emotional problems. Including all of the information presented in the Client’s Guide with the addition of helpful hints and tips for the therapist, the Practitioner’s Guide is straightforward to use in the consulting room with no need for further references. It allows the therapist to work through and help the client learn to deal with their problems from an REBT perspective, covering: ⦿

anxiety

⦿

guilt

⦿

hurt

⦿

unhealthy jealousy

⦿

and a new chapter on unhealthy regret.

⦿

depression

⦿

shame

⦿

unhealthy anger

⦿

unhealthy envy

This practical guide presents each emotion in a similar way, allowing the reader to compare and contrast common and distinctive features of each problem. With new REBT research and updated, accessible terminology, this new edition will remain essential reading for any professional using REBT with their client. Windy Dryden is in clinical and consultative practice and is an international authority on Single-​Session Therapy. He is Emeritus Professor of Psychotherapeutic Studies at Goldsmiths University of London. He has worked in psychotherapy for more than 45 years and is the author or editor of over 265 books.

Dealing with Emotional Problems Using Rational Emotive Behaviour Therapy (REBT)

A Practitioner’s Guide Second Edition

WINDY DRYDEN

Designed cover image: © Getty Images Second edition published 2024 by Routledge 4 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN and by Routledge 605 Third Avenue, New York, NY 10158 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2024 Windy Dryden The right of Windy Dryden to be identified as author of this work has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. First edition published by Routledge 2012 British Library Cataloguing-​in-​Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-​in-​Publication Data Names: Dryden, Windy, author. Title: Dealing with emotional problems using rational emotive behaviour therapy (REBT) : a practitioner’s guide / Windy Dryden. Other titles: Dealing with emotional problems using rational-emotive cognitive behaviour therapy. Practitioner’s guide Identifiers: LCCN 2023025283 (print) | LCCN 2023025284 (ebook) | ISBN 9781032543260 (hardback) | ISBN 9781032542553 (paperback) | ISBN 9781003424338 (ebook) Description: Second edition. | Milton Park, Abingdon, Oxon ; New York, NY : Routledge, 2024. | Includes bibliographical references and index. | Subjects: LCSH: Rational emotive behavior therapy. | Cognitive therapy. Classification: LCC RC489.R3 D78632 2024 (print) | LCC RC489.R3 (ebook) | DDC 616.89/1425–dc23/eng/20230817 LC record available at https://lccn.loc.gov/2023025283 LC ebook record available at https://lccn.loc.gov/202302528 ISBN: 9781032543260 (hbk) ISBN: 9781032542553 (pbk) ISBN: 9781003424338 (ebk) DOI: 10.4324/​9781003424338 Typeset in Stone Serif by Newgen Publishing UK

Contents Preface

vi

Introduction

1

 1  Emotional problems: foundations and healthy alternatives

7

 2  Dealing with anxiety

30

 3  Dealing with depression

68

 4  Dealing with guilt

102

 5  Dealing with unhealthy regret

134

 6  Dealing with shame

168

 7  Dealing with hurt

200

 8  Dealing with unhealthy anger

229

 9  Dealing with unhealthy jealousy

262

10  Dealing with unhealthy envy

295

References

327

Appendix 1

328

Appendix 2

334

Appendix 3

336

Appendix 4

338

Appendix 5

340

Appendix 6

342

Appendix 7

352

Index

373

Preface I have written this book as a practitioner’s companion to Dealing with Emotional Problems with Rational Emotive Behaviour Therapy (REBT): A Client’s Guide. In that book, I cover the nine emotional problems that clients routinely seek help for and show them how they can deal with them. There are three ways I could have written this Practitioner’s Guide. First, I could have written totally separate Client and Practitioner Guides. In taking this approach, I would have to make frequent page references to the Client’s Guide in the Practitioner’s Guide. This means that you would have to have both guides open when working with a client and go backwards and forwards from book to book. While there would be little repetition within each book, you would waste much valuable therapy time consulting both texts at the same time. The second approach I could have taken is to write totally separate Client and Practitioner Guides, but to include them in one volume. Again, in taking this approach I would have to make frequent page references to the Client’s Guide in the Practitioner’s Guide. This means that you would have to go backwards and forwards from guide to guide within a single volume. While again there would be little repetition within each part of the book, you would again waste much valuable therapy time moving from one part to another. The third approach I could have taken and that, in fact, I decided to take involves having a separate Client’s Guide and reproducing this guide in the Practitioner’s Guide. In taking this tack, I present the material so that you have access to it when and where you need it. You do not, therefore, have to go from book to book or from one part of a single book to the other part. While this necessitates repetition of salient material, I believe that this is a price worth paying to facilitate use by practitioners. In the present book, then, I reproduce the Client’s Guide and, at salient points, I discuss issues that may come up in therapy when you use the Client’s Guide with your clients and show how best you can address these issues. The material that I have written for practitioners in this book is in a different typeface to the Client’s Guide so you can easily find it.

Preface   vii

In the Client’s Guide (which is reproduced in this book), I begin with outlining the foundations of emotional problems from an REBT perspective. I then devote one chapter to each of the nine emotional problems and use a similar structure in each chapter. I start by helping clients to understand the emotional problem in question, discuss what they disturb themselves about when they experience the emotion, and outline what largely determines the emotion and how they tend to act and think when they experience it. I show clients how to deal with the emotional problem in question. I help them to identify the themes in the emotion, detail their behaviour and thinking when they experience it before encouraging them to set appropriate emotional, behavioural and thinking goals. Then, I help them to examine and change the rigid/​extreme attitudes that account for their emotional problems and to develop the flexible/​non-​ extreme attitudes that will enable them to achieve their goals. Next, I show clients what they need to do to strengthen their conviction in their flexible/​non-​extreme attitudes so that they become less prone to the emotional problem. I then deal with several additional issues relevant to the emotional problem in question before finally outlining a number of world views that underpin each emotional problem and its healthy alternative. The common chapter structure that I employ in Chapters 2−10 of the Client’s Guide is to ensure that all relevant issues are discussed for each emotional problem. It is unlikely that clients will be prone to all nine emotional problems, but they may be prone to two or three. The view of emotional problems that I am taking in this book states that, while there are common features among the nine emotions, there are also features that are distinctive to each emotion. This is reflected in Chapters 2−10 of the Client’s Guide and clients will need to bear this point in mind when they read these chapters or a selection of them. The same is the case in this Practitioner’s Guide. There are common and distinctive features that are relevant when helping clients deal with the nine emotional problems. To help you use this Practitioner’s Guide, I produce common features in each of the nine chapters and the distinctive features where relevant. I have decided to organise this book in this way to help you get the most out of the relevant chapter when working with a client’s nominated emotional problem. While this means that certain issues are repeated throughout the book, as I mentioned above, it also means that the relevant material is there when and where you need to consult it. Since the first edition of this book was published, I have changed how I refer to key elements of REBT theory. I have used the updated terminology

newgenprepdf

viii   Preface

in this edition and explain the changes and why I have made them in the Introduction. Windy Dryden London and Eastbourne

Introduction In this volume, the terms I have adopted regarding key concepts of REBT theory are radically different from the conventional terms in which such features have been framed in standard REBT literature. So let’s begin by looking at the changes I have made to conventional REBT terminology and the reasons for doing so. In referring to the ABC framework of REBT, I now use A to signify adversity instead of the conventional term ‘activating event’; B stands for basic attitudes instead of the conventional term ‘beliefs’; and C stands for the consequences of B. This ABC framework provides a summary of how REBT views health and psychological disturbance.

WHY I HAVE CHANGED ACTIVATING EVENT TO ADVERSITY Because it is unclear what the event activates, I regard the term ‘activating event’ as problematic. While REBT theory states that the event should activate B, some people think that it should activate C. In addition, the term activating event can be assumed to mean either the event itself or the aspect of the event that someone is most disturbed about. And while REBT states that it should be the latter, some people think it is the former. For that reason, in this book A in the ABC framework represents ‘adversity’ –​the aspect of a situation about which someone is most disturbed. Thus A –​the adversity –​activates B, which results in C.

WHY I HAVE CHANGED BELIEFS TO ATTITUDES Conventionally ‘B’ has stood for ‘beliefs’ in REBT. These beliefs can be ‘rational’ or ‘irrational’. I have always felt uneasy about these particular terms, which is why a number of years ago1 I made the decision to change them formally.

DOI: 10.4324/9781003424338-1

2   Introduction

Several years prior to making the decisions outlined above, I conducted research on how different professional and lay groups understood the ABC framework of REBT.2 This uncovered a large number of errors and confusions on the part of these groups regarding each element in the framework,3 and in particular concerning B. The term ‘belief’, for instance, was frequently taken to describe adversities at A instead of evaluations at B (e.g. ‘I believe she doesn’t like me’). It was then that I realised that these errors and confusions regarding ‘B’ could be eliminated by the use of the term ‘attitude’ instead of belief, since the term ‘belief’ is frequently used in ways that are quite different from how it was being used in REBT. The term ‘belief’ has been defined as ‘any proposition that is accepted as true on the basis of inconclusive evidence’ (Oxford Dictionary of Psychology, 4th edition).4 A client may say, for instance, ‘I believe he is undermining me’ and, although they assume they have expressed a belief, this is not in fact a belief in the way the term has been used in REBT, but instead an inference. It is crucial for an REBT practitioner to distinguish between an inference at A and an attitude at B and, for that reason, anything that allows this distinction to be made routinely is of great value. One way of doing this is by substituting the term ‘attitude’ for ‘belief’. Dictionary definitions of the term ‘attitude’ are more closely aligned to the meaning that REBT theory gives to the term ‘belief’. Colman’s definition of attitude –​‘an enduring pattern of evaluative responses towards a person, object, or issue’5 –​is still the best one I have come across. Before I decided to use the term ‘attitude’ instead of ‘belief’ in both my clinical work and writings, I used the term ‘attitude’ instead of ‘belief’ with clients and discovered that it was far more effective –​and also easier for me –​to convey the meaning of B when I used the term ‘attitude’ than when I used the term ‘belief’; and the corollary was that in this context my clients generally found ‘attitude’ easier to understand than ‘belief’. I therefore decided to use the term ‘attitude’6 instead of ‘belief’ to mean an evaluative stance taken by a person towards an adversity at A that has emotional, behavioural and thinking consequences.7 In deciding to use the term ‘attitude’ rather than the term ‘belief’, I am aware, of course, that, in explaining what the B denotes in the ABC framework, the term ‘attitude’ is problematic because it begins with the letter ‘A’. So, rather than use an ‘AAC’ framework –​which would not be nearly as easy to remember as the ABC framework –​I suggested using the term ‘basic attitudes’8 in formally describing ‘B’ in the ABC framework. This may not be ideal, but the term does include ‘attitudes’ and it has the advantage of indicating that they are central or basic and that they are situated at the base of someone’s responses to adversity. By the use of the term ‘basic’, I have therefore retained the letter B so that the familiar ABC framework can still be used. I will, however, use the

Introduction   3

word ‘attitude’ rather than the phrase ‘basic attitude’ when not formally describing the ABC framework, but instead referring to the particular kind of cognitive processing that, according to REBT, mediates between an adversity and someone’s responses to that negative event.

WHY I HAVE CHANGED IRRATIONAL BELIEFS TO RIGID AND EXTREME ATTITUDES AND WHY I HAVE CHANGED RATIONAL BELIEFS TO FLEXIBLE AND NON-​EXTREME ATTITUDES An additional change I have made is to avoid the terms ‘rational’ and ‘irrational’ and instead use the terms ‘flexible and non-​ extreme’ and ‘rigid and extreme’ in describing the attitudes underpinning psychological health and psychological disturbance. I initiated this change because both clients and non-​REBT therapists do not respond well to the terms ‘rational’ and ‘irrational’. Albert Ellis himself, in his later career, expressed regret that he had called his therapy ‘Rational Therapy’ and wished he had instead called it ‘Cognitive Therapy’. The reason he didn’t do this was because the term ‘cognitive’ was not commonly understood in the mid-​1950s.9 Clients, on the other hand, can easily accept that the attitudes that form the basis of their psychologically disturbed responses to adversities are rigid and extreme. These terms are in fact less pejorative than the term ‘irrational’, which in many clients’ minds may be associated with such terms as ‘crazy’ or ‘bizarre’. And, as a corollary of this, clients may regard the state of being ‘rational’ as unemotional and robot-​like, rather than as something to strive and aim for. The terms ‘flexible’ and ‘non-​extreme’, on the other hand, are more acceptable to clients when describing the attitudes underpinning psychologically healthy responses to adversities at A.

WHY I HAVE CHANGED LOW FRUSTRATION TOLERANCE (LFT) BELIEFS TO UNBEARABILITY ATTITUDES AND HIGH FRUSTRATION TOLERANCE (HFT) BELIEFS TO BEARABILITY ATTITUDES Traditionally in REBT theory, low frustration tolerance (LFT) beliefs point to a person’s perceived inability to tolerate frustration. The term given to these beliefs is confusing. Thus, taking the term at face value, it could

4   Introduction

mean that (i) a person can only tolerate low levels of frustration but cannot tolerate high levels of frustration or that (ii) a person has low tolerance of all levels of frustration. Now LFT beliefs are usually employed to highlight a person’s perceived intolerance of frustration where levels of frustration are not specified. For this reason, the term ‘frustration intolerance’ beliefs has been used to clarify the fact that a person believes that they cannot tolerate frustration. Again, this term does not specify levels of frustration. Latterly, the term ‘discomfort intolerance’ beliefs has been used where ‘discomfort’ has replaced ‘frustration’ in what the person is deemed to be unable to tolerate. It is not clear why this change has been made since the terms ‘frustration’ and ‘discomfort’ are not synonymous. Indeed frustration points to an external event where a person’s pathway to a goal has been blocked while discomfort points to an internal experience. Traditionally in REBT theory, high frustration tolerance (HFT) beliefs point to a person’s perceived ability to tolerate frustration. Again, the term given to these beliefs is confusing. Thus, taking the term at face value, it could mean that (i) a person can tolerate high levels of frustration where their ability to tolerate low levels of frustration is not specified or that (ii) a person has a high ability to tolerate frustration, which raises the question of what happens with a person whose ability to tolerate frustration is present but only at a low level. Now HFT beliefs are usually employed to highlight a person’s perceived tolerance of frustration where levels of frustration are not specified. For this reason, the term ‘frustration tolerance’ beliefs has been used to clarify the fact that a person believes that they can tolerate frustration. Again, this term does not specify levels of frustration. Latterly, the term ‘discomfort tolerance’ beliefs has been used where ‘discomfort’ has replaced ‘frustration’ in what the person is deemed to be able to tolerate. Again, it is not clear why this change has been made since again the terms ‘frustration’ and ‘discomfort’ are not synonymous. As discussed above, frustration points to an external event where a person’s pathway to a goal has been blocked while discomfort points to an internal experience. In addition to the confusion engendered by the terms LFT beliefs, Frustration Intolerance beliefs and Discomfort Intolerance beliefs on the one hand and HFT beliefs, Frustration Tolerance beliefs and Discomfort Tolerance beliefs, on the other, there is another problem with such terminology. The terms as used limit what the person is deemed to be able to tolerate or not tolerate to either frustration or discomfort. In reality, there is a plethora of adversities that a person faces, which they think they can or cannot tolerate. Do we need to add terms like ‘Distress Intolerance/​

Introduction   5

Intolerance’ or ‘Uncertainty Intolerance/​Tolerance’, for example, and have a growing list of such beliefs/​attitudes? The solution to this needless limitation is to dispense with such descriptors like frustration, discomfort, distress and uncertainty altogether. Indeed none of the three other attitudes10 have such a descriptor. Having dispensed with the descriptor when pointing to a person’s perceived ability or inability to bear adversity (in its broadest sense), I decided to use the verb ‘bear’ when naming the attitude under consideration. Thus, I use the term ‘unbearability’ attitude to describe an attitude where a person thinks that they cannot bear the adversity that they face at ‘A’. This ‘A’ can be external (e.g. frustration) or internal (e.g. discomfort) and can point to a myriad of different adversities. Similarly, I use the term ‘bearability’ attitude as the non-​extreme alternative to an unbearability attitude to describe an attitude where a person thinks that they can bear the adversity that they face at ‘A’. Again, this ‘A’ can be external (e.g. frustration) or internal (e.g. discomfort) and can point to a myriad of different adversities.

WHY I HAVE CHANGED DISPUTING BELIEFS TO EXAMINING ATTITUDES The ABC framework, as has been mentioned earlier, is used in REBT as an assessment tool to help clients understand the factors underlying their psychologically disturbed responses to adversities as well as what would constitute psychologically healthy responses to the same adversities. The REBT therapist adds D and E to the ABC framework when moving from assessment to therapy. D conventionally stands for ‘disputing’ beliefs (both irrational and rational) while E stands for the ‘effects’ of the disputing process. I have never liked the term ‘disputing’: it feels adversarial and, while it could mean ‘debating’, it could also mean arguing vehemently. But what it does not suggest is a process whereby two people can stand back and examine the attitudes of one of them. I prefer, for this reason, to use the term ‘examining’ in the context of the therapist and client considering the client’s attitudes –​both rigid/​extreme and flexible/​non-​extreme. To examine something means to inspect it thoroughly with the intention of determining its nature or condition. This I consider more akin to what the therapist and client do together, in what was previously called ‘disputing’. I formally use the term dialectically examining attitudes so that the letter ‘D’ can be preserved. The use of the term ‘dialectical’ is particularly apt here

6   Introduction

Table 1  Terminology employed in this book Traditional REBT language ⦿

Activating Event (at A)

⦿

Irrational (to describe beliefs)

⦿

Belief (at B)

⦿

Rational (to describe beliefs)

⦿

Disputing Beliefs (at D)

Language employed in this book ⦿

Adversity (at A)

⦿

Rigid/​Extreme (to describe attitudes)

⦿

(Basic) Attitude (at B)

⦿

Flexible/​Non-​Extreme (to describe attitudes)

⦿

(Dialectically) Examining Attitudes (at D)

as it denotes trying to resolve the differences between opposing views, and rigid/​extreme and flexible/​non-​extreme are opposing ways of evaluating adversities. However, I will generally use the term ‘examining attitudes’ when not being concerned with formalities to describe the activity more conventionally known as disputing beliefs. Table 1 provides a summary of these changes.

NOTES 1 Dryden (2016). 2 The four groups were: (a) authors of textbooks on counselling and psychotherapy; (b) REBT therapists; (c) Albert Ellis (during the twilight of his career) and his wife (2011); and (d) patients in a psychiatric hospital who were taught the REBT framework. 3 Dryden (2013a). 4 Colman (2015). 5 Colman (2015). 6 Please note that, as this is still a relatively new development, other REBT therapists (including myself in my previous work) still employ the word ‘beliefs’. 7 Dryden (2016). 8 This phrase was suggested by my friend and colleague, Dr Walter Matweychuk. 9 Interestingly enough, when Ellis changed the name of his therapy from ‘Rational Therapy’ to ‘Rational-​ Emotive Therapy’ in 1962 and to ‘Rational Emotive Behaviour Therapy’ in 1993, he had the opportunity to change the ‘rational’ part of the name to ‘cognitive’ but did not do so. 10 Rigid/​flexible attitudes, awfulising/​non-​awfulising attitudes and devaluation/​ unconditional acceptance attitudes.

C H A P T E R

1 Emotional problems: foundations and healthy alternatives

In this book, I am going to discuss some common emotional problems and show you how to deal with them. The book is structured as a workbook so that you can implement the skills that I teach you in a step-​by-​step manner. It is worthwhile stressing to your client that the order of these steps is indicative and not set in stone. Over time and with increased experience, different clients will use the steps in different orders. In this opening chapter, I am going to cover some important material that I regard as foundations to your understanding of the nine emotional problems that I discuss in this book and their healthy alternatives.

WHAT ARE THE NINE EMOTIONAL PROBLEMS? I have been practising in the field of counselling and psychotherapy since 1975 and have worked in a variety of different settings. In that time, I have seen many people suffering from one or more of the nine emotional problems that I cover in this book. They are: ⦿

anxiety

⦿

guilt

⦿

shame

⦿

unhealthy anger

⦿

unhealthy envy.

⦿

depression

⦿

unhealthy regret

⦿

hurt

⦿

unhealthy jealousy

DOI: 10.4324/9781003424338-2

8   Emotional problems

You will note that I have put the adjective ‘unhealthy’ in front of regret, anger, jealousy and envy. I have done this to distinguish the unhealthy version of the emotion from its healthy version. I will discuss healthy alternatives to the nine emotional problems in the next section. Unfortunately, we don’t have agreed language for emotional problems. It is better to use the terms with which your client resonates than to impose on them terms such as those above that are used in the REBT literature. When you have agreed a term for an emotional problem with a client, make a clear note of it in the client’s file.

HEALTHY ALTERNATIVES TO THE NINE EMOTIONAL PROBLEMS Adversity is unfortunately a fact of life.1 None of us can say that we have lived a life untouched by adversity. An adversity is a negative event. So when you are looking for a healthy alternative to an emotional problem in the face of adversity, it is not realistic for you to select an emotion that is positive or neutral.

Problems with positive emotions as healthy alternatives to the emotional problems If you want to feel a positive emotion about an adversity, you will have to convince yourself that it is good that the adversity happened. Now, I concede that adversities do have some positive features, but they are largely negative in nature. As such, the only way you are going to convince yourself that it is a good thing that an adversity happened is to lie to yourself and to believe your lie. As you can see, this is unlikely to work in the longer term and is, thus, not a good strategy.

Problems with neutral emotions as healthy alternatives to the emotional problems It is also not realistic to have a neutral feeling about an adversity. If you want such a neutral response, you will have to convince yourself that it

Emotional problems   9

does not matter to you that the adversity happened. However, that won’t work since it does matter to you that the adversity happened. Quite properly, you would have preferred that the adversity did not happen. So again the only way you are going to convince yourself that it doesn’t matter to you that the adversity happened is to lie to yourself and to find your lie convincing. This, again, is unlikely to work in the longer term and is, thus, not a good strategy.

Problems with living in an emotional vacuum as a healthy alternative to the emotional problems If a positive or neutral emotional response to an adversity is ruled out as a healthy alternative to an emotional problem, what is left? You could say that, when an adversity happens, you don’t want to feel the emotional problem that you felt. Harry regularly experiences anxiety about going to see his tutor because he thinks she is going to criticise his work. When asked what he wanted to feel instead, Harry replied: ‘I don’t want to be anxious about the possibility of my tutor criticising my work.’

The problem with this approach is that we don’t tend to live in an emotional vacuum when an adversity has happened or we think that it is likely to happen. Thus, it matters to Harry that his tutor does not criticise him. We experience emotions in areas of life that matter to us. Since it matters to Harry that his tutor does not criticise him, he is going to experience an emotion about this prospect. Don’t forget that we are looking for a healthy alternative to the emotional problem of anxiety in Harry’s case, and to all nine emotional problems in general.

Problems with reducing the intensity of emotional problems as healthy alternatives to these emotional problems People often say when they are asked to nominate a healthy alternative to an emotional problem that they want to feel a less intense version of the emotional problem. Applying this to our example, when asked what

10   Emotional problems

he wants to feel instead of anxiety about seeing his tutor, Harry says that he wants to feel less anxious. Now the problem with having a less intense version of an emotional problem as a healthy alternative for that emotion is that it is still unhealthy, albeit less intense. If something is unhealthy, it would make sense to want to have a less intense version of it only if this is the only alternative available. Fortunately, it isn’t!

Healthy negative emotions (HNEs) as healthy alternatives to the emotional problems Healthy alternatives to emotional problems are known as ‘healthy negative emotions’ (HNEs). This term is used for two good reasons. First, such emotions have a negative tone and this is their realistic aspect. Remember we are talking about emotions in the context of life’s adversities. It is realistic to feel a negative emotion about a negative event. Second, such emotions are healthy in that they are associated with a different set of behaviours and ways of thinking than are emotional problems. I discuss this in greater detail later in this chapter. For now, here is the list of HNEs:2 ⦿

concern (rather than anxiety)

⦿

remorse (rather than guilt)

⦿

disappointment (rather than shame)

⦿

healthy anger (rather than unhealthy anger)

⦿

healthy envy (rather than unhealthy envy).

⦿

sadness (rather than depression)

⦿

healthy regret (rather than unhealthy regret)

⦿

sorrow (rather than hurt)

⦿

healthy jealousy (rather than unhealthy jealousy)

As with emotional problems (or unhealthy negative emotions –​ UNEs), we do not have agreed terms for HNEs and once again, therefore, it is better to use the terms with which your client resonates than to impose on them terms such as those above that are used in the REBT literature. When you have agreed a term for

Emotional problems   11

an HNE with a client, make a clear note of it in the client’s file. As we will see, this HNE will be your client’s emotional goal in response to the adversity that he or she is facing. The idea that the only truly constructive emotional alternative to an emotional problem about an adversity is an HNE will, in all probability, be a new and revolutionary idea for your client and one that will require quite a bit of digesting before your client accepts it. It is useful to suggest to those clients who are grappling with this idea that, as a homework assignment, they spend some time thinking about all the possible alternatives to their emotional problem and that they write down the advantages and disadvantages of each alternative as they see them. You can then review these with your client in an open and frank manner. Do not hesitate to correct any misconceptions that your client may demonstrate in the course of this review, but do so in an accepting and respectful manner. If you cannot think of any rebuttals to clients’ misconceptions on this issue, discuss this matter with your REBT supervisor.

RATIONAL EMOTIVE BEHAVIOUR THERAPY This book is based on Rational Emotive Behaviour Therapy (known as REBT). You may have heard of cognitive behaviour therapy (CBT) and it being described as a therapeutic approach. However, in my view, CBT is not a therapeutic approach, but a therapeutic tradition in which there are a number of distinctive approaches, of which REBT is one. REBT was founded in 1955 by Dr Albert Ellis (1913−2007). Your client may ask you about the differences between REBT and CBT. They may well have heard of the term CBT, but not REBT. One way of dealing with this question is to build on what appears above, but to say something about the distinctiveness of REBT. Thus, you might say something like: Well, REBT is a specific approach within the general tradition known as CBT, so it is difficult to compare a specific approach within this tradition with the tradition itself. However, while most CBT approaches would agree with Epictetus, the Greek Stoic philosopher, who was reported to say ‘People are disturbed not by things, but by their views of things’, REBT holds that

12   Emotional problems

‘People are disturbed not by things. Rather they disturb themselves by the rigid/​ extreme attitudes that they hold towards things.’ Thus, in REBT we place particular emphasis on helping you to identify these attitudes and to change them to their more constructive flexible/​non-​extreme attitudinal equivalents. This emphasis on rigid/​extreme attitudes is explored further in the Client’s Guide, as you will presently see. Should a client want to go further with this comparison, you might suggest that they consult Dryden (2021), which is a volume in the ‘CBT: Distinctive Features’ series that details the distinctive features of REBT, and to compare this with one of the other CBT approaches in the series, such as Beck’s Cognitive Therapy (Wills, 2022).

The nine emotional problems are underpinned by rigid/​e xtreme attitudes REBT theory argues that each of the nine emotional problems stems from a rigid attitude and one or more of three extreme attitudes that are derived from the rigid attitude. Apart from being rigid and extreme, these attitudes have three other characteristics: ⦿

They are false.

⦿

They have largely unconstructive consequences (e.g., in the face of an adversity they lead to emotional problems).

⦿

They are illogical.

Let me consider rigid and extreme attitudes separately.

Rigid attitudes Perhaps the most basic characteristic of human beings is that we have desires. We want certain things to happen and other things not to happen, but when we turn these desires into rigidities when we don’t get what we want, or get what we don’t want, then we experience one or more of the emotional problems described in this book. Here are a few examples of rigid attitudes:

Emotional problems   13

⦿

I must do well on the forthcoming test.

⦿

The world must not give me too much hassle.

⦿

I would like to do well on the forthcoming test and therefore I must do so.

⦿

I want you to respect my boundaries and therefore you have to do so.

⦿

I would prefer it if the world did not give me too much hassle and therefore it must not do so.

⦿

You must respect my boundaries.

As these examples show, you can hold rigid attitudes towards yourself, others and life conditions. Later on in the Client’s Guide, I discuss flexible attitudes where the client’s desires are kept flexible and not transformed into rigid attitudes. It may therefore be helpful to stress that rigid attitudes also tend to be based on desires as well. You can do this by reformulating the above examples, thus:

The point to emphasise here is that a rigid attitude is based on a desire and an ‘and therefore’ statement in which clients transform their desire into a rigidity.

Three extreme attitudes According to REBT theory, rigid attitudes are paramount in explaining the existence of the emotional problems. Three extreme attitudes tend to be derived from these rigid attitudes. These are: ⦿

awfulising attitudes

⦿

devaluation attitudes.

⦿

unbearability attitudes

While the classic REBT position is that rigid attitudes are primary, and awfulising attitudes, attitudes of unbearability and devaluation attitudes are secondary attitudes derived from these primary rigid attitudes, it is best not to make this a stumbling block if your client does not accept it. As long as they work to

14   Emotional problems

change both their rigid attitude and the one extreme attitude that best accounts for their disturbance, then the question of what is primary and what is secondary can be put aside.

Awfulising attitudes An awfulising attitude from the rigid attitude that things must not be as bad as they are. An awfulising attitude is extreme in the sense that you hold at the time one or more of the following: ⦿

Nothing could be worse.

⦿

No good could possibly come from this bad event.

⦿

The event in question is worse than 100 per cent bad.

⦿

It is not possible for me to get over this event.

⦿

(I must do well on the forthcoming test)… and it will be awful if I don’t.

⦿

(You must respect my boundaries)… and it’s the end of the world when you don’t.

⦿

(The world must not give me too much hassle)… and it’s terrible when it does.

The above points are generic ones, and you need to adapt them to your client’s specific attitudes. While it may be good if your client accepts all these points, this is not necessary. What is important is that they use the point or points that best describe their awfulising attitudes. Keep this issue in mind when you engage your client in examining their awfulising attitudes later. In the following examples of awfulising attitudes, the rigid attitudes are listed in parentheses:

Please bear in mind that in REBT we do not regard words such as ‘awful’ or ‘terrible’ as inherently extreme and therefore bound up with client disturbance. Thus, when a person says ‘It’s awful that it’s raining outside’, they are probably not disturbing themself about the weather. It is only when these words are clearly extreme that they are examples of awfulising attitudes and when the person is in an emotionally disturbed frame of mind. Words need to be considered along with the meaning and context in

Emotional problems   15

which they are used. Explain this point to your client, who may be confused about this issue.

Unbearability attitudes An unbearability attitude stems from a rigid attitude that things must not be as frustrating or uncomfortable as they are. An unbearability attitude is extreme in the sense that you hold at the time one or more of the following: ⦿ ⦿

I will die or disintegrate if the adversity I am facing continues to exist. I will lose the capacity to experience happiness if the adversity I am facing continues to exist.

In the following examples of unbearability attitudes, the rigid attitudes are listed in parentheses: ⦿

(I must do well on the forthcoming test)… and I could not bear it if I don’t.

⦿

(You must respect my boundaries)… and it’s intolerable if you don’t.

⦿

(The world must not give me too much hassle)… and I can’t stand it if it does.

Again, terms like ‘I can’t bear it’ and ‘It’s intolerable’ may not reflect the presence of extreme attitudes. Bear in mind that there is a difference between words and their meaning and the context in which they are used. When someone says, ‘It’s intolerable that there are no taxis when it is raining’ and is angry, but not unhealthily so, then the term ‘It’s intolerable’ is probably not an example of an unbearability attitude. However, the same words in this example can point to the existence of an unbearability attitude if a person is furious and in danger of inflicting damage on taxi drivers when he encounters one when unhealthily angry. If your client appears to confuse language and meaning here, you can use such arguments to help dispel their confusion.

16   Emotional problems

Devaluation attitudes A devaluation attitude stems from the rigid attitude that you, others or things must be as you want them to be and is extreme in the sense that you hold at the time one or more of the following: ⦿

A person (self or other) can legitimately be given a single global rating that defines their essence and the worth of a person is dependent upon conditions that change (e.g., my worth goes up when I do well and goes down when I don’t do well).

⦿

The world can legitimately be given a single rating that defines its essential nature and the value of the world varies according to what happens within it (e.g., the value of the world goes up when something fair occurs and goes down when something unfair happens).

⦿

A person can be rated on the basis of one of his or her aspects and the world can be rated on the basis of one of its aspects.

In the following examples of devaluation attitudes, the rigid attitudes are listed in parentheses: ⦿

(I must do well on the forthcoming test)… and I am a failure if I don’t.

⦿

(The world must not give me too much hassle)… and, if it does, the world is a rotten place.

⦿

(You must respect my boundaries)… and you are bad if you don’t.

Once again, bear in mind the difference between words and their meanings and the contexts in which they are used. When a person says ‘I’m bad’, they are not necessarily devaluing themself, as in Mae West’s famous quote: ‘When I’m good, I’m very good. When I’m bad, I’m better.’ However, if a person is consumed with guilt and says ‘I’m bad’, they probably are devaluing themself.

The healthy alternatives to the nine emotional problems are underpinned by flexible and non-​e xtreme attitudes REBT theory argues that each of the nine healthy alternatives to the emotional problems stems from a flexible attitude and one or more of three

Emotional problems   17

non-​extreme attitudes that are derived from the flexible attitude. Apart from being flexible and non-​extreme, these attitudes have three other characteristics: ⦿

They are true.

⦿

They have largely constructive consequences (e.g., in the face of an adversity they lead to an HNE).

⦿

They are logical.

Let me consider flexible and non-​extreme attitudes separately.

Flexible attitudes As I pointed out earlier in this chapter, it is a basic characteristic of human beings that we have desires. We want certain things to happen and other things not to happen. When we keep these desires flexible and we don’t get what we want, or get what we don’t want, we experience one or more of the healthy negative emotions outlined earlier. Here are a few examples of flexible attitudes: ⦿

I would like to do well on the forthcoming test, but I don’t have to do so.

⦿

I want you to respect my boundaries, but unfortunately you don’t have to do so.

⦿

I would prefer it if the world did not give me too much hassle, but the world does not have to be the way I want it to be.

As these examples show, you can hold flexible attitudes towards yourself, others and life conditions. You will note from these examples that flexible attitudes have two components: ⦿

an ‘asserted preference’ component (e.g., ‘I would like to do well on the forthcoming test…’)

⦿

a ‘negated rigid’ component (e.g., ‘… but I don’t have to do so’).

It is important that you encourage your client to use both parts of a flexible attitude until they truly grasp that they don’t have to have their desires met. When they fully understand this, then when they say ‘I want to be loved’, for example, you will both know that this means ‘I want to be loved, but I don’t have to be loved’.

18   Emotional problems

Until that point, encourage your client to use the full version of their flexible attitude, with both components (i.e., the ‘asserted preference’ component and the ‘negated rigid’ component) stated.

Three non-​extreme attitudes According to REBT theory, flexible attitudes are paramount in explaining the existence of HNEs and three non-​extreme attitudes tend to be derived from these flexible attitudes. These are: ⦿

non-​awfulising attitudes

⦿

acceptance attitudes.

⦿

bearability attitudes

Non-​a wfulising attitudes A non-​awfulising attitude stems from the flexible attitude that you would like things not to be as bad as they are, but that doesn’t mean that they must not be as bad. This attitude is non-​extreme in the sense that you hold at the time one or more of the following: ⦿

Things could always be worse.

⦿

Good could come from this bad event.

⦿

The event in question is less than 100 per cent bad.

⦿

It is possible for me to get over this event

In the following examples of non-​awfulising attitudes, the flexible attitudes are listed in parentheses: ⦿

(I would like to do well on the forthcoming test, but I don’t have to do so)… and if I don’t do well, it would be bad, but not awful.

⦿

(I want you to respect my boundaries, but unfortunately you don’t have to do so)… It’s disadvantageous to me if you don’t, but not the end of the world.

⦿

(I would prefer it if the world did not give me too much hassle, but the world does not have to be the way I want it to be)… It’s bad when it’s not, but not terrible.

Emotional problems   19

You will note from these examples that non-​awfulising attitudes have two components: ⦿

an ‘asserted badness’ component (e.g., ‘If I don’t do well on the forthcoming test, it would be bad…’)

⦿

a ‘negated awfulising’ component (e.g.… ‘but it wouldn’t be awful’).

Ensure that your client uses both components of a non-​awfulising attitude until you are both sure that, by saying ‘It’s bad that x happened’, they truly hold that it is also not terrible that x happened. Then, your client can use the asserted badness component on its own to indicate a non-​awfulising attitude.

Bearability attitudes A bearability attitude stems from the flexible attitude that it is undesirable when adversities are as bad as they are, but unfortunately things don’t have to be different. A bearability attitude is non-​extreme in the sense that you hold at the time one or more of the following: ⦿

I will struggle if the adversity continues to exist, but I will neither die nor disintegrate.

⦿

I will not lose the capacity to experience happiness if the adversity ­ continues to exist, although this capacity will be temporarily diminished.

⦿

The adversity is worth bearing.

⦿

I am willing to bear the adversity.

⦿

I am worth bearing the adversity for.

⦿

I am going to bear the adversity.

⦿

(I would like to do well on the forthcoming test, but I don’t have to do so)… It will be a struggle for me if I don’t do well, but I could bear it and it would be worth bearing. I am worth bearing the adversity for and I am both willing and determined to bear it.

In the following examples of bearability attitudes, the flexible attitudes are listed in parentheses:

20   Emotional problems

⦿

(I want you to respect my boundaries, but unfortunately you don’t have to do so)… It’s hard for me to bear it if you don’t respect my boundaries, but I can tolerate it and it is in my interests to do so. I am worth bearing this and I am both willing to do so and will do so.

⦿

(I would prefer it if the world did not give me too much hassle, but the world does not have to be the way I want it to be)… When the world is not the way I want, it is difficult me to tolerate it, but I can stand it and it’s worthwhile for me to do so and I am worth it too. I am willing to bear the world not being as I want to be and I am committed to do so.

You will note from these examples that bearability attitudes have six components: ⦿

an asserted struggle component (e.g., ‘It will be a struggle for me if I don’t do well on the forthcoming test…’)

⦿

a negated unbearability component (e.g., ‘… but I could bear it…’)

⦿

an I’m worth it component (e.g., ‘… and I’m worth bearing it for’).

⦿

an I’m going to bear it component (e.g., ‘… and I am determined to bear it’).

⦿

an it’s worth it component (e.g., ‘… and it would be worth bearing’).

⦿

an I’m willing to bear it component (e.g., ‘… and I am willing to bear it’).

Ensure that your client uses as many of the six components of a bearability as possible. When you both agree that, by using the first component (i.e., the struggle component), they understand that it indicates a bearability attitude, they can then drop the rest of the components.

Unconditional acceptance attitudes An unconditional acceptance attitude stems from a flexible attitude that it is preferable, but not necessary, that you, others or things are the way you want them to be and is non-​extreme in the sense that you hold at the time one or more of the following: ⦿

A person cannot legitimately be given a single global rating that defines their essence, and their worth, as far as they have it, is not dependent

Emotional problems   21

upon conditions that change (e.g., my worth stays the same whether or not I do well). ⦿

The world cannot legitimately be given a single rating that defines its essential nature and the value of the world does not vary according to what happens within it (e.g., the value of the world stays the same whether fairness exists at any given time or not).

⦿

It makes sense to rate discrete aspects of a person and of the world, but it does not make sense to rate a person or the world on the basis of these discrete aspects.

In the following examples of unconditional acceptance attitudes, the flexible attitudes are listed in parentheses: ⦿

(I would like to do well on the forthcoming test, but I don’t have to do so)… If I don’t do well, it’s bad, but I am not a failure. I am a unique, unrateable, fallible human being capable of doing well and doing poorly on tests.

⦿

(I want you to respect my boundaries, but unfortunately you don’t have to do so)… If you don’t, you are not a bad person; rather you are an ordinary human being capable of doing good, bad and neutral things.

⦿

(I would prefer it if the world did not give me too much hassle, but the world does not have to be the way I want it to be)… When the world does give me more hassle than I want, it is not a rotten place; rather it is a complex mixture of good, bad and neutral aspects.

You will note from these examples that unconditional acceptance attitudes have three components: ⦿

an aspect evaluation component (e.g., ‘If I don’t do well, it’s bad…’)

⦿

an asserted acceptance component (e.g., ‘… I am a unique, unrateable, fallible human being capable of doing well and doing poorly on tests’).

⦿

a negated devaluation component (e.g., ‘… but I am not a failure’)

It is useful to encourage your client to understand that the first two components (the aspect evaluation component and the negated devaluation component) are insufficient for an unconditional acceptance attitude to be held, since your client can

22   Emotional problems

hold the first two components (e.g., ‘If I don’t do well, it’s bad, but I am not a failure’) and still devalue themself (e.g., ‘… but I would be worthier if I succeed than if I fail’). Thus, the really important ingredient of an unconditional acceptance attitude is the asserted acceptance component and the unconditionality of this component (e.g., ‘I am a unique, unrateable, fallible human being capable of doing well and doing poorly on tests and this is the case whether I succeed or fail’). Help your clients grasp this point and they will understand the core of unconditional acceptance attitudes.

INFERENCE THEMES IN RELATION TO YOUR PERSONAL DOMAIN While emotional problems and HNEs can be differentiated in general by the attitudes that underpin them (rigid and extreme in the first case, flexible and non-​extreme in the second), in order to distinguish between particular emotional problems and their specific healthy alternatives, we need to understand a concept known as inference themes, because these relate to an individual’s personal domain. Let me discuss the concept of ‘personal domain’ first.

Personal domain The concept known as the ‘personal domain’ first appeared in the psychological literature in 1976 in an excellent book entitled Cognitive Therapy and the Emotional Disorders by Dr Aaron T. Beck, one of the grandfathers of CBT. Your personal domain has three features: ⦿

Your personal domain contains people, objects and ideas in which you have an involvement.

⦿

Your personal domain is like an onion in that these people, objects and ideas can occupy a central, intermediate and peripheral place within it.

⦿

There are two basic areas within your personal domain − an ego area and a comfort area. As you will see, seven of the nine emotional problems that I discuss in this book can be related to one or both

Emotional problems   23

areas, while two of them (i.e., shame and guilt) appear to be related only to the ego area.

Inference An inference is an interpretation that you make about a situation that goes beyond the data at hand and one that has personal meaning to you. An inference may be accurate or inaccurate and needs to tested against the available evidence. Often you do not know for certain if an inference that you have made is accurate or inaccurate and therefore the best you can do is to make the ‘best bet’ given the data at hand. The accuracy of an inference often becomes clear after you have made it. This is particularly the case when you make an inference about a future event. Let me illustrate these points. You will recall that Harry, to whom I referred earlier in this chapter, was anxious about going to see his tutor. If someone asked him what he was anxious about, he would reply ‘I am anxious about being criticised by my tutor’. The statement ‘being criticised by my tutor’ is an inference in that (a) it goes beyond the data at hand; (b) it has personal meaning for Harry; (c) it may be accurate or inaccurate. Whether it is the ‘best bet’ in the circumstances depends on how critical Harry’s tutor is in general.

Inference theme When Harry made his inference about his tutor’s criticism, we know that he felt anxious. When people feel anxious they tend to do so because they infer some kind of threat to their personal domain. Therefore, we can assume that Harry’s inference about his tutor’s criticism was threat-​based. However, we also know that when people feel concerned (which is the healthy alternative to anxiety), they also tend to do so because they infer some kind of threat to their personal domain. We can conclude from this that, when you make an inference with a threat theme, you will feel either anxious or concerned, but, without knowing anything more, the inference on its own will not help you know whether your emotion is anxiety or concern. As you will see in the following chapters, when you experience one of the following pairs of emotions, each emotion pairing is related to a specific

24   Emotional problems

theme or themes concerned with your personal domain: anxiety vs. concern; depression vs. sadness; guilt vs. remorse; unhealthy regret vs. healthy regret; shame vs. disappointment; hurt vs. sorrow; unhealthy anger vs. healthy anger; unhealthy jealousy vs. healthy jealousy; and unhealthy envy vs. healthy envy. I will discuss and illustrate these themes in the relevant chapters. It is useful to remind your client at this point that an inference does not create feelings. Rather, your client has an emotion (either a UNE or an HNE) about this inference (in this case an adversity) and the healthiness of the negative emotion is not determined by the adversity. The adversity is the same whether the client’s negative emotion is healthy or unhealthy. What differentiates between UNEs and HNEs are the attitudes that your client holds towards the inferences (i.e., adversities) that they make − rigid/​ extreme when they are disturbed (i.e., they have UNEs) and flexible/​non-​ extreme when they experience HNEs.

DISTINGUISHING EMOTIONAL PROBLEMS FROM THEIR HEALTHY ALTERNATIVES In this section, I discuss in general how you can reliably distinguish emotional problems from their healthy alternatives. In the chapters that follow I discuss in detail how to distinguish the emotional problem in question with its specific healthy alternative.

Inference themes and attitudes We know from the above that inference themes show you which of the nine emotional pairings you are experiencing (e.g., when your inference theme is threat, you experience either anxiety or concern), but on their own they do not help you to distinguish which emotion you are experiencing within the pairing (i.e., you cannot tell by the inference theme of threat alone whether your emotion is anxiety or concern). We also know that, when you hold a rigid/​extreme attitude towards an adversity (but we do not know the inference theme of that adversity), your emotion will be unhealthy, but we don’t know which of the nine emotional problems you experience. Conversely, we know that, when you hold a flexible/​non-​extreme attitude towards an adversity (again, we do not know the

Emotional problems   25

Table 1.1  Inference themes, attitudes and emotions Inference theme

Attitude

Emotion

Threat

Rigid/​extreme

Anxiety

Threat

Flexible/​non-​extreme

Concern

inference theme of that adversity), your emotion will be a healthy negative one, but again we don’t know which of the nine HNEs you experience. However, when we combine these two bits of information, we are in a better position to distinguish specific emotional problems from their healthy alternatives. For example, if we know that the theme of your adversity is threat and you hold a rigid/​extreme attitude towards that threat, we are well placed to conclude that you are experiencing anxiety. Similarly, if we know that the theme of your adversity is threat and you hold a flexible/​ non-​extreme attitude towards that threat, we are well placed to conclude that you are experiencing concern. Table 1.1 puts this more succinctly. If your client already knows something about REBT and is wondering how this fits with the ‘ABC’ model, help them to see that inferences (and inference themes) occur at ‘A’ in the model, (basic)3 attitudes at ‘B’ and emotions at ‘C’.

Associated behaviour So far, I have mentioned that one way of distinguishing between an emotional problem and its HNE alternative is to take the theme of what the person has feelings about with respect to the adversity they are facing and the attitude the person holds that accounts for the emotion. You have learned the following: adversity inference theme +​rigid/​ extreme attitude =​emotional problem adversity inference theme +​flexible/​non-​extreme attitude =​HNE Now, when you hold an attitude towards an adversity, you don’t just experience an emotion, you also experience a tendency to act in a certain

26   Emotional problems

way (known as an action tendency), which you may or may not convert into overt behaviour. Thus, another way to tell if what you feel in a specific situation is an emotional problem or an HNE is to examine how you acted or, if you did not take action, to examine your action tendency. Let me illustrate this when a person is trying to figure out whether the anger that they felt was negative and unhealthy, or negative but healthy. Geraldine was angry with her boss when he did not recommend her for promotion, an advancement that she considered she thoroughly deserved. Geraldine considered that her boss had acted in a very unfair manner towards her. Geraldine was unsure whether her anger was negative and unhealthy, or negative but healthy, so she considered how she acted in the situation. This did not help her because she did not take any action when she discovered the news, nor subsequently. Finally, she considered what she felt like doing, but did not do. Geraldine’s action tendency was to scream abuse at her boss and to get revenge against him by getting him into trouble with his own boss. Such action tendencies were clearly hostile in nature and showed Geraldine that her anger was an emotional problem.

When you hold a rigid/​extreme attitude towards an adversity, your behaviour (or action tendencies) will tend to be dysfunctional and will prevent you from dealing with the adversity in a constructive manner. Whereas, when you hold a flexible/​non-​extreme attitude towards an adversity, your behaviour (or action tendencies) will tend to be functional and will help you to deal with the adversity in a constructive manner. In the ‘ABC’ model of REBT, behaviours occur at ‘C’ and are known as behavioural consequences of attitudes. Dysfunctional behaviours are consequences of rigid/​ extreme attitudes and functional behaviours are consequences of flexible/​ non-​ extreme attitudes.

Associated thinking The final way of determining whether you are experiencing an emotional problem or an HNE about an adversity is to inspect the thinking that is associated with the emotion. This is different from the inference that you made about the situation that constituted your adversity. Such thinking has not yet been processed by your attitudes. The thinking that

Emotional problems   27

I am referring to here is the thinking that is associated with your emotion. This is the thinking that has been produced when your adversity has been processed by your attitudes. When your adversity has been processed by rigid/​extreme attitudes, the thinking that results is very likely to be highly distorted and skewed to the negative in content and ruminative in nature. However, when this adversity has been processed by flexible/​non-​extreme attitudes, the thinking that results is very likely to be realistic and balanced in content and non-​ruminative in nature. David Burns, a leading cognitive therapist, first outlined in his book Feeling Good: The New Mood Therapy (Burns, 1980) a list of thinking errors − which are by nature highly distorted and skewed to the negative − that people make when they process adversities with rigid/​extreme attitudes. I outline and illustrate some of these thinking errors and their realistic and balanced alternatives in Appendix 1. You should consult this list if you are unsure whether the thinking you engage in when you are experiencing an emotion is realistic and balanced or highly distorted and skewed to the negative. Let me illustrate all this with reference to another person who is trying to figure out whether the anger that she felt was negative and unhealthy or negative but healthy. Francine (a co-​w orker of Geraldine) was also angry with her boss when he did not recommend her for promotion, an advancement that she considered she thoroughly deserved. Francine considered that her boss had acted in a very unfair manner towards her. Francine was unsure whether her anger was negative and unhealthy, or negative but healthy, so she considered how she thought in the situation. She thought about asserting herself with her boss after planning what to say. After she had done this, she made an appointment to see her boss and, in the days that followed until the meeting, she thought about the issue in passing, but did not ruminate on the issue. Given that Francine’s thinking that went along with her anger was realistic and balanced and non-​r uminative in nature, she considered that her anger was an HNE and not an emotional problem.

In the ‘ABC’ model of REBT, thinking can occur: ⦿

At ‘A’, where it occurs as inferences that your client focuses on. These may be accurate or distorted. If the latter, they are less distorted than the thinking that occurs at ‘C’, when it stems from rigid/​extreme attitudes.

28   Emotional problems

⦿

At ‘B’, where your client processes these inferences with either rigid/​extreme attitudes or flexible/​non-​extreme attitudes.

⦿

At ‘C’, where it is considered as thinking consequences of rigid/​ extreme attitudes and is also inferential in nature. Skewed and highly distorted ruminative thoughts are the thinking consequences of rigid/​ extreme attitudes, whereas realistic and balanced non-​ ruminative thoughts are the thinking consequences of flexible/​non-​extreme attitudes.

This shows that thinking occurs throughout the ‘ABC’ model. If your client is confused about the ubiquitous nature of thinking, you can use the above information with an appropriate example to clarify it for them. Let me summarise the points that I have made in this section and the previous one on behaviour and add it to the material that I presented on p. 25. (See Table 1.2.) In the chapters that follow, I employ a similar structure. First, I outline the major factors that need to be considered when understanding the emotional problem under focus. Second, I show you what steps you need to take to change each emotional problem to an appropriate HNE. Finally,

Table 1.2  Summary Adversity inference theme +​

Rigid/​extreme attitude =​

Emotional problem +​ Unconstructive behaviour and action tendencies +​ Highly distorted thinking that is skewed to the negative and ruminative in nature

Adversity inference theme +​

Flexible/​non-​ extreme attitude =​

Healthy negative emotion (HNE) +​ Constructive behaviour and action tendencies +​ Realistic and balanced thinking that is non-​ruminative in nature

Emotional problems   29

I discuss what you need to do to make yourself less prone to whatever emotional problems you are particularly susceptible to. Throughout each chapter, I illustrate the major points whenever relevant.

NOTES 1 Throughout this book, I will refer to events where you don’t get what you want, or get what you don’t want, as ‘adversities’. 2 We do not have agreed terms for HNEs. Thus, it is important that you use the terms that are meaningful to you if they are different from the terms in this list. 3 To preserve the ‘B’ in the ABC framework, my good friend and REBT colleague, Dr Walter Matweychuk, suggested that I call attitudes ‘basic’ attitudes since they lie at the base of the client’s responses to the adversity at ‘A’. When referring to attitudes, I will use the descriptor ‘basic’ in this book only when I need to preserve the letter ‘B’ in the ABC framework. Otherwise, I will refer to them as attitudes.

C H A P T E R

2 Dealing with anxiety

In this chapter, I begin by presenting REBT’s way of understanding anxiety and then address how to deal with this very common emotional problem.

UNDERSTANDING ANXIETY In understanding anxiety, we need to know what we tend to make ourselves anxious about (i.e., its major inference theme), what attitudes we hold, how we act or tend to act, and how we think when we are anxious. A major point for practitioners who use this guide with clients to consider concerns language and I return to this theme a number of times in this Practitioner’s Guide. Basically, it is my contention that the working alliance between clients and REBT therapists is strengthened when they both use language that is most meaningful to clients rather than language that is typically used to describe concepts in REBT theory and practice (Dryden 2009a). If you are a novice REBT therapist, you are especially prone to use REBT language rather than language with which the client resonates (see Dryden, 2009a) and you should pay particular attention to this issue when you work with your client, who is using the Client’s Guide. In addition, discuss this issue when listening to digital voice recordings of your therapy sessions with your supervisor. With respect to the term ‘anxiety’, you need to be aware that not all clients with an ‘anxiety’ problem resonate with the term ‘anxiety’. They may identify more closely with synonyms such as ‘fear’, ‘being scared’, ‘feeling insecure’ or ‘feeling threatened’. If so, your task is to satisfy yourself and your client that these terms represent the UNE known in REBT as anxiety. Once you have done so, use the client’s language and write this down in your client’s notes.

DOI: 10.4324/9781003424338-3

Dealing with anxiety    31

Major inference themes in anxiety When you are anxious, you are facing or think you are facing a threat to some aspect of your personal domain (see pp. 22–23). There are different forms of anxiety, which I list in Table 2.1 together with the typical threats that feature in them. Your client may not resonate with the term ‘threat’ concerning the theme about which they are anxious. If this is the case, you may suggest ‘danger’ or ‘risk’ as possible synonyms. The important

Table 2.1  Different types of anxiety and their major inference themes Type of anxiety

Typical threats

Social anxiety

⦿ ⦿

Acting poorly in a social setting (e.g., revealing that you are anxious; saying something stupid; not knowing what to say) Being judged negatively by people

Health anxiety

⦿

Being uncertain that a symptom that you have is not malignant

Generalised anxiety

⦿

A general sense that you do not know that you are safe A general sense that something may happen that will result in you losing self-​control in some way Thinking that you may become anxious

⦿ ⦿

Public speaking anxiety

⦿ ⦿

Performing poorly while the focus of the audience is on you (e.g., going blank; revealing that you are anxious) Being judged negatively by people

Test anxiety

⦿ ⦿

 oing poorly on the test D Going blank

Panic

⦿

Not knowing that you will regain self-​control immediately in a situation where you have begun to lose it

32    Dealing with anxiety

thing here, as mentioned above, is that you and your client use the term that makes most sense to them and not the term that is used most often in the REBT literature.

Rigid/​e xtreme attitudes As I explained in Chapter 1, according to REBT, an inference of threat that you make does not account for your emotional problem of anxiety. It is possible for you to make the same inference and be healthily concerned, but not anxious. In order for you to feel anxious when you infer the presence of threat to your personal domain, you have to hold a rigid/​extreme attitude. While the rigid attitude is at the core of anxiety, the extreme attitudes that are derived from the rigid attitude often distinguish between whether you are experiencing ego anxiety (where you devalue yourself) and non-​ego anxiety (where you ‘awfulise’ or find the adversity unbearable). You may, of course, experience both ego anxiety and non-​ego anxiety in a given situation. If your client is unsure about the mediating role that rigid/​ extreme attitudes play in their anxiety, ask them how they would feel if they had a strong conviction in the flexible/​ non-​ extreme attitudes that REBT holds are the healthy alternatives to their anxiety-​ creating rigid/​ extreme attitudes. In using this strategy, it is important that you formulate the flexible/​ non-​ extreme attitudes for your clients, who cannot be expected to do this for themselves at this stage. When you do this, ensure that you match your client’s rigid attitude with a flexible alternative and their main extreme attitude with a non-​extreme alternative, and then ask them how they would feel if they had strong conviction in this flexible/​non-​extreme attitude. For example: ‘If you really believed that you wanted to pass the test, but did not have to do so and that, if you failed it, that would be bad, but it would prove that you were fallible and not a failure, how would you feel about the prospect of failing the test?’ Once your client can see that they would feel differently, go back and help them relate their rigid/​extreme attitudes to anxiety and their flexible/​non-​extreme attitudes to concern. This is quite an elegant strategy since it accomplishes a number of things at once:

Dealing with anxiety    33

1.  It addresses your client’s doubts about the mediating role of rigid/​extreme attitudes in anxiety. 2.  It introduces flexible/​non-​extreme attitudes as a meaningful alternative to these rigid/​extreme attitudes. 3.  It helps your client to see that holding flexible/​ non-​ extreme attitudes can have beneficial effects.

Behaviour associated with anxiety When you hold a rigid/​extreme attitude towards a threat to your personal domain, you feel anxious and you will act or tend to act in a number of ways, the most common of which are as follows: ⦿

You avoid the threat.

⦿

You ward off the threat (e.g., by rituals or superstitious behaviour).

⦿

You withdraw physically from the threat.

⦿

You try to neutralise the threat (e.g., by being nice to people of whom you are afraid).

⦿

You distract yourself from the threat by engaging in other activity.

⦿

You keep checking on the current status of the threat, hoping to find that it has disappeared or become benign.

⦿

You seek reassurance from others that the threat is benign.

⦿

You seek support from others so that, if the threat happens, they will handle it or be there to rescue you.

⦿

You overprepare in order to minimise the threat happening or so that you are prepared to meet it (NB it is the overpreparation that is the problem here).

⦿

You tranquilise your feelings so that you don’t think about the threat.

⦿

You overcompensate for feeling vulnerable by seeking out an even greater threat to prove to yourself that you can cope.

You will see from the above list that the main purpose of most of these behaviours (and action tendencies) is to keep you safe from the threat.

34    Dealing with anxiety

However, such safety-​ seeking behaviour is largely responsible for the maintenance of anxiety since it prevents you either from facing up to the situation in which you think that the threat exists and dealing with the threat if it does exist, or from seeing that your inference of threat is inaccurate. Overcompensation is particularly worthy of comment. Some people are intolerant of the feeling of vulnerability or non-​coping that they experience when they are anxious. They seek safety from the threat of non-​ coping by proving to themselves in actuality that they can cope with a greater threat. This is like a competition high jumper electing to jump a much greater height than the one at which she has twice failed. This is still a safety-​seeking measure because the person seeks safety from the smaller threat by proving to herself that she can cope with the bigger threat. Encouraging your client to surrender their safety-​ seeking behaviour is a very important part of helping them to deal with their anxiety effectively. Consequently, you need to enquire specifically if they have any doubts, reservations or objections to doing so. When they express such doubts, it is important that you strive to understand their sources and deal with them effectively. If you fail to do this, their continued use of these safety-​seeking measures will undermine the development and maintenance of their healthy flexible/​ non-​ extreme attitudes towards threat. You will find that most clients’ doubts about surrendering the use of safety-​seeking behaviours centre on their need to feel immediately safe from threat. When some clients understand this dynamic, they see what they need to do and this understanding is sufficient for them to commit themselves to the idea of bearing the discomfort of feeling anxious while they learn to deal with the threat without using safety-​seeking behaviours. Other clients are much more reluctant to surrender the use of safety-​seeking behaviours and, with these clients, you will need to target for change the rigid/​extreme attitude that underpins their reluctance (e.g., ‘I must feel safe at all times and I can’t bear it when I don’t’). Once these clients have begun to develop and strengthen the flexible/​non-​extreme alternative to this rigid/​extreme attitude, they begin to become more open to facing threat without using safety-​ seeking behaviour.

Dealing with anxiety    35

Thinking associated with anxiety When you hold a rigid/​extreme attitude towards a threat to your personal domain, you will feel anxious and think in a number of ways. Remember what I said in Chapter 1: the thinking that accompanies your anxiety is the result of your threat being processed by your rigid/​extreme attitude and therefore it is likely to contain a number of thinking errors that I present in Appendix 1. There are two types of post-​rigid/​extreme-​attitude thinking that are important for you to understand: ⦿ ⦿

threat-​exaggerating thinking safety-​seeking thinking.

It is important to note that in both types of post-​rigid/​extreme-​attitude thinking, such thinking may be in words or in mental images.

Threat-​exaggerating thinking In the first type of post-​rigid/​extreme-​attitude thinking that is associated with anxiety − which I have called threat-​exaggerating thinking − you elaborate and magnify the threat and its consequences in your mind as shown below: ⦿

You overestimate the probability of the threat occurring.

⦿

You ruminate about the threat.

⦿

You underestimate your ability to cope with the threat.

⦿

You create an even more negative threat in your mind.

⦿

You magnify the negative consequences of the threat and minimise its positive consequences.

⦿

You have more task-​irrelevant thoughts than within concern.

Safety-​seeking thinking The second type of post-​rigid/​extreme-​attitude thinking that is associated with anxiety is the thinking version of behaviour that is designed to keep

36    Dealing with anxiety

you safe in the moment. I call this form of thinking safety-​seeking thinking. Here are some common examples: ⦿

You withdraw mentally from the threat.

⦿

You try to persuade yourself that the threat is not imminent and that you are ‘imagining’ it.

⦿

You think in ways designed to reassure yourself that the threat is benign or, if not, that its consequences will be insignificant.

⦿

You distract yourself from the threat, e.g., by focusing on mental scenes of safety and well-​being.

⦿

You overprepare mentally in order to minimise the threat happening or so that you are prepared to meet it (NB once again it is the overpreparation that is the problem here).

⦿

You picture yourself dealing with the threat in a masterful way.

⦿

You overcompensate for your feeling of vulnerability by picturing yourself dealing effectively with an even bigger threat.

In the final two forms of thinking, the person is seeking safety from the threat of non-​coping by mentally creating images of masterful coping. One important point to note about these two forms of post-​ rigid/​ extreme-​attitude thinking is that they are quite different: in one you elaborate and magnify the threat and in the other you are thinking of ways to protect yourself against the threat. You can, and people often do, switch rapidly between these different forms of thinking. The more your safety-​ seeking thinking fails, the more you will mentally elaborate and magnify the threat, and the more you do the latter, the more you will try to search mentally for safety. The following points are relevant to safety-​seeking thinking. I will consider threat-​ exaggerating thinking directly after. The points that I made about safety-​seeking behaviour are also relevant to safety-​ seeking thinking. It is important for your client to understand that such thinking is designed to keep them safe in the immediate situation, but in doing so they do not get the experience that they need of facing and dealing with their threat while holding flexible/​non-​extreme attitudes. However, while they can readily understand the concept of not acting in ways that are designed to seek immediate safety from threat, they are usually more confused concerning what to do with safety-​seeking thinking

Dealing with anxiety    37

when such thoughts come into their mind. I recommend using the following strategy: ⦿

Encourage your client to acknowledge the existence of the thought without trying to suppress it or to distract themself from it. Explain that if they try to suppress the thought, they may unwittingly make it more likely to come into their mind and if they distract themself from it, they are not dealing with it.

⦿

Encourage your client not to engage with the thought. For example, if your client is anxious about other people doing better on an exam than them, they may try to neutralise this by thinking: ‘I’m sure I will do as well as most of the others.’ If they engage with this thought, they will feel reassured. If they do not engage with the thought, they won’t feel reassured, but will have the opportunity of either rehearsing their flexible/​non-​ extreme attitude towards the threat briefly or getting on with whatever they would be doing if they did not have the thought (e.g., revising for the exam) even though they feel anxious or uncomfortable in the moment.

If a client is unclear about what non-​engagement with a thought involves, you may need to use an analogy such as the one below, which I present as if I am talking directly to a client.

How not to engage with a thought: an analogy ‘You may well find it difficult to grasp the idea of having a thought without engaging with it, so here is an analogy that you may find helpful. Imagine that you are walking down a high street and a charity worker approaches you and tries to engage you in a conversation about a local charity. You know that the charity worker wants you to sign a direct debit form whereby you pay a regular sum every month to the charity. Now, let’s suppose that you neither want to give to the charity nor want to talk to the person. What is the best way of stopping the person from talking to you without being overtly rude to them? My view is that the best way to do this is not to respond to the person. As you continue down the road, the charity worker walks beside you and you are aware of what he is saying but you say nothing in return. You give the person no eye contact nor show him any recognition that he is

38    Dealing with anxiety

there. If you take this tack, after a short while the person will stop pursuing you. This is the approach you need to take with your safety-​seeking thoughts. Acknowledge that they are present, and continue with what you are doing while not engaging with the thoughts and without trying to get rid of them.’ The following points are relevant to helping your client deal with threat-​exaggerating thinking if they raise questions about how to deal with this form of cognitive consequence of rigid/​extreme attitudes: ⦿

Encourage your client to recognise the existence of such thoughts and discourage them from trying to suppress them or to distract themself from them.

⦿

Help them to understand that these thoughts are the products of still active rigid/​ extreme attitudes and are not plausible predictions about what is about to happen, no matter what feelings accompany such thoughts.

⦿

Encourage them either to briefly rehearse their flexible/​ non-​ extreme attitudes towards the threat and/​or get on with whatever they would be doing if they did not have the thought.

HOW TO DEAL WITH ANXIETY If you are prone to anxiety, you tend to experience this emotional problem in a variety of different settings and in response to a variety of threats. Here is how to deal with anxiety so that you become less prone to it.

Step 1: Identify reasons why anxiety is a problem for you and why you want to change While anxiety is generally regarded as an emotional problem, it is useful for you to spell out reasons why anxiety is a problem for you and why you want to change. I suggest that you keep a written list of these reasons and refer to it as needed as a reminder of why you are engaged in a self-​help programme. I discuss the healthy alternative to anxiety in Step 4. If your client is still undecided whether or not anxiety is a problem for them and/​or whether or not they want to change, you

Dealing with anxiety    39

will need to carry out a more thorough assessment of the possible factors involved. This is known as a cost-​benefit analysis where you encourage your client to detail the perceived short-​term and longer-​term advantages and disadvantages of their anxiety and of their concern (the healthy alternative to anxiety). Respond to any perceived advantages of anxiety and perceived disadvantages of concern, correcting any misconceptions that your clients reveal on these issues. Let me start with the issue of a client who is unsure if anxiety is a problem for them. It is useful to start by asking them to spell out ways in which anxiety is a problem for them and ways in which anxiety is not a problem for them. In the latter case, you may well discover that your client thinks that anxiety can be helpful to them in certain ways (e.g., that it motivates them or that it helps them to spot the presence of certain threats). If so, the client understands that concern (to which the client will be introduced presently as the healthy emotional alternative to anxiety) will do the job that they think anxiety does for them, but without the detrimental ‘side-​effects’ of anxiety. For example, I often say to a client that anxiety is motivating in the same way that a headless chicken is motivated to find its head (i.e., with frenzied activity, but without focus). Concern, on the other hand, motivates a client, but in a focused manner and without the frenzy. In addition, you can help your client to consider what for them are the positives and negatives of concern. For example, some people say that concern is too weak to be a plausible alternative to anxiety. In which case, you need to show the person that concern can vary in intensity and, if they are very anxious, they can be very concerned, but unanxious. Now, what if your client acknowledges that anxiety is a problem, but is ambivalent about targeting it for change? The main strategy is to understand their ambivalence. It may be that they do not see a clear alternative to anxiety, in which case you need to teach them what REBT has to say about concern as a healthy alternative to anxiety. It also may be that anxiety has positive features for the client, at least from their frame of reference. In which case, you can respond as suggested above. Time spent on helping your client to be clear and unambivalent about anxiety being a problem for them so that they can fully commit themself to the process of REBT is time well spent.

40    Dealing with anxiety

Step 2: Take responsibility for your anxiety In REBT, we argue that people or things do not make you anxious; rather you create these feelings by the rigid/​ extreme attitudes that you hold towards such people and things. You may object that this involves you blaming yourself for creating your anxious feelings, but this objection is based on a misconception. It assumes that taking responsibility for creating your anxiety is synonymous with self-​ blame. In truth, responsibility means that you take ownership for the rigid/​extreme attitudes that underpin your anxiety while accepting yourself unconditionally for doing so. Blame, on the other hand, means that you regard yourself as worthless (for example) for creating your anxiety. The idea that emotional problems (including anxiety) are based largely on the way that a person thinks about what happens to them may be a familiar one in the professional field of counselling and psychotherapy, but it is still an eye-​opener to many clients. Thus, your client may hold that the reason they are anxious, for example, is that the person they are anxious about is truly scary or that driving tests or going to the dentist are inherently frightening. This type of thinking is known in REBT circles as ‘A–​C’ thinking (where events are deemed to cause feelings). By contrast, the REBT model stresses the ‘ABC’ model, where the impact of events on a person is mediated by the attitudes that they hold towards those events. The ‘ABC’ model holds that the person needs to take responsibility for creating their feelings of anxiety by realising they do so by holding a set of rigid/​extreme attitudes. If your client has difficulty accepting responsibility for their anxious feelings, it is important for you to identify and deal with the source of this difficulty. In the Client’s Guide, I mention one common obstacle that stops clients from accepting such responsibility (i.e., the self-​blame that clients engage in if they accept responsibility for making themselves anxious). However, there are other obstacles to accepting responsibility, such as the following: ⦿

Hopelessness about self-​help (e.g., ‘I can’t do anything to help myself’).

⦿

Self-​ pity (e.g., ‘It’s not me that makes me anxious, it’s the lousy situation that I am in and that I don’t deserve to be in. Poor me!’).

Dealing with anxiety    41

⦿

Loss of benefits (e.g., ‘If I accept that I make myself anxious then I will lose out on the benefits that blaming my environment gives me − such as being spared from doing difficult or potentially threatening tasks at work’).

It is important to help your client to understand the impact of such obstacles on their emotional problems. Then, help them to develop alternatives to these obstacles and review the impact of these alternatives on their emotional problem-​solving. This often helps a client to deal effectively with these obstacles. If not, you may need to do a more detailed assessment of the obstacle, which is outside the scope of this book.

Step 3: Identify the threats you tend to be anxious about The best way of identifying which threats you are particularly vulnerable to is to ask yourself whether or not such threats are to your self-​esteem.

Major threats to self-​esteem ⦿

The prospect of failure

⦿

The prospect of being rejected

⦿

The prospect of being disapproved of

⦿

The prospect of losing status

Major threats that do not involve your self-​esteem ⦿

The prospect of losing self-​control (although this threat may involve your self-​esteem as well)

⦿

Uncertainty that one is not safe from threat

⦿

The prospect of loss of order

⦿

The prospect of experiencing discomfort

⦿

The prospect of experiencing certain internal processes (e.g., unwanted thoughts, feelings, images and urges). Again, this threat may involve self-​esteem as well

42    Dealing with anxiety

Use the above list to identify the themes that you find threatening. If your client finds it difficult to find their threat-​related theme, you can help them by assessing a few specific examples of their anxiety. Have them focus on a specific situation in which they were anxious and ask them what they were most anxious about or found most threatening in the situation. If they still find it difficult to identify the threat in this or other specific situations, use the ‘magic question’ technique. This involves you doing the following: ⦿

Have your client focus on the situation in which they were anxious.

⦿

Ask them to nominate one ingredient that would eliminate or significantly reduce their anxiety without changing the situation.

⦿

The opposite of this nominated ingredient is what they are most anxious about.

Hilda was struggling to identify the specific threat in her dental anxiety. I helped Hilda to use the ‘magic question’ technique as follows: ⦿

I asked Hilda to focus on the situation in which she was anxious: ‘I am waiting to be called into the dentist’s surgery.’

⦿

I asked Hilda to nominate one ingredient that would eliminate or significantly reduce her anxiety without changing the situation: ‘I would not have thoughts about the drill cutting my tongue.’

⦿

The opposite of this nominated ingredient is what she is most anxious about: ‘Having thoughts about the drill cutting my tongue.’

If you assess several specific examples of your client’s anxiety in this way, the threat-​related theme should be apparent. In Hilda’s case, it was having thoughts about external dangers happening to her when she was in a vulnerable position.

Dealing with anxiety    43

Step 4: Identify the three components of your anxiety response and set goals with respect to each component The next step is for you to list the three elements of your anxiety response in the face of each of the threats listed above.

