On the Couch with Dr. Michael Edelstein

Dr. Grohol: Yes, it makes a lot of sense when you break it down in that way.

And it kind of brings up the question in my mind that a lot of us–I guess maybe most of us–actually go through life, if we haven’t been exposed to cognitive behavioral therapy or some of these ideas, and we go through life thinking these kinds of thoughts, these must thoughts, these beliefs. Do you think we were taught them, in some way, as a child, or is it just something that, inherently, we automatically go to because we don’t have an alternative when we’re growing up?

Dr. Edelstein: Well, actually, John, I think it’s both. I think we’re both taught them or we don’t figure out an alternative for ourselves. And some people do. Some people naturally figure out that it’s their thinking that is their problem, or their emotional problem–not necessarily the practical problem, but their emotional problem–and then they work on changing their thinking. So there are people who realize that.

But that idea is reinforced that it’s situations that do it to us, not us. And then we have a genetic predisposition to think that way and part of it, I think, it just seems like if someone criticizes you unfairly and you immediately get angry, intuitively it seems reasonable that they made you angry. So it’s partly just the way we’re built.

But then Freud came along and set back the progress of psychotherapy 50 to 100 years by saying it’s your childhood and it’s your Oedipus complex and it’s your unconscious and how you were treated by your dysfunctional family. Those things, so again he was saying it’s A that causes C, your childhood causes your disturbance rather than what happens right now, but its still a situation.

So we have all these things going against us and that’s why I’m in business.

Dr. Grohol: Understood. Some critics of cognitive behavioral therapy techniques like this one argue that the therapists at times seem to be too intellectual and too simplistic in this thinking. We can just think away our problems and feelings. How do you respond to such critics?

Dr. Edelstein: Well I think that some therapists some of the time could fall into this being too intellectual and too simplistic. But a trained REBT therapist normally starts and ends with feelings, not intellect.

We talk about, in the first session, why the client is here and that has to do with feelings, “I’m depressed, I’m anxious, I’m having panic attacks, I feel guilty, I’m unassertive or I’m acting addictively.” So we do look at feelings.

And then the goal of REBT, this feeling exercise that we described, is to help people improve their feelings. All this is anchored in feelings, but since we see that it’s the intellect, especially the evaluative intelligent creates the feelings, we do focus on cognitions, intellectual, perception and thoughts, attitudes, beliefs. And we see that that’s the power in changing your feelings so it is important to focus on your thinking in order to change your feelings.

There are many more therapists, I think, who go to the other extreme, who are too feeling based and they focus on feelings, feelings, feelings. Get out your feelings, express your feelings, beat the pillow to get your anger out and those kinds of things. They’re barking up the wrong tree because, as I explained, that’s not how humans work.

As far as the simplistic argument, one of the highlights of REBT and the cognitive therapies is that it is simple. You have a few basic premises that it’s your thinking that causes your feelings. Its musty thinking that causes disturbed feelings and to overcome your disturbed feelings and behaviors you change your musty thinking.

Those are the few simple premises with profound implications. It is simple, but simplistic implies overly simple or glibly simple or superficial, and that’s not the case here because we go into your deep core beliefs that cause your problems. It’s not simplistic as far as I can tell, but rather simple, clear cut, and doable.

Dr. Grohol: You mentioned the emotion of anger, and in reading your book you don’t seem to think much about anger as an emotion that people should be able to express and that to combat it we should simply not allow ourselves to be angry in the first place.

It occurred to me that this seems to be going against the belief that there’s no such thing as a bad emotion and that if we try and repress our anger or to redirect it into something else we are suppressing a normal part of the human experience. What do you think about that? Can you talk more about your sense of anger?

Dr. Edelstein: Yes, and I agree with some of the things you say even if they’re criticisms. And that is, suppressing, or repressing anger is not our goal in REBT. It’s to get at the thinking behind it, again, we have some simple principles, it’s your thinking that causes your anger not situations. So if you change your thinking, if you don’t think in an angry, demanding, commanding way then you won’t get angry in the first place. So there’s nothing to suppress and repress in the second place.

Anger comes from a demand, “You must treat me kindly, considerably, lovingly, courteously, reciprocally, reasonably”, those kinds of things. And as long as you demand that, you get anger, and you are much less likely to get the results you want. And you are much less likely to get kind, loving behavior on your partner’s part or your colleague’s part. Because often when you get angry at someone they’ll say, “Who do you think you are telling me what to do, I’ll show you” and they’ll tend to get rebellious themselves. So anger certainly doesn’t work.

I don’t think that people should not necessarily be able to express anger. I think if people want to, and they feel that it’s in their best interest to express anger, that’s certainly their prerogative and I’m not going to try to stop them.

As a therapist, what I do is I ask people, what are your goals, what would you like out of therapy and if they say, “I’m angry but I don’t want to get un angry, I want to get over my cigarette addiction” then I’ll just help them with that.

They certainly have a right to get angry if they want. I’m just saying, in terms of most people’s goals most of the time it tends to sabotage, defeat, and interfere with your goals.

As far as, there’s no such thing as bad emotions, well there is no such thing as bad emotions in the abstract, emotions are all human, however in terms of people’s goals there are bad, self destructive, self defeating emotions. Not in a moralistic sense but in a practical sense that it tends to act against what you’d like to get out of life. In that case anger, anxiety, depression certainly doesn’t work, so I would say that they’re bad emotions.

Dr. Grohol: Good point. You also point out in the book a few problems with self-esteem and the idea of self-esteem. That it can delude us into believing that we are good at something, when in fact we are not. That we can see our self as sort of this unchanging essence and that things like self rating leads us to beat ourselves up unnecessarily when things go badly or compare ourselves unrealistically to others.

What kinds of things do you suggest instead of self esteem?

Dr. Edelstein: You are right that self-esteem is harmful. Its self rating. And in my book Three Minute Therapy, I have a chapter on self-esteem and I call it the “feel good about yourself chap.” Because self esteem, high self-esteem means you are rating yourself highly. You are thinking well of your entire self based on some of your good actions or people’s approval.

But then that’s going to lead to low self esteem if your actions don’t live up to your expectations or people disapprove of you. So you tend to be on that self rating roller coaster. “I’m good when I act well and I’m a bad person when I don’t act well.”

A solution to that is to give up all self rating. You are never a good or bad person no matter who loves you or who hates you, but rather you are always just an imperfect human who acts imperfectly. And if you accept yourself just as an imperfect human, not as a good or bad person who has to rate himself, then you get unconditional self acceptance.

You substitute self-esteem with unconditional self acceptance and then you get off the roller coaster. But you can still enjoy life immensely by setting up goals and working towards your goals and sometimes even achieving your goals. A byproduct of those things is enjoyment if you don’t sabotage it with “I must do well, I must get approval or else I’m no good’ then that leads to anxiety.

Self-esteem is not the solution. Unconditional self-acceptance, along with self discipline, working hard at achieving your goal, those are a better prescription for a happy life than going after proving yourself and high self-esteem.

Dr. Grohol: That certainly seems to make some sense. And I think that people often fall into that trap. So it was really enjoyable to read that chapter in your book and see how you recommend it, that there are alternatives to just self-esteem in that approach.

Dr. Edelstein: That’s right, John. And also, even sadder than that is therapists and teachers and educators and authors often fall into that trap, and most therapists that I’m familiar with and that I’ve read recommend improving your self-esteem. So they’re trapped, and then they teach this to their clients, who assume that this is the way to be and then go along with it, and then never really get over their anxiety or depression problems because they continually reinforce the self-esteem idea rather than abolishing it entirely.