The Intuition Network, A Thinking Allowed Television Underwriter, presents the following transcript from the series Thinking Allowed, Conversations On the Leading Edge of Knowledge and Discovery, with Dr. Jeffrey Mishlove.

PHILOSOPHY IN PSYCHOTHERAPY with ALBERT ELLIS, Ph.D.

   
JEFFREY MISHLOVE, Ph.D.: Hello and welcome. I'm Jeffrey Mishlove. Today we're going to be examining philosophy in psychotherapy. We'll be looking at how our behavior, our emotions, are affected by our ideas. With me is Dr. Albert Ellis, one of the most influential psychologists in the history of psychology. Dr. Ellis is the author of over sixty books and six hundred academic papers. He originally began his career as a sexologist, and as the author of such books as The Art and Science of Love and Sex Without Guilt, and is considered one of the fathers of the sexual revolution of the 1960s. In addition he is considered the grandfather of cognitive behavior therapy, perhaps the most influential psychotherapeutic movement today, and the founder of Rational-Emotive Therapy. Welcome, Dr. Ellis.

ALBERT ELLIS, Ph.D.: It's good to be here, Jeff.

MISHLOVE: It's a pleasure to be with you. You are probably most widely noted for introducing into the field of psychotherapy an idea that seems almost self evident, which is that our behavior, our being, our selves, are affected by our philosophies, by what we think.

ELLIS: Right. And also conversely I introduced many years ago, when I first formed RET, Rational-Emotive Therapy, the idea that our thinking is also affected by our behavior and our feelings.

MISHLOVE: So in effect it's all one system.

ELLIS: That's right, interactional.

MISHLOVE: And that system can therefore obviously be affected by dealing with any part of it, I would assume -- behavior, emotions, or cognition or thoughts.

ELLIS: Right, but if you profoundly change your philosophy, your thinking, then you're more likely in all probability to profoundly change your feeling and your behavior, and especially your disturbed feeling and your disturbed behavior.

MISHLOVE: You drew on the ancient philosophers, coming to the notion that philosophy itself could be a form of psychotherapy. At that point you broke away from psychoanalysis and developed a form of cognitive therapy.

ELLIS: Yes, I practiced and was a psychoanalyst for a while, but then I discovered that it didn't work, and I have a gene for efficiency, while poor Sigmund Freud had a gene for inefficiency. So I went back to my hobby since the age of sixteen, philosophy, the philosophy of the ancients largely -- of Epictetus and Marcus Aurelius, and in the East, of Confucius and Lao Tzu and Buddha -- and amalgamated it with behavior therapy, which I'd used on myself at the age of nineteen to get myself over my phobia of public speaking and of approaching young females.

MISHLOVE: If I could get to the kernel of your thought, it is basically that whatever happens to us in life, it's not totally responsible for our emotions.

ELLIS: Right. It's partly, it contributes to it. A, activating events, contribute to C, consequences in our gut. But it's B, our belief system, our philosophy, which mainly, largely, or certainly in great part, makes us feel and think the way we do -- I should say behave the way we do, especially in a disturbed manner. We disturb ourselves.

MISHLOVE: Typically, I suppose, when a person is very angry or very depressed, they almost always think that it's something outside that's causing that.

ELLIS: Right. And we normally, and I think biologically, tend to think that because C, consequences -- my anger -- immediately follows your treating me unfairly, that you made me angry, instead of you made me feel sorry and regretful to some degree, but my anger I added by commanding and demanding that you not do what you indubitably did.

MISHLOVE: And in a sense, if I'm right, you broke with Freud in suggesting that the parents aren't responsible, early upbringing isn't responsible -- that we teach ourselves these kinds of neurotic behaviors.

ELLIS: Right. We're born gullible to our parents, influenceable, teachable, in the first place. Therefore we stupidly listen to our parents, but then we invent many musts, shoulds, oughts, demands, commands, in addition to the standards, the values, that we adopt from our parents. But the standards don't upset us. We mainly upset ourselves with those Jehovan commands.

MISHLOVE: You've used the term -- I think you must have coined it -- "musterbation."

ELLIS: Right. "Masturbation is good and delicious, but musterbation is evil and pernicious," is one of my sayings.

MISHLOVE: Musterbation is when we tell ourselves, "I must do this," or, "Things must be this way," even though they're not.

