PART FOUR

Therapy: Getting Down to

D—Disputation, and E—the
New Effective Response
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 10

Cognitive Change Strategies

Identifying the As, Bs, and Cs is necessary, but changing the beliefs through steps
D and E is the work of therapy. Disputation is a debate or a challenge to the cli-
ent’s irrational beliefs and can include cognitive, imaginal, emotive/evocative, and
behavioral components.
Initially REBT theoreticians and practitioners focused on the importance of
disputation as the most important change process. However, since the last edi-
tion of this book, REBT practitioners have focused more on the importance of
teaching new rational alternative beliefs at step E as well. Two studies found that
teaching the new alternative belief was more e!ective than just challenging the
Irrational Beliefs (Moriarity, 2002). In addition, a survey of REBT trained prac-
titioners revealed that they thought that teaching the new beliefs was the most
important process of therapy (Beal and DiGiuseppe, 1998).
We have identiked three basic strategies to disputation or changing the belief. #e
krst involves indentifying the A-B-C and then proceeding to challenge the irrational
belief that was identiked. #e therapist proceeds through many di!erent types of
disputes and debates and then helps the client construct a new rational alternative
belief. #is was the primary strategy most o$en used by Albert Ellis. #e second
strategy involves the therapist teaching the distinction between RBs and IBs krst,
and then proceeding to dispute and debate the client’s IBs and reinforcing the alter-
native RBs. A third strategy would involve teaching the distinction between IBs and
RBs and then moving on to have the client rehearse and adopt the new alternative
RBs. We do not yet have research to support which of these strategies is the most
e!ective. We suspect that each strategy might be the most e!ective for specikc types
of clients. For some clients, one problem will improve most with one strategy, but the
same strategy will not work with another problem, with which another strategy is
more e!ective. We encourage you to try to master all three strategies and then keep
track of which strategy works best for which clients or for which type of problems.

W H AT T O D I S P U TE

REBT therapists never challenge or dispute a client’s emotions. Emotions are

experiences, they are not a matter of fact or opinion and therefore not debatable.
162 D I S P U TAT I O N A N D T H E N E W E F F E C T I V E R E S P O N S E

In fact, one of the key di!erences between cognition and emotion is that emotions
are not debatable.
Challenging an emotion invalidates the client’s feeling. It also communicates
to the client that they should not feel the emotion or should change it without
any skills or techniques to do so. Consider this example: If I say I am cold, and
the other two people in the room say they are hot and sweaty and point out that
the temperature in the room is 100 degrees, I still feel cold. #e others’ feedback
is functionally irrelevant. “I’m cold” is not disputable, any more than emotions
are. When others argue with my experience of being cold, they are really saying,
“#ere’s something wrong with you for feeling cold,” and “You really shouldn’t feel
cold.” Now substitute some emotion for the experience of “cold,” and you can see
how invalidating it would seem to clients to have their experience and sense of
reality challenged. Emotions are to be respected. #ey are the client’s experience
and are not to be challenged.
Recall that when clients give us dysfunctional cognitions they will be one
of three broad types: A–(inferences), IB–(demandingness) that are impera-
tive or schematic in nature, and IB–(derivative). #e theory postulates that the
A–(inferences) arise from the core/imperative cognitive schemas. #erefore, we
challenge these core thoughts directly and not the inferences. REBT therapists
aim disputations at either the IB–(demandingness) or the IB–(derivatives). Some
REBT practitioners believe that we should challenge the IB–(demandingness)
krst and then the derivatives. Others believe that we should challenge whichever
IB most resonates with the client’s experience.
When disputations target the clients’ A–(inferences), we term this an inferential
or inelegant dispute. #e cognitive errors will likely involve errors of induction, in
which clients make overgeneralized conclusions based on insuwcient data (e.g.,
“Because he didn’t call me, he doesn’t love me.”). When the client’s attributional
set is dysfunctional—that is, problems at A are seen as internal, global, and sta-
ble—it might be helpful to get the client to reinterpret the problem as temporary,
external, or limited in scope (Weiner, 1985). Assume, for example, that I observe
that a number of people in my audience are not attending to my lecture and my
mood plummets a$er I make the attribution that the audience is inattentive
because I am boring. An inferential disputation would temporarily reassure me
that it is very early in the morning and people probably have not had their co!ee
yet. Nevertheless, I still might be boring, and more evidence will accumulate that
people do not like or attend my lectures. As this evidence accumulates, the reat-
tribution strategy will no longer work. What if my next lecture is in the evening
and people still do not pay attention despite my supplying them with signikcant
amounts of ca!eine? #e feared bad event could always happen. Arguing that it
has a low probability of occurring or that it occurs because of some reason other
than my performance does not give the client a way to cope with it if it does hap-
pen and might hinder progress in therapy, because temporary solutions fail to
change the client’s underlying core, imperative, and derivative beliefs.
Disputations targeted at the irrational beliefs of the client are referred to as
philosophical or elegant disputes. #ey are philosophical because they get to the
Cognitive Change Strategies 163

core assumptions and foundational beliefs of the client. #ey are elegant because
they work in many situations especially when the worst thing really happens.

B2j 10.1
When we teach new students, we o$en observe that they identify their clients’
A-B-Cs, but do not move one to disputation or suggest alternative RBs. Instead,
they return to explore more A-B-Cs. #ey have quickly and ewciently outlined a
simple A-B-C. Instead of moving into D and E, they return to assessment (e.g.,
“ . . . and what else were you feeling?”). Perhaps one of the reasons for this error
is not knowing how to dispute or feeling uncomfortable challenging the clients’
thoughts. A second reason is that students fear that clients will interpret the debate
on their thoughts as an attack on them as a person.
A strategy that helps is to use a setting phrase. For example, you can simply
repeat an irrational belief of the client and then say: “OK, now that we have found
that this specikc belief is causing you trouble, let’s examine this belief.”
If you still feel unsure of how to begin, you might follow the setting phrase by
putting the problem in the hands of the client, “Do you see any ways we could
begin to change that belief?”

C O G N I T I V E D I S P UTATION

Cognitive disputations are attempts to change the client’s erroneous beliefs through
philosophical persuasion, didactic presentations, Socratic dialogue, vicarious
experiences, and other modes of verbal expression. One of the most important
tools in cognitive disputation is the use of questions. We pointed out previously
that it is generally good to avoid asking “why” questions when assessing As, Bs,
and Cs; in disputation, however, “why” questions might be particularly fruitful.
In this section, we will present categories of disputes and specikc questions
to present to clients. #ese disputes are culled from disputations by Ellis (1962,
1971, 1974b, 1979b) and other therapists at the Albert Ellis Institute in New York
City. We present them as examples to get you started. Note that by relying on such
questions, the therapist is making the client do the work and thereby become
more likely to internalize a new healthy philosophy.
We use #omas Kuhn’s (1962) model from the philosophy of science to guide
the disputation process of REBT. #omas Kuhn was a theoretical physicist, his-
torian, and philosopher of science. He reviewed the strategies of thinking and of
examining evidence that lead scientists to change their theories over the centuries.
Kuhn called grand scientikc theories paradigms. He believed that a paradigm was
a set of beliefs that in(uenced the data that one perceived, the inferences that one
drew, and the data one considered important. Irrational beliefs are like paradigms,
but they are personal views about one’s construction of reality at certain moments.
As we have pointed out above, they in(uence the inferences and attributions that
164 D I S P U TAT I O N A N D T H E N E W E F F E C T I V E R E S P O N S E

we make about the world. Kuhn (1977) also believed that scientists (and people)
ignore the evidence against their beliefs until the evidence is so overwhelming that
change happens suddenly. We have this model of change to the therapeutic pro-
cess (DiGiuseppe, 1986). #e clinical strategies suggested by this model include

• Collecting data on the hypotheses and predictions made by the irrational

beliefs/schema and testing them empirically.
• Challenging the logical consistency of the irrational beliefs/schema to see
whether it really explains the important events it is designed to explain.
• Checking the irrational belief/schema paradigm to see whether it is
consistent with other important sets of data to see how consistently it
explains other life events.
• Checking the heuristic value of the irrational belief/schema paradigm by
assessing its e!ect on the quality of the client’s life and its utility in attaining
the client’s personal goals.
• Repeating these steps suwciently so as to create considerable tension in the
client that the irrational belief/schema paradigm is a viable construct.
• Helping the client construct alternative rational belief/schema paradigms
to replace the irrational personal paradigm.
• Reviewing the empirical evidence that was used to disconkrm the previous
irrational paradigm to see whether the present rational paradigm is more
consistent with the data.
• Making predictions from the new rational paradigm and seeing whether
these are empirically supported.
• Reviewing the e!ects on the person’s life to see what di!erence will be
made by adopting the rational paradigm and seeing whether these lead
to an increase in the quality of life and attainment of more of the client’s
personal goals. #at is, assessing the new rational belief ’s heuristic/
functional value.