Identify the three components of your anxiety response I use the term ‘anxiety response’ to describe the three main components that make up this response. The three components of your anxiety response are the emotional, behavioural and thinking components.

Emotional component The emotional component is, of course, anxiety.

Behavioural component The behavioural component concerns overt behaviour or action tendencies. These will be largely safety-​seeking in nature. Consult the list that I provided to help you identify your behaviour associated with each theme when you are anxious (see p. 33).

Thinking component The thinking component concerns theme-​exaggerated thinking or safety-​ seeking thinking. These may be in words or in mental pictures. Consult the list that I provided to help you identify your thinking associated with each theme when you are anxious (see pp. 35–36).

Set goals with respect to each of the three components You need to set goals so that you know what you are striving for when you deal effectively with anxiety. The three goals are emotional, behavioural and thinking goals.

44    Dealing with anxiety

Emotional goal Your emotional goal is concern rather than anxiety (or whatever synonym you prefer to the term ‘concern’). Concern is an HNE, which is an appropriate response to threat, but one that helps you to process what has happened to you and move on with your life rather than get stuck or bogged down. The concept that concern is the healthy alternative to anxiety in the face of threat is based on the following idea. Threat is negative and therefore it is realistic to have a negative emotion about it. The choice, therefore, is between a UNE (anxiety) or an HNE (concern). But, what if your client specifies an unrealistic goal? Here are a number of such goals and how to respond to a client who nominates them: ⦿

⦿

⦿

⦿

‘I don’t want to feel anxious.’ Show your client that they have indicated what they do not want to feel in the face of threat, but not what they do want to feel. Help them to specify an emotion to aim for, like concern! ‘I want to feel less anxious.’ Show your client that, as anxiety is a disturbed emotion, wanting to feel less anxious is still to nominate a disturbed emotion, albeit of lesser intensity. Concern can be strong and healthy. ‘I want to be cool and calm.’ Show your client that, if they are facing a threat (or think that they are), they need to be alert, aroused and geared up to deal with it. Being cool or calm may be attractive states for your client, but show them that these states are not appropriate when they are facing threat. Show them that being concerned, but not anxious, in the face of threat will gear them up without overstimulating them (as would be the case if they were anxious). ‘I want to feel indifferent.’ Being indifferent in the face of threat will also not help your client to be appropriately geared up to deal with it. Help them

Dealing with anxiety    45

to see this. Also show them that the only way that they could achieve a state of indifference about threat is to believe that it does not matter to them if the threat exists or not. In other words, show them that they would have to lie to themself. ⦿

‘I want to be in control.’ Anxiety is a state where you are not fully in control of yourself. As a result, it seems entirely acceptable for your client to nominate ‘being in control’ as something to aim for when they are anxious. This seems entirely reasonable, but you need to be on your guard when your client nominates such a goal. Dealing with anxiety is counterintuitive. Thus, achieving a sense of being in control in the face of threat involves your client tolerating not being in self-​ control. Your client may hold rigid/​ extreme attitudes towards self-​control and, if they bring such attitudes to the task of dealing with anxiety, it will lead them to be more anxious. If your client does have such a rigid attitude towards self-​control, you will need to target this attitude for change. In doing so, you need to help them see the difference between self-​control as a goal and self-​control as a means to achieve this goal. Your client needs to learn that bearing not being in self-​control is the best way of achieving self-​control. Be aware, though, that this is likely to be an alien concept for them and one that will need a lot of discussion and debunking of misconceptions on your part. This is definitely an issue that you should (ideally) take to supervision.

Behavioural goal Your behavioural goal should reflect actions that are based on concern about the threat rather than anxiety. The following are the most common behaviours associated with concern rather than anxiety. You may wish to compare these behaviours with those associated with anxiety that I presented on p. 33. ⦿ ⦿

You face up to the threat without using any safety-​seeking measures. You take constructive action to deal with the threat.

46    Dealing with anxiety

⦿

You seek support from others to help you face up to the threat and then take constructive action by yourself rather than rely on them to handle it for you.

⦿

You prepare to meet the threat but do not overprepare.

You will note that this list is much shorter than the list outlining the behaviours that are associated with anxiety. The reason is that, when you seek safety from threat, there are far more ways of doing so than when you face up to the threat. It is important that your client understands that, as they strive to develop healthy behavioural responses to threat, they will still feel the urge to act in ways designed to help keep them safe from threat. Help them to understand the reason for this. Explain to them that, as they examine their attitudes and commit themself to strengthening their conviction in their flexible/​ non-​ extreme attitudes and to weakening their conviction in their rigid/​extreme attitudes, their rigid/​ extreme attitudes will still be active and produce urges for them to act dysfunctionally. Encourage your client to accept these urges, to recognise that they do not have to act on them and to use them as cues to act in functional ways.

Thinking goal As well as setting behavioural goals related to the feeling of concern in the face of threat, it is important that you set thinking goals associated with this emotion. The following are the most common forms of thinking associated with concern rather than anxiety. Again, you may wish to compare these forms of thinking with those associated with anxiety that I presented on pp. 35–36. ⦿

You are realistic about the probability of the threat occurring.

⦿

You realistically appraise your ability to cope with the threat.

⦿

You view the nature of the threat realistically.

⦿

You think about what to do concerning dealing with the threat constructively rather than ruminate about the threat.

⦿

You have more task-​relevant thoughts than within anxiety.

As the above list shows, the dominant feature of thinking associated with concern is that it is realistic and coping focused. Thus, when you

Dealing with anxiety    47

are concerned, but not anxious, you do not elaborate or magnify the threat, nor do you mentally seek safety from it. Please remember that such thinking may be in words or in mental pictures. The point I made above with respect to your client’s behavioural goals is also relevant with respect to their thinking goals. Your client will still have some conviction in their rigid/​extreme attitudes until they have full conviction in their flexible/​ non-​ extreme attitudes. Given this, your client’s rigid/​extreme attitudes will have some impact on their subsequent thinking as they strive to achieve their goals. Thus, highly distorted and/​or safety-​seeking thoughts will still come into your client’s minds. Help your client to understand why this is the case. When you come to help them deal with these forms of post-​rigid/​extreme-​attitude thinking, do one or more of the following as indicated. Discuss this issue with your REBT supervisor, if necessary: ⦿

Encourage your client to acknowledge the existence of such thoughts without trying to suppress them, distract themself from them or engage with them.

⦿

If relevant, use the presence of this post-​rigid/​extreme-​attitude thinking to help your client to identify and deal with the rigid/​ extreme attitudes.

⦿

Examine the empirical nature of these thinking ‘Cs’ once or twice and then return to the acceptance strategy detailed above.

Step 5: Identify your general rigid/​e xtreme attitudes and alternative general flexible/ ​n on-​e xtreme attitudes A general rigid/​extreme attitude is an attitude that you hold across situations defined by the theme that you find threatening. It accounts for your anxiety response. Its flexible/​non-​extreme alternative, which will also be general in nature, will account for your concern response. I suggest that you identify both sets of attitudes at this point for a number of reasons (as follows). Doing so will help you to: ⦿

see quickly what the alternatives to your rigid/​extreme attitudes are;

48    Dealing with anxiety

⦿

see that you can achieve your goals by acquiring and developing your flexible/​non-​extreme attitudes; and

⦿

get the most out of examining your attitudes later.

Identify your general rigid/​e xtreme attitudes When you identify a general rigid/​extreme attitude, you take a common theme (e.g., criticism or loss of self-​control) and add to this a general rigid attitude and the main extreme attitude that is derived from the rigid attitude. Note the following: ⦿

If you are particularly prone to self-​esteem based anxiety, your main extreme attitude will be a self-​devaluation attitude.

⦿

For anxiety that is non-​self-​esteem based, your main extreme attitude will either be an awfulising attitude or an unbearability attitude, and less frequently it may be an other-​devaluation attitude or a life-​devaluation attitude.

For example: ⦿

‘I must not be criticised and, if I am, it would prove that I am worthless’ (a general self-​esteem based rigid/​extreme attitude).

⦿

‘I must not lose self-​control and it would be awful if I do’ (a general non-​ self-​esteem based rigid/​extreme attitude).

Identify your alternative general flexible/​non-​extreme attitudes When you identify your alternative general flexible/​ non-​ extreme attitude, you take the same common theme (e.g., criticism or loss of self-​control) and add to this a general flexible attitude and the main non-​extreme attitude that is derived from the flexible attitude. Note the following: ⦿

If your general extreme attitude is self-​devaluation (when you are particularly prone to self-​esteem based anxiety), then your general non-​ extreme attitude will be an unconditional self-​acceptance attitude.

Dealing with anxiety    49

⦿

If you are prone to non-​self-​esteem based anxiety, then your alternative general non-​extreme attitude will be a non-​awfulising attitude, a bearability attitude and less frequently an unconditional other-​acceptance attitude or an unconditional life-​acceptance attitude.

For example: ⦿

(‘I would prefer not to be criticised, but I don’t have to be immune to criticism.) If I am criticised, it would be unpleasant, but it would not prove that I am worthless. I am the same fallible human being whether I am criticised or not’ (a general unconditional self-​acceptance attitude).

⦿

(‘I would much prefer not to lose self-​control, but that doesn’t mean that I must not do so.) If I do lose self-​control, it would be very bad, but it would not be awful’ (a general non-​awfulising attitude).

As you will have noticed in the Client’s Guide, I encourage readers/​ clients to identify and work with their general rigid/​ extreme attitudes and to develop general flexible/​ non-​ extreme attitudes and, as you will see, when they are facing specific instances of their problems, I encourage them to focus on specific examples of both sets of attitudes. This will be at variance with your REBT practice, where you will begin with specific examples of your client’s problems and then proceed to work at a more general level with their problems and how these relate to one another. The reason I have chosen to go ‘general’ rather than ‘specific’ when helping reader/​clients to deal with their emotional problems is a pragmatic one. In this book, I aim to help people to deal with a range of emotional problems and therefore, in my view, it is best to give readers/​clients general guidance with respect to dealing with this range of problems and then help them to move from the general to the specific rather than vice versa. My considered view is that I just do not have the space to help readers/​clients focus on specific examples of their emotional problems and then generalise from this specific level. Consequently, one way that you can help your client who is using the Client’s Guide is to help them to work with specific examples of their emotional problem, in this case anxiety. Use the following sequence as you do so and help your client to: ⦿

Select a specific example of their anxiety problem.

50    Dealing with anxiety

⦿

Express why their anxiety constitutes a problem for them.

⦿

Identify what they were most anxious about in the situation.

⦿

Identify the three specific components of their anxiety response and set specific goals with respect to each component.

⦿

Identify their specific rigid/​extreme attitudes and alternative specific flexible/​non-​extreme attitudes.

⦿

Help them to examine both sets of specific attitudes.

In helping your clients to deal with a specific example of their anxiety, you can teach them how to use REBT’s ABCD form, which appears in Appendix 6. The following steps are the same as those that appear in Steps 7−10 later in this chapter. Thus, help your clients to: ⦿

face their threat in imagery (if necessary)

⦿

face their threat in vivo (i.e., in reality), if possible, and take appropriate action

⦿

capitalise on what they have learned

⦿

generalise their learning.

Step 6: Examine your general attitudes While there are many ways of examining your general rigid/​ extreme attitudes and general flexible/​non-​extreme attitudes, in my view the most efficient way involves you first examining together your general rigid attitude and its general flexible attitude alternative and then examining together your main general extreme attitude and your main general non-​ extreme attitude.

Examine your general rigid attitude and its general flexible attitude alternative First, take your general rigid attitude and its general flexible attitude alternative and write them down next to one another on a sheet of paper. Then ask yourself:

Dealing with anxiety    51

⦿

Which is true and which is false?

⦿

Which has largely constructive results and which has largely unconstructive results?

⦿

Which is sensible logically and which does not make sense?

Write down your answer to each of these questions on your piece of paper, giving reasons for each answer. Consult Appendix 2 for help with the answers to these questions, which you need to adapt and apply to the attitudes you are examining.

Examine your main general extreme attitude and its general non-​extreme attitude alternative Next, take your main general extreme attitude and its general non-​extreme attitude alternative and again write them down next to one another on a sheet of paper. Then, ask yourself the same three questions that you used with your general rigid attitude and its general flexible attitude alternative. Again, write down your answer to each of these questions on your piece of paper, giving reasons for each answer. I suggest that you consult Appendix 3 (for help with examining awfulising attitudes and non-​ awfulising attitudes), Appendix 4 (for help with examining unbearability attitudes and bearability attitudes) and Appendix 5 (for help with examining devaluation attitudes and unconditional acceptance attitudes). Again, you need to adapt and apply these arguments to the attitudes you are examining. You should now be ready to commit to acting and thinking in ways consistent with your general flexible/​non-​extreme attitude. For, unless you do so, you will not strengthen your conviction in this attitude. I included Appendices 2−5 in the Client’s Guide as general guidelines to help readers/​clients to examine their rigid/​extreme attitudes and flexible/​non-​extreme attitudes (reproduced in this book as Appendices 2−5). If you are working with a client who is using the Client’s Guide, you will have a chance to look at the examining work that your client has done at this point and give them feedback on that work. No book can provide such feedback. I have suggested that readers/​clients examine their rigid attitude and their flexible attitude together and then their main extreme attitude and non-​ extreme attitude equivalent together using three criteria as shown below. I have done so because, in my view, it is the most efficient way of examining attitudes.

52    Dealing with anxiety

⦿

Rigid attitude vs. flexible attitude ⦿

empirical status

⦿

pragmatic status

⦿

empirical status

⦿

pragmatic status

⦿

⦿

logical status

Main extreme attitude vs. main non-​extreme attitude

⦿

logical status

The final point I want to make about examining attitudes concerns the concept of persuasiveness. Perhaps the most important aspect of the examining process is for your client to develop arguments concerning the false, illogical and unhealthy nature of their rigid/​ extreme attitudes and the true, logical and healthy nature of their flexible/​non-​extreme attitudes that are persuasive to them. So, encourage your clients to develop such persuasive arguments and to make a note of these for future reference.

Step 7: Face your threat in imagery I hope that you have made a commitment to act on your general flexible and relevant non-​extreme attitudes. Assuming that you have, your basic task is to face up to your threat while not using any of the safety-​seeking behavioural measures that you employed to keep yourself safe from the threat when you were anxious. Up to this point, you have worked at a general level concerning the threats you are anxious about, the general rigid/​extreme attitudes that account for this anxiety and their alternative general flexible/​non-​extreme attitudes. However, when you come to apply your general flexible/​non-​ extreme attitudes in dealing with your threats, you need to consider one important point. Since you make yourself anxious about threats in specific situations (actual or imagined), you need to deal with these specific threats by rehearsing specific variants of your general flexible/​non-​extreme attitudes.

Dealing with anxiety    53

While the best way to do this is in specific situations where you infer threat, you may benefit from using imagery first. If this is the case, you need to do the following: ⦿

Imagine a specific situation in which you felt anxious or may feel anxious and focus on your threat.

⦿

See yourself facing the threat while rehearsing a specific flexible/​non-​ extreme attitude relevant to the situation. As you do this, try to make yourself feel concerned, rather than anxious.

⦿

Then, see yourself take action without using the safety-​seeking behavioural measures you would generally use if you were anxious. Make your picture realistic. Imagine yourself experiencing the urge to use your safety-​seeking behaviours, but not doing so. Also, picture yourself acting functionally, but with a faltering performance rather than a masterful one.

⦿

Recognise that some of your post-​ rigid/​ extreme-​ attitude thinking may be distorted. Respond to it without getting bogged down doing so. Accept the presence of any remaining distorted thoughts without engaging with them.

⦿

Repeat the above steps until you feel sufficiently ready to put this sequence into practice in your life.

If you find that facing your threat, in your mind’s eye, is too much for you, use a principle that I call ‘challenging, but not overwhelming’. This means that, instead of imagining yourself facing a threat that you find ‘overwhelming’ at the present time, choose a similar threat to face that you would find ‘challenging, but not overwhelming’. Then employ the same steps that I have outlined above. Work in this way with modified threats until you find your original threat ‘challenging, but not overwhelming’ and then use the steps again. Some of your clients may say that they can’t get very clear images when they try to picture events in their mind’s eye. While they may get more out of imagery techniques if they can get such clear images, they will still get something out of facing threat in imagery even if their images aren’t clear. So, if clients want to face threat in imagery before they do so in reality, encourage them to do so no matter how clear their mental images are.

54    Dealing with anxiety

Step 8: Face your threat in reality Whether or not you have used imagery as a preparatory step, you need to take the following steps when you face your threat in reality. ⦿

Choose a specific situation in which the threat is likely to occur and about which you would ordinarily feel anxious.

⦿

Make a plan of how you are going to deal with the threat and resolve not to use any of your behavioural, safety-​seeking measures.

⦿

Rehearse a specific version of your general flexible/​non-​extreme attitudes before entering the situation so that you can face your threat while in a healthy1 frame of mind. In addition, it would be useful to develop a shorthand version of your specific flexible/​non-​extreme attitude to use while you are in the situation.

⦿

Enter the situation and accept the fact that you are likely to be uncomfortable while doing so. Do not take any safety-​seeking measures and take action as previously planned. React to any consequences from a healthy frame of mind if you can.

⦿

Recognise that, even though you have got yourself into a healthy frame of mind, some of your thinking may be distorted and unrealistic and some may be realistic and balanced. Accept the presence of the former and do not engage with it. Engage with the latter without using it to reassure yourself.

You may find that your client reports various obstacles to facing threat in reality. I list here some of the major obstacles and suggest ways of addressing these obstacles with your client. ⦿

‘It’s too frightening to face the threat.’ If your client thinks that facing a threat-​related situation is too much for them, suggest that they utilise the ‘challenging, but not overwhelming’ principle discussed in the Client’s Guide (see p. 53 in this book). This involves your client selecting a threat-​related situation that would be a challenge for them to face, but not overwhelming for them, at that time.

Dealing with anxiety    55

⦿

⦿

⦿

‘I don’t feel confident to face the threat.’ One of the thinking features of anxiety is that your client holds the inference that they think that they cannot deal with threat. In order to encourage your client to examine this limiting idea, help them to acknowledge and implement the following: ⦿

Help them to see that they do not need to feel confident to face a threat in order to face it.

⦿

Help them to realise that confidence develops from not being confident and that the more they act without confidence, the more they will develop confidence.

‘I don’t feel comfortable facing the threat.’ Help your client to see that, if they wait until they are comfortable before facing the threat, they will wait a very long time. Show them that, if they are comfortable about facing a ‘threat’, it is likely that they are not anxious about it. Consequently, it is important that you help your client realise that they are bound to be uncomfortable about facing a ‘threat-​related situation’. Show them that they can bear this discomfort, that it is worth it to them to do so and that they are worth bearing the discomfort for. Encourage them to be willing to bear the discomfort, to commit themself to do so and to act on this commitment. ‘I can’t face the threat because I don’t feel in control.’ By definition, when your client feels anxious, they are not in control. So, help them to understand that, if they wait to feel in control before they face their threat, then they are caught in a bind. Help them to see that the way out of this bind is for them to hold a flexible attitude towards feeling in control. If they held that it is preferable, but not essential, to feel in control before they face the threat, they would take the unpreferable course of action because it is the only course of action open to them. Encourage them to see that, if they insist that they have to be in control before facing the threat, they will not face it.

56    Dealing with anxiety

⦿

‘I can’t face the threat because I don’t know what is going to happen.’ This obstacle to facing threat is based on a rigid attitude towards uncertainty. Here, your client believes that they have to know the outcome of facing threat before they face it. Help your client to see that this, of course, is not possible and that, if they wait for such certainty, it is highly likely that they will perpetuate their anxiety problem. Show your client that the antidote to this is to hold a flexible attitude towards uncertainty. If they do this, they will acknowledge that, while it would be nice to know the outcome of facing threat, it is not necessary to have such certainty. Help them to realise that all they have is probability and that, if they face threat, the probable outcome is that they will feel uncomfortable in the short term, but they will probably help themself to overcome their anxiety problem in the longer term. By contrast, help your client to see that, if they don’t face threat, they will remain comfortable in the moment, but the probability is that they won’t overcome their problem.

Step 9: Capitalise on what you have learned When you have faced your threat and dealt with it as best you can, it is important that you reflect on what you did and what you learned. In particular, if you were able to face your threat, rehearse your specific flexible/​ non-​extreme attitudes and take constructive action, then ask yourself how you can capitalise on what you achieved. If you experienced any problems, respond to the following questions: ⦿

Did I face the threat and, if not, why not?

⦿

Did I rehearse my flexible/​ non-​ extreme attitudes before and during facing the threat and, if not, why not?

⦿

Did I execute my plan to face the threat and, if not, why not?

⦿

Did I engage with post-​rigid/​extreme attitude distorted thinking and, if so, why?

⦿

Did I use safety-​seeking measures and, if so, why?

Dealing with anxiety    57

Reflect on your experience and put into practice what you have learned the next time you face the threat. It is useful to monitor your client’s responses to these questions and help them to reflect on any issues that they have not considered.

Step 10: Generalise your learning While you can only face and deal with a threat in specific situations, you can generalise what you have learned about dealing effectively with anxiety across situations defined by a threat to which you are particularly vulnerable (e.g., disapproval) and also apply your learning to situations defined by a different threat that you may have problems with (e.g., criticism). Fiona was particularly prone to anxiety about being disapproved of, so she followed the steps outlined in this chapter. Thus: ⦿

Fiona assessed the three components of her anxiety response and set goals with respect to all three components.

⦿

She identified her relevant general rigid/​extreme attitude towards disapproval (i.e., ‘I must not be disapproved of. If I am, I am worthless’) that underpinned her anxiety response and her alternative general flexible/​non-​ extreme attitude (i.e., ‘I don’t want to receive disapproval, but that does not mean I must not be disapproved of. If I am, it’s unfortunate, but it does not prove I’m worthless. I am a unique, unrateable fallible human being whether I am approved or disapproved of’) that underpinned her concern response.

⦿

She examined both elements of her general rigid/​extreme attitude and her flexible/​non-​extreme attitude until she clearly saw that the former were false, made no sense and were detrimental to her, and that the latter were true, sensible and healthy.

⦿

She outlined situations where she particularly feared disapproval and prepared to face them by examining specific versions of these attitudes. She first rehearsed relevant specific versions of her general flexible/​non-​extreme attitude towards disapproval and faced her threat in these specific situations while keeping in mind a shortened version of her flexible/​non-​extreme attitude (i.e., ‘I’m fallible, although disapproved of’) and without using her behavioural and thinking safety-​seeking measures regarding disapproval. As she did so, she tolerated the discomfort that she felt and accepted that some

58    Dealing with anxiety

of her ‘threat-​elaborated’ thinking would still be in her mind. She let such thinking be without engaging with it, suppressing it or distracting herself from it. ⦿

When she had made progress in dealing with her disapproval anxiety, Fiona applied the common features to her fear of failure. She also identified new behavioural and thinking components of her anxiety response with respect to failure and set goals accordingly.

⦿

She identified her relevant general rigid/​extreme attitude towards regarding failure (i.e., ‘I must not fail and, if I do, I am a failure’) that underpinned her anxiety response and her alternative general flexible/​non-​extreme attitude (i.e., ‘I don’t want to fail, but I don’t always have to succeed. It’s bad if I fail, but that does not mean I am a failure. I am a unique, unrateable fallible human being whether I succeed or fail’) that underpinned her concern response.

⦿

She again examined both elements of her general rigid/​extreme attitude and her general flexible/​non-​extreme attitude until she clearly saw that the former was false, made no sense and was detrimental to her and that the latter was true, sensible and healthy.

⦿

She then outlined situations that she had avoided because she particularly feared failure and prepared to face them by examining specific versions of these attitudes. She first rehearsed relevant specific versions of her general flexible/​non-​extreme attitude towards failure and faced her threat in these specific situations while keeping in mind a shortened version of this attitude (i.e., ‘I don’t have to succeed’) and without using her behavioural and thinking safety-​seeking measures regarding failure.

⦿

As she did so she tolerated the discomfort that she felt and accepted that some of her ‘threat-​elaborated’ thinking would still be in her mind. She again let such thinking be without engaging with it, suppressing it or distracting herself from it.

As this section shows, you can generalise what you learn about dealing with anxiety from situation to situation as defined by a specific threat and from there to situations defined by a different threat with which you have a problem. If you do this with all the threats to which you are vulnerable, you will take the toxicity out of the emotional problem of anxiety!

Dealing with anxiety    59

USING REBT’S ABCD FORM TO DEAL WITH SPECIFIC EXAMPLES OF YOUR ANXIETY This chapter is mainly geared to help you deal with your anxiety in general terms. However, you can also use this material to address specific examples of your anxiety. I have developed a self-​help form to provide the structure to assist you in this regard. It is called the ABCD form and it appears with instructions in Appendix 6. In Appendix 6, I outline the major problems clients have in using this form and how to deal with them.

OTHER IMPORTANT ISSUES IN DEALING WITH ANXIETY In the above section, I outlined a 10-​step programme to deal with anxiety. In this section, I discuss some other important issues that may be relevant to you in your work to become less prone to this emotional problem. If you want to, you can incorporate them as additional steps in the above step-​by-​step guide at points relevant to you.

Why you overestimate threat and how to deal with it If you are particularly prone to anxiety, you will be particularly sensitive to seeing threat where others, who are not prone to anxiety, do not. So far in this chapter, I have helped you deal with anxiety in situations where you perceive threat. In this section, I help you to understand and deal with situations where you overestimate threat in the first place.

Why you overestimate threat This is how you come to overestimate threat in your area of vulnerability. I will illustrate this with reference to one of Fiona’s general rigid/​extreme attitudes: ⦿

You take the theme of your general rigid/​extreme attitude: disapproval from the general rigid/​extreme attitude: ‘I must not be disapproved of. If I am, I am worthless.’

60    Dealing with anxiety

⦿

You construct a second general rigid/​ extreme attitude that features uncertainty about the original threat theme: ‘I must be certain that I won’t be disapproved of. I can’t bear such uncertainty.’

⦿

You bring this second general rigid/​extreme attitude to situations where it is possible that you may be disapproved of and you make a threat-​ related inference in the absence of certainty from the threat: ‘Since I don’t have certainty that I won’t be disapproved of, then I will be disapproved of.’

⦿

You focus on this inference and bring a specific version of your original general rigid/​extreme attitude to this inference. For example: Inference: ‘My classmates will disapprove of me.’ Specific rigid/​extreme attitude: ‘My classmates must not disapprove of me. If they do, I am worthless.’

How to deal with your overestimations of threat To deal with your overestimations of threat, you need to take a number of steps, which I will illustrate again with reference to Fiona. ⦿

Construct general flexible/​non-​extreme alternatives, both to your original threat-​focused general rigid/​extreme attitude: ‘I don’t want to receive disapproval, but that does not mean I must not be disapproved of. If I am, it’s unfortunate, but it does not prove I’m worthless. I am a unique, unrateable fallible human being whether I am approved or disapproved of.’

and to your second uncertainty-​focused general rigid/​extreme attitude: ‘I would like to be certain that I won’t be disapproved of, but I don’t need such certainty. It is difficult not having this uncertainty, but I can bear not having it and it is worth bearing.’ ⦿

Examine both sets of attitudes until you can see why the two general flexible/​non-​extreme attitudes are true, logical and healthy, and the two

Dealing with anxiety    61

general rigid/​extreme attitudes are false, illogical and unhealthy, and you can commit to implementing the former. ⦿

Bring your uncertainty-​focused general flexible/​non-​extreme attitude to situations where it is possible that you may be disapproved of and make an inference based on the data at hand: ‘I am not certain if I will be approved or disapproved of, so let’s consider the evidence.’

⦿

If there is evidence indicating there is a good chance that you will be disapproved of, use a specific version of your general disapproval-​focused flexible/​non-​extreme attitude to deal with this. For example: Inference: ‘My classmates will disapprove of me.’ Specific flexible/​non-​extreme attitude: ‘I don’t want my classmates to disapprove of me, but they don’t have to do what I want. If they do disapprove of me, that is uncomfortable, but I am not worthless. I am the same unique, unrateable, fallible person whether they approve or disapprove of me.’

If your client finds that the above explanation is too complex, teach them a simpler version. This involves you showing them that, when they demand that they must know that the threat they have in mind will not occur and they do not know this, they will assume that the threat will occur. However, when they do not demand such certainty, they are more objective about the presence of threat and can examine the accuracy of their inference of threat as shown below.

How to examine the accuracy of your inference of threat, if necessary If you are still unsure if your inference of threat is accurate or inaccurate, answer one or more of the following questions: ⦿

How likely is it that the threat happened (or might happen)?

⦿

Would an objective jury agree that the threat actually happened or might happen? If not, what would the jury’s verdict be?

⦿

Did I view (am I viewing) the threat realistically? If not, how could I have viewed (can I view) it more realistically?

62    Dealing with anxiety

⦿

If I asked someone whom I could trust to give me an objective opinion about the truth or falsity of my inference about the threat, what would the person say to me and why? How would this person encourage me to view the threat instead?

⦿

If a friend had told me that they had faced (were facing or were about to face) the same situation as I faced and had made the same inference of threat, what would I say to them about the validity of their inference and why? How would I encourage the person to view the threat instead?

Assessing and dealing with emotional problems about anxiety While there is quite a lot of evidence that animals get anxious in the presence of threat, there is little evidence that they make themselves disturbed about their anxiety. However, we humans do disturb ourselves about our anxiety and our other emotional problems. The technical term for this is meta-​disturbance (literally disturbance about disturbance) and I will be discussing this phenomenon and how to deal with it here and in the following chapters. It is important to assess carefully the nature of this meta-​disturbance before you can best deal with it. The best way to start dealing with the assessment of any emotional problems you might have about anxiety is to ask yourself the question: ‘How do I feel about being anxious?’ The most common emotional problems that people have about anxiety are as follows: anxiety, depression, unhealthy regret, shame and unhealthy self-​anger. I will discuss only the first of these in this chapter, i.e., anxiety about anxiety, and refer you to the respective chapters on depression, unhealthy regret, shame and unhealthy anger for help on how to deal with these meta-​emotional problems (i.e., emotional problems about emotional problems) as applied to anxiety.

Assessing anxiety about anxiety When you are anxious about anxiety, it is clear that you think of your original anxiety as some kind of threat. The most common of these threats are the following:

Dealing with anxiety    63

⦿

Anxiety is emotionally painful.

⦿

Anxiety is a personal weakness.

⦿

Anxiety means I am losing self-​control.

Dealing with anxiety about anxiety Unless you deal with your anxiety about anxiety (called meta-​anxiety), you are unlikely to deal with your original anxiety, since your meta-​anxiety will lead to general avoidance of situations in which you are likely to feel anxious. Since dealing with anxiety depends on you facing and not avoiding threat, meta-​anxiety (if you experience it) often has to be dealt with before you deal with your original anxiety. As I have made clear in this book, it is important that you develop flexible/​non-​extreme attitudes towards threat and face up to and deal constructively with it without making use of safety-​seeking measures (both behavioural and thinking) and while letting be (i.e., not engaging with or distracting yourself from) any remaining threat-​elaborating thoughts or images that you may have. With these points in mind, let me give you brief advice concerning how to deal with the three forms of anxiety about anxiety I have listed.

Dealing with the threat of the emotional pain of anxiety First, commit yourself to going forward with the set of flexible/​non-​extreme attitudes towards the pain of anxiety after examining both your rigid/​ extreme and flexible/​non-​extreme attitudes as outlined in Appendices 2−4. These are likely to be non-​ego in nature (e.g., ‘I would prefer not to experience the emotional pain of anxiety, but I don’t have to be immune to it. It’s hard bearing such pain, but I can do so and it’s worth doing so because it will help me deal with my original anxiety’). Then, develop a shorthand version of this flexible/​non-​extreme attitude (e.g., ‘The pain of anxiety is bearable and worth bearing’) and use this as you seek out situations in which you are likely to feel anxious, employing the ‘challenging, but not overwhelming’ principle described earlier (see p. 53). Do this without using safety-​seeking measures until you are concerned about the pain of anxiety, but not anxious about it. When you have done all this, you will probably see that anxiety may not be as emotionally painful as you previously thought.

64    Dealing with anxiety

Dealing with the threat of losing self-​c ontrol when you are anxious When you are anxious, you do begin to lose control of your feelings, sensations and thoughts. It is important for you to assess which aspect of loss of self-​control you are anxious about. Then do the following. First, commit yourself to going forward with the set of flexible/​non-​extreme attitudes towards beginning to lose self-​control (after examining both your rigid/​extreme and flexible/​non-​extreme attitudes as outlined in Appendices 2−4). These are likely to be non-​ego in nature (e.g., ‘I would prefer not to lose control, but I don’t always have to have such self-​control and I don’t have to regain it immediately when I have begun to lose it. It’s unfortunate when I begin to lose self-​control, but it isn’t terrible’). Then, develop a shorthand version of this flexible/​non-​extreme attitude (e.g., ‘I don’t have to be in control’) and use this as you seek out situations in which you are likely to feel anxious and begin to lose self-​control. Again, employ the ‘challenging, but not overwhelming’ principle described earlier (see p. 53) and do so without using safety-​seeking measures until you are concerned about losing self-​control but not anxious about it. In particular, accept that you may have thoughts and images where you have lost complete control of yourself. These thoughts do not predict the future, but are the remnants of post-​rigid/​extreme-​attitude thinking and need to be understood and accepted as such. Therefore, don’t engage with them or distract yourself from them. When you have taken these steps, you will probably realise that you have more self-​control when you are anxious than you previously thought and that loss of complete self-​control, while not impossible, is highly unlikely.

Dealing with the threat of anxiety being a personal weakness The first step to dealing with this anxiety is to assume temporarily that anxiety is a personal weakness. First, commit yourself to going forward with the set of flexible/​ non-​ extreme attitudes towards having such a personal weakness (after examining both your rigid/​ extreme and flexible/​non-​extreme attitudes as outlined in Appendices 2 and 5). These are likely to be ego in nature (e.g., ‘I would prefer not to have this personal weakness, but that does not mean that I must not have it. I am not a weak person for having this unfortunate weakness. Rather, I am a fallible human being who has both strengths and weaknesses’). Then, develop a shorthand version of this flexible/​non-​extreme attitude (e.g., ‘Anxiety means I’m fallible’) and use this as you seek out situations in which you are likely

Dealing with anxiety    65

to feel anxious, employing the ‘challenging, but not overwhelming’ principle described earlier (see p. 53). Do this, once again, without using safety-​ seeking measures until you are concerned about your ‘personal weakness’ but not anxious about it. When you have done all this, you will probably see that anxiety may not be as much a personal weakness as you previously thought. To help consolidate this, ask yourself if you would tell a loved one that anxiety is a personal weakness. Your client may need to address their anxiety about anxiety (i.e., their secondary anxiety) before they address their primary anxiety. They may well need to do this particularly when their secondary anxiety gets in the way of them dealing with their primary anxiety. However, despite the interfering presence of secondary anxiety, your client may still want to target their primary anxiety first. There are two ways of dealing with this situation: ⦿

Provide a rationale to help your client target their secondary anxiety first. For example, explain to your client that their secondary anxiety is like having a ball and chain around their leg while they are climbing a steep hill (akin to their primary anxiety). In the same way as climbing the hill is easier when they remove the ball and chain from their leg, dealing with their primary anxiety is easier when they deal with their secondary anxiety first.

⦿

Go along with your client’s wish to deal with their primary anxiety and, if they fail to do so, help them to understand that the reason why they failed is because they had not addressed their secondary anxiety and then agree that they will now do so.

Developing and rehearsing non-​a nxious, concern-​b ased world views People develop views of the world as it relates to them that make it more or less likely that they will experience unhealthy negative emotions (UNEs). The world views that render you vulnerable to anxiety do so in a similar way to your uncertainty-​focused general rigid/​extreme attitudes towards a specific threat theme by making you oversensitive to the presence of threat about which you hold anxiety-​related rigid/​extreme attitudes. However, these anxiety-​based world views have this effect on you much more widely.

66    Dealing with anxiety

Table 2.2  World views that render you vulnerable to anxiety and help you to deal with anxiety Views of the world that render you vulnerable to anxiety

Views of the world that help you deal with anxiety

⦿

The world is a dangerous place

⦿

The world is a place where danger exists, but where there is much safety

⦿

Uncertainty is dangerous. Knowing in all probability that I am safe is not good enough

⦿

Uncertainty can indicate the presence of threat, but more often than not it is associated with the absence of threat, a sign that I am safe from threat. Probability of safety is all I have and is good enough for me

⦿

Not being in control is dangerous. Either I am in control or I am out of control

⦿

Not being in control is unpleasant, but is rarely dangerous. Just because I am not in complete control certainly does not mean that I am out of control

⦿

People cannot be trusted

⦿

People vary enormously along a continuum of trustworthiness. My best stance is to trust someone unless I have evidence to the contrary. If I am let down that is very unfortunate, but hardly terrible and won’t unduly affect my stance towards the next person I meet

It is important that you develop realistic views of the world that will help you to deal with anxiety and experience healthy concern instead. In Table 2.2, you will find an illustrative list of such world views rather than an exhaustive one, so you can get an idea of what I mean. This will enable you to develop your own. In Table 2.2, I first describe a world view that renders you vulnerable to anxiety and then I give its healthy alternative. You will see that the latter views are characterised by complexity and being non-​extreme in nature, whereas, in the former, aspects of the world that relate to threat are portrayed as unidimensional and extreme. If you hold flexible/​non-​extreme attitudes that are consistent with the views of the world listed on the right-​hand side of Table 2.2, and if you

Dealing with anxiety    67

act and think in ways that are, in turn, consistent with these flexible/​non-​ extreme attitudes, you will become less prone to anxiety. In Chapter 3, I discuss the equally common emotional problem of depression and how to deal with it.

NOTE 1 By ‘healthy’ here I mean flexible/​non-​extreme.

C H A P T E R

3 Dealing with depression

In this chapter, I begin by presenting REBT’s way of understanding depression,1 and then address how to deal with this very common emotional problem.

UNDERSTANDING DEPRESSION In understanding depression, we need to know what we tend to make ourselves depressed about (i.e., its major inference themes), what attitudes we hold, how we act or tend to act, and how we think when we are depressed. I mentioned in Chapter 2 that it is important that you use your client’s language when referring to emotional problems. With respect to the term ‘depression’, you need to be aware that not all clients with a ‘depression’ problem resonate with the term ‘depression’. They may identify more closely with terms like ‘feeling down’, ‘feeling blue’, ‘feeling down in the dumps’ or ‘feeling low’. If so, your task is to satisfy yourself and your client that these terms represent the UNE known in REBT as depression. Once you have done so, use the client’s language and write this down in your client’s notes.

The three realms of your personal domain that are implicated in depression The three realms of your personal domain that are implicated in your depression are the autonomous, sociotropic and deservingness realms.

The autonomous realm Here you value such things as freedom from influence, freedom from constraint, freedom to determine your fate, your independence, self-​control and effective functioning. DOI: 10.4324/9781003424338-4

Dealing with depression    69

The sociotropic realm Here you value such things as your relationships with people, your connection to them, being loved, being approved, being cared for by them, being able to rely on them and also being able to look after them.

The deservingness realm Here you value yourself and others being treated fairly by the world.

Major inference themes in depression When you are depressed: ⦿

You have experienced a loss from the sociotropic and/​or autonomous realms of your personal domain.

⦿

You have experienced a failure within the sociotropic and/​or autonomous realms of your personal domain.

⦿

You or others have experienced an undeserved plight.2

Your client may not resonate with the above schema and, in this case, you should encourage them to put it aside and just focus on what they tend to feel depressed about. REBT theory values flexibility and this includes the freedom not to use REBT terms, schemas and frameworks.

Rigid/​e xtreme attitudes As I explained in Chapter 1, according to REBT, inferences on their own do not account for emotional problems. It is possible, therefore, for you to make the same inferences as listed above and be sad but not depressed. For you to feel depressed when you infer the presence of loss, failure or undeserved plight, you have to hold a rigid and one or more extreme attitudes. While the rigid attitude is at the core of depression, the extreme attitudes that are derived from the rigid attitude often distinguish between whether you are experiencing ego depression (where you devalue yourself) or non-​ego depression (where you ‘awfulise’ or find the adversity

70    Dealing with depression

unbearable). You may, of course, experience both ego depression and non-​ ego depression in a given situation. If your client is unsure about the mediating role that rigid/​ extreme attitudes play in their depression, ask them how they would feel if they had a strong conviction in the flexible/​non-​ extreme attitude alternatives to what REBT holds are their depression-​ creating rigid/​ extreme attitudes. In using this strategy, it is important that you formulate the flexible/​ non-​ extreme attitudes for your client, who cannot be expected to do this for themself at this stage. When you do this, ensure that you match your client’s rigid attitude with a flexible alternative and their main extreme attitude with a non-​extreme alternative, and then ask them how they would feel if they had strong conviction in this flexible/​non-​extreme attitude. For example: ‘Let me outline two sets of attitudes towards losing your job and you tell me which leads to depression and which leads to non-​depressed sadness. The first set of attitudes is as follows: “I absolutely should not have lost my job and I am redundant as a human being because I did.” The second set of attitudes is as follows: “I would have much preferred not to have lost my job, but sadly there was no reason why I absolutely should not have lost it. Losing it does not make me redundant as a human being, rather a useful human being who has lost something important.” Now which set of attitudes would lead to depression and which set would lead to non-​depressed sadness?’ Once your client can see that their rigid/​ extreme attitudes underpin depression and their flexible/​ non-​ extreme attitudes underpin non-​ depressed sadness, they have understood the mediating role of attitudes. This is quite an elegant strategy since it accomplishes a number of things at once: 1.  It addresses your client’s doubts about the mediating role of rigid/​ extreme attitudes in depression if they have such concern. 2.  It introduces flexible/​non-​extreme attitudes as a meaningful alternative to these rigid/​extreme attitudes. 3.  It helps your client to see that holding flexible/​ non-​ extreme attitudes can have beneficial effects.

Dealing with depression    71

Behaviour associated with depression When you hold a rigid/​ extreme attitude towards a loss, failure or undeserved plight within the relevant realm of your personal domain, you will feel depressed and then act or tend to act in a number of ways, the most common of which are as follows: ⦿

You withdraw from reinforcements.

⦿

You withdraw into yourself (particularly in autonomous depression).

⦿

You become overly dependent on and seek to cling to others (particularly in sociotropic depression).

⦿

You bemoan your fate or that of others to anyone who will listen (particularly in plight-​based depression –​also called pity-​based depression, see below).

⦿

You create an environment consistent with your depressed feelings.

⦿

You attempt to terminate feelings of depression in self-​destructive ways.

You will see from the above list that these behaviours get in the way of you processing your loss, failure or undeserved plight so that you can grieve appropriately, integrate it into your attitude system and move on with pursuing your life’s goals. If you ask your client whether they want to change their depression-​related behaviour, their response will be affected by their mood. If they are currently depressed, they are less likely to see that this behaviour is dysfunctional than when they are not depressed. If they are depressed, it is useful to encourage them to imagine that they are advising a friend who displays the same depression-​ related behaviour as they do. What would they say to this friend about the functionality or dysfunctionality of such behaviour? They are more likely to see that their own depression-​ related behaviour is dysfunctional after they have told this ‘friend’ that the same behaviour is dysfunctional.

Thinking associated with depression When you hold a rigid/​ extreme attitude towards a loss, failure or undeserved plight, you will feel depressed and then think in a number of

72    Dealing with depression

ways. Remember what I said in Chapter 1: the thinking that accompanies your depression is the result of your loss, failure or undeserved plight being processed by your rigid/​extreme attitude, and therefore it is likely to contain a number of thinking errors that I present in Appendix 1. I list the main features of this post-​rigid/​extreme-​attitude thinking below: ⦿

You see only negative aspects of the loss, failure or undeserved plight.

⦿

You think of other losses, failures and undeserved plights that you (and, in the case of the latter, others) have experienced.

⦿

You think you are unable to help yourself (helplessness).

⦿

You see only pain and blackness in the future (hopelessness).

⦿

You see yourself being totally dependent on others (in autonomous depression).

⦿

You see yourself as being disconnected from others (in sociotropic depression).

⦿

You see the world as full of undeservedness and unfairness (in plight-​ based depression).

⦿

You tend to ruminate concerning the source of your depression and its consequences.

As you can see, such thinking exaggerates the negativity of loss, failure and undeserved plight and the consequences of each. As with post-​rigid/​ extreme-​attitude anxiety thinking, post-​rigid/​extreme-​attitude thinking may be in words or in mental images. One of the main features of post-​rigid/​extreme-​attitude thinking is that it is compelling. As such, it is quite easy for your client to get caught up in this way of thinking and think that it reflects reality. This is an example of ‘cognitive-​emotive’ reasoning: if a thought is plausible and emotionally compelling, therefore it must be true. It is important that you help your client to understand how their mind works with respect to the thinking consequences of rigid/​ extreme attitudes and to encourage them to use such thoughts to go back to address the rigid/​extreme attitudes that spawn them. When they have done this, you can encourage them to respond to these thinking consequences of rigid/​extreme attitudes as these attitudes will not disappear just because they have examined them. When your client responds to these thinking consequences of rigid/​extreme attitudes, they need to do so only a few times on

Dealing with depression    73

any one occasion. After that, they need to accept the presence of such thinking without engaging with it. To summarise, your client needs to: ⦿

Identify the presence of the thinking consequences of rigid/​ extreme attitudes (see Appendix 1).

⦿

Trace these back to the source of this mode of thinking (i.e., identify the underlying rigid/​extreme attitudes).

⦿

Examine these rigid/​extreme attitudes.

⦿

Respond briefly to the thinking consequences of such attitudes, but not get overly involved in this process.

⦿

Accept the lingering presence of these thinking consequences without engaging with them.

⦿

Get on with the business of living.

HOW TO DEAL WITH DEPRESSION If you are prone to depression, you tend to experience this emotional problem in a variety of different settings and in response to a variety of losses, failures and undeserved plights. Here is how to deal with depression so that you become less prone to it.

Step 1: Identify reasons why depression is a problem for you and why you want to change While depression is generally regarded as an emotional problem, it is useful for you to spell out reasons why depression is a problem for you and why you want to change. I suggest that you keep a written list of these reasons and refer to it as needed as a reminder of why you are engaged in a self-​ help programme. I discuss the healthy alternative to depression in Step 5. If your client is still undecided whether or not depression is a problem for them and/​or whether or not they want to change, you will need to carry out a more thorough assessment of the possible factors involved. This involves helping your client to detail what are, from their perspective, the advantages and disadvantages

74    Dealing with depression

(both short term and longer term) of depression and its healthy alternative, sadness. When you have done this, you need to help your client understand and respond to the misconceptions that they have about the advantages of depression and the disadvantages of sadness.

Step 2: Become active Before you focus on the psychological work that you will need to do to deal effectively with your depression, you need to become active. As I pointed out earlier in this chapter, when you are depressed you tend to become inactive quite quickly and, if you allow this to continue, such inactivity leads to more negative thinking, which, in turn, leads to decreased activity. Therefore, the sooner you can go against your tendency to be inactive the better. If your inactivity has not become ingrained, increased activity will help you in two ways. First, such activity can be an antidepressant, particularly if it involves taking exercise. Indeed, running has been shown to be an effective way to deal with mild depression. Second, increased activity enables you to concentrate better on the psychological work that the remaining steps that I will discuss call for. However, what can you do if you have become very inactive and just don’t think that you can become more active or, if you did, that it wouldn’t make any difference? You need to see such resistance to becoming active as depressed thinking, which stems from the rigid/​extreme attitudes that led to your depression in the first place. Rather than respond to it, it is important that you test these thoughts out behaviourally. Thus, if you think that you can’t become active, test it out by seeing if you can walk to the end of the road. If you can do that, then take another step and proceed, bit by bit, until you have become more active. At that point, you can judge whether or not becoming more active has had any impact on your mood. A pound to a penny it has. When you have improved your mood to the point that you can concentrate, then you are ready to take responsibility for your depression in Step 3.

Step 3: Take responsibility for your depression In REBT, we argue that people or things do not make you depressed; rather you create these feelings by the rigid/​ extreme attitudes that you hold towards such people and things. You may object that this involves you

Dealing with depression    75

blaming yourself for creating your depressed feelings, but this objection is based on a misconception. It assumes that taking responsibility for creating your depression is synonymous with self-​blame. In truth, responsibility means that you take ownership for the rigid/​extreme attitudes that underpin your depression while accepting yourself unconditionally for doing so. Blame, on the other hand, means that you regard yourself as being bad or worthless for creating your depression. The idea that emotional problems (including depression) are based largely on the attitudes that a person holds towards what happens to them is, as you know, a central plank in REBT. However, for many clients, it will be a new idea. Thus, your client may hold that the reason they are depressed, for example, is that it is inherently depressing to be made redundant or to be dumped by one’s partner of longstanding. This type of thinking is known in REBT circles as ‘A–​C’ thinking (where events are deemed to cause feelings). By contrast, the REBT model stresses the ‘ABC’ model, where the impact of events on a person is mediated by the attitudes that they hold towards these events. The ‘ABC’ model holds that the person needs to take responsibility for creating their feelings of depression by realising they do so by holding a set of rigid/​extreme attitudes towards loss, failure or undeserved plight. If your client has difficulty accepting responsibility for their depressed feelings, it is important for you to identify the source of this difficulty. In the Client’s Guide, I mention one common obstacle that stops clients from accepting such responsibility (i.e., the self-​blame that clients engage in if they accept responsibility for making themselves depressed). However, there are other obstacles to accepting responsibility, such as the following: ⦿

Hopelessness about self-​help (e.g., ‘I can’t do anything to help myself’). This is particularly the case if the person is depressed.

⦿

Self-​pity (e.g., ‘It’s not me that makes me depressed, it’s the lousy situation that I am in and that I don’t deserve to be in’). If the client’s original depression is self-​pity based, the person can be said to have ‘meta’ self-​pity.

⦿

Loss of benefits (e.g., ‘If I accept that I make myself depressed then I will lose out on the benefits that blaming my environment gives me − such as getting sympathy from other people’).

It is important to help your client to understand the impact of these obstacles on their emotional problems. Then, help them to develop alternatives to these obstacles and review the impact of

76    Dealing with depression

these alternatives on their emotional problem-​solving. This often helps the client to deal effectively with these obstacles. If not, you may need to do a more detailed assessment of the obstacle, which is outside the brief of this book.

Step 4: Identify the themes you tend to be depressed about The best way of identifying depression-​related inference themes to which you are particularly vulnerable is by understanding the themes associated with sociotropic depression, autonomous depression and plight-​ based or pity-​based depression, and seeing which are present when you feel depressed.

Common themes in sociotropic depression Themes in sociotropic depression include the following: ⦿

disapproval

⦿

criticism

⦿

negative evaluation from others

⦿

being on one’s own

⦿

not being looked after or cared for

⦿

rejection

⦿

loss of love

⦿

losing connection with significant others

⦿

loss of reputation or social standing

⦿

not having anyone to look after or care for.

Common themes in autonomous depression Themes in autonomous depression include the following: ⦿

failure

Dealing with depression    77

⦿

goals blocked

⦿

loss of autonomy

⦿

being dependent on others

⦿

loss of self-​control

⦿

loss of status

⦿

inability to do prized activities (e.g., because of sudden disability)

⦿

loss of choice

⦿

freedom curtailed.

The theme in pity-​based depression An undeserved plight has (or you think that it has) happened to you or to others. Here are some examples: ⦿

You may have been made redundant by a company after working very hard for it for many years.

⦿

A major catastrophe happens to people already struggling with their lives.

If your client finds it difficult to find their depression-​ related theme, you can help them by assessing a few specific examples of their depression. Have them focus on a specific situation in which they were depressed and ask them what they were most depressed about. If they still find it difficult to identify the theme in this or other specific situations, use the ‘magic question’ technique. This involves you doing the following: ⦿

Have your client focus on the situation in which they were depressed.

⦿

Ask them to nominate one ingredient that would eliminate or significantly reduce their depression without changing the situation.

⦿

The opposite of this nominated ingredient is what they are most depressed about.

78    Dealing with depression

Jack was struggling to identify the specific theme in his depression about being made redundant. I helped Jack to use the ‘magic question’ technique as follows: ⦿

I asked Jack to focus on the situation in which he was depressed: ‘I am sitting alone in a coffee bar where there are groups of laughing friends.’

⦿

I asked Jack to nominate one ingredient that would eliminate or significantly reduce his depression without changing the situation: ‘Knowing that I had a group of friends with whom I could laugh.’

⦿

The opposite of this nominated ingredient is what he is most depressed about: ‘Not having a group of friends with whom I could laugh.’

If you assess several specific examples of your client’s depression this way, the depression-​ related theme should be apparent. In Jack’s case, it was being aware that he did not belong to a group of good friends. It may be that there are two depression-​related themes present in your client’s depression. For example, your client may feel depressed about sociotropic-​related loss and the presence of an undeserved plight. If this is the case, deal with them one at a time and have your client nominate the theme that they want to focus on first.

Step 5: Identify the three components of your depression response and set goals with respect to each component The next step is for you to list the three elements of your depression response in the face of each of the threats listed above.

Identify the three components of your depression response I use the term ‘depression response’ to describe the three main components that make up this response. The three components of your depression response are the emotional, behavioural and thinking components.

Dealing with depression    79

Emotional component The emotional component here is, of course, depression.

Behavioural component The behavioural component concerns overt behaviour or action tendencies. These will largely reflect your withdrawal from key aspects of life. Consult the list I provided to help you identify your behaviour associated with each theme when you are depressed (see p. 71).

Thinking component The thinking component associated with depression concerns magnification of the negative features of the situation you are in and its future implications. These may be in words or in mental pictures. Consult the list that I provided to help you identify your thinking associated with each theme when you are depressed (see p. 72).

Set goals with respect to each of the three components You need to set goals so that you know what you are striving for when you deal effectively with depression. The three goals are emotional, behavioural and thinking goals.

Emotional goal Your emotional goal is sadness rather than depression (or whatever synonym you prefer to the term ‘sadness’). Sadness is an HNE, which is an appropriate response to loss, failure or undeserved plight, but one that helps you to process what has happened to you (or others in the case of undeserved plight) and move on with your life rather than get stuck or bogged down. The concept that sadness is the healthy alternative to depression in the face of loss, failure or undeserved plight is based on the following idea. These adversities are negative and therefore it is realistic to have a negative emotion about them. The choice, therefore, is between a UNE (depression) or an HNE (sadness). But, what if your clients specify unrealistic goals? Here are a number of such goals and how to respond to clients who nominate them:

80    Dealing with depression

⦿

‘I don’t want to feel depressed.’

⦿

‘I want to feel less depressed.’

⦿

‘I want to be strong.’

⦿

‘I want to feel indifferent.’

Show your client that they have indicated what they do not want to feel in the face of loss, failure or undeserved plight, but not what they do want to feel. Help them to specify an emotion to aim for, like sadness!

Show your client that, as depression is a disturbed emotion, wanting to feel less depressed is still to nominate a disturbed emotion, albeit of lesser intensity. Show them that sadness can be strong and healthy.

If your client says that they want to be strong in the face of loss, failure or undeserved plight, discover what they mean by being strong. Do they mean feeling sad, processing the adversity and moving on or do they mean getting on with life without feel sad, for example? If, by being strong, they mean the former, this is a healthy emotional goal. However, if, by being strong, they mean the latter, you need to help them to see that this kind of strength is not a healthy emotional goal. Show them that it does not help them to process the adversity, integrate it into their overall experiences and move on. Rather, it will soon lead your client to become stuck in their depressed feelings, since they will not have processed or integrated this experience.

Being indifferent in the face of depression-​related adversity will not help your client to be appropriately geared up to deal with it. Help them to see this. Also show them that the only way that they could achieve a state of indifference about loss, failure or undeserved plight is to believe that it does not matter to them whether or not they experienced these adversities. In other words, show your client that they would have to lie to themself.

Behavioural goal Your behavioural goal should reflect actions that are based on sadness about your inferential theme rather than depression. The following are the most common behaviours associated with sadness. You may wish

Dealing with depression    81

to compare these behaviours with those associated with depression that I presented on p. 71. ⦿

You seek out reinforcements after a period of mourning (particularly when your inferential theme is loss).

⦿

You create an environment inconsistent with depressed feelings.

⦿

You express your feelings about the loss, failure or undeserved plight, and talk in a non-​complaining way about your feelings to significant others.

It is important that your client understands that, as they strive to develop healthy behavioural responses to loss, failure and undeserved plight, they will still feel the urge to act in ways designed to help them withdraw from these adversities. Help them to understand the reason for this. Explain to them that, as they examine their attitudes and commit themself to strengthening their conviction in their flexible/​ non-​ extreme attitudes and to weakening their conviction in their rigid/​extreme attitudes, the latter will still be active and producing urges for them to act dysfunctionally. Encourage your client to accept these urges, to recognise that they do not have to act on them and to use them as cues to act in functional ways.

Thinking goal As well as setting behavioural goals related to the feeling of sadness in the face of loss, failure and undeserved plight, it is important that you set thinking goals associated with this emotion. The following are the most common forms of thinking associated with sadness rather than depression. Again, you may wish to compare these forms of thinking with those associated with depression that I presented on p. 72. ⦿

You are able to recognise both negative and positive aspects of the loss or failure.

⦿

You think you are able to help yourself.

⦿

You look to the future with hope.

As the above list shows, the dominant feature of thinking associated with sadness is that it is realistic and optimistic. Please remember that such thinking may be in words or in mental pictures.

82    Dealing with depression

The point I made above with respect to your client’s behavioural goals is also relevant with respect to their thinking goals. Your client will still have some conviction in their rigid/​extreme attitude until they have full conviction in their flexible/​non-​extreme attitude. Given this, your client’s rigid/​extreme attitude will have some impact on their subsequent thinking as they strive to achieve their goals. Thus, highly distorted thoughts will still come into your client’s mind. Help your client to understand why this is the case. When you come to help them deal with these forms of post-​ rigid/​extreme-​attitude thinking, do one or more of the following as indicated. Discuss this issue with your REBT supervisor, if necessary: ⦿

Encourage your client to acknowledge the existence of such thoughts without trying to suppress them, distract themself from them or engage with them.

⦿

If relevant, use the presence of this post-​rigid/​extreme-​attitude thinking to help your client to identify and deal with the rigid/​ extreme-​attitude.

⦿

Encourage your client to examine the empirical nature of these thinking ‘Cs’ once or twice and then return to the acceptance strategy detailed above.

Step 6: Identify your general rigid/​e xtreme attitudes and alternative general flexible/ ​n on-​e xtreme attitudes A general rigid/​extreme attitude leading to your depression response is an attitude that you hold across situations defined by a loss theme, a failure theme or an undeserved plight theme. Its flexible/​non-​extreme attitude alternative, which will also be general in nature, will account for your sadness response.

Identify your general rigid/​extreme attitudes When you identify a general rigid/​extreme attitude, you take a common theme (e.g., rejection, loss of autonomy or unfair suffering) and add to this

Dealing with depression    83

a general rigid attitude and the main extreme attitude that is derived from the rigid attitude. When you are particularly prone to self-​esteem based depression, then your main extreme attitude will be a self-​devaluation attitude. For non-​self-​esteem based depression, your main extreme attitude may be either an awfulising attitude or an unbearability attitude, and less frequently it may be an other-​devaluation attitude or a life-​devaluation attitude. For example: ⦿

‘I must not be rejected and, if I am, it would prove that I am unlovable’ (a general self-​esteem based rigid/​extreme attitude).

⦿

‘I must not be dependent on others and it would be awful if I were’ (a general non-​self-​esteem based rigid/​extreme attitude).

Identify your alternative general flexible/​non-​extreme attitudes When you identify your alternative general flexible/​non-​extreme attitude, you take the same common theme (e.g., rejection, loss of autonomy or unfair suffering) and add to this a general flexible attitude and the main non-​extreme attitude that is derived from the flexible attitude. If your general extreme attitude is self-​devaluation (when you are particularly prone to self-​esteem based depression), your general non-​extreme attitude will be an unconditional self-​acceptance attitude. If you are prone to non-​self-​ esteem based depression, your alternative general non-​extreme attitudes will be a non-​awfulising attitude, a bearability attitude and less frequently an unconditional other-​ acceptance attitude or an unconditional life-​ acceptance attitude. For example: ⦿

‘I would prefer not to be rejected, but I don’t have to be immune to rejection. If I am rejected, it would be painful, but it would not prove that I am unlovable. I am the same person whether I am rejected or accepted’ (a general flexible/​unconditional self-​acceptance based attitude).

⦿

‘I would much prefer not to be dependent on others, but that doesn’t mean that I must not be so. If I do have to be dependent on others, it would be very bad, but it would not be awful’ (a general flexible/​non-​ awfulising based attitude).

As you will have noticed in the Client’s Guide, I encourage readers/​ clients to identify and work with their general rigid/​ extreme

84    Dealing with depression

attitudes and to develop general flexible/​ non-​ extreme attitude alternatives and, as you will see, when they are facing specific instances of their problems, I encourage them to focus on specific examples of both sets of attitudes. This will be at variance with your REBT practice, where you will begin with specific examples of your client’s problems and then proceed to work at a more general level with their problems and how these relate to one another. The reason I have chosen to go ‘general’ rather than ‘specific’ when helping readers/​clients to deal with their emotional problems is a pragmatic one. In this book, I aim to help people to deal with a range of emotional problems and therefore, in my view, it is best to give readers/​clients general guidance with respect to dealing with this range of problems and then help them to move from the general to the specific rather than vice versa. My considered view was that I just do not have the space to help readers/​clients focus on specific examples of their emotional problems and then generalise from this specific level. Consequently, one way that you can help your client who is using the Client’s Guide is to help them to work with specific examples of their emotional problem, in this case depression. Use the following sequence as you do so and help your clients to: ⦿

select a specific example of their depression problem

⦿

identify what they were most depressed about in the situation

⦿

express why their depression constitutes a problem for them

⦿

identify the three specific components of their depression response and set specific goals with respect to each component

⦿

identify their specific rigid/​extreme attitudes and alternative specific flexible/​non-​extreme attitudes

⦿

examine both sets of specific attitudes.

⦿

face their loss, failure or undeserved plight in imagery (if necessary)

In helping your client to deal with a specific example of their depression, you can teach them how to use REBT’s ABCD form, which appears in Appendix 6 The following steps are the same as those that appear in Steps 8–​11 later in this chapter. Thus, help your client to:

Dealing with depression    85

⦿

face their loss, failure or undeserved plight in reality (if possible) and take appropriate action

⦿

capitalise on what they have learned

⦿

generalise their learning.

Step 7: Examine your general attitudes I recommended in Chapter 2 that you first examine together your general rigid attitude and your alternative general flexible attitude and then examine together your main general extreme attitude and your alternative main general non-​extreme attitude.

Examine your general rigid attitude and its general flexible attitude alternative First, take your general rigid attitude and its general flexible attitude alternative and write them down next to one another on a sheet of paper. Then ask yourself: ⦿

Which is true and which is false?

⦿

Which has largely constructive results and which has largely unconstructive results?

⦿

Which is sensible logically and which does not make sense?

Write down your answer to each of these questions on your piece of paper, giving reasons for each answer. Consult Appendix 2 for help with the answers to these questions, which you need to adapt and apply to the attitudes you are examining.

Examine your general extreme attitude and its general non-​extreme attitude alternative Next, take your main general extreme attitude and its general non-​extreme attitude alternative and again write them down next to one another on a sheet of paper. Then, ask yourself the same three questions that you used with your general rigid attitude and its general flexible attitude alternative. Again, write down your answer to each of these questions on your

86    Dealing with depression

piece of paper, giving reasons for each answer. I suggest that you consult Appendix 3 (for help with examining awfulising attitude and non-​ awfulising attitudes), Appendix 4 (for help with examining unbearability attitudes and bearability attitudes) and Appendix 5 (for help with examining devaluation attitudes and unconditional acceptance attitudes). Again, you need to adapt and apply these arguments to the attitudes you are examining. You should now be ready to commit to act and think in ways consistent with your general flexible/​non-​extreme attitude. I included Appendices 2−5 in the Client’s Guide as general guidelines to help readers/​ clients to examine both their rigid/​ extreme attitudes and their flexible/​ non-​ extreme attitudes (reproduced in this book as Appendices 2−5). If you are working with a client who is using the Client’s Guide, you will have a chance to look at the examining work that your client has done at this point and give them feedback on that work. No book can provide such feedback. I have suggested that readers/​clients examine their rigid attitude and their flexible attitude together and then their main extreme attitude and their alternative non-​ extreme attitude together using three criteria as shown below: ⦿

Rigid attitude vs. flexible attitude ⦿

empirical status

⦿

pragmatic status

⦿

empirical status

⦿

pragmatic status.

⦿

⦿

logical status

Main extreme attitude vs. main non-​extreme attitude

⦿

logical status

The final point I want to make about examining attitudes concerns the concept of persuasiveness. Perhaps the most important aspect of the examining process is for your client to develop arguments concerning the false, illogical and unhealthy nature of their rigid/​

Dealing with depression    87

extreme attitudes and the true, logical and healthy nature of their flexible/​non-​extreme attitudes that are persuasive to them. So, encourage your clients to develop such persuasive arguments and to make a note of these for future reference.

Step 8: Face your loss, failure and undeserved plight in imagery I hope that you have made a commitment to act on your general flexible/​ non-​extreme attitude. Assuming that you have, your basic task is for you to face up to your loss, failure or undeserved plight and to learn to think in a flexible/​non-​extreme way about it without withdrawing from life. Up to this point you have worked at a general level with respect to the losses, failures or undeserved plights you are depressed about, the general rigid/​extreme attitudes that account for this depression and their alternative general flexible/​non-​extreme attitudes. However, when you come to apply your general flexible/​non-​extreme attitudes in dealing with your loss, failure or undeserved plight, you need to bear in mind one important point. Since you make yourself depressed about specific losses, failures or undeserved plights (actual or imagined), you need to deal with these specific losses by rehearsing specific variants of your general flexible/​non-​ extreme attitudes. While the best way to do this is in specific situations in which you infer loss, failure or undeserved plight, you may derive benefit by using imagery first. If this is the case, you need to do the following: ⦿

Imagine a specific situation in which you felt depressed or may feel depressed and focus on your loss, failure or undeserved plight.

⦿

See yourself facing the loss, failure or undeserved plight while rehearsing a specific flexible/​non-​extreme attitude relevant to the situation. As you do this, try to make yourself feel sad, rather than depressed.

⦿

Then see yourself getting on with your life after an appropriate period of mourning. As you picture yourself getting on with your life, recognise that it is healthy to feel sad, even well after the event. The main thing is that your sadness does not stop you from reconnecting with life and pursuing your goals.

⦿

Recognise that some of your post-​ rigid/​ extreme-​ attitude thinking may be distorted. Respond to it without getting bogged down doing

88    Dealing with depression

so. Accept the presence of any remaining distorted thoughts without engaging with them. ⦿

Repeat the above steps until you feel sufficiently ready to put this sequence into practice in your life.

If you find that facing your loss, failure or undeserved plight, in your mind’s eye, is too much for you, use the ‘challenging, but not overwhelming’ principle that I introduced in Chapter 2 (see p. 53). This means that, instead of imagining yourself facing a loss, failure or undeserved plight that you find ‘overwhelming’ at the present time, choose a similar loss, failure or undeserved plight that you would find ‘challenging, but not overwhelming’. Then employ the same steps that I have outlined above. Work in this way with modified losses, failures or undeserved plights until you find your original one ‘challenging, but not overwhelming’ and then use the steps again. Some of your clients may say that they can’t get very clear images when they try to picture events in their mind’s eye. While they may get more out of imagery techniques if they can get such clear images, they will still get something out of facing loss, failure or undeserved plight in imagery even if their images aren’t clear. So, if a client wants to face their particular adversity in imagery before they do so in reality, encourage them to do so no matter how clear their mental images are.

Step 9: Face your loss, failure and undeserved plight in reality Whether or not you have used imagery as a preparatory step, you need to take the following steps when you face situations that remind you of your loss, failure, undeserved plight or threat in reality. ⦿

Choose a specific situation in which you will be reminded of your loss, failure or undeserved plight and about which you would ordinarily feel depressed.

⦿

Rehearse a specific version of your general flexible/​non-​extreme attitude before entering the situation so that you can face your loss, failure or underserved plight while in a flexible/​non-​extreme frame of mind. In addition, it would be useful to develop a shorthand version of your specific flexible/​non-​extreme attitude to use while you are in the situation.

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⦿

Enter the situation and accept the fact that you are likely to be uncomfortable while doing so. React to any consequences from a flexible/​non-​ extreme frame of mind if you can.

⦿

Recognise that, even though you have got yourself into a flexible/​non-​ extreme frame of mind, some of your thinking may be distorted and unrealistic and some may be realistic and balanced. Accept the presence of the former and do not engage with it. Engage with the latter without using it to reassure yourself.

You may find that your client reports various obstacles to facing loss, failure or undeserved plight in reality. I list here some of the major obstacles and suggest ways of addressing these obstacles with your client. ⦿

‘It’s too depressing to face the loss/​failure/​undeserved plight.’

⦿

‘I don’t have the capacity to face the loss/​ failure/​ undeserved plight.’

If your client thinks that facing a loss/​failure/​undeserved plight situation is too depressing for them, suggest that they utilise the ‘challenging, but not overwhelming’ principle discussed in the Client’s Guide (see p. 53). This involves your client selecting a loss/​ failure/​ undeserved plight situation that would be a challenge for them to face, but not overwhelming for them, at that time.

One of the thinking features of depression is that your client holds the inference that they are helpless in the face of adversity. In order to challenge this limiting idea, help them to acknowledge and implement the following: ⦿

Help them to understand that this inference stems from a rigid/​extreme attitude and does not reflect reality.

⦿

Help them to see that they do not need to feel capable to face loss/​failure/​undeserved plight in order to face it.

⦿

Help them to realise that such capability develops over time and that, the more they act without this ‘feeling’, the more they will develop actual capability.

90    Dealing with depression

⦿

⦿

‘There is no point in facing loss/​failure/​undeserved plight.’ Another major thinking feature of depression is a sense ofhopelessness in the face of adversity. In order to challenge this limiting idea, help your client to acknowledge and implement the following: ⦿

Help them to understand that this inference stems from a rigid/​extreme attitude and does not reflect reality.

⦿

Ask them how they would advise a loved one who said something similar. Help them to see that they can act on this advice (as long as it is constructive!).

⦿

Help them to see that they do not have to have hope before facing adversity and that hope may develop as a result of facing it.

‘I don’t feel comfortable facing the loss/failure/undeserved plight.’ Help your client to see that, if they wait until they are comfortable before facing loss/​failure/​underserved plight, they will wait a very long time. Show them that, if they are comfortable about facing a loss, failure or underserved plight, then it is likely that they are not depressed about it. Consequently, it is important that you help your client realise that they are bound to be uncomfortable about facing a depression-​related situation even after they have examined their depression-​creating rigid/​extreme attitude. Show them that they can tolerate this discomfort and that it is worth it to them to do so.

Step 10: Capitalise on what you have learned When you have faced the situation that reminded you of your loss, failure or undeserved plight and dealt with it as best you could, it is important that you reflect on what you did and what you learned. In particular, if you were able to face the situation, and rehearse your specific flexible/​non-​ extreme attitudes until you felt sad, then ask yourself how you can capitalise on what you achieved. If you experienced any problems, respond to the following questions: ⦿

Did I face the situation and, if not, why not?

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⦿

Did I rehearse my flexible/​ non-​ extreme attitudes before and during facing the situation and, if not, why not?

⦿

Did I execute my plan to face the situation and, if not, why not?

⦿

Did I engage with post-​rigid/​extreme attitude distorted thinking and, if so, why?

Reflect on your experience and put into practice what you have learned the next time you face a situation that reminds you of your loss, failure or undeserved plight. It is useful to monitor your client’s responses to these questions and help them to reflect on any issues that they have not considered.

Step 11: Generalise your learning Once you have dealt with your depression in a specific situation, you can generalise what you have learned about dealing effectively with depression across situations defined by a loss, failure or undeserved plight to which you are particularly vulnerable to (e.g., failure) and also apply your learning to situations defined by a different theme that you may have problems with (e.g., having to rely on others). James was particularly prone to depression about failure, so he followed the steps outlined in this chapter. Thus: ⦿

James assessed the three components of his depression response and set goals with respect to all three components.

⦿

He identified his relevant general rigid/​extreme attitude regarding failure (i.e., ‘I must not fail and, if I do, I’m a failure’) that underpinned his depression response and his alternative general flexible/​non-​extreme attitude (i.e., ‘I don’t want to fail, but I am not immune to doing so and nor do I have to have such immunity. If I do fail it is bad, but I am not a failure. I am a unique, unrateable, fallible human being capable of failing and succeeding’) that underpinned his sadness response.

