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by Ronald Pies, MD drawing by Sarah Glidden From the Winter 2013-2014 issue of Jewish Currents “The entire purpose of our existence is to overcome our negative habits.” —Rabbi Eliyahu, the Gaon of Vilna (1720-1797) I REALLY HAVE TO BLAME MY MOTHER for the way I turned out. Coming from a psychiatrist, that might sound a little odd, but it’s true. When I was still in my early teens, my mother, Frances Pies Oliver, a psychiatric social worker, was singing the praises of what was then called “RET” — Rational Emotive Therapy, in the late Dr. Albert Ellis’s original formulation. (Ellis later called it “REBT,” with “B” for “Behavioral.”) It still surprises me that in the small, western New York town where I grew up, the mental health clinic would have adopted his radical view of psychopathology, which basically said, “If you are an emotional wreck, it’s because you keep driving your car into a tree” — or, to put it in Ellis’s more positive terms, “Clear thinking... leads to sane emoting” (A Guide to Rational Living, 1961). For Albert Ellis (1913-2007), negative emotions are caused by irrational and self-defeating cognitions. The way back to “feeling good” is paved with logic, discipline, and a determination to stop belly-aching about how “unfair” life is. A typical REBT session usually involves a “Socratic” questioning of the patient’s dysfunctional attitudes and beliefs. A typical session might goes something like this: Joe: I feel so depressed today! I was expecting my best friend to call and invite me to dinner, but she never did. I’m really, really annoyed with her, and I also wonder if our friendship really means much to her! Therapist: Well, okay, Joe — anybody would be disappointed by not getting that invitation. But what do you think you are telling yourself that is leaving you so depressed and annoyed? Joe: Hm, I’m not sure. Maybe I’m telling myself that I really, really deserved to be invited to dinner? Therapist: I don’t believe that thought alone would leave you feeling depressed and annoyed, Joe. Could it be that you are telling yourself something like, “How awful that my friend didn’t invite me to dinner! She really owed me an invitation, and it’s terrible and selfish of her not to call me! She must not think very much of our friendship!” Positive change in therapy also requires more adaptive behaviors. In clinical practice, this means giving the anxious or depressed patient behavioral “homework assignments.” If the patient has crippling anxiety over being “rejected,” the therapist might give the task of asking someone out for a date. If the patient gets the date, fine; if not, he or she will see that the world did not come to an end. However, the therapeutic encounter in REBT is more than a philosophical dialectic and homework assignments. It is also a vibrant emotional experience, in the context of a supportive and empathic relationship with the therapist. Although reading books about REBT may be of some help, it is no substitute for what psychoanalyst Franz Alexander referred to as “the corrective emotional experience” of psychotherapy. Clearly, this active, confrontive, and directive approach to the patient’s thoughts and behavior is radically different from classical psychoanalysis. FAST-FORWARD TO MY PSYCHIATRY RESIDENCY, circa 1980. At Upstate Medical Center in Syracuse, our residency program was steeped in the psychoanalytic and object-relational tradition, from Freud to Mahler to Masterson and Kernberg. Yet I never left behind Albert Ellis, Aaron Beck, and other cognitive theorists who seemed to cut through all the psychoanalytic theorizing like Alexander the Great slashing through the Gordian knot. Whenever it seemed useful, I tried to integrate cognitive-behavioral approaches into a more psychodynamic approach to my patients. It was not until many years later, however, that I discovered that the cognitive therapies, especially Ellis’, have some startling affinities with views expressed in rabbinical Judaism. I can discern at least seven over-arching principles or themes that connect the two:
- The imperative of self-awareness and self-examination.
- The necessity of striving for self-mastery.
- The primacy of behavior over “insight.”
- The cultivation of self-sufficiency and equanimity.
- The understanding and toleration of oneself and others.
- The awareness that happiness and unhappiness are “internally caused.”
- The emptiness of short-range hedonism and immediate gratification.
Both men believed in the power of the human spirit and did not believe in God. [They believed that] as human beings, we are all imperfect and need to accept ourselves with our flaws... [they believed in] forgiveness of ourselves and others, [and that] saying what we believe and believing what we say are but a small part of the important values that, if we learn to embrace [them], can lead to less anxiety and depression and far greater happiness in our lives. Free of psychobabble, Rational Emotive Therapy and Humanistic Judaism support the importance of following up our words with deeds and actions. The power of the present is far more important than what happened in the past. Both approaches emphasize the importance of universal human values to achieve happier and more satisfying lives.REBT and traditional Judaism proceed from vastly different metaphysical and theological premises. They do, however, have this much in common: both assert the primacy of the intellect in its struggle with the chaos of emotion — and both insist that we must take responsibility for how we live our lives. Dr. Ronald Pies is editor emeritus of Psychiatric Times and a professor in the psychiatry departments of SUNY Upstate Medical University and Tufts University School of Medicine. He is the author of The Judaic Foundations of Cognitive Behavioral Therapy; The Three-Petalled Rose: How the Synthesis of Judaism, Buddhism, and Stoicism Can Create a Healthy, Fulfilled and Flourishing Life; a collection of short stories, Ziprin’s Ghost; and a poetry chapbook, The Heart Broken Open. Parts of this essay were published in Voices, journal of the American Academy of Psychotherapists.