Rational-emotive-behavioral therapy. Rational psychotherapy: example and exercise techniques

Cognitive psychotherapy emerged as an independent field in the 1960s. Currently, it is one of the most common areas. Cognitive psychotherapy, based on the most modern developments in the field of scientific psychology, is based on two fundamental ideas about a person:

• a) as a thinking and active person;
• b) reflective and capable of changing oneself and one’s life.

The central category of cognitive psychotherapy is thinking in the broad sense of the word. The main postulate is that it is a person’s thinking (the way he perceives himself, the world and other people) that determines his behavior, feelings and problems. For example, a person who is convinced that he is helpless, when faced with difficulties and problems, will experience feelings of anxiety or despair, a state of disorganization, and therefore try to avoid independent decisions and actions. Such a person constantly has thoughts flashing through his head: “I can’t handle it,” “I’m not capable,” “I’ll disgrace myself,” “I’ll let him down,” etc. Moreover, these thoughts and beliefs may be in direct contradiction with his real opportunities and abilities. However, they are the ones who determine his behavior and performance results.

Restructuring such irrational beliefs and situationally arising thoughts allows you to get rid of difficult experiences and makes it possible to learn how to more constructively solve various life problems. This is exactly the kind of work that is necessary for people suffering from severe emotional problems: anxiety, depression, attacks of irritation and anger. Cognitive psychotherapy has developed a system of highly effective technologies, techniques and exercises aimed at restructuring maladaptive thinking and developing the ability to think more realistically and constructively.

Although cognitive psychotherapy as an evidence-based approach is new, its origins go back to ancient times. One of the fathers of cognitive psychotherapy can be considered Socrates, a sage who became famous for his dialogues, in which he masterfully revealed the errors and distortions of the human mind, thereby helping people get rid of the unbearable fear of death, inconsolable sadness or self-doubt. In every nation there were such sages who had the skills to work with erroneous beliefs, failures of logic and “idols of consciousness” (Francis Bacon). However, in cognitive psychotherapy this art is transformed into a thoughtful and scientifically based system of assistance.

The cognitive model of psychotherapy is based on the idea that emotional disorders are a consequence of both a person’s certain predisposition to them (heredity, as well as experiences acquired in early childhood), and the circumstances of his current life (the influences he experiences, to which he reacts).

Aaron Beck (born 1921) is an American psychotherapist and founder of cognitive psychotherapy. After graduating from Brown University and Yale Medical School, A. Beck began his career in medicine. Initially he was attracted to neurology, but then he turned to psychiatry. While conducting research to validate Freud's theory of depression, A. Beck began to ask questions about the theory itself and soon became disillusioned with it. A. Beck encouraged his patients to focus on so-called “automatic thoughts” (the meaning of the term will be explained later).

Beck's main works: “Cognitive therapy and affective disorders” (1967), “Cognitive therapy for depression” (1979), “Cognitive therapy for personality disorders” (1990).

Rational-emotive psychotherapy (RET) is a method of psychotherapy developed in the 1950s. clinical psychologist Albert Ellis. Initially called rational psychotherapy, since 1962 this method has been called rational-emotive therapy ( rational-emotive therapy).

Albert Ellis (born 1913) received his bachelor's degree in 1934 from City College of New York; He received his Master's and Doctor of Philosophy degrees in 1943 and 1947 from Columbia University. A. Ellis underwent psychoanalytic training and three years of personal analysis. Unlike A. Beck, A. Ellis was more inclined to consider irrational beliefs not by themselves, but in close connection with the unconscious irrational attitudes of the individual. Further observations led him to the idea of ​​negative thoughts as a source of emotional disturbances. In 1958, A. Ellis founded the Institute of Rational Living, and in 1968 - the Institute for Advanced Studies in the Field of Rational Psychotherapy. A. Ellis - winner of numerous awards; has published over 600 articles, book chapters and reviews. He is the author or editor of over fifty books and a consultant to twelve psychotherapy journals.

In addition to A. Beck and A. Ellis, Martin Seligman (explanatory style), Jeffrey Young (early maladaptive schemas), Leon Festinger (the theory of cognitive dissonance), Marsha Linen (cognitive-dialectical psychotherapy of borderline personality disorder) made great contributions to the development of the cognitive-behavioral direction ) and many others.

In this publication we will not dwell on the differences between individual branches of one direction, especially since the boundaries are becoming more and more blurred. A. Beck's cognitive psychotherapy also included behavioral techniques, so we will consider the terms “cognitive” and “cognitive-behavioral” as synonyms.

The basic formula of cognitive therapy is presented in Fig. 3.

Rice. 3. A - activating event; B - intermediate variables (thoughts, attitudes, beliefs, rules) that predetermine a certain perception of the event; C - consequences of the event, including both emotional (Ce) and behavioral components (Cb)

For example:

A - Maria has a headache.

B - Maria thought: “I’m having a stroke.”

Xie - Maria began to panic.

St. Mary ran to the hospital to undergo an examination.

The cognitive model of psychopathology attributes a central role to unproductive thinking in the occurrence of protracted depressive, anxious, and aggressive reactions. Cognitive distortions lead to the individual not adequately reflecting reality, and therefore his ability to cope with difficult situations such as various kinds losses, threats, obstacles are difficult, which increases their negative impact on him.

Cognitive behavioral psychotherapy aims to change, first of all, emotions and behavior by influencing the content of thoughts. The possibility of such changes is based on the connection between thoughts and emotions. From a CBT perspective, thoughts (beliefs) are the main factor determining emotional state and behavior. How a person interprets an event is the resulting emotion he has in this situation. Not external events and people cause negative feelings in us, and our thoughts about these events. Influencing thoughts is a shorter route to achieving change in our emotions and therefore behavior.

The emergence of maladaptive cognitions (attitudes, thoughts, rules) is associated with the patient’s past, when, perceiving them, he did not yet have the skill to conduct a critical analysis at the cognitive level, did not have the opportunity to refute them at the behavioral level, since he was limited in his experience and had not encountered still with situations that could refute them, or received certain reinforcements from the social environment.

Cognitive psychotherapy involves mutual cooperation between the therapist and the patient in a relationship between them that approaches a partnership. The patient and psychotherapist must at the very beginning reach an agreement regarding the goal of psychotherapy (the central problem to be corrected), the means of achieving it, and the possible duration of treatment. For psychotherapy to be successful, the patient must, in general, accept the basic tenet of cognitive psychotherapy about the dependence of emotions and behavior on thinking: “If we want to change feelings and behavior, we must change the ideas that caused them.”

The term "maladaptive cognition" applies to any thought that causes inappropriate or painful emotions that make it difficult to solve a problem, leading to maladaptive behavior. Maladaptive cognitions, as a rule, are of the nature of “automatic thoughts”; they arise without any preliminary reasoning, reflexively, and for the patient they always have the character of well-founded, unquestioned beliefs. They are involuntary and do not attract his attention, although they direct his actions.

Cognitions can be at different levels. The most superficial of them is the level of automatic thoughts, the fundamental is the deepest beliefs.

Deep beliefs are a fundamental level of belief, usually formed in childhood. The formation of deep attitudes is significantly influenced by the characteristics of intrafamily relationships. Deep beliefs are difficult to correct.

Intermediate beliefs occupy a position between deep beliefs and superficial beliefs. They are formed on the basis of deep-seated beliefs, more often formulated as rules, assumptions, life principles.

Automatic thoughts are a stream of thinking that exists in parallel with a more overt stream of thoughts (A. Beck, 1964). Automatic thoughts arise spontaneously and are not based on reflection (thinking, thinking). People are more aware of the emotions associated with certain automatic thoughts than the thoughts themselves. However, this is easy to learn. Meaningful thoughts evoke specific emotions depending on their content. They are often short and fleeting and can take verbal and/or figurative form. People usually accept their automatic thoughts as truth, without thinking or soberly evaluating them. Identifying and assessing automatic thoughts, as well as rational (adaptive) responses to them, contribute to improving the patient’s well-being (Judith Beck, 2006). Automatic thoughts are formed under the influence of intermediate and deep-seated beliefs; there can be a huge number of them: the deeper the level, the fewer attitudes. All attitudes can be imagined as an inverted pyramid, the base of which is automatic thoughts, and the top is deep installations. A cognitive map is a graphically presented relationship between attitudes at different levels that lead to problems in the emotional and/or behavioral sphere.

In Fig. Figure 4 shows an example of a cognitive map of a patient suffering from alcohol dependence (According to R. McMullin “Workshop on Cognitive Therapy”).

Rice. 4

Graphically, the relationship between settings at different levels is shown in Fig. 5 (see p. 80).

Rational emotive therapy - A direction in cognitive psychotherapy (Albert Ellis), based on eliminating the irrational judgments of a patient suffering from neurosis. The key is the so-called ABC theory, according to which, a certain negative manifestation of emotion (frustration, disappointment) or behavior (C) is awakened to life not directly by any event (A), but only indirectly, through a system of interpretations or beliefs ( IN). The goal of psychotherapeutic work is to detect and eliminate the system of pathogenetic interpretations that lead to disturbances in emotional and behavioral reactions.

Ellis emphasized that people do not have direct reactions to most situations, and that emotional reactions depend on the way they perceive events. Thus, it is not events that excite, upset, irritate or anger us, but the way in which a person interprets and makes sense of them.