ELLIS: Right. The three main musts are "I must do well or I'm no good," "You, you louse, must treat me well or your'e worthless and deserve to roast in hell," and "The world must give me exactly what I want, precisely what I want, or it's a horrible, awful place."

MISHLOVE: It would be awful.

ELLIS: It would be terrible, right. Because of the must. If you didn't musterbate, then you wouldn't awfulize, terribilize, catastrophize, say "I can't stand it," and put yourself down. If you only stuck with, "I'd like very much to do well, but I never have to," you wouldn't then disturb yourself.

MISHLOVE: So the technique that you get engaged in with your clients is one of disputing their musts, their ideas, and showing them that logically, scientifically, philosophically, things are not that way -- that nothing must be, if it isn't.

ELLIS: The technique is a scientific method, and we say -- and we're the only cognitive behavioral therapy which does say -- that when you think antiscientifically, devoutly, really piously, dogmatically, which is inflexible, antiscientific, then you disturb yourself. Therefore we use the flexible scientific method to get you philosophically and otherwise to undisturb yourself.

MISHLOVE: Now, many people, I think particularly the Freudian school of therapy, would suggest that simply being told by your therapist that you're thinking things wrong isn't going to make a bit of difference -- that you'll continue with the same old behaviors anyway.

ELLIS: We would agree -- that being told it, or told where you got it, which is you didn't get it from your sacred mother and father -- won't help you. But the insight that I made myself disturbed, I foolishly listened to my mother and father and took them too seriously, and I'm still doing it, and that now I require work and practice, work and practice, to give up my biological and sociological tendency to disturb myself, that will help you -- not the belief that I disturbed myself and that I don't have to. That will help, but not that much.

MISHLOVE: Doesn't the idea that if you can simply change your philosophy your whole behavior will change, somehow go against the behaviorist concept, or the materialist notion, that the mind doesn't really influence matter? In effect you're saying that the mind will influence.

ELLIS: Very significantly. But we also say that since you practiced, worked at this foolish philosophy, engrained it in yourself, conditioned yourself, that therefore it requires work and practice to give it up, and it requires feeling against it. So we always use cognitive thinking and emotive, dramatic, evocative, and behavioral techniques to get people comprehensively to change and to stay changed.

MISHLOVE: In effect what you say is that every emotional state has its concomitant belief system.

ELLIS: Right -- that even sorrow and regret, which would be appropriate emotions when you're not getting what you want, have the belief system, "It's too bad. Isn't it bad? Isn't it unfortunate?" while horror and depression are, "It's awful; it must not be this way; I can't bear it." So each of the negative, self-defeating states such as depression or anxiety or despair or rage has some individual difference in what you tell yourself, what you believe philosophically.

MISHLOVE: So in a sense the heart of your philosophical approach, then, is to distinguish between what we might call appropriate philosophies, appropriate emotions, and inappropriate ones.

ELLIS: And oddly enough, I discovered after years of doing Rational-Emotive Therapy, RET, that there only are a few differences. And one main difference, and it's crucial, is taking a preference, a desire, a goal, a value, practically all of which are legitimate, and escalating it again, transmuting it into a demand, a should, an ought, a must, an absolute.

MISHLOVE: In other words, the most terrible thing could happen to me -- perhaps I have leprosy, or some kind of fatal disease. Or as I think you pointed out, maybe somebody is slowly torturing me to death. That doesn't necessarily justify me going into a state of depression.

ELLIS: Or of horror.

MISHLOVE: Or of horror.

ELLIS: But it does justify your saying, "I don't like this. I wish it weren't so. What am I going to do about it?" Which you won't do if you're horrified. You'll freeze and make yourself worse. So you control largely, not completely, your emotional destiny and your behavioral destiny, and if you change your basic philosophy of life, then you can change it. You have the power to do so, but you only sit on your rump and don't use that power.

MISHLOVE: How would you distinguish your approach, say, from Norman Vincent Peale, the Power of Positive Thinking?

ELLIS: Well, that is a good one in a limited way, because instead of, "I can't do well," it says, "I can hit the tennis ball better," and it helps you perform better. But underlying this philosophy is, "and I have to, and if I don't hit that damn tennis ball well, there's something rotten about me as a tennis player and a person." So we undermine the negative thinking and don't just cover it up, which will help to some degree, with positive and often Pollyannaish thinking: "Day by day in every way, I'm getting better and better and better" -- that's Coue. But he went out of business because people fell on their face and didn't get better day by day.

