Dr. Mike Abrams is one of only 13 psychologists in New Jersey with the National Board Certification in cognitive behavioral therapy (ABPP/ABBCP). And he and Dr. Lidia Abrams are among 4 psychologists in NJ board who are board certified by the Albert Ellis Institute in Rational Emotive and Cognitive Behavior Therapy. In addition Dr. Mike Abrams serves as an examiner for psychologists seeking board certification in psychology. Dr. Lidia Abrams serves as chair of the NJPA Ethics committee.
Dr Mike and Dr Lidia have practiced in Jersey City since 1988 and in Clifton, NJ since 1990.
Dr. Mike Abrams and Dr. Lidia Abrams approach problems in life by continually listening for client beliefs that lead to emotional distress. This humanistic technique applies to social, interpersonal, family and sexual problems. It is derived from the discoveries that led what is now known as cognitive behavior therapy. Specifically, it is not the past or a person’s history that leads to his or her painful emotions but his or her beliefs about the past. Dr. Mike Abrams and Dr. Lidia Abrams are among the few psychologists in new jersey Board Certified in these methods. To help illustrate the type of thinking we help people to change we have set forth some of the core beliefs that cause emotional disturbance.
Rational Emotive Behavior Therapy (REBT / CBT) is a comprehensive approach to psychological treatment that deals not only with the emotional and behavioral aspects of human disturbance, it places a great deal of stress on the thinking component of distress. Human beings are exceptionally complex and they doesn’t seem to be any simple way in which people become “emotionally disturbed” nor is there a single way in which they can be helped to be less-defeating. Our psychological problems arise from misperceptions and mistaken cognitions about what we perceive from our emotional under reactions or overreactions to normal and unusual stimuli and from our habitually dysfunctional behavior patterns which enable us to keep repeating non adjustive responses even when we “know” that we are behaving poorly or even foolishly.
HEALING BY CHANGING ONE’s LIFE PHILOSOPHY
REBT is based on the assumption that what we label our “emotional” reactions are largely caused by our conscious and unconscious evaluations, interpretations and philosophies. Thus, we feel anxious or depressed because we strongly convince ourselves that it is terrible when we fail at something or that we can’t stand the pain of being rejected. We feel hostile because we vigorously believe that people who behave unfairly to us absolutely should not act the way they indubitably do and that it is utterly insufferable when they frustrate us.
Like stoicism, a school of philosophy that existed some two thousand years ago, rational emotive behavior therapy holds that there are virtually no good reasons why human beings have to make themselves very neurotic no matter what kind of negative stimuli impinge on them. It gives them full leeway to feel strong negative emotions such as sorrow, regret, displeasure, annoyance, rebellion and determination to change social conditions. However, it believes that when they experience certain self-defeating and unhealthy emotions (such as panic, depression, worthlessness or rage), they are usually adding an unrealistic and illogical hypothesis to their empirically-based view that their own acts or those of others are reprehensible or inefficient and that something would better be done about changing them.
Rational emotive behavior therapists — often within the first session or two of seeing a client can almost always put their finger on a few central irrational philosophies of life which this client vehemently believes. They can show clients how these ideas inevitably lead to emotional problems. Hence, to presenting clinical symptoms can demonstrate exactly how they forthrightly question and challenge these ideas that can often induce them to work to uproot them and replace with scientifically testable hypotheses about themselves and the world which are not likely to get them into future neurotic difficulties.
Rational Emotive / Cognitive Behavioral Therapy Demonstrates that a Person’s Beliefs is the Fundamental Cause of Distress
They are:
HOW CBT/REBT DIFFERS FROM OTHER PSYCHOTHERAPY APPROACHES
One of the most common mistakes of therapists treating couple in crisis is a function of the often exaggerated self-important self-image of many practitioners. Specifically, some therapists presume that a couple that has had failing communications, deception, romantic or sexual infidelity (to name a few of problems that bring people to couple’s counseling) will suddenly sit side by side in front of the all-powerful therapist and the facades, lies, deceptions, miscommunications etc. all will come to abrupt halt. Why on earth should people suddenly come clean and bare their soul in front of some stranger. Aucontraire (pardon my French) but they will more often redouble their efforts out of shame, fear or simple recalcitrance. Imagine how you would feel after you have been withholding from or even deceiving the person closet to you when you are suddenly confronted by a complete stranger to reveal all. Tell the truth…. you would tell him to f__k off in eloquent and calm terms but continue the lies and deception. If you lie to someone you love or supposedly love but have come to resent, why the hell should you prostrate yourself in front of a stranger with couple of degrees and do an veracity dump?