⦿

He examined both elements of his general rigid/​extreme attitude and his general flexible/​non-​extreme attitude until he clearly saw that the former

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were false, made no sense and were detrimental to him, and that the latter were true, sensible and healthy. ⦿

He outlined situations that particularly reminded him of his failures and prepared to face them by examining specific versions of these attitudes. He first rehearsed relevant specific versions of his general flexible/​non-​extreme attitudes regarding failure and then faced specific situations that reminded him of failing while keeping in mind a shortened version of his flexible/​ non-​extreme attitude (i.e., ‘I don’t have to succeed’). As he did so, he tolerated the discomfort that he felt and accepted that some of his distorted and skewed negative thinking would still be in his mind. He let such thinking be without engaging with it, suppressing it or distracting himself from it.

⦿

When he had made progress in dealing with his failure-​related depression, he applied common features to his depression about being dependent on others. He also identified new behavioural and thinking components of his depression response with respect to being dependent on others and set goals accordingly.

⦿

He identified his relevant general rigid/​extreme attitude regarding being dependent on others (i.e., ‘I must not be dependent on others and, if I am, I am a pathetic individual’) that underpinned his depression response and his alternative general flexible/​non-​extreme attitude (i.e., ‘I don’t want to be dependent on others, but that does not mean that this must not happen. If it does, it is really unpleasant, but it does not prove that I am a pathetic individual. It means that I am a fallible, ordinary person and my temporary dependent state does not define me’) that underpinned his sadness response.

⦿

He again examined both elements of his general rigid/​extreme attitude and his general flexible/​non-​extreme attitude until he clearly saw that the former were false, made no sense and were detrimental to him, and that the latter were true, sensible and healthy.

⦿

He then outlined situations that he had avoided because he would be dependent on others and would depress himself about that and prepared to face them by examining specific versions of these attitudes. He first rehearsed relevant specific versions of his general flexible/​non-​extreme attitude regarding being dependent and faced specific situations in which he would be dependent on others while keeping in mind a shortened

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version of his flexible/​non-​extreme attitude (i.e., ‘Being dependent does not taint me’). ⦿

As he did so, he tolerated the discomfort that he felt and accepted that some of his distorted and skewed negative thinking would still be in his mind as he did so. He again let such thinking be without engaging with it, suppressing it or distracting himself from it.

As this section shows, you can generalise what you learn about dealing with depression from situation to situation as defined by a specific loss, failure or undeserved plight and from there to situations defined by a different theme related to depression with which you have a problem. If you do this with all losses, failures and undeserved plights to which you are particularly vulnerable, you will take the toxicity out of the emotional problem of depression!

USING REBT’S ABCD FORM TO DEAL WITH SPECIFIC EXAMPLES OF YOUR DEPRESSION This chapter is mainly geared to help you deal with your depression in general terms. However, you can also use this material to address specific examples of your depression. I have developed a self-​help form to provide the structure to assist you in this regard. It is called the ABCD form and it appears with instructions in Appendix 6. In Appendix 6, I outline the major problems that clients have in using this form and how to deal with them.

OTHER IMPORTANT ISSUES IN DEALING WITH DEPRESSION In the above section, I outlined an 11-​step programme to deal with depression. In this section, I discuss some other important issues that may be relevant to you in your work to become less prone to this emotional problem. If you want to, you can incorporate them as additional steps in the above step-​by-​step guide at points relevant to you.

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Why you focus so much on loss, failure and undeserved plight and how to deal with this If you are particularly prone to depression, you will be particularly sensitive to focusing on the losses, failures and undeserved plights of your life (and in the lives of others in the case of the latter). You may see losses without seeing gains, you may see failures in what others regard as successes and you may fail to see the good in your life and in the lives of others. So far in this chapter, I have helped you deal with depression in situations where you perceive loss, failure and undeserved plight. In this section, I help you to understand and deal with situations where you overly focus on loss, failure or undeserved plight in the first place.

Why you focus so much on loss, failure and undeserved plight The following explains why you focus so much on loss, failure and undeserved plight. I will illustrate this with reference to one of James’ general rigid/​extreme attitudes: ⦿

You take your general rigid/​extreme attitude:

⦿

You add the concept of uncertainty to this attitude so that you create a second general rigid/​extreme attitude that features this uncertainty:

‘I must do perfectly well and, if I do not, I’m a failure.’

‘I must be sure that I have done perfectly well and I can’t bear not knowing this.’ ⦿

You bring this second general rigid/​extreme attitude to situations where you have not done perfectly well and make an inference coloured by this second general rigid/​extreme attitude: ‘Since I don’t know that I have done perfectly well, I have failed.’

⦿

You focus on this inference and bring a specific version of your original general rigid/​extreme attitude to this inference. For example: Inference: ‘I got 90 per cent on that test. As I could have done better, I have failed.’ Specific rigid/​extreme attitude: ‘I absolutely should not have failed on the test. I am a failure for not doing better.’

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How to deal with your selective focus on loss, failure and undeserved plight In order to deal with your selective focus on loss, failure or undeserved plight, you need to take a number of steps, which I illustrate with reference to James. ⦿

Construct general flexible/​non-​extreme alternatives, both to your original loss-​based, failure-​based or undeserved plight-​based rigid/​extreme attitude: ‘I want to do perfectly well, but I don’t have to do so. If I don’t do perfectly well, it is bad, but I am not a failure. I am a unique, unrateable, fallible human being capable of failing and succeeding.’

and to your second general rigid/​extreme attitude towards uncertainty related to your performance: ‘I would like to be sure that I have done perfectly well, but I really don’t have to know this. If I don’t, it is hard to bear, but I can bear such uncertainty and it’s worth it for me to do so.’ ⦿

Examine both sets of attitudes until you can see the truth, logic and healthiness of the two general flexible/​non-​extreme attitudes and the falseness, illogicality and detrimental value of the two general rigid/​ extreme attitudes and you can commit to implementing the former.

⦿

Bring your two general flexible/​ non-​ extreme attitudes towards your performance and uncertainty related to your performance to situations where you failed to do perfectly well and consider what you did achieve as well as what you did not achieve: ‘Although I originally thought I failed, I can see that achieving 90 per cent is actually evidence that I have done very well.’

⦿

If you did actually fail, use a specific version of your general failure-​ based flexible/​non-​extreme attitude to deal with this. For example: Inference: ‘I actually failed the test.’ Specific flexible/​non-​extreme attitude: ‘I did not want to fail this test, but that does not mean that I absolutely should not have done so. Failing the test is bad, but I am not a failure. I am a unique, unrateable, fallible human being capable of failing and succeeding.’

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If your client finds that the above explanation is too complex, you can help them to see that rigid attitudes towards the presence or absence of depression-​related adversities means that, if it is not clear that the loss/​failure/​undeserved plight has not occurred, they will assume that it has occurred. When their attitudes are flexible, they can be more objective about the presence of these adversities.

How to examine the accuracy of your inference of loss, failure or undeserved plight, if necessary If you are still unsure if you have experienced a loss, failure or undeserved plight, answer one or more of the following questions (which focus on failure to exemplify the points made): ⦿

How valid is my conclusion that I failed (for example)?

⦿

Would an objective jury agree that I failed? If not, what would the jury’s verdict be?

⦿

Is my conclusion that I failed realistic? If not, what is a more realistic conclusion?

⦿

If I asked someone whom I could trust to give me an objective opinion about my conclusion that I failed, what would the person say to me and why? What conclusion would this person encourage me to make instead?

⦿

If a friend had told me that they had made the same conclusion that they had failed, what would I say to them about the validity of their conclusion and why? What conclusion would I encourage this friend to make instead?

Assessing and dealing with emotional problems about depression In Chapter 2, I discussed the concept of meta-​ disturbance (literally disturbance about disturbance). It is important to assess carefully the nature of this meta-​disturbance about depression before you can best deal with it.

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The best way to start dealing with the assessment of any emotional problems you might have about depression is to ask yourself the question: ‘How do I feel about being depressed?’ The most common emotional problems that people have about depression are as follows: anxiety, depression, guilt, unhealthy regret, shame and unhealthy self-​anger. I discuss only the second of these in this chapter, i.e., depression about depression, and refer you to the respective chapters on anxiety, guilt, unhealthy regret, shame and unhealthy anger for how to deal with these emotional problems as applied to depression.

Assessing depression about depression When you are depressed about depression, it is clear that you think of your original depression as a loss, failure or undeserved plight. The most common of these inferences are as follows: ⦿

Depression means that I have lost connection with people (in the sociotropic realm).

⦿

Depression means that I have to rely on others (in the autonomic realm).

⦿

Depression is an additional undeserved burden I have to deal with (in the undeservingness realm).

Dealing with depression about depression Unless you deal with your depression about depression (called meta-​ depression), you are unlikely to deal with your original depression, since your meta-​depression will lead you to focus on themes about which you are likely to feel even more depressed. Thus, meta-​ depression (if you experience it) often has to be dealt with before you deal with your original depression. As I have made clear in this book, it is important that you develop and apply flexible/​non-​extreme attitudes towards loss, failure and undeserved plight, while becoming more active and while letting be (i.e., not engaging with or distracting yourself from) any remaining post-​rigid/​extreme attitude negative thoughts or images you may have. With these points in mind, let me give you brief advice of how to deal with the three forms of depression about depression I have listed.

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Dealing with the loss of connection with others This is an issue that you are more likely to have if your depression is in the sociotropic realm than in the autonomous or undeservingness realms. In order to deal with this issue, you need to do the following. First, develop a set of flexible/​non-​extreme attitudes towards the loss of connection with others (after examining both your rigid/​extreme and flexible/​non-​extreme attitudes as outlined in Appendices 2−5). These may be ego in nature (e.g., ‘I would prefer not to lose connection with others, but that does not mean it must not happen. If it does, that is unfortunate, but it does not prove I am unlovable. I am a unique, unrateable person who is capable of being loved whether I am connected to others or not’) or non-​ego in nature (e.g., ‘I would prefer not to lose connection with others, but that does not mean it must not happen. If it does, it is a struggle for me to put up with this uncomfortable situation, but I can tolerate it and it is worth it to me to do so’). Then, it’s useful for you to develop a shorthand version of these flexible/​ non-​extreme attitudes (e.g., ‘Connection with others is good, but not necessary’) and use this before seeking to reconnect with others and as you do so.

Dealing with relying on others When you are depressed, you may lose some autonomy and be forced to rely on others. This is a particular problem for those who are rigid about having autonomy. If you are likely to make yourself depressed about having to rely on others, this is what you need to do. First, develop a set of flexible/​non-​extreme attitudes towards having to rely on others (after examining both your rigid/​extreme and flexible/​non-​extreme attitudes as outlined in Appendices 2−5). Again, these may be ego in nature (e.g., ‘I would prefer not to rely on others, but I do not always have my wish fulfilled on this issue. If I do have to rely on others, this does not prove I am a weak person. I am a fallible person whose worth does not change if I have to rely on others’) or non-​ego in nature (e.g., ‘I would prefer not to rely on others, but I do not always have to have my wish fulfilled on this issue. If I do have to rely on others, that’s unfortunate, but it isn’t terrible’). Then, it’s again useful to develop a shorthand version of these flexible/​ non-​extreme attitudes (e.g., ‘I am fallible, not weak, if I have to rely on others’) and use this before seeking help from others and as you do so.

Dealing with the additional burden of depression The first step in dealing with this depression is to assume temporarily that depression is an additional burden. Then, develop a set of flexible/​

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non-​ extreme attitudes towards having such undeserved plight (after examining both your rigid/​extreme and flexible/​non-​extreme attitudes as outlined in Appendices 2−4). These are likely to be non-​ego in nature (e.g., ‘I would prefer not to have this additional undeserved burden on me, but that does not mean that I must not have it. It is unfortunate that I have it, but not terrible and I am not a poor person as a result. I am a non-​poor person in a poor situation’). Once again, it’s useful to develop a shorthand version of this flexible/​non-​extreme attitude (e.g., ‘Depression is poor, but I’m not’) and use this before tackling your original depression. Your client will sometimes need to address their depression about depression (i.e., their secondary depression) before they address their primary depression. They need to do this particularly when their secondary depression gets in the way of them dealing with their primary depression. However, despite the interfering presence of secondary depression, your client may still want to target their primary depression first. There are two ways of dealing with this situation: ⦿

Provide a rationale to help your client target their secondary depression. For example, explain to your client that their secondary depression is like having a ball and chain around their leg while they are climbing a steep hill (akin to their primary depression). In the same way as climbing the hill is easier when they remove the ball and chain from their leg, dealing with their primary depression is easier when they deal with their secondary depression first.

⦿

Go along with your client’s wish to deal with their primary depression and, if they fail to do so, help them to understand that the reason why they failed is because they had not addressed their secondary depression and then agree that they will now do so.

Developing and rehearsing non-​d epressed, sadness-​b ased world views People develop views of the world as it relates to them that make it more or less likely that they will experience UNEs. The world views that render you vulnerable to depression do so in a similar way to your general rigid/​ extreme attitudes towards a specific loss, failure or undeserved plight theme by making you focus unduly on the presence of loss, failure or

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undeserved plight about which you hold depression-​related rigid/​extreme attitudes. However, these depression-​based world views have this effect on you much more widely. It is important that you develop realistic views of the world that will help you to deal with depression and experience healthy sadness instead. In Table 3.1, you will find an illustrative list of such world views rather than an exhaustive one, so you can get an idea of what I mean, which will enable you to develop your own. In Table 3.1, I first describe a world view that renders you vulnerable to depression and then I give its healthy alternative. You will see that the latter views are characterised by complexity

Table 3.1  World views that render you vulnerable to depression and help you to deal with depression Views of the world that render you vulnerable to depression

Views of the world that help you deal with depression

⦿

The world is a bad place

⦿

The world is a place where bad, good and neutral things happen

⦿

Life is ultimately meaningless

⦿

Life neither has meaning nor is meaningless. I can find and actively pursue a number of meaningful projects over my life-​span

⦿

People will ultimately reject me, therefore it is best not be get involved with them

⦿

Some people will reject me, others will not. I can actively involve myself in relationships in light of this fact

⦿

People cannot be trusted

⦿

People vary enormously along a continuum of trustworthiness. My best stance is to trust someone unless I have evidence to the contrary. If I am let down that is very unfortunate, but hardly terrible and won’t unduly affect my stance towards the next person I meet

⦿

The world is made up of strong and weak people

⦿

The world is made up of people who all have their strengths and weaknesses

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and being non-​extreme in nature, whereas, in the former, aspects of the world that relate to loss, failure and undeserved plight are portrayed as unidimensional and extreme. If you hold flexible/​non-​extreme attitudes that are consistent with the views of the world listed on the right-​hand side of Table 3.1, and if you act and think in ways that are, in turn, consistent with these flexible/​non-​ extreme attitudes, you will become less prone to depression. In Chapter 4, I discuss guilt and how to deal with it.

NOTES 1 In this chapter, I am talking about non-​clinical depression. Clinical depression is characterised by a number of biological features such as insomnia, loss of appetite, loss of libido and suicidal ideation. If you think you may be clinically depressed, consult your GP in the first instance. 2 When I discuss undeserved plight in this chapter, I am referring to such plight that can befall you and/​or others. This is the major theme in pity-​based depression.

C H A P T E R

4 Dealing with guilt

In this chapter, I begin by presenting REBT’s way of understanding guilt and then address how to deal with this emotional problem.

UNDERSTANDING GUILT In understanding guilt, we need to know what we tend to make ourselves guilty about (i.e., its major inference themes), what attitudes we hold, how we act or tend to act, and how we think when we are feeling guilty. I mentioned in previous chapters that it is important that you use your client’s language when referring to emotional problems. With respect to the term ‘guilt’, the main issue is that your client may confuse the emotion of ‘guilt’ at ‘C’ with being guilty of something at ‘A’. Here, you need to help them see that the two are different and, just because they were ‘guilty’ of something at ‘A’, it does not follow that they felt guilty about it at ‘C’. Thus, they could have felt remorseful about it, which, in REBT, is seen as the healthy alternative to guilt. However, other clients say that they feel ‘remorseful’ when they do actually experience ‘guilt’. Your task is to satisfy yourself and your client that they do have a ‘guilt’ problem and to use whatever term the client resonates with in therapy. When you have done so, write this term down in your client’s notes.

Major inference themes in guilt There are three major themes in relation to your personal domain that are implicated in guilt: ⦿ ⦿

You have broken your moral code (i.e., you have done the wrong thing). You have failed to live up to your moral code (i.e., you failed to do the right thing).

DOI: 10.4324/9781003424338-5

Dealing with guilt    103

⦿

You have hurt someone’s feelings.

Your client may not resonate with the above schema and, in these cases, you should encourage them to put it aside and just focus on what they tend to feel guilty about. REBT theory values flexibility and this includes the freedom not to use REBT terms, schemas and frameworks.

Rigid/​e xtreme attitudes As I explained in Chapter 1, according to REBT, inferences on their own do not account for emotional problems. It is possible, therefore, for you to make the same inferences as listed above and be remorseful, but not guilty. In order for you to feel guilty when you think that you have done the wrong thing, failed to do the right thing or hurt someone’s feelings, you have to hold a rigid/​extreme attitude. In guilt, this will involve you holding a rigid attitude and an extreme self-​devaluation attitude. If your client is unsure about the mediating role that rigid/​ extreme attitudes play in their guilt, ask them how they would feel if they had strong conviction in the flexible/​ non-​ extreme alternatives to their guilt-​ creating rigid/​ extreme attitudes. In using this strategy, it is important that you formulate the flexible/​ non-​extreme attitudes for your client, who cannot be expected to do this for themself at this stage. When you do this, ensure that you match your client’s rigid attitude with a flexible alternative and their extreme self-​devaluation attitude with a non-​extreme unconditional self-​ acceptance alternative, and then ask them how they would feel if they had strong conviction in this flexible/​ non-​extreme attitude. For example: ‘Let me outline two sets of attitudes towards hurting your friend’s feelings and you tell me which leads to guilt and which leads to remorse without guilt. The first set of attitudes is as follows: “I absolutely should not have hurt my friend’s feelings and I am a bad person for doing so.” The second set of attitudes is: “I would have much preferred not to have hurt my friend’s feelings, but sadly I’m not immune to doing so and neither do I have to be so immune. I am not a bad person

104    Dealing with guilt

for hurting my friend’s feelings, rather I am a fallible human being who is capable of doing right and wrong.” Now which set of attitudes would lead to guilt and which set would lead to remorse without guilt?’ Once your client can see that their rigid/​ extreme attitudes underpin guilt and their flexible/​non-​extreme attitudes underpin remorse, they have understood the mediating role of attitudes. This is quite an elegant strategy since it accomplishes a number of things at once: ⦿

It addresses your client’s doubts about the mediating role of rigid/​extreme attitudes in guilt if they have such concern.

⦿

It introduces flexible/​ non-​ extreme attitudes as a meaningful alternative to these rigid/​extreme attitudes.

⦿

It helps your client to see that holding flexible/​ non-​ extreme attitudes can have beneficial effects.

Behaviour associated with guilt When you hold a rigid/​extreme attitude towards doing the wrong thing, failing to do the right thing or hurting someone’s feelings, you will act or tend to act in a number of ways, the most common of which are as follows: ⦿

You escape from the unhealthy pain of guilt in self-​defeating ways.

⦿

You promise unrealistically that you will not ‘sin’ again.

⦿

You defensively disclaim responsibility for wrongdoing.

⦿

You beg forgiveness from the person you have wronged.

⦿

You punish yourself physically or by deprivation.

⦿

You reject offers of forgiveness.

You will see from the above list that these behaviours get in the way of you thinking clearly about what you did or failed to do and the reasons for this so that you can understand and learn from the situation. If you ask your client whether they want to change their guilt-​ related behaviour, their response will be affected by their mood.

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If they are currently feeling guilty, they are less likely to see that this behaviour is dysfunctional than when they are not feeling guilty. Also, if they do feel guilty, they may think that they warrant being punished or punishing themself. In these circumstances, it may be useful to encourage them to imagine that they are advising a friend who displays the same guilt-​related behaviour as they do. What would they say to this friend about the functionality or dysfunctionality of such behaviour? They are more likely to see that their own guilt-​related behaviour is dysfunctional after they have told this ‘friend’ that the same behaviour is dysfunctional.

Thinking associated with guilt When you hold a rigid/​extreme attitude towards doing the wrong thing, failing to do the right thing or hurting someone’s feelings, you will tend to think in a number of ways. Remember what I said in Chapter 1: the thinking that accompanies your guilt is the result of your inference (i.e., that you did the wrong thing, failed to do the right thing or hurt others in some way) being processed by your rigid/​extreme attitude and therefore it is likely to contain a number of thinking errors that I present in Appendix 1. I list the main features of this post-​rigid/​extreme-​attitude guilty thinking below: ⦿

You conclude that you have definitely committed the sin.

⦿

You assign far less responsibility to others than is warranted.

⦿

You assume more personal responsibility than the situation warrants.

⦿

You dismiss possible mitigating factors for your behaviour.

⦿

You see your behaviour only in a guilt-​related context and fail to put it into an overall context.

⦿

You think that you will receive retribution.

As you can see, such thinking exaggerates the degree of responsibility you have and the negative consequences of your behaviour, and also ignores the role of context. As with post-​rigid/​extreme-​attitude anxiety thinking and depressed thinking, post-​rigid/​extreme-​attitude guilty thinking may be in words or in mental images.

106    Dealing with guilt

One of the main features of post-​rigid/​extreme-​attitude thinking is that it is compelling. As such, it is quite easy for your client to get caught up in this way of thinking and think that it reflects reality. This is an example of ‘cognitive-​emotive’ reasoning: if a thought is plausible and emotionally compelling, therefore it must be true. It is important that you help your client to understand how their mind works with respect to the thinking consequences of rigid/​ extreme attitudes and to encourage them to use such thoughts to go back to address the rigid/​extreme attitudes that spawn them. When they have done this, you can encourage them to respond to these thinking consequences of rigid/​extreme attitudes as these attitudes will not disappear just because they have examined them. When your client responds to these thinking consequences of rigid/​extreme attitudes, they need to do so only a few times on any one occasion. After that, they need to accept the presence of such thinking without engaging with it. To summarise, your clients need to: ⦿

identify the presence of the thinking consequences of rigid/​ extreme attitudes (see Appendix 1)

⦿

trace these back to the source of this mode of thinking (i.e., identify the underlying rigid/​extreme attitudes)

⦿

examine these rigid/​extreme attitudes

⦿

respond briefly to the thinking consequences of such attitudes, but not get overly involved in this process

⦿

accept the lingering presence of these thinking consequences without engaging with them

⦿

get on with the business of living.

HOW TO DEAL WITH GUILT If you are prone to guilt, you tend to experience this emotional problem in a variety of different settings and in response to a variety of perceived moral code violations and failures, as well as times when you inflict hurt on others. Here is how to deal with guilt so that you become less prone to it.

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Step 1: Identify reasons why guilt is a problem for you and why you want to change While guilt is generally regarded as an emotional problem, it is useful for you to spell out reasons why guilt is a problem for you and why you want to change. I suggest that you keep a written list of these reasons and refer to it as needed as a reminder of why you are engaged in a self-​help programme. I discuss the healthy alternative to guilt in Step 4. It is important to remember that people who feel guilty a lot of the time think that ‘feeling guilty’ is an appropriate response to acts of moral commission or omission or hurting the feelings of others. In these circumstances, it is important to introduce the idea of feeling remorseful as the healthy alternative to guilt a little earlier than you would normally do (see Step 4). When you have done so, you can then carry out a cost-​benefit analysis of guilt and its healthy alternative, remorse. This involves helping your client to spell out the perceived advantages and disadvantages of both emotions. Respond to any perceived advantages of guilt and perceived disadvantages of remorse, correcting any misconceptions that your client reveals on these issues. For example, imagine that your client thinks that feeling guilty will help stop them from breaking their moral code in the future and that feeling remorseful would not achieve the same end. In this case, help them to see that precisely the reverse is true. The self-​devaluation attitude that your clients hold when they experience guilt is some variant of ‘I am a bad person’. If that is the way that they think of themselves, they are more, rather than less, likely to break their code since bad people do bad things. The unconditional self-​acceptance attitude that underpins remorse is likely to protect the person from breaking their code since it does the following: ⦿

It helps the client to distinguish right from wrong.

⦿

It articulates that it is better to do the right thing than the wrong thing since it is based on a flexible attitude towards moral code violation.

⦿

It helps the person see that they are more likely to do the right thing if they see themself as fallible than if they see themselves as bad.

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Step 2: Take responsibility for your guilt In REBT, we argue that what you do or don’t do does not make you feel guilty; rather you create these feelings by the rigid/​extreme attitudes that you hold towards what you do or don’t do. Unless you accept this point, you will not address your guilt productively. Rather, you will think that the only way not to feel guilty is by always acting morally and never hurting people’s feelings. This will perpetuate your guilt rather than deal with it. The idea that emotional problems (including guilt) are based largely on the attitudes that a person holds towards what happens to them is, as you know, a central plank in REBT. However, for many clients, it will be a new idea. Thus, your client may hold that the reason they are guilty, for example, is that it is inherently wrong to hurt someone’s feelings and that guilt is caused by such a wrongdoing. It may seem that the client is taking responsibility for this emotion of guilt and is taking responsibility for their wrongdoing. However, on closer inspection, this is not the case. In REBT, we don’t say that wrongdoing causes guilt. This is an example of ‘A–​ C’ thinking where ‘A’ is the person’s action of wrongdoing and ‘C’ is the emotion of guilt. Rather, we argue that the reason that the person experiences guilt is largely due to the fact that they hold a set of rigid/​extreme attitudes towards such wrongdoing. If the person held a set of flexible/​non-​extreme attitudes towards the wrongdoing, they would experience remorse rather than guilt. What you need to do, then, is to help your client see that they create their guilty emotion by holding a set of rigid/​ extreme attitudes towards the wrongdoing. In this way, you can help them take two types of responsibility, not only for their actions but also for the rigid/​extreme attitudes that underpin their guilt. If your client continues to have difficulty accepting responsibility for their guilty feelings, it is important for you to identify the source of this difficulty. In the Client’s Guide, I mention one common obstacle that stops clients from accepting such responsibility (i.e., the self-​blame that a client would engage in were they to assume responsibility for making themself guilty). However, there are other obstacles to accepting responsibility such as the following:

Dealing with guilt    109

⦿

Hopelessness about change (e.g., ‘I am a bad person. I don’t just think I am’). Here the client is reluctant to see their guilt as an attitude problem. They consider that they are bad because of their actions or inactions. The best intervention here involves invoking the client’s empathy by asking if they would tell a loved one who did exactly the same thing that they did, for example, that they were bad through and through for doing so. If the client can assume the role of compassionate observer (rather than self-​punitive experiencer), it often helps them to see that their guilt is an attitude problem (e.g., ‘I think I am bad’) for which they can take responsibility and thereby change rather than an identity problem (e.g., ‘I am bad. I don’t just think I am’), which they can’t do anything about if it were true.

⦿

The need for divine forgiveness (e.g., ‘I cannot forgive myself for what I have done. Only God can forgive me’). If your client holds to this position, there are four ways of responding: ⦿

If they are a Christian show them that Christ advises that we accept the sinner, but not the sin (a position similar to unconditional self-​acceptance).

⦿

Ask the client how they know that divine forgiveness does not work through self-​forgiveness.

⦿

Ask them how they know when God forgives them? Also enquire how long they have to condemn themself for God to forgive them. What would they say to a child who asks them these questions?

⦿

If all else fails, find and use a religious representative whose views complement that of REBT since such a person may be a more acceptable authority.

It is important to help your client to understand the impact of these obstacles on their emotional problems. Then, help them to develop alternatives to these obstacles and review the impact of these alternatives on their emotional problem-​solving. This often helps a client to deal effectively with these obstacles. If not, you

110    Dealing with guilt

may need to do a more detailed assessment of the obstacle, which is outside the brief of this book.

Step 3: Identify the themes you tend to be guilty about The best way of identifying guilt-​related inference themes to which you are particularly vulnerable is by understanding the themes associated with guilt, and seeing which are present when you feel guilty. As I outlined above, there are three such themes: ⦿

You have broken your moral code (i.e., you have done the wrong thing).

⦿

You have failed to live up to your moral code (i.e., you have failed to do the right thing).

⦿

You have hurt someone’s feelings.

If your client finds it difficult to find their guilt-​related theme, you can help them by assessing a few specific examples of their guilt. Have them focus on a specific situation in which they felt guilty and ask them what they were most guilty about. If they still find it difficult to identify the theme in this or other specific situations, use the ‘magic question’ technique. This involves you doing the following: ⦿

Have your client focus on the situation in which they felt guilt.

⦿

Ask them to nominate one ingredient that would eliminate or significantly reduce their guilt without changing the situation.

⦿

The opposite of this nominated ingredient is what they are most guilty about.

Lara was struggling to identify the specific theme in her guilt about not visiting her mother, with whom she had a stormy relationship. Lara’s therapist helped Lara to use the ‘magic question’ technique as follows:

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⦿

He asked Lara to focus on the situation in which she felt guilty: ‘I am watching a woman my age and her mother having a coffee.’

⦿

He asked Lara to nominate one ingredient that would eliminate or significantly reduce her guilt without changing the situation: ‘Making more of an effort to understand my mother when I was younger.’

⦿

The opposite of this nominated ingredient is what she is most guilty about: ‘Not making more of an effort to understand my mother when I was younger.’

If you assess a number of specific examples of your client’s guilt this way, the guilt-​related theme should be apparent. In Lara’s case, it was being aware that she had acted selfishly towards her mother when she was growing up. It may be that there are two guilt-​related themes present in your client’s guilt. For example, your client may feel guilty about doing the wrong thing and about failing to do the right thing. If this is the case, deal with them one at a time and have your client nominate the theme that they want to focus on first.

Step 4: Identify the three components of your guilt response and set goals with respect to each component The next step is for you to list the three elements of your guilt response in the face of each of the relevant themes listed above.

Identify the three components of your guilt response I use the term ‘guilt response’ to describe the three main components that make up this response. The three components of your guilt response are the emotional, behavioural and thinking components.

Emotional component The emotional component here is, of course, guilt.

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Behavioural component The behavioural component concerns overt behaviour or action tendencies that you engage in or ‘feel like’ engaging in when you feel guilty. Consult the list that I provided to help you identify your behaviour associated with each relevant theme when you are guilty (see p. 104).

Thinking component The thinking component associated with guilt is listed on p. 105. Again, these may be in words or in mental pictures. Consult the list if necessary.

Set goals with respect to each of the three components You need to set goals so that you know what you are striving for when you deal effectively with guilt. The three goals are emotional, behavioural and thinking goals.

Emotional goal Your emotional goal is remorse rather than guilt (or whatever synonym you prefer to the term ‘remorse’). Remorse is an HNE, which is an appropriate response to doing the wrong thing, not doing the right thing or hurting someone’s feelings. It helps you to think objectively about the situation and your response to it, and helps you to move on with your life rather than get stuck or bogged down. The concept that remorse is the healthy alternative to guilt in the face of doing the wrong thing, failing to do the right thing or hurting someone’s feelings is based on the following idea. These adversities are negative and therefore it is realistic to have a negative emotion about them. The choice, therefore, is between a UNE (guilt) or an HNE (remorse). However, what if your client specifies unrealistic goals? Here are a number of such goals and how to respond to clients who nominate them: ⦿

‘I don’t want to feel guilt.’ Show your client that they have indicated what they do not want to feel in the face of doing the wrong thing, failing to do the right thing or hurting someone’s feelings, but not what they

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do want to feel. Help them to specify an emotion to aim for, like remorse! ⦿

‘I want to feel less guilty.’

⦿

‘I don’t want to feel anything.’

Show your client that, as guilt is a disturbed emotion, wanting to feel less guilty is still to nominate a disturbed emotion, albeit of lesser intensity. Show them that remorse can be strong and healthy.

Not feeling anything in the face of doing the wrong thing, failing to do the right thing or hurting someone’s feelings will not help your clients to be appropriately geared up to deal with it. Help them to see this. Also, show them that the only way that they could achieve a state of not feeling anything is to feel completely indifferent about doing the wrong thing, failing to do the right thing or hurting someone’s feelings. This could be called the psychopathic option − believing that you just don’t care whether or not you have done the wrong thing, failed to do the right thing or hurt someone’s feelings. In order to do this, your client (assuming that they are not psychopathic) would have to lie to themself. Show them this and discourage them from setting such a goal.

Behavioural goal Your behavioural goal should reflect actions that are based on remorse about doing the wrong thing, not doing the right thing or hurting someone’s feelings, rather than guilt. The following are the most common behaviours associated with remorse. You may wish to compare these behaviours with those associated with guilt that I presented on p. 104. ⦿

You face up to the healthy pain that accompanies the realisation that you have sinned.

⦿

You ask, but do not beg, for forgiveness.

⦿

You understand the reasons for your wrongdoing and act on your understanding.

114    Dealing with guilt

⦿

You atone for the sin by taking a penalty.

⦿

You make appropriate amends.

⦿

You do not make excuses for your behaviour or enact other defensive behaviour.

⦿

You accept offers of forgiveness.

It is important that your client understands that, as they strive to develop healthy behavioural responses to doing the wrong thing, failing to do the right thing or hurting someone’s feelings, they will still feel the urge to act in ways that are dysfunctional, as listed on p. 104. Help them to understand the reason for this. Explain to them that, as they examine their attitudes and commit themself to strengthening their conviction in their flexible/​non-​extreme attitudes and to weakening their conviction in their rigid/​extreme attitudes, the latter will still be active and producing urges for them to act dysfunctionally. Encourage your client to accept these urges, to recognise that they do not have to act on them and to use them as cues to act in functional ways.

Thinking goal As well as setting behavioural goals related to the feeling of remorse about doing the wrong thing, not doing the right thing or hurting someone’s feelings, it is important that you set thinking goals associated with this emotion. The following are the most common forms of thinking associated with remorse rather than guilt. Again, you may wish to compare these forms of thinking with those associated with guilt that I presented on p. 105. ⦿

You take into account all relevant data when judging whether or not you have ‘sinned’.

⦿

You assume an appropriate level of personal responsibility.

⦿

You take into account mitigating factors.

⦿

You think you may be penalised rather than receive retribution.

⦿

You assign an appropriate level of responsibility to others.

⦿

You put your behaviour into overall context.

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As the above list shows, the dominant feature of thinking associated with remorse is that it is realistic and balanced. Please remember that such thinking may be in words or in mental pictures. The point I made above with respect to a client’s behavioural goals is also relevant with respect to their thinking goals. A client will still have some conviction in their rigid/​extreme attitudes until they have full conviction in their flexible/​non-​extreme attitudes. Given this, your client’s rigid/​extreme attitudes will have some impact on their subsequent thinking as they strive to achieve their goals. Thus, highly distorted thoughts will still come into your client’s mind. Help your client to understand why this is the case. When you come to help them deal with these forms of post-​rigid/​extreme-​ attitude thinking, do one or more of the following as indicated. Discuss this issue with your REBT supervisor, if necessary: ⦿

Encourage your client to acknowledge the existence of such thoughts without trying to suppress them, distract themself from them or engage with them.

⦿

If relevant, use the presence of this post-​rigid/​extreme-​attitude thinking to help your client to identify and deal with the rigid/​ extreme attitudes.

⦿

Examine the empirical nature of these thinking ‘Cs’ once or twice and then return to the acceptance strategy detailed above.

Step 5: Identify your general rigid/​extreme attitudes and alternative general flexible/​non-​extreme attitudes A general rigid/​extreme attitude leading to your guilt response is a rigid/​ extreme attitude that you hold across situations defined by one of the following themes: breaking your moral code, failing to live up to your moral code or hurting someone’s feelings. Its flexible/​non-​extreme alternative, which will also be general in nature, will account for your remorse response.

Identify your general rigid/​extreme attitudes When you identify a general rigid/​extreme attitude, you take a common guilt-​related theme (i.e., doing the wrong thing, failing to do the right thing

116    Dealing with guilt

or hurting someone’s feelings) and add to this a general rigid attitude and the main extreme attitude that is derived from the rigid attitude. In guilt, your main extreme attitude will be a self-​devaluation attitude. For example: ⦿

‘I must not hurt my family’s feelings and, if I do, I am bad.’

Identify your alternative general flexible/​non-​extreme attitudes When you identify your alternative general flexible/​non-​extreme attitude, you take the same common theme (i.e., doing the wrong thing, failing to do the right thing or hurting someone’s feelings) and add to this a general flexible attitude and the main non-​extreme attitude that is derived from the flexible attitude. In remorse, your main non-​extreme attitude will be an unconditional self-​acceptance attitude. For example: ⦿

‘I really don’t want to hurt my family’s feelings, but that does not mean that I must never do so. If I do, that would be bad, but it would not prove that I am bad. I am fallible and capable of doing good and bad things.’

As you will have noticed in the Client’s Guide, I encourage readers/​ clients to identify and work with their general rigid/​ extreme attitudes and to develop general flexible/​ non-​ extreme attitudes and, as you will see, when they are facing specific instances of their problems, I encourage them to focus on specific examples of both sets of attitudes. This will be at variance with your REBT practice, where you will begin with specific examples of your client’s problems and then proceed to work at a more general level with their problems and how these relate to one another. The reason I have chosen to go ‘general’ rather than ‘specific’ when helping readers/​clients to deal with their emotional problems is a pragmatic one. In this book, I aim to help people to deal with a range of emotional problems and therefore, in my view, it is best to give readers/​clients general guidance with respect to dealing with this range of problems and then help them to move from the general to the specific rather than vice versa. My considered view was that I just do not have the space to help readers/​clients focus on specific examples of their emotional problems and then generalise from this specific level.

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Consequently, one way you can help your client who is using the Client’s Guide is to help them to work with specific examples of their emotional problem, in this case, guilt. Use the following sequence as you do so and help your client to: ⦿

select a specific example of their guilt problem

⦿

identify what they felt most guilty about in the situation

⦿

identify the three specific components of their guilt response and set specific goals with respect to each component

⦿

identify their specific rigid/​extreme attitudes and alternative specific flexible/​non-​extreme attitudes

⦿

examine their specific attitudes.

In helping your client to deal with a specific example of their guilt, you can teach them how to use REBT’s ABCD form, which appears in Appendix 6. The following steps are the same as those that appear in Steps 8−11 later in this chapter. Thus, help your client to: ⦿

face up to what they did that was wrong, what they failed to do that would have been right or hurting someone’s feelings in imagery (if necessary)

⦿

face the person who they wronged, failed to do right by or whose feelings they hurt in reality (if possible) and take appropriate action

⦿

capitalise on what they have learned

⦿

generalise their learning.

Step 6: Examine your general attitudes I recommended in Chapters 2 and 3 that you first examine together your general rigid attitude and its general flexible attitude alternative and then examine together your general extreme attitude and your general non-​ extreme attitude.

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Examine your general rigid attitude and its general flexible attitude alternative First, take your general rigid attitude and its general flexible attitude alternative and write them down next to one another on a sheet of paper. Then ask yourself: ⦿

Which is true and which is false?

⦿

Which has largely constructive results and which has largely unconstructive results?

⦿

Which is sensible logically and which does not make sense?

Write down your answer to each of these questions on your piece of paper, giving reasons for each answer. Consult Appendix 2 for help with the answers to these questions, which you need to adapt and apply to the attitudes you are examining.

Examine your general self-​devaluation attitude and its general unconditional self-​acceptance attitude alternative Next, take your general self-​devaluation attitude and its general unconditional self-​acceptance attitude alternative and again write them down next to one another on a sheet of paper. Then, ask yourself the same three questions that you used with your general rigid attitude and its general flexible attitude alternative. Again, write down your answer to each of these questions on your piece of paper, giving your reasons for each answer. I suggest that you consult Appendix 5 (for help with examining self-​ devaluation attitudes and unconditional self-​ acceptance attitudes). Again, you need to adapt and apply these arguments to the attitudes you are examining. You should now be ready to commit to acting and thinking in ways consistent with your general flexible/​non-​extreme attitude. I included Appendices 2−5 in the Client’s Guide as general guidelines to help readers/​clients to examine their rigid/​extreme and flexible/​ non-​ extreme attitudes (reproduced in this book as Appendices 2−5). If you are working with a client who is using the Client’s Guide, you will have a chance to look at the examining work that your client has done at this point and give them feedback on that work. No book can provide such feedback.

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I have suggested that readers/​clients examine their rigid attitude and their flexible attitudes together and then their self-​ devaluation attitude and their unconditional self-​ acceptance attitude equivalent together using three criteria as shown below: ⦿

Rigid attitude vs. flexible attitude ⦿

empirical status

⦿

pragmatic status

⦿

⦿

logical status

Self-​ devaluation attitude vs. unconditional self-​ acceptance attitude ⦿

empirical status

⦿

pragmatic status.

⦿

logical status

The final point I want to make about examining attitudes concerns the concept of persuasiveness. Perhaps the most important aspect of the examining process is for your client to develop arguments concerning the false, illogical and unhealthy nature of their rigid/​ extreme attitudes and the true, logical and healthy nature of their flexible/​non-​extreme attitudes that are persuasive to them. So, encourage your client to develop such persuasive arguments and to make a note of these for future reference.

Step 7: Take an appropriate amount of responsibility and understand your behaviour in context Once you have committed yourself to your general flexible/​non-​extreme attitude, it is important that you look again at events about which you have made yourself guilty, but this time you need to view them through the eyes of your general flexible/​non-​extreme attitudes (i.e., flexible and

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unconditional self-​acceptance attitudes). This basically involves you taking responsibility for your behaviour, but recognising that others have responsibility too. It also involves you understanding your behaviour in context. This means that you need to consider the factors involved in the situation. When you feel guilt, you see things in black and white, and tend to take far too much responsibility and edit out the impact of other factors external to you. In remorse, you recognise the complexity of the situation and the fact that there are many influences on your behaviour. As such, remorse helps you to learn from situations in which you think you have broken or failed to live up to your moral code or you have hurt someone’s feelings and to use this learning in future situations. In other forms of CBT, therapists tend to help their clients to consider the extent of their responsibility and that of others much earlier in the therapy process than do REBT therapists. When your client indicates clear distortions of personal responsibility in the early phase of discussing their guilt problem, it is tempting to intervene and help them to consider this issue. It is important that you refrain from doing so for the following reason. REBT theory argues that such clear distortions of personal responsibility and difficulty in considering one’s behaviour in an overall context stem largely from rigid/​extreme attitudes and, unless your client addresses their rigid/​extreme attitudes first, they will reflect on matters to do with personal responsibility and with placing their behaviour in its proper context through the distorting lens of their rigid/​extreme attitudes. Thus, help your client to understand the importance of dealing with their rigid/​extreme attitudes before reflecting on these other matters.

Step 8: Face your guilt-​r elated theme in imagery I hope that you have made a commitment to act on your general flexible/​non-​extreme attitudes (i.e., flexible attitude and unconditional self-​ acceptance attitude). Assuming that you have, your basic task is to face up to doing the wrong thing, failing to do the right thing or hurting someone’s feelings, and to learn to think flexibly and in a non-​extreme way about it. Up to this point, you have worked at a general level with respect to your guilt-​related theme, dealing with the general rigid/​extreme attitudes that account for your guilt and developing your alternative general flexible/​ non-​extreme attitudes. However, when you come to apply your general

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flexible/​non-​extreme attitudes in dealing with breaking or failing to live up to your moral code or hurting someone, you need to remember one important point. Since you make yourself guilty about specific events (actual or imagined), you need to deal with these by rehearsing specific variants of your general flexible/​non-​extreme attitudes. While the best way to do this is in specific situations with people who were involved when you broke your moral code, failed to live up to your moral code or whose feelings you hurt, you may derive benefit by using imagery first If this is the case, you need to do the following: ⦿

Imagine a specific situation in which you felt guilty or may feel guilty about breaking or failing to live up to your moral code or hurting someone’s feelings and focus, in your mind’s eye, on what you felt most guilty about (i.e., your ‘A’).

⦿

Focus on this ‘A’ while rehearsing a specific flexible/​non-​extreme attitude relevant to the situation. As you do this, try to make yourself feel remorseful, rather than guilty.

⦿

Then, see yourself acting in ways consistent with your flexible/​non-​ extreme attitude, e.g., apologising, making amends and engaging the other in a productive dialogue.

⦿

Recognise that some of your post-​ rigid/​ extreme-​ attitude thinking may be distorted. Respond to it without getting bogged down doing so. Accept the presence of any remaining distorted thoughts without engaging with them.

⦿

Repeat the above steps until you feel sufficiently ready to put this sequence into practice in your life.

If you find that facing your guilt-​related ‘A’, in your mind’s eye, is too much for you, use the ‘challenging, but not overwhelming’ principle that I introduced in Chapter 2 (see p. 53). This means that, instead of imagining yourself facing a moral code violation (commission or omission) or hurting someone’s feelings that you find ‘overwhelming’ at the present time, choose a similar guilt-​related ‘A’ that you would find ‘challenging, but not overwhelming’. Then employ the same steps that I have outlined above. Work in this way with modified guilt-​related ‘A’s’ until you find your original one ‘challenging, but not overwhelming’ and then use the steps again. Your client may say that they can’t get very clear images when they try to picture events in their mind’s eye. While they may get

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more out of imagery techniques if they can get such clear images, they will still get something out of facing guilt-​related situations in imagery even if their images aren’t clear. So, if your client wants to face their particular adversity in imagery before they do so in reality, encourage them to do so no matter how clear their mental images are.

Step 9: Apologise, make amends and talk things through Once you have understood your behaviour in context and taken responsibility for what you are in fact responsible for, you are in a position to act on this. This may mean apologising to relevant others for your behaviour and/​or making amends to them in some way. Whatever action you need to take, you first need to get into a flexible/​non-​extreme frame of mind. When you feel remorseful, but not guilty, you are encouraged to engage others in a productive dialogue about the situation in question, if they are amenable to doing so. The purpose of this dialogue is mutual understanding and reconciliation. It is particularly helpful to encourage your client to utilise the language of their flexible and unconditional self-​acceptance attitudes when implementing this step, although your client needs to put this into their own words. For example, your client may say: ‘I am sorry that I hurt your feelings and I hope you can forgive me for doing so. I was angry and, while it was bad that I expressed myself in the way that I did, I hope you can see that I am not a bad person for doing so. Can we talk about this as two fallible human beings?’

Step 10: Capitalise on what you have learned When you have faced a situation in which you experienced guilt and dealt with it as best you could, it is important that you reflect on what you did and what you learned. In particular, if you were able to face the situation, and rehearse your specific flexible/​non-​extreme attitudes until you felt remorse, then ask yourself how you can capitalise on what you achieved. If you experienced any problems, respond to the following questions:

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⦿

Did I face the situation and, if not, why not?

⦿

Did I rehearse my flexible/​non-​extreme attitudes before, during or after facing the situation and, if not, why not?

⦿

Did I execute my plan to face the situation and, if not, why not?

⦿

Did I engage with post-​rigid/​extreme attitude distorted thinking and, if so, why?

Reflect on your experience and put into practice what you have learned the next time you face a situation in which you consider that you did the wrong thing, failed to do the right thing or hurt someone’s feelings. It is useful to monitor your client’s responses to these questions and help them to reflect on any issues that they have not considered.

Step 11: Generalise your learning Once you have dealt with your guilt in a specific situation by holding the relevant specific version of your general flexible/​non-​extreme attitude, and by acting and thinking in ways that are consistent with it, you can generalise this learning to situations defined by you breaking or failing to live up to your moral code or hurting others’ feelings. Billy was particularly prone to guilt about hurting others’ feelings, so he followed the steps outlined in this chapter. Thus: ⦿

Billy assessed the three components of his guilt response and set goals with respect to all three components.

⦿

He identified his relevant general rigid/​extreme attitude regarding hurting others’ feelings (i.e., ‘I must not hurt people’s feelings and, if I do, I’m a bad person’) that underpinned his guilt response and his alternative general flexible/​non-​extreme attitude (i.e., ‘I don’t want to hurt people’s feelings, but I am not immune to doing so and nor do I have to be so immune. If I do hurt others’ feelings it is bad, but I am not a bad person. I am an ordinary fallible person who has done something bad’) that underpinned his remorse response.

⦿

He examined both elements of his general rigid/​extreme attitude and his general flexible/​non-​extreme attitude until he clearly saw that the former

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were false, made no sense and were detrimental to him, and that the latter were true, sensible and healthy. ⦿

He thought about what he was actually responsible for and what others were responsible for and saw that there were other factors involved that he did not take into account when he felt guilty, which need to be factored in and understood. Then he met with these others, apologised and made amends when he needed to, and talked things through with them.

⦿

As he did so, he tolerated the discomfort that he felt and accepted that some of his distorted and skewed negative thinking would still be in his mind. He let such thinking be without engaging with it, suppressing it or distracting himself from it.

As this section shows, you can generalise what you learn about dealing with guilt from situation to situation as defined by your moral code violation, failure to live up to that code or by hurting others’ feelings. If you do this, you will take the toxicity out of the emotional problem of guilt!

USING REBT’S ABCD FORM TO DEAL WITH SPECIFIC EXAMPLES OF YOUR GUILT This chapter is mainly geared to help you deal with your guilt in general terms. However, you can also use this material to address specific examples of your guilt. I have developed a self-​help form to provide the structure to assist you in this regard. It is called the ABCD form and it appears with instructions in Appendix 6. In Appendix 6, I outline the major problems that clients have in using this form and how to deal with them.

OTHER IMPORTANT ISSUES IN DEALING WITH GUILT In the above section, I outlined an 11-​step programme to deal with guilt. In this section, I discuss some other important issues that may be relevant to you in your work to become less prone to this emotional problem. If

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you want to, you can incorporate them as additional steps in the above step-​by-​step guide at points relevant to you.

Dealing with your safety-​s eeking measures to avoid guilt I mentioned in Chapter 2 that people use safety-​seeking measures to protect themselves from threat. You may use similar measures to protect yourself from feeling guilty. Here is how this works from your perspective. You reason that, since you feel guilty about (a) doing the wrong thing, (b) failing to do the right thing and (c) hurting people’s feelings, you will take steps to avoid guilt by always doing the right thing and never hurting people’s feelings. Taking this decision means that you will not take risks in life (in case you do the wrong thing or upset others, for example), always put others first (so that others are not upset) and go out of your way to get people to like you (again, to ensure that you do not upset them). However, this behaviour and the reasoning that leads you to take it are flawed and will serve only to perpetuate your chronic guilt. This is due to the fact that your guilt is based not on you (a) doing the wrong thing, (b) failing to do the right thing and (c) hurting people’s feelings, but on your rigid/​extreme attitudes towards these three inferences. So, if you want to deal effectively with guilt, you need to do the following: ⦿

Take healthy risks, put yourself first again in a healthy way, and stop going out of your way to get people to like you, and see what happens. You will probably find that people are not upset as much as you think and that you have not broken any of your moral codes.

⦿

However, if, as a result of your behaviour, you do break one of your moral codes, fail to live up to them or upset others, then you can deal with such situations by holding a set of flexible/​non-​extreme attitudes towards them so that you feel healthy remorse and not unhealthy guilt about these consequences.

It is one of the major themes of both the Client’s Guide and this Practitioner’s Guide that, when your client comes to change their behaviour from dysfunctional to functional, they will still experience urges to act dysfunctionally. This is why it is so important to help your client understand the difference between overt actions and action tendencies. In the present context, this means stressing to your client as they strive to act in ways that address their guilt

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feelings constructively and thus desist from using guilt-​ related safety-​ seeking strategies that they will still feel the urge to use them. Help them to develop ways of accepting, but not necessarily liking, such urges and to implement their healthy remorse-​based behaviour, even though such aforementioned behaviour may be present for some time. You may have to help your client identify and respond to rigid/​extreme attitudes such as: ‘If I feel the urge to do something to get rid of my guilt quickly, then I have to act on that urge.’ Developing and strengthening flexible/​non-​extreme attitudes towards these urges is particularly important for your client.

Why you feel guilty much of the time and how to deal with this If you are particularly prone to guilt, you will think that you often do the wrong thing, fail to do the right thing or hurt the feelings of others. You do this because you hold the following attitude, which I call a ‘chronic guilt-​ based general rigid/​extreme attitude’: ⦿

‘Whenever I am involved, I must make sure that nothing bad happens or others’ feelings are not hurt. If I don’t and bad things happen and others are upset, then it is all my fault and I am a bad person.’

You then take this attitude to relevant situations and, even where your involvement is minimal, you think that you are at fault if there is a bad outcome. As a result, you constantly think that you are responsible for any negative outcomes that happen or might happen and end up by blaming yourself.

How to deal with chronic guilt In order to deal with this chronic sense of guilt, you need to develop and apply an alternative general flexible/​non-​extreme attitude that protects you from such guilt: ⦿

‘Whenever I am involved, I want to make sure that nothing bad happens or that others’ feelings are not hurt, but I don’t have to succeed in doing so. If I don’t and bad things happen and others are upset, then I will take

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the appropriate level of responsibility, assign appropriate responsibility to others and consider the impact of situational factors. I will accept myself for failing to adhere to my code and for any hurt that I inadvertently cause.’ Such an attitude will lead you to think that you have broken your moral code, failed to adhere to the code or hurt someone’s feelings only when there is clear evidence for making such an inference. When there is, you will feel remorse rather than guilt because you will be processing this with a specific flexible/​non-​extreme attitude. If your client finds that the above explanation is too complex, you can help them to see that rigid attitudes towards the presence or absence of guilt-​related adversities means that, if it is not clear that they have not broken their moral code, for example, they will assume that they have done so. When their attitudes are flexible, they can be more objective about the presence of these adversities.

How to examine the accuracy of your guilt-​related inference, if necessary If you are still unsure if you have broken your moral code, failed to live up to it or hurt someone’s feelings, answer one or more of the following questions: ⦿

How valid is my inference that I broke my moral code (for example)?

⦿

Would an objective jury agree that I broke my moral code? If not, what would the jury’s verdict be?

⦿

Is my inference that I broke my moral code realistic? If not, what is a more realistic inference?

⦿

If I asked someone whom I could trust to give me an objective opinion about my inference that I broke my moral code, what would the person say to me and why? What inference would this person encourage me to make instead?

⦿

If a friend had told me that they had made the same inference about breaking their moral code in the same situation, what would I say to them about the validity of their inference and why? What inference would I encourage this friend to make instead?

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Dealing with failure to practise healthy self-​c are People who have a chronic problem with guilt find it very hard to practise healthy self-​care. The reason for this is as follows. Healthy self-​care involves you putting yourself first unless others’ needs are truly more important than your own. People with a chronic guilt problem generally think that others’ needs are more important than their own and that to put oneself first is being selfish, which, if you have a chronic problem, you will seek to avoid. Putting others first helps you both to avoid considering yourself a bad person if you do put yourself first and to feel virtuous.

How to practise healthy self-​care In order to practise healthy self-​care, you need to do the following: ⦿

Develop a healthy general flexible/​non-​extreme attitude that underpins the practice of healthy self-​care (e.g., ‘I am a fallible human being and if I don’t look after myself, nobody will. I am not a bad person if I put myself first even though doing this is uncomfortable’).

⦿

Put this into practice and rehearse shortened specific versions of this general flexible/​non-​extreme attitude before you take self-​caring action, while you do so and after you have done so.

⦿

Recognise that this will feel very uncomfortable because it will be unfamiliar. However, if you bear this discomfort and keep acting in ways that are consistent with your healthy general flexible/​non-​extreme attitude, then this discomfort will subside and eventually practising healthy self-​care will become the familiar position for you.

As you help your client implement a philosophy of healthy self-​ care, you may well find that some of them may not do so, not for guilt-​related reasons, but because they have self-​discipline issues. If this is the case, you may want to suggest that they read and follow the guidelines outlined in my book on the subject (Dryden, 2009b).

Identifying and dealing with the hidden conceit in guilt It may sound strange, but, when you think about guilt from a particular perspective, an attitude of hidden conceit is revealed. Such conceit is

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revealed when you are asked to judge someone who has acted in a situation in the same way as you. Let me give an example to make this clear. June felt guilty whenever she said ‘No’ to her mother, even when the latter made unreasonable requests on June, as she increasingly did. June’s general rigid/​extreme attitude with respect to her mother was: ‘I must make my mother happy and I am bad if I don’t.’ June’s friend Harriet also had a problem saying ‘No’ to her own mother and whenever she discussed her guilt and helplessness with June, June advised Harriet to think more of herself and lay down boundaries with her mother. This was precisely what June did not do for herself. June’s view of Harriet was that she was a fallible human being with limitations who had to lay down healthy boundaries to deal with this complex situation. June’s view of herself was that she should be a good daughter, strong enough to cope with the demands of her mother, and that she was bad if she did not. June’s hidden conceit is thus revealed in her differential expectations of herself and Harriet. She sees Harriet as fallible with limitations. She sees herself as someone who should be able to cope with a situation that she does not expect Harriet to be able to cope with. This ‘holier than thou’ attitude is common in guilt: ‘I must be thoroughly good and, if I’m not, I’m bad.’

It is very important that you deal with this hidden conceit if you want to become less prone to guilt. You do this in ways that should now be familiar to you: ⦿

By all means have high standards for yourself in the moral realm of the personal domain, but remind yourself that you don’t always have to achieve these standards.

⦿

Accept yourself as a fallible human being with limitations in the same way as you would others. Self-​compassion is crucial here and I recommend the writings of Paul Gilbert on this subject (e.g., The Compassionate Mind, 2009).

Please bear in mind that your client may not resonate with the term ‘hidden conceit’. If this is the case, help them to suggest a term that is more acceptable to them, but which accurately represents the concept.

Can you hurt the feelings of others? Throughout this chapter, I have used terms such as ‘hurting people’s feelings’. I have done so because this is how people prone to guilt tend to

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think. When you think that you have hurt someone’s feelings, this is an inference and, as we have seen in this book, people’s emotional problems are not determined by inferences alone, they are largely determined by the rigid/​extreme attitudes that they hold towards these inferences. Thus, you don’t feel guilty because you think you have hurt someone’s feelings, you feel guilty because you hold a rigid/​extreme attitude towards this inference. So, to deal with guilt, you need to assume temporarily that you did, in fact, hurt someone’s feelings so that you can identify and deal effectively with your guilt-​inducing rigid/​extreme attitudes. When you have done this and are looking back at the event with your flexible/​non-​extreme mind, it is useful to consider the question: ‘Can I, in reality, hurt the feelings of others?’ From the perspective of REBT, the answer is ‘No’. As I will explain in Chapter 6, when a person feels hurt about someone’s behaviour, they do so because they hold a rigid/​extreme attitude towards that person’s behaviour. So, when you say that you have hurt someone’s feelings, you are working on the assumption that your behaviour directly makes the other person feel hurt. You are implying that the person’s attitudes play no part in this, which is patently false. So, it is important that you don’t take responsibility for the other person’s feelings. That does not mean that you can treat another person badly, safe in the knowledge that you aren’t responsible for that person’s feelings. Far from it! What I am suggesting is that, while you should not take responsibility for the feelings of others, you should take full responsibility for the way you treat others. However, taking full responsibility for your behaviour does not mean that you have to blame yourself if you do treat someone badly, for responsibility is not synonymous with blame. If you do treat someone badly, it is healthy for you to feel remorse about that, an emotion based on a flexible/​non-​extreme attitude that will help you to stand back and learn from the experience so you are less likely to act that way in future. While it is important that your client addresses their rigid/​ extreme attitudes towards hurting people’s feelings before helping them to reconsider the question of whether you can, in fact, hurt people’s feelings, occasionally you will need to reverse this order. This will be when a client won’t deal with their rigid/​ extreme attitudes towards hurting others’ feelings, no matter what strategy you use, until they have achieved some symptom question relief by realising that they did not hurt the other person’s feelings. When they have done so, they become more open to the issue of attitude change towards hurting people’s feelings. In REBT, we call this changing ‘A’ before changing ‘B’.

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Additionally, you can help your client deal with this form of guilt only by encouraging them to see that, while they may have acted badly towards others, which they can take responsibility for and accept themself for, this does not mean that they have hurt the feelings of these others. What you are doing here is switching the ‘A’ from ‘I have hurt the feelings of others’ to ‘I have acted badly towards others’ and then helping them develop flexible/​ non-​extreme attitudes towards this new ‘A’.

Assessing and dealing with emotional problems about guilt In previous chapters, I discussed the concept of meta-​disturbance (literally disturbance about disturbance). It is important to assess carefully the nature of this meta-​disturbance about guilt before you can best deal with it. The best way to start dealing with the assessment of any emotional problems you might have about guilt is to ask yourself the question: ‘How do I feel about my feeling of guilt?’ The most common emotional problems that people have about guilt are as follows: anxiety, depression, unhealthy regret, shame and unhealthy self-​anger. As it is unlikely that you will feel guilty about feeling guilty, I refer you to the chapters on anxiety, depression, unhealthy regret, shame and unhealthy anger for help on how to deal with these meta-​emotional problems about guilt. Your client will sometimes need to address their emotional problem about guilt before they address their guilt. They need to do this particularly when their secondary emotional problem gets in the way of them dealing with their primary guilt. However, despite the interfering presence of their secondary problem, your client may still want to target their primary guilt. There are two ways of dealing with this situation: ⦿

Provide a rationale to help your client target their secondary problem. For example, explain to your client that their secondary problem is like having a ball and chain around their leg while they are climbing a steep hill (akin to their primary feelings of guilt). In the same way as climbing the hill is easier when they remove the ball and chain from their leg, dealing with their primary guilt is easier when they deal with their secondary problem first.

132    Dealing with guilt

⦿

Go along with your client’s wish to deal with their primary guilt and, when they fail to do so, help them to understand that the reason why they failed is because they had not addressed their secondary problem and then agree that they will now do so.

Developing and rehearsing non-​g uilt, remorse-​b ased world views People develop views of the world as it relates to them that make it more or less likely that they will experience UNEs. The world views that render you vulnerable to guilt do so in a similar way to the chronic guilt-​based general rigid/​extreme attitude discussed above (i.e., ‘Whenever I am involved, I must make sure that nothing bad happens or others’ feelings are not hurt. If I don’t, it is all my fault and I am a bad person’) by making you focus unduly on things you have done that you think are wrong, your failures to do the right thing and the hurt you think you have caused others. However, these guilt-​based world views have this effect on you much more widely. It is important that you develop realistic views of the world that will help you to deal with guilt and experience remorse instead. In Table 4.1, you will find an illustrative list of such world views rather than an exhaustive one, so you can get an idea of what I mean, which will enable you to develop your own. In Table 4.1, I first describe a world view that renders you vulnerable to guilt and then I give its healthy alternatives You will see that the latter views are characterised by the idea that you are as important and as fallible as others, whereas, in the former, you are less important and more responsible than others. If you hold flexible/​non-​extreme attitudes that are consistent with the views of the world listed on the right-​hand side of Table 4.1, and if you act and think in ways that are, in turn, consistent with these flexible/​non-​ extreme attitudes, you will become less prone to guilt. In Chapter 5, I discuss unhealthy regret and how to deal with it.

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Table 4.1  World views that render you vulnerable to guilt and help you to deal with guilt Views of the world that render you vulnerable to guilt

Views of the world that help you deal with guilt

⦿

Other people’s desires are more important than my own

⦿

My desires are no less important to me than others’ desires are to them. I can flexibly and healthily prioritise my desires in the same way as others can flexibly and healthily prioritise theirs

⦿

When I am involved I have responsibility for the hurt feelings of others.

⦿

When I am involved, I have responsibility for my actions, but ultimately I am not responsible for the feelings of others. They are responsible

⦿

In the moral domain, I expect more of myself than I do of others

⦿

In the moral domain, I can expect the same of myself as I can expect of others

⦿

It is possible to always act morally

⦿

It is rarely possible to always act morally since, if you do the right thing from one perspective, you may be doing the wrong thing from another perspective

⦿

Saying ‘No’ to others is a sign of selfishness

⦿

Saying ‘No’ to others may be selfish, but is more likely to be a sign of healthy self-​care

C H A P T E R

5 Dealing with unhealthy regret

In this chapter, I begin by presenting REBT’s way of understanding unhealthy regret and then address how to deal with this emotional problem.

UNDERSTANDING UNHEALTHY REGRET In understanding unhealthy regret, we need to know what we tend to make ourselves unhealthily regretful about (i.e., its major inference themes), what attitudes we hold, how we act or tend to act, and how we think when we are feeling unhealthy regret. I mentioned in previous chapters that it is important that you use your client’s language when referring to emotional problems. With respect to the term ‘unhealthy regret’, you need to be aware that not all clients with a ‘regret’ problem resonate with the term ‘unhealthy regret’. They may identify more closely with terms like ‘overthinking about the past’ or ‘indecisiveness about the future’. If so, your task is to satisfy yourself and your client that these terms represent the UNE known in REBT as unhealthy regret. Once you have done so, use your client’s language and write this down in your client’s notes. There are, in my view, two forms of regret: retrospective regret where you are regretful about matters in the past and prospective regret where you are mindful of what you may regret in the future, which impacts on your present behaviour and future.

Major inference themes in unhealthy regret There are two major themes in relation to your personal domain that are implicated in unhealthy retrospective regret: ⦿

You took action in the past and wished you had not done so.

DOI: 10.4324/9781003424338-6

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⦿

You failed to take action in the past and wished you had done so.

⦿

You face uncertainty about the consequences of taking action now or in the future.

There is one major theme in relation to your personal domain that is implicated in unhealthy prospective regret:

Your client may not resonate with the above schema and, in these cases, you should encourage them to put it aside and just focus on what they tend to feel unhealthy regret about. REBT theory values flexibility and this includes the freedom not to use REBT terms, schemas and frameworks.

Rigid/​e xtreme attitudes As I explained in Chapter 1, according to REBT, inferences on their own do not account for emotional problems. It is possible, therefore, for you to make the same inferences as listed above and be healthily regretful, but not unhealthily regretful. In order for you to feel unhealthy regret about taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so and about the uncertainty you face about making a decision1 now or in the future, you have to hold a rigid/​extreme attitude. If your client is unsure about the mediating role that rigid/​ extreme attitudes play in their unhealthy regret, ask them how they would feel if they had strong conviction in the flexible/​non-​ extreme alternatives to their unhealthy regret-​ creating rigid/​ extreme attitudes. In using this strategy, it is important that you formulate the flexible/​non-​extreme attitudes for your client, who cannot be expected to do this for themself at this stage. When you do this, ensure that you match your client’s rigid attitude with a flexible alternative and their extreme attitude with a non-​extreme alternative, and then ask them how they would feel if they had strong conviction in this flexible/​ non-​ extreme attitude. For example: ‘Let me outline two sets of attitudes towards you having chosen to study philosophy at university when you now think that doing so was a mistake and you tell me which leads to unhealthy regret and which leads to healthy regret. The first

136    Dealing with unhealthy regret

set of attitudes is as follows: “I absolutely should not have made the mistake that I did make, and I am a fool for not taking into account the likely impact studying philosophy would have on my earning potential”. The second set of attitudes is: “I would have much preferred not to have made the mistake that I made, but I am not immune to making mistakes and I don’t have to have such immunity. I am not a fool for not taking into account the likely impact studying philosophy would have on my earning potential, rather I am a fallible human being who is capable of doing the right thing and of making mistakes.” Now which set of attitudes would lead to unhealthy regret and which set would lead to healthy regret?’ Once your client can see that their rigid/​ extreme attitudes underpin unhealthy regret and their flexible/​ non-​ extreme attitudes underpin healthy regret, they have understood the mediating role of attitudes. This is quite an elegant strategy since it accomplishes a number of things at once: ⦿

It addresses your client’s doubts about the mediating role of rigid/​ extreme attitudes in unhealthy regret if they have such concern.

⦿

It introduces flexible/​ non-​ extreme attitudes as a meaningful alternative to these rigid/​extreme attitudes.

⦿

It helps your client to see that holding flexible/​ non-​ extreme attitudes can have beneficial effects.

Behaviour associated with unhealthy regret When you hold a rigid/​extreme attitude towards taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so and towards the uncertainty you face about making a decision now or in the future, you will act or tend to act in a number of ways. When you are focused on the past in unhealthy retrospective regret: ⦿

You review physical evidence in the hope of finding something that you missed at the time that would have led you to have made the best decision2 and not stopping until you feel at ease.

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⦿

You seek reassurance from others that the best decision was made, but do not feel reassured.

When you are focused on the present/​future in unhealthy prospective regret: ⦿

You review physical evidence in order to find the best decision possible and feel certain that you have done so, and you don’t stop until you have done so to your satisfaction.

⦿

You do more research until you have gotten all possible information so that you can be certain that you can make the best decision.

⦿

You seek guidance from others about what is the best decision you can make until you feel certain that have found it.

⦿

You are indecisive.

You will see from the above list that these behaviours get in the way of you thinking clearly about what you did or what you failed to do and the reasons for this so that you can understand and learn from the situation. If you ask your client whether they want to change their unhealthy regret-​related behaviour, their response will be affected by their mood. If they are currently feeling unhealthy regret, they are less likely to see that this behaviour is dysfunctional than when they are not feeling unhealthy regret. In these circumstances, it may be useful to encourage them to imagine that they are advising a friend who displays the same unhealthy regret-​related behaviour as they do. What would they say to this friend about the functionality or dysfunctionality of such behaviour? They are more likely to see that their own unhealthy regret-​related behaviour is dysfunctional after they have told this ‘friend’ that the same behaviour is dysfunctional.

Thinking associated with unhealthy regret When you hold a rigid/​extreme attitude towards taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so and towards the uncertainty you face about making a decision now or in the future, you will tend to think in a number of ways. Remember what I said in Chapter 1: the thinking that accompanies your unhealthy regret is the result of your inference (i.e., that you

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took action in the past and wished you had not done so, failed to take action in the past and wished you had done so and face uncertainty about making a decision now or in the future), is being processed by your rigid/​ extreme attitude and therefore it is likely to contain a number of thinking errors that I present in Appendix 1. I list the main features of this post-​ rigid/​extreme attitude unhealthy regret thinking below. Please note that all these thinking consequences are ruminative in nature. When you are focused on the past in unhealthy retrospective regret: ⦿

You revisit the decision in your mind with the purpose of discovering what would have led you to have made the best decision possible and you criticise yourself for not knowing what it was and for thereby making the wrong decision.3

⦿

You are sure that you made the wrong decision.

⦿

You engage in if-​only thinking. You are sure that, if you had taken a different course of action, your life would have taken a much better course.

When you are focused on the present/​future in unhealthy prospective regret: ⦿

You review all the evidence in your mind until you are sure that you have made the best decision, but without ever achieving such certainty.

⦿

You think that you have missed something crucial, but do not know what it is and you search for the missing ingredient in your mind until you have found it.

As you can see, such thinking exaggerates the negative consequences of your behaviour and also ignores the role of context. Post-​rigid/​extreme attitude unhealthy regret thinking may be in words or in mental images. One of the main features of post-​rigid/​extreme attitude thinking is that it is compelling. As such, it is quite easy for your client to get caught up in this way of thinking and think that it reflects reality. This is an example of ‘cognitive-​emotive’ reasoning: if a thought is plausible and emotionally compelling, therefore it must be true. It is important that you help your client to understand how their mind works with respect to the thinking consequences of rigid/​ extreme attitudes and to encourage them to use such thoughts to go back to address the rigid/​extreme attitudes that spawn them.

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When they have done this, you can encourage them to respond to these thinking consequences of rigid/​extreme attitudes as these attitudes will not disappear just because they have examined them. When your client responds to these thinking consequences of rigid/​extreme attitudes, they need to do so only a few times on any one occasion. After that, they need to accept the presence of such thinking without engaging with it. To summarise, your clients need to: ⦿

identify the presence of the thinking consequences of rigid/​ extreme attitudes (see Appendix 1)

⦿

trace these back to the source of this mode of thinking (i.e., identify the underlying rigid/​extreme attitudes)

⦿

examine these rigid/​extreme attitudes

⦿

respond briefly to the thinking consequences of such attitudes, but not get overly involved in this process

⦿

accept the lingering presence of these thinking consequences without engaging with them

⦿

get on with the business of living.

HOW TO DEAL WITH UNHEALTHY REGRET If you are prone to unhealthy regret, you tend to experience this emotional problem in a variety of different settings and in response to a variety of instances where you took action in the past and wished you had not done so, failed to take action in the past and wished you had done so and when you are uncertain about making a decision now or in the future. Here is how to deal with unhealthy regret so that you become less prone to it.