MISHLOVE: In effect I guess what you're saying is things may or may not get better; they may even get worse. But they don't have to get awful.

ELLIS: Right. One of the techniques in RET is to show you that you can do better, which is positive thinking, but if you don't, you don't, and even at the very worst -- and we sometimes implode what you may do or what may happen to you at the worst, show you that you don't have to be miserable. My book which is just coming out now, my new book for the public, is called How to Stubbornly Refuse to Make Yourself Miserable about Anything -- Yes, Anything.

MISHLOVE: That's quite a title. You just used a technical term, implode. Why don't we elaborate on that?

ELLIS: Implode means really get into your feeling or your behavior, and do it many times forcefully, vigorously

-- feel the worst, feel very upset -- and then change it to appropriate negative feelings. We're not against feelings, just against inappropriate, self-defeating feelings such as sorrow and regret and frustration and annoyance, which will drive you back to A, activating events, bad events in life, to change them. So we want you to feel, we don't want you to have no feeling, indifference, nirvana, desirelessness, or anything like that, but real feeling.

MISHLOVE: In a sense it would seem that when people awfulize, when they make things awful, they're using that almost as a screen to keep from getting in touch with their genuine feelings of disappointment.

ELLIS: That's right. Their very genuine feeling, their good negative feeling, would be disappointment: "I don't like this. What can I do to change it? How bad, how unfortunate." And they miss that with, "How awful, how horrible, how terrible." And then again they get bad results and sit on their rumps again and do nothing, instead of forcing themselves to go back to the grind and change what you change what you can change and to accept what you cannot.

MISHLOVE: It almost sounds like good old-fashioned American philosophy in some way.

ELLIS: Well, Emerson had some of it, and Thoreau, and some of the American philosophers, and I got it mainly from the original philosophers, and also from their derivatives

-- from John Dewey, who had a good deal of it; Bertrand Russell, the English philosopher; Karl Popper, the great philosopher of science, and other modern philosophers.

MISHLOVE: In effect you're saying if you just live your life more rationally, if you think things through, you'll be saner.

ELLIS: Much saner. But then again you'd better force yourself to do what you're afraid of, and to feel differently. So again RET is always primarily cognitive-philosophic, but very much also emotive, dramatic, evocative and behavioral-active.

MISHLOVE: In your work as a therapist you don't just sit back and calmly philosophize. You try and use philosophical approaches that really get inside of a person, to their own inner thoughts, and work with them to change those inner thoughts, what they tell themselves.

ELLIS: Right. And we teach them to do it. We have homework, cognitive and behavioral homework, so that they as homework can do most of it themselves. That's why our therapy, Rational-Emotive Therapy, is an intrinsically briefer therapy than almost all the others. That's the way it usually, not always, is.

MISHLOVE: When you're dealing with logic, you would admit, I know, that most people are irrational much of the time.

ELLIS: Much of the time.

MISHLOVE: Not only do we feel that we have to be a certain way, and that we must do this, and we can't do that, but we also feel bad if we don't. That is, if I'm a little bit upset, then I feel I must not be, so I make it even worse.

ELLIS: Yes, the secondary disturbance is worse than the primary. The primary is, "I must do well and I'm no good if I don't," or, "You must love me and you're no good if you don't." But the secondary one is, "My God, I feel anxious, I feel depressed, I feel angry, as I must not, as I should not, as I ought not be." And you get anxious about your anxiety, depressed about your depression, guilty about your anger, and then you really --

MISHLOVE: Then you go into a panic state.

ELLIS: That's right, and then you're not able to really correct the primary. And so in RET we first get you over your self-downing about your disturbance, then we go back to the original disturbance, showing how you mainly, largely created it, and how you have the power within you to think differently, act differently, and feel differently, and undo it.

MISHLOVE: A good deal of the philosophical aspects of this, I suppose, has to do with the labels that a person applies to themself: "I am a horrible person."

ELLIS: Right, and we quote general semantics -- Alfred Korzybski, a genius, not a therapist, who said, "When we overgeneralize we render ourselves unsane." So we are against overgeneralized thinking, which again is one of the cores of human disturbance.

MISHLOVE: So you would spend a lot of time, if a person thinks that they're a horrible person, saying, "Well, maybe you did a horrible thing, but that doesn't mean you're always a horrible person."