Illustration: a child hears his father yelling at him and gets upset; however, the housemate who hears exactly the same “objective stimuli” does not react at all to this parental outburst (or reacts differently: gets angry, for example).

Ellis is based on the fact that people can and do have maladaptive and irrational ways of interpreting events, causing emotional disturbances of such intensity that cannot in any way be justified by a real rational assessment of the event.

Ellis models emotional behavior in a sequence that is easy to remember as a simple ABC mnemonic:

The relationship between A and C is unpredictable if we do not know B. That is, if we know that such and such an individual found himself in such and such a situation (for example, his leg was crushed in public transport), but we do not know the model of the human world (at least in key points), then the consequences of his actions are difficult to predict (a person with a crushed leg can cause a scandal, he can cry, he can start reading notations, he can ignore him, he can immediately get into a fight...).

Types of irrational judgments

Ellis divided irrational judgments into four types:

1. "Obligatory" indicate that someone (or something) should be different from what it is ("I should win the game", "He should be nice to me", "Everyone should be honest with me") . Such judgments are based on some kind of obsessive goal setting.

2. "Horror" judgments are based on the fact that everything is terrible, creepy and nightmarish, because everything is not as it should be (“It will be terrible if I don’t finish cleaning before my husband arrives,” “It’s terrible that my plan was figured out, now I’m finished "). Such judgments are made based on strong negative emotions, in this case there is a “fear of horror”.

3. Judgments "proper" reflect a person’s inability to withstand or tolerate the world if it differs from what he “should” or “should” be (“I can’t stand it if it turns out that my best friend is a deceiver,” “Everyone around me turns out to be enemies, and I I can't bear it."

4. "Censure" judgments belittle a person (one’s own or that person’s because of whom the situation has become different from what it “should” or “should” be). Such judgments are based on an infantile model of the world, in which people are divided into good and bad, kind and evil, and also an infantile idea of ​​​​the duty of each person to reward or punish good or bad. Examples: “He is a terrible person, he should be punished for being late,” “If he says one more bad word to me, I will understand that he is a scoundrel, and then I will take revenge on him.”

Twelve Basic Irrational Ideas According to Ellis

In more detail, Ellis identified the most typical, “core” irrational ideas that explicitly or implicitly underlie most emotional disorders.

1. For an adult, it is absolutely necessary that every step he takes is attractive to others.

2. There are vicious and nasty actions, and those guilty of them should be severely punished.

3. It's a disaster when everything doesn't go as we would like.

4. All troubles are imposed on us from the outside - by people or circumstances.

5. If something scares or causes concern, you need to be alert.

6. It is easier to avoid responsibility and difficulties than to overcome them.

7. Everyone needs something stronger and more significant than what he feels in himself.

8. You must be competent, adequate, reasonable and successful in all respects. You need to know everything, be able to do everything, understand everything and achieve success in everything.

9. What greatly influenced your life once will always influence it later.

10. Our well-being is influenced by the actions of other people, so we must do everything to ensure that these people change in the direction we desire.

11. Going with the flow and doing nothing is the path to happiness.

12. We have no control over our emotions and cannot help but experience them.

Typical scheme of work in RET

1. Prove to the client the validity of rational-emotive therapy. Explain the theoretical foundations of RET in accessible language. Consider examples from life. Introduce the ABC model and reveal to the client the core idea of ​​the therapy. Give an example of irrational and rational thoughts caused by a social event that would be understandable and close to the client. Discuss what rational or irrational behavioral and emotional consequences these judgments may lead to.

2. Obtain the client’s consent to consider his own irrational judgments using the RET apparatus.

3. The therapist discusses and challenges the client's irrational judgments. Present a list of identified irrational statements and discuss with the client why these statements are irrational and what rational statements can replace them. It's a good idea to write down these rational statements.

4. The client is encouraged to develop his own arguments against irrational judgments, practice them, and replace the irrational judgments with more appropriate appraisals of the activating events. Encourage the client to define their own situation. Discuss with him what irrational thoughts come to his mind in such a situation and what consequences this situation most often leads to. Write down these imaginable consequences and encourage the client to generate and write down more rational thoughts.

5. Development of new rational and realistic judgments about events, actual and possible. At this final stage, it is important to develop and strengthen the client's "repaired" model of the world.

6. Encouraging the client to identify irrational thoughts, feelings and actions that arise in certain problematic situations. Situations must be specific, causing certain difficulties. It is preferable, for example, to say: “When I see an attractive girl, I think... What if I can’t find anything to say... And so I stand there, staring like a fool, with my mouth open...” (to This statement can be applied to irrational thoughts No. 3 and No. 8 from the list of irrational ideas). Less preferable are general statements such as “When I am around people, I have no self-confidence.” In order to help clients cover all the conflicts of problem situations, we used a simple imagination technique. Clients are asked to close their eyes, relax, and imagine problematic situations that recently occurred, and then talk about the thoughts and feelings they had in those specific situations.

7. After identifying several situations, you need to order them according to the criterion of difficulty (you can rely on the degree of stress of the situation). If possible, situations are arranged in a hierarchy.

8. The therapist presents each of the problem situations, starting with the easiest. Situations are presented in discussion, in imagination, in real life. The client is instructed to describe his feelings and thoughts during each presentation. The purpose of the exercise is to ensure that a certain emotional state becomes a signal to search for irrational thoughts. At this stage, thoughts will appear less carefully packaged and labeled. The therapist's job is to delve deeper into the client's statements and compare them. When the therapist decides that he is able to formulate the client's thoughts, he can either ask the client to generalize which irrational judgment is dominant in him, or he can make a generalization himself.

9. As each irrational idea is presented, it is challenged by the therapist. The therapist then gradually encourages the client to take on the role of challenger. This process is controversial. The client is asked whether his judgments are 100% true, inevitable and based on irrefutable facts. Counterexamples are presented, and the client is led to formulate more rational judgments about the activating event and imagine what results these rational judgments might lead to.

10. The client is presented with activating events (in imagination, in a role-play or in real life) and asked to practice rational alternatives in the presence of the therapist. The therapist teaches the client how to control his emotional reaction (here the “fear thermometer” method with divisions from 0 to 100 points is most convenient). In the initial stages, the therapist also acts as a prompter and compiler of rehearsed rational judgments. Monitoring and exercises continue until the activating event no longer causes intense emotion.

Hometasks

On different stages therapy, you can give the client homework, the completion of which the client talks about at subsequent meetings. Here are examples of homework:

1. Ask the client to identify (in addition to those discussed in the sessions) two more of his real life problems and identify the ABC sequence in them. Let him try to find more rational judgments and study the consequences to which they can lead.

2. The psychotherapist asks the client to try the technique of turning irrational judgments into rational ones in real life situations. Records of this practice and the improvements achieved are recorded in a diary.

Rational Emotive Therapy (RET) by A. Ellis

Continuing the conversation about cognitive psychology and psychotherapy, it should also be noted the developments of another of its representatives - Albert Ellis. Like Beck, Ellis gave great importance namely the cognitive sphere of a person, which was completely ignored by the behavioral approach to therapy popular at that time.

In 1955, Albert Ellis proposed a new type of therapy, which he called rational therapy. He wanted to emphasize that the basis of our psychological problems is not so much specific events as our irrational attitudes, irrational beliefs that prevent us from accepting life as it is. In 1961, having improved and supplemented his therapy, Ellis gave it a new name - rational emotional therapy, abbreviated RET. It is still used under this name, although Ellis himself renamed it again in 1993 rational emotive behavior therapy, or REBT, thereby emphasizing the importance of attention to the real behavior of the client, which allows it to be classified as both behavioral and cognitive psychotherapy. The new name never caught on, and despite the fact that the latest version of therapy is now being used in work, it is called by its former name - RET.

If behavioral therapy seeks to change behavior by transforming external conditions, then RET sees its task in changing emotions, and then behavior, through transforming thoughts. The essence of the RET concept can be reflected in the diagram: A-B-C, where A - activation event - exciting (activating) event; B - belief system - belief system; C - emotional consequence - emotional consequences. An emotion seems to immediately follow the activating event, but Ellis believed that a person's thoughts and beliefs necessarily lie between them. Anxiety and other negative emotions are initiated by irrational cognitions. Ellis believed that such irrational thoughts and beliefs must be examined and exposed by rational thinking. This will help you overcome them and the negative feelings they provoke.

Ellis identified two types of cognitions: descriptive and evaluative. Descriptive (or describing) - represent relatively objective information about reality, evaluative - express a person’s attitude towards what is perceived. The latter are associated with varying degrees of rigidity: evaluative cognitions can be close to reality and very far from it. Ellis called the latter irrational judgments, which include errors such as incorrect conclusions, absolutization, exaggeration, simplification, etc.

One of the goals of Ellis therapy is to separate the negative feelings, emotions and beliefs that are periodically present in any person into rational and irrational. In other words, there are events that inherently should cause sadness, sadness, and some dissatisfaction; this is a normal reaction of a healthy person. But sometimes experiences arise on the basis of irrational beliefs, for example, when a person suffers because, having set himself unrealistic goals, he cannot achieve them, or because he cannot accept reality as it is, he suffers from the fact that nothing impossible to change. Feelings with such a basis do not help solve problems. It should be noted that Ellis did not use the concept of “irrational” in the sense of pathology. He called rational that which helps a person achieve the goals that he really needs, and irrational - everything that prevents this, and it is precisely certain beliefs - “cognitions” that interfere.

