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Rational Emotive Behavior Therapy

Using REBT to Treat Panic Disorder

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Updated June 18, 2014

Rational emotive behavior therapy - REBT – is a cognitive behavioral technique developed by Dr. Albert Ellis. REBT is known to be effective for the treatment a variety of anxiety disorders. The cognitive and behavioral techniques used in REBT have demonstrated effectiveness in treating panic disorder.

Considered the grandfather of CBT, Dr. Ellis developed his technique to teach his patients to detect and dispute “irrational beliefs” that he believed were causing their psychological problems. He puts most irrational beliefs under three main headings:

  1. I must do well and have the approval of others or else I am no good.
  2. Other people must treat me well and do "the right thing" or else they are no good and deserve to be punished.
  3. Life must be easy, and I must get what I want without discomfort or inconvenience.

Ellis believed that holding such rigid underlying beliefs is at the root of emotional disturbances because we become unable to experience negative life occurrences in a psychologically healthy way. Instead, we develop unhealthy feelings, such as depression, anxiety and decreased self-esteem. By uncovering faulty thought patterns, they can be restructured. We become free from blaming ourselves and others for imperfections, and we can discard the demands of our irrational thoughts.

Let’s look at an example

Mary stopped socializing with family and friends because of her panic attacks. She believed that if she were out and began to panic, her family and friends wouldn’t understand. They would think she was “crazy.” After exploring Mary’s thought process using REBT, the following irrational beliefs are discovered:

  • I must have others' approval or else I am not a good person.
  • I must avoid doing anything that would make others think less of me.
  • I must avoid unpleasant situations.

These thoughts are viewed as irrational because they are unrealistic and not self-accepting. Emotionally, Mary has increased panic and anxiety. Behaviorally, she demonstrates avoidance.

What’s Next?

A therapist using REBT will take on a role of teacher. After detecting irrational beliefs, the next step is to dispute them. This would involve debating or challenging the beliefs logically so that Mary would be able to identify which are rational and which are irrational. The irrational are reworded so that they are more logical and realistic. For example:

If I go out with my friends and begin to panic, it may be uncomfortable or inconvenient, but it will not be devastating.

I don’t need to have others' approval to be OK.

REBT Techniques

Cognitive techniques are used to detect irrational beliefs, to separate the rational from the irrational and to change one’s way of thinking. An REBT professional may guide you in:

  • Debating and disputing your irrational ideas
  • Gathering information to validate or refute your assumptions
  • Rewording your self-talk

Emotive techniques are used to further dispute irrational beliefs and change thoughts, emotions and behaviors. Emotive techniques may include:

  • Role playing to rehearse situations and work through any underlying irrational beliefs and associated feelings.
  • Shame-attacking exercises to help reduce the shame associated with certain behaviors and increase your self-acceptance.
  • Using humor can bring about emotional benefits by pointing out absurdities in your pattern of thinking and behaving.

Behavioral techniques are used to develop more effective ways of thinking and doing. For example, learning and using relaxation techniques, such as:

Deep Breathing
Progressive Muscle Relaxation
Guided Imagery
Meditation
Journaling

Finding an REBT Professional

The Albert Ellis Institute maintains a searchable database of REBT professionals. You can search by location and specialty to find a panic disorder treatment provider in your area.

Sources:

Corey,G. (2009). Theory and Practice of counseling and Psychotherapy. Belmont, CA: Thomson Brooks/Cole.

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