Dr. Mike Abrams was personally trained by sex therapy founder, Dr. Albert Ellis in couples therapy and marriage counseling. His approach is to see each member of the couple separately (while both are present in the office) assuring complete confidentiality for all content conveyed in the partial-session to each. Dr. Abrams then formulates — using the the two perspectives he would now have apprehended — a model relationship from the participant’s points of view. From this he has a clear idea of the difficulties the relationship faces to survive and the specific actions required of each participant to achieve a working and loving relationship.
He then meets with them together and has each recapitulate that portion of what was disclosed in confidence that he or she is willing to reveal in the presence of his/her partner. From this point on the couple is asked to view themselves, the partner and relationship itself in a new light with renewed goals, expectations and demands.
In most major cities, people seeking to provide you with mental health services. The first thing to check for is a license. This may seem unnecessary but unfortunately there is a significant number of people who are not licensed to provide professional services and circumvent the licensing laws by using terms that do not fall under the license laws, terms like life coach or professional advisor are among those that are not regulated. A Google search for licensees in each field should separate this type of wheat from the chaff.
One you have found an individual with a license you will want to ascertain the amount of training or experience they have in the problem you are having. Have they taken courses? Have they taught in the field? Have they published in the area? These are key questions for determining competence.
Related to the previous, determine what they have done to keep up with the field. Find out what they do to learn the latest evidenced based treatments. In general, an educated integrative approach is best.
Here the therapist has developed some competence in several treatment methods and have specific criteria for selecting the one most appropriate for your problem. A major and often overlooked requirement of quality healthcare is the measure the therapist uses to support his or her own diagnosis, progress and hypotheses about you. You would not see a physician who uses no testing to confirm his/her diagnosis. Why would you expect less of a therapist? In fact, some authors have found that therapists that do no have an objective measure of their client’s mental status tend to improve minimally with experience.
Finally determine how they bill, how they work with insurance, and how their rates compare with others providing similar services. The very best people do not necessarily charge the highest fees.
Half a century ago Albert Ellis noted that a typically intelligent person would often act in ways that seem self-defeating or foolish. His explanation for this phenomenon became the basis of all psychotherapies that are called any of cognitive behavioral, cognitive, interpersonal or Rational Emotive. In contrast to both the psychotherapeutic dogma of his time and his clinical education Ellis came to a novel explanation of emotional dysfunction. His epiphany was that it was not unconscious forces or conflicts that led to adversities that fall within the realm of mental health. Based on a pattern observed among clients, he concluded that all dysfunctions that can be ameliorated by psychotherapy are a result of two factors. The first is a function innate constitutional propensities, the second is the inevitable tendency towards and irrational thinking (ref). Importantly, he observed that people are fully aware of most of their irrational beliefs yet tend to tenaciously maintain them despite their leading to despair and dysfunctional behavior. These conclusions, the product of his early clinical work, and his work as a sex therapist led in 1953 his break with psychoanalysis. Once this break was complete he commenced calling himself a rational therapist through which he advocated psychological interventions with goal of changing peoples irrational thinking and behavior.
Early in the process of developing an new therapeutic paradigm Ellis also noted that people with sexual and intimacy problems were also victims of the same type of irrational thinking. Specifically, the preponderance of sexual difficulties were spawned by rigid inflexible thinking and obsessive demands on people, including oneself. In essence irrational thinking and acting in sexual affairs led to disruptions of relationships, difficulty in achieving stable bonds and emotional distress in encounters. Sexual intimacy in the best of circumstances can be difficult, especially enduring intimacy. In any cases sexual passion lasts just long enough for copulation, occasionally it endures long enough to wean a child in rare and uniquely romantic cases. Love and sex and remain intimately connected for the lifetime of one of the partners.
Sadly, the third case is rare. The dismal reality, based on the high rate of divorce and relationship dissolution is that the transition from romantic love to an enduring conjugal love commonly fails to manifest. Although, divorce rates remained fairly constant in the last two decades, there has been a trend towards fewer couples marrying. For example, approximately 85% of people born from 1940 to 1944 were married by the age of 30 in contrast to the 65% of people born from 1970 to 1974. Estimated divorce and separation rates range from 40% to higher rates as those found by Martin and Bumpass who concluded that when allowing for underreporting the actual rate is closer to 66%. Whatever the precise rate of divorce, it likely understates the rate of relationship dissolution, as many relationships fail before marriage is achieved.
Given high rate of divorce, relationship instability and the range of negative emotions that arise from disrupted relationships it would seem to beg the question is there evidence that the same type of distorted thinking that is addressed in all modern therapies the foundation of despair in love and intimacy. This was studied at this center utilizing two surveys of total of 550 people, it was found that those people who most strongly endorsed the irrational beliefs detailed by Ellis had the greatest degree of sexual difficulties.
