It helps to understand current psychotherapies if you first understand the therapies that preceded them because so many of the current therapies are founded on objections to the original therapies - specifically, psychoanalysis. In the beginning was psychoanalysis and Freud saw the psychoanalysis and said that it was good. Furthermore, he was the "only game in town." Recall that psychoanalysis was based largely on the unconscious and two basic instincts, sex and aggression. As I have mentioned previously humans weren't particularly flattered by this characterization but for the most part accepted it reluctantly because there wasn't anything else that explained why they were so goofy. But this insult to our dignity was like a burr under the saddle. People kept trying to explain human behavior with an explanation that weren't so demeaning - that left us with some dignity. We have already discussed one response to this - Carl Rogers and client-centered therapy. Rogers of course went overboard when he said everybody was just naturally good if you gave them a chance. Others, however, objected more to the psychoanalytic notion that we were irrational and hardly had sense enough to pound sand in a rat hole (as my mother was fond of saying). These people were responsible for the rational therapies and we'll lead off here with Albert Ellis.
Ellis was originally trained in psychoanalysis but got frustrated with the slow pace of therapy that came from having to wait for the patient gain insight on their own. "Why can't I just tell them what the problem is?" Ellis asked, "Why do I have to wade through all this psychoanalytic crap to get to the point?" (Knowing Ellis's tendency to use explicit language, he probably would have used a stronger term than "crap.") So he developed a therapy that would "cut to the chase," so to speak: Rational Emotive Therapy (often abbreviated "RET").
Rational Emotive Therapy basically says that people's emotions mirror what they think. So if you think you're worthless, that will make you feel depressed. The emotive part - the emotion - follows the thought. Or, if you think what you did was morally wrong - like say, not coming to class - you will feel guilty. This is what the "rational-emotive" means - think something and associated emotion will follow. Given that, the way to therapeutic success becomes clear: change the thoughts and you will change the emotion.
But how do you do that? Now we get to the second part of the theory: Ellis thought people were by nature irrational and also taught by society and parents to think irrationally - to believe "crazy" things (his term)like, "I should never make a mistake," or "Everyone should like me" or "I must always be on time." (Because Ellis heard his clients talk so much about what they "must" do, he called this "muster-bating.") But Ellis said these beliefs were irrational because there was no evidence for them. (Had he been in this class he would have undoubtedly pointed out that these beliefs had the burden of proof Whenever a client would say something like I feel guilty because I didn't visit my mother last night, Ellis would respond with his favorite phrase: "Where is it written that you must to visit your mother"? In other words, he was saying that the client was inappropriately feeling guilty because he irrationally thought that people had to visit their mother and were bad if they didn't. This was the guts of RET: Challenge the irrational thoughts and show that there is no evidence of their validity and the distressing emotions associated with them would go away.
According to Ellis, most thinking followed this pattern: First there was a rational statement that described an event or situation. Someone may correctly note that they, say, failed an exam. That's a rational statement. But then, according to Ellis, this perfectly rational statement was followed by an irrational one: "Because I failed an exam, I am a worthless turd who is too dumb to live and will never pass another exam as long as I live." It was the latter thought that was the source of their distress. Ellis would point out to his clients in cases like this that this is an irrational conclusion because one instance is insufficient to conclude that. Then he would proceed to attack the logic from other directions. He would argue forcefully that for their conclusion to be valid, the client would have to take several exams over time and fail every one of them - and from several different instructors teaching several different courses. And Ellis might go on to say, "And suppose that did happened? Would that be so bad? What's wrong with being a worthless stupid turd? God knows you'd have plenty of company." Ellis was famous for that kind of dialogue - that and his obscene language.
This tendency for people to exaggerate any misfortune into a major calamity, Ellis called "catastrophizing" or "awfulizing." The slightest inconvenience, according to Ellis, was enough to cause hyperbolic ("highly exaggerated") negative interpretation. If the client failed at something - why, that was the most awful thing that had ever happened since the beginning of time. If they didn't get a job they wanted or the person they loved didn't love them, it was AWFUL. If they failed at something, they were totally inept and they would never again succeed at anything they tried. If they committed some slight indiscretion, they were the most evil person who ever lived. In therapy Ellis often challenged the rationality of these extreme responses and tried to show how silly it was by making exaggerated sarcastic responses. ("You were late for an appointment? Well, I'm not sure I should be seen with such a (expletive deleted). Hold on while I call the governor to ask that you be executed at dawn for that unspeakable crime against humanity.") Often his hyperbolic responses would have the client convulsed in gales of laughter– which I guess is good.
Some more of Ellis's wild therapeutic antics: He would have the client stand in the middle of a large department store and call out the seconds in a loud voice. Once he had a woman get on a bus wearing a hat that had condums hanging from the rim. He called these "shame-attacking exercises" and they were designed to show the client how silly it was to be upset by what other people thought.
The latest in RET has been the pseudo-update of adding a "B" to the formula. Now it's REBT which stands for "Rational-Emotive-Behavior Therapy. We could entitle this development as "Albert Ellis Meets B.F. Skinner." I think this merger is caused by the wild success of behavior treatments to the extent that almost any therapy which doesn't purport to include the concepts of Behaviorism could not be considered up-to-date. The new version, is virtually the same as the old version. You may want to check out this website.
My opinion is that this therapy works because the client has someone who he respects telling him/her they shouldn't be upset – but that's my jaded opinion.
It is important to note that RET is quite different from client-centered therapy. It does not provide a whole lot of "unconditional positive regard" since criticism of the client is common. Also it gets pretty directive as when the therapist tells the client what is rational and what is not. It should also be noted that sometimes RET can have an undesirable effect by giving people an excuse to be irresponsible. I once recall talking with a husband whose wife had been in RET. He said that she refused to clean the house or cook dinner and that when he asked her to, she replied "Where is it written that I am supposed to do the chores of a housekeeper?" (Keep in mind that she didn't work outside the home.) And imagine the employee who adopted the philosophy of RET in a confrontation with his boss over his poor performance: Boss: "Your sales are way down this month." Employee: "Where is it written that I must meet your expectations to be adequate?" Boss: (You fill in the response!)
At some point I would also like to demonstrate this technique in class.
This rational style of therapy appealed to a lot of therapists and clients alike - they liked using a rational approach to solving problems. As a result there were a lot of RET "lookalikes" brought out - some of them obvious hybrids like "RBT" (Rational Behavior Therapy), Beck's "Cognitive Therapy" and Glasser's just plain "Rational Therapy." Ellis, not willing to share credit for his creation, said these were all just variations on his therapy and were not really new therapies. I think Ellis is a good person but has some questionable ideas (where did I borrow that from?)