Disputing, then, is not just empirical verikcation or logical challenging, but a

complicated process whereby the logical consistency, heuristic/functional value,
and empirical evidence are used to evaluate the theory and the alternatives. Each
of these cognitive disputes is described below. We do not mean to imply that they
should come in any order. Presently there has been very little research on the
di!erential e!ectiveness of these disputes. However, our survey of practitioners
trained at the Albert Ellis Institute indicated that they believed that the heuristic/
functional were the most e!ective.
Below we will present some questions that are examples of logical, empirical,
and heuristic/functional disputes. When you read these examples think of the fol-
lowing case and how the questions challenge this client’s irrational beliefs. Barbara
is a nurse who works in a busy ward of a hospital on a large team of healthcare
providers. She has ideas of how the team could work more ewciently but fails
to assertively o!er her suggestions. When the therapist asked Barbara how she
would feel if she did speak up, she reported that she felt fearful and anxious that
Cognitive Change Strategies 165

her peers would reject her ideas and would think she was stupid and intrusive
(A–Inference). She revealed these irrational beliefs:

• IB–(imperative/demand)—Because I want my peers to respect me, I must

be respected by them.
• IB–(derivative/ awfulizing)—It would be awful if my peers disliked me.
• IB–(derivative/self-worth)—I would be worthless if they did not respect me.
• IB–(derivative/frustration intolerance)—I cannot stand it if they do not
respect me.

Logical Disputation Questions

#e krst group of questions asks for semantic clarity and logical consistency
in the client’s thinking and can be used to challenge any IB. #e discussion of
semantic clarity is necessary and precedes any discussion of the logic of any
position.

• What do you mean by that word “must”?

• What do you mean by the word “awful”?
• What do you mean by the word “worthless”?
• What do you mean by “I can’t stand”?
• You said that because you want your peers to respect you, they must
respect you. Is that good logic?
• How do you get from wanting them to respect you to the belief that they
must respect you?
• If you heard someone else making a similar argument that because she
wanted something, that it must be, would you be convinced?
• Why is it illogical to say that because you want your peers to respect you,
they must respect you?
• Explain to me how you become worthless because they do not respect you?
• Why does it have to be so, just because you want it?
• How is it inconsistent to believe that because you want their respect you
must have their respect?
• Does it logically follow that because you want them to respect you, they
must respect you?
• Does it logically follow that you become worthless based on their respect
for you?
• What is wrong with the notion that you are a worthless person?
• What is wrong with the notion that you would not stand it?
• How does it follow that you will not be able to stand not getting what
you want?
• You might not like it if your colleagues do not respect you, but does it
logically follow that you cannot stand it?
166 D I S P U TAT I O N A N D T H E N E W E F F E C T I V E R E S P O N S E

#ese questions focus on whether the client’s irrational beliefs follow from the
reasoning that the client uses. For example, when most clients are asked, “Why
must the world be the way you say it must be?” they proceed to explain how it
would be more desirable for them. Ellis’s classic dispute points out that because
something is more desirable, it does not logically follow that the world must pro-
vide what is desirable. Desirability and the client’s reality are not related to each
other; to proceed from desiring to demanding is to use a logical non sequitur.
Some therapists like to ask the direct question “Why must it be . . . ?” or
“Why must it not be . . . ?” when the client and therapist have formulated a clear
imperative/demanding cognition as the cause of the C. It is surprising how
successful this question can be, as well as how much information it can yield and
how therapeutic it can be.
Other disputes focus on the logical inconsistency among di!erent aspects of the
client’s belief system. For example, Barbara condemns herself for not accomplish-
ing a specikc goal or reaching a specikc aspiration. She could be asked (a) would
you condemn others for failing to reach that same goal? On the other hand
(b) would you condemn others for failing to reach their own goals? Clients o$en
respond “no” to such questions. Moreover, we respond “How is it logical, to con-
demn one person for failing, but not another person for the exact same thing?”
#e logical inconsistency can be repeatedly illustrated with such questions and
comparisons.

Empirical or Reality-Testing Disputation Questions

#e second group of questions requires clients to evaluate whether their beliefs

are consistent with empirical reality. For example, most “demanding” beliefs can
be shown to be inconsistent with reality. No matter how strongly clients believe
that the world “must” be the way they want it to be, the universe usually does not
change to match the “must.” Content analyses of Ellis’s therapy recordings indi-
cate that he o$en used this argument. He asked clients what reality is, and then
pointed out that it is not consistent with their “must.”
Clients who endorse frustration intolerance beliefs can be shown that even
though they think they cannot stand the occurrence of A, they have, in fact, “stood
it” repeatedly. Questions can require the client to evaluate whether future events
will occur, and, if so, whether they will be as unpleasant as the client anticipates.
Self-downing beliefs, in which the person condemns himself or herself as totally
worthless, can be shown through questioning to be incorrect, because all people
do some things well. Below are some examples of questions to test the consistency
between a client’s belief(s) with empirical reality.

• You have been demanding that they respect you for years. Has that demand
changed them in any way?
• So they have disrespected you despite the fact that you demand that they
respect you.
Cognitive Change Strategies 167

• Where is the evidence that your colleagues must respect you?

• Where is the evidence that you are worthless to society, the universe, or
anyone because your colleagues disrespect you?
• If your colleagues have disrespected you, and you are still here, have you
stood it?
• Assume that they do disrespect you, what is good and worthwhile about
you now that they are disrespecting you?
• What do you do well even as they are disrespecting you?
• If these colleagues disrespect you, do you have value for any others in the
world?
• What would really happen to you if your colleagues disrespected you?
• What is the most diwcult adversity you have survived in your life? Client
answers . . .
• Well, you survived and stood it. Now how does that compare with their not
respecting you?
• So, have you survived or stood anything worse than their disrespecting you?
• Let’s be scientists. What do the data show?
• What good things could happen even if they disrespected you?
• Can you be happy even if you do not get what you want?
• How will your world be destroyed if they do not respect you?
• Where is it written that your peers must respect you?
• Where is it written that you need your peers’ respect to be worthwhile?

Pragmatic Disputation Questions

#e third group of questions does not challenge the logic or test the reality of the
clients’ thinking, but instead persuades clients to assess the hedonic, pragmatic,
or heuristic value of their beliefs. Remember, rational beliefs help one attain one’s
goals. #erefore, beliefs can be evaluated on this functional criterion. Does a par-
ticular idea help the client to solve a personal problem? Attain a desired goal?
Provide other positive consequences? Mitigate emotional turmoil? Below are
some pragmatic disputes that could be used with the client, Barbara.

• So you believe that they must respect you. How much money has that
made you?
• How has the demand that they must respect you gotten them to respect you?
• When you condemn yourself for not being respected, how does that help
you get what you want? Or to be e!ective?
• So, you think it is terrible that they do not respect you. How is that thought
working for you?
• “Whatever I want, I must get.” Where will that command get you?
• Is it worth it for you to hold on to the belief that “I must be respected”?
• When you think that way, how do you feel? . . . And is that feeling helpful
to you?
168 D I S P U TAT I O N A N D T H E N E W E F F E C T I V E R E S P O N S E

• Does that thought motivate you to get to work?

• What happens to you when you think that thought?
• Why do you hold onto a belief that causes you so much trouble?
• Can you list all of the ways that your belief has helped and hurt you to
accomplish your goals?