Ellis primarily classified absolutist cognitions as irrational beliefs. These are various oughts - categorical and inflexible, when a person perceives the world through the concepts of “must”, “necessary”. For some, this “should - shouldn’t” extends to themselves and their immediate circle of friends, for others - and to the distant one, for others - it generally reaches the existential level, that everything in the world is not so and should be different. Ellis believed that the most important point in gaining mental health is the refusal of absolutization - “should” must be replaced with “it would be necessary,” “it would be nice,” “I would like.” That is, to soften the rigidity of demands on oneself, others, and the surrounding reality, which drive a person into intolerable internal discomfort and create the same unbearable discomfort for others. Instead of being pleasant, a person sticks out his hard corners in all directions and then is surprised that no one approaches him. This is because you can get cut off and hit on these corners.

Irrational ideas lead to negative emotions (depression, anxiety, anger, guilt), which seriously interfere with the achievement of goals. They underlie dysfunctional behavior, such as avoidance of decisions, the habit of procrastination, alcoholism, etc. At the same time, cognitions create programs of self-fulfilling prophecies due to constant exercise and reinforcement, i.e., a vicious circle arises - a negative judgment causes a negative emotion, which confirms a negative judgment, such as “everything is bad.”

Ellis paid great attention to the first (initial) acquaintance of the psychotherapist with the patient.

Here sample instructions RET psychotherapist:

“The therapy we begin is aimed at teaching you to manage your emotions and get rid of negative experiences. In the first stages of work, you will be given the opportunity to understand the ways in which you have created your negative feelings. You can also change these ways and thereby experience other, positive emotions. All this will require you to be active in your work both here and at home, since therapy involves doing homework, listening to audio recordings, and reading specialized literature. I am not a magician or wizard who will instantly save you from your problems. I can be a guide who will help you walk the road to your desired goal” (Fedorov A.P., 2002).

It must be said that Ellis did not share the opinion of representatives of Rogerian humanistic therapy about the decisive role of empathic support without the active intervention of the therapist. Ellis agreed that the client must be accepted as he is, but believed that this, however, should not exclude the appropriate activity of the psychotherapist, who can, if necessary, criticize the patient and expose his erroneous judgments. Ellis believed that uncritical, benevolent acceptance of the patient perpetuated his problems, as often happens in the family. And he especially actively recommended attacking the self-tyranny of obligation, when the patient drives himself into stress and anxiety with inflated demands on himself and others.

Based on a large practical experience Ellis differentiated approaches to patients different types. Thus, he recommends avoiding an overly friendly, emotionally charged style of interaction with “hysterical” patients; an overly intellectual style with “obsessive-compulsive” patients; an overly directive style with people whose sense of autonomy is easily shaken; overly active style with patients who too quickly become passive.

Let's consider the stages of emotional rational therapy.

First, you need to identify and verbalize (clearly express in words) irrational beliefs. Wherein Special attention is given to absolutist cognitions, which are manifested in the patient’s use of the words “must,” “must,” and “necessary.” This so-called tyranny of obligation becomes the main object of therapeutic work. The therapist must show the client how this belief system weighs on him.

Once core irrational beliefs have been clarified, the work of restructuring these cognitions at three levels begins: cognitive, emotional, and behavioral.

At the cognitive level main task The therapist’s goal is to force the patient to abandon perfectionism (inflated demands for perfection), showing him that this will already make his life simpler and more joyful.

Socratic dialogue and cognitive debate are used here (step-by-step bringing the client’s beliefs to the discovery of their incorrectness and harmfulness).

To influence the emotional damage, the drama of preferences and oughts is played out to distinguish between these two phenomena - “it would be better” and “should” with the help of role-playing games. Persuasion is carried out at the emotional level.

To enhance the emotional background, the therapist can, for example, invite members of the therapeutic group to tell one of its participants what they think about him, or encourage participants to admit their shortcomings, “shameful” feelings (envy, hostility, etc.). To do this, patients will have to show courage and make an effort on themselves, but as a result they will see that the group does not judge them, accepts them as they are, and the participants will be able to experience a sense of mutual trust and intimacy. To enhance this effect, Ellis used techniques that brought sensual pleasure: a friendly hug, stroking, expression kind words, which patients previously did not dare to undertake.

At the behavioral level, work is aimed not only at eliminating symptoms, but also at changing cognitions. For example, perfectionistic tendencies can be reduced by the following therapist tasks:

• ? overcome shyness and make a date;
• ? deliberately fail when speaking in front of an audience (therapeutic group);
• ? imagine yourself enduring a situation of failure;
• ? imagine yourself in difficult circumstances and accept them;
• ? allow yourself a pleasant activity only after completing an unpleasant but necessary task;
• ? start doing something right away, without putting it off until later, while enduring the discomfort of fighting the habit;
• ? take on an unpleasant task for the sake of deferred goals;
• ? from time to time behave as an already rational person (so that the patient can understand that change is possible).

Albert Ellis sought to bring emotional and rational perception to the same level, that is, to show a person his true needs, and not the real ones that possess the patient, false or unrealistic, overestimated or underestimated needs. The work of a psychotherapist should consist largely of revising the client’s goals and desires, assessing them - is this really what he needs, or does it just seem to him that maybe these are far-fetched, not true needs, and they are the ones that drain energy from achieving what is really truly needed?

Ellis believed that For psychological well-being, a person needs to have important life goals and actively strive to achieve them. Therefore, one of the therapist’s tasks in cognitive counseling is to analyze what goals his client sets and what he does to achieve them. After all, goals can be the most “rational” ones, but at the same time a person doesn’t really do anything to achieve them, he only thinks about it, but puts everything off until later. So, for example, a person decided to find a job, but every day he finds reasons to postpone the search, being distracted by all sorts of other things not related to the goal. Start, act, and along the way something will be added that will strengthen your position! Because deferred actions, if we recognize their necessity, give rise to neuroses, and those, in turn, are aggravated by further inaction. Therefore, if a person really understands that he needs to act, he should begin to act without fear of failure. There is a very good proverb: “Not every action brings success, but there is no success without action.” We must understand that not every step promises us success, but if we do nothing at all, then there will be no success. This is a very therapeutic proverb and can be used to counter a client's resistance. “Well, I acted and acted - and nothing happened.” And you immediately remember: “Not every action brings success, but there is no success without action.” You may not have achieved victory this time, but without making an attempt, there would be no chance of achieving it at all.

It is very important that the goals are adequate, not overestimated, otherwise you will never achieve them, but will only be disappointed and always remain in frustration, nervous tension, and not underestimated, since they will not allow a person to achieve personal growth, reveal his potential, which will also make a person unhappy. Abraham Maslow said: “I warn you that if you refuse to realize your abilities, you will be a deeply unhappy person.” Just like everything in nature - every blade of grass, every animal - so a person is programmed for maximum self-realization, and when not due to some circumstances, but on his own, a person moves away from development into passivity, laziness or some false goals, then this over time causes frustration, dissatisfaction, tension and emotional and sometimes even somatic disturbances.

Since a person lives in society, sometimes the achievement of his personal goals may not be consistent with the goals and desires of other people, which leads to conflicts both with others and with himself. He often has to solve a dilemma: give up his desires or act against the desires of others. This point is also the subject of the work of a psychological consultant or therapist, who must look at where the client’s desires and aspirations conflict with the desires and aspirations of other people, and help him find a reasonable compromise. If a person constantly “pulls the blanket over himself,” his relationships with the people around him will deteriorate, become fragile and insincere, and if, on the contrary, he constantly gives in to others, then his own desires will suffer and his self-realization will not occur, which will also make the person will feel unhappy. This means that it is necessary to show diplomacy and show that “I’m ready to give in, but I’m counting on certain concessions from you, let’s try to be more mutually accommodating!” In many cases, the psychologist will discover that there are no real contradictions as such, there is simply a different assessment of contradictory events, which is based on different psychological attitudes. And it may turn out that to resolve the conflict, it will be enough to look at the situation differently, and then it will become clear that satisfying your desire will actually not hurt anyone. To do this, it is necessary to investigate what beliefs underlie actions - rational, allowing one to achieve a goal, or irrational, preventing this.

Ellis's approach can also be called hedonistic. We know that there is such a direction in philosophy - hedonism. Its founder was Aristippus, who lived in Ancient Greece. According to this trend, the goal human life is about receiving pleasure. And, apparently, nature itself has laid down in man certain indicators of what he should strive for. Bad, as a rule, is unpleasant, painful; and good things bring pleasure. And one should be less led by social prejudices and trust more in the voice of nature, because she could not turn the good and pleasant into sinful and bad. It must be said that Ellis put a slightly different meaning into this term, hedonism. He spoke about the so-called delayed hedonism. What it is? Ellis believed that a person should have certain delayed gratifications for which he is now willing to endure some discomfort. For example, you understand that you will enjoy receiving a diploma and further good employment. But for this, now you need to study and sometimes do certain work, pass tests and exams, which are now right in your throat. Knowing that your true efforts will pay off in the long run helps you to force yourself to study diligently (to bother yourself with an activity). An athlete trains, tortures himself, so that later he can win and receive awards and glory, because he understands that without effort he will not achieve what he wants.

