Understanding therapies: CBT, REBT & DBT

Author and Medical Reviewer
Dr. Jose Toledo

Understanding therapies CBT, REBT & DBT

What is known as “behavior therapy” started about a century ago. This is a hugely popular and successful type of therapy today.

It is regarded by many experts in the field of psychology that psychologist Alfred Adler (1870-1937) was the first to look in detail at the mental system of how we get information and understanding. This he concluded comes from our thoughts, experiences and our senses.

It is what is known as “cognition” – a word deriving from Latin meaning “get to know”. This is key to CBT (cognitive behavioral therapy) – as it is based on the theory that what we think and believe shapes our behavior.

So this means events that are very similar can be interpreted in different ways. This is due to the meaning different people can place on them.

Patterns of thinking

An example of this is that one person asked to work some extra hours might think it’s a recognition that they are doing well at work. But another person might think it has been given to them as a punishment for not working efficiently.

They may even think it means they are being pushed to the limit, so that their company can find a reason to let them go. They will then have fear as a driving force – and that will negatively affect their behavior.

CBT aims to recognize and change patterns of thinking that are negative. If these can be replaced by positive thoughts it leads to positive feelings and beneficial changes in behavior.

The three therapies of CBT, REBT (rational emotive behavior therapy) & DBT (dialectical behavior therapy) have been extremely popular and successful forms of therapy for some decades now. They are distinct and yet also linked to one another.

Since it was founded, CBT came to be known not only as a therapy but as the way to describe all cognitive-based therapies. As well as CBT, this includes REBT and DBT.

This can cause confusion. So here we set out to explain each of these effective therapies.

REBT (rational emotive behavior therapy)

REBT is the original form of CBT. So it is both the ancestor of and a type of CBT.

REBT is based on the theory that emotional disturbances such as self-pity, shame, guilt, depression, stress and anxiety are largely self-constructed by our thoughts and belief systems. It seeks to address this often irrational self-defeating thinking.

It was created in the 1950s by psychologist and psychotherapist Albert Ellis (1913-2007). Ellis was inspired by Greek, Asian, Roman and modern-day philosophers.

He explained that the major principle of REBT was that individuals are affected by their thinking about situations and events rather than the actual situation or event itself. Ellis wrote that this “was originally discovered and stated by ancient Stoic philosophers”.

In fact, it is one of the best known Stoic quotes, said by Marcus Aurelius: “People are not disturbed by things, but by the views they take of them.” 

So Ellis saw that people often have erroneous beliefs about an event or a situation they find themselves in. It is then their perception that leads to their issues and unhappiness. 

These beliefs he sought to challenge. Then the person could change them to enable better outcomes – and ultimately give them happiness.

So it was the quality of their thinking that was determining their happiness or otherwise. Ellis called his new method rational emotive behavior therapy.

CBT (cognitive behavioral therapy)

From REBT another form of therapy that became known as CBT developed in the 1960s. Similarly to REBT, CBT helps individuals identify harmful patterns and learn how to interrupt them.

Inspired by REBT, psychiatrist Aaron T. Beck noticed it was some types of thinking that caused emotional suffering. From this he developed CBT.

CBT works on looking at automatic thoughts that have been learned and become fixed during childhood, and then in due time become dysfunctional patterns. CBT seeks to undo these automatic thoughts.

It achieves this by teaching people how to spot them and take a different view on actual experiences. This allows them to challenge their unhealthy thought patterns.

With CBT, people learn that our thoughts, feelings and behaviors are inextricably connected. A negative thought causes a negative feeling that can lead to unhealthy behavior.

An example of an unhealthy thought pattern is such as if someone growing up was only shown positive attention when they achieved top exam grades. So this person may develop a thought pattern that tells them they have to always be the best – or they are unloveable.

As no one can possibly be the best all the time, this then sets them up to see themselves consistently as someone who is a failure who cannot possibly be loveable.

They may look to “cope” in unhealthy ways. For instance, to block out the negative feelings they have of being an unloveable person who fails too often they may end up drinking or taking drugs addictively or become consumed with a behavioral addiction.

CBT also helps people to work out what they’d like most from life. Then it shows them how to analyze thought and behavior patterns that are hindering them from achieving their aims.

It has been proven over the decades to be highly effective in helping with nearly all types of mental health illnesses, including addictions, depression and anxiety.

DBT (dialectical behavior therapy)

DBT was developed from CBT by psychologist Marsha M. Linehan in the 1980s.

“Dialectical” means “acting through opposing forces”. It is based on the theory that bringing together acceptance and change in therapy is more effective than just focusing on one of these.

Initially, Linehan developed DBT for people struggling with BPD (borderline personality disorder). Some of these people had limited success with the traditional form of CBT.

BPD is a mental health condition that means someone usually has a distorted sense of identity or barely any sense of self at all. They frequently suffer from abandonment fears, excessive emotional responses, feelings of emptiness, unstable relationships and a detachment from reality.

Depression, eating disorders and substance abuse are frequently seen in people with BPD. In a recent study the lifetime prevalence of BPD was seen to be close to six percent of men and more than six percent of women.

DBT sets out to teach people how to be more in control of their emotions, develop ways to deal with stress, how to live and keep life in the present moment and how to have healthy relationships.

DBT treatment frequently begins with enabling someone to accept themselves as well as how their life actually is – instead of how they think it ought to be. They will then be guided to realize that they need to make certain changes in order to get on in life.

Since proving itself in helping people with BPD, DBT is presently also used to help people diagnosed with bipolar disorder, attention deficit hyperactivity disorder (ADHD), eating disorders, post-traumatic stress disorder (PTSD) as well as substance abusers and people who are self-harming.

We offer CBT here at Tikvah Lake Recovery. Our therapists have great experience in treating all types of mental health issues – and we have seen great success with many conditions after CBT and/or DBT.

“We feel the therapies that work the best are CBT and DBT,” explains Tikvah Lake’s Clinical Director Dr Jeff Allen. “Both are used for individuals with a mental health issue as well as addictions.”

Contact us today to speak about what we can offer you or someone you care about.

David Hurst - Tikvah Lake Recovery

About David Hurst

David Hurst has four books published on mental health recovery, including 12 Steps To 1 Hero, The Anxiety Conversation and Words To Change Your Life. He has written for national newspapers and magazines around the world for 30 years including The Guardian, Psychologies, GQ, Esquire, Marie Claire and The Times. He has been in successful continual recovery since January 2002.

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