Saturday, September 8, 2012

Rational Emotive Behavioral Therapy - my go-to approach in treating eating disorders... this is why

This blog is a discussion post I submitted for a class in my graduate program called Counseling Theories and Practice. I thought some might find it of interest... Our professor posed a question:

-What is the main theory you would choose as a framework for practice? Why?
a) How does this theory reflect your beliefs about human nature; what makes people "tick"?
b) How does this theory reflect your personal style, qualities, strengths, and values?

This is how I answered:

    The theory I most gravitate towards when thinking of my goal as a future Eating Disorder and Body Image therapist is Rational Emotive Behavioral Therapy. Eating disordered thought revolve around faulty thinking, catastrophizing cycles, and self-destructive emotions. The words “should, ought, must” are staples in the vocabulary of a disordered eater. Because of their irrational beliefs and standards, they set themselves up for failure; when they do fail, it is an utter catastrophe in their eyes.
     I fully agree with the statement in the text on p.251 that "people's cognitions are the primary source of their difficulties." In order to get someone to think more rationally, distorted thoughts have to be identified, evaluated, disputed and changed in order to facilitate a switch in perspective from irrational to rational in order to improve resulting emotions and behaviors. Albert Ellis developed an easily approachable solution that a therapist would initially teach a client to use so the client can continue on to self-treat throughout their lives. This, of course, is the ABCDEF Method in which irrational belief systems are disputed and the client can recognize that they ultimately have the choice. 
     I like that REBT goes further than that though as well. REBT recognizes that frustration tolerance is key to being able to cope as it stresses that life will not always go as planned. No kidding, right? This is needed to avoid catastrophizing and becoming easily disappointed. For example, in the eating disorder world, one might attempt to restrict. This makes for high levels of anxiety in their pursuit of “being good”. Once the restrictor fails to restrict by overeating or “binging”, extreme, awfulized and catastrophic beliefs take over which cause depression, anger, disappointment, guilt, etc. I thoroughly believe that if an eating disordered individual is taken through the steps in the ABCDEF model, they can restructure by disputing their irrational and catastrophic beliefs which will allow them to recognize they have a choice in how to label their beliefs. In turn, they can build a more rational belief system and develop new feelings and behaviors which can ultimately stop their eating disordered cycle.
    One of the three levels of insight described in the text states, "The insight to see that we choose to upset ourselves" (p.255).  REBT also recognizes that we, as individuals, always have a choice. Once a client can recognize their irrationality and distorted beliefs, they can choose an alternative and rational thought. Once someone is able to process their phenomenological view and how it may involve some irrationality, they can become their own therapist and dispute faulty thinking and live a much more serene and positive life in the present and future.
    My idea regarding human nature is certainly that all people are innately good. I am a firm believer that societal standards and negative life experiences can make any person lose sight of rationality and an ability to self-control. I believe that when one sets absolutes (shoulds, oughts, musts) about themselves or their lives, they are setting themselves up for failure. Failure, irrationality and recurring awfulizing thoughts make people tick, and jerk, and spaz... Once the sight of logic is lost, so is the nondefeating, appropriate and rational mind.
    As a future eating disorder therapist, the theory of REBT reflects my values, strengths and qualities in many ways. On a personal level, I have suffered through an eating disorder and I know very well the irrationality surrounding it’s perpetual cycle. My strengths are reflected in the sense that I will have the ability to be patient with a client in this disputation process. I feel as though I am good at educating clients and pointing out self-defeating thought processes empathetically. My personal style, in fact, is based around education. I thoroughly believe that if a client has not learned something in therapy, simply talking about their problems and faulty beliefs won’t make a bit of difference. In fact, it could make them worse off. Education is needed to promote recovery or problem solving. And, education and awareness are needed to promote prevention of relapse or future problems.
    Rational Emotive Behavioral Therapy; although it is similar to cognitive therapy, I prefer the structure involved in the disputation process of REBT. I will bring disordered eaters into recovery with this theory, of this I am certain.

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