Caveats for Cognitive Disputing

When you challenge clients’ IBs, allow the client time to contemplate your ques-
tions fully. New therapists o$en knd these silences aversive, especially if they mis-
takenly believe that they must be directive at all times. Silence, in this instance,
can indeed be golden. #is suggestion implies that you will be careful to ask only
one question at a time; no barrages, please. If you stack the questions, the client
does not have the opportunity to think through your disputes. Take your time
and become comfortable with the client’s silences. In social situations, silences
are uncomfortable and indicate a break in the conversation or a poor connection
between the speakers. In disputation, a silence means the client is thinking about
your question. #e longer they remain silent the more cognitive restructuring is
taking place. A good barometer of an e!ective disputation question is how long it
takes the client to answer. If they answer immediately, they might not be rethink-
ing, and you might not have asked a penetrating question. So attend to the latency
of the client’s response a$er your questions. Long latencies can be good. Do not
provide answers to your own questions until you give the client a chance to reach
for his or her own answers.
Be aware, however, that disputation questions can lead to discomfort for some
clients, primarily because many of the questions have no immediate or com-
mon sense answer (e.g., “Where is the evidence for that belief?” None exists.).
#erefore, although you are waiting for the clients’ responses, observe any non-
verbal signs of discomfort that might be exhibited during this period. If your cli-
ents are exceptionally distressed, ask them what feelings they are having and knd
out what irrational beliefs they are telling themselves. Perhaps they are awfulizing
about not knowing the answers to your questions or realize that they are thinking
in an unhelpful way. #ey might feel uncomfortable that you are asking them to
give up a familiar idea. If any of these are true, they might not be attending to the
points you are making during disputation. Uproot these irrational beliefs before
you continue with the original disputation.
Clients frequently respond to disputing questions by giving you evidence in
favor of the rational belief. For example, when the therapist attempts to dispute
the concept of awfulness (e.g., “Where’s the evidence that this is so terrible?”), the
response of the client will usually be to justify why the situation is undesirable
(e.g., “Because I don’t like it!”). In this example, the client is failing to discriminate
between undesirable and awful. #e most common error made by a new therapist
is to be stumped by the client’s reasoning. Instead, the therapist can point out to
the client that his or her retort provides evidence for the rational statement, but
Cognitive Change Strategies 169

is not an answer to the original question. #e therapist repeats the question until
the client comes to the appropriate conclusion that no evidence exists for the IB.
Consider this interchange with the client, Barbara, mentioned above.

T: But what evidence do you have, Barbara, that you must have their respect?
C: Because, well I want them to respect me. And, I will feel better if they respect
me.
T: Barbara, that is evidence for why you want it. Because you want it and would feel
good if they respected you, but the question is why must they respect you?
C: Because I have a lot to o!er and I have good ideas. I deserve their respect!
T: Barbara, it could be true that you have great ideas and make a great contribu-
tion to work. However, that is only further evidence that it is unfortunate you
did not get their respect. Why must they respect you even if you are making a
great contribution and have great ideas?
C: You mean that they do not have to respect me even if I deserve their respect?
T: #at’s right, Barbara! #ey are who they are, and they feel what they feel and
although you might have great ideas and could make a contribution, we cannot
make them respect you.

In the above example, the therapist validates that not getting the respect would
in fact be bad, but that does not mean that it must not exist. In general, it is good
to realize that when clients say that something is terrible or awful that they o$en
are saying two things: (1) something is bad or even very bad; and (2) that there-
fore it must not exist. We want only to direct our interventions to the second
one and leave the krst one alone. For example, when someone has experienced
a very bad life event, such as a soldier who experiences the death of his comrade
beside him, he will say that it was terrible. When you dispute this with: “How is
it terrible?” #e person could answer: “What do you know about such an expe-
rience?” Challenging the awfulizing can be invalidating to the client and they
might be very resistant to the intervention. So, we can help such clients by saying,
“Although such things are very bad, they still do happen. Now will it help you to
acknowledge that such bad things do occur.” In cases of trauma, we do not recom-
mend disputing the awfulness of the trauma but encourage the client to accept or
acknowledge that the trauma did happen.
Clients will o$en persist in providing similar answers far longer than Barbara
did. #e therapist can continue to go over the distinction between the rational and
irrational beliefs until the client understands it. #is could take several sessions.

Question Core/Imperative IBs and Derivative IBs

We noted earlier the importance of questioning your client’s irrational beliefs in

the form of both her/his core/imperative (rigid belief) and at least one of his/
her three derivatives from that premise (awfulizing belief, frustration intoler-
ance belief, or depreciation belief). If you decide to question the demand before
170 D I S P U TAT I O N A N D T H E N E W E F F E C T I V E R E S P O N S E

beginning to question a derivative from the demand, persist until you have shown
your client that there is no evidence in support of his/her demand. Similarly, if
you have chosen to question your client’s rational belief krst, show her/him that
there is evidence in support of the RB before moving on to question the main
derivative from the rational belief.
Switching from demand to derivative (and from derivative to demand) can be
confusing for the client. However, if you have persisted in questioning a demand
and it becomes clear that your client is not knding this helpful, you can redirect
your focus toward a derivative and then monitor your client’s reactions. Some cli-
ents knd it easier to understand why these derivatives are irrational than why their
musts are irrational. In the same way, if your client knds it hard to understand why
her preference is rational, then it might be more enlightening for him/her to con-
centrate on discussing a derivative (e.g., self-acceptance) from the demand.

S T Y L E S O F C O G NITIVE DISPUTING

A second dimension of cognitive disputation strategies is the style of the argu-

ment. #erapists can provide each of the above arguments in didactic, Socratic,
metaphorical, humorous, vicarious, and self-disclosing styles.

Didactic Style

Didactic strategies include the use of mini-lectures, analogies, and parables to

teach a point. Lectures, as we suggested earlier, are best kept brief and could be
useful when new ideas are being presented to the client. As the client becomes
familiar with REBT, the amount of time spent on didactic teaching can be gradu-
ally decreased over the sessions. When you do didactically teach, try to assess
whether the client understands the concept you are teaching. A good way to do
this is to follow didactic discourse with some Socratic dialogue. #ere is wide lati-
tude for creativity in devising or borrowing stories to teach how the client’s rea-
soning is faulty and what alternative philosophies can replace it. Some examples
are provided in the following sections, in which suggested disputations for core
irrational concepts are outlined.
Although REBT therapists prefer the Socratic style, asking questions does not
always prove productive. If not, you might have to shi$ to give more lengthy
didactic explanations concerning why an irrational belief is self-defeating and
why a rational belief is more productive. Indeed, you will probably have to use
didactic explanations to varying degrees with all of your clients at some point in
treatment.
When you use didactic explanations, be sure that your clients understand what
you have said by asking them to paraphrase your points. You might say, for exam-
ple, “How would you say that?” Observe your client’s nonverbal and paralinguistic
signs of understanding (e.g., head nods, “hmm-hmms”) as evidence that they have
Cognitive Change Strategies 171

understood you. Such questions help your clients to become active participants in
didactic explanations of REBT, and not passive recipients of the information.

Socratic Style

Many forms of psychotherapy, especially forms of CBT, use the Socratic Dialogue
and its sequencing of questions to guide clinical interviews, foster self-discovery,
and promote change. Some scholars consider Socrates the krst psychotherapist
(Chessick, 1982). Socrates saw the purpose of his teaching as deepening a per-
son’s self-awareness, self-acceptance, and self-regulation (Overholser, 1996) and
promoting virtue and self-development (Overholser, 1999). #e importance of
self-awareness emerges in the statement attributed to Socrates, “the unexamined
life is not worth living” (Lageman, 1989). Socrates viewed himself as a gad(y that
irritates the horse and keeps it moving without guiding or directing it. Socrates
used an analogy for human thought as a winged chariot driver struggling to use
reason to control his two horses, one noble, rational, and calm, while the other
was unruly, impulsive, and emotionally reactive. #e struggle of the charioteer
serves as a metaphor for our clients’ struggle to use their rational thinking to
control the irrational beliefs and emotions. #e goal of the Socratic Method is to
teach students to internalize the questioning process (Areeda, 1996). #is sounds
remarkably close to the objectives of REBT. By constantly questioning our think-
ing, we develop and reawrm philosophies that are more rational, experience
healthier emotions, and achieve a more adaptive life.
Overholser (1993a; 1993b; 1994; 1995; 1996; 1999; 2010) has written extensively
on the Socratic Method in psychotherapy, and in CBT in particular. He has identi-
ked several components of the Socratic Method for therapists to follow from the
work of the ancient Greek philosophers. Overholser’s works provide an excellent
guide to integrating the Socratic Method into clinical practice, and we strongly
recommend that you read his works. Overholser’s components of the Socratic
Method include (1) systematic questioning (1993a); (2) inductive reasoning
(1993b); (3) exploring universal deknitions (1994); (5) disavowal of knowledge
(1995); (5) self-improvement (1996); and promoting virtue in daily life (1999).
Systematic questioning involves a planned sequence of questions that guide
the dialogue. #erapeutic questions encourage the exploration of di!erent topics
and strands of evidence and result in the accumulation of relevant information
about the topic at hand. Systematic questioning allows clients to actively think
di!erently and examine personal issues, values, and assumptions. Questions can
vary by the form, content, and process used to structure a series of questions
(Overholser, 1993a). #e form of a question in(uences the type of answer that
is elicited. Socratic questioning is not legalistic interrogation (Areeda, 1996). It
avoids stacking questions for the client to answer at once, so s/he feels as though
the therapist is playing “Guess what I am thinking.”
#e Socratic Method helps clients and therapists engage in collaborative
searches for information and an understanding of each client’s experiences.
172 D I S P U TAT I O N A N D T H E N E W E F F E C T I V E R E S P O N S E