Step 1: Identify which type of unhealthy regret you experience and the reasons why unhealthy regret is a problem for you and why you want to change While unhealthy regret is generally regarded as an emotional problem, it is useful for you first to be clear with yourself whether you are experiencing

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unhealthy retrospective regret or unhealthy prospective regret. If you experience both, you need to deal with them one at a time. Then, you need to spell out reasons why unhealthy regret is a problem for you and why you want to change. I suggest that you keep a written list of these reasons and refer to it as needed as a reminder of why you are engaged in a self-​help programme. I discuss the healthy alternative to unhealthy regret in Step 4. It is important to remember that, if your client feels unhealthy regret a lot of the time, they may think that ‘feeling regret’ is an appropriate response to times when they took action in the past and wished they had not done so, failed to take action in the past and wished they had done so or whenever they are uncertain about making a decision now or in the future. In these circumstances, it is important to introduce the idea of feeling healthily regretful as the healthy alternative to unhealthy regret a little earlier than you would normally do (see Step 4). When you do so, you need to help your client clearly differentiate between unhealthy and healthy regret. When you have done so, you can then carry out a cost-​ benefit analysis of unhealthy regret and its healthy alternative, healthy regret. This involves helping your client to spell out the perceived advantages and disadvantages of both emotions. Respond to any perceived advantages of unhealthy regret and perceived disadvantages of healthy regret, correcting any misconceptions that your client reveals about these issues. For example, imagine that your client thinks that feeling unhealthy prospective regret will help stop them from making a poor decision now and that feeling healthy prospective regret would not achieve the same end. In this case, help them to see that precisely the reverse is true. The indecision that stems from holding a rigid/​extreme attitude that underpins unhealthy prospective regret means that your client feels compelled to take no action when action is probably beneficial for them, while healthy prospective regret enables the client to take a calculated risk based on a flexible/​non-​extreme attitude.

Step 2: Take responsibility for your unhealthy regret In REBT, we argue that what you do or don’t do does not make you feel unhealthy regret; rather, you create these feelings through the rigid/​

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extreme attitudes that you hold towards what you do or don’t do. Unless you accept this point, you will not address your unhealthy regret productively. Rather, you will think that the only way not to feel unhealthy regret is by always ensuring that you made the right decision in the past and that you will do so now and in the future. The idea that emotional problems (including unhealthy regret) are based largely on the attitudes that a person holds towards what happens to them is, as you know, a central plank in REBT. However, for many clients, it will be a new idea. Thus, your client may hold that the reason they are unhealthily regretful, for example, is that it is inherently terrible to make the wrong decision4 that unhealthy regret is caused by such a mistake. It may seem that the client is taking responsibility for this emotion of unhealthy regret and is taking responsibility for their wrong decision-​making. However, on closer inspection, this is not the case. In REBT, we don’t say that making the wrong decision causes unhealthy regret. This is an example of ‘A–​ C’ thinking where ‘A’ is the person’s action of wrong decision-​making and ‘C’ is the emotion of unhealthy regret. Rather, we argue that the reason that the person experiences unhealthy regret is largely due to the fact that they hold a set of rigid/​ extreme attitudes towards such wrong decision-​making. If the person held a set of flexible/​non-​extreme attitudes towards making a wrong decision, they would experience healthy regret rather than unhealthy regret. What you need to do, then, is to help your client see that they create their unhealthy regret by holding a set of rigid/​ extreme attitudes towards their wrong decision-​making. In this way, you can help them take two types of responsibility, not only for their actions but also for the rigid/​ extreme attitudes that underpin their unhealthy regret. If your client continues to have difficulty accepting responsibility for their feelings of unhealthy regret, it is important for you to identify the source of this difficulty. In the Client’s Guide, I mention one common obstacle that stops clients from accepting such responsibility (i.e., the self-​ blame that a client would engage in were they to assume responsibility for making themself unhealthily regretful). However, there is one other obstacle to accepting responsibility as shown in the following: ⦿

Hopelessness about change (e.g., ‘I am a stupid person. I don’t just think I am. I keep on making wrong decisions’).

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Here the client is reluctant to see their unhealthy regret as an attitude problem. They consider that they are stupid because of their actions or inactions. The best intervention here involves invoking the client’s empathy by asking if they would tell a loved one who did exactly the same thing that they did, for example, that they were stupid for doing so. If the client can assume the role of compassionate observer (rather than self-​punitive experiencer), it often helps them to see that their unhealthy regret is an attitude problem (e.g., ‘I think I am a stupid person’) for which they can take responsibility and thereby change rather than an identity problem (e.g., ‘I am a stupid person. I don’t just think I am’), which they can’t do anything about if it were true. It is important to help your client to understand the impact of these obstacles on their emotional problems. Then, help them to develop alternatives to these obstacles and review the impact of these alternatives on their emotional problem-​solving. This often helps a client to deal effectively with these obstacles. If not, you may need to do a more detailed assessment of the obstacle, which is outside the brief of this book.

Step 3: Identify the themes you tend to be unhealthy regretful about The best way of identifying unhealthy regret-​ related inference themes to which you are particularly vulnerable is by understanding the themes associated with unhealthy regret, and seeing which are present when you feel unhealthy regret. As I outlined above, there are three such themes: Themes in unhealthy retrospective regret: ⦿ ⦿

You took action in the past and wished you had not done so. You failed to take action in the past and wished you had done so.

Theme in unhealthy prospective regret: ⦿

You face uncertainty about the consequences of taking action now or in the future.

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If your client finds it difficult to find their unhealthy regret-​related theme, you can help them by assessing a few specific examples of their unhealthy regret. Have them focus on a specific situation in which they felt unhealthy regret and ask them what they were most unhealthily regretful about. If they still find it difficult to identify the theme in this or other specific situations, use the ‘magic question’ technique. This involves you doing the following: ⦿

Have your client focus on the situation in which they felt unhealthy regret.

⦿

Ask them to nominate one ingredient that would eliminate or significantly reduce their unhealthy regret without changing the situation.

⦿

The opposite of this nominated ingredient is what they are most unhealthily regretful about.

Sam was struggling to identify the specific theme in his unhealthy prospective regret about not making his decision about where to go on holiday. Sam’s therapist helped him to use the ‘magic question’ technique as follows: ⦿

She asked Sam to focus on the situation in which he felt unhealthy regret: ‘I am reading holiday brochures.’

⦿

She asked Sam to nominate one ingredient that would eliminate or significantly reduce his unhealthy regret without changing the situation: ‘Being sure that I will have a great holiday.’

⦿

The opposite of this nominated ingredient is what Sam is most unhealthily regretful about: ‘Not being sure that I will have a great holiday.’

If you assess a number of specific examples of your client’s unhealthy regret this way, the unhealthy regret-​ related theme should be apparent. In Sam’s case, not being sure that his decisions would have a good outcome.

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It may be that there are two unhealthy regret-​related themes present in your client’s unhealthy regret. For example, your client may feel unhealthy retrospective regret about not taking action in the past when they wished they had and, in a different life area, about taking a particular course of action that they wished they had not taken. If this is the case, deal with them one at a time and have your client nominate the theme that they want to focus on first.

Step 4: Identify the three components of your unhealthy regret response and set goals with respect to each component The next step is for you to list the three elements of your unhealthy regret response in the face of each of the relevant themes listed above.

Identify the three components of your unhealthy regret response I use the term ‘unhealthy regret response’ to describe the three main components that make up this response. The three components of your unhealthy regret response are the emotional, behavioural and thinking components.

Emotional component The emotional component here is, of course, unhealthy regret.

Behavioural component The behavioural component concerns overt behaviour or action tendencies that you engage in or ‘feel like’ engaging in when you feel unhealthy regret. Consult the list that I provided to help you identify your behaviour associated with each relevant theme when you feel unhealthy regret (see pp. 136–137).

Thinking component The thinking component associated with unhealthy regret is listed on p. 138. Again, these may be in words or in mental pictures. Consult the list if necessary.

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Set goals with respect to each of the three components You need to set goals so that you know what you are striving for when you deal effectively with unhealthy regret. The three goals are emotional, behavioural and thinking goals.

Emotional goal Your emotional goal is healthy regret rather than unhealthy regret (or whatever synonym you prefer for the term ‘healthy regret’). Healthy regret is an HNE, which is an appropriate response to taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so or to the uncertainty you face about making a decision now or in the future. It helps you to think objectively about the situation and your response to it and helps you to move on with your life rather than get stuck or bogged down. The concept that healthy regret is the healthy alternative to unhealthy regret in the face of taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so or the uncertainty you face about making a decision now or in the future is based on the following idea. These adversities are negative and therefore it is realistic to have a negative emotion about them. The choice, therefore, is between a UNE (unhealthy regret) or an HNE (healthy regret). However, what if your client specifies unrealistic goals? Here are a number of such goals and how to respond to clients who nominate them: ‘I don’t want to feel unhealthy regret.’ Show your client that they have indicated what they do not want to feel in the face of taking action in the past and wishing they had not done so, failing to take action in the past and wishing they had done so or being uncertain about making a decision now or in the future, but not what they do want to feel. Help them to specify an emotion to aim for, like healthy regret! ⦿

‘I want to feel less unhealthy regret.’ Show your client that, as unhealthy regret is a disturbed emotion, wanting to feel less unhealthy regret is still to nominate ⦿

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a disturbed emotion, albeit of lesser intensity. Show them that healthy regret can be strong and healthy. ‘I don’t want to feel anything.’ Not feeling anything in the face of taking action in the past and wishing they had not done so, failing to take action in the past and wishing they had done so or being uncertain about making a decision now or in the future will not help your client to be appropriately geared up to deal with it. Help them to see this. Also, show them that the only way that they could achieve a state of not feeling anything is to feel completely indifferent about taking action in the past and wishing they had not done so, failing to take action in the past and wishing they had done so or being uncertain about making a decision now or in the future. In order to do this, your client would have to lie to themself. Show them this and discourage them from setting such a goal. ⦿

Behavioural goal Your behavioural goal should reflect actions that are based on healthy regret about taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so or being uncertain about making a decision now or in the future, rather than unhealthy regret. The following are the most common behaviours associated with healthy regret. You may wish to compare these behaviours with those associated with unhealthy regret that I presented on pp. 136–137. In healthy retrospective regret: ⦿

If you come across physical evidence pertaining to the past decision, you do not review this as it will not change the past.

⦿

You tell others, if relevant, what you did or did not do and why you acted or failed to act in the way that you did.

In healthy prospective regret: ⦿

You review physical evidence in order to find the option that will yield the best outcome, but without needing to feel certain about this.

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⦿

You realise that more research is always possible, but decide not to do that research and to make a choice of action based on the available evidence.

⦿

You share your thinking with others for their feedback and to make any changes based on that feedback, but you do not need to feel certain about the outcome of your decision.

⦿

You make a decision when it is right for you to do so.

It is important that your client understands that, as they strive to develop healthy behavioural responses to taking action in the past while wishing they had not done so, failing to take action in the past while wishing that they had done so or to being uncertain about making a decision now or in the future, they will still feel the urge to act in ways that are dysfunctional, as listed on pp. 136–137. Help them to understand the reason for this. Explain to them that, as they examine their attitudes and commit themself to strengthening their conviction in their flexible/​non-​extreme attitudes and to weakening their conviction in their rigid/​extreme attitudes, the latter will still be active and produce urges for them to act dysfunctionally. Encourage your client to accept these urges, to recognise that they do not have to act on them and to use them as cues to act in functional ways.

Thinking goal As well as setting behavioural goals related to the feeling of healthy regret about taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so or being uncertain about making a decision now or in the future, it is important that you set thinking goals associated with this emotion. The following are the most common forms of thinking associated with healthy regret rather than unhealthy regret. Again, you may wish to compare these forms of thinking with those associated with unhealthy regret that I presented on p. 138. In healthy retrospective regret: ⦿

If you revisit the decision in your mind, you remind yourself that you acted according to the information that was available at the time and that was the best you could have done.

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⦿

You recognise that there is no way of knowing if you made the right or wrong decision. You made a decision that you thought was right at the time.

⦿

You recognise that, if you had acted differently, your life may have been better, it may have been worse or it may have made no difference.

In healthy prospective regret: ⦿

You review all the evidence and then make a decision based on the probability, not certainty, that you have chosen wisely.

⦿

You recognise that you may have missed something crucial, but accept that possibility and do not delay making a decision.

As the above list shows, the dominant feature of thinking associated with healthy regret is that it is non-​ruminative, realistic and balanced. Please remember that such thinking may be in words or in mental pictures. The point I made above with respect to a client’s behavioural goals is also relevant with respect to their thinking goals. A client will still have some conviction in their rigid/​ extreme attitudes until they have full conviction in their flexible/​ non-​ extreme attitudes. Given this, your client’s rigid/​ extreme attitudes will have some impact on their subsequent thinking as they strive to achieve their goals. Thus, highly distorted thoughts will still come into your client’s mind. Help your client to understand why this is the case. When you come to help them deal with these forms of post-​ rigid/​ extreme-​ attitude thinking, do one or more of the following as indicated. Discuss this issue with your REBT supervisor, if necessary: ⦿

Encourage your client to acknowledge the existence of such thoughts without trying to suppress them, distract themself from them or engage with them.

⦿

If relevant, use the presence of this post-​rigid/​extreme-​attitude thinking to help your client to identify and deal with the rigid/​ extreme attitudes.

⦿

Examine the empirical nature of these thinking ‘Cs’ once or twice and then return to the acceptance strategy detailed above.

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Step 5: Identify your general rigid/​e xtreme attitudes and alternative general flexible/​ non-​e xtreme attitudes A general rigid/​extreme attitude leading to your unhealthy regret response is a rigid/​extreme attitude that you hold across situations defined by one of the following themes: taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so or being uncertain about making a decision now or in the future. Its flexible/​ non-​extreme alternative, which will also be general in nature, will account for your healthy regret response.

Identify your general rigid/​extreme attitudes When you identify a general rigid/​extreme attitude, you take a common unhealthy regret-​related theme (i.e., taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so or being uncertain about making a decision now or in the future) and add to this a general rigid attitude and the main extreme attitude that is derived from the rigid attitude. In unhealthy regret, your main extreme attitude may be an awfulising attitude, an unbearability attitude and/​or a self-​devaluation attitude. For example, in unhealthy retrospective regret this might be: ⦿

‘I absolutely should not have taken the course of action that I did back then and it is terrible that I did.’

Identify your alternative general flexible/​non-​extreme attitudes When you identify your alternative general flexible/​ non-​ extreme attitude, you take the same common theme (i.e., taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so or being uncertain about making a decision now or in the future) and add to this a general flexible attitude and the main non-​extreme attitude that is derived from the flexible attitude. In healthy regret, your main non-​extreme attitude will be a non-​awfulising attitude, a bearability attitude and/​or an unconditional self-​acceptance attitude. For example, in healthy retrospective regret this might be:

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⦿

I wish I had not taken the course of action that I did back then, but that does not mean that I absolutely should not have done so. It is unfortunate that I did so, but it is not terrible.’

As you will have noticed in the Client’s Guide, I encourage readers/​ clients to identify and work with their general rigid/​ extreme attitudes and to develop general flexible/​ non-​ extreme attitudes and, as you will see, when they are facing specific instances of their problems, I encourage them to focus on specific examples of both sets of attitudes. This will be at variance with your REBT practice, where you will begin with specific examples of your client’s problems and then proceed to work at a more general level with their problems and how these relate to one another. The reason I have chosen to go ‘general’ rather than ‘specific’ when helping readers/​clients to deal with their emotional problems is a pragmatic one. In this book, I aim to help people to deal with a range of emotional problems and therefore, in my view, it is best to give readers/​clients general guidance with respect to dealing with this range of problems and then help them to move from the general to the specific rather than vice versa. My considered view was that I just do not have the space to help readers/​clients focus on specific examples of their emotional problems and then generalise from this specific level. Consequently, one way you can help your client who is using the Client’s Guide is to help them to work with specific examples of their emotional problem, in this case, unhealthy regret. Use the following sequence as you do so and help your client to: ⦿

select a specific example of their unhealthy regret problem

⦿

identify what they felt most unhealthily regretful about in the situation

⦿

identify the three specific components of their unhealthy regret response and set specific goals with respect to each component

⦿

identify their specific rigid/​extreme attitudes and alternative specific flexible/​non-​extreme attitudes

⦿

examine their specific attitudes.

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In helping your client to deal with a specific example of their unhealthy regret, you can teach them how to use REBT’s ABCD form, which appears in Appendix 6. The following steps are the same as those that appear in Steps 8−11 later in this chapter. ⦿

Help your client to face the relevant scenario in imagery and to do so while rehearsing their flexible/​non-​extreme attitude.

⦿

Encourage your client to think and act in ways that deepen their conviction in their flexible/​non-​extreme attitude.

⦿

Capitalise on what they have learned.

⦿

Generalise their learning.

Step 6: Examine your general attitudes I recommended in previous chapters that you first examine together your general rigid attitude and its general flexible attitude alternative and then examine together your general extreme attitude and your general non-​ extreme attitude.

Examine your general rigid attitude and its general flexible attitude alternative First, take your general rigid attitude and its general flexible attitude alternative and write them down next to one another on a sheet of paper. Then ask yourself: ⦿

Which is true and which is false?

⦿

Which has largely constructive results and which has largely unconstructive results?

⦿

Which is sensible logically and which does not make sense?

Write down your answer to each of these questions on your piece of paper, giving reasons for each answer. Consult Appendix 2 for help with the answers to these questions, which you need to adapt and apply to the attitudes you are examining.

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Examine your relevant general extreme attitude and its general non-​extreme attitude alternative Next, take your general extreme attitude (e.g., awfulising attitude, unbearability attitude or self-​devaluation attitude) and its general non-​ extreme attitude alternative (e.g., non-​ awfulising attitude, bearability attitude or unconditional self-​acceptance attitude) and again write them down next to one another on a sheet of paper. Then, ask yourself the same three questions that you used with your general rigid attitude and its general flexible attitude alternative. Again, write down your answer to each of these questions on your piece of paper, giving your reasons for each answer. I suggest that you consult Appendix 3 (for help with examining awfulising attitudes and non-​awfulising attitudes), Appendix 4 (for help with examining unbearability attitudes and bearability attitudes) and Appendix 5 (for help with examining devaluation attitudes and unconditional acceptance attitudes). Again, you need to adapt and apply these arguments to the attitudes you are examining. You should now be ready to commit to acting and thinking in ways consistent with your general flexible/​non-​extreme attitude. I included Appendices 2−5 in the Client’s Guide as general guidelines to help readers/​clients to examine their rigid/​extreme and flexible/​ non-​ extreme attitudes (reproduced in this book as Appendices 2−5). If you are working with a client who is using the Client’s Guide, you will have a chance to look at the examining work that your client has done at this point and give them feedback on that work. No book can provide such feedback. I have suggested that readers/​clients examine their rigid attitude and their flexible attitudes together and then their relevant extreme attitude and their non-​extreme attitude equivalent together using three criteria as shown below: ⦿

Rigid attitude vs. flexible attitude ⦿

empirical status

⦿

pragmatic status

⦿

empirical status

⦿

⦿

logical status

Extreme attitude vs. non-​extreme attitude

Dealing with unhealthy regret    153

⦿ ⦿

logical status pragmatic status.

The final point I want to make about examining attitudes concerns the concept of persuasiveness. Perhaps the most important aspect of the examining process is for your client to develop arguments concerning the false, illogical and unhealthy nature of their rigid/​ extreme attitudes and the true, logical and healthy nature of their flexible/​non-​extreme attitudes that are persuasive to them. So, encourage your client to develop such persuasive arguments and to make a note of these for future reference.

Step 7: Dispel the myth of the perfect decision solution and understand your behaviour in context Once you have committed yourself to your general flexible/​non-​extreme attitude, it is important that you do the following.

In retrospective regret Look back at events about which you have made yourself unhealthily regretful, but this time view them through the eyes of your general flexible/​non-​extreme attitudes. Recognise that your decision was based on the information that was available to you at the time and, even if you failed to use some of that information, that was the reality. When you feel unhealthy retrospective regret, you are demanding that you absolutely should have known what you did not know and made a decision that would have turned out well for you. This implies that you could see into the future and gauge with accuracy the outcome of all the different courses of action open to you and select the right one. In other words, you are demanding perfect conditions, which would have enabled you to make a perfect decision that, in turn, would have yielded a perfect outcome. In healthy retrospective regret, you recognise the complexity of the situation and the fact that there are many influences on your behaviour. Thus, back then, you were in the position of choosing a course of action in the face of many complex variables. If you can stand back and be humble, you will see that making perfect decisions is usually not possible. As such, healthy retrospective regret helps you to learn from situations in which

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you think you may have made a mistake in deciding to take a course or not to take a course of action and to use this learning in future situations.

In prospective regret Here, recognise that your job is to consider the information at your disposal before making a decision and that, if you wait for certainty or postpone making your decision by getting even more information, then you are choosing to delay, which is also an option and one that will probably yield the worst outcome for you. When you think about when is the best time to help your client deal with uncertainty and recognise that there is, in all probability, no risk-​free option available, your answer as a REBT therapist is when they have addressed their rigid/​extreme attitudes so that you can discuss this important issue with them through the non-​ distorting lens of their flexible/​ non-​ extreme attitudes. Thus, help your client to understand the importance of dealing with their rigid/​extreme attitudes before reflecting on these other matters.

Step 8: Face your unhealthy regret-​r elated theme in imagery I hope that you have made a commitment to act on your general flexible/​ non-​extreme attitudes. Assuming that you have, your basic task is to face up to taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so or being uncertain about making a decision now or in the future and to learn to think flexibly and in a non-​extreme way about your particular theme. Up to this point, you have worked at a general level with respect to your unhealthy regret-​ related theme, dealing with the general rigid/​ extreme attitudes that account for your unhealthy regret and developing your alternative general flexible/​non-​extreme attitudes. However, when you come to apply your general flexible/​ non-​ extreme attitudes in dealing with taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so or being uncertain about making a decision now or in the future, you need to remember one important point. Since you make yourself unhealthily regretful about specific events (actual or imagined), you need to deal

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with these by rehearsing specific variants of your general flexible/​non-​ extreme attitudes. Since unhealthy regret largely involves your relationship with that part of you that made or may make the wrong decision, you will derive benefit from using imagery while you face these specific situations. In doing so: ⦿

Imagine a specific situation in which you felt unhealthy regret or may feel unhealthy regret about taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so or being uncertain about making a decision now or in the future and focus, in your mind’s eye, on what you felt most unhealthy regret about (i.e., your ‘A’).

⦿

Focus on this ‘A’ while rehearsing a specific flexible/​non-​extreme attitude relevant to the situation. As you do this, try to make yourself feel healthily regretful, rather than unhealthily regretful.

⦿

Then, see yourself acting in ways consistent with your flexible/​non-​ extreme attitude, e.g., telling people that while you may have made the wrong decision in the past you have decided to let that go and will go forward with a new flexible approach to making important decisions or making a decision in the present and telling people what you have done.

⦿

Recognise that some of your post-​ rigid/​ extreme-​ attitude thinking may be distorted. Respond to it without getting bogged down doing so. Accept the presence of any remaining distorted thoughts without engaging with them.

⦿

Repeat the above steps until you feel sufficiently ready to put this sequence into practice in your life.

If you find that facing your unhealthy regret-​related ‘A’, in your mind’s eye, is too much for you, use the ‘challenging, but not overwhelming’ principle that I introduced in Chapter 2 (see p. 53). This means that, instead of imagining yourself facing a situation where you, for example, made a decision that you think turned out very badly, select a situation where the consequences of a poor decision were less negative for you. Then employ the same steps that I have outlined above. Work in this way with modified unhealthy regret-​related ‘A’s’ until you find your original one ‘challenging, but not overwhelming’ and then use the steps again.

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Your client may say that they can’t get very clear images when they try to picture events in their mind’s eye. While they may get more out of imagery techniques if they can get such clear images, they will still get something out of facing unhealthy regret-​related situations in imagery even if their images aren’t clear. So, if your client wants to face their particular adversity in imagery before they do so in reality, encourage them to do so no matter how clear their mental images are.

Step 9: Forgive yourself and show yourself compassion Even if your unhealthy regret5 is based on a rigid attitude and an awfulising or an unbearability attitude, it is likely that you will also be critical and unforgiving of yourself for not making the ‘right’ decision in the relevant circumstances. Thus, it is important that you develop an attitude of self-​ forgiveness and then develop self-​compassion. Here are examples of each in retrospective regret.

Self-​forgiveness ⦿

‘I may have made the wrong decision and, if I did, I forgive myself as a fallible human being who did the wrong thing. I am not stupid or an idiot. I am the same person even if I made the right decision. The rightness or wrongness of my decision varies, but I do not.’

Self-​compassion ⦿

‘It is difficult being human when there are so many variables to consider before making an important decision. I am not alone in finding it a struggle. The vast majority of people also struggle with this. So, I am going to remind myself that, as I did not set out to make a wrong decision, I am going to give myself a break and recognise that I did the best that I could at the time. Then I will let any remaining self-​critical thoughts stay in my mind without engaging with them or trying to get rid of them. They will go as I get on with the business of living.’

You may find it difficult to help your client to develop self-​ compassion while they are in a self-​critical, self-​unforgiving frame

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of mind. So, it is best to help them develop self-​ forgiveness (or unconditional self-​ acceptance) before you help them to develop self-​compassion (see Dryden, 2013b). However, this will depend on your client. They may find the reverse order more helpful. So be flexible!

Step 10: Capitalise on what you have learned When you have faced a situation in which you experienced unhealthy regret and dealt with it as best you could, it is important that you reflect on what you did and what you learned. In particular, if you were able to face the situation (in unhealthy regret, this will largely be in your mind), and rehearse your specific flexible/​non-​extreme attitudes until you felt healthy regret, then ask yourself how you can capitalise on what you achieved. If you experienced any problems, respond to the following questions: ⦿

Did I face the situation and, if not, why not?

⦿

Did I rehearse my flexible/​non-​extreme attitudes before, during or after facing the situation and, if not, why not?

⦿

Did I execute my plan to face the situation and, if not, why not?

⦿

Did I engage with post-​rigid/​extreme attitude distorted thinking and, if so, why?

Reflect on your experience and put into practice what you have learned the next time you face a situation in which you consider that you acted in a way you wished you had not acted or failed to act in a way you wished you had acted. It is useful to monitor your client’s responses to these questions and help them to reflect on any issues that they have not considered.

Step 11: Generalise your learning Once you have dealt with your unhealthy regret in a specific situation by holding the relevant specific version of your general flexible/​non-​extreme attitude and by acting and thinking in ways that are consistent with it, you can generalise this learning to situations defined by your particular

158    Dealing with unhealthy regret

regret-​based theme (taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so or the uncertainty you face about making a decision now or in the future). Mary was particularly prone to unhealthy prospective regret about making important life decisions, so she followed the steps outlined in this chapter. Thus: ⦿

Mary assessed the three components of her unhealthy regret response and set goals with respect to all three components.

⦿

She identified her relevant general rigid/​extreme attitude regarding making important life decisions (i.e., ‘I must be certain that I am doing the right thing and that I will not regret my decision later and I can’t bear not having such certainty’) that underpinned her unhealthy prospective regret response and her alternative general flexible/​non-​extreme attitude (i.e., ‘I would like to be certain that I am doing the right thing and that I will not regret my decision later, but I don’t need such certainty and I can bear not having it’) that underpinned her healthy prospective regret response.

⦿

She examined both elements of her general rigid/​extreme attitude and her general flexible/​non-​extreme attitude until she clearly saw that the former were false, made no sense and were detrimental to her, and that the latter were true, sensible and healthy.

⦿

She then recognised that she needed to take action now rather than postponing it and decided to take the job she was offered rather than remain in her current job. When she thought that she was making the wrong decision, she reminded herself that she did not know this and did not need to know it and that she would respond productively to whatever happened in the future. As she did so, she tolerated the discomfort that she felt and accepted that some of her distorted and skewed negative thinking would still be in her mind as she did so. She let such thinking be without engaging with it, suppressing it or distracting herself from it.

As this section shows, you can generalise what you learn about dealing with unhealthy regret from situation to situation as defined by your particular regret-​based theme (i.e., taking action in the past and wishing you had not done so, failing to take action in the past and wishing you had done so or facing the uncertainty about making a decision now or in the

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future). If you do this, you will take the toxicity out of the emotional problem of unhealthy regret!

USING REBT’S ABCD FORM TO DEAL WITH SPECIFIC EXAMPLES OF YOUR UNHEALTHY REGRET This chapter is mainly geared to help you deal with your unhealthy regret in general terms. However, you can also use this material to address specific examples of your unhealthy regret. I have developed a self-​help form to provide the structure to assist you in this regard. It is called the ABCD form and it appears with instructions in Appendix 6. In Appendix 6, I outline the major problems that clients have in using this form and how to deal with them.

OTHER IMPORTANT ISSUES IN DEALING WITH UNHEALTHY REGRET In the above section, I outlined an 11-​ step programme to deal with unhealthy regret. In this section, I discuss some other important issues that may be relevant to you in your work to become less prone to this emotional problem. If you want to, you can incorporate them as additional steps in the above step-​by-​step guide at points relevant to you.

Dealing with your safety-​s eeking measures to avoid unhealthy regret I mentioned in Chapter 2 that people use safety-​seeking measures to protect themselves from threat. You may use similar measures to protect yourself from feeling unhealthy regret. Here is how this works from your perspective. In outlining this, I will use unhealthy prospective regret as an example. You reason that, since you feel unhealthy prospective regret facing the uncertainty about making a decision now or in the future, you will take steps to avoid unhealthy regret by not making a decision until you know for certain that it will have a good outcome for you as your life

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pans out. Taking this tack means that you will not take risks in life in case you choose a course of action that may turn out badly. However, this behaviour and the reasoning that leads you to take it are flawed and will serve only to perpetuate your chronic unhealthy regret. This is due to the fact that your unhealthy prospective regret is based not on you facing the uncertainty about making a decision now or in the future, but on your rigid/​extreme attitudes towards this inference. So, if you want to deal effectively with unhealthy regret, you need to take a healthy risk by making a considered decision about a desired course of action without seeking reassurance from others that you are doing the right thing. It is one of the major themes of both the Client’s Guide and this Practitioner’s Guide that, when your client comes to change their behaviour from dysfunctional to functional, they will still experience urges to act dysfunctionally. This is why it is so important to help your client understand the difference between overt actions and action tendencies. In the present context, this means stressing to your client as they strive to act in ways that address their unhealthy regret feelings constructively and thus desist from using unhealthy regret-​related safety-​seeking strategies that they will still feel the urge to use them. Help them to develop ways of accepting, but not necessarily liking, such urges and to implement their healthy regret-​based behaviour, even though such aforementioned behaviour may be present for some time. You may have to help your client identify and respond to rigid/​extreme attitudes such as: ‘If I feel the urge to do something to get rid of my unhealthy regret quickly, then I have to act on that urge.’ Developing and strengthening flexible/​non-​extreme attitudes towards these urges is particularly important for your client.

Accepting a range of outcomes from making a decision In 1983, I decided to take voluntary redundancy from my lecturing job at the University of Aston in Birmingham. After two years of applying for jobs, I got a lectureship at Goldsmiths College, where I stayed until I retired in 2014. Did I make the right decision? I don’t know is the honest answer because I have no way of determining what would have happened to me if I had stayed at Aston. I may have had a better life, a worse life or it may have made no difference. This is the point. If you have a problem

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with unhealthy retrospective regret, for example, you tend to think that, if you had made a different decision, it would have turned out better for you. This conclusion is produced by your rigid/​extreme attitude towards taking action in the past and wishing you had not done so or failing to take action in the past and wishing you had done so. Once you have developed a flexible/​non-​extreme attitude towards these inferences, you will see that, when you make a decision, and it turns out badly for you, it may be that, if you had decided to do something different, it may have turned out better for you, it may have turned out worse or it may have made no difference.

Accepting that you can’t know what you don’t know In unhealthy regret, you tend to hold the view that it is possible to make a decision where everything turns out as you want it to. If it doesn’t, then it is your fault, and you warrant self-​criticism. However, in reality, all you can do is take action or choose not to take action based on the information available at the time. It is always possible to do more research, but, if you do so, you may delay taking action, which may be a mistake. The idea, then, that you should have known what you did not know, which is prevalent in unhealthy regret, is rigid and preposterous. How can you know what you do not know? Giving up such a demand is central to dealing productively with unhealthy regret.

Why you feel unhealthy regret much of the time and how to deal with this If you are particularly prone to unhealthy regret, you will often think that you (a) have taken action in the past and wished you had not done so, (b) have failed to take action in the past and wished you had done so or (c) are facing the uncertainty about making a decision now or in the future. You do this because you hold what I call a ‘chronic unhealthy regret-​based general rigid/​extreme attitude’. Here is an example of such an attitude in unhealthy prospective regret. ⦿

‘Whenever I have an important decision to make, I must make sure that it will turn out well. If it doesn’t, then it is terrible, I can’t bear it and I am a stupid person for not making a better decision.’

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You then take this attitude to relevant situations and, when some negative consequences occur when you choose a course of action or fail to take action, you think that you are at fault if there is a bad outcome. As a result, you constantly think that you are responsible for any negative outcomes that happen or might happen and end up criticising yourself.

How to deal with chronic unhealthy regret In order to deal with this chronic sense of unhealthy regret, you need to develop and apply an alternative general flexible/​non-​extreme attitude that protects you from such unhealthy regret. Here is an example of such an attitude in healthy prospective regret. ⦿

Whenever I have an important decision to make, I want to make sure that it will turn out well, but I do not have to succeed at this. If it doesn’t turn out well, then it is bad, but not terrible, I can bear it and I am not a stupid person for not making a better decision. I am fallible, that’s all.’

Such an attitude will lead you to think that you have made a wrong decision only when there is clear evidence for making such an inference. When there is, you will feel healthy regret rather than unhealthy regret because you will be processing this with a specific flexible/​non-​extreme attitude. If your client finds that the above explanation is too complex, you can help them to see that rigid attitudes towards the presence or absence of unhealthy regret-​related adversities means that, if it is not clear that they have made a good decision, for example, they will assume that they have made a bad one. When their attitudes are flexible, they can be more objective about the presence of these adversities.

How to examine the accuracy of your unhealthy regret-​related inference, if necessary If you are still unsure if you decided on the wrong course of action in the past, for example, answer one or more of the following questions: ⦿

How valid is my inference that I took the wrong course of action (for example)?

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⦿

Would an objective jury agree that I took the wrong course of action? If not, what would the jury’s verdict be?

⦿

Is my inference that I took the wrong course of action realistic? If not, what is a more realistic inference?

⦿

If I asked someone whom I could trust to give me an objective opinion about my inference that I took the wrong course of action, what would the person say to me and why? What inference would this person encourage me to make instead?

⦿

If a friend had told me that they had made the same inference about taking the wrong course of action in the same situation, what would I say to them about the validity of their inference and why? What inference would I encourage this friend to make instead?

Identifying and dealing with the hidden conceit in unhealthy regret It may sound strange, but when you think about unhealthy regret from a particular perspective, an attitude of hidden conceit is revealed. Such conceit is revealed when you are asked to judge someone who has acted in a situation in the same way as you. Let me give an example from unhealthy retrospective regret to make this clear. Nathan felt unhealthy retrospective regret whenever he thought about his decision to break off his relationship with his fiancée two years ago. He thought he made a mistake because he is still single while his ex-​f iancée is herself engaged. Nathan’s rigid/​extreme attitude with respect to this decision was: ‘I made the wrong decision by breaking off my engagement, and I absolutely should not have done so.’ At the same time, Nathan’s friend Pete also broke off his engagement and is also still single. When Pete talked about the fact that he also made a mistake, Nathan told him that, if it was a mistake, he is human for doing so and he should cut himself some slack. This was precisely the attitude that Nathan did not apply to himself. He refused to cut himself some slack and regarded himself as stupid for making the mistake that he holds now that he absolutely should not have made. Nathan’s hidden conceit is thus revealed in his differential expectations of himself and Pete. He sees Pete as fallible with limitations. He sees himself as someone who must not make the same mistake as he permits Pete to have made. This ‘holier than thou’ attitude is common in unhealthy regret: ‘I must make perfect decisions and, if not, I am stupid.’

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It is very important that you deal with this hidden conceit if you want to become less prone to unhealthy regret. You do this in ways that should now be familiar to you: ⦿

By all means have high standards for yourself in making important decisions, but remind yourself that you don’t always have to achieve these standards.

⦿

Accept yourself as a fallible human being with limitations in the same way as you would others. Then develop self-​compassion. I recommend the writings of Paul Gilbert (e.g., 2009) on this subject.

Please bear in mind that your client may not resonate with the term ‘hidden conceit’. If this is the case, help them to suggest a term that is more acceptable to them, but that accurately represents the concept.

Assessing and dealing with emotional problems about unhealthy regret In previous chapters, I discussed the concept of meta-​disturbance (literally disturbance about disturbance). It is important to assess carefully the nature of this meta-​disturbance about unhealthy regret before you can best deal with it. The best way to start dealing with the assessment of any emotional problems you might have about unhealthy regret is to ask yourself the question: ‘How do I feel about my feeling of unhealthy regret?’ The most common emotional problems that people have about unhealthy regret are as follows: anxiety, depression, unhealthy regret, shame and unhealthy self-​anger. I refer you to the chapters on anxiety, depression, unhealthy regret, shame and unhealthy anger for help on how to deal with these meta-​emotional problems about unhealthy regret. Your client will sometimes need to address their emotional problem about unhealthy regret before they address their unhealthy regret. They need to do this particularly when their secondary emotional problem gets in the way of them dealing with their primary unhealthy regret. However, despite the interfering presence of their secondary problem, your client may still want to target their primary unhealthy regret. There are two ways of dealing with this situation:

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⦿

Provide a rationale to help your client target their secondary problem. For example, explain to your client that their secondary problem is like having a ball and chain around their leg while they are climbing a steep hill (akin to their primary feelings of unhealthy regret). In the same way as climbing the hill is easier when they remove the ball and chain from their leg, dealing with their primary unhealthy regret is easier when they deal with their secondary problem first.

⦿

Go along with your client’s wish to deal with their primary unhealthy regret and, when they fail to do so, help them to understand that the reason why they failed is because they had not addressed their secondary problem and then agree that they will now do so.

Developing and rehearsing healthy regret-​b ased world views People develop views of the world as it relates to them that makes it more or less likely that they will experience UNEs. The world views that render you vulnerable to unhealthy regret do so in a similar way to the chronic unhealthy regret-​ based general rigid/​ extreme attitude discussed above (i.e., ‘Whenever I have an important decision to make, I must make sure that it will turn out well. If it doesn’t, then it is terrible, I can’t bear it, and I am a stupid person for not making a better decision’) by making you focus unduly on courses of action that you think were wrong, for example. However, these unhealthy regret-​based world views have this effect on you much more widely. It is important that you develop realistic views of the world that will help you to deal with unhealthy regret and experience healthy regret instead. In Table 5.1, you will find an illustrative list of such world views rather than an exhaustive one, so you can get an idea of what I mean, which will enable you to develop your own. In Table 5.1, I first describe a world view that renders you vulnerable to unhealthy regret and then I give its healthy alternative. You will see that the latter views are characterised by the idea that you are fallible and can make good and bad decisions, whereas, in the former, you must only make good decisions. If you hold flexible/​non-​extreme attitudes that are consistent with the views of the world listed on the right-​hand side of Table 5.1, and if you

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Table 5.1 World views that render you vulnerable to unhealthy regret and help you to deal with unhealthy regret Views of the world that render you vulnerable to unhealthy regret

Views of the world that help you deal with unhealthy regret

⦿

It is possible to make perfect decisions that have only positive short-​term and long-​term consequences

⦿

It may occasionally be possible to make perfect decisions that have only positive short-​term and long-​term consequences, but most of the time it’s not

⦿

As it is possible to make perfect decisions, I must be able to make such decisions and I am stupid if I can’t

⦿

Even if it is possible to make perfect decisions, it does not follow that I have to do so. If I don’t, I’m fallible, not stupid

⦿

Unless I have all the relevant information to hand, I must not make important decisions. I can only make such decisions when I am confident that I have all such information at my disposal

⦿

It’s not always possible to have all the relevant information to hand. If not, I can still decide on a course of action given the information that I have

⦿

I need to be certain that I am doing the right thing now and in the future before I make an important decision. It is possible to always act morally

⦿

Having certainty that I am doing the right thing now and in the future would be nice, but, as I have only probability to rely on, I will make decisions on the basis of probability, not certainty

⦿

If I think long enough, I will discover what I should have done in the past and what I should do now

⦿

A certain amount of thinking is good, but too much thinking will lead to pointless rumination. Continuing to think when thinking has not revealed the answer is like digging myself ever deeper into a hole

act and think in ways that are, in turn, consistent with these flexible/​non-​ extreme attitudes, you will become less prone to unhealthy regret. In Chapter 6, I discuss shame and how to deal with it.

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NOTES 1 Such a decision may involve choosing a course of action or choosing not to act. 2 By ‘best decision’ here, I mean a course of action (or inaction) that would have resulted in a situation where the person would have no regrets about what they did or did not do. 3 Whether or not you made a wrong decision is a question for later. In REBT, in order for you to deal effectively with your unhealthy regret, it is important for you to assume temporarily that you did make the wrong decision. 4 Remember that in REBT, for you to help your client deal effectively with their unhealthy regret, it is important that they assume temporarily that they did make the wrong decision. There will be an opportunity to examine this later. 5 While this section is particularly relevant in unhealthy retrospective regret, it also applies to unhealthy prospective regret. However, I will focus on the former here.

C H A P T E R

6 Dealing with shame

In this chapter, I begin by presenting REBT’s way of understanding shame and then address how to deal with this emotional problem.

UNDERSTANDING SHAME In understanding shame, we need to know what we tend to make ourselves feel ashamed about (i.e., its major inference themes), what attitudes we hold, how we act or tend to act, and how we think when we feel ashamed. While shame and guilt are often seen as similar emotions (and they both involve self-​devaluation), they differ in the following respects: ⦿

The inference themes are different, as we shall see.

⦿

In guilt, you tend only to devalue yourself about your own behaviour and its consequences, while you can feel ashamed not only about your own behaviour, but also about the behaviour of members of a social group with whom you closely identify. Thus, while you may talk about bringing shame on your family, you tend not to talk about bringing guilt on your family.

⦿

You tend to act and think in different ways when you feel shame than when you feel guilt.

I mentioned in previous chapters that it is important that you use your client’s language when referring to emotional problems. With respect to the term ‘shame’, the main issue is that clients often confuse the emotion of ‘shame’ with the emotion of ‘guilt’. While I have spelled out the differences between the two in the Client’s Guide, if a client prefers to use the term ‘guilt’ rather than ‘shame’, then go along with this to preserve the working alliance, but write this in the client’s notes for reference so that you remember the client’s preference. Trying to persuade a client

DOI: 10.4324/9781003424338-7

Dealing with shame    169

to use a term standing for ‘shame’ that does not make sense to them is counterproductive, even when this term is a more accurate representation of the client’s experience at ‘C’.

Major inference themes in shame There are three major themes in relation to your personal domain that are implicated in shame: ⦿

Something highly negative has been revealed about you (or about a group with whom you identify) by yourself or by others.

⦿

You have acted in a way that falls very short of your ideal.

⦿

Others look down on or shun you (or a group with whom you identify) or you think that they do.

Your client may not resonate with the above schema and, in this case, you should encourage them to put it aside and just focus on what they tend to feel ashamed about. REBT theory values flexibility and this includes the freedom not to use REBT terms, schemas and frameworks.

Rigid/​e xtreme attitudes As I explained in Chapter 1, according to REBT, inferences on their own do not account for emotional problems. It is possible, therefore, for you to make the same inferences as listed above and be disappointed, but not ashamed.1 In order for you to feel ashamed when you think that (a) something highly negative has been revealed about you (or about a group with whom you identify) by yourself or by others, (b) you have acted in a way that falls very short of your ideal and/​or (c) others look down on or shun you (or a group with whom you identify) or you think that they do, you have to hold a rigid/​extreme attitude. As with guilt (see Chapter 4), in shame you hold a rigid attitude and an extreme self-​devaluation attitude. If your client is unsure about the mediating role that rigid/​ extreme attitudes play in their feelings of shame, ask them how they would feel if they had a strong conviction in the flexible/​non-​ extreme alternatives to what REBT holds are their shame-​creating

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rigid/​extreme attitudes. In using this strategy, it is important that you formulate the flexible/​non-​extreme attitudes for your client, who cannot be expected to do this for themself at this stage. When you do this, ensure that you match your client’s rigid attitude with a flexible alternative and their extreme self-​devaluation attitude with a non-​extreme unconditional self-​acceptance alternative, and then ask them how they would feel if they had strong conviction in this flexible/​non-​extreme attitude. For example: ‘Let me outline two sets of attitudes towards revealing what you consider to be a weakness and you tell me which leads to shame and which leads to disappointment without shame. The first set of attitudes is as follows: “I absolutely should not have revealed this weakness and I am a weak person for doing so.” The second set of attitudes is as follows: “I would have much preferred not to have revealed this weakness, but sadly I’m not immune to doing so and neither do I have to be so immune. I am not a weak person for revealing this weakness, rather I am a fallible human being who is capable of acting weakly and strongly.” Now which set of attitudes would lead to shame and which set would lead to disappointment without shame?’ Once your client can see that their rigid/​ extreme attitudes underpin shame and their flexible/​ non-​ extreme attitudes underpin disappointment, they have understood the mediating role of attitudes. This is quite an elegant strategy since it accomplishes a number of things at once: 1.  It addresses your client’s doubts about the mediating role of rigid/​extreme attitudes in shame if they have such a doubt. 2.  It introduces flexible/​non-​extreme attitudes as a meaningful alternative to these rigid/​extreme attitudes. 3.  It helps your client to see that holding flexible/​ non-​ extreme attitudes can have beneficial effects.

Behaviour associated with shame When you hold a rigid/​ extreme attitude towards(a) something highly negative being revealed about you (or about a group with whom you identify) by yourself or by others, (b) acting in a way that falls very short of

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your ideal and/​or (c) others looking down on or shunning you (or a group with whom you identify), you will act or tend to act in a number of ways, the most common of which are as follows: ⦿

You remove yourself from the ‘gaze’ of others.

⦿

You save face by attacking other(s) who have ‘shamed’ you.

⦿

You ignore attempts by others to restore social equilibrium.

⦿

You isolate yourself from others.

⦿

You defend your threatened self-​esteem in self-​defeating ways.

If you ask your client whether they want to change their shame-​ based behaviour, their response will be affected by their state of mind or mood. If they are currently experiencing shame, they are less likely to see that this behaviour is dysfunctional than when they are not experiencing shame. If they are feeling ashamed, it is useful to encourage them to imagine that they are advising a friend who displays the same shame-​based behaviour as they do. What would they say to this friend about the functionality or dysfunctionality of such behaviour? They are more likely to see that their own shame-​based behaviour is dysfunctional after they have told their ‘friend’ that the same behaviour is dysfunctional.

Thinking associated with shame When you hold a rigid/​ extreme attitude towards(a) something highly negative being revealed about you (or a group with whom you identify) by yourself or by others, (b) acting in a way that falls very short of your ideal and/​or (c) others looking down on or shunning you (or a group with whom you identify), you will tend to think in a number of ways. Remember what I said in Chapter 1: the thinking that accompanies your shame is the result of your shame-​based inference being processed by your rigid/​extreme attitude and therefore it is likely to contain a number of thinking errors that I present in Appendix 1. I list the main features of this post-​rigid/​extreme attitude shame-​based thinking below: ⦿ ⦿

You overestimate the negativity of the information revealed. You overestimate the likelihood that the judging group will notice or be interested in the information.

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⦿

You overestimate the degree of disapproval you (or your reference group) will receive.

⦿

You overestimate how long any disapproval will last.

⦿

identify the presence of the thinking consequences of rigid/​ extreme attitudes (see Appendix 1)

⦿

trace these back to the source of this mode of thinking (i.e., identify the underlying rigid/​extreme attitudes)

⦿

examine these rigid/​extreme attitudes

⦿

respond briefly to the thinking consequences of such attitudes, but not get overly involved in this process

⦿

accept the lingering presence of these thinking consequences without engaging with them

⦿

get on with the business of living.

As you can see, such thinking exaggerates the negative social consequences of your behaviour (or that of the member of your identified social group) and also ignores the role of context. Such thinking may be in words or in mental images. One of the main features of post-​rigid/​extreme-​attitude thinking is that it is compelling. As such, it is quite easy for your client to get caught up in this way of thinking and think that it reflects reality. This is an example of ‘cognitive-​emotive’ reasoning: if a thought is plausible and emotionally compelling, therefore it must be true. It is important that you help your client to understand how their mind works with respect to the thinking consequences of rigid/​ extreme attitudes and to encourage them to use such thoughts to go back to address the rigid/​extreme attitudes that spawn them. When they have done this, you can encourage the client to respond to these thinking consequences of rigid/​extreme attitudes as these attitudes will not disappear just because they have examined these attitudes. When they respond to these thinking consequences, they need to do so only a few times on any one occasion. After that, they need to accept the presence of such thinking without engaging with it. To summarise, your client needs to:

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HOW TO DEAL WITH SHAME If you are prone to shame, you tend to experience this emotional problem in a variety of different settings and in response to a variety of situations where something highly negative has been revealed about you (or about a group with whom you identify) by yourself or by others; you have acted in a way that falls very short of your ideal and/​or others look down on or shun you (or a group with whom you identify) or you think that they do. Here is how to deal with shame so that you become less prone to it.

Step 1: Identify reasons why shame is a problem for you and why you want to change While shame is generally regarded as an emotional problem, it is useful for you to spell out reasons why shame is a problem for you and why you want to change. I suggest that you keep a written list of these reasons and refer to it as needed as a reminder of why you are engaged in a self-​help programme. I discuss the healthy alternative to shame in Step 4. When your client experiences shame, they are already in an avoidant frame of mind, so it may well be that they are ashamed of feeling ashamed. This will lead them to deny that they are experiencing shame. In helping your client to acknowledge that they have a shame problem, it is important that you don’t do anything that, from their perspective, ‘shames’ them further. You can do this by doing the following: ⦿

Refraining from using language that may be construed by your client as pejorative. Also, the term ‘shame’ is difficult for people experiencing this emotion to acknowledge and thus finding a more acceptable synonym should be a priority when this is the case.

⦿

‘Normalising’ the experience of shame. While ‘shame’ is a UNE, it is commonly experienced and helping your client to see this may help them become unashamed about their feelings of shame.

⦿

Showing your client that you accept them unconditionally for their fall from grace, as they see it, can provide a particularly powerful model for unconditional self-​acceptance, which is the antidote to shame.

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Some people who feel shame think that ‘feeling ashamed’ is an appropriate response to situations where (a) something highly negative has been revealed about them (or about a group with whom they identify) by themselves or by others, (b) they have acted in a way that falls very short of their ideal or (c) others look down on or shun them (or a group with whom they identify) or they think that they do. In these circumstances, it is important to introduce the idea of feeling disappointed as the healthy alternative to shame a little earlier than you would normally do (see Step 4). When you have done so, you can then carry out a cost-​benefit analysis of shame and its healthy alternative, disappointment. This involves helping your client to spell out the perceived advantages and disadvantages of both emotions. Respond to any perceived advantages of shame and perceived disadvantages of disappointment, correcting any misconceptions that your client reveals on these issues. For example, imagine that your client thinks that feeling ashamed will help motivate them to achieve their ideal in the future and that feeling disappointment would not achieve the same end. In this case, help them to see that precisely the reverse is true. The self-​devaluation attitude that your client holds when they experience shame is some variant of ‘I am defective’. If that is the way that they think of themself, they are more, rather than less, likely to fail to achieve their ideal in the future since ‘defective people’ are doomed to continue to fall short of their ideals. The unconditional self-​acceptance attitude that underpins disappointment is likely to help the person concentrate on what they are doing rather than how well or poorly they are doing it and this focus increases rather than decreases the chances of them achieving their ideals (or at least getting closer to achieving them).

Step 2: Take responsibility for your shame In REBT, we argue that what you do or what people think of you do not make you feel ashamed; rather you create these feelings by the rigid/​ extreme attitudes that you hold towards what you do and what people think of you. Unless you accept this point, you will not address your shame productively. Rather, you will think that the only way not to feel ashamed is by always achieving the ideal standards that you have for yourself or

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ensuring that others think well of you. This view will perpetuate your shame rather than help you deal with it. The idea that emotional problems (including shame) are based largely on the attitudes that a person holds towards what happens to them is, as you know, a central plank in REBT. However, for your client, this way well be a new idea. Thus, your client may hold that the reason they are ashamed, for example, is that it is inherently shameful to let down your reference group and that shame is caused by such behaviour. It may seem that the client is taking responsibility for this emotion of shame and is taking responsibility for their behaviour. However, on closer inspection, this is not the case. In REBT, we don’t say that letting down one’s reference group causes shame. This is an example of ‘A–​C’ thinking where ‘A’ is the person’s letting down the reference group and ‘C’ is the emotion of shame. Rather, we argue that the reason that the person experiences shame is largely due to the fact that they hold a set of rigid/​ extreme attitudes towards them letting down the group. If they held a set of flexible/​non-​extreme attitudes towards the ‘letting down’, they would experience disappointment rather than shame. What you need to do, then, is to help your client see that they create their emotion of shame by holding a set of rigid/​extreme attitudes towards the ‘letting down’. In this way, you can help them take two types of responsibility, not only for their actions but also for the rigid/​extreme attitudes that underpin their shame. If your client continues to have difficulty accepting responsibility for their shame, it is important for you to identify the source of this difficulty. In the Client’s Guide, I mention one common obstacle that stops a client from accepting such responsibility (i.e., the self-​devaluation that the client would engage in were they to assume responsibility for making I ashamed). However, there are other obstacles to accepting responsibility such as the following: ⦿

Hopelessness about change (e.g., ‘I am a defective person. I don’t just think I am’). Here your client is reluctant to see their shame as an attitude problem. They consider that they are defective for what they did or failed to do. The best intervention here involves invoking your client’s empathy by asking if they would tell a loved one who did exactly the same thing that they did, for example, that their loved one was defective for doing so.

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If your client can assume the role of compassionate observer (rather than self-​punitive experiencer), it often helps them to see that their shame is an attitude problem (e.g., ‘I think I am defective’) for which they can take responsibility and thereby change, rather than an identity problem (e.g., ‘I am defective. I don’t just think I am’), which they can’t do anything about if it were true. ⦿

Taking responsibility for shame means admitting a weakness. Here the block is the rigid/​ extreme attitude that your client holds towards having and/​ or admitting having a weakness (e.g., ‘I cannot take responsibility for shame because it means admitting that I have a weakness that I must not have or must not admit to publicly’). If your client holds to this position, help them to understand that having a weakness is quintessentially human and does not mean that they are defective. Ironically, this is the very flexible/​non-​extreme attitude that they need to develop about whatever it is that they are ashamed about in the first place.

It is important to help your client to understand the impact of these obstacles on their emotional problems. Then, help them to develop alternatives to these obstacles and review the impact of these alternatives on their emotional problem-​solving. This often helps your client to deal effectively with these obstacles. If not, you may need to do a more detailed assessment of the obstacle, which is outside the brief of this book.

Step 3: Identify the themes you tend to be ashamed about The best way of identifying shame-​related inference themes to which you are particularly vulnerable is by understanding the themes associated with shame, and seeing which are present when you feel ashamed. As I outlined above, there are three such themes: ⦿

Something highly negative has been revealed about you (or about a group with whom you identify) by yourself or by others.

⦿

You have acted in a way that falls very short of your ideal.

Dealing with shame    177

⦿

Others look down on or shun you (or a group with whom you identify) or you think that they do.

If your client finds it difficult to find their shame-​related theme, you can help them by assessing a few specific examples of their shame. Have them focus on a specific situation in which they felt ashamed and ask them what they were most ashamed about. If they still find it difficult to identify the theme in this or other specific situations, use the ‘magic question’ technique. This involves you doing the following: ⦿

Have your client focus on the situation in which they felt shame.

⦿

Ask them to nominate one ingredient that would eliminate or significantly reduce their shame without changing the situation.

⦿

The opposite of this nominated ingredient is what they are most ashamed about.

Hugh was struggling to identify the specific theme in his shame about failing his driving test. Hugh used the ‘magic question’ technique as follows: ⦿

Hugh focused on the situation in which he felt ashamed: ‘I failed my driving test.’

⦿

He nominated one ingredient that would eliminate or significantly reduce his shame without changing the situation: ‘My father would not feel let down by my failure.’

⦿

The opposite of this nominated ingredient is what he is most ashamed about: ‘My father will feel let down by me failing my driving test.’

If you assess several specific examples of your client’s shame in this way, the shame-​related theme should be apparent. In Hugh’s case, it was letting down the men in his family, specifically his father. It may be that there are two shame-​related themes present in your client’s shame. For example, your client may feel ashamed about

178    Dealing with shame

not living up to their ideals and about letting their peer group down. If this is the case, deal with them one at a time and have your client nominate the theme that they want to focus on first.

Step 4: Identify the three components of your shame response and set goals with respect to each component The next step is for you to list the three elements of your shame response in the face of each of the relevant themes listed above.

Identify the three components of your shame response I use the term ‘shame response’ to describe the three main components that make up this response. The three components of your shame response are the emotional, behavioural and thinking components.

Emotional component The emotional component here is, of course, shame.

Behavioural component The behavioural component concerns overt behaviour or action tendencies that you engage in or ‘feel like’ engaging in when you feel shame. Consult the list that I provided to help you identify your behaviour associated with each relevant theme when you feel shame (see p. 171).

Thinking component The thinking component associated with shame is listed on pp. 171–172. Again, these may be in words or in mental pictures. Consult this list if necessary.

Set goals with respect to each of the three components You need to set goals so that you know what you are striving for when you deal effectively with shame. The three goals are emotional, behavioural and thinking goals.

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Emotional goal Your emotional goal is disappointment rather than shame (or whatever synonym you prefer to the term ‘disappointment’). Disappointment is an HNE, which is an appropriate response to the three shame-​related themes detailed above. It helps you to think objectively about the situation and your response to it and helps you to move on with your life rather than get stuck or bogged down. The concept that disappointment is the healthy alternative to shame: (a) when something highly negative has been revealed about your client (or about a group with whom they identify) by themself or by others, (b) when they have acted in a way that falls very short of their ideal and (c) when others look down on or shun them (or a group with whom they identify) or they think that they do is based on the following idea. These adversities are negative and therefore it is realistic to have a negative emotion about them. The choice, therefore, is between a UNE (shame) or an HNE (disappointment). However, what if your client specifies an unrealistic goal? I will list three and show how to respond to a client who nominates them: ‘I don’t want to feel shame.’ Show your client that they have indicated what they do not want to feel in the face of (a) something highly negative having been revealed about them (or about a group with whom they identify) by themself or by others, (b) their acting in a way that falls very short of their ideal or (c) others looking down on or shunning them (or a group with whom they identify) or them thinking that they do. They need to specify how they do want to feel instead of shame. ⦿

‘I want to feel less ashamed.’ Show your client that, as shame is a disturbed emotion, wanting to feel less ashamed is still to nominate a disturbed emotion, albeit of lesser intensity. Show them that disappointment can be strong and healthy. ⦿

‘I don’t want to feel anything.’ Not feeling anything in the face of something highly negative being revealed about them (or about a group with whom they ⦿

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identify) by themself or by others, or falling very short of their ideal or others looking down on or shunning them (or a group with whom they identify) will not help your client to be appropriately geared up to deal with it. Help them to see this. Also show them that the only way that they could achieve a state of not feeling anything is to feel completely indifferent about (a) something highly negative being revealed about them (or about a group with whom they identify) by themself or by others, (b) acting in a way that falls very short of their ideal and (c) others looking down on or shunning them (or a group with whom they identify) or them thinking that they do. This could be called the asocial option –​believing that they just don’t care whether or not they have had something highly negative revealed about them etc. In order to do this, your client (assuming that they are not asocial) would have to lie to themself. Show them this and discourage them from setting such a goal.

Behavioural goal Your behavioural goal should reflect actions that are based on disappointment rather than shame. The following are the most common behaviours associated with disappointment. You may wish to compare these behaviours with those associated with shame that I presented on p. 171. ⦿ ⦿

You continue to participate actively in social interaction. You respond positively to attempts of others to restore social equilibrium.

It is important that your client understands that, as they strive to develop healthy behavioural responses to (a) when something highly negative has been revealed about them (or about a group with whom they identify) by themself or by others, (b) when they have acted in a way that falls very short of their ideals or (c) when others look down on or shun them (or a group with whom they identify) or they think that they do, they will still feel the urge to act in ways that are dysfunctional, as listed on p. 171. Help them to understand the reason for this. Explain to them that, as they examine their attitudes and commit themself to strengthening their conviction in their flexible/​ non-​ extreme attitudes and to weakening their conviction in their rigid/​extreme attitudes, the latter will still be active and producing urges for them to act

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dysfunctionally. Encourage your client to accept these urges, to recognise that they do not have to act on them and to use them as cues to act in functional ways.

Thinking goal As well as setting behavioural goals related to the feeling of disappointment about (a) something highly negative being revealed about you (or about a group with whom you identify) by yourself or by others, (b) acting in a way that falls very short of your ideal and/​or (c) others looking down on or shunning you (or a group with whom you identify), it is important that you set thinking goals associated with this emotion. The following are the most common forms of thinking associated with disappointment rather than shame. Again, you may wish to compare these forms of thinking with those associated with shame that I presented on pp. 171–172. ⦿

You see the information revealed in a compassionate self-​ accepting context.

⦿

You are realistic about the likelihood that the judging group will notice or be interested in the information revealed.

⦿

You are realistic about the degree of disapproval self (or reference group) will receive.

⦿

You are realistic about how long any disapproval will last.

As the above list shows, the dominant feature of thinking associated with disappointment is that it is realistic and balanced. Please remember that such thinking may be in words or in mental pictures. The point I made above with respect to your client’s behavioural goals is also relevant with respect to their thinking goals. Your client will still have some conviction in their rigid/​extreme attitudes until they have full conviction in their flexible/​ non-​ extreme attitudes. Given this, your client’s rigid/​extreme attitudes will have some impact on their subsequent thinking as they strive to achieve their goals. Thus, highly distorted thoughts will still come into your client’s mind. Help your client to understand why this is the case. When you come to help them deal with these forms of post-​ rigid/​ extreme-​ attitude thinking, do one or more of the

182    Dealing with shame

following as indicated. Discuss this issue with your REBT supervisor, if necessary: ⦿

Encourage your client to acknowledge the existence of such thoughts without trying to suppress them, distract themself from them or engage with them.

⦿

If relevant, use the presence of this post-​rigid/​extreme-​attitude thinking to help your client to identify and deal with the rigid/​ extreme attitudes.

⦿

Examine the empirical nature of these thinking ‘Cs’ once or twice and then return to the acceptance strategy detailed above.

Step 5: Identify your general rigid/​extreme attitudes and alternative general flexible/​non-​extreme attitudes A general rigid/​extreme attitude leading to your shame response is a rigid/​ extreme attitude that you hold across situations defined by one of the following themes: ⦿

Something highly negative has been revealed about you (or about a group with whom you identify) by yourself or by others.

⦿

You have acted in a way that falls very short of your ideal.

⦿

Others look down on or shun you (or a group with whom you identify) or you think that they do.

Its flexible/​non-​extreme alternative, which will also be general in nature, will account for your disappointment response.

Identify your general rigid/​extreme attitudes When you identify a general rigid/​extreme attitude, you take a common shame-​related theme (see above) and add to this a general rigid attitude and the main extreme attitude that is derived from the rigid attitude. In shame, your main extreme attitude will be a self-​devaluation attitude. For example: ⦿

‘I must not fall short of my high social standards and I am defective if I do.’

Dealing with shame    183

Identify your alternative general flexible/​non-​extreme attitudes When you identify your alternative general flexible/​non-​extreme attitude, you take the same common theme –​(a) something highly negative has been revealed about you (or about a group with whom you identify) by yourself or by others, (b) you have acted in a way that falls very short of your ideal or (c) others look down on or shun you (or a group with whom you identify) or you think that they do –​and add to this a general flexible attitude and a general unconditional self-​acceptance attitude. For example: ⦿

‘I really don’t want to fall very short of my high social standards, but that does not mean that I must not do so. If I do it would be unfortunate, but it would not prove that I am defective. Rather it proves that I am fallible.’

As you will have noticed in the Client’s Guide, I encourage readers/​ clients to identify and work with their general rigid/​ extreme attitudes and to develop general flexible/​ non-​ extreme attitudes and, as you will see, when they are facing specific instances of their problems, I encourage them to focus on specific examples of both sets of attitudes. This will be at variance with your REBT practice, where you will begin with specific examples of your client’s problems and then proceed to work at a more general level with their problems and how these relate to one another. The reason I have chosen to go ‘general’ rather than ‘specific’ when helping readers/​clients to deal with their emotional problems is a pragmatic one. In this book, I aim to help people to deal with a range of emotional problems and therefore, in my view, it is best to give readers/​clients general guidance with respect to dealing with this range of problems and then help them to move from the general to the specific rather than vice versa. My considered view was that I just do not have the space to help readers/​clients focus on specific examples of their emotional problems and then generalise from this specific level. Consequently, one way that you can help your client who is using the Client’s Guide is to help them to work with specific examples of their emotional problem, in this case shame. Use the following sequence as you do so and help your client to: ⦿

select a specific example of their shame problem

184    Dealing with shame

⦿

express why their shame constitutes a problem for them

⦿

identify what they felt most ashamed about in the situation

⦿

identify the three specific components of their shame response and set specific goals with respect to each component

⦿

identify their specific rigid/​extreme attitudes and alternative specific flexible/​non-​extreme attitudes

⦿

examine their specific attitudes.

⦿

face up to in imagery (if necessary) (a) what has been revealed about them (or about a group with whom they identify) that is highly negative either by themself or by others, (b) what they did that fell very short of their ideal and (c) others looking down on or shunning them (or a group with whom they identify)

⦿

face the same things in reality (if possible) and take appropriate action

⦿

capitalise on what they have learned

In helping your client to deal with a specific example of their shame, you can teach them how to use REBT’s ABCD form, which appears in Appendix 6. The following steps are the same as those that appear in Steps 8–​11 later in this chapter. Thus, help your client to:

⦿

generalise their learning.

Step 6: Examine your general attitudes I recommended in previous chapters that you first examine together your general rigid attitude and its general flexible attitude alternative and then examine together your general extreme attitude and your general non-​ extreme attitude.

Examine your general rigid attitude and its general flexible attitude alternative First, take your general rigid attitude and its general flexible attitude alternative and write them down next to one another on a sheet of paper. Then ask yourself:

Dealing with shame    185

⦿

Which is true and which is false?

⦿

Which has largely constructive results and which has largely unconstructive results?

⦿

Which is sensible logically and which does not make sense?

Write down your answer to each of these questions on your piece of paper, giving reasons for each answer. Consult Appendix 2 for help with the answers to these questions, which you need to adapt and apply to the attitudes you are examining.

Examine your general self-​devaluation attitude and its general unconditional self-​acceptance attitude alternative Next, take your general self-​devaluation attitude and its general unconditional self-​acceptance attitude alternative and again write them down next to one another on a sheet of paper. Then, ask yourself the same three questions that you used with your general rigid attitude and its general flexible attitude alternative. Again, write down your answer to each of these questions on your piece of paper, giving reasons for each answer. I suggest that you consult Appendix 5 (for help with examining self-​devaluation attitudes and unconditional self-​acceptance attitudes). Again, you need to adapt and apply these arguments to the attitudes you are examining. You should now be ready to commit to acting and thinking in ways consistent with your general flexible/​non-​extreme attitude. I included Appendices 2–​ 5 in the Client’s Guide as general guidelines to help readers/​clients to examine their rigid/​extreme and flexible/​ non-​ extreme attitudes (reproduced in this book as Appendices 2–​5). If you are working with clients who are using the Client’s Guide, you will have a chance to look at the examining work that your clients have done at this point and give them feedback on that work. No book can provide such feedback. I have suggested that readers/​clients examine their rigid attitude and their flexible attitude together and then their self-​ devaluation attitude and their unconditional self-​ acceptance attitude equivalent together using three criteria as shown below: ⦿

Rigid attitude vs. flexible attitude ⦿

empirical status

186    Dealing with shame

⦿

⦿

logical status

⦿

pragmatic status

⦿

empirical status

⦿

pragmatic status.

Self-​ devaluation attitude vs. unconditional self-​ acceptance attitude

⦿

logical status

The final point I want to make about examining attitudes concerns the concept of persuasiveness. Perhaps the most important aspect of the examining process is for your client to develop arguments concerning the false, illogical and unhealthy nature of their rigid/​ extreme attitudes, and the true, logical and healthy nature of their flexible/​non-​extreme attitudes that are persuasive to them. So, encourage your clients to develop such persuasive arguments and to make a note of these for future reference.

Step 7: Adopt a healthy orientation towards your high standards Once you have committed yourself to strengthening your conviction in your general flexible/​non-​extreme attitude, it is useful for you to develop what I call a healthy orientation towards your high standards. This involves you doing the following: ⦿

Recognise that there is nothing intrinsically wrong with having high standards.

⦿

View these standards as signposts to aim for rather than as yardsticks that you must achieve. As such, your high standards are similar to self-​ actualisation in that you can never achieve them once and for all. Rather you can work steadily to achieve them.

⦿

Accept that, when you fail to live up to your high standards, the best way of dealing with this situation is to learn from it and to apply your learning on future occasions having first accepted yourself unconditionally for your failure.

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In other forms of CBT, therapists tend to help their clients to examine the utility of their high standards much earlier in the therapy process than do REBT therapists. When your client indicates that they have very high standards in the early phase of discussing their shame problem, it is tempting to intervene and help them to consider this issue. It is important that you refrain from doing so for the following reason. REBT theory argues that it is not having very high standards that is the client’s problem. Rather it is their rigid/​ extreme attitudes towards falling short of these standards that is the problem and, unless your client addresses their rigid/​extreme attitudes first, they will reflect on matters to do with the utility of high standards through the distorting lens of their rigid/​ extreme attitudes. Thus, help your client to understand the importance of dealing with their rigid/​extreme attitudes before reflecting on these other matters.

Step 8: Face your shame-​r elated theme in imagery I hope that you have made a commitment to act on your general flexible/​non-​extreme attitudes (i.e., flexible attitude and unconditional self-​ acceptance attitude). Assuming that you have, your basic task is face up to (a) something highly negative being revealed about you (or about a group with whom you identify) by yourself or by others, (b) acting in a way that falls very short of your ideal and/​or (c) others looking down on or shunning you (or a group with whom you identify) or you think that they do and to learn to think in flexible/​non-​extreme ways about it. Up to this point, you have worked at a general level with respect to your shame-​related theme, dealing with the general rigid/​extreme attitudes that account for your shame and developing your alternative general flexible/​ non-​extreme attitudes. However, when you come to apply your general flexible/​ non-​ extreme attitudes in dealing with shame-​ related themes, you need to bear in mind one important point. Since you make yourself ashamed about specific events (actual or imagined), you need to deal with these by rehearsing specific variants of your general flexible/​non-​extreme attitudes. While the best way to do this is in specific shame-​related situations, you may derive benefit by using imagery first. If this is the case, you need to do the following:

188    Dealing with shame

⦿

Imagine a specific situation in which you felt shame or may feel shame about (a) something highly negative being revealed about you (or about a group with whom you identify) by yourself or by others, (b) acting in a way that falls very short of your ideal or (c) others looking down on or shunning you (or a group with whom you identify) or you think that they do and focus, in your mind’s eye, on what you felt most ashamed about (i.e., your ‘A’).

⦿

Focus on this ‘A’ while rehearsing a specific flexible/​non-​extreme attitude relevant to the situation. As you do this, try to make yourself feel disappointed, rather than ashamed.

⦿

Then see yourself acting in ways consistent with your flexible/​ non-​ extreme attitude, e.g., holding your head up high and admitting publicly to any pratfalls.

⦿

Recognise that some of your post-​ rigid/​ extreme-​ attitude thinking may be distorted. Respond to it without getting bogged down doing so. Accept the presence of any remaining distorted thoughts without engaging with them.

⦿

Repeat the above steps until you feel sufficiently ready to put this sequence into practice in your life.

If you find that facing your shame-​related ‘A’, in your mind’s eye, is too much for you, use the ‘challenging, but not overwhelming’ principle that I introduced in Chapter 2 (see p. 53). This means that, instead of imagining yourself facing a shame-​related situation that you find ‘overwhelming’ at the present time, choose a similar shame-​related ‘A’ that you would find ‘challenging, but not overwhelming’. Then employ the same steps that I have outlined above. Work in this way with modified shame-​related ‘As’ until you find your original one ‘challenging, but not overwhelming’ and then use the steps again. Your client may say that they can’t get very clear images when they try to picture events in their mind’s eye. While they may get more out of imagery techniques if they can get such clear images, they will still get something out of facing (a) something highly negative being revealed about them (or about a group with whom they identify) by themself or by others, (b) acting in a way that falls very short of their ideal or (c) others looking down on or shunning them (or a group with whom they identify) or they think that they do even if their images aren’t clear. So, if your client

Dealing with shame    189

wants to face their particular adversity in imagery before they do so in reality, encourage them to do so, no matter how clear their mental images are.