ELLIS: Right, and you're never a good person. Because if you do a good deed -- save a child, for example, from drowning at the risk of your own life -- that's a good deed. But ten minutes later you might kill somebody, or steal, or lie. So you're a person who does good, valuable, self- helping, and bad, unfortunate, self-defeating things. You are not ratable. We teach people and show them how to not rate themselves. They're being only what they do -- their performances, their deeds, their acts.

MISHLOVE: Consequently, I suppose, when they're angry at someone else, not to damn another person, no matter what they do.

ELLIS: Right. One of the main derivatives of the musts is, "You must do well as I think you must, and if you haven't done what you must, you are a totally rotten individual, and you deserve, again, to never get any joy on earth and maybe roast in hell for eternity." So we are against damnation of you, of other people, and the universe.

MISHLOVE: This must involve, in a sense, an unconditional acceptance of whoever might walk into your office, no matter what they may have done in their lives.

ELLIS: Right. We and the late Carl Rogers had unconditional positive regard or acceptance for people. But we also teach them, which I'm afraid Carl did not, how to regard themselves -- how to teach themselves to always, under all conditions at all times, no matter how badly they act, or who doesn't adore them, to accept themselves, just because they're human, just because they're alive. Period.

MISHLOVE: I guess that aspect of your work is what has caused many people to label you profoundly humanistic.

ELLIS: Oh yes, and I am. One of my best and most popular books, published by McGraw-Hill, is called Humanistic Psychotherapy: The Rational-Emotive Approach, which is a little different from some other so-called humanistic approaches.

MISHLOVE: Well, when a person is really all worked up, in a state of panic, as it were, do you find that disputing with them is effective when they're in that heightened aroused state, or are there other techniques that are more appropriate at such a time?

ELLIS: We have many emotive, evocative techniques. One of them is accepting them ourselves, which is emotive. And we have Rational-Emotive imagery, where we get people to imagine the worst and then feel terrible, and then work on their feeling. We have my famous shame attacking exercise, because shame is the essence of much disturbance, where we get you and other people and our clients to go out and do something asinine, ridiculous, foolish, and not feel ashamed. Now don't get in trouble; don't walk naked in the streets or anything like that. But yell out the stops, if you're civilized enough in your city to have a subway, like we're civilized enough in New York. And stop somebody on the street and say, "I just got out of the loony bin. What month is it?" and not feel ashamed when they look in horror at you and think you're off your rocker, which they think you are but you're really not; you're being very much saner than they are.

MISHLOVE: In other words, it's almost the opposite of positive thinking. You have people really confront their greatest fear.

ELLIS: Right.

MISHLOVE: And then in the middle of the thing that they thought would be the most awful thing that could ever happen to them, they learn that at least it's not totally awful -- that there must be something redeeming about it.

ELLIS: Right. I got this partly because at the age of nineteen I was scared witless of public speaking and approaching young females, and I made myself in vivo, alive, uncomfortably speak in public, so I got over my fear, and now you can't keep me away from the public speaking platform. And approaching those females -- I approached a hundred of them, and I only got one date, and she didn't show up; but I saw cognitively that nothing terrible happened, and I got over my fear of approaching women. So we get people to act against their nutty philosophies.

MISHLOVE: It's as if in a sense when a person thinks that things are hopeless, if you can use your approach to show them one tiny little ray of light, that that's an improvement for them.

ELLIS: That's right. When you say, "I can't stand it," you mean, "I'll die of it," which you won't, or, "I can't be happy at all if you reject me, or I fail an examination." We show you can be happy at all; you can often be very happy, despite the failure, despite the rejection, and therefore nothing is really that hopeless.

MISHLOVE: One of the techniques that I see in your work that strikes me as quite interesting, and a little unfamiliar to me personally, is the use of sarcasm.

ELLIS: Right, we use humor. We're sarcastic about your ideas if you're upset, because when you're unhumorous you take things too seriously, and we reduce your ideas to absurdity. But we never laugh at you, only the way you think and act and feel, and we show you how to laugh at yourself and not to take yourself too seriously, which is what emotional disturbance, again, is.

MISHLOVE: You've even written a whole series of little songs that you teach people to sing, to sort of sarcastically laugh at their own ideas.

ELLIS: Right, rational, humorous songs, to show them that they can look at themselves and what they do and laugh at it, and not upset themselves about it, even when they fail.