Overholser recommends using open-ended questions. Open questions ask the

respondent to think and re!ect. #ey ask for opinions, and they put control of
the conversation to the respondent. #ese questions allow for multiple possible
answers. Open-ended questions encourage creativity concerning what line of
experiences and evidence are examined, and o$en results in the therapist and
client taking a new perspective on the problem. Although open-ended questions
are preferred, Overholser (1993b) suggests that when clients are stuck and fail to
answer, therapists can switch to leading questions to push the dialogue forward. A
leading question includes an implied assumption. For example, the question “Did
that thought help you in that situation?” assumes that the thought led or contrib-
uted to the outcome of being upset. An explication question involves stepping
backward when the client answers, “I don’t know.” When the therapist asks, “What
did happen when you had that thought?” and the client replies, “Well, it was not
a good outcome,” but does not identify the outcome, the therapist might just ask:
“So what did happen a$er you had that thought?” or “Did you accomplish your
goals a$er that thought?”
#e Socratic Method also uses inductive reasoning to reach conclusions.
#e questioning guides clients to examine aspects of their lives and collect
information. Inductive reasoning makes generalizations based on individual
instances. In this sense, it is contrasted with deductive reasoning. Inductive
reasoning helps clients form new generalizations through a gradual accumula-
tion and systematic review of evidence (Gambrill, 1993). Inductive reasoning
involves analyzing similarities and di!erences among specikc experiences to
extract a general principle about a class of events. In psychotherapy, inductive
reasoning helps clients develop appropriate expectations and coping strategies
at an abstract level.
Dekning terms can be the beginning of disputing. Universal deknitions describe
the characteristics of a thing that are suwcient to capture the essence of a concept
(Overholser, 1994). We strive for deknitions of words that describe a concept in
such a way that the concept remains unchanged when specikc instances or exam-
ples of the concept vary. For example, “love” can be dekned broadly as to feel
tender a!ection for somebody such as a close relative or friend, or for something
such as a place, an ideal, an animal, or a person. When a client says that someone
does not love him or her because the person did not like everything the client
does, the client is placing a new characteristic into the deknition. #is new dekni-
tion could set such a high standard for love that few people, if anyone, could be
said to love the client because almost no one could like everything the client does.
#e process of formulating deknitions helps clients evaluate the appropriateness
of the terms they use and the generalizations they make. “So, what do most people
mean when they say they are worthless?” Deknitions are important because lan-
guage in(uences our perceptions, descriptions, and understanding of the world
(Efran et al., 1990).
#e deknition process usually begins with refuting a critical evaluation of the
client’s generalization. When the client uses a term to classify a broad category
of events, the therapist requests a clear and unambiguous deknition of the term.
Cognitive Change Strategies 173

#e questioning process o$en reveals confusion in the client’s original generaliza-

tion and its deknition. #erapist and client work together to knd the limitations or
exceptions to the client’s deknition. Acceptable deknitions must meet certain cri-
teria. #e deknition should not use kgurative or metaphorical language. #erapists
can ask clients to clarify their term (e.g., “What do you mean when you say you
are worthless?”) and explain how they use a term. Such dialogues examine the cli-
ent’s deknition to identify where and how it might be inadequate. In true Socratic
style, the dialogue aims to refute the client’s original deknition, delimit overgen-
eralizations, and gradually collect examples that help the client develop a new
and more useful deknition (Chessick, 1982; Sternberg, 1998). #is aspect of the
Socratic Method incorporates the aspects of General Semantic theory that we dis-
cussed in Chapter 1. People o$en use words indiscriminately and do not examine
their meaning nor do they o$en perceive the e!ect that labeling people and events
with certain terms has upon them. By exploring the deknitions of terms, much
of the client’s overgeneralization, self-condemnation, and catastrophizing can be
eliminated.
Disavowal of knowledge is another characteristic of the Socratic Method
(Overholser, 1995). Classical scholars refer to the disavowal of knowledge as
“Socratic ignorance.” A Greek citizen once declared, “No one is wiser than
Socrates” because Socrates was the rare person who admitted he was ignorant.
Socrates claimed to have no knowledge, but he had respect for the inquisitive
abilities of the mind. Socratic ignorance helps both therapist and client to respect
the limits of their knowledge. #ey recognize that they do not know what is best
for the client, or what experiences the client has had that are relevant to solving
the problem at hand. Even if therapists think they do know an answer, they rely
on their client’s ability to reach the conclusion independently. Most people tend
to notice, accept, and remember information that supports their beliefs while they
ignore, avoid, or belittle information that does not match their view. Clients can
learn to evaluate the (1) quantity, (2) quality, (3) diversity, and (4) coherence of the
evidence for and against their beliefs.
In order for the process to be e!ective, all four of these components need to
work together. #erapy can focus on client self-improvement, with an empha-
sis on self-awareness, self-acceptance, and potential self-regulation of a!ect and
behavior. In addition, therapy discussions can explore the meaning of virtue,
including wisdom, courage, moderation, justice, and piety.
Overholser (1995) recognized that Socrates used his teaching method to pro-
mote self-improvement. Socrates divided self-improvement into three main
components: self-awareness, self-acceptance, and self-regulation. #e most rel-
evant to our present discussion is the use of the Socratic Method to promote
self-acceptance. Self-acceptance can be achieved a$er a thorough and rational
review of the client’s strengths and weaknesses. #rough questioning, therapists
can help clients to knd their natural skills, talents, and traits to help them grow
into useful qualities and productive habits. #e Socratic Method adheres to the
metaphor that “you can only help an acorn grow into an oak tree” or the ancient
view, “do not force a cobbler to become a soldier.”
174 D I S P U TAT I O N A N D T H E N E W E F F E C T I V E R E S P O N S E

B2j 10.2
One of Ellis’s krst trainees and early supervisors at the Albert Ellis Institute, Ed
Garcia, used an exercise with new therapists to teach Socratic Dialogue. He asked
them to conduct an entire therapy session using only questions and avoiding any
declarative sentences. Record a session and notice how close you came to this
goal. We are not recommending that all therapy sessions only take the form of
evocative questions. Too many questions could prove irritating to clients if they
believe that you have something to say and are “beating around the bush” instead
of saying it directly. #is exercise is designed to give you practice in the art of
Socratic Dialogue.

Humorous Style

Another widely used form of cognitive disputation and a primary tool of REBT is
humor. Ellis (1977c) was noted for his use of this style, not only in front of audi-
ences but also in individual, group, and conjoint sessions. #ere is no rule that
therapy must be stodgy, dull, or super-serious.
Ellis always thought humor was a critical part of psychotherapy and used it as
a means of attitude change. Humor is the tendency of particular cognitive expe-
riences to provoke laughter and provide amusement. #e term derives from the
humoral medicine of the ancient Greeks, which taught that the balance of (uids in
the human body, known as humors (as in the Greek word chymos, literally juice
or sap), controlled human health and emotion.
Cognitive scientists (Hurley, Dennett, and Adams, 2011) have noted that most
theories concerning humor focus on the content of why we knd certain things
funny. However, the more intriguing questions concern why humans knd any-
thing funny and have a sense of humor at all. From an evolutionary perspective,
what is the survival value of humor? According to their new theory, Hurley et al.
(2011) see humor as a means of correcting our false assumptions and thinking
errors. #e primary purpose of the human brain is to make sense of our daily lives
by designing schema and assumptions based on sparse, incomplete information.
However, mistakes in our schema are inevitable and even a small faulty assump-
tion can lead to costly mistakes. Humor is the reward we get for seeking out and
correcting our mistaken assumptions. A cognitively based psychotherapy focused
on correcting faulty thinking welcomes humor as a natural error detector.
Watching comedic and humorous videos increases self-control (Tice, Baumeister,
Shmueli and Muraven, 2007). Humor works best when it contrasts ideas, con-
trasts di!erent meanings for the same word, and exaggerates aspects of an idea of
meaning.
#ough ultimately decided by personal taste, the extent to which an individ-
ual will knd something humorous depends upon a host of variables, including
geographical location, culture, maturity, level of education, intelligence, and con-
text. For example, young children may favor slapstick. Satire may rely more on
Cognitive Change Strategies 175