Step 9: Face situations and people with your head held high Having learned the lessons from previous shame-​based episodes, you are ready to go back to the social milieu and hold your head up as you do so. ⦿

Choose a specific situation in which you will be reminded of your ‘fall from grace’ and about which you would ordinarily feel ashamed.

⦿

Rehearse a specific version of your general flexible/​non-​extreme attitudes before entering the situation so that you can be prepared to face the music while in a flexible/​non-​extreme frame of mind.

⦿

Develop a shortened version of this flexible/​non-​extreme attitude in mind as you enter the situation (e.g., ‘I’m still fallible even though I have fallen from grace’) and accept the fact that you are likely to be uncomfortable while doing so. React to any consequences from a flexible/​non-​extreme frame of mind if you can.

⦿

Recognise that, even though you have got yourself into a flexible/​non-​ extreme frame of mind, some of your thinking may be distorted and unrealistic and some may be realistic and balanced. Accept the presence of the former and do not engage with it. Engage with the latter as much as you can.

At this stage, it is very important to encourage your client to face these situations without using obvious or subtle safety-​ seeking manoeuvres. Otherwise, they will not derive as much therapeutic benefit from facing relevant situations with their head held high.

Step 10: Capitalise on what you have learned When you have faced a situation in which you experienced shame and dealt with it as best you could, it is important that you reflect on what you did and what you learned. In particular, if you were able to face the situation, and rehearse your specific flexible/​non-​extreme attitudes until

190    Dealing with shame

you felt disappointment, then ask yourself how you can capitalise on what you achieved. If you experienced any problems, respond to the following questions: ⦿

Did I face the situation and, if not, why not?

⦿

Did I rehearse my flexible/​non-​extreme attitudes before, during or after facing the situation and, if not, why not?

⦿

Did I execute my plan to face the situation and, if not, why not?

⦿

Did I engage with post-​rigid/​extreme attitude distorted thinking and, if so, why?

Reflect on your experience and put into practice what you have learned the next time you face a situation in which (a) something highly negative was revealed about you (or about a group with whom you identify) by yourself or by others, (b) you acted in a way that falls very short of your ideal or (c) others looked down on or shunned you (or a group with whom you identify) or you think that they did. It is useful to monitor your client’s responses to these questions and help them to reflect on any issues that they have not considered.

Step 11: Generalise your learning Once you have dealt with your shame in a specific situation by holding the relevant specific version of your general flexible/​non-​extreme attitude and by acting and thinking in ways that are consistent with it, you can generalise this learning to situations defined by your shame-​based theme. Miranda was particularly prone to shame about falling very short of her ideal of acting with decorum. Thus: ⦿

Miranda assessed the three components of her shame response and set goals with respect to all three components.

⦿

She identified her relevant general rigid/​extreme attitude regarding falling very short of her standards (i.e., ‘I must achieve my high behavioural standards and I am a disgrace if I don’t’) that underpinned her shame response and her alternative general flexible/​non-​extreme attitude (i.e., ‘I want to achieve my high behavioural standards, but I don’t always

Dealing with shame    191

have to do so. If I do not achieve my high standards, it is bad, but I am not a disgrace. I am an ordinary fallible person who has done something unfortunate’) that underpinned her disappointment response. ⦿

She examined both elements of her general rigid/​extreme attitude and her general flexible/​non-​extreme attitude until she clearly saw that the former were false, made no sense and were detrimental to her, and that the latter were true, sensible and healthy.

⦿

She acted on her flexible/​non-​extreme attitudes in specific situations, held her head up and engaged in eye contact as she did so, even though people tended to look down on her.

⦿

As she did so, she tolerated the discomfort that she felt and accepted that some of her distorted and skewed negative thinking would still be in her mind. She let such thinking be without engaging with it, suppressing it or distracting herself from it.

As this section shows, you can generalise what you learn about dealing with shame from situation to situation as defined by your shame-​based inference.

USING REBT’S ABCD FORM TO DEAL WITH SPECIFIC EXAMPLES OF YOUR SHAME This chapter is mainly geared to help you deal with your shame in general terms. However, you can also use this material to address specific examples of your shame. I have developed a self-​help form to provide the structure to assist you in this regard. It is called the ABCD form and it appears with instructions in Appendix 6. In Appendix 6, I outline the major problems that clients have in using this form and how to deal with them.

OTHER IMPORTANT ISSUES IN DEALING WITH SHAME In the above section, I outlined an 11-​step programme to deal with shame. In this section, I discuss some other important issues that may be relevant

192    Dealing with shame

to you in your work to become less prone to this emotional problem. If you want to, you can incorporate them as additional steps in the above step-​by-​step guide at points relevant to you.

Dealing with your safety-​s eeking measures to avoid shame I mentioned in Chapter 2 that people use safety-​seeking measures to protect themselves from threat. You may use similar measures to protect yourself from feeling shame. Here is how this works from your perspective. You reason that, since you feel ashamed about (a) something highly negative being revealed about you (or about a group with whom you identify) by yourself or by others, (b) acting in a way that falls very short of your ideal and/​or (c) others looking down on or shunning you (or a group with whom you identify), you will take two major steps to avoid shame. First, you will always act in ways that are socially acceptable and get those with whom you are connected to do the same thing as well. Second, you will avoid situations where you may fall very short of your ideal. Taking this decision means that you will not take risks in life (in case you do socially unacceptable things or fall very short of your ideal) and you will curtail the autonomy of others in case they ‘shame’ you. However, this behaviour and the reasoning that leads you to take it are flawed and will serve only to perpetuate your chronic shame. This is due to the fact that your shame is not based on (a) something highly negative being revealed about you (or about a group with whom you identify) by yourself or by others, (b) acting in a way that falls very short of your ideal and/​or (c) others looking down on or shunning you (or a group with whom you identify), but on your rigid/​extreme attitudes towards these three inferences. So, if you want to deal effectively with shame, you need to do the following: ⦿

Take healthy risks and let others with whom you are connected do the same and see what happens. You will probably find that people do not disapprove as much as you think and that, while you may fall short of your ideal, this fall from grace will not be as dramatic as you predicted.

⦿

However, if as a result of your behaviour or that of others, something highly negative is revealed, you do fall very short of your ideal or that others do highly disapprove or shun you (or others with whom you are connected), then you can deal with such situations by holding a set of

Dealing with shame    193

flexible/​non-​extreme attitudes towards them so that you feel healthy disappointment and not shame about these consequences. It is one of the major themes of both the Client’s Guide and this Practitioner’s Guide that, when your client comes to change their behaviour from dysfunctional to functional, they will still experience urges to act dysfunctionally. This is why it is so important to help your client understand the difference between overt actions and action tendencies. In the present context, this means stressing to your client as they strive to act in ways that address their shame feelings constructively and thus desist from using shame-​ related safety-​ seeking strategies that they will still feel the urge to use them. Help them to develop ways of accepting, but not necessarily liking, such urges and to implement their healthy disappointment-​ based behaviour even though such aforementioned behaviour may be present for some time. You may have to help your client identify and respond to rigid/​extreme attitudes such as: ‘If I feel the urge to do something to get rid of my shame quickly, I have to act on that urge.’ Developing and strengthening flexible/​non-​extreme attitudes towards these urges is particularly important for the client.

Why you feel shame much of the time and how to deal with this If you are particularly prone to shame, you will often focus on times where (a) something highly negative has been revealed about you (or about a group with whom you identify) by yourself or by others, (b) you have acted in a way that falls very short of your ideal or (c) others look down on or shun you (or a group with whom you identify) or you think that they do. You do this because you hold the following attitude, which I call a ‘chronic shame-​based general rigid/​extreme attitude’: ⦿

I must ensure that I and people with whom I am closely connected must always achieve the highest of standards and be socially approved and, if not, it proves that we are defective, disgusting or diminished.’

You then take this attitude to situations where it is possible that you and others will fall short or be socially disapproved of, and you attempt to

194    Dealing with shame

protect all involved from the predicted negative outcomes by getting all to maintain standards or withdraw so that social approval is maintained. However, in doing so, you are keeping alive the three inferences of shame. For you are saying to yourself that, if I did not take the appropriate steps, the following would have happened: ⦿

Something highly negative would be revealed about you (or about a group with whom you identify) by yourself or by others.

⦿

You would act in a way that falls very short of your ideal.

⦿

Others would look down on or shun you (or a group with whom you identify).

How to deal with chronic shame In order to deal with this chronic sense of shame, you need to develop and apply an alternative general flexible/​non-​extreme attitude that protects you from such shame: ⦿

‘I would like to ensure that I and people with whom I am closely connected always achieve the highest standards and are socially approved, but I do not have to do so. If I do not it would be unfortunate, but it would not prove that we are defective, disgusting or diminished. Rather, it would prove that we are fallible human beings and that does not change whether or not we fall from grace and are disapproved of.’

Such an attitude will lead you to think that the following occurred only when there is clear evidence for making such an inference: ⦿

Something highly negative has been revealed about you (or about a group with whom you identify) by yourself or by others.

⦿

You have acted in a way that falls very short of your ideal.

⦿

Others look down on or shun you (or a group with whom you identify) or you think that they do.

When there is such evidence, you will feel disappointment rather than shame because you will be processing this with a specific flexible/​non-​ extreme attitude. If your client finds that the above explanation is too complex, you can help them to see that rigid attitudes towards the presence

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or absence of shame-​related adversities means that, unless they are clear that they have not put their reference group in a bad light, for example, then they think that they have done so. When their attitudes are flexible, they can be more objective about the presence of these adversities.

How to examine the accuracy of your shame-​related inference, if necessary If you are still unsure whether (a) something highly negative has been revealed about you (or about a group with whom you identify) by yourself or by others, (b) you have acted in a way that falls very short of your ideal or (c) others looked down on or shunned you (or a group with whom you identify), answer one or more of the following questions: ⦿

How valid is my inference that I have fallen very short of my ideal (for example)?

⦿

Would an objective jury agree that I have fallen very short of my ideal? If not, what would the jury’s verdict be?

⦿

Is my inference that I have fallen very short of my ideal realistic? If not, what is a more realistic inference?

⦿

If I asked someone whom I could trust to give me an objective opinion about my inference that I have fallen very short of my ideal, what would the person say to me and why? What inference would this person encourage me to make instead?

⦿

If a friend had told me that they had made the same inference about falling very short of their ideal in the same situation, what would I say to them about the validity of their inference and why? What inference would I encourage the person to make instead?

The Individual ‘I’ and the Socially Defined ‘I’ If you have a problem with shame, you probably find it difficult to conceive that you can hold an attitude towards yourself (i.e., the Individual ‘I’) that is radically different from how others see you (i.e., the Socially Defined ‘I’). Yet this is your task if it does transpire that people consider you defective, disgusting or diminished either for falling very short of your ideal or for acting in a way that is greatly at variance from the mores of the judging social group.

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In REBT, we argue that it is possible for you to accept yourself as a fallible human being in the face of others considering you defective, disgusting or diminished. Let me show you how Shireen used a technique that I call Dryden’s Invitation Technique. Shireen came from a close-​k nit religious Muslim family, but was not religious herself. When she went to college, she met and fell in love with a young Hindu man. When her family and community discovered this, they put her under enormous pressure to end the relationship, which she refused to do. Then they told her that, because she was defective, they did not want to have anything to do with her. Initially, Shireen felt intense shame when they told her that she was defective. Then, she helped herself by using Dryden’s Invitation Technique in the following way: ⦿

Shireen recognised that, when her family considered her defective, they were in fact issuing her with an invitation, saying in effect: ‘We regard you as defective for going against your family and social group and we invite you to define yourself as defective.’

⦿

Shireen then recognised that, as with a wedding invitation, she had a choice to accept or decline the invitation. Thus, she could say: ⦿ ‘Thank you for your invitation for me to agree with you. I accept’ or

⦿ ⦿

⦿ ‘Thank you for your invitation for me to agree with you. I decline’. Shireen chose to decline the invitation and felt disappointed, but not ashamed, about going against her family and social group. Had Shireen accepted the invitation, she would have felt ashamed.

As Shireen has shown, it is possible to hold on to a healthy definition of yourself (i.e., the Individual ‘I’) in the face of others’ unhealthy definition of you (i.e., the Socially Defined ‘I’).

Assessing and dealing with emotional problems about shame In previous chapters, I discussed the concept of meta-​disturbance (literally disturbance about disturbance). It is important to assess carefully the

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nature of this meta-​disturbance about shame before you can best deal with it. The best way to start dealing with the assessment of any emotional problems you might have about shame is to ask yourself the question: ‘How do I feel about my feeling of shame?’ The most common emotional problems that people have about shame are as follows: anxiety, depression, unhealthy regret, shame and unhealthy self-​anger. I refer you to the chapters on anxiety, depression, unhealthy regret and unhealthy anger for help on how to deal with these meta-​emotional problems about shame. Here I will help you to deal with your meta-​shame.

Dealing with shame about shame When you experience shame about shame, you take your original feelings of shame and regard them as evidence of you falling very short of your ideal. Then you hold the following rigid and self-​devaluation attitudes towards this ‘fall from grace’ and experience meta-​shame: ⦿

‘I must not fall from grace by experiencing shame and I am defective for so doing.’

First, you need to develop a healthy alternative to these attitudes, such as: ⦿

‘I would much prefer not to fall from grace by experiencing shame, but that doesn’t mean that I must not have this feeling. If I do, it’s unfortunate, but does not prove I am defective. It proves that I am an ordinary, fallible human being capable of experiencing a range of healthy and unhealthy emotions including shame. Shame does not and cannot define me!’

Examine both sets of attitudes (referring to Appendices 2 and 5 for guidance) and do so until you can fully commit yourself to your flexible/​ non-​extreme attitudes . Then you can openly admit to yourself and to others that you sometimes feel ashamed. In doing so, you are coming out of your shame closet and, as shame hates the light and disclosure to others, you will feel disappointed, not ashamed, by your original shame. When you have done this, you are best placed to deal effectively with this original feeling of shame. Your client will sometimes need to address their emotional problems about shame before they address their shame. They need

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to do this particularly when their secondary emotional problem gets in the way of them dealing with their primary shame. However, despite the interfering presence of their secondary problem, your client may still want to target their primary shame. There are two ways of dealing with this situation: ⦿

Provide a rationale to help your client target their secondary problem. For example, explain to your client that their secondary problem is like having a ball and chain around their leg while they are climbing a steep hill (akin to their primary feelings of shame). In the same way as climbing the hill is easier when they remove the ball and chain from their leg, dealing with their primary shame is easier when they deal with their secondary problem first.

⦿

Go along with your client’s wish to deal with their primary shame and, when they fail to do so, help them to understand that the reason why they failed is because they had not addressed their secondary problem and then agree that they will now do so.

Developing and rehearsing non-​s hame, disappointment-​b ased world views People develop views of the world as it relates to them that make it more or less likely that they will experience UNEs. The world views that render you vulnerable to shame do so in a similar way to the chronic shame-​based general rigid/​extreme attitude discussed above (i.e., ‘I must ensure that I and people that I am closely connected with must always achieve the highest standards and be socially approved and, if not, it proves that we are defective, disgusting or diminished’), by making you focus unduly on times when you fell very short of your ideal standards and times when you or others acted against important social mores and by leading you to overestimate the frequency of such events happening. However, these shame-​ based world views have this effect on you much more widely. It is important that you develop realistic views of the world that will help you to deal with shame and experience healthy disappointment instead. In Table 6.1, you will find an illustrative list of such world views rather than an exhaustive one, so you can get an idea of what I mean, which will enable you to develop your own. In Table 6.1, I first describe a world view that renders you vulnerable to shame and then I give its healthy

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Table 6.1 World views that render you vulnerable to shame and help you to deal with shame Views of the world that render you vulnerable to shame

Views of the world that help you deal with shame

⦿

There is always the danger that I will not achieve my ideal standards

⦿

There is always this danger, but these standards are there to guide me, not to be achieved all the time

⦿

Social situations are dangerous because other people will judge me negatively if I put a foot wrong

⦿

Social situations can be dangerous, but they can also be benign. If I put a foot wrong, people may judge me negatively, but they may also show me understanding and compassion

⦿

Social situations are dangerous because I may be exposed as defective, disgusting or diminished at any moment

⦿

If I fall short of my ideal or go against a social custom, I am revealing my fallibility and my humanity. This makes facing social situations far less dangerous

alternative. You will see that the former views are characterised by a conception of the social world as highly dangerous in which, if you slip up, you will be revealed to the harsh judging group as defective, disgusting or diminished. In the latter, a more forgiving picture of others is revealed and a variety of responses to your ‘shameful’ behaviour can be expected. If you hold flexible/​non-​extreme attitudes that are consistent with the views of the world listed on the right-​hand side of Table 6.1, and if you act and think in ways that are, in turn, consistent with these flexible/​non-​ extreme attitudes, you will become less prone to shame. In Chapter 7, I discuss hurt and how to deal with it.

NOTE 1 I regard disappointment as the HNE alternative to shame and I use this term throughout this chapter. However, as we do not have agreed terms for HNEs, feel free to use your own term to denote the healthy alternative to shame.

C H A P T E R

7 Dealing with hurt

In this chapter, I begin by presenting REBT’s way of understanding hurt and then address how to deal with this emotional problem.

UNDERSTANDING HURT In understanding hurt, we need to know what we tend to make ourselves feel hurt about (i.e., its major inference themes), what attitudes we hold, how we act or tend to act, and how we think when we feel hurt. I mentioned in previous chapters that it is important that you use your client’s language when referring to emotional problems. With respect to the term ‘hurt’, you need to be aware that not all clients with a ‘hurt’ problem resonate with the term ‘hurt’. They may identify more closely with terms like ‘upset’. In addition, since hurt often coexists with anger, some clients can relate better to a term such as ‘angry hurt’, rather than just ‘hurt’. If such is the case, your task is to satisfy yourself and your client that these terms represent the UNE known in REBT as hurt. Once you have done so, use the client’s language and write this down in your client’s notes.

Major inference themes in feeling hurt There are two major themes in relation to your personal domain that are implicated in feeling hurt: ⦿

Others treat you badly (and you think you do not deserve such treatment).

⦿

You think that the other person has devalued your relationship (i.e., someone indicates that their relationship with you is less important to them than the relationship is to you).

DOI: 10.4324/9781003424338-8

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Your client may not resonate with the above schema and, in these cases, you should encourage them to put it aside and just focus on what they tend to feel hurt about. REBT theory values flexibility and this includes the freedom not to use REBT terms, schemas and frameworks.

Rigid/​e xtreme attitudes As I explained in Chapter 1, according to REBT, inferences on their own do not account for emotional problems. It is possible, therefore, for you to make the same inferences as listed above and feel sorrowful and not hurt. In order for you to feel hurt, you have to hold a rigid/​extreme attitude. While the rigid attitude is at the core of hurt, the extreme attitudes that are derived from the rigid attitude often distinguish between whether you are experiencing ego ‘less me’ hurt (where you devalue yourself) or non-​ ego ‘poor me’ hurt (where you ‘awfulise’, find the adversity unbearable or devalue life). If your client is unsure about the mediating role that rigid/​ extreme attitudes play in their hurt, ask them how they would feel if they had strong conviction in the flexible/​ non-​ extreme alternatives to what REBT holds are their hurt-​creating rigid/​ extreme attitudes. In using this strategy, it is important that you formulate the flexible/​non-​extreme attitudes for your client, who cannot be expected to do this for themself at this stage. When you do this, ensure that you match your client’s rigid attitude with a flexible alternative and their extreme attitude with a non-​extreme alternative, and then ask them how they would feel if they had strong conviction in this flexible/​ non-​ extreme attitude. For example: ‘Let me outline two sets of attitudes towards being neglected by your friend and you tell me which leads to hurt and which leads to sorrow without hurt. The first set of attitudes is as follows: “My friend absolutely should not have neglected me and it’s terrible that they did. Poor me!” The second set of attitudes is as follows: “I would have much preferred it if my friend had not neglected me, but they do not have to act in the way that I prefer. It’s not terrible that they neglected me and, while it is a poor state of affairs, I am not a poor person because it happened

202    Dealing with hurt

to me.” Now which set of attitudes would lead to hurt and which set would lead to sorrow without hurt?’ Once your client can see that their rigid/​ extreme attitudes underpin hurt and their flexible/​non-​extreme attitudes underpin sorrow, they have understood the mediating role of attitudes. This is quite an elegant strategy since it accomplishes a number of things at once: 1.  It addresses your client’s doubts about the mediating role of rigid/​extreme attitudes in hurt if they have such concern. 2.  It introduces flexible/​non-​extreme attitudes as a meaningful alternative to these rigid/​extreme attitudes. 3.  It helps your client to see that holding flexible/​ non-​ extreme attitudes can have beneficial effects.

Behaviour associated with hurt When you hold a rigid/​extreme attitude towards one of the two major inference themes, you will act or tend to act in a number of ways, the most common of which are as follows: ⦿

You stop the communicating channel with the other person.

⦿

You sulk and make it obvious you feel hurt without disclosing details of the matter.

⦿

You indirectly criticise or punish the other person for their offence.

If you ask your client whether they want to change their hurt-​ based behaviour, their response will be affected by their state of mind or mood. If they are currently experiencing hurt, they are less likely to see that this behaviour is dysfunctional than when they are not feeling hurt. If they are feeling hurt, it is useful to encourage them to imagine that they are advising a friend who displays the same hurt-​based behaviour as they do. What would they say to this friend about the functionality or dysfunctionality of such behaviour? They are more likely to see that their own hurt-​ based behaviour is dysfunctional after they have told their ‘friend’ that the same behaviour is dysfunctional.

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Thinking associated with feeling hurt When you hold a rigid/​extreme attitude towards being unfairly treated by someone close to you, or about another indicating that their relationship to you is less important to them than it is to you, you will tend to think in a number of ways. Remember what I said in Chapter 1: the thinking that accompanies your hurt is the result of your hurt-​based inference being processed by your rigid/​extreme attitude and therefore it is likely to contain a number of thinking errors that I present in Appendix 1. I list the main features of this post-​rigid/​extreme attitude hurt-​based thinking below: ⦿

You overestimate the unfairness of the other person’s behaviour.

⦿

You think that the other person does not care for you or is indifferent to you.

⦿

You see yourself as alone, uncared for or misunderstood.

⦿

You expect the other to make the first move toward repairing the relationship.

⦿

You tend to think of past ‘hurts’.

As you can see, such thinking exaggerates the negative consequences of being treated unfairly or having your relationship devalued by others. Such thinking may be in words or in mental images. One of the main features of post-​rigid/​extreme-​attitude thinking is that it is compelling. As such, it is quite easy for your client to get caught up in this way of thinking and think that it reflects reality. This is an example of ‘cognitive-​emotive’ reasoning: if a thought is plausible and emotionally compelling, therefore it must be true. It is important that you help your client to understand how their mind works with respect to the thinking consequences of rigid/​ extreme attitudes and to encourage them to use such thoughts to go back to address the rigid/​extreme attitudes that spawn them. When they have done this, you can encourage them to respond to these thinking consequences of rigid/​extreme attitudes as these attitudes will not disappear just because they have examined these attitudes. When they respond to such thinking consequences, they need to do so only a few times on any one occasion. After that, they need to accept the presence of such thinking without engaging with it.

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To summarise, your client needs to: ⦿

identify the presence of the thinking consequences of rigid/​ extreme attitudes (see Appendix 1)

⦿

trace these back to the source of this mode of thinking (i.e., identify the underlying rigid/​extreme attitudes)

⦿

examine these rigid/​extreme attitudes

⦿

respond briefly to the thinking consequences of such attitudes, but not get overly involved in this process

⦿

accept the lingering presence of these thinking consequences without engaging with them

⦿

get on with the business of living.

HOW TO DEAL WITH FEELING HURT If you are prone to feeling hurt, you tend to experience this emotional problem in a variety of different settings and in response to a variety of situations where someone thinks less of their relationship with you than you do or where someone treats you badly when you don’t deserve it. Here is how to deal with feeling hurt so that you become less prone to it.

Step 1: Identify reasons why feeling hurt is a problem for you and why you want to change While feeling hurt is generally regarded as an emotional problem, it is useful for you to spell out reasons why feeling hurt is a problem for you and why you want to change. I suggest that you keep a written list of these reasons and refer to it as needed as a reminder of why you are engaged in a self-​help programme. I discuss the healthy alternative to feeling hurt in Step 4. Some people who feel hurt think that ‘feeling hurt’ is an appropriate response to situations where (a) others have treated them badly (and they think that they do not deserve such treatment) or (b) where they think that others have devalued their relationship (i.e., someone indicates that their relationship with your client is less important to them than the relationship is to your client).

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In these circumstances, it is important to introduce the idea of feeling sorrow as the healthy alternative to hurt a little earlier than you would normally do (see Step 4). When you have done so, you can then carry out a cost-​benefit analysis of hurt and its healthy alternative, sorrow. This involves helping your client to spell out the perceived advantages and disadvantages of both emotions. Respond to any perceived advantages of hurt and perceived disadvantages of sorrow, correcting any misconceptions that your client reveals on these issues. For example, imagine that your client thinks that feeling hurt will lead the other person to apologise for their bad behaviour and that sorrow would not achieve the same end. In this case, help your client to see that precisely the reverse is true. Hurt tends to lead to sulking and, as such, the other person is not clear that they have anything to apologise for. By contrast, sorrow is more likely to lead the person to communicate clearly and respectfully, thus increasing the chances that they will apologise for their behaviour if they see things from your client’s perspective.

Step 2: Take responsibility for your hurt In REBT, we argue that people do not hurt you; rather you create these hurt feelings by the rigid/​extreme attitudes that you hold towards how people treat you. You may object that this view condones other people’s behaviour, but this objection is based on a misconception. You can take responsibility for creating your hurt and still not condone others’ bad behaviour. The idea that emotional problems (including hurt) are based largely on the rigid/​extreme attitudes that a person holds towards what happens to them is, as you know, a central plank in REBT. However, for many clients, it will be a new idea. Thus, your client may hold that the reason they are hurt, for example, is that it is inherently hurtful to be treated badly by someone that one cares for and treats well. This is an example of ‘A–​C’ thinking where ‘A’ is the person being treated badly by someone that they care for and ‘C’ is the emotion of hurt. Rather, we argue that the reason that the person experiences hurt is largely due to the fact that they hold a set of rigid/​extreme attitudes towards this bad treatment. If they held a set of flexible/​non-​extreme attitudes towards the bad treatment, they would experience sorrow rather than hurt.

206    Dealing with hurt

If your client continues to have difficulty accepting responsibility for their hurt, it is important for you to identify the source of this difficulty. Here are two common obstacles and how to respond to them: ⦿

The double penalty: this obstacle is expressed like this: ‘If I accept responsibility for my feelings of hurt, it is as if I am being punished twice. First, I have been treated badly by someone I care for and, second, I am being told that I am responsible for these feelings. This lets the other person off the hook.’ If your client holds this view, help them to see that, while they have been penalised by being treated badly, they are actually penalising themself by making themself feel hurt. Show your client that you want to spare them this second penalty by helping them to experience an HNE (sorrow) rather than a UNE (hurt).

⦿

Taking responsibility for hurt means admitting a weakness: here the block is the rigid/​extreme attitude that your client holds towards having and/​ or admitting having a weakness (e.g., ‘I cannot take responsibility for my hurt feelings because it means admitting that I have a weakness that I must not have or must not admit to publicly’). If your client holds to this position, help them to understand that having a weakness is quintessentially human and does not mean that they are defective.

It is important to help your client to understand the impact of these obstacles on their emotional problems. Then, help them to develop alternatives to these obstacles and review the impact of these alternatives on their emotional problem-​solving. This often helps clients to deal effectively with these obstacles. If not, you may need to do a more detailed assessment of the obstacle, which is outside the brief of this book.

Step 3: Identify themes you tend to feel hurt about The best way of identifying hurt-​related inference themes to which you are particularly vulnerable is by understanding the themes associated with hurt, and seeing which are present when you feel hurt. As I outlined above, there are two such themes:

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⦿

Others treat you badly (and you think you do not deserve such treatment).

⦿

You think that the other person has devalued your relationship (i.e., someone indicates that their relationship with you is less important to them than the relationship is to you).

If your client finds it difficult to find their hurt-​related theme, you can help them by assessing a few specific examples of their hurt. Have them focus on a specific situation in which they felt hurt and ask them what they were most hurt about. If they still find it difficult to identify the theme in this or other specific situations, use the ‘magic question’ technique. This involves you doing the following: ⦿

Have your client focus on the situation in which they felt hurt.

⦿

Ask them to nominate one ingredient that would eliminate or significantly reduce their feelings of hurt without changing the situation.

⦿

The opposite of this nominated ingredient is what they are most hurt about.

Lisa was struggling to identify the specific theme in her hurt about her best friend not returning her calls. Lisa used the ‘magic question’ technique as follows: ⦿

Lisa focused on the situation in which she felt hurt: ‘My friend is not returning my calls.’

⦿

She nominated one ingredient that would eliminate or significantly reduce her shame without changing the situation: ‘My friend still cares for me.’

⦿

The opposite of this nominated ingredient is what she is most hurt about: ‘My friend no longer cares for me.’

If you assess a number of specific examples of your client’s hurt in this way, the hurt-​related theme should be apparent. In Lisa’s case, it was being uncared for by people close to her. It may be that there are two hurt-​related themes present in your client’s hurt. For example, your client may feel hurt about being

208    Dealing with hurt

treated badly by others or that they care more about someone than that person cares about your client. If this is the case, deal with them one at a time and have your client nominate the theme that they want to focus on first.

Step 4: Identify the three components of your hurt response and set goals with respect to each component The next step is for you to list the three elements of your hurt response in the face of each of the relevant themes listed above.

Identify the three components of your hurt response I use the term ‘hurt response’ to describe the three main components that make up this response. The three components of your hurt response are emotional, behavioural and thinking components.

Emotional component The emotional component here is, of course, hurt.

Behavioural component The behavioural component concerns overt behaviour or action tendencies that you engage in or ‘feel like’ engaging in when you feel hurt. Consult the list that I provided to help you identify your behaviour associated with each relevant theme when you feel hurt (see p. 202).

Thinking component The thinking component associated with hurt is listed on p. 203. Again, these may be in words or in mental pictures. Consult this list if necessary.

Set goals with respect to each of the three components You need to set goals so that you know what you are striving for when you deal effectively with hurt. The three goals are emotional, behavioural and thinking goals.

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Emotional goal Your emotional goal is sorrow rather than hurt (or whatever synonym you prefer to the term ‘sorrow’). Sorrow is an HNE, which is an appropriate response to the two hurt-​related themes detailed above. It helps you to think objectively about the situation and your response to it and helps you to move on with your life rather than get stuck or bogged down. The concept that sorrow is the healthy alternative to hurt when (a) others treat you badly (and you think you do not deserve such treatment) or (b) you think that the other person has devalued your relationship (i.e., someone indicates that their relationship with you is less important to them than the relationship is to you) is based on the following idea. These adversities are negative and therefore it is realistic to have a negative emotion about them. The choice, therefore, is between a UNE (hurt) or an HNE (sorrow). However, what if your client specifies unrealistic goals? Here are three such goals and how to respond to clients who nominate them: ‘I don’t want to feel hurt.’ Show your client that they have indicated what they do not want to feel in the face of (a) others treating them (when they do think they deserve such treatment) or when (b) they think that the other person has devalued their relationship. Your client needs to specify how they want to feel instead of hurt. ⦿

‘I want to feel less hurt.’ Show your client that, as hurt is a disturbed emotion, wanting to feel less hurt is still to nominate a disturbed emotion, albeit of lesser intensity. Show them that sorrow can be strong and healthy. ⦿

‘I don’t want to feel anything.’ Not feeling anything in the face of being treated badly by someone close to your client when they don’t deserve it or in the face of having someone devalue their relationship with them will not help your client to be appropriately geared up to deal with it. Help them to see this. Also show them that the only way that they could achieve a state of not feeling anything is to feel completely indifferent about being treated badly by someone close or when someone devalues their relationship with your client. ⦿

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This can be achieved only if your client lies to themselves. Show them this and discourage them from setting such a goal.

Behavioural goal Your behavioural goal should reflect actions that are based on sorrow rather than hurt. The following are the most common behaviours associated with sorrow. You may wish to compare these behaviours with those associated with hurt that I presented on p. 202. ⦿ ⦿

You communicate your feelings to the other directly. You request that the other person acts in a fairer manner towards you.

It is important that your client understands that, as they strive to develop healthy behavioural responses to being treated badly or having their relationship with a person devalued by that person, they will still feel the urge to act in ways that are dysfunctional, as listed on p. 202. Help them to understand the reason for this. Explain to them that, as they examine their attitudes and commit themself to strengthening their conviction in their flexible/​non-​ extreme attitudes and to weakening their conviction in their rigid/​extreme attitudes, the latter will still be active and producing urges for them to act dysfunctionally. Encourage your client to accept these urges, to recognise that they do not have to act on them and to use them as cues to act in functional ways.

Thinking goal As well as setting behavioural goals related to the feeling of sorrow about (a) being unfairly treated by someone close to you or about (b) another indicating that their relationship to you is less important to them than it is to you, it is important that you set thinking goals associated with this emotion. The following are the most common forms of thinking associated with sorrow rather than hurt. Again, you may wish to compare these forms of thinking with those associated with hurt that I presented on p. 203. ⦿

You are realistic about the degree of unfairness in the other person’s behaviour.

⦿

You think that the other person has acted badly rather than demonstrating lack of caring or indifference.

Dealing with hurt    211

⦿

You see yourself as being in a poor situation, but still connected to, cared for by and understood by others not directly involved in the situation.

⦿

If you think of past hurts, you do so with less frequency and less intensity than when you feel hurt.

⦿

You are open to the idea of making the first move towards the other person.

As the above list shows, the dominant feature of thinking associated with sorrow is that it is realistic and balanced. Please remember that such thinking may be in words or in mental pictures. The point I made above with respect to your client’s behavioural goals is also relevant with respect to their thinking goals. Your client will still have some conviction in their rigid/​extreme attitudes until they have full conviction in their flexible/​ non-​ extreme attitudes. Given this, your client’s rigid/​ extreme attitudes will have some impact on their subsequent thinking as they strive to achieve their goals. Thus, highly distorted thoughts will still come into your client’s mind. Help your client to understand why this is the case. When you come to help them deal with these forms of post-​rigid/​extreme-​ attitude thinking, do one or more of the following as indicated. Discuss this issue with your REBT supervisor, if necessary: ⦿

Encourage your client to acknowledge the existence of such thoughts without trying to suppress them, distract themselves from them or engage with them.

⦿

If relevant, use the presence of this post-​rigid/​extreme-​attitude thinking to help your client to identify and deal with the rigid/​ extreme attitudes.

⦿

Examine the empirical nature of these thinking ‘Cs’ once or twice and then return to the acceptance strategy detailed above.

Step 5: Identify your general rigid/​e xtreme attitudes and alternative general flexible/​ non-​e xtreme attitudes A general rigid/​extreme attitude leading to your hurt response is a rigid/​ extreme attitude that you hold across situations defined by one of the following themes:

212    Dealing with hurt

⦿

Others treat you badly (and you think you do not deserve such treatment).

⦿

Relationship devaluation (i.e., someone indicates that their relationship with you is less important to them than the relationship is to you).

Its flexible/​non-​extreme alternative, which will also be general in nature, will account for your sorrow response.

Identify your general rigid/​extreme attitudes When you identify a general rigid/​extreme attitude, you take a common hurt-​related theme (see above) and add to this a general rigid attitude and the main extreme attitude that is derived from the rigid attitude. In hurt, your main extreme attitude will be either an unbearability attitude with an accompanying sense of ‘self-​pity’ (I call this ‘poor me’ hurt) or a self-​ devaluation attitude (I call this ‘less me’ hurt). Here is an example of each type of hurt: ‘Poor me’ hurt: ‘I must not be treated unfairly by people close to me when I don’t deserve to be and I can’t bear it when this happens. Poor me!’ ⦿

‘Less me’ hurt: ‘When my relationship with people is important to me, they must find the relationship equally important to them. If they don’t, it proves that I am less worthy.’ ⦿

Identify your alternative general flexible/​non-​extreme attitudes When you identify your alternative general flexible/​non-​extreme attitude, you take the same common theme –​i.e., others treat you badly (and you think you do not deserve such treatment) and relationship devaluation (i.e., someone indicates that their relationship with you is less important to them than the relationship is to you) –​and add to this a general flexible attitude and a general discomfort tolerance attitude or a general self-​ acceptance attitude. For example:

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Non-​self-​pity based sorrow: ‘I don’t want to be treated unfairly by people close to me when I don’t deserve to be, but they don’t have to treat me the way I want them to. When this happens, it is a struggle, but I can stand it and I am not a poor person, even though I have been treated poorly.’ ⦿

Unconditional self-​acceptance based sorrow: ‘When my relationship with people is important to me, I want them to find the relationship equally important to them, but they don’t have to do so. If they don’t, it would be bad, but it would not prove that I am less worthy. I am the same person whether or not they value our relationship as much as I do.’ ⦿

As you will have noticed in the Client’s Guide, I encourage readers/​ clients to identify and work with their general rigid/​ extreme attitudes and to develop general flexible/​ non-​ extreme attitudes and, as you will see, when they are facing specific instances of their problems, I encourage them to focus on specific examples of both sets of attitudes. This will be at variance with your REBT practice, where you will begin with specific examples of your client’s problems and then proceed to work at a more general level with their problems and how these relate to one another. The reason I have chosen to go ‘general’ rather than ‘specific’ when helping readers/​clients to deal with their emotional problems is a pragmatic one. In this book, I aim to help people to deal with a range of emotional problems and therefore, in my view, it is best to give readers/​clients general guidance with respect to dealing with this range of problems and then help them to move from the general to the specific rather than vice versa. My considered view was that I just do not have the space to help readers/​clients focus on specific examples of their emotional problems and then generalise from this specific level. Consequently, one way that you can help your client who is using the Client’s Guide is to help them to work with specific examples of their emotional problem, in this case hurt. Use the following sequence as you do so and help your clients to: ⦿ ⦿

select a specific example of their hurt problem express why their hurt constitutes a problem for them

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⦿

identify what they felt most hurt about in the situation

⦿

identify the three specific components of their hurt response and set specific goals with respect to each component

⦿

identify their specific rigid/​extreme attitudes and alternative specific flexible/​non-​extreme attitudes

⦿

examine their specific attitudes.

⦿

face up to what they are most hurt about in imagery (if necessary)

⦿

face the same things in reality (if possible) and take appropriate action

⦿

capitalise on what they have learned

In helping your client to deal with a specific example of their hurt, you can teach them how to use REBT’s ABCD form, which appears in Appendix 6. The following steps are the same as those that appear in Steps 8–​11 later in this chapter. Thus, help your client to:

⦿

generalise their learning.

Step 6: Examine your general attitudes I recommended in previous chapters that you first examine together your general rigid attitude and its general flexible attitude alternative and then examine together your general extreme attitude and its general non-​ extreme attitude alternative.

Examine your general rigid attitude and its general flexible attitude alternative First, take your general rigid attitude and its general flexible attitude alternative and write them down next to one another on a sheet of paper. Then ask yourself: ⦿ ⦿

Which is true and which is false? Which is sensible logically and which does not make sense?

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⦿

Which has largely constructive results and which has largely unconstructive results?

Write down your answer to each of these questions on your piece of paper, giving reasons for each answer. Consult Appendix 2 for help with the answers to these questions, which you need to adapt and apply to the attitudes you are examining.

Examine your general extreme attitude and its general non-​extreme attitude alternative Next, take your general extreme attitude and its general non-​extreme attitude alternative and again write them down next to one another on a sheet of paper. Then, ask yourself the same three questions that you used with your general rigid attitude and its general flexible attitude alternative. Again, write down your answer to each of these questions on your piece of paper, giving reasons for each answer. I suggest that you consult Appendix 3 (for help with examining awfulising attitudes and non-​ awfulising attitudes), Appendix 4 (for help with examining unbearability attitudes and bearability attitudes) and Appendix 5 (for help with examining devaluation attitudes and unconditional acceptance attitudes). Again, you need to adapt and apply these arguments to the attitudes you are examining. You should now be ready to commit to acting and thinking in ways consistent with your general flexible/​non-​extreme attitude. I included Appendices 2–​ 5 in the Client’s Guide as general guidelines to help readers/​clients to examine their rigid/​extreme and flexible/​ non-​ extreme attitudes (reproduced in this book as Appendices 2–​5). If you are working with a client who is using the Client’s Guide, you will have a chance to look at the examining work that your client has done at this point and give them feedback on that work. No book can provide such feedback. I have suggested that readers/​clients examine their rigid attitude and their flexible attitude together and then their main extreme attitude and non-​ extreme attitude equivalent together using three criteria as shown below: ⦿

Rigid attitude vs. flexible attitude ⦿

empirical status

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⦿ ⦿ ⦿

logical status pragmatic status

Main extreme attitude vs. main non-​extreme attitude ⦿

empirical status

⦿

pragmatic status.

⦿

logical status

The final point I want to make about examining attitudes concerns the concept of persuasiveness. Perhaps the most important aspect of the examining process is for your client to develop arguments concerning the false, illogical and unhealthy nature of their rigid/​ extreme attitudes and the true, logical and healthy nature of their flexible/​non-​extreme attitudes that are persuasive to them. So, encourage your client to develop such persuasive arguments and to make a note of these for future reference.

Step 7: Adopt a healthy orientation towards reciprocity in close relationships and its absence Once you have committed yourself to strengthening your conviction in your general flexible/​non-​extreme attitude, it is useful for you to develop what I call a healthy orientation towards reciprocity in relationships and, in particular, its absence. This involves you doing the following: ⦿

Recognise that there is nothing intrinsically wrong with wanting reciprocity in relationships. However, it is also important to acknowledge that what you want from a relationship with a person may not be the same as what they want from a relationship with you.

⦿

Recognise that most of the time when you act fairly towards others, they will act fairly towards you. In other words, fair treatment tends to yield fair treatment. However, this is certainly not a universal rule and sometimes people close to you will take advantage of your good nature and betray your trust and otherwise treat you unfairly. It is important that you don’t add disturbance to this adversity by demanding that the reciprocity effect must exist in such situations. It doesn’t and no

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amount of demanding that it must will make it so. Rather, look at the situation from your flexible/​non-​extreme mind. When you do so, you will still feel very badly about it (i.e., sorrow), but you won’t be disturbed (i.e., hurt). It is very important that you discuss this healthy orientation about reciprocity in close relationships only when you have helped your client to adopt a set of flexible/​non-​extreme attitudes towards relationship reciprocity and its violations. Otherwise, your client will bring their rigid/​extreme attitudes to the discussion and it is probable that they will not be in the best frame of mind to consider your arguments carefully. During this discussion, don’t forget that the main purpose of helping your client to adopt a healthy orientation towards reciprocity in relationships (and its absence) is so that they deal healthily when others do not reciprocate their care and concern. It is worth periodically reminding your client of the pragmatic nature of your discussion, particularly if the discussion is becoming overly philosophical.

Step 8: Face your hurt-​r elated theme in imagery I hope that you have made a commitment to act on your general flexible/​non-​extreme attitudes. Assuming that you have, your basic task is to face up to others treating you badly (where you think you do not deserve such treatment) and relationship devaluation (where someone indicates that their relationship with you is less important to them than the relationship is to you) and to learn to think in a flexible/​non-​extreme way about it. Up to this point, you have worked at a general level with respect to your hurt-​related theme, dealing with the general rigid/​extreme attitudes that account for your hurt and developing your alternative general flexible/​ non-​extreme attitudes. However, when you come to apply your general flexible/​non-​extreme attitudes in dealing with others treating you badly (where you think you do not deserve such treatment) and with relationship devaluation (where someone indicates that their relationship with you is less important to them than the relationship is to you), you need to bear in mind one important point. Since you make yourself hurt about specific events (actual or imagined), you need to deal with these by rehearsing specific variants of your general flexible/​non-​extreme attitudes.

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While the best way to do this is in specific situations where others treat you badly (where you think you do not deserve such treatment) and where your relationship is devalued (where someone indicates that their relationship with you is less important to them than the relationship is to you), you may derive benefit by using imagery first. If this is the case, you need to do the following: ⦿

Imagine a specific situation in which you felt hurt or may feel hurt about (a) others treating you badly (where you think you do not deserve such treatment) or (b) where someone indicates that their relationship with you is less important to them than the relationship is to you and focus, in your mind’s eye, on what you felt most hurt about (i.e., your ‘A’). Focus on this ‘A’ while rehearsing a specific flexible/​non-​extreme attitude relevant to the situation. As you do this, try to make yourself feel sorrowful, rather than hurt.

⦿

Then, see yourself acting in ways consistent with your flexible/​non-​ extreme attitude, e.g., expressing your sorrow, asking the other person for their perspective and engaging the other person in a productive dialogue.

⦿

Recognise that some of your post-​ rigid/​ extreme attitude thinking may be distorted. Respond to it without getting bogged down doing so. Accept the presence of any remaining distorted thoughts without engaging with them.

⦿

Repeat the above steps until you feel sufficiently ready to put this sequence into practice in your life.

If you find that facing your hurt-​related ‘A’, in your mind’s eye, is too much for you, use the ‘challenging, but not overwhelming’ principle that I introduced in Chapter 2 (see p. 53). This means that, instead of imagining yourself facing a hurt-​related situation that you find ‘overwhelming’ at the present time, choose a similar hurt-​related ‘A’ that you would find ‘challenging, but not overwhelming’. Then employ the same steps that I have outlined above. Work in this way with modified hurt-​related ‘A’s’ until you find your original one ‘challenging, but not overwhelming’ and then use the steps again. Your client may say that they can’t get very clear images when they try to picture events in their mind’s eye. While they may get more out of imagery techniques if they can get such clear images, they will still get something out of facing others treating them

Dealing with hurt    219

badly or devaluing their relationship with them in imagery even if their images are unclear. So, if your client wants to face their particular adversity in imagery before they do so in reality, encourage them to do so, no matter how clear their mental images are.

Step 9: Face people who have treated you unfairly, disclose your sorrow and have a constructive conversation about the experience Once you have got yourself into a flexible/​non-​extreme frame of mind about situations about which you felt hurt so that you now feel sorrowful about it, you are in a position to tell people how you healthily feel about what they did or did not do. As you do so, it is important that you don’t blame them for the feelings of hurt that you initially felt when you held rigid/​extreme attitudes towards their behaviour or its lack. Once you do this, be ready to listen to their response and try to understand them from their perspective. If you do so, they may well let go of their defensiveness and they also may, and I stress the word ‘may’ here, apologise for their behaviour. However, even if they don’t apologise, once you hold flexible/​non-​extreme attitudes towards their unfair behaviour (for example) rather than rigid/​extreme attitudes, you have more of a chance of having a constructive dialogue over the episode and of coming to a constructive resolution. You may find that your client reports various obstacles to facing those who have treated them unfairly even after they hold flexible/​ non-​extreme attitudes towards such unfair treatment. I list here some of the major obstacles and suggest ways of addressing these obstacles with your clients. ‘If I tell them how I feel, they will take advantage and that would be terrible.’ If your client thinks that facing someone has, in common parlance, hurt them and will result in the person taking advantage of them, it is important that you help them to specify the nature of this ‘taking advantage’ and then help them to take the horror out of it. Your client may think that feeling hurt places them in a weaker position with respect to the other person. In this case, you can help your client to see that handling such ‘hurtful’ behaviour well and communicating feelings of sorrow ⦿

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places them in an emotionally strong position with respect to the other person in that they are showing the other that they can communicate as an equal. ‘I may get upset when I face the other person and that is shameful.’ Here you can use the material in Chapter 5 on ‘shame’ and help your client to do two things. First, help them to accept themselves unconditionally for showing ‘weakness’ (here you accept that such emotional expression does constitute a weakness). Then help them to reconsider the inference that showing upset is weak. ⦿

‘I don’t feel comfortable facing the person who has “hurt” me.’ Help your client to see that, if they wait until they are comfortable before facing the person, they will wait a very long time. Show them that, if they are comfortable about facing the person, it is likely that they are not hurt about what the other person did or failed to do. Consequently, it is important that you help your client realise that they are bound to be uncomfortable about facing a hurt-​related situation even after they have disputed their hurt-​creating rigid/​extreme attitudes. Show your client that they can tolerate this discomfort and that it is worth it to them to do so. ⦿

Step 10: Capitalise on what you have learned When you have faced a situation in which you experienced hurt and dealt with it as best you could, it is important that you reflect on what you did and what you learned. In particular, if you were able to face the situation, and rehearse your specific flexible/​non-​extreme attitudes until you felt sorrow, ask yourself how you can capitalise on what you achieved. If you experienced any problems, respond to the following questions: ⦿ ⦿

Did I face the situation and, if not, why not? Did I rehearse my flexible/​non-​extreme attitudes before, during or after facing the situation and, if not, why not?

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⦿ ⦿

Did I execute my plan to face the situation and, if not, why not? Did I engage with post-​rigid/​extreme attitude distorted thinking and, if so, why?

Reflect on your experience and put into practice what you have learned the next time you face a situation in which someone treats you badly (and you think you do not deserve such treatment) and where someone has devalued your relationship by indicating that their relationship with you is less important to them than the relationship is to you. It is useful to monitor your client’s responses to these questions and help them to reflect on any issues that they have not considered.

Step 11: Generalise your learning Once you have dealt with your hurt in a specific situation by holding the relevant specific version of your general flexible/​non-​extreme attitude and by acting and thinking in ways that are consistent with it, you can generalise this learning to situations defined by your hurt-​ based theme. Gina was particularly prone to hurt about others with whom she was close neglecting her. Thus: ⦿

Gina assessed the three components of her hurt response and set goals with respect to all three components.

⦿

She identified her relevant general rigid/​extreme attitude regarding being neglected (i.e., ‘I must not be neglected by those close to me and, if I am, I am unlovable’) that underpinned her hurt response and her alternative general flexible/​non-​extreme attitude (i.e., ‘I don’t want to be neglected by those close to me, but that does not mean that it must not happen. If it does, it is unfortunate, but it does not prove that I am unlovable. I am the same person whether or not they neglect me’) that underpinned her sorrow response.

⦿

She examined both elements of her general rigid/​extreme attitude and her general flexible/​non-​extreme attitude until she clearly saw that the former

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were false, made no sense and were detrimental to her, and that the latter were true, sensible and healthy. ⦿

She acted on shortened versions of her flexible/​non-​extreme attitudes in specific situations and disclosed her feelings of sorrow about being neglected. This resulted in a useful discussion with the other, which sometimes resulted in them apologising to her and taking her less for granted in the future.

⦿

As she acted on her flexible/​non-​extreme attitudes, she tolerated the discomfort that she felt and accepted that some of her distorted and skewed negative thinking would still be in her mind as she did so. She let such thinking be without engaging with it, suppressing it or distracting herself from it.

As this section shows, you can generalise what you learn about dealing with hurt from situation to situation as defined by your hurt-​ based inference.

USING REBT’S ABCD FORM TO DEAL WITH SPECIFIC EXAMPLES OF YOUR HURT This chapter is mainly geared to help you deal with your hurt in general terms. However, you can also use this material to address specific examples of your hurt. I have developed a self-​help form to provide the structure to assist you in this regard. It is called the ABCD form and it appears with instructions in Appendix 6. In Appendix 6, I outline the major problems that clients have in using this form and how to deal with them.

OTHER IMPORTANT ISSUES IN DEALING WITH HURT In the above section, I outlined an 11-​step programme to deal with hurt. In this section, I discuss some other important issues that may be relevant to you in your work to become less prone to this emotional problem. If you want to, you can incorporate them as additional steps in the above step-​by-​step guide at points relevant to you.

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Dealing with your safety-​s eeking measures to avoid hurt I mentioned in Chapter 2 that people use safety-​seeking measures to protect themselves from threat. You may use similar measures to protect yourself from feeling hurt. Here is how this works from your perspective. You reason that, since you feel hurt about (a) others treating you unfairly and (b) relationship devaluation (where someone indicates that their relationship with you is less important to them than the relationship is to you), you will take one major step to avoid hurt. This involves you keeping yourself at a distance from others to whom you would like to get close and not putting yourself in a position where you feel vulnerable to be taken advantage of. Adopting this position means that you will have superficial relationships with people and will thus be unhappy and frustrated since you ideally want to be closer to them. However, this stance and the reasoning that leads you to take it are flawed and will only serve to perpetuate your tendency to feel hurt. This is due to the fact that your hurt is not based on (a) others treating you badly (when you think you do not deserve such treatment) or (b) relationship devaluation (where someone indicates that their relationship with you is less important to them than the relationship is to you), but on your rigid/​ extreme attitudes towards these two inferences. So, if you want to deal effectively with hurt, you need to do the following: ⦿

Take healthy risks and allow yourself to get close to people and to feel vulnerable. However, do this while holding flexible/​non-​extreme attitudes towards the above inferences.

⦿

If it transpires that some people do treat you badly or show that they do not value the relationship as much as you do, deal with this by bringing to such situations appropriate specific versions of your general flexible/​non-​extreme attitudes so that you feel sorrow and not hurt about these episodes. Also, act and think in ways that are consistent with these specific flexible/​ non-​ extreme attitudes as far as you can.

If you do this, you will be less likely to keep your distance from those to whom you would like to get close. It is one of the major themes of both the Client’s Guide and this Practitioner’s Guide that, when your client comes to change their

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behaviour from dysfunctional to functional, they will still experience urges to act dysfunctionally. This is why it is so important to help your client understand the difference between overt actions and action tendencies. In the present context, this means stressing to your client as they strive to act in ways that address their hurt feelings constructively and thus desist from using hurt-​ related safety-​ seeking strategies that they will still feel the urge to use them. Help them to develop ways of accepting, but not necessarily liking, such urges and to implement their healthy sorrow-​based behaviour, even though such aforementioned behaviour may be present for some time. You may have to help your client identify and respond to rigid/​extreme attitudes such as: ‘If I feel the urge to do something to get rid of my hurt quickly, then I have to act on that urge.’ Developing and strengthening flexible/​non-​extreme attitudes towards these urges is particularly important for this client.

Why you feel hurt much of the time and how to deal with this If you are particularly prone to hurt, you hold the following attitude, which I call a ‘chronic hurt-​based general rigid/​extreme attitude’: ⦿

‘Once I invest in people close to me, I must get, and see clearly that I am getting, a fair return on that investment and, if I don’t, it’s terrible and proves that I am unworthy or to be pitied.’

Holding this attitude, you will do the following: ⦿

You will often focus on past relationships where (a) others have treated you unfairly or (b) where their investment in your relationship was not as strong as yours.

⦿

You scan your current relationships certain to find evidence that others are treating you badly or that they don’t care for you as much as you care for them. If there is any ambiguity about this, you err on the side of undeserved treatment and relationship devaluation.

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⦿

Finally, as we have seen, you will avoid getting close to people because you are sure that, in your terms, they will hurt you.

How to deal with chronic hurt In order to deal with this chronic sense of hurt, you need to develop and apply an alternative general flexible/​non-​extreme attitude that protects you from such hurt: ⦿

‘Once I invest in people close to me, I really want to get, and see clearly that I am getting, a fair return on that investment, but I don’t have to do so. If I don’t, it’s bad, but not terrible and it neither proves that I am unworthy nor to be pitied. Rather, I am a non-​poor, fallible human being who has been treated poorly.’

Such an attitude will lead you to think that the following occurred only when there is clear evidence for making such an inference: ⦿

Someone did take advantage of your good nature and treated you unfairly.

⦿

The other person does not value your relationship with you as much as you value your relationship with them.

When there is such evidence, you will feel sorrow rather than hurt because you will be processing this with a specific flexible/​non-​extreme attitude. In addition, this attitude will help you to think of times in the past when others did treat you fairly and reciprocated your positive feelings about the relationship as well as helping you to see the potential for good (and bad) in future relationships. If your client finds that the above explanation is too complex, you can help them to see that holding rigid attitudes towards the presence or absence of hurt-​related adversities means that, unless they are clear that they have not been treated badly, for example, then they think they have been treated badly. When their attitudes are flexible, they can be more objective about the presence of these adversities.

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How to examine the accuracy of your hurt-​related inference, if necessary If you are still unsure whether people have treated you badly or do not reciprocate the value you put on your relationship with them, answer one or more of the following questions: ⦿

How valid is my inference that the other person has betrayed me (for example)?

⦿

Would an objective jury agree that the other person betrayed has me? If not, what would the jury’s verdict be?

⦿

Is my inference that the other person has betrayed me realistic? If not, what is a more realistic inference?

⦿

If I asked someone whom I could trust to give me an objective opinion about my inference that the other person has betrayed me, what would that person say to me and why? What inference would this person encourage me to make instead?

⦿

If a friend had told me that they had made the same inference about being betrayed in the same situation, what would I say to them about the validity of their inference and why? What inference would I encourage the person to make instead?

Assessing and dealing with emotional problems about hurt In previous chapters, I discussed the concept of meta-​disturbance (literally disturbance about disturbance). It is important to assess carefully the nature of this meta-​disturbance about hurt before you can best deal with it. The best way to start dealing with the assessment of any emotional problems you might have about hurt is to ask yourself the question: ‘How do I feel about my feeling of hurt?’ The most common emotional problems that people have about hurt are as follows: anxiety, depression, unhealthy regret, shame and unhealthy self-​anger. I refer you to the relevant chapters on these emotional problems in this book for help on how to deal with meta-​emotional problems about hurt. Your client will sometimes need to address their emotional problems about hurt before they address their hurt feelings.

Dealing with hurt    227

They need to do this particularly when their secondary emotional problem gets in the way of them dealing with their primary hurt. However, despite the interfering presence of their secondary problem, your client may still want to target their primary hurt. There are two ways of dealing with this situation: ⦿

Provide a rationale to help your client target their secondary problem. For example, explain to your client that their secondary problem is like having a ball and chain around their leg while they are climbing a steep hill (akin to their primary feelings of hurt). In the same way as climbing the hill is easier when they remove the ball and chain from their leg, dealing with their primary hurt is easier when they deal with their secondary problem first.

⦿

Go along with your client’s wish to deal with their primary hurt and, when they fail to do so, help them to understand that the reason why they failed is because they had not addressed their secondary problem and then agree that they will now do so.

Developing and rehearsing non-​h urt, sorrow-​b ased world views People develop views of the world as it relates to them that make it more or less likely that they will experience UNEs. The world views that render you vulnerable to hurt do so in a similar way to the chronic hurt-​based general rigid/​extreme attitude discussed above (i.e., ‘Once I invest in people close to me, I must get a fair return on that investment and, if I don’t, it’s terrible and proves that I am unworthy or to be pitied’) by making you focus unduly on times when you have been, are or will be treated unfairly by others or when your feelings were not, are not or will not be reciprocated in your relationships with others. However, these hurt-​based world views have this effect on you much more widely. It is important that you develop realistic views of the world that will help you to deal with hurt and experience healthy sorrow instead. In Table 7.1, you will find an illustrative list of such world views rather than an exhaustive one, so you can get an idea of what I mean, which will enable you to develop your own. In Table 7.1, I first describe a world view that renders you vulnerable to hurt and then I give its healthy alternative. You will see that the former views are characterised by a conception of

228    Dealing with hurt

Table 7.1  World views that render you vulnerable to hurt and help you to deal with hurt Views of the world that render you vulnerable to hurt

Views of the world that help you deal with hurt

⦿

When I do a lot for those close to me, they will fail to reciprocate and will abuse my generosity

⦿

When I do a lot for people, most will reciprocate, but some won’t and some may even abuse my generosity

⦿

If I trust those close to me, they will often betray me while I would not betray them

⦿

If I trust those close to me, most won’t betray me, but some may well do so

⦿

Significant others will act unfairly towards me while I would not be unfair to them

⦿

Some significant others will indeed act unfairly to me, but not all will. Can I really be sure that I would not act unfairly to them?

⦿

Those close to me will often exclude or neglect me for no good reason

⦿

Those close to me may sometimes exclude or neglect me, but most won’t. When they do, I may not understand why, but this does not mean that they have done so for no good reason

significant others as being basically malevolent (e.g., withholding, unfair, excluding, neglectful) individuals who will betray your trust. In the latter views, a more benign, balanced, but realistic picture of others is revealed and thus a healthier response to their unfair treatment can be expected. If you hold flexible/​non-​extreme attitudes that are consistent with the views of the world listed on the right-​hand side of Table 7.1, and if you act and think in ways that are, in turn, consistent with these flexible/​non-​ extreme attitudes, you will become less prone to hurt. In Chapter 8, I discuss unhealthy anger and how to deal with it.

C H A P T E R

8 Dealing with unhealthy anger

In this chapter, I begin by presenting REBT’s way of understanding unhealthy anger and then address how to deal with this very common emotional problem.

UNDERSTANDING UNHEALTHY ANGER In understanding unhealthy anger, we need to know what we tend to make ourselves unhealthily angry about (i.e., its major inference themes), what attitudes we hold, how we act or tend to act, and how we think when we are unhealthily angry. I mentioned in previous chapters that it is important that you use your client’s language when referring to emotional problems. With respect to the term ‘unhealthy anger’, you need to be aware that not all clients with an ‘anger’ problem resonate with the term ‘unhealthy anger’. Indeed, as we will see, people who have a problem with anger are often quite reluctant to see their ‘anger’ as a problem. However, even those who do see their anger as a problem may baulk at using the term ‘unhealthy anger’ as a way of referring to it. They may identify more closely with terms like ‘upset’, ‘feeling hostile’ or ‘rage’. If so, your task is to satisfy yourself and your client that these terms represent the UNE known in REBT as unhealthy anger. Once you have done so, use your client’s language and write this down in your client’s notes.

Major inference themes in unhealthy anger When you are unhealthily angry, your anger is about one or more of the following: ⦿

You have been frustrated in some way.

DOI: 10.4324/9781003424338-9

230    Dealing with unhealthy anger

⦿

Your movement towards an important goal has been obstructed in some way.

⦿

Someone has transgressed one of your personal rules.

⦿

Someone has shown you disrespect.

⦿

You have transgressed one of your own personal rules.

⦿

Someone or something has threatened your self-​esteem.

Your client may not resonate with the above schema and, in these cases, you should encourage them to put it aside and just focus on what they tend to feel unhealthily angry about. REBT theory values flexibility and this includes the freedom not to use REBT terms, schemas and frameworks.

Rigid/​e xtreme attitudes As I explained in Chapter 1, according to REBT, an inference on its own does not account for your emotional problem of unhealthy anger. It is possible for you to make the same inference and be healthily rather than unhealthily angry. In order for you to feel unhealthily angry when you make one of the six inferences listed above, you have to hold a rigid/​ extreme attitude. While the rigid attitude is at the core of unhealthy anger, the extreme attitudes that are derived from the rigid attitude often distinguish between whether you are experiencing ego unhealthy anger (where you devalue yourself) or non-​ego unhealthy anger (where you ‘awfulise’, find the adversity unbearable or devalue another person). You may, of course, experience both ego unhealthy anger and non-​ ego unhealthy anger in a given situation. If your client is unsure about the mediating role that rigid/​ extreme attitudes play in their unhealthy anger, ask them how they would feel if they had strong conviction in the flexible/​non-​ extreme alternatives to what REBT holds are their unhealthy anger-​creating rigid/​extreme attitudes. In using this strategy, it is important that you formulate the flexible/​non-​extreme attitudes for your client, who cannot be expected to do this for themself at this stage. When you do this, ensure that you match your client’s rigid attitude with a flexible alternative and their main extreme attitude with a non-​extreme alternative, and then ask them how they would feel if they had strong conviction in this flexible/​non-​ extreme attitude.

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For example: ‘Let me outline two sets of attitudes towards being disrespected and you tell me which leads to unhealthy anger and which leads to healthy anger. The first set of attitudes is as follows: “Others must not show me disrespect and, if they do, they are scum.” The second set of attitudes is as follows: “I really don’t want others to show me disrespect, but, sadly and regretfully, this does not mean that they must not do so. If they do, they are not scum; they are fallible humans who are acting ‘scummily’.” Now which set of attitudes would lead to unhealthy anger and which would lead to healthy anger?’ Be aware that this question often leads to a lengthy discussion of the behavioural and thinking correlates of the two forms of anger (which I outline later in the Client’s Guide) and you should be prepared to help your client list these and see the differences between the two. Once your client can see that their rigid/​extreme attitudes underpin unhealthy anger and their flexible/​ non-​ extreme attitudes underpin healthy anger, they have understood the mediating role of attitudes. This is quite an elegant strategy since it accomplishes a number of things at once: 1.  It addresses your client’s doubts about the mediating role of rigid/​extreme attitudes in unhealthy anger if they have such concern. 2.  It introduces flexible/​non-​extreme attitudes as a meaningful alternative to these rigid/​extreme attitudes. 3.  It helps your client to see that holding flexible/​ non-​ extreme attitudes can have beneficial effects.

Behaviour associated with unhealthy anger When you hold a rigid/​extreme attitude towards one of the six things that people make themselves angry about (see pp. 229–230), you feel unhealthy anger and you will act or tend to act in a number of ways, the most common of which are as follows: ⦿

You attack the other(s) physically.

⦿

You attack the other(s) passive-​aggressively.

⦿

You attack the other(s) verbally.

232    Dealing with unhealthy anger

⦿

You displace the attack onto another person, animal or object.

⦿

You recruit allies against the other(s).

⦿

You withdraw aggressively.

You will see from the above list that the main purpose of most of these behaviours (and action tendencies) is to destroy or avoid the person who you think (albeit wrongly) has made you angry. However, such destructive or avoidance behaviour is largely responsible for the maintenance of unhealthy anger, since it prevents you from facing up to the situation in which you make yourself unhealthily angry and from dealing with the issues involved in a healthy manner. If you ask your client whether they want to change their unhealthy anger-​related behaviour, their response will be affected by whether or not they are in an unhealthily angry mood. If they are, they will be far less likely to see that this behaviour is dysfunctional than when they are not unhealthily angry. In other chapters, I suggest that you ask your client how they would advise a friend who displays the same behaviour as they do when they are emotionally disturbed. With these other UNEs, your clients can usually see that, even though they are currently emotionally disturbed, they would advise their friend not to act as they would when in that disturbed frame of mind. However, this is less likely the case with unhealthy anger and as such I suggest that you use this strategy with great care. It is best used after your client has made some progress in holding a flexible/​ non-​ extreme attitude towards the provocation at ‘A’.

Thinking associated with unhealthy anger When you hold a rigid/​extreme attitude towards an anger-​related inference, you will feel unhealthily angry and think in a number of ways. Remember what I said in Chapter 1: the thinking that accompanies your unhealthy anger is the result of your inference being processed by your rigid/​extreme attitude and therefore it is likely to contain a number of thinking errors that I present in Appendix 1. I list the main features of this post-​rigid/​extreme attitude unhealthy anger-​based thinking below: ⦿ ⦿

You overestimate the extent to which the other(s) acted deliberately. You see malicious intent in the motives of the other(s).

Dealing with unhealthy anger    233

⦿

You see yourself as definitely right and the other(s) as definitely wrong.

⦿

You plot to exact revenge.

⦿

You are unable to see the point of view of the other(s).

⦿

You ruminate about the other’s behaviour and imagine coming out on top.

It is important to note that such post-​rigid/​extreme-​attitude thinking in unhealthy anger may be in words or in mental images. One of the main features of post-​rigid/​extreme-​attitude thinking is that it is compelling. As such, it is quite easy for your client to get caught up in this way of thinking and think that it reflects reality. This is an example of ‘cognitive-​emotive’ reasoning: if a thought is plausible and emotionally compelling, therefore it must be true. It is important that you help your client to understand how their mind works with respect to the thinking consequences of rigid/​ extreme attitudes and to encourage them to use such thoughts to go back to address the rigid/​extreme attitudes that spawn them. When they have done this, you can encourage them to respond to these thinking consequences of rigid/​extreme attitudes as they will not disappear just because your client has examined these attitudes. When they respond to these thinking consequences, they need to do so only a few times on any one occasion. After that, they need to accept the presence of such thinking without engaging with it. To summarise, your client needs to: ⦿

identify the presence of the thinking consequences of rigid/​ extreme attitudes (see Appendix 1)

⦿

trace these back to the source of this mode of thinking (i.e., identify the underlying rigid/​extreme attitudes)

⦿

examine these rigid/​extreme attitudes

⦿

respond briefly to the thinking consequences of such attitudes, but not get overly involved in this process

⦿

accept the lingering presence of these thinking consequences without engaging with them

⦿

get on with the business of living.

234    Dealing with unhealthy anger

HOW TO DEAL WITH UNHEALTHY ANGER If you are prone to unhealthy anger, you tend to experience this emotional problem in a variety of different settings and in response to a variety of anger-​related inferences. Here is how to deal with unhealthy anger so that you become less prone to it.

Step 1: Identify reasons why unhealthy anger is a problem for you and why you want to change While most UNEs are generally regarded as problematic, this is less so when it comes to unhealthy anger. Indeed, often people whose anger meets the criteria for unhealthy anger (i.e., it leads to largely unconstructive results and leaves them preoccupied with whatever it is that they are unhealthily angry about) are ambivalent about seeing their anger as a problem and thus targeting it for change. If this is true for you, this may be due to two major factors: ⦿ ⦿

You may not understand what constitutes healthy anger. Even when you understand the differences between healthy and unhealthy anger, you may construe unhealthy anger positively and/​or healthy anger negatively.

Let me now discuss these two points more fully.

Understanding the differences between unhealthy anger and healthy anger In this book, I have consistently made the point that the differences between UNEs and HNEs reside not in the inferences that you make about situations in which you find yourself, but in the attitudes that you hold towards these inferences and in the way you subsequently think and act. With respect to anger, then, it is particularly important that you have a clear idea what constitutes healthy anger and, in particular, what are the behaviours and modes of thinking that accompany this healthy form of anger. I refer you to pp. 243–244 and p. 244 for a review. Then compare these responses to those that accompany unhealthy anger (see pp. 231–232 and pp. 232–233). You should ideally see that, in the main, healthy anger

Dealing with unhealthy anger    235

is more constructive for you in the longer term than unhealthy anger. If not, you may need to identify and investigate your positive connotations of unhealthy anger and negative connotations of healthy anger.

Identifying and responding to your positive connotations of unhealthy anger and your negative connotations of healthy anger Having understood the differences between unhealthy anger and healthy anger, you may find yourself drawing back from making a commitment to working towards becoming healthily rather than unhealthily angry. The reasons for this may be due to how you construe both types of anger. These constructions are likely to be based on misconceptions of these different anger types.

Common positive connotations of unhealthy anger Here are two examples of commonly found positive connotations of unhealthy anger that people tend to make, which stop them from committing to healthy anger as a constructive alternative to their unhealthy anger. I list each positive connotation and then briefly discuss how to respond to it. ‘When I feel unhealthy anger, I feel powerful and I don’t want to lose that feeling.’ Response: the power that you experience is based on the attitude of a tyrant (e.g., ‘Things have to be my way’). You can experience a different form of power related to being assertive and flexible with healthy anger. ⦿

‘My unhealthy anger is an appropriately strong response to someone breaking one of my most important rules.’ Response: Healthy anger can be strong without the destructive effects of unhealthy anger. ⦿

Common negative connotations of healthy anger Here are two examples of commonly found negative connotations of healthy anger that again stop people from committing to healthy anger. As before I list each negative connotation and then briefly discuss how to respond to it

236    Dealing with unhealthy anger

‘Healthy anger is weak and wishy-​washy.’ Response: While never as strong as blind rage, healthy anger can be very strong and can be based on firmness. ⦿

‘If you are healthily angry, you let people get away with acting badly.’ Response: No, you don’t. You tell them in no uncertain terms how you feel about their bad behaviour and you apply the necessary consequences, but without damning them. ⦿

It is important that you take time to elicit and deal effectively with all your client’s doubts, reservations and objections to seeing unhealthy anger as a problem and healthy anger as a solution to this problem. Time spent on taking care over this issue will be rewarded later. If you rush matters at this point, you increase the risk that your client will remain uncommitted to seeing their unhealthy anger as a problem for them and/​ or seeing healthy anger as a constructive alternative to this problem.