MISHLOVE: I suppose the interesting thing about your work, as a whole body of work, is that in today's day and age psychotherapy in general is controversial. Scientists question whether any form of therapy works, but there's quite a bit of research that suggests that these approaches that you've developed are effective with specific problems.

ELLIS: We have about 250 studies of our therapy, mainly RET, but also what is called cognitive therapy, or cognitive behavioral therapy, that shows when you get people to basically change their irrational thinking, they become significantly improved. Almost all those 250, about 80 percent or 90 percent, do. Then we have another 250 studies or so which show that what I call irrational ideas -- "You must do well, and it's terrible when you don't" -- when you endorse more of those, you're more disturbed, and the people who are psychologically and psychiatrically disturbed do endorse more of them, so they look like they're valid. These are experiments. They're not clinical studies, which are always prejudiced by the therapist, but these are objective studies.

MISHLOVE: Some of the reports go rather far, in terms of being able, for example, to help a person get rid of a physiological addiction, like cocaine or alcohol, by working through the cognitive processes that they have.

ELLIS: Yes, cognitivlly and behaviorally. Especially in the San Francisco area, we have Dr. Emmett Belton, who's very good at this, and many of us are. We have a new book on the Rational-Emotive treatment of alcoholism and substance abuse, by myself and some of my collaborators, and we show people that they don't have to get themselves anxious, and when they're anxious they don't have to run for the bottle or the coke or the methadone or whatever they use when they're anxious, and they don't have to put themselves down for being alcoholic or drug addicts. We show them all those things, and if they change their basic attitude and then push themselves to not take the substances, then they can overcome it, and they overcome.

MISHLOVE: In other words, you get at the belief system that they must have, that it would be awful if they don't continue with their addiction.

ELLIS: That's right, because that's low frustration tolerance. The two main things that upset people are, one, "I have to do well and be approved, and I'm no good," but, two, "Things must be easy, and my anxiety or my despair or my depression must not exist, must not exist. I can't stand it, so I'll cop out by taking the alcohol or the drugs." We show them they can stay with the anxiety, define it as a pain in the neck and not as awful, as horrible, and then work using RET to give it up.

MISHLOVE: But when a person's belief system is that they have to -- "I have to have this drug," and they say, "Well, physiologically it's a disease; I know I'm addicted," how do you logically dispute that?

ELLIS: Well, the answer is that some people -- alcoholics, for example, do have a gene for alcoholism, so they find it most difficult to drink one drink and not finish the bottle. But they don't have to drink even one drink, and when they're anxious or depressed or anything, they can say, "Too bad, tough; that's the way I am. I don't have to cover it up or drink to feel better. I'm going to get better by facing my pain and then working through it" -- which again RET specializes in telling them how to do.

MISHLOVE: In a sense it's very much influenced, I think, by the Stoic philosophers, in showing people how to lump life.

ELLIS: Right, and St. Francis' philosophy, and Reinhold Neibuhr, and Alcoholics Anonymous: "Give me the courage to change what I can change, the serenity to accept what I cannot change, and the wisdom to know the difference between the two." That's one of the precepts of RET, which we got mainly from the ancient philosophers.

MISHLOVE: Well, Dr. Albert Ellis, this has been an exciting half hour. We've got just a couple of minutes left, and I wonder if there's any final thought you might like to leave our viewers with.

ELLIS: The main thing is to accept responsibility for what you do -- you do it, it doesn't do itself -- but never to damn yourself for other human beings, no matter how abominable or stupid or incompetent your behavior.

MISHLOVE: No matter how low you've gone, no matter what you've done in your life, you can respect and accept yourself as a human being.

ELLIS: Right, and in a sense you can like yourself and dislike what you do, and acknowledge what you do, and again work to change it. But even if you never change, you are you. You are neither good nor bad. You are a person who does good and bad, self-helping and self-defeating things. Now, how do you stop it and change?

MISHLOVE: In a sense there's a paradox in all of this. It's as if you're telling people they have to face the worst, and in facing the worst there's always a ray of hope, there's always a sense of optimism.

ELLIS: Right. Because you face it, because you don't put yourself down for it, because you see that with hard work and practice -- thinking, emoting, and behaving -- you can change. Because almost invariably you can.

MISHLOVE: Well, Dr. Albert Ellis, it's been a pleasure sharing this half hour with truly one of the giants in the field of psychology. Thank you very much for being with me.

ELLIS: It's good to have been here, Jeff.

END


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