understanding the target of the humor and thus tends to appeal to more mature
audiences. Nonsatirical humor can be specikcally termed “recreational drollery.”
Many theories exist about what humor is and what social function it serves. #e
prevailing types of theories attempting to account for the existence of humor
include psychological theories, the vast majority of which consider humor-induced
behavior to be very healthy; spiritual theories, which may, for instance, consider
humor to be a “gi$ from God”; and theories that consider humor to be an unex-
plainable mystery, very much like a mystical experience.
#e root components of humor are (a) being re(ective of or imitative of reality,
and (b) surprise/misdirection, contradiction/paradox, or ambiguity. #e methods
of humor include hyperbole, metaphor, reduction ad absurdum or farce, refram-
ing, and timing.
Once you get used to using humor carefully, you and your client could enjoy
your hours together more. #e use of humor does entail one caveat: the target of
the humor is always the client’s irrational belief and not the client. It is important
to assess your client’s ability to use and understand humor, and his/her ability to
understand the target of the humor. #e therapist might want to discuss the use of
humor with the client prior to utilizing it.
With some clients, a productive way of making the point that there is no evi-
dence for irrational beliefs is to use humor or humorous exaggeration. As Walen
et al. (1992) note:
If the client says, “It’s really awful that I failed the test!” the therapist might
respond, “You’re right! It is not only awful, but I do not see how you are going to
survive. #at is the worst news I have ever heard! #is is so horrendous that I can-
not bear to talk about it. Let’s talk about something else, quick!” Such paradoxical
statements frequently point out the senselessness of the irrational belief to the cli-
ent, and very little further debate might be necessary to make the point.

Metaphoric Style

Metaphors are the concept or process of understanding one thing in terms of

another. A metaphor is a kgure of speech that constructs an analogy between
two ideas. #e analogy is conveyed by the use of a metaphorical word in place
of some other word. For example: “Her voice was a sonata.” Metaphors compare
things without using the words “like” or “as.” Metaphors involve the transfer of
meaning from one element to another. Scholars, authors, and teachers have used
them for centuries as a method of teaching and communicating in many kelds.
Ortony (1975) noted the mnemonic function of metaphor by pointing out that
the memorability, compactness, and vividness of metaphors are what make them
a highly e!ective learning device. #is general facilitation view deknes metaphors
as high-imagery words that are more memorable and has received empirical sup-
port (Reynolds and Schwartz, 1983; Paivio, 1986).
Psychotherapists have used metaphors since Breuer and Freud (1895/1955)
started the “talking cure”; and there are many di!erent ways that they can be used.
176 D I S P U TAT I O N A N D T H E N E W E F F E C T I V E R E S P O N S E

(See Muran and DiGiuseppe, 1990 for a review.) Clinical experience suggests that
clients o$en become overwhelmed by cognitive restructuring and fail to remem-
ber all the relevant challenges to their IBs and the RBs. Muran and DiGiuseppe
(1990) suggested that the mnemonic functions of metaphors ameliorate this pro-
cess because of their usefulness in learning. #is mnemonic function allows for
the synchronous organization of information into large, integrated chunks.
Successfully challenging any particular dysfunctional thought in therapy o$en
involves a creative search for metaphors that have symbolic signikcance or per-
sonal meaning for the client and, therefore, could have high persuasive impact.
#is search might involve joining a client’s own use of a metaphor and reframing
it according to a particular disputational strategy. DiGiuseppe and Muran (1992)
identiked several rules for selecting metaphors for use in therapy. #ese include

(a) clearly dekning the concept that you wish to communicate or teach;
(b) attending to the client’s language and search for an arena which he/she
understands and has comfortably mastered;
(c) searching for an analogue construct in the client’s arena of knowledge
that includes the core elements of the concept that you wish to teach; and
(d) if none exists or comes to mind, start over with a new arena about
which the client has knowledge.

For example, a client with athletic experience or interest recently asked one of us
for more direction and specikc advice on how to respond to a practical problem.
#e therapist tried a way to explain a therapist’s role; that is, a therapist teaches cli-
ents skills to solve life’s problems without making the actual decisions for clients.
Because of the client’s active involvement in sports and her use of other metaphors
in the athletic sphere, the metaphor of “coach” came into the therapist’s mind. #e
therapist explained that the therapist was like a coach, teaching skills and making
sure that the athlete practiced. A coach, however, cannot compete for the athlete.
A therapist can likewise teach a client what steps to go through to make decisions,
but cannot make them for the client. Here, the abstract concept embodied in a
familiar arena (i.e., a coach in athletics) was applied to a new arena (i.e., a therapist
in therapy) to help the client understand a new concept (i.e., the therapist’s role).
#is successfully resolved the issue of the client seeking advice on practical deci-
sions and facilitated learning the skills to think through her choices.
Movie characters can also serve as metaphors for use in therapy. Films provide
visual, experiential story lines that people can recall to suggest new ways of think-
ing whenever they remind themselves of the character or plot. Consider the follow-
ing example of an angry young man and the use of the 1972 movie The Godfather,
directed by Francis Ford Coppola. Vito aspired to be a kghter and a tough guy.
He frequently got into kghts that he did not win because he would challenge any-
one, even if he was outnumbered. #e therapist (RD) struggled to teach Vito two
concepts, the di!erence between adaptive anger and rage, and that people did not
have to respect him and his family, even if he wanted them to do so. Vito loved The
Godfather movie. #e therapist suggested that Vito was just like the Godfather’s
Cognitive Change Strategies 177

son, Sonny, played by James Caan. Sonny was quick to anger and thought people,
especially his brother-in-law, must respect the family, especially Sonny’s sister. #e
competing families knew of Sonny’s quick, impulsive temper and staged a kght
between Sonny’s sister and brother-in-law. When the sister calls Sonny to tell him
of the kght, Sonny gets angry, runs to his car and drives to her rescue. #e route
to his sister’s is through a tollbooth, and there the other family soldiers are waiting
for Sonny and shoot him hundreds of times. #e therapist reminded Vito of the
story and asked him to focus on his favorite character Sonny.

T: And what happened to Sonny when he lost his temper?

C: Well, I guess he acted impulsively and that did him in.
T: So, do you think and act like Sonny?
C: All the time.
T: And does it work for you?
C: No, this week I got my ass kicked because I started with a group of guys in the
next neighborhood.
T: So, perhaps you will end up like Sonny?
C: It could happen.
T: Well, what if each time you thought people were challenging your honor or
reputation you think of Sonny. Did his anger work for him?
C: Not at all. It got him killed.
T: And did Sonny’s thoughts that others must not disrespect him help him?
C: No, that helped get him killed.
T: So what if each time you perceive that someone is challenging you, you think
of Sonny.
C: Yeah, I could think, “What happened to Sonny for thinking that way?” #at
would get me to stop and think di!erently.

#is reference to the character “Sonny” consolidated all the information about the
dysfunctional nature of Vito’s anger and the heuristic disputes mentioned above.
“#ink of Sonny” brought all this information to his mind and helped Vito move
on to more rational alternative responses.
As you progress as a therapist you will accumulate metaphors that you use to
help clients give up dysfunctional beliefs and adopt new ones. Stott et al. (2010)
have provided many examples of metaphors to use in a wide range of situations
in general CBT.

Be Creative

#e more experience you gain in questioning irrational and rational beliefs, the
more you will develop your own individual style of questioning. You will build
a repertoire of stories, aphorisms, metaphors, and other examples to show your
clients why their irrational beliefs are self-defeating and why rational alternatives
will promote psychological health.
178 D I S P U TAT I O N A N D T H E N E W E F F E C T I V E R E S P O N S E

For example, in working with clients who believe they must not experience
panic and could not stand it if they did, one of us (WD) uses a technique called
the Terrorist Dispute:

I say, “Let’s suppose that your parents have been captured by radical terror-
ists, and these radicals will release your parents only if you agree to put up
with ten panic attacks. Will you agree to these terms?” #e client usually
says, “Yes.” If so, I will then say, “But I thought you couldn’t stand the experi-
ence of panic.” #e client usually replies, “Well, but I would do it in order to
save my parents.” To which I respond, “Yes, but will you do it for your own
mental health?”

Another creative questioning strategy is what we call the Best Friend Dispute, an
approach that is useful for pointing out to clients the existence of unreasonable
self-standards.

