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Treating Male Suicide & Depression
Male Suicide & Depression continuing education psychologist CEUs

Section 11
Treating Depression with Rational Emotive Behavior Therapy

CEU Question 11 | CE Test | Table of Contents | Depression
Psychologist CEs, Counselor CEUs, Social Worker CEUs, MFT CEUs, Nurse CEUs

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On the last track we discussed "Claiming Strengths" and the "4 W's and an H Question" techniques to use with depressed suicidal male clients.

I found a good companion technique to be Ellis's ABC's. As you know examining self-talk, you can help a client first see the root of his anger, which may be layered over the depression and then change it.

Technique: Ellis's "Rational Emotive Therapy"
I used Ellis's "Rational Emotive Therapy" technique with Gerry, a 41-year-old small-business owner recently diagnosed as having a major depressive episode. Gerry felt angry about his job and about the constant nagging of his wife, Sarah. In one study, anger attacks were found in more than 40 percent of subjects with major depression.

Gerry described to me how he felt when driving home from work one evening. He stated, "I feel I am a "loser." Like I just wish I could self destruct! My business is failing. I dreaded going home to hear Sarah complain. I also hate like hell seeing my "bratty" kids pound on each other and spill stuff." After Gerry finished ranting for several minutes, I ask him, "Do you feel these thoughts of self-destruction are contributing to your anger and depression?"

I ask Gerry, "Do you want to try a different way of viewing your situation from a different perspective? Rational Emotive Therapy, or R.E.T., focuses on disputing destructive, irrational thoughts like you say yours are." I explain to Gerry that RET is based upon what are called the ABCs:
-- A is the activating experience, or anger-provoking situation,
-- B is your self-talk, or beliefs about that activating experience, and
-- C is the emotional consequences of your self-talk, or how you feel about the activating experience.

Using these ABCs, Gerry and I worked through his thought process in the car ride home. The activating experience was that Gerry's business was failing and his wife, Sarah, was nagging him. The belief was that he was a loser because "winners" have successful businesses and wives who don't nag. The emotional consequences were that Gerry felt frustrated, depressed, and angry because of the irrational belief that he was a loser.

I told Gerry, "You are missing the D of Rational Emotive Therapy… the D stands for disputing irrational beliefs." Gerry was accepting of the concept of being aware of his self-talk. He agreed that his self talk even when it was self-effacing.

With the concept of disputing his beliefs, Gerry and I returned to the ABCs of Rational Emotive Therapy. However, this time we were looking at ways to dispute his beliefs. The "A", or activating experience, remained the same: Gerry's business was failing and his wife was nagging him. But instead of believing he was a loser, Gerry could take a more positive approach. His D, or disputing, sounded something like this: "Sure, my business might not be doing so well, and my marriage isn't as strong as it could be. But maybe I can switch businesses and start doing something I like instead of managing this headache of a business now."

Gerry further stated, "Maybe I can spend more time with my family…but then I'd be neglecting my business. I just can't seem to find a balance. Wait, there I go again with the negative beliefs that add to my depression. I can figure something out to improve my relationship with Sarah, and we can start having a better marriage." Of course this took several sessions to get Gerry to the point of disputing his self-talk.

As you know from your experience with not only depressed male clients but, clients in general, disputing irrational beliefs doesn't come easily. When Gerry tried it, he said he fell into the old pattern of thinking negatively. However, he said that with effort, he was able to correct some of his irrational beliefs and think more positively. Just like in the Fishbowl Technique we discussed earlier, Gerry had to first become aware of his irrational beliefs.

He said he wasn't sure he could recognize when his beliefs became unreasonable. I told him to listen for phrases like, "It's terrible," or "It's awful," or "I'm worthless," or "It shouldn't be." I reminded Gerry, "These phrases are a signal that you believe everybody should be perfect and that everything should go right all the time. Obviously, such lofty expectations can never be met."

A good example of converting irrational beliefs into rational beliefs is found in Gerry's statement, "I can't help feeling angry; Sarah nags all the time, so it's her fault." I told Gerry that whenever he felt that way, he needed to take responsibility for his anger. He could say, "Others can make me angry, but it is up to me to choose how intense my anger will be and how long it will last. Only I can choose what I do with my anger."

As you know, this realization is a big step for angry, depressed men to take. However, it's an important step for depressed men because they can begin to interpret their emotions more accurately. Would it be beneficial for you to consider using information regarding Ellis's ABC's and D in a future session with a depressed male client?

Once a client has opened himself to disputing what Ellis would call their irrational beliefs, I found the creation of an anger log most benificial. The anger log is discussed on the next track.

National Male Health Policy Supporting Document

- The Department of Health. National Male Health Policy Supporting Document. Healthy Minds, 2018, p. 1-16.

Peer-Reviewed Journal Article References:
Davis, H., & Turner, M. J. (2019). The use of rational emotive behavior therapy (REBT) to increase the self-determined motivation and psychological well-being of triathletes. Sport, Exercise, and Performance Psychology. Advance online publication. 

Ward, J. J. (2011). “Oh, the humanity!”: Kurt Vonnegut and rational emotive behavior therapy's existential rejoinder to the irrationality of the human condition. The Humanistic Psychologist, 39(2), 105–120. 

Wright, A. G. C., Hallquist, M. N., Swartz, H. A., Frank, E., & Cyranowski, J. M. (2014). Treating co-occurring depression and anxiety: Modeling the dynamics of psychopathology and psychotherapy using the time-varying effect model. Journal of Consulting and Clinical Psychology, 82(5), 839–853.

Online Continuing Education QUESTION 11
What are the "ABC's and a D" of Rational Emotive Therapy? To select and enter your answer go to CE Test

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