Many neurotic individuals do not know how to live in delayed hedonism. They prefer instant hedonism and follow the principle “if I can’t get something right away, then I won’t try,” that is, they cannot set themselves up for the fact that effort now will lead to success in the future. This is one of the most important tasks in raising children - to teach them from childhood to work for delayed gratification: if you finish a quarter well, you will get a bicycle, etc. Children must learn to force themselves to endure difficulties, and not just like that, but for the sake of obtaining pleasure in the future. Friedrich Engels said: “Man must live for the joys of tomorrow.” A person should have as many different delayed joys as possible, associated, for example, with a pleasant meeting, achievement, success or some other pleasure in the future, the anticipation of which brightens up our life today.

Ellis identified several criteria for psychological health:

• ? respecting one's own interests;
• ? social interest;
• ? self-government, readiness for reasonable cooperation;
• ? high tolerance to states of frustration;
• ? flexibility, lack of rigidity towards oneself and others;
• ? acceptance of uncertainty;
• ? dedication to creative pursuits;
• ? scientific thinking;
• ? self-acceptance;
• ? riskiness;
• ? delayed hedonism.

Let's try to explain these concepts.

Ellis believed that one of the signs of a person’s mental norm is his healthy selfishness. What did he mean by this concept? First of all, a person should not forget about his interests. Ellis considered complete submission of oneself to the desires of others to be an unhealthy phenomenon, as well as the opposite situation. That is, it must be a reasonable consideration of one’s own and others’ interests, but with priority given to one’s own.

In this regard, the position of the so-called altars, whose role is often played by parents who sacrifice themselves and their interests to the interests of their children, is unhealthy and creates ill health in others. It seems to them that by doing this they are doing better for their children, but in reality they are spoiling them, making them unable to achieve their goals on their own.

Sometimes this happens to mothers, and more often to single mothers who give up any pleasure for the sake of their child. And what example do such parents set for their children? If a mother really wants the best for her daughter, for example, then instead of depriving herself of everything, she should show her that, despite the difficulty of the situation, the woman copes, does not lose heart, takes care of herself, she is attractive to men, and is able to rejoice and think about your own interests. The daughter should see in front of her an example of what she should be. Otherwise, she will grow up selfish or as “flawed” as her mother, believing from childhood that loving another means completely abandoning her own desires. That is, healthy egoism is a necessary condition for the well-being of not only the person himself, but also his loved ones, for whom he is ready to sacrifice himself.

The ability to observe one’s own interests is complemented by another important characteristic of the norm - the ability to take into account and social interest. That is, the fact that a person lives as a complete egoist, thinking only about his own needs, Ellis recognized as abnormal. He believed that healthy views are expressed in the ability to take into account not only one’s own interests, but to be attentive to the needs of others, and also to be capable of cooperation and cooperation.

The next standard criterion is self management. This is, on the one hand, the willingness to solve one’s problems independently, without shifting them onto the shoulders of others and bearing responsibility for the results obtained, and on the other hand, the ability, if necessary, to accept help, enter into cooperation and cooperation. Here it is important to emphasize the fact that a person, always relying primarily on himself, does not refuse reasonable help and is capable of being useful on occasion; this is a manifestation of healthy beliefs.

Another characteristic of the norm sounds like high1 high tolerance to frustration. Let us remember that tolerance means tolerance, the ability to endure, and frustration is defined as strong emotional dissatisfaction. The essence of the characteristic is that a person with healthy cognitions is able to experience and overcome life’s difficulties without slipping into deep depression. Life is impossible without failures, troubles and difficulties, and it is natural to feel upset when they happen, but this should not unsettle a person, force him to give up on things and give up. And it is precisely the presence of tolerance to frustration that helps a person resist ongoing troubles.

Psychological health is also determined by the ability to express flexibility, non-rigidity(rigidity, as is known, is insufficient flexibility) towards yourself and others. Flexibility can be described as the ability of a person to change his thoughts and actions when necessary in accordance with new circumstances, thereby adapting to an ever-changing environment. The world does not stand still, and to be successful, a person must change with it. But here we are mainly talking about the flexibility of cognition. Each person has his own principles; these are fairly stable human beliefs that create a system of views on the world. Some of them must remain unchanged, but some must change sometimes. Excessive rigidity of beliefs can hinder a person’s development and prevent his or her normal functioning in general. The most important point of Ellis's rational-emotive therapy is the identification of rigidly fixed beliefs, which, due to their rigidity, cause the patient a lot of trouble. It happens like this: a person, following his principles, not wanting to change them, complicates the life of himself and others, runs into various points that with rational therapy turn out to be unimportant, and it is also discovered that one can look at these things differently. For example, I may not like the behavior of a person, not because it is objectively bad, but because I personally don’t like it, but I take it and give it objectivity. I begin to believe that this is not my subjectivity, but important principle which must be followed. This, naturally, will begin to prevent me from communicating normally with others, and with myself.

Now let's look at the characteristic acceptance of uncertainty. We know that exact definitions exist only in the abstract science of mathematics. In life there is always some element of uncertainty, tolerance. There is no such thing as 100% gold - it is 99-odd, the highest standard. Therefore, nothing in life happens one hundred percent, but not for neurotics - they are not tolerant of uncertainty, everything should be this way, only this way, and no other way! People with such beliefs drive themselves into the framework of their ideas. And since others cannot be driven there, they worry that they are not understood, that they are not loved, that everything is done to spite them. And therefore they feel very unhappy. Therefore, accepting the fact that there is some uncertainty in everything, recognizing that not everything is not always as we would like, is important for reducing internal tension.

The next standard criterion is dedication to creative pursuits- determines the presence of creativity in a person’s life. It appears in the desire to learn and try something new, to be interested in various things, art or science, to have hobbies, hobbies, and not out of necessity, but from the inner needs of a person. That is, this is the desire to enrich and saturate your life, and not reduce it to the automatism of everyday affairs.

Scientific thinking. What does scientific thinking mean? George Kelly said that every person acts like a scientist in his life, but only at the everyday level. What does a scientist do? Puts forward a hypothesis, conducts an experiment, obtains results that confirm or refute the main provisions. If the hypothesis is not confirmed, then the scientist revises it and tries to do something differently. Essentially, this is what happens in our lives. Before we do something, we first assume what will come of it, we expect to get a certain result. And then we carry out an action, an experiment and check - did it turn out what I expected or not? If the hypothesis is not confirmed, then you need to think about what to do next, what should be changed in the initial positions. What happens to a neurotic personality? The hypothesis does not change, although it has not been confirmed many times and is not confirmed further, bringing great discomfort and torment to a person. But, despite this, a neurotic cannot change the hypothesis, his attitude towards himself, or people, or a certain matter, and so on, because he cannot understand that the problem lies precisely in himself, that it needs to be corrected, since the results of his actions are deplorable. Therefore, one of the therapist’s tasks is to analyze the client’s hypotheses for their rationality.

Self-acceptance. This is the ability to accept yourself as you are, with all the pros and cons. We do not always perceive ourselves adequately, i.e. We overestimate some of our abilities, and underestimate others. When a person evaluates himself inadequately, he can be upset all the time, because others evaluate him differently than he evaluates himself, and the person can always think: “They don’t understand me.” Or he thinks: “I’m not presenting myself this way,” and, afraid of being unsuccessful, begins to do something completely out of character for him. This is mistake. Because a natural person is always perceived better than an artificial one, because no one likes falsehood. And we always think that we need to pretend to be something, then I will look better, then they will perceive me better. This is an illusion and torture. Yesenin wrote: “Happiness is dexterity of mind and hands. All awkward souls are always known for being unfortunate, but you cannot understand how much torment broken, deceitful gestures bring.” When a person begins to play a role that is not his own, even a seemingly beautiful one, he experiences discomfort, because the chosen role is not actually consistent with his inner world. And therefore a person may worry that others will notice this discrepancy. That is, the most effective thing will be to accept yourself as you are, and then a person will not need to pretend to be something. Don't be afraid of the word "flaw." Or label it as reserves, that is, where you think you have a gap in something, think: “I have a reserve for improvement.”

Riskiness. This is the ability to take reasonable risks in certain situations. The British have a proverb: “Nothing venture nothing have”, which translates as: “Risk nothing - have nothing.” It perfectly characterizes this criterion of psychological health. To express the essence - taking risks, you can achieve success. It is important to understand here that it is impossible to remain passive in life; it requires movement, action, and sometimes risk. Sometimes, in order to achieve development, it is necessary to take risks: change jobs or place of residence, start a family, etc. Otherwise, a person’s life will turn into a stagnant swamp, stagnation. It is necessary not to be afraid of new things - ideas, acquaintances, activities, circumstances, etc. Taking risks is necessary to move forward. Our life is a risk.

And the last criterion of the norm - delayed hedonism. We discussed it in detail above, describing the features of Ellis's approach. The essence of this phenomenon lies in the ability to live with deferred joy, to consciously endure difficulties in the name of achieving success in the future.

So, we have considered all the criteria for psychological norm, now I would like you to work on the following points.

Take another look at the listed criteria of psychological health, analyze how pronounced each of them is in you, and also rate it on a 10-point scale (10 is the most expressed, respectively 1 is the least expressed). At the same time, I suggest that you do not follow your first feeling when grading, but think carefully (remember examples from your own life), or better yet, ask someone who knows you how well this score really corresponds to the expression of one or another standard criterion.