Imagine that your client has failed an important test and believes, “I must
do well, and I am no good if I don’t.” Ask her whether she would condemn
her best friend for a similar failure in the same way she condemns herself.
Normally, your client will say no. If so, point out that she has a di!erent atti-
tude toward her friend than she has toward herself. Suggest that if she chose
to be as compassionate toward herself as she is toward her friend, she would
be better able to help herself solve her own emotional problems.

Vicarious Modeling

#erapists can frequently teach clients that many people in their environment
have similar activating events and yet do not su!er from unhealthy dysfunc-
tional emotions, because they do not adhere to the same IBs. Clients can learn
much through vicarious modeling; clients can become aware that others are
not devastated by similar problems. Clients can then apply this knowledge to
themselves. #e process can also sensitize clients to look for data in their envi-
ronment that they could have selectively screened out. Vicarious modeling is a
good strategy to use when clients’ As are virtually universal, such as romantic
breakups. We have all lived through them. One of us recently treated the mother
of a child with Giles de la Tourette’s syndrome. She was unfamiliar with the dis-
order and horriked by the child’s bizarre behavior, convinced that her child was
the only case in the world. #rough some investigation, the therapist found an
association for parents of children with Tourette’s syndrome and advised the
mother to attend a meeting of this group. #is experience provided the woman
with a coping model. At her next therapy session she concluded, “I guess people
can learn to adjust and live with it.” One of the benekts of groups is Yalom’s
Universality Principle, that humans are not unique in their su!ering (Yalom and
Leszcz, 2005).
Cognitive Change Strategies 179

C O N S T R U C T I N G ALTERNATIVE RATIONAL B E L I E F S

Challenging, questioning, and arguing against an IB is only part of the process.

People will not give up an idea or behavior unless they have a replacement for it.
Kuhn’s analysis of the history of science shows that people o$en know that their
contemporary theories are (awed and inconsistent with reality. However, they
hold on to them because they lack an alternative idea to replace the faulty one they
believe. An example involves Charles Darwin and the theory of evolution. Before
Darwin set out on his travels on the HMS Beagle, scientists knew for years that the
existing theories in biology were (awed. Darwin did not discover any new data
that weakened the existing ideas. He did develop a new idea. And once that new
idea of evolution was cast, the debate was on. New ideas do not come along very
easily. #ey come from human creativity and dialectics of debating a new idea and
the old ideas. In behavior therapy, it is well established that it is diwcult to sup-
press or eliminate a dysfunctional behavior. #e best strategy is to reinforce a new
alternative and incompatible behavior. REBT also believes that clients are more
likely to surrender their IBs when they have new alternative RBs.
#e question remains: Do new ideas develop through teaching or self-discovery?
#e idea that self-discovery is a superior way to learn originated with the develop-
mental psychologist Jean Piaget. Despite his enthusiasm for this means of learning,
little research has conkrmed the superiority of learning through self-discovery
(Brainerd, 2003).
Learning through self-discovery appears to be valued in counseling and psy-
chotherapy. Some psychotherapists would provide clients with feedback that their
ideas or behavior are incorrect or dysfunctional, and wait for the client to con-
ceive a replacement idea or behavior. REBT practitioners think it is more ewcient
to help the client adopt an alternative based on its philosophy.
We have no good data that self-discovery leads to more adaptive or enduring
new philosophies. Also, discovering new RBs takes time, and while the therapist
waits for the client to discover the new idea, s/he continues to su!er. We do not
have the unlimited resources of time and money to pursue self-discovery. In the
wake of no evidence that self-discovery leads to more enduring, deeper, or adap-
tive new beliefs, REBT advocates that therapists teach the client a new rational phi-
losophy. However, self-discovery might be of value. So the therapeutic dilemma is
how long to wait for clients to self-discover their new alternative beliefs.
We recommend that therapists always ask clients what new beliefs they could
have or have had that would be associated with a more functional, nondisturbed
emotion. If the client could identify this thought, we would then discuss how it
could be more benekcial for them. If they could not, we might ask them to pick a
model of someone who copes well with the situation that upsets them, and a$er
identifying a coping model ask the client how they think (or know) that the model
thinks di!erently from them. Again, if they can come up with a rational alter-
native belief, we will work to rehearse and strengthen the client’s endorsement
of that belief. However, if these strategies fail within a reasonable frame of time
to uncover a new belief, we would suggest one. We recommend that therapists
180 D I S P U TAT I O N A N D T H E N E W E F F E C T I V E R E S P O N S E

o!er new RBs as hypotheses, and seek the client’s feedback on whether that belief
makes sense to them. We have found that clients o$en rephrase the new RB into
their own words (See Chapter 12).

L E V E L S O F A B S T RACTION

#e goal of disputation is to change clients’ negative dysfunctional thinking in

such a way that they can relieve the emotional disturbance from which they are
su!ering. #e level of abstraction at which such change takes place will vary from
client to client. For example, I might not “get” the most elegant and comprehen-
sive idea that I don’t need anyone’s love and approval, but I could be able to “get”
the idea that I do not need the love and approval of a particular person. Although
the latter idea is less inclusive, it is nonetheless rational and elegant; it would be
consistent with happy living if I did not have that particular relationship in my
life. Usually, we do not need to go to the most abstract level of the irrational belief,
because it is unlikely that the individual will ever have to cope with it in real-
ity. For example, it is unlikely that an individual will achieve no success at all or
receive no love within the space of a lifetime.
Consider another example. If Ralph is angry with his spouse for not having
dinner on the table when he thought she should, we could identify many levels of
irrational thinking that lead to his dysfunctional anger:

• My wife must have dinner on the table when I want her to.
• My wife must do chores the way I want her to.
• My wife must do things the way I want her to.
• Family members must do things the way I want them to.
• People in my life must do things the way I want them to.
• All people must behave the way I want them to behave.
• #e world must be the way I want it to be.

#ese thoughts illustrate a continuum of abstraction and represent a ladder of

abstraction of IBs. #ey illustrate why the level of abstraction is clinically signik-
cant. If our client only believed the krst irrational idea, he would react to a few
future activating events, but the more abstract the IBs he subscribes to, the more
potential distress he might su!er. As a parallel, the less abstract the rational belief,
the less generalizable his coping will be.
Clients usually report beliefs at the lower end of the abstraction continuum. #ese
lower-level beliefs are more readily experienced and admitted by the client, and thus
might be more accessible to change. #e client’s ability to generalize from a spe-
cikc example to new situations will be enhanced if the therapist works at the more
abstract levels. Our suggestion, therefore, is that therapists conceptualize the IBs
and dispute them up and down the ladder of abstraction as the therapy progresses.
Let us return to Ralph’s situation. If Ralph’s therapist begins disputation at a
concrete level (“My wife must have dinner on the table when I want her to”),
Cognitive Change Strategies 181

Ralph is likely to gain some control over his dysfunctional anger in a frequently
occurring event and thus be reinforced for making progress in therapy. Later, the
therapist might want to explore with Ralph whether he has other demands of his
wife or other people, and that the world does not have to be the way he wants it
to be. #us, by moving up and down the ladder of abstraction, the therapist will
ensure that Ralph learns to deal with specikc activating events and can apply the
REBT solution to other similar aversive events; and that he understands the rule
behind the reasoning and can apply it to other aversive events.

Additional Aids to Disputing

An important prerequisite for successful disputation is the therapist’s ability to