Step 2: Take responsibility for your unhealthy anger In REBT, we argue that people or things do not make you unhealthily angry; rather you create these feelings by the rigid/​extreme attitudes that you hold towards such people and things. You may object that this involves you blaming yourself for creating your feelings of unhealthy anger, but this objection is based on a misconception. It assumes that taking responsibility for creating your unhealthy anger is synonymous with self-​blame. In truth, responsibility means that you take ownership for the rigid/​extreme attitudes that underpin your unhealthy anger while accepting yourself for doing so. Blame, on the other hand, means that you regard yourself as being bad for creating your own unhealthy anger. The idea that emotional problems (including unhealthy anger) are based largely on the rigid/​ extreme attitudes that a person holds towards what happens to them is, as you know, a central plank in REBT. However, for your client, it will be a new idea. Thus, your client may hold that the reason they are unhealthily angry, for example, is that it is inherently unhealthy anger-​ making to be shown disrespect or when another transgresses one of the cardinal rules for living held by your client. This type of

Dealing with unhealthy anger    237

thinking is known in REBT circles as ‘A–​C’ thinking (where events are deemed to cause feelings) and it is very prevalent in people with an unhealthy anger problem. By contrast, the REBT model stresses the ‘ABC’ model, where the impact of events on a person is mediated by the attitudes that they hold towards these events. The ‘ABC’ model holds that the person needs to take responsibility for creating their feelings of unhealthy anger by realising they do so by holding a set of rigid/​extreme attitudes. If your client has difficulty accepting responsibility for their unhealthy anger, it is important for you to identify the source of this difficulty. This source is most frequently evidenced in your client’s negative connotations of what accepting such responsibility means. Here are a number of common negative connotations and how to respond to them: ‘Accepting responsibility for my unhealthy anger means that I will be blamed for doing this.’ Response: Even if you will be blamed for this, it is the attitude that you hold towards such blame that is important. If you demand that you must not be blamed, you will disturb yourself further. However, if you prefer but do not demand that you are not blamed, you will react to this situation more healthily. Additionally, whether or not you are blamed for accepting responsibility for your unhealthy anger, you do not have to blame yourself for doing so. Adopting an attitude of unconditional self-​acceptance will help you accept full responsibility for your unhealthy anger and will help you to work on dealing with this problem in a committed way. ⦿

‘Accepting responsibility for my unhealthy anger means letting the other person off the hook.’ (This is a very common misconception that, unless addressed and readdressed throughout therapy, will constitute an ongoing obstacle to effective therapy.) Response: You can accept responsibility for creating your unhealthy anger, while still holding the other person to full account for their behaviour towards you. The one does not preclude the other. Also, whether or not you disturb yourself about the other person’s behaviour is not relevant to whether they should take responsibility for their behaviour towards you. ⦿

238    Dealing with unhealthy anger

In REBT, we argue that the person should ideally do so, which does not mean that they necessarily will. We do know, however, that they are less likely to do so when they receive an unhealthy response from you. While expressing healthy anger towards the other person will not guarantee that they will hold themself to account for their behaviour, it will increase the chances that they will do so. ‘Accepting responsibility for my unhealthy anger means that I am being punished twice.’ Response: This view is based on the idea that accepting responsibility for unhealthy anger is a form of punishment. Actually, it is the first step that you need to take to deal with your emotional problem. Indeed, if you consider that unhealthy anger is NOT an emotional problem, you are being penalised twice: first, with respect to the negative way you were treated by the other person and, second, by needlessly disturbing yourself about such treatment, which you consider healthy. Dealing with your unhealthy anger will still leave you with the problem of the other person’s behaviour, but it will remove the optional self-​ punishment known as unhealthy anger. ⦿

It is important to help your client to understand the impact of these obstacles on their emotional problems. Then, help them to develop alternatives to these obstacles and review the impact of these alternatives on their emotional problem-​solving. This often helps your client to deal effectively with these obstacles. If not, you may need to do a more detailed assessment of the obstacle, which is outside the brief of this book.

Step 3: Identify the themes about which you tend to feel unhealthy anger You should now be in a position to commit yourself to working towards experiencing healthy anger rather than unhealthy anger. As the object of your unhealthy anger may be yourself, others or aspects of life that do not relate to yourself or others, your anger-​related inferences exist in each of these realms of your personal domain. I will group them as such.

Dealing with unhealthy anger    239

Anger-​related inferences concerning self When you are unhealthily angry with yourself, you consider that you either have broken or failed to live up to one of your own personal rules concerning your behaviour. What differentiates unhealthy self-​anger from depression is that, in unhealthy anger, you want to attack yourself angrily more than you do in depression. What differentiates unhealthy self-​anger from shame and guilt is that, in the latter, your rules concern your moral and socially acceptable behaviour, while, in the former, they tend to be less concerned with the social or moral world and more concerned with the non-​moral rules that you have created for yourself.

Anger-​related inferences concerning others As with anxiety, it is useful to ask yourself when you are unhealthily angry with others whether they are, in your mind, threatening your self-​esteem or not. Let me first outline the inferences that you make that are relevant to self-​esteem when you are unhealthily angry. These threats are experienced more in the here and now than is the case with anxiety.

Common threats to self-​e steem in unhealthy anger towards others Here you infer that the other person has: ⦿

disrespected you

⦿

made you look stupid

⦿

criticised you

⦿

rejected you.

Common anger-​r elated inferences about others that do not involve threats to your self-​e steem Here you infer that the other person has: ⦿ ⦿

broken your personal rule concerning how people are to behave failed to live up to your personal rule about how others are to behave

240    Dealing with unhealthy anger

⦿ ⦿

blocked your path towards an important goal frustrated you.

Common anger-​related inferences about inanimate objects ⦿ ⦿

The object frustrates you (e.g., it does not work properly). The object blocks your path towards an important goal (e.g., a ticket machine does not issue you with a ticket so that you can’t travel and get to an important meeting).

If your client finds it difficult to find their unhealthy anger-​related theme, you can help them by assessing a few specific examples of their unhealthy anger. Have them focus on a specific situation in which they were unhealthily angry and ask them about what were they unhealthily angry about. If they still find it difficult to identify the theme in this or other specific situations, use the ‘magic question’ technique. This involves you doing the following: ⦿

Have your client focus on the situation in which they were unhealthily angry.

⦿

Ask them to nominate one ingredient that would eliminate or significantly reduce their unhealthy anger in the situation.

⦿

The opposite of this nominated ingredient is what they are most unhealthily angry about. Harriet was struggling to identify the specific theme in her unhealthy anger about others being late. I helped Harriet to use the ‘magic question’ technique as follows: ⦿

I asked Harriet to focus on the situation in which she was unhealthily angry: ‘I have arranged to meet a friend after work and she is late.’

⦿

I asked Harriet to nominate one ingredient that would eliminate or significantly reduce her unhealthy anger without changing the situation: ‘Her showing me respect by calling ahead of time to tell me that she would be late.’

Dealing with unhealthy anger    241

⦿

The opposite of this nominated ingredient is what she is most unhealthily angry about: ‘Her not showing me respect by calling ahead of time to tell me that she would be late.’

If you assess several specific examples of your client’s unhealthy anger in this way, the unhealthy anger-​related theme should be apparent. In Harriet’s case, being shown disrespect by others was the dominant theme in her unhealthy anger. It may be that there are two unhealthy anger-​related themes present in your client’s unhealthy anger. For example, your client may feel unhealthily angry about being shown disrespect and also about another person breaking their personal rule of living. If this is the case, deal with them one at a time and have your client nominate the theme that they want to focus on first.

Step 4: Identify the three components of your unhealthy anger response and set goals with respect to each component The next step is for you to list the three elements of your unhealthy anger response in the face of each of the themes listed above.

Identify the three components of your unhealthy anger response I use the term ‘unhealthy anger response’ to describe the three main components that make up this response. The three components of your unhealthy anger response are the emotional, behavioural and thinking components.

Emotional component The emotional component is, of course, unhealthy anger.

Behavioural component The behavioural component concerns overt behaviour or action tendencies. These will be largely attacking in nature. Consult the list that I provided

242    Dealing with unhealthy anger

to help you identify your behaviour associated with each theme when you are unhealthily angry (see pp. 231–232). It is important to note that we are often taught to suppress our tendency to act in ways that are consistent with our unhealthy anger. This is why identifying such suppressed behavioural tendencies is often a more reliable guide to the fact that your anger is unhealthy than your actual behaviour will be.

Thinking component The thinking component of your unhealthy anger often concerns fantasies of getting even and gaining revenge. Such behaviour reflects how you would like to respond if you did not suppress your actual behaviour and your action tendencies. Whereas, in unhealthy behaviour, you can frequently be said to be prosocial in your actual behaviour in that you will not give full behavioural expression to what you would like to do, in your thinking you are antisocial in that your thoughts and images often express the full extent of your wish to get back at the person or object that, in your mind, has angered you.

Set goals with respect to each of the three components You need to set goals so that you know what you are striving for when you deal effectively with unhealthy anger. The three goals are emotional, behavioural and thinking goals.

Emotional goal Your emotional goal is healthy anger rather than unhealthy anger (or whatever synonym you prefer to the term ‘healthy anger’). Healthy anger is an HNE, which is an appropriate response to the anger-​related inferences I outlined earlier, but one that helps you to process what has happened to you and move on with your life rather than get stuck or bogged down. The concept that healthy anger is the healthy alternative to unhealthy anger in the face of being frustrated, having your movement towards an important goal obstructed in some way, someone transgressing a personal rule, you transgressing one of your own personal rules, someone showing you disrespect or someone otherwise threatening your self-​esteem is based on the following idea. These adversities are negative and therefore it is realistic to have a negative emotion about them. The choice,

Dealing with unhealthy anger    243

therefore, is between a UNE (unhealthy anger) or an HNE (healthy anger). But what if your clients specify unrealistic goals? Here are three such goals and how to respond to your client who nominates them: ‘I don’t want to feel unhealthily angry.’ Show your client that they have indicated what they do not want to feel in the face of anger-​related themes, but not what they do want to feel. Help them to specify an emotion to aim for, like healthy anger! ⦿

‘I want to feel less unhealthily angry.’ Show your client that, as unhealthy anger is a disturbed emotion, wanting to feel less unhealthily angry is still to nominate a disturbed emotion, albeit of lesser intensity. Show them that healthy anger can be strong (but not in response to blind rage) and healthy. ⦿

‘I want to feel calm.’ Being calm in the face of unhealthy anger-​related adversity will not help your client to be appropriately geared up to deal with it. Help them to see this. Also, show them that the only way that they could achieve a state of calmness about such adversity is to believe that it does not matter to them whether or not they experienced these adversities. In other words, show them that they would have to lie to I! ⦿

Behavioural goal Your behavioural goal should reflect actions that are based on healthy anger rather than unhealthy anger. The following are the most common behaviours associated with healthy anger. You may wish to compare these behaviours with those associated with unhealthy anger that I presented on pp. 231–232. ⦿

You assert yourself with the other(s).

⦿

You leave an unsatisfactory situation non-​aggressively after taking steps to deal with it.

⦿

You request, but do not demand, behavioural change from the other(s).

244    Dealing with unhealthy anger

It is important that your client understands that, as they strive to develop healthy behavioural responses to anger-​related themes, they will still feel the urge to act in ways designed to help them aggress against these adversities. Help them to understand the reason for this. Explain to them that, as they examine their attitudes and commit themself to strengthening their conviction in their flexible/​ non-​ extreme attitudes and to weakening their conviction in their rigid/​ extreme attitudes, their rigid/​ extreme attitudes will still be active and producing urges for them to act dysfunctionally. Encourage your client to accept these urges, to recognise that they do not have to act on them and to use them as cues to act in functional ways.

Thinking goal As well as setting behavioural goals related to the feeling of healthy anger in the face of anger-​related inferences, it is important that you set thinking goals associated with this emotion. The following are the most common forms of thinking associated with healthy anger rather than unhealthy anger. Again, you may wish to compare these forms of thinking with those associated with unhealthy anger that I presented on pp. 232–233. ⦿

You think that the other(s) may have acted deliberately, but you also recognise that this may not have been the case.

⦿

You are able to see the point of view of the other(s).

⦿

You have fleeting rather than sustained thoughts to exact revenge.

⦿

You think that other(s) may have had malicious intent in their motives, but you also recognise that this may not have been the case.

⦿

You think that you are probably rather than definitely right and the other(s) are probably rather than definitely wrong.

As the above list shows, the dominant feature of thinking associated with healthy anger is that it is realistic and balanced. Please remember that such thinking may be in words or in mental pictures. The point I made above with respect to your client’s behavioural goals is also relevant with respect to their thinking goals. Your client will still have some conviction in their rigid/​extreme attitudes until they have full conviction in their flexible/​ non-​ extreme attitudes. Given this, your client’s rigid/​extreme attitudes

Dealing with unhealthy anger    245

will have some impact on their subsequent thinking as they strive to achieve their goals. Thus, highly distorted thoughts will still come into your client’s minds. Help your client to understand why this is the case. When you come to help them deal with these forms of post-​ rigid/​ extreme-​ attitude thinking, do one or more of the following as indicated. Discuss this issue with your REBT supervisor, if necessary: ⦿

Encourage your client to acknowledge the existence of such thoughts without trying to suppress them, distract themself from them or engage with them.

⦿

If relevant, use the presence of this post-​rigid/​extreme-​attitude thinking to help your clients to identify and deal with the rigid/​ extreme attitudes.

⦿

Examine the empirical nature of these thinking ‘Cs’ once or twice and then return to the acceptance strategy detailed above.

Step 5: Identify your general rigid/​extreme attitudes and alternative general flexible/​non-​extreme attitudes A general rigid/​extreme attitude is a rigid/​extreme attitude that you hold across situations defined by the anger-​related inference theme(s) to which you are vulnerable. It accounts for your unhealthy anger response. Its flexible/​non-​extreme alternative, which will also be general in nature, will account for your healthy anger response.

Identify your general rigid/​extreme attitudes When you identify a general rigid/​extreme attitude, you take a common anger-​related theme (e.g., threat to your self-​esteem or someone breaking your personal rule) and add to this a general rigid attitude and the main extreme attitude that is derived from the rigid attitude. When you are particularly prone to self-​esteem based unhealthy anger, your main extreme attitude will be an other-​devaluation attitude when your focus is on the other person who threatened your self-​esteem, but you will also have an underlying self-​devaluation attitude. For non-​ self-​ esteem based unhealthy anger, your main extreme attitude will frequently be an other-​devaluation attitude (when the focus of

246    Dealing with unhealthy anger

your unhealthy anger is others) or it may be an unbearability or a life-​ devaluation attitude (particular when the focus of your unhealthy anger is inanimate objects or frustrating life conditions). For example: ⦿

‘People must not put me down. If they do, I am inadequate’ (a general self-​esteem based rigid/​extreme attitude).

⦿

‘People must keep their promises and they are bad if they don’t’ (a general non-​self-​esteem based rigid/​extreme attitude).

Identify your alternative general flexible/​non-​extreme attitudes When you identify your alternative general flexible/​non-​extreme attitude, you take the same common theme (e.g., the threat to your self-​esteem or someone breaking your personal rule) and add to this a general flexible attitude and the main non-​extreme attitude that is derived from the flexible attitude. If your general extreme attitude was self-​devaluation (when you are particularly prone to self-​esteem based unhealthy anger), your general non-​ extreme attitude will be an unconditional self-​acceptance attitude. If you are prone to non-​self-​esteem based unhealthy anger, your alternative general non-​extreme attitudes will be an other-​acceptance attitude, a bearability attitude or an unconditional acceptance attitude towards another or life. For example: ⦿

‘I don’t want people to put me down, but that does not mean that they must not do so. If they do, I am not inadequate and they are not bad. We are both fallible human beings who can act in a myriad of different ways, both good and bad’ (a general unconditional self-​acceptance based on a flexible/​non-​extreme attitude).

⦿

‘I want people to keep their promises, but unfortunately they don’t have to do so. If they don’t, it’s bad, but they are not. They are fallible and capable of acting well and badly’ (a general unconditional other-​ acceptance based on a flexible/​non-​extreme attitude).

As you will have noticed in the Client’s Guide, I encourage readers/​ clients to identify and work with their general rigid/​ extreme attitudes and to develop general flexible/​ non-​ extreme attitudes and, as you will see, when they are facing specific instances of their

Dealing with unhealthy anger    247

problems, I encourage them to focus on specific examples of both sets of attitudes. This will be at variance with your REBT practice, where you will begin with specific examples of your client’s problems and then proceed to work at a more general level with their problems and how these relate to one another. The reason I have chosen to go ‘general’ rather than ‘specific’ when helping readers/​clients to deal with their emotional problems is a pragmatic one. In this book, I aim to help people to deal with a range of emotional problems and therefore, in my view, it is best to give readers/​clients general guidance with respect to dealing with this range of problems and then help them to move from the general to the specific rather than vice versa. My considered view was that I just do not have the space to help readers/​clients focus on specific examples of their emotional problems and then generalise from this specific level. Consequently, one way that you can help your client who is using the Client’s Guide is to help them to work with specific examples of their emotional problem, in this case unhealthy anger. Use the following sequence as you do so and help your client to: ⦿

select a specific example of their unhealthy anger problem

⦿

express why their unhealthy anger constitutes a problem for them

⦿

identify what they were most unhealthily angry about in the situation

⦿

identify the three specific components of their unhealthy anger and set specific goals with respect to each component

⦿

identify their specific rigid/​extreme attitudes and alternative specific flexible/​non-​extreme attitudes

⦿

examine their specific attitudes.

⦿

face up to what they are most unhealthily angry about in imagery (if necessary)

In helping your client to deal with a specific example of their unhealthy anger, you can teach them how to use REBT’s ABCD form, which appears in Appendix 6. The following steps are the same as those that appear in Steps 7–​10 later in this chapter. Thus, help your client to:

248    Dealing with unhealthy anger

⦿

face being frustrated (e.g., having their movement towards an important goal being obstructed in some way, someone transgressing a personal rule, your client transgressing one of their own personal rules, someone showing them disrespect or someone threatening their self-​esteem in reality, if possible) and take appropriate action

⦿

capitalise on what they learned

⦿

generalise their learning.

Step 6: Examine your general attitudes While there are many ways of examining your general rigid/​extreme attitudes and general flexible/​non-​extreme attitudes, in my view the most efficient way involves you first examining together your general rigid attitude and its general flexible attitude alternative, and then examining together your general extreme attitude and its general non-​extreme attitude alternative.

Examine your general rigid attitude and its general flexible attitude alternative First, take your general rigid attitude and its general flexible attitude alternative and write them down next to one another on a sheet of paper. Then ask yourself: ⦿

Which is true and which is false?

⦿

Which has largely constructive results and which has largely unconstructive results?

⦿

Which is sensible logically and which does not make sense?

Write down your answer to each of these questions on your piece of paper, giving reasons for each answer. Consult Appendix 2 for help with the answers to these questions, which you need to adapt and apply to the attitudes you are examining.

Examine your general extreme attitude and its general non-​extreme attitude alternative Next, take your general extreme attitude and its general non-​extreme attitude alternative and again write them down next to one another on a sheet of paper. Then, ask yourself the same three questions that you used

Dealing with unhealthy anger    249

with your general rigid attitude and its general flexible attitude alternative. Again, write down your answer to each of these questions on your piece of paper, giving reasons for each answer. I suggest that you consult Appendix 3 (for help with examining awfulising and non-​ awfulising attitudes), Appendix 4 (for help with examining unbearability attitudes and bearability attitudes) and Appendix 5 (for help with examining devaluation attitudes and unconditional acceptance attitudes). Again, you need to adapt and apply these arguments to the attitudes you are examining. You should now be ready to commit to act and think in ways consistent with your general flexible/​non-​extreme attitude. I included Appendices 2–​ 5 in the Client’s Guide as general guidelines to help readers/​clients to examine their rigid/​extreme and flexible/​ non-​ extreme attitudes (reproduced in this book as Appendices 2–​5). If you are working with a client who is using the Client’s Guide, you will have a chance to look at the examining work that your client has done at this point and give them feedback on that work. No book can provide such feedback. I have suggested that readers/​clients examine their rigid attitude and their flexible attitude together and then their main extreme attitude and non-​ extreme attitude equivalent together using three criteria as shown below: ⦿

Rigid attitude vs. flexible attitude ⦿

empirical status

⦿

pragmatic status

⦿

empirical status

⦿

pragmatic status.

⦿

⦿

logical status

Main extreme attitude vs. main non-​extreme attitude

⦿

logical status

The final point I want to make about examining attitudes concerns the concept of persuasiveness. Perhaps the most important aspect of the examining process is for your client to develop arguments concerning the false, illogical and unhealthy nature of their rigid/​ extreme attitudes and the true, logical and healthy nature of their flexible/​non-​extreme attitudes that are persuasive to them. So, encourage your client to develop such persuasive arguments and to make a note of these for future reference.

250    Dealing with unhealthy anger

Step 7: Face your unhealthy anger-related theme in imagery I hope that you have made a commitment to act and think in ways that are consistent with your general flexible/​non-​extreme attitudes. Assuming that you have, your basic task is to face up to your anger-​related theme while rehearsing your flexible/​non-​extreme attitudes. Up to this point, you have worked at a general level with respect to the anger-​related themes about which you are unhealthily angry, the general rigid/​extreme attitudes that account for this unhealthy anger and their alternative general flexible/​ non-​ extreme attitudes. However, when you come to apply your general flexible/​non-​extreme attitudes in dealing with your response to these themes, you need to bear in mind one important point. Since you make yourself unhealthily angry in specific situations (actual or imagined), you need to deal with these specific situations by rehearsing specific variants of your general flexible/​non-​extreme attitudes. While the best way to do this is in specific situations in which you infer threat to your self-​esteem or where others have broken your personal rules, you may derive benefit from using imagery first. If this is the case with you, you need to do the following: ⦿

Imagine a specific situation in which you felt unhealthily angry and focus on what you were most angry about.

⦿

See yourself facing what you were most angry about while rehearsing a specific flexible/​ non-​ extreme attitude relevant to the situation. As you do this, try to make yourself feel healthily angry, rather than unhealthily angry.

⦿

Then see yourself take assertive action. Make your picture realistic. Picture a faltering performance rather than a masterful one.

⦿

Recognise that some of your post-​ rigid/​ extreme-​ attitude thinking may be distorted. Respond to it without getting bogged down doing so. Accept the presence of any remaining distorted thoughts without engaging with them.

⦿

Repeat the above steps until you feel sufficiently ready to put this sequence into practice in your life.

If you find that facing your anger-​related inference theme, in your mind’s eye, is too much for you, use the ‘challenging, but not overwhelming’

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principle that I introduced in Chapter 2 (see p. 53). This means that, instead of imagining yourself facing a situation about which you would make yourself overwhelmingly angry, choose a similar situation in which you would make yourself unhealthily angry, but not overwhelmingly so. Then employ the same steps that I have outlined above. Work in this way until you feel able to face what you were previously overwhelmingly angry about and then use the steps again. Your client may say that they can’t get very clear images when they try to picture events in their mind’s eye. While they may get more out of imagery techniques if they can get such clear images, they will still get something out of facing anger-​related adversity in imagery even if their images aren’t clear. So, if your client wants to face their particular anger-​related adversity in imagery before they do so in reality, encourage them to do so no matter how clear their mental images are.

Step 8: Act assertively in relevant anger-​r elated situations Whether or not you have used imagery as a preparatory step, you need to take the following steps when you assert yourself in anger-​related situations. ⦿

Choose a specific situation that contains the theme about which you are likely to make yourself unhealthily angry.

⦿

Make a plan of how you are going to assert yourself in the situation.

⦿

Rehearse a specific version of your general flexible/​non-​extreme attitudes before entering the situation so that you can face what you are angry about while in a flexible/​non-​extreme frame of mind. In addition, it would be useful to develop a shorthand version of your specific flexible/​ non-​extreme attitude to use while you are in the situation.

⦿

Enter the situation and accept the fact that you are likely to be uncomfortable while doing so. Assert yourself as previously planned. React to any consequences from a flexible/​non-​extreme frame of mind if you can.

⦿

Recognise that, even though you have got yourself into a flexible/​non-​ extreme frame of mind, some of your thinking may be distorted and unrealistic and some may be realistic and balanced. Accept the presence of the former and do not engage with it. Engage with the latter as much as you can.

252    Dealing with unhealthy anger

You may find that your client reports various obstacles to facing being frustrated, such as having their movement towards an important goal obstructed in some way, someone transgressing a personal rule, a client transgressing one of their own personal rules, someone showing them disrespect or someone threatening their self-​esteem in reality. I list here some of the major obstacles and suggest ways of addressing these obstacles with your client. ⦿

‘It’s easier to avoid the object of my anger than to face it.’

⦿

‘I will lose control if I face the object of my anger.’

⦿

‘I don’t feel comfortable facing the object of my anger.’

Help your client to see that avoiding the source of their anger will not help them in the long term to deal with this problem. They may spare themself in the short term, but overcoming anger involves facing the object of their anger and rehearsing flexible/​non-​extreme attitudes as they do so.

As your client may feel out of control when they experience unhealthy anger, they may be reluctant to face the object of their anger. If this is the case, help your client to understand that, if they rehearse their flexible/​non-​extreme attitudes, they may think that they will lose control, but probably won’t. Show your client that avoiding the object of their anger will increase the sense that they will lose control of their anger since they are not dealing with the source of their angry feelings, namely their rigid/​extreme attitudes. In this respect, it may be helpful for you to help your client develop a flexible/​non-​extreme attitude towards losing self-​control before proceeding.

Help your client to see that, if they wait until they are comfortable before facing the object of their anger, they will wait a very long time. Consequently, it is important that you help your client realise that they are bound to be uncomfortable about facing the object of their anger even after they have examined their unhealthy anger-​ creating rigid/​ extreme attitudes and developed healthy anger-​based flexible/​non-​extreme attitudes. Show your client that they can bear this discomfort, that it is worth it to them to do so and that they are worth bearing it for. Encourage them to commit to bearing discomfort and plan with them to do so.

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Step 9: Capitalise on what you have learned When you have faced the situation and dealt with it as best you could, it is important that you reflect on what you did and what you learned. In particular, if you were able to face the relevant theme, rehearse your specific flexible/​non-​extreme attitudes and assert yourself, ask yourself how you can capitalise on what you achieved. If you experienced any problems, respond to the following questions: ⦿

Did I focus on the aspect of the situation that I was unhealthily angry about and, if not, why not?

⦿

Did I rehearse my flexible/​ non-​ extreme attitudes before and during facing what I was unhealthily angry about and, if not, why not?

⦿

Did I assert myself and, if not, why not?

⦿

Did I engage with post-​rigid/​extreme attitude distorted thinking and, if so, why?

Reflect on your experience and put into practice what you have learned the next time you face what you are unhealthily angry about. It is useful to monitor your client’s responses to these questions and help them to reflect on any issues that they have not considered.

Step 10: Generalise your learning While you can really deal with your unhealthy anger only in specific situations, you can generalise what you have learned about dealing effectively with unhealthy anger across situations defined by an anger-​related theme to which you are particularly vulnerable (e.g., people breaking your personal rules) and also apply your learning to situations defined by a different theme that you may have problems with (e.g., frustration). Clare was particularly prone to unhealthy anger about other people cancelling arrangements at the last minute, so she followed the steps outlined in this chapter. Thus: ⦿

Clare assessed the three components of her unhealthy anger response and set goals with respect to all three components.

254    Dealing with unhealthy anger

⦿

She identified her relevant general rigid/​extreme attitude regarding her rule for people keeping arrangements with her (i.e., ‘People must not cancel arrangements with me at the last minute and, if they do, they are bad people’) that underpinned her unhealthy anger response and her alternative general flexible/​non-​extreme attitude (i.e., ‘I don’t want people to cancel arrangements with me at the last minute, but they don’t have to do what I want them to do. It’s bad that they have done the wrong thing, but they are not bad for doing so. They are fallible human beings who are acting badly’) that underpinned her healthy anger response.

⦿

She examined both elements of her general rigid/​extreme attitude and her general flexible/​non-​extreme attitude until she clearly saw that the former were false, made no sense and were detrimental to her, and that the latter were true, sensible and healthy.

⦿

She outlined situations where she thought other people were likely to cancel on her and used imagery to practise specific versions of her flexible/​non-​ extreme attitudes while focusing on the other person cancelling on her. She did this until she felt healthily angry. She then used these skills in actual relevant situations. She used shortened versions of her flexible/​non-​extreme attitude (i.e., ‘It’s bad, but they are fallible’) as she asserted herself with the other person and told them that she did not like their behaviour and hoped that they would not cancel late again. As she used her assertive skills, she tolerated the discomfort that she felt and accepted that some of her ‘post-​ rigid/​extreme-​attitude’ thinking would still be in her mind as she did so. She let such thinking be without engaging with it, suppressing it or distracting herself from it.

⦿

When she had made progress in dealing with her unhealthy anger about such cancellations, she applied these skills to dealing with her discomfort-​ related unhealthy anger with respect to people frustrating her in shops and other public settings.

⦿

She identified her relevant general rigid/​extreme attitude regarding frustration (i.e., ‘They must not frustrate me and I can’t bear it when they do’) that underpinned her unhealthy anger response and her alternative general flexible/​non-​extreme attitude (i.e., ‘I don’t want others to frustrate me, but they don’t have to do what I want. It’s difficult for me to bear such frustration, but I can do so, it’s worth it to me to do so and I am worth doing it for’) that underpinned her healthy anger response.

⦿

She again examined both elements of her general rigid/​extreme attitude and her general flexible/​non-​extreme attitude until she clearly saw that the

Dealing with unhealthy anger    255

former were false, made no sense and were detrimental to her, and that the latter were true, sensible and healthy. ⦿

She then outlined situations that she found particularly frustrating and prepared to face them by examining specific versions of these attitudes. She first rehearsed relevant specific versions of her general flexible/​non-​extreme attitudes regarding frustration and faced this in these specific situations while keeping in mind a shortened version of her flexible/​non-​extreme attitude (i.e., ‘I can bear being frustrated’).

⦿

As she did so, she stayed in the situation and allowed herself to experience her feeling of healthy anger. She accepted that some of her ‘unhealthy anger’ thinking would still be in her mind as she did so. She again let such thinking be without engaging with it, suppressing it or distracting herself from it.

As this section shows, you can generalise what you learn about dealing with unhealthy anger from situation to situation as defined by a specific anger-​related theme and from there to situations defined by a different anger-​related theme. If you do this consistently, you will eventually take the toxicity out of the emotional problem of unhealthy anger!

USING REBT’S ABCD FORM TO DEAL WITH SPECIFIC EXAMPLES OF YOUR UNHEALTHY ANGER This chapter is mainly geared to help you deal with your unhealthy anger in general terms. However, you can also use this material to address specific examples of your unhealthy anger. I have developed a self-​help form to provide the structure to assist you in this regard. It is called the ABCD form and it appears with instructions in Appendix 6. In Appendix 6, I outline the major problems that clients have in using this form and how to deal with them.

OTHER IMPORTANT ISSUES IN DEALING WITH UNHEALTHY ANGER In the above section, I outlined a 10-​step programme to deal with unhealthy anger. In this section, I discuss some other important issues that may be relevant to you in your work to become less prone to this emotional

256    Dealing with unhealthy anger

problem. If you want to, you can incorporate them as additional steps in the above step-​by-​step guide at points relevant to you.

Why you overestimate the presence of anger-​r elated themes and how to deal with it If you are particularly prone to unhealthy anger, you will be particularly sensitive to seeing the presence of anger-​related themes (such as others showing you disrespect) where others, who are not prone to unhealthy anger, do not. So far in this chapter, I have helped you to deal with unhealthy anger in situations where you infer the presence of anger-​related themes. In this section, I help you to understand and deal with situations where you overestimate their presence in the first place. I will use the example where you are particularly prone to infer disrespect in the behaviour of others.

Why you overestimate the presence of disrespect This is how you come to overestimate the presence of disrespect in the behaviour of others. ⦿

You take the theme of your general rigid/​extreme attitude:

⦿

You construct a second general rigid/​ extreme attitude that features ambiguity about the theme:

Disrespect from the general rigid/​extreme attitude: ‘I must not be shown disrespect. Others are bad if they do not respect me.’

‘It must be clear that others respect me. I can’t tolerate such ambiguity.’ ⦿

You bring this second general rigid/​extreme attitude to situations where it is possible that you may be or have been disrespected and you make an inference about the presence of disrespect because you cannot convince yourself that you have been respected: ‘Since it is not clear that you have shown me respect, you have disrespected me.’

⦿

You focus on this inference and bring a specific version of your original general rigid/​extreme attitude to this inference. For example: Inference: ‘My boss disrespected me.’

Specific rigid/​extreme attitude: ‘My boss must not show me disrespect. He is bad for doing so.’

Dealing with unhealthy anger    257

How to deal with your overestimations of the presence of disrespect In order to deal with your overestimations of the presence of disrespect, you need to take a number of steps, which I will illustrate. ⦿

Construct general flexible/​ non-​ extreme alternatives to your original disrespect-​focused general rigid/​extreme attitude:

‘I don’t want to be disrespected, but that does not mean I must not be disrespected. If I am, it’s bad but the person is not bad for doing so. They are fallible.’ ⦿

And to your second ambiguity-​focused general rigid/​extreme attitude:

⦿

Examine both sets of attitudes until you can see the truth, logic and helpful nature of the two general flexible/​non-​extreme attitudes and the falseness, illogic and unhelpful nature of the two general rigid/​extreme attitudes and you can commit to implement the former.

⦿

Bring your ambiguity-​focused general flexible/​non-​extreme attitude to situations where it is possible that you may be or have been disrespected and make an inference based on the data at hand:

‘I would like to have clear evidence that I am respected, but I don’t need such clarity. It is difficult not having this clarity, but I can bear not having it and it is worth bearing.’

‘It’s not clear if I have been disrespected or not, so let’s consider the evidence.’ ⦿

If there is evidence indicating there is a good chance that you will be or have been disrespected, use a specific version of your general disrespect-​ focused flexible/​non-​extreme attitude to deal with this. For example:



Inference: ‘My boss has disrespected me.’ Specific flexible/​non-​extreme attitude: ‘I don’t want my boss to disrespect me, but sadly he does not have to do what I want him to do. It is bad that he did so, but he is not bad. He is a fallible human being who is capable of showing respect and disrespect.’ If your client finds that the above explanation is too complex, you can help them to see that rigid attitudes towards the presence or absence of unhealthy anger-​related adversities means that, if it is not clear that the frustration, goal obstruction, personal rule transgression, disrespect or threat to their self-​esteem was absent,

258    Dealing with unhealthy anger

they will assume that it is present. When their attitudes are flexible, your client can be more objective about the presence of these adversities.

How to examine the accuracy of your inference of threat, if necessary If you are still unsure if your inference of disrespect is accurate or inaccurate, answer one or more of the following questions: ⦿

How likely is it that I was disrespected (or might be disrespected)?

⦿

Would an objective jury agree that I was (or might be) disrespected? If not, what would the jury’s verdict be?

⦿

Did I view (am I viewing) the situation in which I inferred disrespect realistically? If not, how could I have viewed (can I view) it more realistically?

⦿

If I asked someone whom I could trust to give me an objective opinion about the truth or falsity of my inference about being disrespected, what would the person say to me and why? What inference would this person encourage me to make instead?

⦿

If a friend had told me that they had faced (were facing or were about to face) the same situation as I faced and had made the same inference of disrespect, what would I say to them about the validity of their inference and why? What inference would I encourage the person to make instead?

Assessing and dealing with emotional problems about unhealthy anger As I have already pointed out, we have the unique ability to disturb ourselves about our emotional problems. It is important to assess carefully the nature of this meta-​disturbance about unhealthy anger before you can best deal with it. The best way to start dealing with the assessment of any emotional problems you might have about unhealthy anger is to ask yourself the question: ‘How do I feel about my feeling of unhealthy anger?’ The most common emotional problems that people have about unhealthy anger

Dealing with unhealthy anger    259

are as follows: anxiety, depression, guilt, unhealthy regret, shame and unhealthy self-​anger. I discuss only unhealthy self-​anger about unhealthy anger in this chapter and refer you to the relevant chapters on these emotional problems in this book for help on how to deal with meta-​emotional problems about unhealthy anger.

Assessing unhealthy self-​anger about unhealthy anger When you are unhealthily angry with yourself about your unhealthy anger, it is clear that you think that you have broken your own rule about experiencing unhealthy anger. This may be about the whole response itself or one or more of its components (i.e., the feeling component, the behavioural component or the thinking component). In my experience, you are most likely to be unhealthily angry with yourself for what you did (or felt like doing) when you were originally unhealthily angry.

Dealing with unhealthy self-​anger about unhealthy anger Unless you deal with your unhealthy self-​anger about unhealthy anger, you are unlikely to deal with your original unhealthy anger. This is because your focus will be on blaming yourself for your anger problem, which will take you away from dealing with this problem. The best way of dealing with your unhealthy self-​anger about your original unhealthy anger is to accept yourself unconditionally for having a problem with unhealthy anger. Yes, you may be breaking one of your personal rules by being unhealthily angry and expressing it in unconstructive ways, but sadly there is no reason why you must not break your rule about being angry or expressing your unhealthy anger. You are human and humans do break their rules. That does not mean that you should not take responsibility for making yourself unhealthily angry in the first place and expressing it unconstructively in the second place. Far from it! Indeed, unless you take responsibility for your unhealthy anger, you won’t deal with it. But you can take responsibility without the self-​blame that is a central feature of your unhealthy self-​anger about your original anger problem. Your client will sometimes need to address their disturbance about their unhealthy anger (i.e., their secondary disturbance) before they address their primary unhealthy anger. They need to do this particularly when their secondary emotional problem gets in the way of them dealing with their primary problem. However,

260    Dealing with unhealthy anger

despite the interfering presence of their secondary disturbance, your client may still want to target their primary unhealthy anger first. There are two ways of dealing with this situation: ⦿

Provide a rationale to help your client target their secondary disturbance. For example, explain to your client that their secondary problem is like having a ball and chain around their leg while they are climbing a steep hill (akin to their primary problem). In the same way as climbing the hill is easier when they remove the ball and chain from their leg, dealing with their primary unhealthy anger is easier when they deal with their secondary disturbance first.

⦿

Go along with your client’s wish to deal with their primary unhealthy anger and, when they fail to do so, help them to understand that the reason why they failed is because they had not addressed their secondary disturbance and then agree with them that they will now do so.

Developing and rehearsing healthy anger-​b ased world views People develop views of the world as it relates to them that make it more or less likely that they will experience UNEs. The world views that render you vulnerable to unhealthy anger do so in a similar way to your ambiguity-​ focused general rigid/​extreme attitudes towards a specific anger-​related theme –​by making you oversensitive to the presence of the theme about which you hold unhealthy anger-​related rigid/​extreme attitudes. However, these unhealthy anger-​based world views have this effect on you much more widely. It is important that you develop realistic views of the world that will help you to deal with unhealthy anger and experience healthy anger instead. In Table 8.1, you will find an illustrative list of such world views rather than an exhaustive one, so you can get an idea of what I mean, which will enable you to develop your own. In Table 8.1, I first describe a world view that renders you vulnerable to unhealthy anger and then I give its healthy alternative. You will see that the latter views are characterised by complexity and being non-​extreme in nature, whereas, in the former, aspects of the world that relate to the anger-​related theme are portrayed as unidimensional and extreme.

Dealing with unhealthy anger    261

Table 8.1 World views that render you vulnerable to unhealthy anger and help you to deal with unhealthy anger Views of the world that render you vulnerable to unhealthy anger

Views of the world that help you deal with unhealthy anger

⦿

It’s a dog-​eat-​dog world

⦿

The world is very complex and varied. It can be dog-​eat-​dog, but it can also be dog-​look-​after-​dog!

⦿

People only selfishly look after themselves and their own

⦿

People look after themselves and their own, but in a self-​caring way as well as selfishly. They also look after others as well

⦿

There’s no such thing as an accident. People always act with malicious intent

⦿

People can act with malicious intent, but certainly not all the time and accidents do happen

⦿

People are out to get me, so I need to get them before they get me

⦿

People may be out to get me, but they also may be out to help me and be friendly. I don’t need to go on the attack unless there is clear evidence that they are out to harm me

If you hold flexible/​non-​extreme attitudes that are consistent with the views of the world listed on the right-​hand side of Table 8.1, and if you act and think in ways that are, in turn, consistent with these flexible/​non-​ extreme attitudes, you will become less prone to unhealthy anger. In Chapter 9, I discuss unhealthy jealousy and how to deal with it.

C H A P T E R

9 Dealing with unhealthy jealousy

In this chapter, I begin by presenting REBT’s way of understanding unhealthy jealousy and then address how to deal with this emotional problem.

UNDERSTANDING UNHEALTHY JEALOUSY In understanding unhealthy jealousy, we need to know what we tend to make ourselves unhealthily jealous about (i.e., its major inference themes), what attitudes we hold, how we act or tend to act, and how we think when we are unhealthily jealous. I mentioned in previous chapters that it is important that you use your client’s language when referring to emotional problems. With respect to the term ‘unhealthy jealousy’, you need to be aware that not all clients with a ‘jealousy’ problem resonate with the term ‘unhealthy jealousy’. Indeed, people who have a problem with jealousy may be quite reluctant to see their ‘jealousy’ as a problem, seeing it instead as a sign that they really care for the other person. However, even those who do see their jealousy as problematic may baulk at using the term ‘unhealthy jealousy’ as a way of referring to their problem. They may identify more closely with terms like ‘overpossessiveness’ or ‘insecurity’. If so, your task is to satisfy yourself and your client that these terms represent the UNE known in REBT as unhealthy jealousy. Once you have done so, use the client’s language and write this down in your client’s notes.

Major inference themes in unhealthy jealousy There are two major themes in relation to your personal domain that are implicated in unhealthy jealousy:

DOI: 10.4324/9781003424338-10

Dealing with unhealthy jealousy    263

⦿

A threat is posed to your relationship with your partner from a third person. While you may experience unhealthy jealousy in relationships that are not romantic in nature, in this chapter I focus on unhealthy jealousy within the context of romantic relationships since it is the most common form of jealousy and it brings out quite vividly how your mind works in this emotional problem.

⦿

A threat is posed by the uncertainty you face concerning your partner’s whereabouts, behaviour, thoughts and feelings in the context of the first threat.

Your client may not resonate with the above schema and, in this case, you should encourage them to put it aside and just focus on what they tend to feel unhealthily jealous about. REBT theory values flexibility and this includes the freedom not to use REBT terms, schemas and frameworks.

Rigid/​e xtreme attitudes As I explained in Chapter 1, according to REBT, inferences on their own do not account for emotional problems. It is possible, therefore, for you to make the same inferences as listed above and feel healthy jealousy and not unhealthy jealousy.1 In order for you to feel unhealthy jealousy, you have to hold a rigid attitude and one or more extreme attitudes. While the rigid attitude is at the core of unhealthy jealousy, the extreme attitudes that are derived from the rigid attitude often distinguish between where you devalue yourself (usually when you compare yourself to your ‘rival’ or if you were to lose your partner) and where you find the uncertainty of not knowing key aspects to do with your partner unbearable. In chronic unhealthy jealousy, you often hold both a threat-​related self-​devaluation attitude and an uncertainty-​ related unbearability attitude in a given situation. If your client is unsure about the mediating role that rigid/​ extreme attitudes play in their unhealthy jealousy, ask them how they would feel if they had strong conviction in the flexible/​non-​ extreme alternatives to what REBT holds are their unhealthy jealousy-​creating rigid/​extreme attitudes. In using this strategy, it is important that you formulate the flexible/​ non-​ extreme attitudes for your client who cannot be expected to do this for themself at this stage. When you do this, ensure that you match

264    Dealing with unhealthy jealousy

their rigid attitude with a flexible alternative and their main extreme attitude with a non-​extreme alternative, and then ask them how they would feel if they had strong conviction in this flexible/​non-​extreme attitude. For example: ‘Let me outline two sets of attitudes towards being uncertain that your partner is cheating on you, and you tell me which leads to unhealthy jealousy and which leads to healthy jealousy. The first set of attitudes is as follows: “I must know for certain that my partner is not cheating on me and I can’t bear not knowing this.” The second set of attitudes is as follows: “I really would like to know for certain that my partner is not cheating on me, but I don’t need such certainty. I can bear not knowing this, although it is tough not to have certainty.” Now which set of attitudes would lead to unhealthy jealousy and which would lead to healthy jealousy?’ Be aware that this question often leads to a lengthy discussion of the behavioural and thinking correlates of the two forms of jealousy (which I outline later in the Client’s Guide) and you should be prepared to help your client list these and see the differences between the two. Once your client can see that their rigid/​extreme attitudes underpin unhealthy jealousy and their flexible/​ non-​ extreme attitudes underpin healthy jealousy, they have understood the mediating role of attitudes. This is quite an elegant strategy since it accomplishes a number of things at once: 1.  It addresses your client’s doubts about the mediating role of rigid/​extreme attitudes in unhealthy jealousy if they have such concern. 2.  It introduces flexible/​non-​extreme attitudes as a meaningful alternative to these rigid/​extreme attitudes. 3.  It helps your client to see that holding flexible/​ non-​ extreme attitudes can have beneficial effects.

Behaviour associated with unhealthy jealousy When you hold a rigid/​extreme attitude towards a threat that you think is posed by someone else to your relationship and by the uncertainty

Dealing with unhealthy jealousy    265

involved in this threat, you will act or tend to act in a number of ways, the most common of which are as follows: ⦿

You seek constant reassurance that you are loved.

⦿

You search for evidence that your partner is involved with someone else.

⦿

You set tests that your partner has to pass.

⦿

You sulk.

⦿

You monitor the actions and feelings of your partner.

⦿

You attempt to restrict the movements or activities of your partner.

⦿

You retaliate for your partner’s presumed infidelity.

If you ask your client whether they want to change their unhealthy jealousy-​ related behaviour, their response will be affected by whether or not they are in an unhealthily jealous frame of mind. If they are, they are less likely to see that this behaviour is dysfunctional than when they are not unhealthily jealous. If they are feeling unhealthily jealous, it is useful to encourage them to imagine that they are advising a friend who displays the same unhealthy jealousy-​based behaviour as they do. What would they say to their friend about the functionality or dysfunctionality of such behaviour? They are more likely to see that their own unhealthy jealousy-​based behaviour is dysfunctional after they have told their ‘friend’ that the same behaviour is dysfunctional.

Thinking associated with unhealthy jealousy When you hold a rigid/​extreme attitude towards a threat that you think is posed by someone else to your relationship, and you face uncertainty concerning your partner’s whereabouts, behaviour or thinking, you will tend to think in a number of ways. Remember what I said in Chapter 1: the thinking that accompanies your unhealthy jealousy is the result of your inference being processed by your rigid/​extreme attitude and therefore it is likely to contain a number of thinking errors that I present in Appendix 1. I list the main features of this post-​rigid/​extreme attitude unhealthy jealousy-​based thinking below:

266    Dealing with unhealthy jealousy

⦿

You exaggerate any threat to your relationship that does exist.

⦿

You think the loss of your relationship is imminent.

⦿

You misconstrue your partner’s ordinary conversations with relevant others as having romantic or sexual connotations.

⦿

You construct visual images of your partner’s infidelity.

⦿

If your partner admits to finding another person attractive, you think that your partner finds that person more attractive than you and that your partner will leave you for this other person.

As you can see, such thinking exaggerates the negative consequences of the perceived threat to your relationship. Such thinking may be in words or in mental images. One of the main features of post-​rigid/​extreme-​attitude thinking is that it is compelling. As such, it is quite easy for your client to get caught up in this way of thinking and think that it reflects reality. This is an example of ‘cognitive-​emotive’ reasoning: if a thought is plausible and emotionally compelling, therefore it must be true. It is important that you help your client to understand how their mind works with respect to the thinking consequences of rigid/​ extreme attitudes and to encourage them to use such thoughts to go back to address the rigid/​extreme attitudes that spawn them. When they have done this, you can encourage them to respond to these thinking consequences of rigid/​extreme attitudes as they will not disappear just because they have examined these attitudes. When they respond to these thinking consequences, they need to do so only a few times on any one occasion. After that, they need to accept the presence of such thinking without engaging with it. To summarise, your client needs to: ⦿

identify the presence of the thinking consequences of rigid/​ extreme attitudes (see Appendix 1)

⦿

trace these back to the source of this mode of thinking (i.e., identify the underlying rigid/​extreme attitudes)

⦿

examine these rigid/​extreme attitudes

⦿

respond briefly to the thinking consequences of such attitudes, but not get overly involved in this process

Dealing with unhealthy jealousy    267

⦿

accept the lingering presence of these thinking consequences without engaging with them

⦿

get on with the business of living.

HOW TO DEAL WITH UNHEALTHY JEALOUSY If you are prone to unhealthy jealousy, you tend to experience this emotional problem in a variety of different settings and in response to a variety of situations where you think someone poses a threat to your relationship. Here is how to deal with unhealthy jealousy so that you become less prone to it.

Step 1: Identify reasons why unhealthy jealousy is a problem for you and why you want to change While unhealthy jealousy is generally regarded as an emotional problem, it is useful for you to spell out reasons why unhealthy jealousy is a problem for you and why you want to change. I suggest that you keep a written list of these reasons and refer to it as needed as a reminder of why you are engaged in a self-​help programme. I discuss the healthy alternative to unhealthy jealousy in Step 4. Some people who feel unhealthily jealous think that it is an appropriate response to situations where they think that others pose a threat to their relationship and where they are not certain that this is the case. In these circumstances, it is important to introduce the idea of feeling healthily jealous as the healthy alternative to unhealthy jealousy a little earlier than you would normally do (see Step 4). When you have done so, you can then carry out a cost-​ benefit analysis of unhealthy jealousy and its constructive alternative, healthy jealousy. This involves helping your client to spell out the perceived advantages and disadvantages of both emotions. Respond to any perceived advantages of unhealthy jealousy and perceived disadvantages of unhealthy jealousy, correcting any misconceptions that your client reveals on these issues. For example, imagine that your client thinks that feeling unhealthy jealousy is a sign to their partner and to others that

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they love their partner very deeply and that healthy jealousy does not communicate the depths of their loving feelings. In this case, help your client to see that they can love their partner deeply without being unhealthily jealous and that, rather than being a sign of deep love, unhealthy jealousy is a sign of deep disturbance. Also, demonstrations of unhealthy jealousy after a while tend to alienate the partner, which is not the case with expressions of healthy jealousy.

Step 2: Take responsibility for your unhealthy jealousy In REBT, we argue that people do not make you unhealthily jealous; rather you create these feelings by the rigid/​ extreme attitudes that you hold towards what such people do or do not do. You may object that this view condones other people’s behaviour, but this objection is based on a misconception. You can take responsibility for creating your unhealthy jealousy and still not condone others’ behaviour when it is clear that they have posed a threat to your relationship. You may object that this view involves you blaming yourself for creating your feelings, but this objection is also based on a misconception. It assumes that taking responsibility for creating your unhealthy jealousy is synonymous with self-​blame. In truth, responsibility means that you take ownership for the rigid/​extreme attitudes that underpin your unhealthy jealousy while accepting yourself for doing so. Blame, on the other hand, means that you regard yourself as being bad for creating your own unhealthy jealousy. The idea that emotional problems (including unhealthy jealousy) are based largely on the attitudes that a person holds towards what happens to them is, as you know, a central plank in REBT. However, for your client, it will be a new idea. Thus, your client may hold that the reason they are unhealthily jealous is that their partner seems interested in other men or women. This is an example of ‘A–​C’ thinking where ‘A’ is the client’s partner appearing to be interested in other men or women and ‘C’ is the emotion of unhealthy jealousy. Rather, we argue that the reason that the person experiences unhealthy jealousy is largely due to the fact that they hold a set of rigid/​extreme attitudes towards this actual or perceived threat to their relationship. If they

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held a set of flexible/​non-​extreme attitudes towards the threat, they would experience healthy jealousy rather than unhealthy jealousy. If your client continues to have difficulty accepting responsibility for their unhealthy jealousy, it is important for you to identify the source of this difficulty. Here are two common obstacles and how to respond to them: ⦿

The double penalty: This obstacle is expressed like this: ‘If I accept responsibility for my feelings of unhealthy jealousy, it is as if I am being punished twice. First, my partner is threatening our relationship and, second, I am being told that I am responsible for these feelings. This lets the other person off the hook.’ If your client holds to this view, help them to see that, while they may be being penalised by their partner threatening their relationship (and remember that, in REBT, we assume that this inference is true until investigating this much later in the process), they are actually penalising themself by making themself feel unhealthily jealous. Show your client that you want to spare them this second penalty by helping them to experience an HNE (healthy jealousy) rather than a UNE (unhealthy jealousy). This involves them first taking responsibility for creating their unhealthy jealousy. Actually, assuming such responsibility is a help not a penalty!

⦿

Taking responsibility for unhealthy jealousy means admitting a weakness: Here the block is the rigid/​extreme attitude that your client holds towards having and/​or admitting having a weakness (e.g., ‘I cannot take responsibility for my unhealthy jealousy because it means admitting that I have a weakness that I must not have or must not admit to publicly’). If your client holds this view, help them to understand that having a weakness is quintessentially human and does not mean that they are defective. Rather it means that they are fallible human beings with strengths and weaknesses.

It is important to help your client to understand the impact of these obstacles on their emotional problems. Then, help them to develop alternatives to these obstacles and review the impact of these alternatives on their emotional problem-​solving. This often helps the client to deal effectively with these obstacles. If not, you

270    Dealing with unhealthy jealousy

may need to do a more detailed assessment of the obstacle, which is outside the brief of this book.

Step 3: Identify themes about which you tend to feel unhealthy jealousy The best way of identifying what you tend to feel unhealthy jealousy about is to understand the major themes associated with unhealthy jealousy and how this theme manifests with respect to your personal domain. As I outlined, one major theme in unhealthy jealousy is when you perceive a risk posed by a third person to your relationship. Such threat might be manifest in the following ways: ⦿ ⦿

You think that your partner will leave you. You think that you are not the most important person in your partner’s life. Here you think that your partner finds another person more attractive than you and that you will be displaced as the most important person in your partner’s life (even though you don’t think that your partner will go off with the other person).

⦿

You think that you are not your partner’s one and only.

⦿

You think that someone is showing an interest in your partner.

Here, it is important to you that your partner is interested only in you and that your partner’s interest in another person means that you are no longer his or her one and only.

Here, it is important to you that no one (who has the potential to be a love rival) shows an interest in your partner, so, when someone does, you deem this to be a threat.

The second major inference theme in your unhealthy jealousy concerns the threat posed by the uncertainty you face concerning your partner’s whereabouts, behaviour or thinking in the context of the first threat. If your client finds it difficult to find their unhealthy jealousy-​ related theme, you can help them by assessing a few specific examples of their unhealthy jealousy. Have them focus on a

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specific situation in which they felt unhealthily jealous and ask them what they were most unhealthily jealous about. If they still find it difficult to identify the theme in this or other specific situations, use the ‘magic question’ technique. This involves you doing the following: ⦿

Have your client focus on the situation in which they felt unhealthily jealous.

⦿

Ask them to nominate one ingredient that would eliminate or significantly reduce their feelings of unhealthy jealousy without changing the situation.

⦿

The opposite of this nominated ingredient is what they are most jealous about.

Bill was finding it difficult to pinpoint the specific theme with respect to his feelings of unhealthy jealousy about his girlfriend’s friendliness to other men. Bill used the ‘magic question’ technique as follows: ⦿

Bill focused on the situation in which he felt unhealthily jealous: ‘My girlfriend is being friendly to other men.’

⦿

He nominated one ingredient that would eliminate or significantly reduce his unhealthy jealousy without changing the situation: ‘Knowing that I am number one in my girlfriend’s affections.’

⦿

The opposite of this nominated ingredient is what he is most unhealthily jealous about: ‘Not knowing that I am number one in my girlfriend’s affections.’

If you assess a number of specific examples of your client’s unhealthy jealousy in this way, the relevant unhealthy jealousy-​ related theme should be apparent. In Bill’s case, it was being unsure that he was the most important person in his girlfriend’s life. It may be that there are two unhealthy jealousy-​related themes present in your client’s unhealthy jealousy. For example, your client may feel unhealthily jealous about being second best and

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about not knowing what their partner is doing at any given time. If this is the case, deal with them one at a time and have your client nominate the theme that they want to focus on first.

Step 4: Identify the three components of your unhealthy jealousy response and set goals with respect to each component The next step is for you to list the three elements of your unhealthy jealousy response in the face of each of the relevant themes listed above.

Identify the three components of your unhealthy jealousy response I use the term ‘unhealthy jealousy response’ to describe the three main components that make up this response. The three components of your unhealthy jealousy response are the emotional, behavioural and thinking components.

Emotional component The emotional component here is, of course, unhealthy jealousy.

Behavioural component The behavioural component concerns overt behaviour or action tendencies that you engage in or ‘feel like’ engaging in when you feel unhealthy jealousy. Consult the list that I provided to help you identify your behaviour associated with each relevant theme when you feel unhealthy jealousy (see p. 265).

Thinking component The thinking component associated with unhealthy jealousy is listed on p. 266. Again, these may be in words or in mental pictures. Consult this list if necessary.

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Set goals with respect to each of the three components You need to set goals so that you know what you are striving for when you deal effectively with unhealthy jealousy. The three goals are emotional, behavioural and thinking goals.

Emotional goal Your emotional goal is healthy jealousy rather than unhealthy jealousy (or whatever synonym you prefer to the term ‘healthy jealousy’). Healthy jealousy is an HNE, which is an appropriate response to the threat that you think is being posed to your relationship by a third person and to the threat of uncertainty related to your partner in the context of the first threat. It helps you to think objectively about the situation and your response to it and helps you to move on with your life rather than get stuck or bogged down. The idea that healthy jealousy is the healthy alternative to unhealthy jealousy when there is a perceived threat to your client’s relationship with their partner and when your client is in a state of uncertainty about salient aspects of their thoughts, feelings, behaviour and whereabouts is based on the following idea. These adversities are negative and therefore it is realistic to have a negative emotion about them. The choice, therefore, is between a UNE (unhealthy jealousy) or a HNE (healthy jealousy). However, what if your client specifies unrealistic goals? Here are three such goals and how to respond to clients who nominate them: ‘I don’t want to feel unhealthily jealous.’ Show your client that they have indicated what they do not want to feel in the face of a perceived threat to their relationship with their partner and when they are in a state of uncertainty about salient aspects of their partner’s thoughts, feelings, behaviour and whereabouts. Your client needs to specify how they do want to feel instead of unhealthy jealousy. ⦿

‘I want to feel less unhealthily jealous.’ Show your client that, as unhealthy jealousy is a disturbed emotion, wanting to feel less unhealthily jealous is still to nominate a disturbed emotion, albeit of lesser intensity. Show your client that healthy jealousy can be strong and healthy. ⦿

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‘I don’t want to feel anything.’ Not feeling anything in the face of a perceived threat to your client’s relationship with their partner and when they are in a state of uncertainty about salient aspects of their thoughts, feelings, behaviour and whereabouts will not help your client to be appropriately geared up to deal with these situations. Help them to see this. Also show them that the only way that they could achieve a state of not feeling anything is to feel completely indifferent about a perceived threat to their relationship with their partner and about being in a state of uncertainty about salient aspects of their partner’s thoughts, feelings, behaviour and whereabouts. This can be achieved only if your client lies to themself. Show them this and discourage them from setting such a goal. ⦿

Behavioural goal Your behavioural goal should reflect actions that are based on healthy jealousy rather than unhealthy jealousy. The following are the most common behaviours associated with healthy jealousy. You may wish to compare these behaviours with those associated with unhealthy jealousy that I presented on p. 265. ⦿

You allow your partner to initiate expressing love for you without prompting him or her or seeking reassurance once your partner has done so.

⦿

You allow your partner freedom without monitoring his or her feelings, actions and whereabouts.

⦿

You allow your partner to show natural sexual interest in others without setting tests.

It is important that your client understands that, as they strive to develop healthy behavioural responses to actual or perceived threats to their relationship or being in a state of uncertainty about salient aspects of their partner’s behaviour, feeling, thoughts and whereabouts, they will still feel the urge to act in ways that are dysfunctional, as listed on p. 265. Help them to understand the reason for this. Explain to them that, as they examine their

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attitudes and commit themself to strengthening their conviction in their flexible/​ non-​ extreme attitudes and to weakening their conviction in their rigid/​ extreme attitudes, the latter will still be active and producing urges for them to act dysfunctionally. Encourage your client to accept these urges, to recognise that they do not have to act on them and to use them as cues to act in functional ways.

Thinking goal As well as setting behavioural goals related to the feeling of healthy jealousy about a threat posed by a third person to your relationship, it is important that you set thinking goals associated with this emotion. The following are the most common forms of thinking associated with healthy jealousy rather than unhealthy jealousy. Again, you may wish to compare these forms of thinking with those associated with unhealthy jealousy that I presented on p. 266. ⦿

You tend not to exaggerate any threat to your relationship that does exist.

⦿

You do not misconstrue ordinary conversations between your partner and another man or woman.

⦿

You do not construct visual images of your partner’s infidelity.

⦿

You accept that your partner will find others attractive, but you do not see this as a threat.

As the above list shows, the dominant feature of thinking associated with healthy jealousy is that it is realistic and balanced. Please remember that such thinking may be in words or in mental pictures. The point I made above with respect to your client’s behavioural goals is also relevant with respect to their thinking goals. Your client will still have some conviction in their rigid/​extreme attitudes until they have full conviction in their flexible/​ non-​ extreme attitudes. Given this, your client’s rigid/​extreme attitudes will have some impact on their subsequent thinking as they strive to achieve their goals. Thus, highly distorted thoughts will still come into your client’s mind. Help your client to understand why this is the case. When you come to help them deal with these forms of post-​ rigid/​ extreme-​ attitude thinking, do one or more of the

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following as indicated. Discuss this issue with your REBT supervisor, if necessary: ⦿

Encourage your client to acknowledge the existence of such thoughts without trying to suppress them, distract themself from them or engage with them.

⦿

If relevant, use the presence of this post-​rigid/​extreme-​attitude thinking to help your client to identify and deal with the rigid/​ extreme attitudes.

⦿

Examine the empirical nature of these thinking ‘Cs’ once or twice and then return to the acceptance strategy detailed above.

Step 5: Recognise that your symptoms of unhealthy jealousy are evidence of disturbance and not necessarily of the existence of threat to your relationship Once you have identified your unhealthily jealous response and its healthy alternative, it is important that you realise one important point. If you feel jealous a lot, your feelings and the thoughts that accompany them are most likely to be evidence that you have a jealousy problem rather than proof that there truly exists a threat to your relationship. When you think that there is a threat to your relationship because you have jealous feelings and jealous thoughts, you are succumbing to two thinking errors known as emotional reasoning and cognitive reasoning. In emotional reasoning, you assume that because you feel jealous, your relationship is under threat. In cognitive reasoning, you think that your jealous thoughts are proof that again your relationship is under threat (e.g., ‘Because I think that my partner would much prefer to be with the woman he is talking to rather than with me, then he would, in reality, rather have a relationship with her than me’). If your unhealthy jealousy is chronic, when you have jealous feelings and thoughts, your task is to remind yourself that these are, in all probability, signs that you are thinking in rigid/​extreme ways and that you need to identify and deal with the rigid/​extreme attitudes that underpin your unhealthy jealousy response rather than to act on them. You may well find this difficult, because, when you have jealous feelings and thoughts, you will also experience an urge to act on them. Refraining from doing so will

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go against the grain and will thus be uncomfortable, but, if you do so, you will put yourself in the position of dealing effectively with your unhealthy jealousy. If you don’t, you will maintain this emotional problem.

Step 6: Identify your general rigid/​extreme attitudes and alternative general flexible/​non-​extreme attitudes A general rigid/​ extreme attitude leading to your unhealthy jealousy response is a rigid/​extreme attitude that you hold across situations defined by one of the following two themes: ⦿

The threat posed by a third person to your relationship: ⦿ ⦿ ⦿ ⦿

⦿

You think that your partner will leave you. You think that you are not the most important person in your partner’s life. You think that you are not your partner’s one and only. You think that someone is showing an interest in your partner.

The threat posed by the uncertainty you face concerning your partner’s whereabouts, behaviour or thinking in the context of the first threat.

Its flexible/​non-​extreme alternative, which will also be general in nature, will account for your healthy jealousy response.

Identify your general rigid/​extreme attitudes When you identify a general rigid/​extreme attitude, you take a common unhealthy jealousy-​related theme (see above) and add to this a general rigid attitude and the main extreme attitude that is derived from the rigid attitude. In unhealthy jealousy, your main extreme attitude will be either an unbearability attitude or a self-​devaluation attitude. Here is an example of a rigid/​extreme attitude related to each theme in unhealthy jealousy: ⦿

‘Third person threat’ unhealthy jealousy:

‘My partner must not find any other person attractive. If they do, then it proves that I am unlovable.’

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⦿

‘Uncertainty threat’ unhealthy jealousy:

‘I must know what my partner is thinking when we are in the company of attractive people and I can’t bear not knowing.’

Identify your alternative general flexible/​non-​extreme attitudes When you identify your alternative general flexible/​ non-​ extreme attitude, you take the same common theme (e.g., the threat posed by a third person to your relationship and the threat posed by the uncertainty you face concerning your partner’s whereabouts, behaviour or thinking in the context of the first threat) and add to this a general flexible attitude and a general discomfort tolerance attitude or a general unconditional self-​ acceptance attitude. For example: ⦿

‘Third person threat’ healthy jealousy:

⦿

‘Uncertainty threat’ healthy jealousy:

‘I don’t want my partner to find any other person attractive, but that does not mean that they must not do so. If they do then it is unfortunate, but it does not prove that I am unlovable. I can accept myself as a unique, unrateable, fallible human being whose worth is not changed by my partner finding another person attractive.’

‘I would like to know what my partner is thinking when we are in the company of attractive people, but I don’t have to know this. It’s a struggle not knowing, but I can bear not knowing and it is worth it to me to do so.’ As you will have noticed in the Client’s Guide, I encourage readers/​ clients to identify and work with their general rigid/​ extreme attitudes and to develop general flexible/​non-​extreme attitudes and, as you will see, when they are facing specific instances of their problems, I encourage them to focus on specific examples of both sets of attitudes. This will be at variance with your REBT practice, where you will begin with specific examples of your client’s problems and then proceed to work at a more general level with their problems and how these relate to one another. The reason I have chosen to go ‘general’ rather than ‘specific’ when helping readers/​clients to deal with their emotional problems is a pragmatic one. In this book, I aim to help people to deal with

Dealing with unhealthy jealousy    279

a range of emotional problems and therefore, in my view, it is best to give readers/​clients general guidance with respect to dealing with this range of problems and then help them to move from the general to the specific rather than vice versa. My considered view was that I just do not have the space to help readers/​clients focus on specific examples of their emotional problems and then generalise from this specific level. Consequently, one way that you can help your client who is using the Client’s Guide is to help them to work with specific examples of their emotional problem, in this case unhealthy jealousy. Use the following sequence as you do so and help your client to: ⦿

select a specific example of their unhealthy jealousy problem

⦿

express why their unhealthy jealousy constitutes a problem for them

⦿

identify what they felt most unhealthily jealous about in the situation

⦿

identify the three specific components of their unhealthily jealous response and set specific goals with respect to each component

⦿

identify their specific rigid/​extreme attitudes and alternative specific flexible/​non-​extreme attitudes

⦿

examine their specific attitudes.

In helping your clients to deal with a specific example of their unhealthy jealousy, you can teach them how to use REBT’s ABCD form, which appears in Appendix 6. The following steps are the same as those that appear in Steps 8–​11 later in this chapter. Thus, help your clients to: ⦿

face up to what they are most unhealthily jealous about in imagery (if necessary)

⦿

face the same things in reality (if possible) and take appropriate action

⦿

capitalise on what they have learned

⦿

generalise their learning.

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Step 7: Examine your general attitudes I recommended in previous chapters that you first examine together your general rigid attitude and its general flexible attitude alternative and then examine together your general extreme attitude and its general non-​ extreme attitude alternative.

Examine your general rigid attitude and its general flexible attitude alternative First, take your general rigid attitude and its general flexible attitude alternative and write them down next to one another on a sheet of paper. Then ask yourself: ⦿

Which is true and which is false?

⦿

Which has largely constructive results and which has largely unconstructive results?

⦿

Which is sensible logically and which does not make sense?

Write down your answer to each of these questions on your piece of paper, giving reasons for each answer. Consult Appendix 2 for help with the answers to these questions, which you need to adapt and apply to the attitudes you are examining.

Examine your general extreme attitude and its general non-​extreme attitude alternative Next, take your general extreme attitude and its general non-​extreme attitude alternative and again write them down next to one another on a sheet of paper. Then, ask yourself the same three questions that you used with your general rigid attitude and its general flexible attitude alternative. Again, write down your answer to each of these questions on your piece of paper, giving reasons for each answer. I suggest that you consult Appendix 3 (for help with examining awfulising attitudes and non-​ awfulising attitudes), Appendix 4 (for help with examining unbearability attitudes and bearability tolerance attitudes) and Appendix 5 (for help with examining devaluation attitudes and unconditional acceptance attitudes). Again, you need to adapt and apply these arguments to the attitudes you are examining. You should now be ready to commit to act and think in ways consistent with your general flexible/​non-​extreme attitude.

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I included Appendices 2–​ 5 in the Client’s Guide as general guidelines to help readers/​clients to examine their rigid/​extreme and flexible/​ non-​ extreme attitudes (reproduced in this book as Appendices 2–​5). If you are working with a client who is using the Client’s Guide, you will have a chance to look at the examining work that your clients have done at this point and give them feedback on that work. No book can provide such feedback. I have suggested that readers/​clients examine their rigid attitude and their flexible attitude together and then their main extreme attitude and non-​ extreme attitude equivalent together using three criteria as shown below: ⦿

Rigid attitude vs. flexible attitude ⦿

empirical status

⦿

pragmatic status

⦿

⦿

logical status

Main extreme attitude vs. main non-​extreme attitude ⦿

empirical status

⦿

pragmatic status.

⦿

logical status

The final point I want to make about examining attitudes concerns the concept of persuasiveness. Perhaps the most important aspect of the examining process is for your client to develop arguments concerning the false, illogical and unhealthy nature of their rigid/​ extreme attitudes and the true, logical and healthy nature of their flexible/​non-​extreme attitudes that are persuasive to them. So, encourage your clients to develop such persuasive arguments and to make a note of these for future reference.

Step 8: Face your unhealthy jealousy-​r elated theme in imagery I hope that you have made a commitment to act on your general flexible/​non-​extreme attitudes. Assuming that you have, your basic task is for

282    Dealing with unhealthy jealousy

you to face up to threats posed to your relationship with your partner from another person and to uncertainty about the whereabouts, behaviour, thoughts and feelings of your partner and to learn to think flexibly/​ non-​extremely about it. Up to this point, you have worked at a general level with respect to your unhealthy jealousy-​related theme, dealing with the general rigid/​extreme attitudes that account for your unhealthy jealousy and developing your alternative general flexible/​ non-​ extreme attitudes. However, when you come to apply your general flexible/​ non-​ extreme attitudes in dealing with threats posed to your relationship with your partner from another person and to uncertainty about the whereabouts, behaviour, thoughts and feelings of your partner, you need to bear in mind one important point. Since you make yourself unhealthily jealous about specific instances of this threat (actual or imagined) and related uncertainty, you need to deal with these by rehearsing specific variants of your general flexible/​non-​ extreme attitudes. While the best way to do this is in specific threat-​and uncertainty-​related situations, you may derive benefit by using imagery first. If this is the case, you need to do the following: ⦿

Imagine a specific situation in which you felt or may feel unhealthily jealous about a threat being posed to your relationship with your partner from another person or related to uncertainty about the whereabouts, behaviour, thoughts and feelings of your partner and focus, in your mind’s eye, on what you felt most unhealthily jealous about (i.e., your ‘A’).

⦿

Focus on this ‘A’ while rehearsing a specific flexible/​non-​extreme attitude relevant to the situation. As you do this, try to make yourself feel healthily jealous, rather than unhealthily jealous.

⦿

Then see yourself acting in ways consistent with your flexible/​ non-​ extreme attitude, e.g., expressing your concern to your partner and listening with an open mind to what he or she has to say in response.

⦿

Recognise that some of your post-​ rigid/​ extreme-​ attitude thinking may be distorted. Respond to it without getting bogged down doing so. Accept the presence of any remaining distorted thoughts without engaging with them.

⦿

Repeat the above steps until you feel sufficiently ready to put this sequence into practice in your life.

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If you find that facing your unhealthily jealousy-​related adversity at ‘A’, in your mind’s eye, is too much for you, use the ‘challenging, but not overwhelming’ principle that I introduced in Chapter 2 (see p. 53). This means that, instead of imagining yourself facing a threat to your relationship or an instance of uncertainty about your partner’s whereabouts that you find ‘overwhelming’ at the present time, choose a similar unhealthy jealousy-​related ‘A’ that you would find ‘challenging, but not overwhelming’. Then employ the same steps that I have outlined above. Work in this way with modified unhealthy jealousy-​related ‘A’s’ until you find your original one ‘challenging, but not overwhelming’ and then use the steps again. Your client may say that they can’t get very clear images when they try to picture events in their mind’s eye. While they may get more out of imagery techniques if they can get such clear images, they will still get something out of facing threats posed to their relationship with their partner from another person and to uncertainty about the whereabouts, behaviour, thoughts and feelings of their partner in imagery even if their images aren’t clear. So, if your client wants to face their particular adversity in imagery before they do so in reality, encourage them to do so no matter how clear their mental images are.