Self-knowledge is a most interesting and fascinating process that has no limits to improvement. Therefore, try to assess your reserves for growth, use the word “reserves” and not “shortcomings”. Because it is better to focus your attention on reserves than on shortcomings, because the more resources you discover, the more it will inspire you. Moreover, you will see that many parameters are interrelated with each other. And if you want to develop one of them, the others will automatically develop as well. When you or your client justify your assessments, try to understand what beliefs you (or he) are guided by and whether these beliefs are rational, i.e. really helping him to realize himself, or are they still irrational.

Summarizing the tasks and essence of the RET procedure, we can say: in order to achieve a change in worldview, patients are recommended to:

• 1. Understand that their psychological problems arose not so much from external conditions and events, but from their attitude towards them.
• 2. Believe that they are capable of solving their problems themselves.
• 3. Realize that their problems are caused mainly by irrational absolutist beliefs.
• 4. Understand your irrational cognitions and make sure that your problems can be looked at rationally.
• 5. Expose your irrational views using logic and common sense, and by experimentally acting against them.
• 6. Through repeated repetitions, using cognitive, emotional and behavioral methods, bring new, rational beliefs to their complete internal acceptance.
• 7. Constantly continue the process of positive restructuring of beliefs, replacing irrational cognitions with rational ones.

Workshop

• 1. Try to find irrational beliefs in yourself (or your client) and justify why you consider them to be so.
• 2. Debunk them with logic and common sense (you can use humor).
• 3. Formulate alternative rational cognitions based on the identified problems.
• 4. Analyze your (or your client's) beliefs in terms of Ellis' psychological health criteria, how much you implement them, what reserves you have and how you are going to replenish them.

Self-test questions

• 1. Why did Ellis name his rational-emotive therapy that way?
• 2. Decipher the circuit A-B-C.
• 3. How do rational and irrational cognitions differ?
• 4. What are absolutist cognitions and why are they harmful?
• 5. Describe the main stages of RET.
• 6. List the criteria for psychological health according to Ellis.
• 7. What is delayed hedonism?

At the beginning of the 20th century. French psychiatrist P. Dubois put forward the idea that a psychogenic illness is the result of the patient’s wrong decisions, his logical errors, and misconceptions when analyzing a traumatic situation and searching for actions to overcome this situation. Consequently, the main task of a psychotherapist is to reveal such misconceptions, to strengthen the patient’s ability to make logically sound conclusions, so that a correct internal picture of the disease is formed. The patient must realize that the cause of his illness lies in the weak and incorrect use of his rational, mental capabilities, therefore, under the guidance of a psychotherapist, the patient corrects his logical inaccuracies, creates a correct internal picture of the disease and finds promising ways to get rid of painful symptoms. Du Bois called this psychotherapy rational.

As J. Dejerine and E. Hokkler emphasized, there can be no stereotypes or templates in this method. Each psychotherapist solves the treatment problem based on the patient’s personal characteristics, the plot of his mental trauma and his own intellectual capabilities, acting on the patient with convincing dialectical logic in the analysis of his problem. It is important to find the arguments that are most acceptable for this particular patient. These arguments can be reproduced impromptu by a psychotherapist based on his own life experience, and for a religious person - using provisions canonized in a given religious direction, or it is possible to attract the ideas of ancient and modern philosophers, writers, public figures, etc. to substantiate new necessary arguments.

The main thing in rational psychotherapy is that the strictly logical reasoning of the psychotherapist, like a key to a lock, approaches the characteristics of the patient’s psyche and is perceived by him productively. This technique of conducting a psychotherapeutic session is a kind of professional art, individually inherent in each practicing psychotherapist.

In rational psychotherapy, it is advisable to adhere to certain principles of work. It is important, for example, to accurately remember the facts and their interpretation by the patient when presenting his problem, his experiences and actions, since this material will be used in the future by the psychotherapist, but in a different logical format.

As the psychotherapeutic dialogue progresses, it is necessary to notice and immediately correct the patient’s inaccurate, contradictory and vague statements, constantly activating his ability for a logical analysis.

Psychotherapy should be conducted slowly, consistently and systematically. It is important that the patient has a clear idea that he himself has figured it out, understood everything and found a new solution leading to recovery. During psychotherapeutic sessions, it is advisable for a specialist to gradually relegate himself to the background, then the therapeutic effect will be more effective.

The psychotherapist's reasoning should be conducted in a form that is accessible to the patient, clear and convincing to him. When conducting sessions in the style of rational psychotherapy, the patient should constantly feel an understanding, friendly attitude towards him from the psychotherapist.

Psychotherapeutic work is carried out in three stages.

On first stage Information is collected about the patient’s current complaints and problems, his life history and illness. Moreover, what is associated with painful issues must be clarified down to the smallest detail, details so that the patient, as it were, again emotionally acutely experiences the circumstances of mental trauma. A certain “explosion” occurs, the exploration of the most painful memories and experiences before the subsequent reaction effect. Therefore, this stage of rational psychotherapy is sometimes called explorative.

Second phase work is therapeutic psychological correction. The patient is broken by mental trauma. He tends to incredibly expand its scale to the level of absolute disaster. A conglomerate of emotions in the form of despair, panic, melancholy, horror, fear completely takes over the patient’s field of consciousness, blocks his ability to consider problems from different angles, find a promising solution, and change his attitude to current events. It is necessary to narrow and focus the scope of experiences, to find new points of support and goals of action, using all the intellectual capabilities of the patient.

When a person experiences great grief, at first this situation seems hopeless, a dead end. He is even inclined to reject the help offered to him, considering it meaningless. People who suddenly become blind, for example, often behave this way and are therefore in a state of depression. They can be extremely distrustful of psychotherapeutic services, believing that everything is hopeless and no one can help them.

As an example, here is a fragment of an introductory psychotherapeutic conversation in a rehabilitation center for people who have lost their sight:

“Do you think there is no greater grief than the loss of vision? Do you really think that a blind person is deprived of the opportunity to be happy? Always, everywhere and in everything? Are sighted people always and everywhere happy? We can treat the same phenomenon differently. It's raining. Is it good or bad? Is it beautiful or ugly? Neither one nor the other. It's just rain. And we evaluate it depending on what it means to us at the moment and in what mood we are in. Under the impression of an interesting day, full of vivid impressions, I can say to myself, standing at the window: “What a powerful downpour, what stormy streams of water, how indomitable and beautiful nature!” And if I have Bad mood, then this same rain prompts a different assessment of what is happening: “What a gloomy sky, what a dull, endless and hopeless rain, what cold and disgusting mud all around.” The world is neither good nor bad. He is who he is. We paint events in this world in those tones that are most consonant with our state of mind at a given moment in time... It is unlikely that there are more failures and misfortunes in life than joys and pleasures. We just shouldn’t run away from these joys, from the perception of the fullness of life, from what we can achieve in life. A person has quite a lot of reserve capabilities for this... V. Dikul at first after the spinal injury fell into despair, but, being immobilized, he found reserves in himself, developed them, bringing his body to perfection, and pleases others and himself with inexhaustible possibilities of your existence... It is important to accept the idea that there is no eternal sorrow and eternal joy. Both happen. In Sweden, people with congenital mental retardation created an orchestra and perform in many countries around the world, receiving enthusiastic applause from the audience...”

A religious person in difficult life circumstances usually needs support higher powers. It is not without reason that in the United States, psychiatrist P. Mayer productively integrates work with clients of psychologists, psychotherapists and clergy in psychotherapeutic centers.

At this second stage of rational psychotherapy, specialists often use the “Socratic dialogue” tactics proposed by E. Kretschmer. It consists in drawing a third conclusion after analyzing two opposing judgments.

For example, a 36-year-old man, K.V., came to see a psychotherapist about his experiences related to the collapse of his marital relationship due to his wife’s infidelity. He begins to desperately scold his wife and all women, claiming that none of them can be trusted, they are insidious, calculating, harmful creatures, etc.

The therapist supports this idea of ​​the insignificance of women and grotesquely and figuratively extends derogatory characteristics to the patient's mother, to his first teacher, to the girl of his first love. The client begins to object violently, declaring that these women are wonderful.

Then the psychotherapist develops the opposite idea about the beauty of women, about the subtlety and tenderness of their feelings, about their sacrifice and ability to empathize, to bear children, etc. up to the grotesque about the exceptional greatness and infallibility of women. The client objects again.

Then, finally, in discussing the issue, a third position is formulated according to the principle not “either this or that,” but “neither this nor that,” and a third, reasonable assessment of his wife, their relationship throughout the marriage and the circumstances of the breakup is derived.

When the client’s life circumstances are difficult and it is impossible to radically correct something significant, the psychotherapist often resorts to the tactics of “deliberate neglect.” This, at the beginning of psychotherapy, can help the patient understand that not everything is so hopeless and irreparable, that he has resources that can be used to work with the problem.

For example, patient V.A., 40 years old, an educated, intelligent woman, suffering from a severe form of childhood cerebral palsy and scoliosis, sought psychotherapeutic help due to obsessive thoughts and depression that developed after her loved one left her. During the conversation, he declares that his future life is meaningless and painful. It is clear that the situation is objectively difficult. This means that it is advisable to start the work with what can really be improved.

During a conversation, the psychotherapist, as if casually, notices that the color of her dress does not emphasize the beauty of the color of her eyes. The next time they meet, just as casually, they discuss a hairstyle that could be changed to hide some of her facial imperfections. Gradually, the patient’s self-esteem begins to grow, and further psychotherapeutic work becomes more promising.