think rationally about the client’s problem. How can therapists dispute something
they believe that really must not happen? First, we advise therapists to ask them-
selves, “Why must this not happen?” If they are not convinced, how will they ever
convince the client? One therapist, for example, found herself overwhelmed by a
client’s fears of sexual rejection a$er a mastectomy. Only a$er the therapist had
philosophically accepted that such losses can happen and that people can lose a
breast was she able to calmly help her client to the same conclusion.
We think it is helpful to practice the disputation process and prepare before
each session with clients. Beal, Kopec, and DiGiuseppe (1996) created a chart of
di!erent types of disputes and asked trainees to complete the chart on a client
before the session began. #ey found that such practice increased the trainees’
sense of self-ewcacy in the disputing process. Table 10.1 presents the form they
used in their research. A blank form appears in Appendix 3. A$er reading the
sample provided in Table 10.1, the reader can print several copies of the form and
complete them for specikc irrational beliefs for the clients you are presently treat-
ing. If you do this for several weeks, you might notice that you are getting better.
You might also feel more conkdent in the session and pay better attention to what
the clients are saying because you will be struggling less on how you will dispute
the beliefs and support the new rational beliefs.
When you are ready to challenge the beliefs, make sure you target the appropri-
ate philosophical concept, not the metaphor in which it is expressed. For example,
if a client says, “I failed—what a horse’s ass I am!” it is easy to point out that he is
mistaken since he clearly does not possess the characteristics of equine buttocks.
#e philosophical point might be missed, however, because the client’s miscon-
ception about human worth being dependent on accomplishment is still intact.
Once you have uncovered a core IB, realize that it will take a signikcant amount
of time to dispute it. Inasmuch as the essence of REBT is to change irrational
beliefs, D is obviously the most critical part. Do not be afraid to repeat a dispu-
tation over the course of many sessions if necessary. #ere are several ways to
assure plentiful time for disputation. One way to increase disputing time is to
avoid taking on a new problem in a session if you have not knished disputing an
older problem from a previous session. You can begin your next session by asking
 Table 10.1. T)v!,!,- !, D!./01v1!2, S1)v12-!2. (F)23 B2v4, K2/25, v,6 D!G!0.2//2, 7889)
Ejv3/42 7—D!./01!,- 1:2 I))v1!2,v4 B24!2;: “I’3 ,2 G226 !; M% F)!2,6. L22' D2+, 2, M2.”
Disputing Strategy
Logical Empirical Functional Rational Alternative
Didactic If your friends look down on You are made up of many It looks like holding that belief It seems to me that a more rational
you, then what they do is to parts. Even if some of the gets you a lot of negative emo- belief could be: “I am a complex,
observe parts of you and con- parts are “faulty” there is tions, anxiety, and depression. unratable, fallible human being even
clude that those parts are “bad” no evidence that “all” of if my friends disapprove of me.”
(undesirable to them). #en you is faulty!
they jump from those parts to
the conclusion that “all of you
is no good.” #at is bad logic!
Socratic If your friends look down on Is there any evidence that What does holding the belief: What do you think would be a more
you, then what they do is to a part can dekne a whole? “I’m no good if my friends helpful and adaptive (rational) belief
observe parts of you and con- look down on me” get you? that you can create right now about
clude that those parts are “bad” yourself in the situation where your
(undesirable to them). #en friends are looking down on you?
they jump from those parts to
all of you is no good. Is that
logical? Why not?
Metaphor Let’s suppose that I own the Clearly, some people, even Abraham Lincoln took a Many famous movie stars and celebri-
“car of the year.” However, it very important and in(u- major stand when he freed the ties held the belief that they were no
has a defective spark plug. So ential people thought Jesus slaves with the Emancipation good if their friends or the public
by your logic, the whole car is Christ was “no good.” Proclamation. Many of his looked down on them. Some even
“no good,” right? Even so, was that evidence friends looked down on him. committed suicide. #ink how their
that he was no good, or Where the United States would lives would have di!ered with a more
just their opinion? be today if he held your belief? rational belief?
Humor If I were the president of the If I thought you were a By your deknition then, if With my friends opinion of me and
United States, or the Pope, and gira!e, would your neck your friends looked up to you, $2.50 I can ride the subway. Wow!
I reasoned that way, that would grow? then you would be “good.”
make it sound logic, right? Hitler’s friends and followers
deiked him. Did that make
him good?
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Disputing Strategy
Logical Empirical Functional Rational Alternative
Didactic It doesn’t logically follow that #ere is absolutely no It seems that as long as you It seems to me that it would be
just because the relationship evidence to support the keep telling yourself you are a better to unconditionally accept
ended, you’re a failure as a belief that just because one failure because your relation- yourself as a person of worth
person. person ended a relation- ship ended, you will su!er whose relationship may have failed.
ship with you, that makes deep depression. It is not Moreover, that does not make you a
you a failure as a human helping you to keep downing failure as a person.
being. In fact, you are just yourself and rating yourself.
a person whose relation-
ship ended.
Socratic Is it logical to believe that just Where is the proof to How does it help you to keep What do you think would be a more
because a relationship ends, support the belief that thinking that because the helpful and truthful (rational) belief
you or anybody else is there- just because the relation- relationship failed, you are that you can create right now about
fore a total failure as a person? ship ended, you’re sud- a failure? (Where does that a failed relationship and your accep-
denly a total failure and belief get you? As long as you tance of your self?
no-good-nik as a person? keep thinking that way, what
happens to you?)
(continued)
 Table 10.1. T)v!,!,- !, D!./01v1!2, S1)v12-!2. (F)23 B2v4, K2/25, v,6 D!G!0.2//2, 7889) (Cont&nu())
Disputing Strategy
Logical Empirical Functional Rational Alternative
Metaphor If a baseball player has a.300 Where’s the evidence that If #omas Edison had told Many famous movie stars, musi-
batting average that is very says that the student who himself that he was a total cians, etc. have believed that they
good, right? However, that fails one quiz or test will failure when his early experi- MUST be successful in all endeavors
means the player has not therefore fail ALL tests and ments with electricity failed, or else they are failures, and some
gotten a hit 70% of the time. will therefore be a total what would it have gotten him committed suicide. #ink how their
So, not succeeding in some failure as a student and a (and us!)? lives would have been di!erent with
circumstances doesn’t logically person? more self-acceptance.
make the player a total failure.
Humor So you are saying that because Elizabeth Taylor MUST be a Marie Antoinette may have If you died and went to heaven,
I experience failures in rela- total failure because she has been the perfect partner, and and told St. Peter of your failed
tionships that I am a failure had quite a few marriages. look what it got her! relationship, would you be sent
too! Oh no! If I am a total Is that true? Is it true that directly to Hell? Or would he prob-
failure because some relation- if a person has not experi- ably remind you that you are still
ships don’t work out, I better enced a failed relationship, a person of worth, even in a failed
stop practicing psychology! they must be God? relationship.
Cognitive Change Strategies 185

the client if he or she recalls the problem, outlining the As, Bs, and Cs quickly,
and launching immediately into disputation. Another strategy is to take the new
problems brought in by the client and show how they relate to his or her core IBs,
and then proceed with the disputation.
Whenever possible, it is important to work krst with the client’s motivation
before beginning a disputing strategy. Point out to the client the benekts of chang-
ing his or her beliefs—especially the benekt of feeling less emotional distress. #is
strategy depends, of course, on assuring that the client does want to change C.
If the client has an anger problem, for example, the therapist might krst inquire,
“Can you see any advantages to being (less angry) annoyed rather than angry?”
A$er these are listed, the therapist might ask, “Can you think of any ways to feel
annoyed (less angry)?” When motivation is established, the client might be more
receptive to a cognitive or behavioral intervention.
#us, among the disputing techniques to help the client challenge distress-
producing Bs are those that krst point out the lack of value of the distress.
Again taking anger as an example, the therapist might state something like the
following:
“Let’s krst take a look at whether your anger is working for you or against you.
What does rage do? It sets the stage for a kght! In addition, it is not good for you; it
gets your juices (owing, makes you feel more irritated, and so forth. Now concern
or annoyance, on the other hand, serves as a sensible cue for you to say, ‘How can
I change this? What can I do to help the situation? Perhaps if I explain to him . . . ?’
See, now we are talking about strategies. And if a strategy does not work, what
would you do? You would go back to the drawing board and try another. You see,
you can do that kind of problem solving once you’re not in a rage.”
If your clients are unsure about whether they want to change their behaviors
or emotions, try to determine other motivations that might be serving to main-
tain the pathology. A good technique to help clients become aware of the rein-
forcers operating to perpetuate a problem is the following sentence-completion
item from Lazarus (1972): “#e good thing about . . . [e.g., procrastination] is . . . ”
Repeat this phrase until the client has exhausted all suggestions. If clients cannot
think of anything to say, urge them to say something anyway, the krst thing that
comes to mind. Stress that they need not believe what they say, nor does it have to
be true of them. #e therapist could even suggest a sentence-completion line as a
model to get the client started. #e therapist would do well to listen for a pattern
in the client’s responses, for not only might the client’s statements indicate reasons
to keep the distress, but new irrational beliefs might emerge as well.
Disputation is hard work, for what you are trying to do is shi$ the client’s posi-
tion on major philosophic issues that they have o$en rehearsed for a long period.
Accomplishing this task requires many trials and a great deal of persistence on
the part of the therapist. Like any good persuader, therapists had better believe in
what they are saying, and demonstrate this belief by their persistence and enthu-
siasm for their position—rationality.
Persistence, however, does not mean a continual hard sell; some challenges are
subtle and can take place even when the therapist is being supportive or re(ective.
186 D I S P U TAT I O N A N D T H E N E W E F F E C T I V E R E S P O N S E

If you are in the early stages of therapy and attempting to build rapport, you might
wish to be supportive but at the same time not reinforce irrational beliefs. For
example, if your client says, “I need . . . ,” you can re(ect by saying, “I know that . . .
is something you want very badly.” #e therapist is thus modeling a more rational
statement while conveying understanding of the client’s plight.