Step 9: Act in ways that are consistent with your general flexible/​n on-​e xtreme attitude As I mentioned earlier, when you experience the emotional problem of unhealthy jealousy and the thoughts that accompany it, you will also experience a strong urge to act on them. If you do, you will serve only to strengthen the rigid/​ extreme attitudes that underpin such behaviour. So, after you have examined your rigid/​extreme and flexible/​non-​ extreme attitudes in the way I suggested above and committed yourself to strengthening your conviction in your flexible/​non-​extreme attitudes, it is very important that you act in ways that will do this and to refrain from acting in ways that will do the opposite. This is perhaps the most important principle involved in dealing effectively with unhealthy jealousy. I have seen many people in my practice who have had ineffective therapy where the focus was on helping them to identify the childhood roots of these feelings. I am not against this practice, but the reason such therapy often fails is that, while the person

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is engaged in such an exploration, they are acting, in the present, in ways that stem from their rigid/​extreme attitudes and serve only to reinforce these attitudes. So, it is crucial that you act according to the behavioural goals that you identified in Step 4 and accept that, while you do so, you will still have the urge to act and think in unhealthy ways. Accept that this is an almost inevitable and natural part of the change process and that these unhealthy urges and thoughts will eventually subside if you do not engage with them. I stress that this is difficult, but if you are clear about what you need to do and act accordingly, you will stack the odds in favour of, rather than against, dealing effectively with your unhealthy jealousy. You may find that your client reports various obstacles to facing situations about which they have felt unhealthily jealous while acting in ways that are consistent with their general flexible/​non-​ extreme attitudes. I list here some of the major obstacles and suggest ways of addressing them with your client. ⦿

‘If I face jealousy-​related situations, I will become too upset.’

⦿

‘If I face jealousy-​related situations, I will find the urge to act dysfunctionally too tempting.’

Here, your client may have an unbearability attitude towards feeling upset. This is evidenced in the phrase ‘I will become too upset’. Help your client to see that, if they do become upset, they can bear this and still act in ways that are consistent with their flexible/​non-​extreme attitudes.

Here your client considers that the urge to act in ways that have previously maintained their unhealthy jealousy may be too powerful for them to resist. Consequently, your client is reluctant to face jealousy-​related situations while rehearsing their developing flexible/​non-​extreme attitudes and acting constructively. Help your client to develop a greater sense of control over their urges by allowing them to be there and showing themself that they do not have to act on such urges. ⦿

‘I don’t feel comfortable facing jealousy-​related situations.’

Help your client to see that, if they wait until they are comfortable before facing jealousy-​related situations, they will wait a very long time. Show your client that, if they are comfortable about facing such situations, it is likely that they are not

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unhealthily jealous about them. Consequently, it is important that you help your client realise that they are bound to be uncomfortable about facing a jealousy-​related situation even after they have examined their unhealthy jealousy-​ creating rigid/​extreme attitudes and begun to hold flexible/​non-​extreme attitudes towards the situation. Show them that they can bear this discomfort and that it is worth it to them to do so.

Step 10: Capitalise on what you have learned When you have faced a situation in which you experienced unhealthy jealousy and dealt with it as best you could, it is important that you reflect on what you did and what you learned. In particular, if you were able to face the situation, and rehearse your specific flexible/​non-​extreme attitudes until you felt healthy jealousy, ask yourself how you can capitalise on what you achieved. If you experienced any problems, respond to the following questions: ⦿

Did I face the situation and, if not, why not?

⦿

Did I rehearse my flexible/​non-​extreme attitudes before, during or after facing the situation and, if not, why not?

⦿

Did I execute my plan to face the situation, and, if not, why not?

⦿

Did I engage with post-​rigid/​extreme attitude distorted thinking and, if so, why?

Reflect on your experience and put into practice what you have learned the next time you face a situation in which someone poses a threat to your relationship or where a threat is posed to you by uncertainty concerning your partner’s whereabouts, behaviour or thinking in the context of the first threat. It is useful to monitor your client’s responses to these questions and help them to reflect on any issues that they have not considered.

Step 11: Generalise your learning Once you have dealt with your unhealthy jealousy in a specific situation by holding the relevant specific version of your general flexible/​non-​extreme

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attitude and by acting and thinking in ways that are consistent with it, you can generalise this learning to situations defined by your unhealthy jealousy-​based theme. Donald was particularly prone to unhealthy jealousy about women he was going out with. Thus: ⦿

Donald assessed the three components of his unhealthy jealousy response and set goals with respect to all three components.

⦿

He identified his relevant general rigid/​extreme attitudes regarding what he saw as threats to his relationship with his current girlfriend (i.e., ‘I must be the only person that my girlfriend is attracted to and, if I’m not, I am less worthy than my rival’) and uncertainty about her whereabouts (‘I must know where my girlfriend is and what she is doing at all times and I can’t bear not knowing this’) that underpinned his unhealthy jealousy response. He then identified his alternative general flexible/​non-​extreme attitudes towards the third person threat (i.e., ‘I would like to be the only person that my girlfriend is attracted to, but I don’t have to be. If I’m not, I am not less worthy than my rival. I am equal in worth to him’) and the uncertainty threat (i.e., ‘I would like to know where my girlfriend is and what she is doing at all times, but I do not need to know this. I can bear not knowing this even though it is difficult and it is worth it to me to do so’) that underpinned his healthy jealousy response.

⦿

He examined both elements of his general rigid/​extreme attitudes and his general flexible/​non-​extreme attitudes until he clearly saw that the former were false, made no sense and were detrimental to him, and that the latter were true, sensible and healthy.

⦿

He acted on shortened versions of his flexible/​non-​extreme attitudes in specific situations and did not keep checking on his girlfriend, either when she was talking to other men or when he did not know where she was or what she was doing. Instead, he acted as if he trusted her to be faithful to him, even though she might find other men attractive. However, he did disclose his feelings of displeasure towards her if it was clear that she was being overly flirtatious towards other men at social gatherings.

⦿

As he acted on his flexible/​non-​extreme attitudes, he tolerated the discomfort that he felt and accepted that some of his distorted and skewed negative thinking would still be in his mind as he did so. He let such thinking be without engaging with it, suppressing it or distracting himself from it.

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As this section shows, you can generalise what you learn about dealing with unhealthy jealousy from situation to situation as defined by your unhealthy jealousy-​based inference.

USING REBT’S ABCD FORM TO DEAL WITH SPECIFIC EXAMPLES OF YOUR UNHEALTHY JEALOUSY This chapter is mainly geared to help you deal with your unhealthy jealousy in general terms. However, you can also use this material to address specific examples of your unhealthy jealousy. I have developed a self-​help form to provide the structure to assist you in this regard. It is called the ABCD form and it appears with instructions in Appendix 6. In Appendix 6, I outline the major problems that clients have in using this form and how to deal with them.

OTHER IMPORTANT ISSUES IN DEALING WITH UNHEALTHY JEALOUSY In the above section, I outlined an 11-​ step programme to deal with unhealthy jealousy. In this section, I discuss some other important issues that may be relevant to you in your work to become less prone to this emotional problem. If you want to, you can incorporate them as additional steps in the above step-​by-​step guide at points relevant to you.

Dealing with your safety-​s eeking measures to avoid unhealthy jealousy I mentioned in Chapter 2 that people use safety-​seeking measures to protect themselves from threat. You may use similar measures to protect yourself from feeling unhealthy jealousy. Here is how this works from your perspective. You reason that, since you feel unhealthy jealousy about ‘third person’ and ‘uncertainty’ threats to your relationship with your partner, you will take steps to avoid unhealthy jealousy. This involves you ensuring that your partner does not interact with potential rivals and that you know where your partner is and what he or she is doing.

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However, this stance and the reasoning that leads you to take it are flawed and will serve only to perpetuate your tendency to feel unhealthy jealousy. This is due to the fact that your unhealthy jealousy is not based on ‘third person’ and ‘uncertainty’ threats to your relationship, but on your rigid/​ extreme attitudes towards such threats. So, if you want to deal effectively with unhealthy jealousy, you need to do the following: ⦿

Do not attempt to prevent your partner from interacting with potential rivals.

⦿

Do not keep tabs on your partner. Allow your partner to do what they want without you knowing exactly where your partner is, what they are doing and with whom they are interacting.

⦿

If you actually face threats to your relationship as a result, deal with these by bringing to such situations appropriate specific versions of your general flexible/​non-​extreme attitudes so that you feel healthily jealous and not unhealthy jealousy about these episodes. Also, act and think in ways that are consistent with these specific flexible/​ non-​ extreme attitudes as far as you can.

It is one of the major themes of both the Client’s Guide and this Practitioner’s Guide that, when your client comes to change their behaviour from dysfunctional to functional, they will still experience urges to act dysfunctionally. This is why it is so important to help your client understand the difference between overt actions and action tendencies. In the present context, this means stressing to your clients as they strive to act in ways that address their unhealthily jealous feelings constructively and thus desist from using unhealthy jealousy-​ related safety-​ seeking strategies that they will still feel the urge to use them. Help them to develop ways of accepting, but not necessarily liking, such urges and to implement their healthy jealousy-​based behaviour, even though such aforementioned behaviour may be present for some time. You may have to help your client identify and respond to rigid/​ extreme attitudes such as: ‘If I feel the urge to do something to get rid of my unhealthily jealous feelings quickly, then I have to act on that urge.’ Developing and strengthening flexible/​non-​extreme attitudes towards such urges is particularly important for the client.

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Why you feel unhealthy jealousy much of the time and how to deal with this If you are particularly prone to unhealthy jealousy, you hold the following attitude, which I call a ‘chronic unhealthy jealousy-​based general rigid/​ extreme attitude’: ⦿

‘I must know for sure that my relationship is not under threat and I can’t bear not knowing this. If I don’t have such certainty, then my relationship is under threat, and I will lose my partner because I am not good enough to hold any partner in the face of such threat.’

As you can see, this attitude has a number of elements: ⦿

It relates to the threat of uncertainty and you finding not knowing unbearable.

⦿

It relates to the threat to your relationship and the self-​devaluation attitude you implicitly hold.

Holding this attitude, you will do the following: ⦿

You will assume that uncertainty means that your relationship is under threat. Thus, you will see threat in ordinary exchanges between your partner and others where none objectively exists.

⦿

You will think that you will lose out to any rival because they have more to offer your partner than you do.

⦿

You will focus on past relationships where you thought your partner was unfaithful to you.

⦿

You will scan your current relationship hoping not to find, but certain that you will find, evidence that your partner is interested in someone else and is making plans to leave you. If there is any ambiguity about this, you will err on the side of threat to and loss of your relationship.

⦿

You will employ all the thinking and behavioural strategies that you use to keep yourself safe from threat. This serves only to strengthen your conviction that you are under threat.

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How to deal with chronic unhealthy jealousy In order to deal with this chronic sense of unhealthy jealousy, you need to develop and apply an alternative general flexible/​non-​extreme attitude that protects you from such unhealthy jealousy. ⦿

‘I would like to know for sure that my relationship is not under threat, but, although it is a struggle, I can bear not knowing this and it is worth it to me to do so. If I don’t have such certainty, it does not follow that my relationship is under threat, unless there is objective evidence that it is. If there is such a threat, then it does not follow that I will lose my partner. I am fallible and good enough to hold any partner in the face of such threat.’

When you hold this attitude and there exists objective evidence that your relationship is under threat, you will feel healthy jealousy rather than unhealthy jealousy because you will be processing this with a specific flexible/​non-​extreme attitude. In addition, this attitude will help you to: ⦿

revisit your past and see that past partners were more trustworthy than you thought at the time

⦿

see that your current partner is more trustworthy than you think when you hold your set of specific and general rigid/​extreme attitudes

⦿

see that any future partners will be trustworthy unless you find objective evidence to the contrary.

If your client finds that the above explanation is too complex, you can help them to see that holding rigid attitudes towards the presence or absence of unhealthy jealousy-​related threats means that, unless they are clear that these threats do not exist, then they assume that they are present. When your client’s attitudes are flexible then they can be more objective about the presence of these adversities.

How to examine the accuracy of your unhealthy jealousy-​related inference, if necessary If you are still unsure whether a threat exists to your relationship or not, answer one or more of the following questions:

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⦿

How valid is my inference that there is a threat to my relationship?

⦿

Would an objective jury agree that there is a threat to my relationship? If not, what would the jury’s verdict be?

⦿

Is my inference that there is a threat to my relationship realistic? If not, what is a more realistic inference?

⦿

If I asked someone whom I could trust to give me an objective opinion about my inference that there is a threat to my relationship, what would that person say to me and why? What inference would this person encourage me to make instead?

⦿

If a friend had told me that they had made the same inference about them facing a threat to their relationship, what would I say to this friend about the validity of their inference and why? What inference would I encourage this friend to make instead?

Assessing and dealing with emotional problems about unhealthy jealousy In previous chapters, I discussed the concept of meta-​disturbance (literally disturbance about disturbance). It is important to assess carefully the nature of this meta-​disturbance about unhealthy jealousy before you can best deal with it. The best way to start dealing with the assessment of any emotional problems you might have about unhealthy jealousy is to ask yourself the question: ‘How do I feel about my feeling of unhealthy jealousy?’ The most common emotional problems that people have about unhealthy jealousy are as follows: anxiety, depression, unhealthy regret, shame and unhealthy self-​anger. I refer you to the relevant chapters on these emotional problems in this book for help on how to deal with meta-​emotional problems about unhealthy jealousy. Your client will sometimes need to address their emotional problems about unhealthy jealousy before they address their unhealthy jealousy. They need to do this particularly when their secondary emotional problem gets in the way of them dealing with their primary unhealthy jealousy. However, despite the interfering presence of their secondary problem, your client may still want to target their primary jealousy. There are two ways of dealing with this situation:

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⦿

Provide a rationale to help your client target their secondary problem. For example, explain to your client that their secondary problem is like having a ball and chain around their leg while they are climbing a steep hill (akin to their primary feelings of unhealthy jealousy). In the same way as climbing the hill is easier when they remove the ball and chain from their leg, dealing with their primary unhealthy jealousy is easier when they deal with their secondary problem first.

⦿

Go along with your client’s wish to deal with their primary unhealthy jealousy and, when they fail to do so, help them to understand that the reason why they failed is because they had not addressed their secondary problem and then agree that they will now do so.

Developing and rehearsing healthy jealousy-​b ased world views People develop views of the world as it relates to them that make it more or less likely that they will experience UNEs. The world views that render you vulnerable to unhealthy jealousy do so in a similar way to the chronic unhealthy jealousy-​based general rigid/​extreme attitude discussed above (i.e., ‘I must know for sure that my relationship is not under threat and I can’t stand not knowing this. If I don’t have such certainty then my relationship is under threat and I will lose my partner because I am not good enough to hold any partner in the face of such threat’) by making you focus unduly on times when you have, are or will face threats to your relationship. However, these unhealthy jealousy-​based world views have this effect on you much more widely. It is important that you develop realistic views of the world that will help you to deal with unhealthy jealousy and experience healthy jealousy instead. In Table 9.1, you will find an illustrative list of such world views rather than an exhaustive one, so you can get an idea of what I mean, which will enable you to develop your own. In Table 9.1, I first describe a world view that renders you vulnerable to unhealthy jealousy and then I give its healthy alternative. You will see that the former views are characterised by a conception of your partners as being basically untrustworthy and potential rivals as being basically predatory. In the latter views, a more benign, balanced, but realistic picture of others is revealed

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Table 9.1 World views that render you vulnerable to unhealthy jealousy and help you to deal with unhealthy jealousy Views of the world that render you vulnerable to unhealthy jealousy

Views of the world that help you deal with unhealthy jealousy

⦿

My partners are ultimately untrustworthy

⦿

Some of my partners may be untrustworthy, but most will probably be trustworthy

⦿

My partners will ultimately leave me

⦿

Some of my partners may leave me, but others won’t. However, I may drive away people in this last group through my jealous behaviour

⦿

If I trust someone, they will make a fool of me. So, I need to always be on my guard

⦿

If I trust someone, it is possible that the person may betray my trust, but it is also possible that they won’t. If they do, they can’t make a fool out of me –​only I can do this with my rigid and self-​devaluation attitudes towards their behaviour

⦿

Not knowing what my partner is feeling, thinking and doing is very dangerous

⦿

Not knowing what my partner is feeling, thinking and doing is not inherently dangerous

⦿

Every attractive person is my rival

⦿

Some attractive people may be my rivals, but most won’t be

⦿

Attractive people are predatory and will seek to displace me in the affections of my partner

⦿

A few attractive people are predatory and will seek to displace me in the affections of my partner, but most will not

and thus a healthier response to the possible existence of relationship threat can be expected. If you hold flexible/​non-​extreme attitudes that are consistent with the views of the world listed on the right-​hand side of Table 9.1, and if you

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act and think in ways that are, in turn, consistent with these flexible/​non-​ extreme attitudes, you will become less prone to unhealthy jealousy. In Chapter 10, I discuss unhealthy envy and how to deal with it.

NOTE 1 As I have mentioned before, we don’t have agreed terms for HNEs. Therefore, if you don’t resonate with the term ‘healthy jealousy’, use a term that makes more sense to you.

C H A P T E R

10 Dealing with unhealthy envy

In this chapter, I begin by presenting REBT’s way of understanding unhealthy envy and then address how to deal with this emotional problem.

UNDERSTANDING UNHEALTHY ENVY In understanding unhealthy envy, we need to know what we tend to make ourselves feel unhealthily envious about (i.e., its major inference themes), what attitudes we hold, how we act or tend to act, and how we think when we are unhealthily envious. I mentioned in previous chapters that it is important that you use your client’s language when referring to emotional problems. With respect to the term ‘unhealthy envy’, you need to be aware that not all clients with an ‘envy’ problem resonate with the term ‘unhealthy envy’. Indeed, they may be quite reluctant to see their ‘envy’ as a problem, seeing it instead as a sign of healthy competition. However, even if your client sees their envy as problematic, they may baulk at using the term ‘unhealthy envy’ as a way of referring to their problem. They may identify more closely with terms like ‘covetousness’, ‘greed’ or ‘insecurity’. If so, your task is to satisfy yourself and your client that these terms represent the UNE known in REBT as unhealthy envy. Once you have done so, use the client’s language and write this down in your client’s notes.

Major inference theme in unhealthy envy The major theme in relation to your personal domain that is implicated in unhealthy envy is that someone has something that you prize, but don’t have. In unhealthy envy your focus may be on the object,1 that is you think you really want the object for its own sake (I call this object-​focused unhealthy envy), or on the person who has the object, i.e., you prize the object only because the particular person has it (I call this person-​focused DOI: 10.4324/9781003424338-11

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unhealthy envy). The common denominator in these different types of envy is that you consider yourself to be in a state of deprivation. Your client may not resonate with the above schema and, in these cases, you should encourage them to put it aside and just focus on what they tend to feel unhealthily envious about. REBT theory values flexibility and this includes the freedom not to use REBT terms, schemas and frameworks.

Rigid/​e xtreme attitudes As I explained in Chapter 1, according to REBT, inferences on their own do not account for emotional problems. It is possible, therefore, for you to make the same inference as listed above and feel healthy envy and not unhealthy envy.2 In order for you to feel unhealthy envy, you have to hold a rigid attitude and one or more extreme attitudes. While the rigid attitude is at the core of unhealthy envy, the extreme attitudes that are derived from the rigid attitude often distinguish between whether you are experiencing unhealthy ego envy (where you devalue yourself) and unhealthy non-​ego envy (where you ‘awfulise’, find the deprivation or inequality involved unbearable or devalue the other who is involved). You may, of course, experience both unhealthy ego envy and unhealthy non-​ego envy in a given situation. If your client is unsure about the mediating role that rigid/​ extreme attitudes play in their unhealthy envy, ask them how they would feel if they had strong conviction in the flexible/​non-​ extreme alternatives to what REBT holds are their unhealthy envy-​creating rigid/​extreme attitudes. In using this strategy, it is important that you formulate the flexible/​non-​extreme attitudes for your client, who cannot be expected to do this for themself at this stage. When you do this, ensure that you match your client’s rigid attitude with a flexible alternative and their main extreme attitude with a non-​extreme alternative, and then ask them how they would feel if they had strong conviction in this flexible/​non-​ extreme attitude. For example: ‘Let me outline two sets of attitudes towards your friends having what you don’t have but prize, and you tell me which leads to unhealthy envy and which leads to healthy envy. The first set of attitudes is as follows: “I must have what my friends have and I can’t bear the deprivation of not having it.” The second set of attitudes is as follows: “I really would like to have what my friends have, but it isn’t necessary that I have it. It’s

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difficult putting up with the deprivation, but I can do so and it’s worth it to me to do so.” Now which set of attitudes would lead to unhealthy envy and which would lead to healthy envy?’ Be aware that this question often leads to a lengthy discussion of the behavioural and thinking correlates of the two forms of envy (which I outline later in the Client’s Guide) and you should be prepared to help your client list these and see the differences between the two. Once your client can see that their rigid/​extreme attitudes underpin unhealthy envy and their flexible/​non-​extreme attitudes underpin healthy envy, they have understood the mediating role of attitudes. This is quite an elegant strategy since it accomplishes a number of things at once: 1.  It addresses your client’s doubts about the mediating role of rigid/​ extreme attitudes in unhealthy envy if they have such concern. 2.  It introduces flexible/​non-​extreme attitudes as a meaningful alternative to these rigid/​extreme attitudes. 3.  It helps your client to see that holding flexible/​ non-​ extreme attitudes can have beneficial effects.

Behaviour associated with unhealthy envy When you hold a rigid/​extreme attitude towards someone having something that you prize, but don’t have, you will act or tend to act in a number of ways, the most common of which are as follows: ⦿

You disparage verbally the person who has the desired possession to others.

⦿

You disparage verbally the desired possession to others.

⦿

If you had the chance, you would take away the desired possession from the other (either so that you will have it or so that the other is deprived of it).

⦿

If you had the chance, you would spoil or destroy the desired possession so that the other person does not have it.

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If you ask your client whether they want to change their unhealthy envy-​ related behaviour, their response will be affected by whether or not they are in an unhealthily envious frame of mind. If they are, they are far less likely to see that this behaviour is dysfunctional than when they are not unhealthily envious. If they are feeling unhealthily envious, it is useful to encourage them to imagine that they are advising a friend who displays the same unhealthily envious-​based behaviour as they do. What would they say to this friend about the functionality or dysfunctionality of such behaviour? They are more likely to see that their own unhealthy envy-​based behaviour is dysfunctional after they have told their ‘friend’ that the same behaviour is dysfunctional.

Thinking associated with unhealthy envy When you hold a rigid/​ extreme attitude towards someone having something that you prize, but don’t have, you will tend to think in a number of ways. Remember what I said in Chapter 1: the thinking that accompanies your unhealthy envy is the result of your inference being processed by your rigid/​extreme attitude and therefore it is likely to contain a number of thinking errors that I present in Appendix 1. I list the main features of this post-​rigid/​extreme attitude unhealthy envy-​based thinking below: ⦿

You tend to denigrate in your mind the value of the desired possession and/​or the person who possesses it.

⦿

You try to convince yourself that you are happy with your possessions (although you are not).

⦿

You think about how to acquire the desired possession regardless of its usefulness.

⦿

You think about how to deprive the other person of the desired possession.

⦿

You think about how to spoil or destroy the other’s desired possession.

As you can see, such thinking deepens the sense of deprivation that you experience and exaggerates the inequality that there is between you and

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the other person or persons involved. Once again, such thinking may be in words or in mental images. One of the main features of post-​rigid/​extreme-​attitude thinking is that it is compelling. As such, it is quite easy for your client to get caught up in this way of thinking and think that it reflects reality. This is an example of ‘cognitive-​emotive’ reasoning: if a thought is plausible and emotionally compelling, therefore it must be true. It is important that you help your clients to understand how their mind works with respect to the thinking consequences of rigid/​ extreme attitudes and to encourage them to use such thoughts to go back to address the rigid/​ extreme attitudes that spawn them. When your client has done this, you can encourage them to respond to these thinking consequences of rigid/​extreme attitudes as they will not disappear just because they have examined these attitudes. When they respond to these thinking consequences, they need to do so only a few times on any one occasion. After that, they need to accept the presence of such thinking without engaging with it. To summarise, your client needs to: ⦿

identify the presence of the thinking consequences of rigid/​ extreme attitudes (see Appendix 1)

⦿

trace these back to the source of this mode of thinking (i.e., identify the underlying rigid/​extreme attitudes)

⦿

examine these rigid/​extreme attitudes

⦿

respond briefly to the thinking consequences of such attitudes, but not get overly involved in this process

⦿

accept the lingering presence of these thinking consequences without engaging with them

⦿

get on with the business of living.

HOW TO DEAL WITH UNHEALTHY ENVY If you are prone to unhealthy envy, you tend to experience this emotional problem in a variety of different settings and in response to a variety

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of situations where someone has something that you prize, but don’t have. Here is how to deal with unhealthy envy so that you become less prone to it.

Step 1: Identify reasons why unhealthy envy is a problem for you and why you want to change While unhealthy envy is generally regarded as an emotional problem, it is useful for you to spell out reasons why unhealthy envy is a problem for you and why you want to change. I suggest that you keep a written list of these reasons and refer to it as needed as a reminder of why you are engaged in a self-​help programme. I discuss the healthy alternative to unhealthy envy in Step 4. What makes it harder for you to admit that you have an envy problem is that it is often an ‘ugly’ emotion (in that you seek to destroy or spoil what others have), you often feel ashamed of the malevolence that often accompanies unhealthy envy and thus, to cope with your shame, you deny having an envy problem. If you suspect that this is the case, I suggest that you deal with your shame about your envy first (see Chapter 6) and then come back to dealing with your unhealthy envy once you are disappointed, but not ashamed, about your unhealthy envy response. A client who feels unhealthily envious may think that it is an appropriate response to situations where others have what they prize, but lack. In these circumstances, it is important to introduce the idea of feeling healthily envious as the healthy alternative to unhealthy envy a little earlier than you would normally do (see Step 4). When you have done so, you can then carry out a cost-​ benefit analysis of unhealthy envy and its constructive alternative, healthy envy. This involves helping your client to spell out the perceived advantages and disadvantages of both emotions. Respond to any perceived advantages of unhealthy envy and perceived disadvantages of healthy envy, correcting any misconceptions that your client reveals on these issues. For example, imagine that your client thinks that feeling unhealthily envious motivates them to get what others have that they prize, but which they do not have, whereas healthy envy lacks that motivational thrust. In this case, help your client to see that unhealthy envy leads them to seek blindly what they think they desire, irrespective of their true long-​term wishes. Far from being

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motivational, unhealthy envy is evidence that the person is in a disturbed state of mind.

Step 2: Take responsibility for your unhealthy envy In REBT, we argue that people or things do not make you unhealthily envious; rather you create these feelings by the rigid/​extreme attitudes that you hold towards such people and things. You may object that this involves you blaming yourself for creating your feelings of unhealthy envy, but this objection is based on a misconception. It assumes that taking responsibility for creating your unhealthy envy is synonymous with self-​blame. In truth, responsibility means that you take ownership for the rigid/​extreme attitudes that underpin your unhealthy envy while accepting yourself for doing so. Blame, on the other hand, means that you regard yourself as being bad for creating your own unhealthy envy. The idea that emotional problems (including unhealthy envy) are based largely on the rigid/​extreme attitudes that a person holds towards what happens to them is, as you know, a central plank in REBT. However, for your client, it may be a new idea. Thus, your client may claim that the reason why they are unhealthily envious is that their friends have new clothes and they don’t. This is an example of ‘A–​C’ thinking where ‘A’ is others having what I want, but lack and ‘C’ is the emotion of unhealthy envy. Rather, we argue that the reason that the person experiences unhealthy envy is largely due to the fact that they hold a set of rigid/​extreme attitudes towards this state of inequality. If they held a set of flexible/​ non-​ extreme attitudes towards the deprivation, they would experience healthy envy rather than unhealthy envy. If your client continues to have difficulty accepting responsibility for their unhealthy envy, it is important for you to identify the source of this difficulty. The most common obstacle is shame. You will recall that shame in this context involves inferring that one has fallen from grace and that correspondingly the person’s self-​esteem plummets. If shame is a significant block, it will mean that your clients will not admit that they do have an unhealthy envy problem or, if they do admit this, they will blame other people. Consult Chapter 6 for a full overview concerning how to respond to shame-​based problems.

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It is important to help your client to understand the impact of this as well as other obstacles on their emotional problems. Then, help them to develop alternatives to these obstacles and review the impact of these alternatives on their emotional problem-​solving. This often helps your client to deal effectively with these obstacles. If not, you may need to do a more detailed assessment of the obstacle, which is outside the brief of this book.

Step 3: Identify the themes about which you tend to feel unhealthy envy The best way of identifying what you tend to feel unhealthy envy about is to understand the major theme associated with unhealthy envy and how this theme manifests with respect to your personal domain. As I outlined, the major theme in unhealthy envy is when someone else has something that you prize, but don’t have. It is also important that you distinguish between unhealthy envy that is mainly object focused (in which case keep a list of the objects that you tend to covet) or person focused (in which case keep a list of the people about whom you tend to be envious). If your client finds it difficult to find their unhealthy envy-​ related theme, you can help them by assessing a few specific examples of their unhealthy envy. Have them focus on a specific situation in which they felt unhealthily envious and ask them what they were most unhealthily envious about. If they still find it difficult to identify the theme in this or other specific situations, use the ‘magic question’ technique. This involves you doing the following: ⦿

Have your client focus on the situation in which they felt unhealthily envious.

⦿

Ask them to nominate one ingredient that would eliminate or significantly reduce their feelings of unhealthy envy without changing the situation.

⦿

The opposite of this nominated ingredient is what they are most envious about.

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Lionel was finding it difficult to pinpoint the specific theme with respect to his feelings of unhealthy envy about his friends. Thus, he used the ‘magic question’ technique as follows: ⦿

Lionel focused on the situation in which he felt unhealthily envious: ‘My friends are out playing when I have to study.’

⦿

He nominated one ingredient that would eliminate or significantly reduce his unhealthy envy without changing the situation: ‘Not being in a deprived situation.’

⦿

The opposite of this nominated ingredient is what he is most unhealthily envious about: ‘Being in a deprived situation.’

If you assess a number of specific examples of your client’s unhealthy envy in this way, the relevant unhealthy envy related theme should be apparent. In Lionel’s case, it was being deprived of so many good things that his friends all enjoyed. If your client is envious about two ‘deprivations’, it may be that there are two unhealthy envy-​related themes present in your client’s unhealthy envy. For example, your client may feel unhealthily envious about the deprivation of time, which they had so little of and others had in greater abundance. In addition, they may feel envious of the quality of friendships that others demonstrated, which they lacked. If this is the case, deal with these two issues one at a time and have your client nominate the one that they want to focus on first.

Step 4: Identify the three components of your unhealthy envy response and set goals with respect to each component The next step is for you to list the three elements of your unhealthy envy response in the face of each of the relevant themes listed above.

Identify the three components of your unhealthy envy response I use the term ‘unhealthy envy response’ to describe the three main components that make up this response. The three components of your

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unhealthy envy response are the emotional, behavioural and thinking components.

Emotional component The emotional component here is, of course, unhealthy envy.

Behavioural component The behavioural component concerns overt behaviour or action tendencies that you engage in or ‘feel like’ engaging in when you feel unhealthy envy. Consult the list that I provided to help you identify your behaviour associated with each relevant theme when you feel unhealthy envy (see p. 297).

Thinking component The thinking component associated with unhealthy envy is listed on p. 298. Again, these may be in words or in mental pictures. Consult this list if necessary.

Set goals with respect to each of the three components You need to set goals so that you know what you are striving for when you deal effectively with unhealthy envy. The three goals are emotional, behavioural and thinking goals.

Emotional goal Your emotional goal is healthy envy rather than unhealthy envy (or whatever synonym you prefer to the term ‘healthy envy’). Healthy envy is an HNE, which is an appropriate response to someone having something that you prize, but don’t have. It helps you to think objectively about the situation and your response to it and helps you to move on with your life rather than get stuck or bogged down. The concept that healthy envy is the healthy alternative to unhealthy envy when someone has what your client desires but lacks is based on the following idea. Such an adversity is negative and therefore it is realistic to have a negative emotion about it. The choice, therefore, is between a UNE (unhealthy envy) or an HNE (healthy envy). However, what if your client specifies an

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unrealistic goal? Here are three such goals and how to respond to clients who nominate them: ⦿

‘I don’t want to feel unhealthily envious.’

⦿

‘I want to feel less unhealthily envious.’

⦿

‘I don’t want to feel anything.’

Show your client that they have indicated what they do not want to feel in the face of someone having something that they covet, but do not have. Your client needs to specify how they do want to feel instead of unhealthy envy.

Show your client that, as unhealthy envy is a disturbed emotion, wanting to feel less unhealthily envious is still to nominate as a goal a disturbed emotion, albeit of lesser intensity. Show your client that healthy envy can be strong and healthy.

Not feeling anything in the face of someone having something that your client covets, but does not have, will not help your client to decide if they genuinely want what they covet and, if it is truly what they want, it will not motivate them to take appropriate action to get it. Help your client to see this. Also show them that the only way that they could achieve a state of not feeling anything is to feel completely indifferent about not having what they covet. This can be achieved only if your client lies to themself. Show them this and discourage them from setting such a goal.

Behavioural goal Your behavioural goal should reflect actions that are based on healthy envy rather than unhealthy envy. The following are the most common behaviours associated with healthy envy. You may wish to compare these behaviours with those associated with unhealthy envy that I presented on p. 297. ⦿

You strive to obtain the desired possession if it is truly what you want.

It is important that your client understands that, as they strive to develop healthy behavioural responses to not having what they

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prize that someone else has, they will still feel the urge to act in ways that are dysfunctional, as listed on p. 297. Help them to understand the reason for this. Explain to them that, as they examine their attitudes and commit themself to strengthening their conviction in their flexible/​ non-​ extreme attitudes and to weakening their conviction in their rigid/​extreme attitudes, the latter will still be active and produce urges for them to act dysfunctionally. Encourage your client to accept these urges, to recognise that they do not have to act on them and to use them as cues to act in functional ways.

Thinking goal As well as setting behavioural goals related to the feeling of healthy envy about a situation where someone has something that you want but lack, it is important that you set thinking goals associated with this emotion. The following are the most common forms of thinking associated with healthy envy rather than unhealthy envy. Again, you may wish to compare these forms of thinking with those associated with unhealthy envy that I presented on p. 298. ⦿

You honestly admit to yourself that you desire the desired possession.

⦿

You are honest with yourself if you are not happy with your possessions, rather than defensively trying to convince yourself that you are happy with them when you are not.

⦿

You think about how to obtain the desired possession because you desire it for healthy reasons.

⦿

You can allow the other person to have and enjoy the desired possession without denigrating that person or the possession.

As the above list shows, the dominant feature of thinking associated with healthy envy is that it is realistic and balanced. Please remember that such thinking may be in words or in mental pictures. The point I made above with respect to your client’s behavioural goals is also relevant with respect to their thinking goals. Your client will still have some conviction in their rigid/​extreme attitudes until they have full conviction in their flexible/​ non-​ extreme attitudes. Given this, your client’s rigid/​extreme attitudes will have some impact on their subsequent thinking as they strive

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to achieve their goals. Thus, highly distorted thoughts will still come into your client’s mind. Help your client to understand why this is the case. When you come to help them deal with these forms of post-​rigid/​extreme-​attitude thinking, do one or more of the following as indicated:3 ⦿

Encourage your client to acknowledge the existence of such thoughts without trying to suppress them, distract themself from them or engage with them.

⦿

If relevant, encourage your client to use the presence of this post-​rigid/​extreme-​attitude thinking to help them identify and deal with their rigid/​extreme attitudes.

⦿

Then, suggest that they examine the empirical nature of these thinking ‘Cs’ once or twice before returning to the acceptance strategy detailed above.

Step 5: Recognise that your symptoms of unhealthy envy are evidence of disturbance and not necessarily that you truly desire the prized object that the other person has, but you don’t Once you have identified your unhealthily envious response and its healthy alternative, it is important that you realise one important point. If you feel envious a lot, your feelings and the thoughts that accompany them are most likely to be evidence that you have an envy problem rather than proof that you truly desire what the other has that you don’t. When you think that you really want something that others have that you don’t because you have envious feelings and envious thoughts, you are again succumbing to the two thinking errors known as emotional reasoning and cognitive reasoning. In emotional reasoning, you assume that, because you feel envious, that is evidence that you truly want the prized object. In cognitive reasoning, you think that your envious thoughts are proof that again your desire is for the object itself and not to make equal what in your eyes is an unequal situation (where someone has what you prize, but don’t have). If your unhealthy envy is chronic, when you have envious feelings and thoughts, your task is to remind yourself that these are, in all probability, signs that you need to identify and deal with the rigid/​extreme attitudes that

308    Dealing with unhealthy envy

underpin your unhealthy envy response rather than to act on them. You may well find this difficult, because, when you have envious feelings and thoughts, you will also experience an urge to act on them. Refraining from doing so will go against the grain and will thus be uncomfortable, but, if you do so, you will put yourself in the position of dealing effectively with your unhealthy envy. If you don’t, you will maintain this emotional problem.

Step 6: Identify your general rigid/​e xtreme attitudes and alternative general flexible/​ non-​e xtreme attitudes A general rigid/​extreme attitude leading to your unhealthy envy response is a rigid/​extreme attitude that you hold across situations defined by the major theme: someone has something that you prize, but don’t have. Remember that your unhealthy envy can be object focused or person focused (see pp. 295–296 for how to distinguish between the two). In addition, your unhealthy envy may relate to the ego part or the non-​ego part of your personal domain. The flexible/​non-​extreme alternative to this attitude, which will also be general in nature, will account for your healthy envy response.

Identify your general rigid/​extreme attitudes When you identify a general rigid/​extreme attitude, you take a common unhealthy envy related theme (see above) and add to this a general rigid attitude and the main extreme attitude that is derived from the rigid attitude. In unhealthy envy, your main extreme attitude will be either an unbearability attitude or a self-​devaluation attitude. Let me provide examples of the rigid/​extreme attitudes associated with each of the four types of unhealthy envy: ⦿

Object-​focused unhealthy ego envy:

⦿

Object-​focused unhealthy non-​ego envy:

‘I must have the latest gadgets that some of my friends have and, if I don’t have them, I am useless.’

‘I must have the latest gadgets that some of my friends have and I can’t bear the deprivation of not having them.’

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⦿

Person-​focused unhealthy ego envy:

⦿

Person-​focused unhealthy non-​ego envy:

‘I must have what my younger sisters have and, if I don’t, then they are better than me.’

‘I must have what my younger sisters have and I can’t bear the inequality of not having what they have.’

Identify your alternative general flexible/​non-​extreme attitudes When you identify your alternative general flexible/​non-​extreme attitude, you take the same common theme and add to this a general flexible attitude and a general discomfort tolerance attitude or a general self-​acceptance attitude. For example: ⦿

Object-​focused healthy ego envy:

⦿

Object-​focused healthy non-​ego envy:

⦿

Person-​focused healthy ego envy:

⦿

Person-​focused healthy non-​ego envy:

‘I would like to have the latest gadgets that some of my friends have, but it is not necessary that I have them. If I don’t have them, that is unfortunate, but it does not prove that I am useless. I am a unique, unrateable, fallible human being whether or not I have these gadgets.’

‘I would like to have the latest gadgets that some of my friends have, but it is not necessary that I have them. If I don’t have them, it would be a struggle for me to bear the deprivation, but I can do so, it would be worth it to me to do so and I am worth doing it for.’

‘I would like to have what my younger sisters have, but I don’t have to have what they have. If I don’t, that would be bad, but it would not prove that they are better than me. I am equal to them even though they may have more than me.’

‘I would like to have what my younger sisters have, but I don’t have to have what they have. It would be hard for me to bear the resultant inequality, but I can do so, it would be worth it to me to do so and I am worth doing it for.’

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As you will have noticed in the Client’s Guide, I encourage readers/​ clients to identify and work with their general rigid/​ extreme attitudes and to develop general flexible/​ non-​ extreme attitudes and, as you will see, when they are facing specific instances of their problems, I encourage them to focus on specific examples of both sets of attitudes. This will be at variance with your REBT practice, where you will begin with specific examples of your client’s problems and then proceed to work at a more general level with their problems and how these relate to one another. The reason I have chosen to go ‘general’ rather than ‘specific’ when helping readers/​clients to deal with their emotional problems is a pragmatic one. In this book, I aim to help people to deal with a range of emotional problems and therefore, in my view, it is best to give readers/​clients general guidance with respect to dealing with this range of problems and then help them to move from the general to the specific rather than vice versa. My considered view was that I just do not have the space to help readers/​clients focus on specific examples of their emotional problems and then generalise from this specific level. Consequently, one way that you can help your client who is using the Client’s Guide is to help them to work with specific examples of their emotional problem, in this case unhealthy envy. Use the following sequence as you do so and help your clients to: ⦿

select a specific example of their unhealthy envy problem

⦿

express why their unhealthy envy constitutes a problem for them

⦿

identify what they felt most unhealthily envious about in the situation

⦿

identify the three specific components of their unhealthy envy response and set specific goals with respect to each component

⦿

identify their specific rigid/​extreme attitudes and alternative specific flexible/​non-​extreme attitudes

⦿

examine their specific attitudes.

In helping your client to deal with a specific example of their unhealthy envy, you can teach them how to use REBT’s ABCD form, which appears in Appendix 6. The following steps are the same as those that appear in Steps 8–​11 later in this chapter. Thus, help your clients to:

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⦿

face up to what they are most envious about in imagery (if necessary)

⦿

face the same things in reality (if possible) and take appropriate action

⦿

capitalise on what they have learned

⦿

generalise their learning.

Step 7: Examine your general attitudes I recommended in previous chapters that you first examine together your general rigid attitude and its general flexible attitude alternative and then examine together your general extreme attitude and its general non-​ extreme attitude alternative.

Examine your general rigid attitude and its general flexible attitude alternative First, take your general rigid attitude and its general flexible attitude alternative and write them down next to one another on a sheet of paper. Then ask yourself: ⦿

Which is true and which is false?

⦿

Which has largely constructive results and which has largely unconstructive results?

⦿

Which is sensible logically and which does not make sense?

Write down your answer to each of these questions on your piece of paper, giving reasons for each answer. Consult Appendix 2 for help with the answers to these questions, which you need to adapt and apply to the attitudes you are examining.

Examine your general extreme attitude and its general non-​extreme attitude alternative Next, take your general extreme attitude and its general non-​extreme attitude alternative and again write them down next to one another on a sheet of paper. Then, ask yourself the same three questions that you used with your general rigid attitude and its general flexible attitude alternative.

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Again, write down your answer to each of these questions on your piece of paper, giving reasons for each answer. I suggest that you consult Appendix 3 (for help with examining awfulising attitudes and non-​ awfulising attitudes), Appendix 4 (for help with examining unbearability attitudes and bearability attitudes) and Appendix 5 (for help with examining devaluation attitudes and unconditional acceptance attitudes). Again, you need to adapt and apply these arguments to the attitudes you are examining. You should now be ready to commit to acting and thinking in ways consistent with your general flexible/​non-​extreme attitude. I included Appendices 2–​ 5 in the Client’s Guide as general guidelines to help readers/​clients to examine their rigid/​extreme and flexible/​ non-​ extreme attitudes (reproduced in this book as Appendices 2–​5). If you are working with a client who is using the Client’s Guide, you will have a chance to look at the examining work that your client has done at this point and give them feedback on that work. No book can provide such feedback. I have suggested that readers/​clients examine their rigid attitude and their flexible attitude together and then their main extreme attitude and non-​ extreme attitude equivalent together using three criteria as shown below: ⦿

Rigid attitude vs. flexible attitude ⦿

empirical status

⦿

pragmatic status

⦿

empirical status

⦿

pragmatic status.

⦿

⦿

logical status

Main extreme attitude vs. main non-​extreme attitude

⦿

logical status

The final point I want to make about examining attitudes concerns the concept of persuasiveness. Perhaps the most important aspect of the examining process is for your client to develop arguments concerning the false, illogical and unhealthy nature of their rigid/​ extreme attitudes and the true, logical and healthy nature of

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their flexible/​non-​extreme attitudes that are persuasive to them. So, encourage your client to develop such persuasive arguments and to make a note of these for future reference.

Step 8: Face your unhealthy envy-​r elated theme in imagery I hope that you have made a commitment to act on your general flexible/​non-​extreme attitudes (i.e., flexible attitude and unconditional self-​ acceptance attitude). Assuming that you have, your basic task is to face up to someone having something that you prize, but don’t have, and to learn to think flexibly and in a non-​extreme way about it. Up to this point, you have worked at a general level with respect to your unhealthy envy-​ related theme, dealing with the general rigid/​ extreme attitudes that account for your unhealthy envy and developing your alternative general flexible/​non-​extreme attitudes. However, when you come to apply your general flexible/​non-​extreme attitudes in dealing with someone having something that you prize, but don’t have, you need to bear in mind one important point. Since you make yourself unhealthily envious about specific events (actual or imagined) where someone has something that you prize, but do not have, you need to deal with these events by rehearsing specific variants of your general flexible/​non-​extreme attitudes. While the best way to do this is in specific situations where someone has something that you prize, but don’t have, you may derive benefit by using imagery first. If this is the case, you need to do the following: ⦿

Imagine a specific situation in which you felt or may feel unhealthily envious about someone having something that you prize, but don’t have, and focus, in your mind’s eye, on what you felt most unhealthily envious about (i.e., your ‘A’ or adversity).

⦿

Focus on this ‘A’ while rehearsing a specific flexible/​non-​extreme attitude relevant to the situation. As you do this, try to make yourself feel healthily envious, rather than unhealthily envious.

⦿

Then see yourself acting in ways consistent with your flexible/​ non-​ extreme attitude, such as expressing admiration for rather than denigrating the person or object concerned.

⦿

Recognise that some of your post-​ rigid/​ extreme-​ attitude thinking may be distorted. Respond to it without getting bogged down doing

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so. Accept the presence of any remaining distorted thoughts without engaging with them. ⦿

Repeat the above steps until you feel sufficiently ready to put this sequence into practice in your life.

If you find that facing your unhealthy envy-​ related adversity at ‘A’, in your mind’s eye, is too much for you, use the ‘challenging, but not overwhelming’ principle that I introduced in Chapter 2 (see p. 53). This means that, instead of imagining yourself facing someone having something that you prize, but don’t have, that you find ‘overwhelming’ at the present time, choose a similar unhealthy related ‘A’ that you would find ‘challenging, but not overwhelming’. Then employ the same steps that I have outlined above. Work in this way with modified unhealthy envy related ‘As’ until you find your original one ‘challenging, but not overwhelming’ and then use the steps again. Your client may say that they can’t get very clear images when they try to picture events in their mind’s eye. While they may get more out of imagery techniques if they can get such clear images, they will still get something out of facing someone having something that they prize, but don’t have, in imagery even if their images aren’t clear. So, if your client wants to face their particular adversity in imagery before they do so in reality, encourage them to do so no matter how clear their mental images are.

Step 9: Act in ways that are consistent with your general flexible/​n on-​e xtreme attitude As I mentioned earlier, when you experience the emotional problem of unhealthy envy and the thoughts that accompany it, you will also experience a strong urge to act on them. If you do, you will serve only to strengthen the rigid/​extreme attitudes that underpin such behaviour. So, after you have examined your rigid/​extreme and flexible/​non-​extreme attitudes in the way I suggested above and committed yourself to strengthening your conviction in your flexible/​non-​extreme attitudes, it is very important that you act in ways that will do this and refrain from acting in ways that will do the opposite. So, it is crucial that you act according to the behavioural goals that you identified in Step 3 and accept that, while you do so, you will still have the urge to act and think in unhealthy ways. Accept that this is an almost inevitable and natural part of the change process and these unhealthy urges

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and thoughts will eventually subside if you do not engage with them. I stress that this is difficult, but if you are clear about what you need to do and act accordingly, you will stack the odds in favour of, rather than against, you dealing effectively with your unhealthy envy. You may find that your client reports various obstacles to facing situations about which they have felt unhealthily envious while acting in ways that are consistent with their general flexible/​non-​ extreme attitudes. I list here three major obstacles and suggest ways of addressing them with your clients. ⦿

‘If I face envy-​related situations, I will become too upset.’

⦿

‘If I face envy-​related situations, I will find the urge to act dysfunctionally too tempting.’

Here, your client may have an unbearability attitude towards feeling upset. This is evidenced in the phrase ‘I will become too upset’. Help your client to see that, if they do become upset, they can bear this and still act in ways that are consistent with their flexible/​non-​extreme attitudes.

Here, your client considers that the urge to act in ways that have previously maintained their unhealthy envy may be too powerful for them to resist. Consequently, they are reluctant to face envy-​related situations while rehearsing their developing flexible/​non-​extreme attitudes and acting constructively. Help your client to develop a greater sense of control over their urges by allowing them to be there and showing themself that they do not have to act on such urges. ⦿

‘I don’t feel comfortable facing envy-​related situations.’

Help your client to see that, if they wait until they are comfortable before facing envy-​related situations, they will wait a very long time. Show them that, if they are comfortable about facing such situations, it is likely that they are not unhealthily envious about them. Consequently, it is important that you help your client realise that they are bound to be uncomfortable about facing an envy-​related situation even after they have examined their unhealthy envy-​creating rigid/​extreme attitudes and begun to operate according to their flexible/​ non-​ extreme attitudes. Show them that they can bear this discomfort, that it is worth it to them to do so and that they are worth doing it for.

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Step 10: Capitalise on what you have learned When you have faced a situation in which you experienced unhealthy envy and dealt with it as best you could, it is important that you reflect on what you did and what you learned. In particular, if you were able to face the situation, and rehearse your specific flexible/​non-​extreme attitudes until you felt healthy envy, ask yourself how you can capitalise on what you achieved. If you experienced any problems, respond to the following questions: ⦿

Did I face the situation and, if not, why not?

⦿

Did I rehearse my flexible/​non-​extreme attitudes before, during or after facing the situation and, if not, why not?

⦿

Did I execute my plan to face the situation and, if not, why not?

⦿

Did I engage with post-​rigid/​extreme attitude distorted thinking and, if so, why?

Reflect on your experience and put into practice what you have learned the next time you face a situation in which someone has something that you prize, but lack. It is useful to monitor your client’s responses to these questions and help them to reflect on any issues that they have not considered.

Step 11: Generalise your learning Once you have dealt with your unhealthy envy in a specific situation by holding the relevant specific version of your general flexible/​non-​extreme attitude, and by acting and thinking in ways that are consistent with it, you can generalise this learning to situations defined by your unhealthy envy-​based theme. Virginia was particularly prone to person-​f ocused unhealthy ego envy with respect to her friends’ boyfriends. She did not have a boyfriend of her own and, to prove that she was lovable, she flirted with their boyfriends and encouraged them to make passes at her. When they did, she took that as proof that she was lovable and rebuffed their advances. In helping herself deal with this type of unhealthy envy, she did the following:

Dealing with unhealthy envy    317

⦿

Virginia assessed the three components of her unhealthy envy response and set goals with respect to all three components.

⦿

She identified her relevant general rigid/​extreme attitude regarding her envy-​ related theme (i.e., ‘I must have what my friends have and I am less lovable than them if I don’t’) that underpinned her unhealthy envy response. She then identified her alternative general flexible/​non-​extreme attitude (i.e., ‘I would like to have what my friends have, but I don’t have to have it. It is frustrating when I don’t have it, but it does not prove that I am less lovable than them. We are equal in lovability even if we are unequal in that they have what I want’) that underpinned her healthy envy response.

⦿

She examined her general rigid/​extreme attitude and her general flexible/​ non-​extreme attitude until she clearly saw that the former were false, made no sense and were detrimental to her, and that the latter were true, sensible and healthy.

⦿

She acted on shortened versions of her flexible/​non-​extreme attitudes in specific situations and had non-​flirtatious conversations with her friends’ boyfriends rather than encouraging them to make passes at her.

⦿

As she acted on her flexible/​non-​extreme attitudes, she tolerated the discomfort that she felt and accepted that some of her distorted and skewed negative thinking would still be in her mind as she did so. She let such thinking be without engaging with it, suppressing it or distracting herself from it.

As this section shows, you can generalise what you learn about dealing with unhealthy envy from situation to situation as defined by your unhealthy envy-​based inference.

USING REBT’S ABCD FORM TO DEAL WITH SPECIFIC EXAMPLES OF YOUR UNHEALTHY ENVY This chapter is mainly geared to help you deal with your unhealthy envy in general terms. However, you can also use this material to address specific examples of your unhealthy envy. I have developed a self-​help form to provide the structure to assist you in this regard. It is called the ABCD form and it appears with instructions in Appendix 6.

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In Appendix 6, I outline the major problems that clients have in using this form and how to deal with them.

OTHER IMPORTANT ISSUES IN DEALING WITH UNHEALTHY ENVY In the above section, I outlined an 11-​ step programme to deal with unhealthy envy. In this section, I discuss some other important issues that may be relevant to you in your work to become less prone to this emotional problem. If you want to, you can incorporate them as additional steps in the above step-​by-​step guide at points relevant to you.

Rethinking the place of objects in your life In unhealthy envy, you think a certain way about the place of objects in your life.4 In object-​focused unhealthy ego envy, you tend to think that such objects, particularly when you don’t have them, define your worth as a person. Thus, when you don’t have what you prize and another person has it, you think that you are less worthy than you would be if you did have it. Ironically, however, were you to possess the object, your self-​esteem might be raised, but this would be temporary and you would devalue yourself when you focused on something else that someone else had that you prized, but lacked. This clearly shows that the possession of prized objects does not solve your self-​esteem problem; rather, it perpetuates the problem. Self-​devaluation in the face of someone having something that you prize but lack is a psychological problem and can be solved only by psychological means. In REBT, we argue that unconditional self-​acceptance is the most robust solution to self-​esteem problems and I suggest that you review this flexible/​non-​extreme attitude in Appendix 5. I also discuss it in my book How to Accept Yourself (Dryden, 1999). Basically, holding this attitude means that, while you may prize the object that someone else has that you don’t have, its lack does not lessen your worth and your possession of it does not raise your worth. Your worth is fixed and is most healthily based on certain facts about you that do not change (i.e., your humanity, your fallibility, your uniqueness and your aliveness). It may be better if you possessed the object, but you are not better for having it. Interestingly, holding this flexible/​non-​extreme attitude helps you to determine how

Dealing with unhealthy envy    319

important the object really is to you, once you have stripped it of its power to determine your self-​worth! In object-​focused non-​ego unhealthy envy, you tend to think of prized objects that others have but you lack as ‘must have’ items that are necessary for your overall happiness rather than things that are desirable and may improve the quality of a restricted part of your life. Once you think that something is necessary, rather than desirable but not necessary, you overvalue it and often become obsessed by it. However, as in object-​focused unhealthy ego envy, if you finally possess the object, your joy will be short-​ lived as you focus on something else that someone else has that you prize but lack. Again, the rigid and unbearability attitudes that underpin object-​ focused non-​ ego unhealthy envy represent the existence of a psychological problem that is perpetuated rather than solved by the possession of prized objects. Indeed, if you are prone to this type of unhealthy envy, it is very likely that you will have a large collection of discarded objects that you once saw as essential to your life. You discard such items as soon as you focus on another object that someone else has that you prize but lack. It is only when you adopt a set of flexible/​non-​extreme (flexible and bearability) attitudes that you will take a realistic position on the role of objects in your life and, in doing so, you will pursue only objects that will have enduring value for you. Your client may think that you mean that any value that they place on possessing objects is unhealthy. Help your client to see that this is not the case. Make the point that unhealthy interest in objects is fuelled by two dysfunctional ideas: that possession of coveted objects raises their self-​esteem and deprivation of objects that they think they want is unbearable. Once they put in place more functional alternative ideas − their worth is not changed by possession of coveted objects and deprivation of such objects is bearable, worth bearing and that they are worth bearing it for − they are in a position to determine if the possession of such objects is based on true desire. On this point, help your client to consider why they want to possess the coveted object by asking the following questions: ⦿

Why do you want the object?

⦿

Once you get the object, will your attention shift to something else that you covet but don’t have?

⦿

Can you see yourself enjoying or using the object over time?

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If your client does not provide good, persuasive answers to these questions, it may be that they need to do more work on developing healthy envy-​based flexible/​non-​extreme attitudes.

Making healthy comparisons As I have already shown you, in person-​focused unhealthy envy your focus is on the person who has the object that you think you prize rather than on the object itself. I say ‘think you prize’ here because, in this type of unhealthy envy, should someone else with whom you are not in competition possess this object, you will not experience unhealthy envy. Thus, person-​ focused unhealthy envy involves competition and comparison. The goal of flexible/​non-​extreme thinking is not to eradicate competition and comparison, but to maximise the chances that, when you are competitive and make comparisons, you do so healthily. In person-​ focused unhealthy ego envy, you are making comparisons between yourself and another person with whom you feel competitive, and, if you lose out in the comparison, your self-​esteem goes down. As in object-​focused unhealthy ego envy, in its person-​focused counterpart you adhere to the idea that you can rate a person and your rival has more worth than you if the other person has something that you think you prize but lack. To deal with this type of unhealthy envy, once again you need to develop an attitude of unconditional self-​acceptance and realise that you and your rival are equal in worth and that this cannot be altered by the possession or non-​possession of prized objects. Adopting this philosophy will help you determine whether you want the prized object for what it can offer you in that sphere of your life or whether you want it only because your rival has it. In person-​focused unhealthy non-​ego envy, you make a similar comparison between yourself and your rival and you conclude that it is unfair when your rival has something that you think you prize but lack. The root of this type of unhealthy envy is in your rigid attitude that such unfairness must not exist in the first place or must be eradicated in the second place and that, if not, the continuing unfairness is intolerable. As a result, you seek to make things fair either by getting what you don’t have or by spoiling what the other person has. This is quite clearly a psychological problem and cannot be solved by making things fair. It can be solved only by adopting a healthy flexible/​non-​extreme attitude towards unfairness. You do this by swallowing a bitter pill and seeing that, however undesirable, there is no law of the universe that decrees that unfairness (as

Dealing with unhealthy envy    321

expressed in situations where certain people with whom you are in competition have what you think you prize, but don’t have) must not exist in the first place or must be eradicated in the second place. You also see that the ongoing existence of such unfairness is difficult to tolerate, but you can tolerate it and it is worth it to you to do so. If you adopt this philosophy, you will be able to determine whether or not you want the prized object for its own sake and whether or not it will have any enduring value for you. You will also see that, while it may be unfair (to you) not having what certain others have, it is equally unfair (to others) not having what you have. You will come to see, therefore, that ‘unfairness’ is an inference and a matter of perspective rather than an objectively determined fact.

Why you feel unhealthy envy much of the time and how to deal with this If you are particularly prone to unhealthy envy, you hold the following attitude, which I call a ‘chronic unhealthy envy-​ based general rigid/​ extreme attitude’: ⦿

‘I must have what I want and, if I don’t have it, I am unworthy (or less worthy than those with whom I am in competition who do have it). It is also unfair when I don’t have what I want when others have it and I must eradicate this unfairness and I can’t bear it if I can’t.’

As you can see, this attitude refers to both ego and non-​ego aspects, since in my experience people who have a problem with chronic envy have problems with envy in both these realms of the personal domain. Holding this attitude, you will do the following: ⦿

You will focus on what you don’t have when others have it and will assign more importance to this than to what you have. When you focus on what you don’t have, you will disturb yourself with a specific version of your general rigid/​extreme attitude.

⦿

You will initially be pleased to get what you have previously prized but lacked, but you will soon lose interest in this because you have used the object to solve your psychological problem and it can never do that and you will soon become aware of something else that others have that you want, but don’t have.

322    Dealing with unhealthy envy

⦿

You will ignore all the things that you have previously prized, obtained and lost interest in, and continue to think that what you presently covet will solve your envy problem.

How to deal with chronic unhealthy envy To deal with this chronic sense of unhealthy envy, you need to develop and apply an alternative general flexible/​non-​extreme attitude that protects you from such unhealthy envy. ⦿

‘I would like to have what I want, but I don’t need to have it. If I don’t get it, that would be unfortunate, but it would not prove that I am unworthy (or less worthy than those with whom I am in competition who do have it). My worth is fixed and is equal to the worth of others and that cannot change unless I refuse to acknowledge this fact. While it may be unfair when I don’t have what I want when others have it, I don’t have to eradicate this unfairness and, if I can’t, that would be hard to bear, but I can do so, it would be in my healthy interests to do so and I am worth bearing it for.’

When you hold this attitude and there exists objective evidence that others have what you truly want, you will feel healthy envy rather than unhealthy envy because you will be processing this with a specific flexible/​ non-​extreme attitude. In addition, this attitude will help you to ⦿

focus on and appreciate what you do have as well as acknowledge what you truly want that others have and you don’t

⦿

see that your possessions have their place, but are not as important as you previously thought

⦿

pursue what you don’t have when it is likely to have lasting rather than transitory value for you and when it is not too time consuming to pursue it.

If your client finds that the above explanation is too complex, you can help them to see that holding rigid attitudes towards not having what they covet but lack means that, unless they are clear that they do not want the object, they assume that they do want it. When their attitudes are flexible, they can be more objective about this issue.

Dealing with unhealthy envy    323

How to examine the strength of your desire for what others have that you prize, but don’t have When you operate according to a set of general and specific flexible/​non-​ extreme attitudes with respect to what someone else has that you prize, but don’t have, you should be able to gauge how important the desired object truly is to you. However, if you are still unsure that you really want what others have that you prize, but don’t have, answer one or more of the following questions: ⦿

Ask yourself how strong is your desire for the prized object?

⦿

Ask yourself whether or not you would still want the object if getting it did not improve your self-​esteem or make you feel better about life?

⦿

If the other people who possess the desired object suddenly discarded it, would you still want it?

⦿

Draw up a list of pros and cons for striving to get the object.

Assessing and dealing with emotional problems about unhealthy envy In previous chapters, I discussed the concept of meta-​disturbance (literally disturbance about disturbance). It is important to assess carefully the nature of this meta-​disturbance about unhealthy envy before you can best deal with it. The best way to start dealing with the assessment of any emotional problems you might have about unhealthy envy is to ask yourself the question: ‘How do I feel about my feeling of unhealthy envy?’ The most common emotional problems that people have about unhealthy envy are as follows: anxiety, depression, unhealthy regret, shame and unhealthy self-​anger. I refer you to the relevant chapters on these emotional problems in this book for help in dealing with meta-​ emotional problems about unhealthy envy. Your client may need to address their emotional problems about unhealthy envy before they address their unhealthy envy. They need to do this particularly when their secondary emotional problem gets in the way of them dealing with their primary unhealthy envy. However, despite the interfering presence of their

324    Dealing with unhealthy envy

secondary problem, your client may still want to target their primary envy. There are two ways of dealing with this situation: ⦿

Provide a rationale to help your client target their secondary problem. For example, explain to your client that their secondary problem is like having a ball and chain around their leg while they are climbing a steep hill (akin to their primary feelings of unhealthy envy). In the same way as climbing the hill is easier when they remove the ball and chain from their leg, dealing with their primary unhealthy envy is easier when they deal with their secondary problem first.

⦿

Go along with your client’s wish to deal with their primary unhealthy envy and, when they fail to do so, help them to understand that the reason why they failed is because they had not addressed their secondary problem and then agree that they will now do so.

Developing and rehearsing healthy envy-​b ased world views People develop views of the world as it relates to them that make it more or less likely that they will experience UNEs. The world views that render you vulnerable to unhealthy envy do so in a similar way to the chronic unhealthy envy-​based general rigid/​extreme attitude discussed above (i.e., ‘I must have what I want and, if I don’t have it, I am unworthy (or less worthy than those with whom I am in competition who do have it). It is also unfair when I don’t have what I want when others have it and I must eradicate this unfairness and I can’t bear it if I can’t’) by making you focus unduly on not having that which you prize when others do have it. However, these unhealthy envy-​based world views have this effect on you much more widely. It is important that you develop realistic views of the world that will help you to deal with unhealthy envy and experience healthy envy instead. In Table 10.1, you will find an illustrative list of such world views rather than an exhaustive one, so you can get an idea of what I mean, which will enable you to develop your own. In Table 10.1, I first describe a world view that renders you vulnerable to unhealthy envy and then I give its healthy alternative. You will see that the former views are characterised by a conception of life where objects and possessions are seen as the source

Dealing with unhealthy envy    325

Table 10.1 World views that render you vulnerable to unhealthy envy and help you to deal with unhealthy envy Views of the world that render you vulnerable to unhealthy envy

Views of the world that help you deal with unhealthy envy

⦿

My worth is measured by my possessions

⦿

My worth is determined by my aliveness and not by my possessions

⦿

If others with whom I am in competition have more than me, they are worthier than me

⦿

If others with whom I am in competition have more than me, they have more than me, but we are of equal worth

⦿

The more I have, the happier I will be

⦿

My happiness is determined by my striving to achieve what I find personally meaningful and I am unlikely to find such meaning in possessions

⦿

I can be happy only if I get the possessions that I want

⦿

I can be happy even if I do not get the possessions that I want

⦿

If someone has what I want, I really want it

⦿

If someone has what I want, I may think I really want it, but that level of desire is coloured by my feelings of unhealthy envy

⦿

It’s unfair if others have what I don’t have, but it is fair if I have what others don’t have

⦿

If it’s unfair that others have what I don’t have, it’s unfair to others if they don’t have what I have

of happiness and a major determinant of personal worth. In the latter views, a more balanced view of life is put forward in which objects and possessions are not the ‘be all and end all’ of life and personal worth. As a result, these latter views will help you deal more healthily with situations where others have what you prize but lack. If you hold flexible/​non-​extreme attitudes that are consistent with the views of the world listed on the right-​hand side of Table 10.1, and if you

326    Dealing with unhealthy envy

act and think in ways that are, in turn, consistent with these flexible/​non-​ extreme attitudes, you will become less prone to unhealthy envy. We have reached the end of this book. I hope you have found it instructive and valuable and I would appreciate any feedback c/​o the publisher.

NOTES 1 I am using the word ‘object’ here very broadly to include anything that you prize. 2 As I have mentioned before, we don’t have agreed terms for HNEs. Therefore, if you don’t resonate with the term ‘healthy envy’, use a term that makes more sense to you. 3 Discuss this issue with your REBT supervisor, if necessary. 4 Please remember that I am using the term ‘objects’ in this chapter to include anything that you prize.

References Beck, A.T. (1976). Cognitive Therapy and the Emotional Disorders. New York: International Universities Press. Burns, D. (1980). Feeling Good: The New Mood Therapy. New York: William Morrow. Colman, A. (2015). Oxford Dictionary of Psychology. 4th edition. Oxford: Oxford University Press. Dryden, W. (1999). How to Accept Yourself. London: Sheldon. Dryden, W. (2009a). How to Think and Intervene Like an REBT Therapist. Hove, East Sussex: Routledge. Dryden, W. (2009b). Self-​Discipline: How to Get It and How to Keep It. London: Sheldon. Dryden, W. (2013a). The ABCs of REBT: Perspectives on Conceptualization. New York: Springer. Dryden, W. (2013b). Unconditional self-​ acceptance and self-​ compassion. In M.E. Bernard (Ed.), The Strength of Self-​ Acceptance: Theory, Practice and Research. New York: Springer (pp. 107–​120). Dryden, W. (2016). Attitudes in Rational Emotive Behaviour Therapy: Components, Characteristics and Adversity-​Related Consequences. London: Rationality Publications. Dryden, W. (2021). Rational Emotive Behaviour Therapy: Distinctive Features. 3rd edition. Abingdon, Oxon: Routledge. Ellis, A. and Joffe Ellis, D. (2011). Rational Emotive Behavior Therapy. Washington: American Psychological Association. Gilbert, P. (2009). The Compassionate Mind: A New Approach to Life’s Challenges. London: Robinson. Wills, F. (2022). Beck’s Cognitive Therapy: Distinctive Features. 2nd edition. Abingdon, Oxon: Routledge.

Appendix 1 Descriptions, foundations and illustrations of thinking errors and their realistic and balanced alternatives

Descriptions of thinking errors and Illustrations* realistic and balanced alternatives Jumping to unwarranted conclusions Here, when something bad happens, you make a negative interpretation and treat this as a fact even though there is no definite evidence that convincingly supports your conclusions Sticking to the facts and testing out your hunches Here, when something bad happens, you stick to the facts and resolve to test out any negative interpretations you may make, which you view as hunches to be examined rather than as facts

⦿ ‘Since

they have seen me fail… [as I absolutely should not have done]… they will view me as an incompetent worm’

⦿ ‘Since

they have seen me fail… [as I would have preferred not to do, but do not demand that I absolutely should not have done]… I am not sure how they will view me. I think that some will think badly of me, others will be compassionate towards me and yet others may not have noticed or be neutral about my failure. I can always ask them, if I want to know’

Appendix 1   329

All-​or-​none thinking Here, you use non-​overlapping black or white categories Multi-​category thinking Here, you make use of a number of relevant categories

Overgeneralising Here, when something bad happens, you make a generalisation from this experience that goes far beyond the data at hand Making a realistic generalisation Here, when something goes wrong, you make a generalisation from this experience that is warranted by the data at hand Focusing on the negative Here, you pick out a single negative detail and dwell on it exclusively so that your vision of all reality becomes darkened, like the drop of ink that discolours the entire glass of water Focusing on the complexity of experiences Here, you focus on a negative detail, but integrate this detail into the complexity of positive, negative and neutral features of life

⦿ ‘If

I fail at any important task… [as I must not do]… I will only ever fail again’

⦿ ‘If

I do fail at any important task… [as I would prefer not to do, but do not demand that I must not do]… I may well both succeed and fail at important tasks in the future’

⦿ ‘[My

boss must like me]… If my boss does not like me, it follows that nobody at work will like me’

⦿ ‘[I

want my boss to like me, but my boss does not have to do so]… If my boss does not like me, it does not follow that others at work may or may not like me’

⦿ ‘As

things are going wrong… [as they must not do and it is unbearable that they are]… I can’t see any good that is happening in my life’

⦿ ‘As

things are going wrong… [as I prefer they did not, but don’t demand this. When they do go wrong, I can bear it]… I can see that my life is made up of the good, the bad and the neutral’

330   Appendix 1

Disqualifying the positive Here, you reject positive experiences by insisting they ‘don’t count’ for some reason or other, thus maintaining a negative view that cannot be contradicted by your everyday experiences Incorporating the positive into a complex view of your experiences Here, you accept positive experiences and locate these into the complexity of positive, negative and neutral features of life

Mind reading Here, you arbitrarily conclude that someone is reacting negatively to you, and you don’t bother to check this out. You regard your thought as a fact Owning and checking one’s thoughts about the reactions of others Here, you may think someone is reacting negatively to you, but you check it out with the other person rather than regarding your thought as fact

⦿ ‘[I

absolutely should not have done the foolish things that I have done]… When others compliment me on the good things I have done, they are only being kind to me by seeming to forget those foolish things’

⦿ ‘[I

would have preferred not to have done the foolish things that I have done, but that does not mean that I absolutely should not have done them]… When others compliment me on the good things I have done, I can accept these compliments as being genuine even though I also did some foolish things, which the others may also have recognised’

⦿ ‘I

made some errors in my presentation… [that I absolutely should not have made]… and, when I looked at my boss, I thought he was thinking how hopeless I was and therefore he did think this’

⦿ ‘I

made some errors in my presentation… [that I would have preferred not to have made, but that does not mean that I absolutely should not have made them]… and, when I looked at my boss, I thought he was thinking that I was hopeless, but I quickly realised that this was my thought rather than his and resolved to ask him about this in the morning’

Appendix 1   331

Fortune telling Here, you anticipate that things will turn out badly, and you feel convinced that your prediction is an already established fact Owning and checking one’s thoughts about what will happen in the future Here, you anticipate that things may turn out badly, but you regard that as a prediction that needs examining against the available data and is not an established fact Always and never thinking Here, when something bad happens, you conclude that it will always happen and/​ or the good alternative will never occur Balanced thinking about the past, present and future Here, when something bad happens you recognise that, while it may happen again, it is not inevitable that it will and it is very unlikely that it will always occur. Also, you recognise that the good alternative may well occur in the future and that it is very unlikely that it will never happen

⦿ ‘Because

I failed at this simple task… [which I absolutely should not have done]… I think that I will get a very bad appraisal and thus this will happen’

⦿ Because

I failed at this simple task… [which I would have preferred not to have done, but I do not have to be immune to so doing]… I may get a very bad appraisal, but this is unlikely since I have done far more good than bad at work during the last year’

⦿ ‘Because

my present conditions of living are not good… [and they are actually unbearable because they must be better than they are]… it follows that they’ll always be this way and I’ll never have any happiness’

⦿ ‘Because

my present conditions of living are not good… [but they are bearable because they don’t have to be better than they are]… it does not follow that they will always be that way and I can be happy again’

332   Appendix 1

Magnifying Here, when something bad happens, you exaggerate its negativity

Keeping things in realistic perspective Here, when something bad happens, you view it in its proper perspective

Minimising Here, you inappropriately shrink things until they appear tiny (your own desirable qualities or other people’s imperfections)

Using the same balanced perspective for self and others Here, when you do something good and/​or others do something bad, you can recognise this kind of behaviour for what it is

⦿ ‘I

made a faux pas when introducing my new colleague… [which I absolutely should not have done and it’s awful that I did so]… and this will have a very negative effect on my career’

⦿ ‘I

made a faux pas when introducing my new colleague… [which I wish I had not done, but I do not have to be exempt from doing. It’s bad that I did so, but hardly the end of the world]… and, while people may remember it for a day or two, I doubt that it will have much lasting impact on my career’

⦿ ‘[I

must do outstandingly well and I am completely useless when I do not do so]… When I have seemingly done reasonably well, this is the result of luck and anyone could have done this. Whereas, if another person had done the same thing, I would acknowledge their achievement’

⦿ ‘[I

want to do outstandingly well, but I do not have to do so. I am not useless when I do not do so]… When I or someone else has seemingly done reasonably well, this may be the result of luck, but it may be because I or they fully deserved to do well’

Appendix 1   333

Emotional reasoning Here, you assume that your negative emotions necessarily reflect the way things really are: ‘I feel it, therefore it must be true’

⦿ ‘Because

I have performed so poorly… [as I absolutely should not have done]... I feel like everybody will remember my poor performance and my strong feeling proves that they will’

Sound reasoning based on thinking and feeling

⦿ Because

Personalising

⦿ ‘I

Here, when a negative event occurs involving you that you may or may not be primarily responsible for, you see yourself definitely as the cause of it Making a realistic attribution Here, when a negative event occurs involving you that you may or may not be primarily responsible for, you acknowledge that you may be the cause of it, but you don’t assume that you definitely are. Rather, you view the event from the whole perspective before making an attribution of cause, which is likely to be realistic

I have performed so poorly… [as I wish I had not done, but do not demand this]... I think and feel that people will have different responses to my performance: some negative and nasty, some compassionate and empathic, and some neutral and this is probably the case’ am involved in a group presentation and things are not going well… [Since I am acting worse than I absolutely should act]… and the audience is laughing, I am sure they are laughing only at me’

⦿ ‘I

am involved in a group presentation and things are not going well… [Since I am acting worse than I would like, but do not demand, I must do]… and the audience is laughing, I am not sure who or what they are laughing at and, indeed, some might be laughing with us and not at us’

Note: * In these illustrations, the attitudes (rigid/​extreme and flexible/​non-​extreme) are shown in square brackets and the thinking errors and realistic and balanced alternatives are underlined.