A psychotherapist who uses rational psychotherapy, when analyzing patients’ problems and correcting them, proceeds from a position of common sense. There are some situations in the lives of patients that occur quite often and are problematic for them.

Often people, having failed in something, begin to anxiously expect another failure in a similar situation, thereby dooming themselves to failure again in advance. Patients develop an attitude of failure, of losing. Working through such an attitude can help the patient overcome a situation that is alarming for him. The arguments offered by the psychotherapist, of course, may vary depending on the circumstances. But the main thing is that there is no reason to take on something, believing that it will not work out. If so, then you don’t need to take it on, and if you decide, then go for the win. Is it advisable for a girl going on a date to think that she won't like her? young man and everything is meaningless. If you are going on a date, be imbued with desire and confidence that you will win and win his heart, otherwise why agree to the invitation and go on this date?

Patients often fall into despair because a friend has betrayed them, a woman in whom they trusted wholeheartedly has cheated, etc. From the analysis of such situations, a conclusion arises about the danger of absolute faith in something and someone. It is dangerous to become completely dependent on specific circumstances or specific people. It makes sense to remember the aphorism “Do not make yourself an idol.” You can’t, figuratively speaking, bet on one horse, it may fall; it is always advisable to take care of the “island of safety” and be ready to answer the question: “What will I do if this doesn’t work out?”

The patient may despair of how wonderful he lived before, how he loved and was loved, but now none of this exists. He endlessly indulges in memories, lives past life, cursing the present. Or he ignores the present and lives for the future. In the process of psychotherapy, it is important for the patient to realize that he lives in the present moment, now, and the past no longer exists and it is impossible to return it. A person can return to the places of his “pink”, carefree childhood, shrouded in the affection of his parents. But he will not have the same feelings and state of mind as he did in childhood, since much has changed in the situation: his parents are no longer alive, and the house, which seemed so big in childhood, turned out to be small, and he himself is no longer the same . In a word, sadness and disappointment are more likely to arise, but not immersion in the past. And it is also pointless to live in a future that does not yet exist, and no one knows for sure what will happen. This future may turn out to be completely different from what it seems at the moment. Therefore, it is impossible to control either the past or the future. There is the present as the only reality in which you can try to do everything that you can, know how and want, without putting it off for later, without skipping by.

Sometimes a lonely person believes that no one needs him or is interested in him. Let’s say, having lost someone very close to him, he believes that life has lost its meaning, because loneliness is unbearable and inevitable. It is important to convince the patient that there is no such person in the world who is not interesting to anyone. There is always someone who needs such a person, is pleasant, desirable and interesting.

At the correctional stage of rational psychotherapy, the patient needs to consider his traumatic situation from different angles and find new points of support in life, new goals. A person must be confident that he has enough strength and capabilities to achieve these goals, based on reality. At the same time, the psychotherapist, discussing problems with the patient, clearly follows the laws of logic and leads the patient to the possibility of making an independent decision with responsibility for this choice. This decision should under no circumstances be suggested by a psychotherapist. Only when the solution is hard-won and found by the patient himself will it be effective and efficient. A person will find an opportunity to get rid of the psychopathological symptoms of the disease and enter the path of recovery.

Third stage rational psychotherapy can be described as supportive. After the patient stops regularly attending treatment sessions and actively engages in life, it is advisable to meet with him occasionally for a while (say, once every three to four weeks) to discuss how he is able to implement everything that has been achieved in the process of psychotherapy how he copes with specific circumstances, and whether any previous symptoms of the disease arise in new problematic situations. There should be few such meetings in order to avoid the formation of the patient’s dependence on the psychotherapist. It is important that the patient is confident in own strength and opportunities and independently overcame life’s difficulties.

So, rational psychotherapy is one of many methods of psychotherapy. The work of a specialist with a patient in this direction does not mean that during the course of the treatment process there will be no need to use individual techniques and interpretation options borrowed from other methods of psychotherapy. It is only important to remember that the use of such fragments of other methods should not be eclectic, but based on a pathogenetic and psychogenetic understanding of the mechanism of psychopathological manifestations of the disease, and not chaotic, but integrated integratively into the overall strategic task of psychotherapeutic work with the patient.

Since when conducting rational psychotherapy it is necessary to correct incorrect judgments and conclusions of patients, in this regard it is possible to use certain techniques borrowed from neurolinguistic programming (NLP), which is currently used as a psychotherapeutic method of work.

Rational Emotive Therapy (RET) by Albert Ellis

The founder of RET, A. Ellis (b. 1913), began as an orthodox psychoanalyst, then studied under the guidance of K. Horney. In the fifties of the twentieth century, A. Ellis formulated a number of provisions that formed the basis of a new direction in practical psychology. One such statement, often quoted by A. Ellis, is the Stoic sayingEpictetus: “People are not disturbed by things, but by the way they see them.”Already in this position, one of the main ideas of all cognitivism, starting with J. Kelly and up to the latest research in psychosemantics, can easily be traced, namely: a person reflects and experiences reality depending on the structure of his individual consciousness. Hence the main focus of his efforts in rational-emotive therapy: methods of reasoning and action. A. Ellis - apparently under the influence of A. Adler - pays considerable attention in his concept to the restructuring of I-statements and the analysis of unconditionally accepted norms and obligations of the individual. Based on emphasized scientific approaches to the structure of individual consciousness, RET strives to free the client from the bonds and blinders of stereotypes and clichés, to provide a more free and unprejudiced view of the world.

Idea of ​​a person. In the concept of A. Ellis, a person is interpreted as self-evaluating, self-supporting and self-speaking. Besidesa person is born with a certain potential, which has two sides: rational and irrational; constructive and destructive, striving for love and growth and striving for destruction and self-blame, etc.

According to A. Ellis, psychological problems manifest themselves when a person tries to follow simple preferences (desires of love, approval, etc.) and mistakenly believes that these simple preferences are the absolute measure of his success in life. Man is a creature extremely susceptible to various influences, from the biological level to the social level. Therefore, A. Ellis is not inclined to reduce all the changing complexity of human nature to one thing - whether we are talking about psychoanalytic reduction or a favorable psychological climate for client-centered therapy.

Basic theoretical principles of the concept. A. Ellis's concept assumes thatThe source of psychological disorders, with all its diversity, is a system of individual irrational ideas about the world, learned, as a rule, in childhood from significant adults.Neurosis, in particular, is interpreted by A. Ellis as “irrational thinking and behavior.” The core of emotional disorders is, as a rule, self-blame.

RET identifies three leading psychological aspects of human functioning: thoughts (cognitions), feelings and behavior. A. Ellis identified two types of cognitions: descriptive and evaluative.Descriptive cognitions contain information about reality, about what a person has perceived in the world; this is “pure” information about reality. Evaluative cognitions reflect a person’s attitude towards this reality.Descriptive cognitions are necessarily connected with evaluative connections of varying degrees of rigidity. Biased events themselves evoke positive or negative emotions in us, and our internal perception of these events is their assessment. We feel what we think about what we perceive.

An important concept in RET is the concept of “trap” - all those cognitive formations that are aware of unreasonable (neurotic) anxiety, irritability, etc. A. Ellis's concept states that although it is pleasant to be loved in an atmosphere of acceptance, a person should also feel quite vulnerable outside such an atmosphere. Therefore, a kind of“neurotic code” - erroneous judgments, the desire to fulfill which leads to psychological problems. Among them: “I I must prove to everyone that I am a successful, skillful and lucky person; when I get rejected, it’s terrible”; “ I I must like all the people who are significant to me”; “ l The best thing is to do nothing, let life decide for itself.”

A. Ellis proposed a multicomponent structure of behavioral acts of the individual, which he called the first letters of the Latin alphabet ( A-B-C-D - theory ). This theory, or rather even a conceptual scheme, has found wide application in practical psychology, since it allows the client himself to conduct effective introspection and introspection in the form of diary entries.In this conceptual scheme, A is the activating event, B (belief) is the opinion about the event, C (consequence) is the consequence (emotional or behavioral) of the event; D (dispatching) - subsequent reaction to an event (as a result of mental processing); E (effect) - the final value conclusion (constructive or destructive).

The "ABC diagram" is used to help a client in a problematic situation move from irrational attitudes to rational ones. The work is being built in several stages.The first stage is clarification, clarification of the parameters of the event (A), including the parameters that most emotionally affected the client and caused him to have inadequate reactions.

At this stage, a personal assessment of the event occurs. Classification allows the client to differentiate between events that can and cannot be changed. In this case, the purpose of correction is not to encourage the client to avoid a collision with the event, not to change it (for example, switching to new job in the presence of an insoluble conflict with the boss), and awareness of the system of evaluative cognitions that complicate the resolution of this conflict, restructuring of this system and only after that - making a decision to change the situation. Otherwise, the client remains potentially vulnerable in similar situations.

The second stage is the identification of the emotional and behavioral consequences of the perceived event (C).The purpose of this stage is to identify the entire range of emotional reactions to an event (since not all emotions are easily differentiated by a person, and some are suppressed and not recognized due to the inclusion of rationalization and other defense mechanisms).

Awareness and verbalization of experienced emotions may be difficult for some clients: for some, due to vocabulary deficits, for others, due to behavioral deficits (the absence in the arsenal of behavioral stereotypes usually associated with moderate expression of emotions). Such clients react with polar emotions, or intense love, or complete rejection.