B2j 10.3
Remind your clients that it is important not merely to be aware that one’s thoughts
are irrational, but to actively dispute these thoughts outside of the therapy ses-
sions. In addition, it is important to actively construct and forcefully rehearse new
rational beliefs to replace the old irrational ones. (See Chapter 12)

New therapists frequently assume that generalization of behavior change will

automatically take place. Although we believe that generalization is one of the
advantages of cognitive interventions, we do not assume that it occurs without
e!ort. As with behavior therapies, generalization requires planning. #us, it might
be desirable to dispute the same irrational notion across many situations, even
though the irrational beliefs, the disputation, and the resulting rational beliefs
could be the same in each example.
A prototype of the generalization problem is the male client with sexual diw-
culties, for whom a hierarchy of anxiety-arousing situations has been constructed.
#e client might have progressed through several exercises, such as sensate focus
or masturbation training, during which he successfully counteracted his irratio-
nal beliefs about failure and performance. At the top of the hierarchy, when he is
instructed to resume having intercourse with his partner, he might completely
reinterpret the situation and resume his irrational catastrophizing. He then might
be saying to himself, “#is is the Real #ing; now if I fail, it will indeed be ter-
rible!” #us, although you might have helped him counteract his irrational beliefs
at lower points in the hierarchy, you cannot assume that his rational beliefs will
generalize to the next step. In this example, the therapist specikcally questions the
client about his cognitions during the various performance stages.
In addition, do not assume that if clients are thinking rationally in one problem
area, they are doing so in other problem areas as well. For example, Margaret could
present several problems at once: anxiety in social situations, guilt about sexual per-
formance, anger at her boss, and so on. Generally, it is wise to work on one problem
at a time. If the therapist chooses to work on the anxiety in social situations and helps
the client to rid herself of all of her irrational beliefs in this area, there is no guarantee
that she will automatically begin thinking rationally about sexual guilt or about her
anger at her boss. #ese other problem areas will probably require separate work.
One strategy to maximize generalization benekts is to help clients believe that
they are responsible for their own success. A number of studies in the behavioral
literature have indicated that internal rather than external attribution for suc-
cess at an endeavor is an important cognitive factor in generalization (Ruth and
Cognitive Change Strategies 187

DiGiuseppe, 1989). If clients believe that their success was attributable to internal
factors, they are more likely to believe that they have control over future problems
and to apply what they have learned in therapy to new problems.
A knal suggestion, before we turn to a case example of disputation, is to use as
many disputing strategies with each client as possible. Lazarus (2009) has pro-
posed that the more modalities therapists utilize (cognitive, experiential, ima-
ginal, and behavioral) the more e!ective the disputation will be and the longer
lasting its e!ects. We have found this to be a helpful suggestion.

B2j 10.4
Dispute with respect. We are not making fun of client’s erroneous or self-defeating
thinking, but working to repair or modulate it. First, however, we accept and study
it. IBs are there, presumably, for a good reason.
For example, one client had lost her parents at a very young age and been sent
to live with her grandparents, who soon died, so that she ended up with distant
relatives. Her silent conclusion, based on the data of her life, was that love, trust, or
closeness was the “kiss of death.” Small wonder that she had diwculty establishing
intimate adult relationships, including a therapeutic rapport. #e work of ther-
apy consisted of respectfully understanding her early experience, as interpreted
by a frightened young child, which led to her illogical core belief. Gradually she
learned to reinterpret her experience, reassure herself, and trust in her ability to
love and, as an adult, to tolerate the potential for loss of a love object.

A C A S E E X A M P L E OF DISPUTING

A transcript of portions of a sample session conducted by Ellis will demonstrate

the process of disputing. #is transcript is adapted from a public demonstration
in which a participant asked to work with Ellis. #e krst problem dealt with the
individual’s nervousness at being on display.

Getting at the B
T: What do you think you’re telling yourself to make yourself nervous?
C: I’m an idiot for being up here!
T: You’re an idiot because . . .
C: I might reveal sensitive areas of myself and I would feel uncomfortable.

Clarifying which IB is more prominent

T: And you should feel comfortable? Is that what you’re saying? Or you should
not reveal yourself at all?
C: Not at all.
T: If you reveal yourself, what? What are you predicting would happen if you
reveal yourself?
188 D I S P U TAT I O N A N D T H E N E W E F F E C T I V E R E S P O N S E

C: An outburst of emotion . . . I would feel embarrassed.

T: So you might act foolishly in front of these people, right?
C: Yes.
T: Well, if you did, why would that be upsetting? Anxiety-provoking, if you did?
C: Can you restate the question?

Client’s confusion is probably an index of his anxiety level.

T: Yes. You are saying, “I might act foolishly in front of this audience.” But you’d
never get anxious just from that statement. #at’s just an observation or pre-
diction. But how are you evaluating yourself if you do act foolishly?
C: I don’t understand.

Repeat
T: Well, just that statement alone doesn’t cause an emotion. Something follows.
You might be saying, “I might act foolishly, and isn’t that great! I might act
foolishly, and that would be good practice at acting foolishly!” And then you
wouldn’t be anxious, right?
C: Right.
T: But you’re saying, “I might act foolishly, and isn’t that what?” You’re not saying,
“It’s great!”
C: I need to not act out of character.
T: “And if I act out of character—what?”
C: I might act fearful.

The derivative component of IB is still missing.

T: “And if I act fearful, what?” You see, you’re still not giving me the evaluation of
you or the situation. “I would like it? Dislike it? Be enthusiastic? I would be?”
What’s your evaluation of you or the results of acting foolishly?
C: It would make me feel unstable.
#erapist clarikes that “unstable” is not an emotion but an A–(inference).
T: So, “I would be an unstable person if I act foolishly up here?” Or, “#ey would
think of me as an unstable person?”
C: Yes.
T: But that is a hypothesis about how you behave, not an irrational belief.

Inference Chaining—Assuming the worst

T: Well, let’s suppose they do think you are unstable! Let’s suppose they say, “Oh,
shit, he’s unstable.” Now, you don’t know that they’d say that! #ey might say,
“Oh boy, he’s got the guts to go up there and I’m scared shitless. But let’s sup-
pose they do say you’re unstable. What’s the horror of that?
C: #at would support what I already think.
T: “#at I am unstable.” Well, how are you evaluating your so-called instability?
C: As a negative.
T: “I don’t like this characteristic?” But then you’d only feel concerned. You
wouldn’t feel embarrassed or ashamed. You’d just say, “Well, I have a negative
Cognitive Change Strategies 189

trait called instability.” Do you see that you’re saying something stronger than
that to make yourself anxious?
C: Could it be rejection possibly?
T: Yes. “Because if I’m rejected . . . ”
C: #en I’m di!erent from them.
T: “And if I’m di!erent from them . . . ” What are you concluding from that?
C: I’d be lonely.

Rephrasing C as an A to show the A-C connection

T: “I would be quite alone.” And how do you feel about being quite alone?
C: Depressed.

Therapist summarizes the A-B complex.

T: Yes. So if I hear you right, you’re saying, “If I act foolishly up here, it would
prove I’m di!erent. Other people would know I’m di!erent. #ey would prob-
ably boycott me to some degree, and I couldn’t bear that—that would be awful.”
Is that right?
C: Yes.
T: All right. But even if that occurred . . . and we don’t know if it would occur . . .
why would it be horrible? #at they thought you were boycottable and you
were alone? Why would that be awful?
C: #e evidence is my past experience. By being di!erent, I was alienated.
T: But why was that horrible? Let’s assume that that occurred. You were alienated
and le$ alone. Why was that horrible?
C: I feel like I need someone to share things with.
T: Prove it! Prove that you need someone.
C: (pause) #ere is no evidence.
T: But if you believe it, how will you feel?
C: Terrible.
T: #at’s right! You’ve dekned these things as terrible, and if you gave up those def-
initions, you’d feel all right. How do you feel right now about being up here?
C: A little looser.
T: Do you realize why you are feeling a little looser? Do you know why that is so?
C: I have more of an I-don’t-give-a-shit attitude.
T: All right. #at’s good. And, you’ve gotten distracted somewhat. Instead of
focusing on the audience, you’re focusing on what we’re talking about. Now,
what other problem would you like to discuss?