Appendix 2 Reasons why rigid attitudes are false, illogical and have largely unhealthy consequences and flexible attitudes are true, logical and have largely healthy consequences

Rigid attitude

Flexible attitude

A rigid attitude is false

A flexible attitude is true

For such a demand to be true the demanded conditions would already have to exist when they do not. Or, as soon as you make a demand, these demanded conditions would have to come into existence. Both positions are clearly false or inconsistent with reality.

A flexible attitude is true because its two component parts are true. You can prove that you have a particular desire and can provide reasons why you want what you want. You can also prove that you do not have to get what you desire.

A rigid attitude is illogical

A flexible attitude is logical

A rigid attitude is based on the same desire as a flexible one but is transformed as follows:

A flexible attitude is logical since both parts are not rigid and thus the second component logically follows from the first. Thus, consider the following flexible attitude:

⦿ ‘I

⦿ ‘I

The first component [‘I prefer that x happens (or does not happen...)’] is not rigid, but the second component [‘… and therefore this absolutely must (or must not) happen’] is rigid. As such, a rigid attitude is illogical since one cannot logically derive something rigid from something that is not rigid.

The first component [‘I prefer that x happens (or does not happen)’…] is not rigid, and the second component [‘… but this does not mean that it must (or must not) happen’] is also not rigid. Thus, a flexible attitude is logical because it is comprised of two non-​rigid parts connected together logically.

prefer that x happens (or does not happen)… and therefore this absolutely must (or must not) happen.’

prefer that x happens (or does not happen)… but this does not mean that it must (or must not) happen.’

Appendix 2   335

A rigid attitude has largely unhealthy consequences

A flexible attitude has largely healthy consequences

A rigid attitude has largely unhealthy consequences because it tends to lead to UNEs, unconstructive behaviour and highly distorted and biased subsequent thinking when the person is facing an adversity.

A flexible attitude has largely healthy consequences because it tends to lead to HNEs, constructive behaviour and realistic and balanced subsequent thinking when the person is facing an adversity.

Appendix 3 Reasons why awfulising attitudes are false, illogical and have largely unhealthy consequences and non-​awfulising attitudes are true, logical and have largely healthy consequences

Awfulising attitude

Non-​awfulising attitude

An awfulising attitude is false

A non-​awfulising attitude is true

When you hold an awfulising attitude towards your adversity, this attitude is based on the following ideas:

When you hold a non-​awfulising attitude towards your adversity. this attitude is based on the following ideas:

⦿ Nothing

⦿ Things

could be worse.

⦿ The

event in question is worse than 100 per cent bad. good could possibly come from this bad event.

could always be worse.

⦿ The

event in question is less than 100 per cent bad.

⦿ No

⦿ Good

⦿ You

⦿ You

All four ideas are false and thus your awfulising attitude is false.

All four ideas are true and thus your non-​ awfulising attitude is true.

cannot transcend this experience. It is the end.

could come from this bad event. can transcend this experience. It is not the end.

Appendix 3   337

An awfulising attitude is illogical

A non-​awfulising attitude is logical

An awfulising attitude is based on the same evaluation of badness as a non-​ awfulising attitude, but is transformed as follows

A non-​awfulising attitude is logical since both parts are non-​rigid and thus the second component logically follows from the first. Thus, consider the following non-​awfulising attitude:

⦿ ‘It

⦿ ‘It

The first component [‘It is bad if x happens (or does not happen...)’] is non-​extreme, but the second component [‘… and therefore it is awful if it does (or does not) happen’] is extreme. As such, an awfulising attitude is illogical since one cannot logically derive something extreme from something that is non-​extreme.

The first component [‘It is bad if x happens (or does not happen)’…] is non-​extreme and the second component [‘… but it is not awful if it does happen (or does not happen)’] is also non-​ extreme. Thus, a non-​awfulising attitude is logical because it is comprised of two non-​extreme parts connected together logically.

An awfulising attitude has largely unhealthy consequences

A non-​awfulising attitude has largely healthy consequences

An awfulising attitude has largely unhealthy consequences because it tends to lead to UNEs, unconstructive behaviour and highly distorted and biased subsequent thinking when the person is facing an adversity.

A non-​awfulising attitude has largely healthy consequences because it tends to lead to HNEs, constructive behaviour and realistic and balanced subsequent thinking when the person is facing an adversity.

is bad if x happens (or does not happen)… and therefore it is awful if it does happen (or does not happen).’

is bad if x happens (or does not happen)… but it is not awful if it does happen (or does not happen).’

Appendix 4 Reasons why unbearability attitudes are false, illogical and have largely unhealthy consequences and bearability attitudes are true, logical and have largely healthy consequences

Unbearability attitude

Bearability attitude

An unbearability attitude is false

A bearability attitude is true

When you hold an unbearability attitude towards your adversity, this attitude is based on the following components, which are all false:

When you hold a bearability attitude towards your adversity, this attitude is based on the following components, which are all true:

⦿ I

⦿ I

am unable to bear the adversity.

⦿ I

will die or disintegrate if the adversity continues to exist. will lose the capacity to experience happiness if the adversity continues to exist.

am able to bear the adversity.

⦿ I

will struggle if the adversity discomfort continues to exist, but I will neither die nor disintegrate.

⦿ I

⦿ I

⦿ Even

⦿ The

⦿ Even

⦿ I

am worth bearing it for.

⦿ Even

⦿ I

am willing to bear the adversity.

⦿ Even

⦿ I

am going to bear the adversity.

All seven components are false and thus your unbearability attitude is false.

All seven components are true and thus your bearability is true.

if I could bear it, the adversity is not worth bearing (even though it is). if I could bear it, I am not worth bearing it for. if I could bear it, I am not willing to bear it. if I could bear it, I am not going to bear it.

will not lose the capacity to experience happiness if the adversity continues to exist, although this capacity will be temporarily diminished. adversity is worth bearing (assuming it is).

Appendix 4   339

An unbearability attitude is illogical

A bearability attitude is logical

An unbearability attitude is based on the same sense of struggle as a discomfort tolerance attitude, but is transformed as follows:

A bearability attitude is logical since all parts are non-​extreme and are logically connected with one another. Thus, consider the following bearability attitude:

⦿ ‘It

⦿ ‘It

The first component [‘It would be difficult for me to bear it if x happens (or does not happen…)’] is non-​ extreme, but the second component [‘… and therefore I could not bear it’] is extreme. As such, an unbearability attitude is illogical since one cannot logically derive something extreme from something that is non-​extreme.

All six components of the bearability attitude are non-​extreme. Thus, a bearability attitude is logical because it is comprised of six components that are all connected together logically

An unbearability attitude has largely unhealthy consequences

A bearability attitude has largely healthy consequences

An unbearability attitude has largely unhealthy consequences because it tends to lead to UNEs, unconstructive behaviour and highly distorted and biased subsequent thinking when the person is facing an adversity.

A bearability attitude has largely healthy consequences because it tends to lead to HNEs, constructive behaviour and realistic and balanced subsequent thinking when the person is facing an adversity.

would be difficult for me to bear it if x happens (or does not happen)… and therefore I could not bear it.’

would be difficult for me to bear it if x happens (or does not happen)… but I could bear it. It would be worth bearing and I am worth bearing it for. I am willing to bear it and I am going to bear it.’

Appendix 5 Reasons why devaluation attitudes are false, illogical and have largely unhealthy consequences and unconditional acceptance attitudes are true, logical and have largely healthy consequences

Devaluation attitude

Unconditional acceptance attitude

A devaluation attitude is false

An unconditional acceptance attitude is true

When you hold a devaluation attitude in the face of your adversity, this attitude is based on the following ideas, which are all false:

When you hold an unconditional acceptance attitude in the face of your adversity, this attitude is based on the following ideas, which are all true:

⦿ A

⦿ A

⦿ A

⦿ Discrete

Both of these ideas are false and thus your devaluation attitude is false.

Both of these ideas are true and thus your devaluation attitude is true.

person (self or other) or life can legitimately be given a single global rating that defines their or its essence and the worth of a person or life is dependent upon conditions that change (e.g., my worth goes up when I do well and goes down when I don’t do well). person or life can be rated on the basis of one of his or her or its aspects.

person (self or other) or life cannot legitimately be given a single global rating that defines their or its essence, and their or its worth, as far as they or it have it, is not dependent upon conditions that change (e.g., my worth stays the same whether or not I do well). aspects of a person and life can be legitimately rated, but a person or life cannot be legitimately rated on the basis of these discrete aspects.

Appendix 5   341

A devaluation attitude is illogical

An unconditional acceptance attitude is logical

A devaluation attitude is based on the idea that the whole of a person or a life can logically be defined by one of their or its parts. Thus:

An unconditional acceptance attitude is based on the idea that the whole of a person or a life cannot be defined by one or more of their or its parts. Thus:

⦿ ‘x

⦿ ‘x

is bad… and therefore I am bad.’

is bad, but this does not mean that I am bad, I am a fallible human being even though x occurred.’

This is known as the part-​whole error, which is illogical.

Here the part-​whole illogical error is avoided. Rather it is held that the whole incorporates the part, which is logical.

A devaluation attitude has largely unhealthy consequences

An unconditional acceptance attitude has largely healthy consequences

A devaluation attitude has largely unhealthy consequences because it tends to lead to UNEs, unconstructive behaviour and highly distorted and biased subsequent thinking when the person is facing an adversity.

An unconditional acceptance attitude has largely healthy consequences because it tends to lead to HNEs, constructive behaviour and realistic and balanced subsequent thinking when the person is facing an adversity.

Appendix 6 ABCD blank form with instructions Situation =​

‘A’ (Adversity) =​

‘r/​e B’

(rigid/​extreme basic attitude) =​

‘f/​n B’

(flexible/​non-​extreme basic attitude) =​

‘C’

(emotional consequence) =​

‘C’

(emotional goal) =​

(behavioural consequence) =​

(behavioural goal) =​

(thinking consequence) =​

(thinking goal) =​

1. Write down a brief, objective description of the ‘situation’ you were in. 2. Identify your ‘C’ –​your major disturbed emotion, your dysfunctional behaviour and, if relevant, your distorted subsequent thinking. 3. Identify your ‘A’ –​this is what you were most disturbed about in the situation, known as an ‘adversity’ (Steps 2 and 3 are interchangeable.) 4. Set emotional, behavioural and thinking goals. 5. Identify your rigid/​extreme basic attitudes (‘r/​e Bs’), i.e., rigid attitude +​awfulising attitude, unbearability attitude or devaluation attitude. 6. Identify the alternative flexible/​non-​extreme attitudes (‘f/​n Bs’) that will enable you to achieve your goals, i.e., flexible attitude +​non-​awfulising attitude, bearability attitude or unconditional acceptance attitude. 7. Develop persuasive arguments to convince yourself that your rigid/​extreme attitudes are false, illogical and unhealthy, and that your flexible/​non-​extreme attitudes are true, logical and healthy –​‘D’. These arguments will help you to achieve your emotional, behavioural and thinking goals. 8. Re-​examine ‘A’ and consider how realistic it was. Given all the facts, would there have been a more realistic way of looking at ‘A’? If so, write it down.

Appendix 6   343

‘D’ (Dialectical examination of ‘B’*)

Taking action

Re-​examine ‘A’ =​

Note: * Dialectical examination is a process of resolving a conflict between opposing views (e.g., rigid/​extreme basic attitudes and flexible/​non-​extreme basic attitudes.

344   Appendix 6

NOTES FOR PRACTITIONERS These notes refer to the eight instructions that are listed on the ABCD self-​ help form and highlight errors that your client may make at each of the nine steps. In these notes, I outline the most frequent of these errors and suggest ways of helping your client to address these errors effectively.

1. Write down a brief, objective description of the ‘situation’ you were in The error that your client may make here is to be too general in their description of the situation in which they experienced their problem. If this is the case, show your client how to apply the rules of the game Cluedo (called ‘Clue’ in the USA) to describing the ‘situation’. This involves clients specifying precisely where they were in the episode, who else was there and what happened (e.g., ‘It was Colonel Mustard, in the dining room, who killed the victim with the candelabra’).

2. Identify your ‘C’ –​your major disturbed emotion, your dysfunctional behaviour and, if relevant, your distorted subsequent thinking Here your clients can make several errors, although the fact that the Client’s Guide is structured in the way that it is means that, if your client is working on anxiety, for example, they should list ‘anxiety’ as their emotional consequence and they should select the appropriate behavioural and thinking consequences that are listed in Chapter 2. This should be the case for each of the nine emotional problems dealt with in the Client’s Guide. However, if your client has a number of emotional problems or if they are using the ABCD form as a stand-​alone method without reference to any specific chapter, they may make a number of errors in this step. ⦿

Error: Your client does not list a specific UNE, dysfunctional behaviour and/​or grossly distorted and (where relevant) safety-​seeking thinking. Response: Help your client to specify this material.

⦿

Error: Your client lists a vague emotion. For example, your client may write that they felt ‘bad’ or ‘upset’.

Appendix 6   345

Response: Explain why this response is vague and then ask again for a specific UNE, giving suitable prompts and suggestions when relevant. ⦿

Error: Your client lists an inference as an emotion. For example, your client may write that they felt ‘rejected’ or ‘criticised’. Response: Explain why this response is an inference rather than a UNE and ask your client how they felt when they were rejected or criticised, assuming, of course, that they were.

To help you assist your client to identify the emotional, behavioural and thinking components of their situationally based problem, I have included all relevant information with respect to emotional problems (and their healthy alternatives) in Appendix 7. This appendix will help you to easily find this information and save valuable therapy time.

3. Identify your ‘A’ –​this is what you were most disturbed about in the situation In REBT, ‘A’ is perhaps the most difficult concept for clients and novice therapists alike to grasp. In this book, I refer to ‘A’ as an adversity when discussing emotional problems and their healthy alternatives. It may also be referred to as a ‘negative activating event’. The most important thing that you need to bear in mind and help your client to do when identifying ‘A’ when assessing a specific example of their emotional problems is that ‘A’ represents the aspect of the situation about which your client disturbs themself the most. One way to describe this to your client is to ask them to imagine that a doctor is assessing their leg reflexes with a rubber hammer. In that procedure, the doctor asks them to cross their legs and, when the doctor hits the right spot, your client’s reflex is triggered. If the doctor misses this spot by much, then no response is forthcoming. If the doctor’s attempt is there or thereabouts, but not directly on the right spot, your client’s response will be present but muted. When you help your client to assess ‘A’, your goal is to hit the right spot so that your client says something like ‘That’s exactly what I was most anxious about’, for example. Here are common client errors in assessing ‘A’ on the ABCD self-​help form and how best to respond.

346   Appendix 6

⦿

Error: Your client reiterates the situation as ‘A’. Response: Ascertain whether this is exactly what the client was most disturbed about and, if not, help to identify ‘A’ (e.g., by using the magic question technique). In using the magic question technique, you do the following:

⦿

Ask your client to imagine the situation in which they were disturbed (specify the precise UNE that they experienced in this situation).

⦿

Without changing what happened, ask your client to nominate one ingredient that would have eliminated or significantly reduced their disturbed emotion.

⦿

The opposite of the nominated ingredient is likely to be the client’s ‘A’.

⦿

Error: The relevant theme is not clear in your client’s ‘A’. In Chapters 2–​ 10, I outlined for each emotional problem and its healthy alternative the themes that are present in these problems. In this context, if your client is anxious in their chosen specific example, they will be anxious about an aspect of the situation that they found particularly threatening –​threat being the inferential theme associated with anxiety and its healthy alternative, concern. The inferential themes associated with each emotional problem and healthy alternative are listed in Appendix 7. Response: If the theme is not clear in your client’s ‘A’, then use this theme (or themes) in your questions to help your client in this regard (e.g., what did you find was most threatening about being in this situation?). Also, using the magic question technique (described above) will usually help you to identify the theme. You may wish to encourage your client to specify the theme at ‘A’ in addition to listing what they were most disturbed about. You may suggest this to any client who needs an additional reminder of the relevant theme to identify ‘A’. Thus, instead of ‘Being criticised by my boss’ your client might be encouraged to write ‘My biggest threat in the situation was being criticised by my boss’.

(Steps 2 and 3 are interchangeable.) In the ABCD form, I recommend that a client identify the emotional, behavioural and thinking components of their emotional problem before identifying ‘A’. I suggest this because it is often helpful for the client to use the emotional component, in particular, to identify ‘A’ (e.g., ‘What was I most anxious about in this situation?’). However, your client may find it more helpful to identify ‘A’ before ‘C’ and it is fine to let them do

Appendix 6   347

so, although it is worth checking that their nominated ‘A’ is, in fact, what they were most disturbed about after they have identified their ‘A’.

4. Set emotional, behavioural and thinking goals ⦿

Error: Your client does not list one or more of the following as goals: a specific HNE alternative to their UNE, functional alternatives to their dysfunctional behaviour and realistic and balanced alternatives to their highly distorted (and where relevant) safety-​seeking thinking. Response: Help your client to specify this material.

⦿

Error: Your client may suggest an emotional goal that is based on the absence of the UNE (e.g., ‘I don’t want to be anxious’). Response: Explain why this is problematic (i.e., people do not exist in an emotional vacuum in the face of an adversity) and outline and provide a rationale for the HNE alternative to their listed UNE (e.g., concern as an alternative to anxiety).

⦿

Error: Your client may suggest an emotional goal that is based on the idea that it is desirable to experience the UNE with less intensity (e.g., ‘I want to feel less anxious’). Response: Explain that a less intense version of a disturbed emotion is still a disturbed emotion and, if achieved, it will be done, not only by retaining your client’s rigid/​extreme attitude, but also by reducing the importance of their preference. Outline and provide a flexible/​non-​ extreme attitude for the HNE alternative to their UNE and explain that this HNE will allow your client to retain the importance of their preference by changing their rigid/​extreme attitudes to their flexible/​non-​ extreme alternatives.

⦿

Error: Your client may nominate safety-​seeking behaviour as a behavioural goal. Response: Remind your client that their behavioural goal should ideally be in response to the adversity at ‘A’. Help your client to understand that the behaviour that they have nominated as a goal is designed to help keep them safe in the situation or to change this ‘A’ before they have dealt with it, rather than to deal effectively with their ‘A’. With this

348   Appendix 6

principle in mind, help your client to set an appropriate behavioural goal in the face of ‘A’. ⦿

Error: Your client may nominate safety-​ seeking thinking as a thinking goal. Response: The most common form of safety-​ seeking thinking that your client is likely to nominate as a thinking goal is self-​reassurance. Help them to see that such thinking is not designed to help them face their ‘A’ and deal with it effectively. Rather it is designed to eradicate their UNE. Explain this to your client and help them instead to nominate as a goal thinking that is realistic, balanced and designed to help them to face and deal with their ‘A’.

⦿

Error: Your client may nominate unrealistically positive thinking as a thinking goal. Response: Help your client to understand that thinking positively about an adversity is not healthy and that realistic and balanced thinking about the adversity is the healthy alternative to highly distorted and exaggerated negative thinking about it. Help your client to nominate the latter as their thinking goal at ‘C’.

5. Identify your rigid/​extreme basic attitudes (i.e., rigid attitude +​awfulising attitude, unbearability attitude or devaluation attitude) ⦿

Error: Your client uses the word ‘should’ to denote a rigid attitude. Response: This may or may not be an error. While the word ‘should’ may reflect a rigid demand, it may also denote a non-​rigid, ideal or preferable ‘should’. The best way to tell is to ask your client whether they believe that their ‘should’ must come to pass or not. If they say ‘yes’, then their ‘should’ is rigid. If they say ‘no’, then it may not represent a rigid/​extreme attitude. If your client is going to use the word ‘should’ to denote a rigid attitude then I suggest that you encourage your client to qualify the ‘should’ with the term ‘absolutely’ or alternatively to use the word ‘must’.

Appendix 6   349

⦿

Error: Your client thinks that role-​devaluation –​where your client globally depreciates their performance in a role –​is synonymous with self-​ devaluation –​where they depreciate their ‘self’ (e.g., ‘I’m a bad parent’ is synonymous with ‘I am a bad person’). Response: If this occurs, help your client to differentiate self-​devaluation from role-​devaluation and to make the former explicit on the form (e.g., ‘I’m a bad person for being a bad person’).

6. Identify the alternative flexible/​non-​extreme attitudes that will enable you to achieve your goals (i.e., flexible attitude +​non-​awfulising attitude, bearability attitude or acceptance attitude) ⦿

Error: Your client articulates a partial flexible/​non-​extreme attitude but does not negate the rigid/​extreme attitude (e.g., ‘I want to be loved’ as opposed to ‘I want to be loved, but I do not have to be loved’). Response: If this happens, explain to your client the importance of negating their rigid/​extreme attitude as well as asserting their partial flexible/​non-​extreme attitude and ensure that they do so. If they assert only their partial flexible/​non-​extreme attitude (e.g., ‘It would be bad if I fail’), then they may implicitly transform this into a rigid/​extreme attitude (‘It would be bad if I fail and therefore it would be awful if I do so’). Whereas, if your client explicitly states both parts of a flexible/​ non-​extreme attitude, this is unlikely to happen (e.g., ‘It would be bad if I fail, but it would not be awful if I did so’).

7. Develop persuasive arguments to convince yourself that your rigid/​extreme attitudes are false, illogical and unhealthy and that your flexible/​non-​extreme attitudes are true, logical and healthy –​‘D’. These arguments will help you to achieve your emotional, behavioural and thinking goals ⦿

Error: In the Client’s Guide, I provide tips for your client when they come to examine their attitudes (both rigid/​non-​extreme and flexible/​

350   Appendix 6

non-​ extreme) –​see Appendices 2–​ 5. If I did not provide these tips, clients would probably struggle to examine these attitudes. However, their inclusion may mean that your client will apply the arguments contained in the appendices rather than using them to develop their own persuasive arguments. Response: If you suspect that your client’s arguments in the examining process lack persuasiveness, ask them to rate each argument on a 0–​10 persuasiveness scale. If your client’s scores are low, have them develop arguments with you in the session that help to increase these ratings.

8. Re-​examine ‘A’ and consider how realistic it was. Given all the facts, would there have been a more realistic way of looking at ‘A’? If so, write it down ⦿

Error: In REBT, we encourage clients to assume temporarily that their inferences at ‘A’ are correct (see Step 3) so that they can identify and deal with the rigid/​extreme attitudes that they hold towards these adversities (at ‘B’) that underpin their disturbed responses at ‘C’. Only when they have examined their rigid/​extreme attitudes and their alternative flexible/​non-​extreme attitudes, and have developed some conviction in the latter are they ready to re-​examine their ‘A’s’. This is why this is the last step on the ABCD self-​help form. However, sometimes a client takes this step first rather than last. When they do this, their commitment to change their rigid/​extreme attitudes is lowered, since they have changed ‘A’ rather than ‘B’ to change ‘C’. Response: Ask your client when they completed Step 8. If they did this at the outset or certainly before Step 5, then explain the problems with doing so and encourage them to take this step last.

Appendix 6   351

USE SUPERVISION If you are not sure how to respond to your client’s errors when completing the ABCD form, then take these issues to your REBT supervisor. In addition, I suggest that you take to supervision a random selection of your client’s completed forms since you may not spot a number of your client’s errors. Your supervisor will take a form and ask you to identify your client’s errors and how you responded to them. If you fail to spot errors, your supervisor will point these out to you.

Appendix 7 Quick reference guide to the nine emotional problems and their healthy alternatives ANXIETY VERSUS CONCERN Adversity

⦿ You

Basic attitude Emotion Behaviour

⦿ You

are facing a threat to your personal domain

Rigid/​extreme

Flexible/​non-​extreme

Anxiety

Concern

avoid the threat

⦿ You

⦿ You

withdraw physically from the threat

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

ward off the threat (e.g. by rituals or superstitious behaviour)

try to neutralise the threat (e.g. by being nice to people of whom you are afraid) distract yourself from the threat by engaging in other activity

face up to the threat without using any safety-​ seeking measures stay in the situation and take constructive action to deal with the threat do not employ any attempts to ward off the threat. You see the value of facing it and dealing with it directly employ no neutralising methods, preferring to deal with the threat directly if it happens face the threat if it occurs without distracting yourself from it

Appendix 7   353

⦿ You

keep checking on the current status of the threat, hoping to find that it has disappeared or become benign

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

seek reassurance from others that the threat is benign

overprepare in order to minimise the threat happening or so that you are prepared to meet it (NB it is the overpreparation that is the problem here) seek support from others to help you face up to the threat and rely on them to protect you from it by handling it for you

tranquilise your feelings so that you don’t think about the threat

overcompensate for feeling vulnerable by seeking out an even greater threat to prove to yourself that you can cope

develop a plan to deal with the threat if it happens and get on with the business of living without checking on the status of the threat make your own mind up if the threat is benign. If it is, you go about your business. If it is not benign, then you deal with it prepare to meet the threat but do not overprepare

seek support from others to help you face up to the threat and then take constructive action by yourself rather than rely on them to handle it for you or to be there to rescue you think about the threat and remind yourself how you can deal with it and that you have the resources to do so. You do this without tranquilising your feelings deal with the threat as it is and accept your feelings of vulnerability as you do so. You do not overcompensate for feeling vulnerable by seeking to deal with a greater threat

354   Appendix 7

Subsequent thinking

Threat-​exaggerated thinking overestimate the probability of the threat occurring

Realistic thinking about threat

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

create an even more negative threat in your mind ruminate about the threat

underestimate your ability to cope with the threat magnify the negative consequences of the threat and minimise its positive consequences have more task-​ irrelevant thoughts than in concern

Safety-​seeking thinking

withdraw mentally from the threat

are realistic about the probability of the threat occurring view the threat realistically

think about what to do concerning dealing with threat constructively rather than ruminate about the threat realistically appraise your ability to cope with the threat

are balanced in your thinking about the negative and positive consequences of the threat have more task-​relevant thoughts than in anxiety

Realistic thinking about threat

⦿ You

⦿ You

⦿ You

⦿ You

try to persuade yourself that the threat is not imminent and that you are ‘imagining’ it

mentally face the threat

are realistic about the likelihood of the threat occurring

Appendix 7   355

⦿ You

think in ways designed to reassure yourself that the threat is benign or, if not, that its consequences will be insignificant

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

distract yourself from the threat, e.g. by focusing on mental scenes of safety and well-​being overprepare mentally in order to minimise the threat happening or so that you are prepared to meet it (NB once again it is the overpreparation that is the problem here) picture yourself dealing with the threat in a masterful way overcompensate for your feeling of vulnerability by picturing yourself dealing effectively with an even bigger threat

are realistic about the nature of the threat and its likely consequences

focus on the threat when it is apparent and don’t distract yourself from it

prepare to meet the threat but do not overprepare

picture yourself dealing with the threat in a way that is ordinary and not masterful see yourself dealing with the threat as it is and do not picture yourself dealing with an even bigger threat

356   Appendix 7

DEPRESSION VERSUS SADNESS Adversity

⦿ You

have experienced a loss from the sociotropic and/​or autonomous realms of your personal domain

⦿ You

have experienced failure within the sociotropic and/​or autonomous realms of your personal domain

⦿ You

or others have experienced an undeserved plight

Basic attitude Emotion Behaviour

Rigid/​extreme

Flexible/​non-​extreme

Depression

Sadness

⦿ You

become overly dependent on and seek to cling to others (particularly in sociotropic depression)

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

bemoan your fate or that of others to anyone who will listen (particularly in pity-​based depression) create an environment consistent with your depressed feelings

attempt to terminate feelings of depression in self-​ destructive ways

seek out reinforcements after a period of mourning (particularly when your inferential theme is loss) create an environment inconsistent with depressed feelings

express your feelings about the loss, failure or undeserved plight, and talk in a non-​complaining way about these feelings to significant others accept your feelings of sadness and deal with them in constructive ways

Appendix 7   357

Subsequent thinking

⦿ You

see only negative aspects of the loss, failure or undeserved plight

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ Even

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

think of other losses, failures and undeserved plights that you (and in the case of the latter, others) have experienced think you are unable to help yourself (helplessness) only see pain and blackness in the future (hopelessness) see yourself being totally dependent on others (in autonomous depression)

see yourself as being disconnected from others (in sociotropic depression)

see the world as full of undeservedness and unfairness (in plight-​based depression) tend to ruminate concerning the source of your depression and its consequences

are able to recognise both negative and positive aspects of the loss or failure think of losses/​failures/​ and undeserved plights and gains/​successes/​advantages

think you are able to help yourself look to the future with hope

though you may have to rely on others to some degree, you realise that you are still autonomous see yourself as still connected to others, although you may be temporarily unconnected with them see the world as a complex mix of good/​bad and neutral events

think about the source of your sadness and its consequences without rumination

358   Appendix 7

GUILT VERSUS REMORSE Adversity

⦿ You

have broken your moral code

⦿ You

have hurt someone’s feelings

⦿ You

Basic attitude Emotion Behaviour

have failed to live up to your moral code

Rigid/​extreme

Flexible/​non-​extreme

Guilt

Remorse

⦿ You

escape from the unhealthy pain of guilt in self-​defeating ways

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

beg forgiveness from the person you have wronged promise unrealistically that you will not ‘sin’ again

punish yourself physically or by deprivation defensively disclaim responsibility for wrongdoing

reject offers of forgiveness

face up to the healthy pain that accompanies the realisation that you have sinned ask, but do not beg, for forgiveness

understand the reasons for your wrongdoing and act on your understanding atone for the sin by taking a penalty accept responsibility and make appropriate amends. You do not make excuses for your behaviour or enact other defensive behaviour do accept offers of forgiveness

Appendix 7   359

Subsequent thinking

⦿ You

conclude that you have definitely committed the sin

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

assume more personal responsibility than the situation warrants assign far less responsibility to others than is warranted dismiss possible mitigating factors for your behaviour only see your behaviour in a guilt-​related context and fail to put it into an overall context think that you will receive retribution

take into account all relevant data when judging whether or not you have ‘sinned’ assume an appropriate level of personal responsibility assign an appropriate level of responsibility to others take into account mitigating factors

put your behaviour into overall context

think you may be penalised rather than receive retribution

360   Appendix 7

UNHEALTHY REGRET VERSUS HEALTHY REGRET Adversity

⦿ You

took action in the past and wished you had not done so

⦿ You

failed to take action in the past and wished you had done so

⦿ You

face uncertainty about the consequences of taking action now or in the future Rigid/​extreme

Flexible/​non-​extreme

Unhealthy regret

Healthy regret

Basic attitude Emotion Behaviour

Past focus

Past focus

⦿ You

⦿ If

⦿ You

⦿ You

Present/​Future focus

Present/​Future focus

⦿ You

⦿ You

⦿ You

⦿ You

review physical evidence in the hope of finding something that you missed at the time that would have led you to have made the best decision* and not stopping until you feel at ease seek reassurance from others that you made the best decision, but you do not feel reassured by their reassurance

review physical evidence in order to find the best decision possible until you feel certain that you have done so and you don’t stop until you are satisfied do more research until you have gotten all possible information so that you can be certain that you have made the best decision

you come across physical evidence pertaining to the past decision, you do not review this as it will not change the past

tell others, if relevant, what you did or did not do and why you acted or failed to act in the way that you did

review physical evidence in order to find the option that will yield the best outcome but without needing to feel certain about this realise that more research is always possible, but decide not to do that research and to make a choice of action based on the available evidence

Appendix 7   361

⦿ You

seek guidance from others about what is the best decision you can make until you feel certain that you have found it

⦿ You

Subsequent thinking

are indecisive

⦿ You

share your thinking with others for their feedback and to make any changes based on that feedback, but you do not need to feel certain about the outcome of your decision

⦿ You

make a decision when it is right for you to do so

Past focus –​This is ruminative in nature

Past focus –​This is non-​ ruminative in nature

⦿ You

⦿ If

⦿ You

⦿ You

⦿ You

⦿ You

revisit the decision in your mind with the purpose of discovering what would have led you to have made the best decision possible and you criticise yourself for not knowing what it was and for thereby making the wrong decision are sure that you made the wrong decision

engage in if-​only thinking. You are sure that, if you had taken a different course of action, your life would have taken a much better course

you revisit the decision in your mind, you remind yourself that you acted according to the information that was available at the time and that was the best you could have done

recognise that there is no way of knowing if you made the right or wrong decision. You made a decision that you thought was right at the time recognise that, if you had acted differently, your life may have been better, it may have been worse or it may have made no difference

362   Appendix 7

Present focus –​This is ruminative in nature

Present focus –​This is non-​ruminative in nature

⦿ You

⦿ You

⦿ You

⦿ You

review all the evidence in your mind until you are sure that you have made the best decision, but without ever achieving such certainty think that you have missed something crucial, but do not know what it is and you search for the missing ingredient in your mind until you have found it

review all the evidence and then make a decision based on the probability, not certainty, that you have chosen wisely

recognise that you may have missed something crucial, but accept that possibility and do not delay making a decision

Note: * By ‘best decision’ here, I mean a course of action (or inaction) that would have resulted in a situation where the person would have no regrets about what they did or did not do.

Appendix 7   363

SHAME VERSUS DISAPPOINTMENT Adversity

⦿ Something

highly negative has been revealed about you (or about a group with whom you identify) by yourself or by others

⦿ You

have acted in a way that falls very short of your ideal

⦿ Others

look down on or shun you (or a group with whom you identify) or think that they do

Basic attitude Emotion Behaviour

Rigid/​extreme

Flexible/​non-​extreme

Shame

Disappointment

⦿ You

remove yourself from the ‘gaze’ of others

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

isolate yourself from others save face by attacking other(s) who have ‘shamed’ you defend your threatened self-​esteem in self-​defeating ways ignore attempts by others to restore social equilibrium

stay within the ‘gaze’ of others continue to participate actively in social interaction assert yourself with the other

accept what the other has to say if it is true and reject it if it is false respond positively to attempts of others to restore social equilibrium

364   Appendix 7

Subsequent thinking

⦿ You

overestimate the negativity of the information revealed

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

overestimate the likelihood that the judging group will notice or be interested in the information overestimate the degree of disapproval you (or your reference group) will receive overestimate how long any disapproval will last

see the information revealed in a compassionate self-​accepting context are realistic about the likelihood that the judging group will notice or be interested in the information revealed are realistic about the degree of disapproval self (or reference group) will receive are realistic about how long any disapproval will last

Appendix 7   365

HURT VERSUS SORROW Adversity

⦿ Others

treat you badly (and you think you do not deserve such treatment)

⦿ You

think that the other person has devalued your relationship (i.e., someone indicates that their relationship with you is less important to them than the relationship is to you)

Basic attitude Emotion Behaviour

Rigid/​extreme

Flexible/​non-​extreme

Hurt

Sorrow

⦿ You

stop communicating with the other person

⦿ You

⦿ You

⦿ You

⦿ You

⦿ If

sulk and make obvious you feel hurt without disclosing details of the matter indirectly criticise or punish the other person for their offence

communicate your feelings to the other directly request that the other person acts in a fairer manner towards you

you have anything critical to say to the other, you say it directly and in a respectful way

366   Appendix 7

Subsequent thinking

⦿ You

overestimate the unfairness of the other person’s behaviour

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ If

⦿ You

⦿ You

think that the other person does not care for you or is indifferent to you

see yourself as alone, uncared for or misunderstood

tend to think of past ‘hurts’

think that it is out of the question that you should make the first move towards the other person

are realistic about the degree of unfairness in the other person’s behaviour think that the other person has acted badly rather than demonstrating lack of caring or indifference see yourself as being in a poor situation, but still connected to, cared for by and understood by others not directly involved in the situation you think of past hurts, you do so with less frequency and less intensity than when you feel hurt are open to the idea of making the first move towards the other person

Appendix 7   367

UNHEALTHY ANGER VERSUS HEALTHY ANGER Adversity

⦿ You

think that you have been frustrated in some way

⦿ Your

movement towards an important goal has been obstructed in some way

⦿ Someone

has transgressed one of your personal rules

⦿ You

have transgressed one of your own personal rules

⦿ Someone

has disrespected you

⦿ Someone

or something has threatened your self-​esteem Rigid/​extreme

Flexible/​non-​extreme

Unhealthy anger

Healthy anger

Basic attitude Emotion Behaviour

⦿ You

attack the other(s) physically

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

attack the other(s) verbally

attack the other(s) passive-​aggressively

displace the attack on to another person, animal or object

⦿ You

withdraw aggressively

assert yourself with the other(s) request, but do not demand, behavioural change from the other(s) express your feelings to the other in a direct way and not behind their back are direct in your expression of healthy anger and do not displace your feelings on to others or objects

⦿ You

stay in the situation or come back to it quickly if you leave it. If you do leave the situation if your attempts to deal with it have not been successful, you do so non-​aggressively

368   Appendix 7

recruit allies against the other(s)

Subsequent thinking

⦿ You

⦿ If

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

overestimate the extent to which the other(s) acted deliberately

see malicious intent in the motives of the other(s)

see yourself as definitely right and the other(s) as definitely wrong

are unable to see the point of view of the other(s)

⦿ You

⦿ You

plot to exact revenge

ruminate about the other’s behaviour and fantasise about coming out on top

you discuss the situation with others, you do so without attempting to recruit them as allies think that the other(s) may have acted deliberately, but you also recognise that this may not have been the case think that other(s) may have had malicious intent in their motives, but you also recognise that this may not have been the case think that you are probably rather than definitely right and the other(s) are probably rather than definitely wrong are able to see the point of view of the other(s)

⦿ You

have fleeting, rather than sustained, thoughts to exact revenge

⦿ You

think about what you can say to the other, but without rumination and without fantasising how you may come out on top

Appendix 7   369

UNHEALTHY JEALOUSY VERSUS HEALTHY JEALOUSY Adversity

⦿ A

threat is posed to your relationship with your partner from a third person

⦿ A

threat is posed by uncertainty you face concerning your partner’s whereabouts, behaviour or thinking in the context of the first threat Rigid/​extreme

Flexible/​non-​extreme

Unhealthy jealousy

Healthy jealousy

Basic attitude Emotion Behaviour

⦿ You

seek constant reassurance that you are loved

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

monitor the actions and feelings of your partner

search for evidence that your partner is involved with someone else

attempt to restrict the movements or activities of your partner

set tests that your partner has to pass

allow your partner to initiate expressing love for you without prompting them or seeking reassurance once they have done so allow your partner freedom without monitoring their feelings, actions and whereabouts allow your partner to show natural interest in other people without setting tests acknowledge that your partner is an independent person and do not curtail their activities do not set tests for your partner

370   Appendix 7

⦿ You

retaliate for your partner’s presumed infidelity

⦿ You

Subsequent thinking

sulk

exaggerate any threat to your relationship that does exist

⦿ You

remain faithful despite any doubts you may have about your partner’s fidelity, which you express directly

⦿ If

you have anything to say to your partner, you do so directly and respectfully

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ If

⦿ You

think the loss of your relationship is imminent

misconstrue your partner’s ordinary conversations with relevant others as having romantic or sexual connotations construct visual images of your partner’s infidelity

your partner admits to finding another person attractive, you think that s/​ he finds that person more attractive than you and that s/​he will leave you for this other person

tend not to exaggerate any threat to your relationship that does exist think that your relationship will continue unless you have clear evidence to the contrary do not misconstrue ordinary conversations between your partner and another people

do not construct visual images of your partner’s infidelity accept that your partner will find others attractive but you do not see this as a threat

Appendix 7   371

UNHEALTHY ENVY VERSUS HEALTHY ENVY Adversity

⦿ Another

person possesses and enjoys something that you prize, but do not have

Basic attitude Emotion Behaviour

Rigid/​extreme

Flexible/​non-​extreme

Unhealthy envy

Healthy envy

⦿ You

strive to obtain the desired possession even though you will discard it later

⦿ You

⦿ You

⦿ You

⦿ If

⦿ If

⦿ If

⦿ If

disparage verbally the desired possession or the person who has it to others

you had the chance, you would take away the desired possession from the other (either so that you will have it or that the other is deprived of it) you had the chance, you would spoil or destroy the desired possession so that the other person does not have it

strive to obtain the desired possession if it is truly what you want

discuss the desired object with others without disparaging it or the person who has it you had the chance, you would take steps to obtain the desired possession if you really want it, but you would not take it away from the other person you had the chance to spoil or destroy the desired possession so that the other person does not have it, you would not take it

372   Appendix 7

Subsequent thinking

⦿ You

tend to denigrate in your mind the value of the desired possession and/​or the person who possesses it

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

⦿ You

try to convince yourself that you are happy with your possessions (although you are not)

think about how to acquire the desired possession regardless of its usefulness think about how to deprive the other person of the desired possession

think about how to spoil or destroy the other’s desired possession

honestly admit to yourself that you desire the desired possession

are honest with yourself if you are not happy with your possessions, rather than defensively trying to convince yourself that you are happy with them when you are not think about how to obtain the desired possession because you desire it for healthy reasons can allow the other person to have and enjoy the desired possession without denigrating that person or the possession can allow the other person to have and enjoy the desired possession without thinking of how you might spoil or destroy it

Index Note: Page numbers in bold denote tables. ‘A–​C’ thinking: anger 236–​237; anxiety 40; depression 75; envy 301; guilt 108; hurt 205; jealousy 268–​269; regret 141; shame 175 ABC framework: behaviour 26; responsibility 40; terminology 1–​6, 6; thinking 27–​28 ABCD form 59, 342–​351 acceptance attitudes see unconditional acceptance attitudes action tendencies 25–​26; see also behaviour all-​or-​none thinking 329 always and never thinking 331 anger (healthy) 10, 234–​236; associated behaviour 243–​244; associated thinking 244–​245; case example 253–​255; flexible/​non-​extreme attitudes 230–​231, 245, 246, 248–​250, 257–​258; goals 242–​245; imagery technique 250–​251; negative connotations of 235–​236; quick reference guide 367–​368; world views 260–​261, 261 anger (unhealthy) 7, 229–​261; accuracy of inferences 258; assertiveness 251–​252; associated behaviour 26, 231–​232, 241–​242; associated thinking 27, 232–​233, 242; capitalising on learning 253; case examples 26, 27, 240–​241, 253–​255; comparison with healthy anger 234–​236; dealing with a specific example of 246–​248; emotional problems about 258–​260; examining attitudes 248–​250; facing situations in reality 251–​252; flexible/​non-​extreme attitudes 230–​231, 245, 246, 248–​250,

257–​258; generalisation of learning 253–​255; goals 242–​245; imagery technique 250–​251; inference themes 229–​230, 238–​241; ‘magic question’ technique 240–​241; overestimations of presence of disrespect 256–​258; positive connotations of 235; quick reference guide 367–​368; responsibility 236–​238, 259; rigid/​extreme attitudes 230–​231, 245–​246, 248–​249, 256; self-​anger 239, 259; steps to deal with 234–​255; world views 260–​261, 261 anxiety 7, 30–​67; accuracy of inferences 61–​62; associated behaviour 33–​34, 43; associated thinking 35–​38, 43; capitalising on learning 56–​57; case examples 9, 23, 42, 57–​58; cost-​benefit analysis 39; dealing with a specific example of 49–​50; emotional pain of 63; emotional problems about 62–​65; examining attitudes 50–​52; facing threat in reality 54–​56; flexible/​non-​ extreme attitudes 24–​25, 25, 32–​33, 47, 48–​49, 50–​52, 60–​61, 63–​65; generalisation of learning 57–​58; goals 43–​47; imagery technique 52–​53; inference themes 23, 31–​32, 31, 41–​42; loss of self-​control 64; ‘magic question’ technique 42; meta-​anxiety 62–​65; overestimations of threat 59–​61; as personal weakness 64–​65; quick reference guide 352–​355; responsibility 40–​41; rigid/​extreme attitudes 24–​25, 25, 32–​33, 47–​48, 50–​52, 59–​60; steps to deal with 38–​58; world views 65–​67, 66 apologising and making amends 122

374   Index

‘aspect evaluation’ component 21–​22 ‘asserted acceptance’ component 21–​22 ‘asserted badness’ component 19 ‘asserted preference’ component 17 ‘asserted struggle’ component 20 assertiveness 251–​252 autonomous depression 71, 72, 76–​77, 98 autonomous realm 68 awfulising attitudes 14–​15, 336–​337; anxiety 48; depression 83; regret 149 balanced thinking 328–​333 bearability attitudes 3–​5, 19–​20, 338–​339; anger 246; anxiety/​concern 49; depression/​sadness 83; envy 309, 319; hurt/​sorrow 212–​213; jealousy 278; regret 149 behaviour 25–​26, 28; anxiety 33–​34, 43; concern 45–​46; depression 71, 79; disappointment 180–​181; guilt 104–​105, 112; healthy anger 243–​244; healthy envy 305–​306; healthy jealousy 274–​275; healthy regret 146–​147; hurt 202, 208; remorse 113–​114; sadness 80–​81; shame 170–​171, 178; sorrow 210; unhealthy anger 26, 231–​232, 241–​242; unhealthy envy 297–​298, 304; unhealthy jealousy 264–​265, 272; unhealthy regret 136–​137, 144; see also safety-​seeking measures behavioural goals: anger 243–​244; anxiety/​concern 45–​46; depression/​ sadness 80–​81; envy 305–​306; guilt/​ remorse 113–​114; hurt/​sorrow 210; jealousy 274–​275; regret 146–​147; shame/​disappointment 180–​181 beliefs 1–​6, 6 benefits, loss of 41, 75 case examples: anger 26, 27, 240–​241, 253–​255; anxiety 9, 23, 42, 57–​58; depression 78, 91–​93; envy 303, 316–​317; guilt 110–​111, 123–​124, 129; hurt 207, 221–​222; jealousy 271, 286; regret 143, 158, 163; shame 177, 190–​191, 196

‘challenging, but not overwhelming’ principle: anxiety 53, 54, 63, 65; depression 88; guilt 121; hurt 218; shame 188; unhealthy anger 250–​251; unhealthy envy 314; unhealthy jealousy 283; unhealthy regret 155 chronic problems: guilt 126–​127, 128; hurt 224–​225; shame 193–​195; unhealthy envy 307–​308, 321–​322; unhealthy jealousy 263, 276–​277, 289–​290; unhealthy regret 160, 161–​162 cognitive behaviour therapy (CBT) 11–​12 cognitive reasoning 276, 307 comfort area of personal domain 22–​23 complexity of experiences 329 concern 10, 23; associated behaviour 45–​46; associated thinking 46–​47; case example 57–​58; cost-​benefit analysis 39; flexible/​non-​extreme attitudes 24–​25, 25, 32–​33, 47, 48–​49, 50–​52, 60–​61, 63–​65; goals 43–​47; imagery technique 52–​53; quick reference guide 352–​355; world views 65–​67, 66 cost-​benefit analysis: anxiety/​concern 39; envy 300–​301; guilt/​remorse 107; hurt/​ sorrow 205; jealousy 267–​268; regret 140; shame/​disappointment 174 depression 7, 68–​101; accuracy of inferences 96; activity and 74; additional burden of 98–​99; associated behaviour 71, 79; associated thinking 71–​73, 79; capitalising on learning 90–​91; case examples 78, 91–​93; comparison with self-​anger 239; dealing with a specific example of 84–​85; emotional problems about 96–​99; examining attitudes 85–​87; facing situations in reality 88–​90; flexible/​non-​extreme attitudes 70, 82, 83, 85–​87, 95–​96; generalisation of learning 91–​93; goals 79–​82; imagery technique 87–​88; inference themes 69, 76–​78; ‘magic question’ technique 77–​78; meta-​depression 96–​99; personal domain and 68–​69; quick reference guide 356–​357; responsibility

Index   375

74–​76; rigid/​extreme attitudes 69–​70, 82–​83, 85–​87, 94; selective focus on loss, failure and undeserved plight 94–​96; steps to deal with 73–​93; world views 99–​101, 100 deservingness realm 69 devaluation attitudes 16, 340–​341; anger 245–​246; anxiety 48; depression 83; envy 308, 318; guilt 103, 116, 118, 119; hurt 212; jealousy 263, 277; regret 149; shame 169, 182, 185, 197 disappointment 10; associated behaviour 180–​181; associated thinking 181–​182; case examples 190–​191, 196; cost-​ benefit analysis 174; flexible/​non-​ extreme attitudes 170, 182, 183, 184–​186, 193, 194–​195; goals 178–​182; imagery technique 187–​189; quick reference guide 363–​364; world views 198–​199, 199 discomfort intolerance beliefs 4; see also unbearability attitudes discomfort tolerance beliefs 4; see also bearability attitudes disputing beliefs 5–​6; see also examining attitudes divine forgiveness, guilt and 109 double penalty obstacle: anger 238; hurt 206; jealousy 269 Dryden’s Invitation Technique 196 ego anxiety 32, 64 ego area of personal domain 22–​23 ego depression 69–​70, 98 ego envy 296, 308–​309, 316–​317, 318–​319, 320 ego ‘less me’ hurt 201, 212 ego unhealthy anger 230 emotional goals: anger 242–​243; anxiety/​ concern 44–​45; depression/​sadness 79–​80; envy 304–​305; guilt/​remorse 113–​114; hurt/​sorrow 209–​210; jealousy 273–​274; regret 145–​146; shame/​disappointment 179–​180 emotional problems 7–​8; distinguishing from healthy alternatives 24–​28, 25, 28; healthy alternatives to 8–​11; intensity of 9–​10; underpinning

attitudes 12–​16; see also meta-​ emotional problems emotional reasoning 276, 307, 333 emotional vacuum 9 envy (healthy) 10; associated behaviour 305–​306; associated thinking 306–​307; case example 316–​317; cost-​benefit analysis 300–​301; flexible/​non-​extreme attitudes 296–​297, 308, 309, 311–​313, 318–​319, 322; goals 304–​307; imagery technique 313–​314; quick reference guide 371–​372; world views 324–​326, 325 envy (unhealthy) 7, 295–​326; associated behaviour 297–​298, 304; associated thinking 298–​299, 304; capitalising on learning 316; case examples 303, 316–​317; chronic 307–​308, 321–​322; cost-​benefit analysis 300–​301; dealing with a specific example of 310–​311; emotional problems about 300, 301, 323–​324; evidence of disturbance 307–​308; examining attitudes 311–​313; facing situations in reality 314–​315; flexible/​non-​extreme attitudes 296–​297, 308, 309, 311–​313, 318–​319, 322; generalisation of learning 316–​317; goals 304–​307; imagery technique 313–​314; inference themes 295–​296, 302–​303; ‘magic question’ technique 302–​303; object-​focused 295–​296, 302, 308–​309, 318–​320; person-​focused 295–​296, 302, 308–​309, 316–​317, 320–​321; personal domain and 295–​296; quick reference guide 371–​372; responsibility 301–​302; rigid/​ extreme attitudes 296–​297, 308–​309, 311–​312, 321–​322; self-​esteem and 318–​319, 320; shame and 300, 301; steps to deal with 299–​317; strength of desire for prized object 323; thinking errors 307; world views 324–​326, 325 examining attitudes 5–​6; anger 248–​250; anxiety 50–​52; depression 85–​87; envy 311–​313; guilt 117–​119; hurt 214–​216; jealousy 280–​281; regret 151–​153; shame 184–​186

376   Index

extreme attitudes 3, 12, 13–​16, 24–​25, 25, 28; anger 230–​231, 245–​246, 248–​249, 256; anxiety 24–​25, 25, 32–​33, 47–​48, 50–​52, 59–​60; depression 69–​70, 82–​83, 85–​87, 94; envy 296–​297, 308–​309, 311–​312, 321–​322; guilt 103–​104, 115–​116, 117–​119, 126, 130; hurt 201–​202, 211–​212, 214–​216, 224–​225; jealousy 263–​264, 277–​278, 280–​281, 289; regret 135–​136, 149, 151–​153, 161–​162; shame 169–​170, 182, 184–​186, 193–​194 flexible attitudes 3, 16–​18, 24–​25, 25, 28, 334–​335; anger 230–​231, 245, 246, 248–​250, 257–​258; anxiety/​concern 24–​25, 25, 32–​33, 47, 48–​49, 50–​52, 60–​61, 63–​65; depression/​sadness 70, 82, 83, 85–​87, 95–​96; envy 296–​297, 308, 309, 311–​313, 318–​319, 322; guilt/​remorse 103–​104, 115, 116, 117–​119, 125, 126–​127, 128; hurt/​ sorrow 201–​202, 212–​213, 214–​216, 223, 225; jealousy 263–​264, 277, 278, 280–​281, 288, 290; regret 135–​136, 149–​150, 151–​153, 162; shame/​ disappointment 170, 182, 183, 184–​186, 193, 194–​195 fortune telling 331 frustration intolerance beliefs 4; see also unbearability attitudes frustration tolerance beliefs 4; see also bearability attitudes generalisations 329 generalised anxiety 31 goals: anger 242–​245; anxiety/​concern 43–​47; depression/​sadness 79–​82; envy 304–​307; guilt/​remorse 112–​115; hurt/​ sorrow 208–​211; jealousy 273–​276; regret 145–​148; shame/​disappointment 178–​182 guilt 7, 102–​133; accuracy of inferences 127; apologising and making amends 122; associated behaviour 104–​105, 112; associated thinking 105–​106, 112; capitalising on learning 122–​123; case examples 110–​111, 123–​124, 129;

chronic 126–​127, 128; comparison with self-​anger 239; comparison with shame 168; cost-​benefit analysis 107; dealing with a specific example of 116–​117; divine forgiveness and 109; emotional problems about 131–​132; examining attitudes 117–​119; flexible/​ non-​extreme attitudes 103–​104, 115, 116, 117–​119, 125, 126–​127, 128; generalisation of learning 123–​124; goals 112–​115; healthy self-​care 128; hidden conceit in 128–​129; imagery technique 120–​122; inference themes 102–​103, 110–​111; ‘magic question’ technique 110–​111; personal domain and 102–​103; quick reference guide 358–​359; responsibility 105, 108–​110, 119–​120, 122, 130–​131; rigid/​extreme attitudes 103–​104, 115–​116, 117–​119, 126, 130; safety-​seeking measures 125–​126; self-​compassion 129; steps to deal with 106–​124; world views 132, 133 health anxiety 31 healthy negative emotions (HNEs) 10–​11; distinguishing from emotional problems 24–​28, 25, 28; underpinning attitudes 16–​22 healthy self-​care 128 hidden conceit: in guilt 128–​129; in unhealthy regret 163–​164 high frustration tolerance (HFT) beliefs 3–​5; see also bearability attitudes high standards, healthy orientation towards 129, 163–​164, 186–​187 hopelessness: anxiety and 40; depression and 75, 90; guilt and 109; shame and 175–​176; unhealthy regret and 141–​142 hurt 7, 200–​228; accuracy of inferences 226; associated behaviour 202, 208; associated thinking 203–​204, 208; capitalising on learning 220–​221; case examples 207, 221–​222; chronic 224–​225; cost-​benefit analysis 205; dealing with a specific example of 213–​214; emotional problems about

Index   377

226–​227; examining attitudes 214–​216; facing people in reality 219–​220; flexible/​non-​extreme attitudes 201–​202, 212–​213, 214–​216, 223, 225; generalisation of learning 221–​222; goals 208–​211; healthy orientation towards reciprocity in relationships 216–​217; imagery technique 217–​219; inference themes 200–​201, 206–​208; ‘magic question’ technique 207; personal domain and 200–​201; quick reference guide 365–​366; responsibility 205–​206; rigid/​extreme attitudes 201–​202, 211–​212, 214–​216, 224–​225; safety-​seeking measures 223–​224; steps to deal with 204–​222; world views 227–​228, 228 hurting others’ feelings see guilt ‘I’, Individual and Socially Defined 195–​196 ‘I’m going to bear it’ component 20 ‘I’m willing to bear it’ component 20 ‘I’m worth it’ component 20 imagery technique: anger 250–​251; anxiety 52–​53; depression 87–​88; envy 313–​314; guilt 120–​122; hurt 217–​219; jealousy 281–​283; regret 154–​155; shame 187–​189 Individual ‘I’ 195–​196 inference themes 22, 23–​24, 25, 28; anxiety 23, 31–​32, 31, 41–​42; depression 69, 76–​78; guilt 102–​103, 110–​111; hurt 200–​201, 206–​208; shame 169, 176–​178; unhealthy anger 229–​230, 238–​241; unhealthy envy 295–​296, 302–​303; unhealthy jealousy 262–​263, 270–​272; unhealthy regret 134–​135, 142–​144 inferences, accuracy of 23; anger 258; anxiety 61–​62; depression 96; guilt 127; hurt 226; jealousy 290–​291; regret 162–​163; shame 195 intensity of emotional problems 9–​10 irrational beliefs 3; see also extreme attitudes; rigid attitudes ‘it’s worth it’ component 20

jealousy (healthy) 10; associated behaviour 274–​275; associated thinking 275–​276; case example 286; cost-​benefit analysis 267–​268; flexible/​ non-​extreme attitudes 263–​264, 277, 278, 280–​281, 288, 290; goals 273–​276; imagery technique 281–​283; quick reference guide 369–​370; world views 292–​294, 293 jealousy (unhealthy) 7, 262–​294; accuracy of inferences 290–​291; associated behaviour 264–​265, 272; associated thinking 265–​267, 272; capitalising on learning 285; case examples 271, 286; chronic 263, 276–​277, 289–​290; cost-​benefit analysis 267–​268; dealing with a specific example of 278–​279; emotional problems about 291–​292; evidence of disturbance 276–​277; examining attitudes 280–​281; facing situations in reality 283–​285; flexible/​non-​extreme attitudes 263–​264, 277, 278, 280–​281, 288, 290; generalisation of learning 285–​287; goals 273–​276; imagery technique 281–​283; inference themes 262–​263, 270–​272; ‘magic question’ technique 271; personal domain and 262–​263; quick reference guide 369–​370; responsibility 268–​270; rigid/​ extreme attitudes 263–​264, 277–​278, 280–​281, 289; safety-​seeking measures 287–​288; steps to deal with 267–​287; thinking errors 276; world views 292–​294, 293 jumping to conclusions 328 ‘less me’ hurt 201, 212 low frustration tolerance (LFT) beliefs 3–​5; see also unbearability attitudes ‘magic question’ technique: anger 240–​241; anxiety 42; depression 77–​78; envy 302–​303; guilt 110–​111; hurt 207; jealousy 271; regret 143; shame 177 magnifying 332 meta-​emotional problems 62; about anger 258–​260; about anxiety 62–​65;

378   Index

about depression 96–​99; about envy 300, 301, 323–​324; about guilt 131–​132; about hurt 226–​227; about jealousy 291–​292; about regret 164–​165; about shame 173, 196–​198 mind reading 330 minimising 332 multi-​category thinking 329 ‘negated awfulising’ component 19 ‘negated devaluation’ component 21–​22 ‘negated rigid’ component 17 ‘negated unbearability’ component 20 neutral emotions 8–​9 non-​awfulising attitudes 18–​19, 336–​337; anxiety 49; depression 83; regret 149 non-​ego anxiety 32, 63, 64 non-​ego depression 69–​70, 98, 99 non-​ego envy 296, 308–​309, 319, 320–​321 non-​ego ‘poor me’ hurt 201, 212 non-​ego unhealthy anger 230 non-​extreme attitudes 3, 16–​17, 18–​22, 24–​25, 25, 28; anger 230–​231, 245, 246, 248–​250, 257–​258; anxiety/​ concern 24–​25, 25, 32–​33, 47, 48–​49, 50–​52, 60–​61, 63–​65; depression/​ sadness 70, 82, 83, 85–​87, 95–​96; envy 296–​297, 308, 309, 311–​313, 318–​319, 322; guilt/​remorse 103–​104, 115, 116, 117–​119, 125, 126–​127, 128; hurt/​ sorrow 201–​202, 212–​213, 214–​216, 223, 225; jealousy 263–​264, 277, 278, 280–​281, 288, 290; regret 135–​136, 149–​150, 151–​153, 162; shame/​ disappointment 170, 182, 183, 184–​186, 193, 194–​195 object-​focused anger 240 object-​focused unhealthy envy 295–​296, 302, 308–​309, 318–​320 overcompensation 34 overgeneralising 329 panic 31 person-​focused unhealthy envy 295–​296, 302, 308–​309, 316–​317, 320–​321

personal domain 22–​23; depression and 68–​69; guilt and 102–​103; hurt and 200–​201; shame and 169; unhealthy envy and 295–​296; unhealthy jealousy and 262–​263; unhealthy regret and 134–​135 personal weakness: anxiety as 64–​65; hurt and 206; jealousy and 269; shame and 170, 176 personalising 333 plight/​pity-​based depression 71, 72, 77, 98–​99 ‘poor me’ hurt 201, 212 positive emotions 8 positive experiences 330 prospective regret 135, 140; associated behaviour 137, 146–​147; associated thinking 138, 148; case example 158; chronic 160, 161–​162; goals 146–​147, 148; inference themes 135, 142; myth of perfect decision solutions 154; safety-​seeking measures 159–​160 public speaking anxiety 31 quick reference guides: anger 367–​368; anxiety/​concern 352–​355; depression/​ sadness 356–​357; envy 371–​372; guilt/​ remorse 358–​359; hurt/​sorrow 365–​366; jealousy 369–​370; regret 360–​362; shame/​disappointment 363–​364 rational beliefs 3; see also flexible attitudes; non-​extreme attitudes Rational Emotive Behaviour Therapy (REBT): ABCD form 59, 342–​351; comparison with CBT 11–​12; terminology 1–​6, 6; see also ABC framework realistic thinking 328–​333 reciprocity in relationships 216–​217 regret (healthy) 10; associated behaviour 146–​147; associated thinking 147–​148; case example 158; cost-​benefit analysis 140; flexible/​non-​extreme attitudes 135–​136, 149–​150, 151–​153, 162; goals 145–​148; imagery technique 154–​155;

Index   379

quick reference guide 360–​362; world views 165–​166, 166 regret (unhealthy) 7, 134–​166; acceptance of decision outcomes 160–​161; accuracy of inferences 162–​163; associated behaviour 136–​137, 144; associated thinking 137–​139, 144; capitalising on learning 157; case examples 143, 158, 163; chronic 160, 161–​162; cost-​benefit analysis 140; dealing with a specific example of 150–​151; emotional problems about 164–​165; examining attitudes 151–​153; flexible/​non-​ extreme attitudes 135–​136, 149–​150, 151–​153, 162; generalisation of learning 157–​159; goals 145–​148; hidden conceit in 163–​164; imagery technique 154–​155; inference themes 134–​135, 142–​144; ‘magic question’ technique 143; myth of perfect decision solutions 153–​154; personal domain and 134–​135; quick reference guide 360–​362; responsibility 140–​142; rigid/​extreme attitudes 135–​136, 149, 151–​153, 161–​162; safety-​seeking measures 159–​160; self-​compassion 156–​157; self-​forgiveness 156–​157; steps to deal with 139–​159; world views 165–​166, 166 remorse 10; apologising and making amends 122; associated behaviour 113–​114; associated thinking 114–​115; case example 123–​124; cost-​benefit analysis 107; flexible/​non-​extreme attitudes 103–​104, 115, 116, 117–​119, 125, 126–​127, 128; goals 112–​115; imagery technique 120–​122; quick reference guide 358–​359; responsibility 119–​120, 122, 130–​131; world views 132, 133 responsibility: anxiety 40–​41; depression 74–​76; guilt 105, 108–​110, 119–​120, 122, 130–​131; hurt 205–​206; shame 174–​176; unhealthy anger 236–​238, 259; unhealthy envy 301–​302; unhealthy jealousy 268–​270; unhealthy regret 140–​142

retrospective regret 134–​135, 140; acceptance of decision outcomes 161; associated behaviour 136–​137, 146; associated thinking 138, 147–​148; case example 163; flexible/​non-​extreme attitudes 149–​150; goals 146, 147–​148; hidden conceit in 163–​164; inference themes 134–​135, 142; myth of perfect decision solutions 153–​154; rigid/​ extreme attitudes 149; self-​compassion 156; self-​forgiveness 156 rigid attitudes 3, 12–​13, 24–​25, 25, 28, 334–​335; anger 230–​231, 245–​246, 248–​249, 256; anxiety 24–​25, 25, 32–​33, 47–​48, 50–​52, 59–​60; depression 69–​70, 82–​83, 85–​87, 94; envy 296–​297, 308–​309, 311–​312, 321–​322; guilt 103–​104, 115–​116, 117–​119, 126, 130; hurt 201–​202, 211–​212, 214–​216, 224–​225; jealousy 263–​264, 277–​278, 280–​281, 289; regret 135–​136, 149, 151–​153, 161–​162; shame 169–​170, 182, 184–​186, 193–​194 sadness 10; associated behaviour 80–​81; associated thinking 81–​82; case example 91–​93; flexible/​non-​extreme attitudes 70, 82, 83, 85–​87, 95–​96; goals 79–​82; imagery technique 87–​88; quick reference guide 356–​357; world views 99–​101, 100 safety-seeking measures:​anxiety 33–​34, 43, 53; guilt 125–​126; hurt 223–​224; shame 192–​193; unhealthy jealousy 287–​288; unhealthy regret 159–​160 safety-​seeking thinking 35–​38, 43 secondary emotional problems see meta-​ emotional problems self-​acceptance attitudes: anger 246; anxiety/​concern 48, 49; depression/​ sadness 83; envy 309, 318, 320; guilt/​ remorse 116, 118, 119, 122; hurt/​ sorrow 212–​213; jealousy 278; regret 149; shame/​disappointment 183, 185 self-​anger 239, 259 self-​blame: anxiety 40; depression 75; unhealthy anger 236, 237, 259;

380   Index

unhealthy envy 301; unhealthy jealousy 268 self-​care 128 self-​compassion: guilt 129; regret 156–​157 self-​control, loss of 64 self-​devaluation attitudes: anger 245; anxiety 48; depression 83; envy 308, 318; guilt 103, 116, 118, 119; hurt 212; jealousy 263, 277; regret 149; shame 169, 182, 185, 197 self-​discipline issues 128 self-​esteem: anger and 239, 245–​246; anxiety and 41, 48; depression and 83; envy and 318–​319, 320 self-​forgiveness 109, 156–​157 self-​pity: anxiety and 40; depression and 71, 72, 75, 77, 98–​99; hurt and 201, 212 shame 7, 168–​199; accuracy of inferences 195; associated behaviour 170–​171, 178; associated thinking 171–​172, 178; capitalising on learning 189–​190; case examples 177, 190–​191, 196; chronic 193–​195; comparison with guilt 168; comparison with self-​anger 239; cost-​ benefit analysis 174; dealing with a specific example of 183–​184; emotional problems about 173, 196–​198; envy and 300, 301; examining attitudes 184–​186; facing situations and people in reality 189; flexible/​non-​extreme attitudes 170, 182, 183, 184–​186, 193, 194–​195; generalisation of learning 190–​191; goals 178–​182; healthy orientation towards high standards 186–​187; imagery technique 187–​189; Individual ‘I’ and Socially Defined ‘I’ 195–​196; inference themes 169, 176–​178; ‘magic question’ technique 177; meta-​shame 196–​198; personal domain and 169; quick reference guide 363–​364; responsibility 174–​176; rigid/​ extreme attitudes 169–​170, 182, 184–​186, 193–​194; safety-​seeking measures 192–​193; steps to deal with 173–​191; world views 198–​199, 199 social anxiety 31 Socially Defined ‘I’ 195–​196

sociotropic depression 71, 72, 76, 98 sociotropic realm 69 sorrow 10; associated behaviour 210; associated thinking 210–​211; case example 221–​222; cost-​benefit analysis 205; flexible/​non-​extreme attitudes 201–​202, 212–​213, 214–​216, 223, 225; goals 208–​211; imagery technique 217–​219; quick reference guide 365–​366; world views 227–​228, 228 terminology 1–​6, 6 test anxiety 31 themes see inference themes thinking 26–​28, 28; anxiety 35–​38, 43; concern 46–​47; depression 71–​73, 79; disappointment 181–​182; guilt 105–​106, 112; healthy anger 244–​245; healthy envy 306–​307; healthy jealousy 275–​276; healthy regret 147–​148; hurt 203–​204, 208; non-​ engagement with thoughts 38; remorse 114–​115; sadness 81–​82; shame 171–​172, 178; sorrow 210–​211; unhealthy anger 27, 232–​233, 242; unhealthy envy 298–​299, 304; unhealthy jealousy 265–​267, 272; unhealthy regret 137–​139, 144; see also ‘A–​C’ thinking thinking errors 27, 328–​333; envy 307; jealousy 276 thinking goals: anger 244–​245; anxiety/​ concern 46–​47; depression/​sadness 81–​82; envy 306–​307; guilt/​remorse 114–​115; hurt/​sorrow 210–​211; jealousy 275–​276; regret 147–​148; shame/​disappointment 181–​182 threat-​exaggerating thinking 35, 38, 43 unbearability attitudes 3–​5, 15, 338–​339; anger 246; anxiety 48; depression 83; envy 308, 315, 319; hurt 212; jealousy 263, 277, 284; regret 149 unconditional acceptance attitudes 20–​22, 340–​341; anger 246; anxiety/​ concern 48–​49; depression/​sadness 83; envy 309, 318, 320; guilt/​remorse 116, 118, 119, 122; hurt/​sorrow

Index   381

212–​213; jealousy 278; regret 149; shame/​disappointment 183, 185 working alliance 30 world views: anger 260–​261, 261; anxiety/​concern 65–​67, 66;

depression/​sadness 99–​101, 100; envy 324–​326, 325; guilt/​remorse 132, 133; hurt/​sorrow 227–​228, 228; jealousy 292–​294, 293; regret 165–​166, 166; shame/​disappointment 198–​199, 199