Analysis of the words used by the client helps identify irrational attitudes. Usually, irrational attitudes are associated with words that reflect the extreme degree of emotional involvement of the client (nightmarish, terrible, amazing, unbearable, etc.), having the nature of a mandatory prescription (necessary, must, must, obliged, etc.), as well as global assessments of a person or object or events.

A. Ellis identified the four most common groups of irrational attitudes that create problems:

1. Catastrophic installations.

2. Installations of mandatory obligation.

3. Installations for the mandatory fulfillment of one’s needs.

4. Global assessment settings.

The goal of the stage is achieved when irrational attitudes are identified in the problem area (there may be several of them), the nature of the connections between them is shown (parallel, articulatory, hierarchical dependence), making the multicomponent reaction of the individual in a problem situation understandable.

It is also necessary to identify the client’s rational attitudes, since they constitute a positive part of the relationship, which can be expanded in the future.

The third stage is the reconstruction of irrational attitudes. Reconstruction should begin when the client easily identifies irrational attitudes in a problem situation. It can occur: at the cognitive level, the level of imagination, the level of behavior - direct action.

Reconstruction at the cognitive level includes the client’s proof of the truth of the attitude and the need to maintain it in a given situation. In the process of this type of evidence, the client sees even more clearly Negative consequences save this setting. The use of auxiliary modeling (how others would solve this problem, what attitudes they would have) allows us to form new rational attitudes at the cognitive level.

When reconstructing at the level of imagination, both negative and positive imagination are used. The client is asked to mentally immerse himself in a traumatic situation. With a negative imagination, he must experience the previous emotion as fully as possible, and then try to reduce its level and realize through what new attitudes he managed to achieve this. This immersion in a traumatic situation is repeated many times. The training can be considered effectively completed if the client has reduced the intensity of the emotions experienced using several options. With a positive imagination, the client immediately imagines problematic situation with a positively colored emotion.

Reconstruction through direct action is a confirmation of the success of modifications of attitudes carried out at the cognitive level and in the imagination. Direct actions are implemented according to the type of flood techniques, paradoxical intention, and modeling techniques.

The fourth stage is consolidation of adaptive behavior with the help of homework performed by the client independently. They can also be carried out at the cognitive level, in the imagination or at the level of direct action. RET is primarily indicated for clients who are capable of introspection, reflection, and analysis of their thoughts.

Analysis of client behavior or self-analysis according to the scheme: “event-perception-reaction-thinking-conclusion” has a very high productivity and learning effect.In general, the psychological prerequisites of RET are the following: 1) recognition of personal responsibility for one’s problems; 2) acceptance of the idea that it is possible to decisively influence these problems; 3) recognition that emotional problems stem from irrational ideas; 4) detection (awareness) of these ideas; 5) recognition of the usefulness of serious discussion of these ideas; 6) agreement to make efforts to confront one’s illogical judgments; 7) consent to use RET.

Description of the advisory

and psychotherapeutic process

Goals of psychological assistance. The main goal is to help revise the system of beliefs, norms and ideas. A private goal is liberation from the idea of ​​self-blame.A. Ellis, in addition, formulated a number of desirable qualities, the achievement of which can be specific purpose advisory or psychotherapeutic work: social interest, self-interest, self-government, tolerance, flexibility, acceptance of uncertainty, scientific thinking, involvement, self-acceptance, risk-taking, realism (not falling into utopia).

Psychologist's position. The position of a consulting psychologist or psychotherapist working in line with this concept is, of course, directive.He explains, convinces, he is an authority who refutes erroneous judgments, pointing out their inaccuracy, arbitrariness, etc. Appeals to science, to the ability to think and, in the words of A. Ellis, does not engage in “absolution of sins,” after which the client may feel better, but it is not known whether life is easier.

Client's position. The client is given the role of a studentand, accordingly, his success is interpreted depending on motivation and identification
with the role of a student. It is assumed thatthe client goes through three levels of insight: superficial (awareness of the problem), in-depth (recognition of one’s own interpretations) and deep (at the level of motivation to change).

Psychotechnics in rational-emotive therapy.RET is characterized by a wide range of psychotechniques, including those borrowed from other areas and united by a pronounced pragmatism*.

1 . Discussion and refutation of irrational views: the consulting psychologist actively discusses with the client, refutes his irrational views, demands evidence, clarifies logical grounds, etc.

Much attention is paid to softening categoricalness: instead of “you should” - “I would like”; instead of “it will be terrible if...” - “probably, it won’t be very convenient if...”

2. Cognitive homework : associated with self-analysis according to the ABC model and with the restructuring of habitual verbal reactions and interpretations.

Also used:

3. Rational-emotive imagination: The client is asked to vividly imagine a difficult situation for him and the feelings in it, then he is asked to change his sense of self in the situation and see what changes in behavior this will cause.

4. Role-playing game - disturbing situations are usually played out, inadequate interpretations are worked out, especially those that carry self-blame and self-deprecation.

5. Attack on fear - The technique consists of homework, the purpose of which is to perform an action that usually causes fear or psychological difficulties in the client.

Preview:

At the beginning of our practical lesson, we will conduct a short test that will help us answer the question of whether you have irrational attitudes.

Albert Ellis test. Methodology Diagnosis of the presence and severity of irrational attitudes. Rational-emotive therapy (RET):

A – completely agree;

B - not sure

C – I completely disagree.

Test questions:

1. Dealing with some people can be unpleasant, but it is never terrible.
2. When I'm wrong about something, I often say to myself, "I shouldn't have done that."
3. People, of course, must live according to the laws.
4. There is nothing that I “can’t stand.”
5. If I am ignored or feel awkward at a party, my sense of self-worth decreases.
6. Some situations in life are truly downright terrible.
7. I definitely need to be more competent in some areas.
8. My parents should have been more restrained in their demands on me.
9. There are things I can't stand.
10. My sense of “self-worth” doesn’t improve even if I do really well in school or work.
11. Some kids behave really badly.
12. I shouldn't have made several obvious mistakes in my life.
13. If my friends promised to do something very important for me, they are not obliged to fulfill their promises.
14. I can't deal with my friends or my children if they act stupid, wild or wrong in a given situation.
15. If you evaluate people by what they do, then they can be divided into “good” and “bad”.
16. There are times in life when truly terrible things happen.
17. There is nothing in life that I really have to do.
18. Children must eventually learn to fulfill their responsibilities.
19. Sometimes I just can't stand my poor performance in school and work.
20. Even when I make serious mistakes and hurt others, my self-esteem does not change.
21. It would be terrible if I couldn't win the favor of the people I love.
22. I would like to study or work better, but there is no reason to believe that I should achieve this at any cost.
23. I believe that people definitely shouldn't behave badly in public.
24. I just can't stand a lot of pressure or stress on me.
25. The approval or disapproval of my friends or family members does not affect how I evaluate myself.
26. It would be unfortunate, but not terrible, if one of my family members had serious health problems.
27. If I decide to do something, I must do it very well.
28. In general, I'm okay with teenagers acting differently than adults, such as waking up late in the morning or throwing books or clothes on the floor in their room.
29. I can't stand some things that my friends or family members do.
30. Anyone who constantly sins or brings harm to others is a bad person.
31. It would be terrible if someone I loved became mentally ill and ended up in a mental hospital.
32. I have to be absolutely sure that everything is going well in the most important areas of my life.
33. If it's important to me, my friends should strive to do whatever I ask them to do.
34. I easily tolerate unpleasant situations that I find myself in, as well as unpleasant interactions with friends.
35. How I evaluate myself depends on how others evaluate me (friends, bosses, teachers, professors).
36. It's terrible when my friends behave badly and incorrectly in public places.
37. I definitely shouldn't make some of the mistakes that I keep making.
38. I don't believe that my family members should act exactly the way I want them to.
39. It's completely unbearable when things don't go the way I want.
40. I often evaluate myself by my success at work and school, or by my social achievements.
41. It would be terrible if I failed completely at work or school.
42. I as a person should not be better than I actually am.
43. There are definitely some things that people around you shouldn't do.
44. Sometimes (at work or school) people do things that I absolutely cannot stand.
45. If I have serious emotional problems or break laws, my sense of self-worth decreases.
46. Even very bad, disgusting situations in which a person fails, loses money or loses a job, are not terrible.
47. There are several significant reasons why I should not make mistakes at school or at work.
48. There is no doubt that my family members should take better care of me than they sometimes do.
49. Even if my friends behave differently than I expect them to, I continue to treat them with understanding and acceptance.
50. It is important to teach children to be " good boys" And " good girls": studied hard at school and earned the approval of their parents.

Key to A. Ellis test.

We assign points for each answer

A - 1 point, except for questions 1,4,13,17,20,22,25, 26,28,34,38,42, 46,49 - for them 3 points

B - 2 points

C - 3 points except questions 1,4,13,17,20,22,25, 26,28,34,38,42, 46,49 - for them 1 point

Processing the results of the Ellis technique.

Catastrophization 1,6,11,16,21,26,31,36,41,46

Ought in relation to oneself 2,7,12,717,22,27,32,37,42,47

Owing to others 3,8,13,18,23,28,33,38,43,48

Self-esteem and rational thinking 5,10,15,20,25,30,35,40,45,50

Frustration tolerance 4,9,14,49,24,49,34,39,44,49

Interpretation, decoding for the Ellis test.

The “catastrophizing” scale reflects people's perceptions of various adverse events. A low score on this scale indicates that a person tends to evaluate every adverse event as terrible and unbearable, while high score says otherwise.

Indicators of the “shoulds in relation to oneself” and “shoulds in relation to others” scales indicate the presence or absence of excessively high demands on oneself and others.

“Evaluative attitude” shows how a person evaluates himself and others. The presence of such an attitude may indicate that a person tends to evaluate not individual traits or actions of people, but the personality as a whole.

The other two scales are an assessment of a person’s frustration tolerance, which reflects the degree of tolerance to various frustrations (i.e., shows the level of stress resistance) and a general assessment of the degree of rationality of thinking.

Explanation of the results obtained:

Less than 15 points - Pronounced and distinct presence of irrational attitudes leading to stress.

From 15 to 22 - The presence of an irrational attitude. Average probability of occurrence and development of stress.

More than - 22 There are no irrational attitudes.

So, the results have been calculated, and I ask those who are more likely to have the irrational “catastrophizing” attitude to raise their hands. Please join a separate group. Now raise your hands, those who have a predominant “should in relation to themselves.” Also join a group. (and so on) Owing to others; Self-esteem and rational thinking; Frustration tolerance.

Now I would like to introduce you in more detail to the “ABC model”. Let's take a certain situation. For example, a woman with severe emotional disturbances was rejected by her lover (A), she believes that this is terrible, that no one needs her, that no one will ever love her again, and that she deserves to be condemned (B). Therefore, she is very depressed and upset (C).

A – situation

B – thoughts

C – emotion

Task 1. B The following examples describe situations ABC, but all of them lack V. You need to guess what thoughts(IN) need to be inserted to connect the situation(A) and emotions (C). Determine in each case A and C and write B.

1. Anatoly’s boss scolded him for being late. After this, Anatoly felt depressed.

2. Elena went through two sessions of therapy and left it because she thought it wasn’t working.

3. Katerina’s stomach hurt. She felt scared.

4. Oleg was fined for speeding, and he became very angry.

5. Irina was embarrassed when her friends noticed that she was crying during the romantic scenes of the film.

6. Sergei was furious when the employee asked for his documents while he was filling out the form.

Task 2. Give five examples from your life in which your thoughts (B) caused painful emotions(WITH). Describe them in terms ABC.

We invite each group to role-play the situation given to them. And try to look at it from the other side. Those. First, you replay the given situation, and then what thoughts and feelings it aroused in you. Then you need to change your thoughts about the situation and watch how your emotions change. By losing it, of course.

Task 3. If B changes, then C will also change

Give your clients some examples of AB. Take situation (A) as a constant, and internal dialogue as a variable. Ask them to identify the emotion that different thoughts would evoke (B). Analyze various options reaction (C) to the same event (A).

The best examples are those created by the client himself. Their advantage is that they are personally significant and therefore have an inherent persuasive power. The therapist should encourage the client to think in his own way. own examples B call S.

Self-esteem and rational thinking.

1. Imagine the situation that you went to a cafe to drink coffee, there you meet a friend who asks you to stay with her and her fellow hobbyists for a party in honor of her victory in a competition, which she just found out about. You stay, but no one pays attention to you. They talk about their own things. Roles: Client, her friend, a friend's friend, maybe an outside observer of what is happening

2. While shopping with a company you know, you accidentally drop your handbag, from which half of the contents spill out, you have to collect it all on the floor in full view of the company, buyers and sellers. Roles: Client, company or acquaintance, maybe other visitors, observer.

3. You are driving a car, at medium speed you fly through a large puddle, a fan of dirty splashes on both sides, and then your passenger tells you that two young men in white sweatshirts were passing on the sidewalk and you splashed them pretty much. Roles: client-driver, passenger, observer.

Frustration tolerance.

1) Situation: you are walking down the street with an acquaintance and he, telling you a story from his life, screams loudly, expressing his emotions. Roles: client, acquaintance, observer.

2) On your only day off, you decided to stay at home, your parents come up to you and say that you are all going together to your grandmother for a family dinner and more relatives will come there, you don’t want to go. Roles: client, parent, observer.

3) They ask you educational task and suddenly you discover that you were the only one who couldn’t cope with it because you didn’t understand anything. Roles: Client, classmate, observer.

Obligation to others.

1) You come home and find that they have prepared a nice dinner, but from something you don’t like. Roles: client, family member, observer.

2) You go to school along a certain route and regularly, in some places on your route, drivers park their cars on the sidewalk for the whole day. Roles: client, driver, observer.

3) You have a final event after the competition, at which it will become clear who the winner is, you or your opponent. This is very important to you, but the society and format of the event is new to you. You ask a loved one to go with you, but he refuses because of the celebration he promised to attend. Role: client, loved one, observer.

Owement to oneself.

1) For several months you were paid a stipend and you independently paid for a number of things you needed, then they stop paying you due to your slight negligence. You understand that you can’t do without your usual things, but you can’t ask your parents either.

2) Your family went on vacation, and your mother left her favorite, very whimsical flower for you to care for, but you were very busy, and while your parents were on vacation, the plant withered.

3) You decided to renovate your room, and, despite the dissuasions of your loved ones, you decided to do it yourself. The process was long and painstaking, it took a large number of funds, but the result of the repair was disastrous.

4) In a company you know well, a topic arises that falls within your area of ​​expertise, and you realize that you cannot say anything about it.

Catastrophization.

1) You need to get a job because you have already been recommended by someone close to you and important to you.

2) You need a job, you are in a critical situation. You find a job, but at the last moment someone else is hired for the position.

3) You live in a rented apartment, the landlady of which tells you that in a week you must vacate the room because she has unforeseen family circumstances. Naturally, moving was not part of your plans.

Task 4. Basic perceptual shift

1. In the first column, ask him to list all the thoughts or beliefs that cause him negative emotions in a certain situation. Obviously the list cannot go on indefinitely. However, even if some thoughts seem repetitive, it is better to include them than to leave any pattern unrecorded.

Perceptual Worksheet shift

2. Help the client decide whether each belief is helpful or not. Find evidence both for and against and decide which is stronger. It is important that the client makes a decision based on objective data, and not under the influence of subjective feelings. The client evaluates the usefulness of the belief in the second column.

3. In the third column, the client should write down the best argument against each thought or belief. Ideallythe argument must be both emotionally persuasive and rational-sounding.

4. “In the last column, the client must provide evidence from his own experience to support each argument. This is the key to the perceptual shift technique. With the help of the therapist, the client must prove the validity of the argument by finding support from his life experience.

Preview:

To use presentation previews, create an account for yourself ( account) Google and log in: https://accounts.google.com

Slide captions:

Rational-emotive therapy by A. Ellis

The method belongs to the cognitive direction of psychotherapy. “People are not bothered by things, but by how they see them.” Epictetus

A person is born with a certain potential, which has two sides: rational and irrational; constructive and destructive, striving for love and growth and striving for destruction and self-blame, etc.

The source of psychological disorders, with all its diversity, is a system of individual irrational ideas about the world, learned, as a rule, in childhood from significant adults.

Descriptive cognitions contain information about reality, about what a person has perceived in the world; this is “pure” information about reality. Evaluative cognitions reflect a person’s attitude towards this reality.

The “Neurotic Code” is erroneous judgments, the desire to fulfill which leads to psychological problems. Examples: “I must prove to everyone that I am a successful, skillful and lucky person; when I get rejected, it’s terrible”; “I must be liked by all the people who are significant to me”; “The best thing is to do nothing, let life decide for itself.”

A-B-C-D - theory A - activating event, B (belief) - opinion about the event, C (consequence) - consequence (emotional or behavioral) of the event; D (dispatching) - subsequent reaction to an event (as a result of mental processing); E (effect) - final value conclusion (constructive or destructive)

The first stage is clarification, clarification of the parameters of the event (A), including the parameters that most emotionally affected the client and caused him to have inadequate reactions. The second stage is the identification of the emotional and behavioral consequences of the perceived event (C).

A. Ellis identified the four most common groups of irrational attitudes that create problems: 1. Catastrophic attitudes. 2. Installations of mandatory obligation. 3. Installations for the mandatory fulfillment of one’s needs. 4. Global assessment settings.

The third stage is the reconstruction of irrational attitudes. The fourth stage is consolidation of adaptive behavior with the help of homework performed by the client independently.

Analysis of client behavior or self-analysis according to the scheme: “event-perception-reaction-thinking-conclusion” has a very high productivity and learning effect.

Psychological prerequisites for RET: 1) recognition of personal responsibility for one’s problems; 2) acceptance of the idea that it is possible to decisively influence these problems; 3) recognition that emotional problems stem from irrational ideas; 4) detection (awareness) of these ideas; 5) recognition of the usefulness of serious discussion of these ideas; 6) agreement to make efforts to confront one’s illogical judgments; 7) consent to use RET.

Description of the counseling and psychotherapeutic process

The main goal is to help revise the system of beliefs, norms and ideas. A private goal is liberation from the idea of ​​self-blame.

The position of a consultant psychologist or psychotherapist working in line with this concept is directive.

The client's position is the role of a student. The client goes through three levels of insight: superficial (awareness of the problem), in-depth (recognition of one’s own interpretations), and deep (at the level of motivation to change).

Psychotechnics in rational-emotive therapy. 1. Discussion and refutation of irrational views 2. Cognitive homework 3. Rational-emotive imagination 4. Role play 5. Attacking fear