In 1895 Breuer and Freud published a book titled Studies in Hysteria that paved the way for a century of psychoanalytic explanations of human behavior. The theme of the explanations is that expressed or repressed sexuality, aggression underlie and direct all human behavior. Indeed, even the most creative acts are viewed as resulting from disguised sexual intentions in the form of sublimation. Although, psychoanalytic theory has largely failed to meet research support, it seems to have stumbled onto a key principle of today’s zeitgeist, evolutionary psychology. Evolutionary psychology supports the idea that sex does permeate most every aspect of our lives. A man does not buy the expensive sports car only because he wants to drive fast. A woman does not dye her hair or buy a snug fitting dress because she wants to look good for herself. Even someone cramming for college entrance exams might be trying to bring his or her grades up for reasons other than college admissions. Entrance into a better school leads to increased income and consequently better access to a mate.
Supporting this perspective, psychologist David Buss theorized that virtually all male violence has a sexual basis. This point was compellingly detailed by authors Malcolm Potts and Thomas Hayden who cogently argue that most wars can be traced to innate sexual competition. This evolutionary perspective of violence is based on both direct and indirect sexual jealousy. Direct sexual jealousy usually involves a male guarding his mate, whereas indirect jealousy extends to encounters that are tangential to the love relationship. For example, the rage a man feels when slighted is abstractly sexual, as it may result in his losing prestige or social standing. Since all men are potential sexual competitors, loss of face typically leads to a diminution in a man’s access to females. Indeed, many evolutionary psychologists opine that homicidal jealousy is an evolutionary adaption since killing a direct or indirect sexual competitor was an efficient solution during human evolution. Why not? There were no jails, lawsuits or any consequences save for revenge by the slain man’s kin. Killing one’s sexual competitor smoothed the path towards passing one’s genes to future generations. In short, evolution may have made it more adaptive to kill than be cuckolded. The need to take an evolutionary view of sex is emphasized by Dobzhansky, who said “nothing in biology makes sense except in the light of evolution. By logical extension it follows that nothing in sexuality makes sense except in light of evolution. Psychologists who attempt to understand and treat couples in distress must at least make an attempt to understand human social behavior in terms of our evolutionary past.
Many psychotherapists still treat anxiety based on the theories of a 19th century Vienna physician who along with collaborator Josef Breuer proposed that anxiety arises when unconsciously repressed sexual and aggressive impulses begin to force their way into consciousness. Despite more than a century of discredit people with anxiety spend hours with therapists who futilely seek to uncover these secret urges as a means to mitigate the anxious anguish of their client. This is a sad waste of time and money.& Anxiety is a natural adaptive emotion that arises primarily from a brain module called the amygdala. This part of the brain mediates fear, aggression, and many other survival related affects. Importantly, in some people it is far more active than in others. That is, some people feel fear more intensely and pervasively than others. Indeed, there are a few people who have been documented to never experience fear or anxiety at all. And sadly, their are others who are plagued with dread or even terror with the most minor or provocations.
People with anxiety of the kind described above are bi necessarily deficient. Instead they may very well be adapted for dangerous environments in which fearfulness and the associated vigilance would enhance their survival chances. However, too much of a good (or adaptive) thing can be problematic. When someone’s amygdala interprets too many events as dangers – and these events include the person’s own thoughts — then fear will be handicapping or even disabling. Such a person needs to first understand the nature of his or her fears, the circumstances in which they become worse and unique way in which they manifest. Anxiety is not always perceived as dread but can be experienced as dizziness, fatigue, irritability, and a range of other physical expressions. One reason for this is one of the many connection sites of the amygdala is the insular cortex that can link bodily sensations to emotions. An understanding of the multifaceted expressions of anxiety can act to reduce the secondary fears that often accompany it. The sufferer must then learn to identify the triggers of the the anxiety — and this is often not readily accomplished.. Joseph LeDoux of New York University has experimentally demonstrated that there are at least two fear pathways one largely conscious and the other unconscious. Consequently, a person can experience fear or anxiety after being exposed to a thing or event that unconsciously represents danger without any awareness of the anxiety trigger.
Recent research by Dr. Abrams has shown that people with health problems often use irrational beliefs to evade appropriate self-care. Using a brief measure of personality, Dr. Abrams and his co-workers found that people resistent to new ideas, with less emotional resilence, and less commitement to consciencious behavior often allow their health to deteriorate. If you have a chronic health problem it is very much in your interest to be aware that your personal philosophy can lead to a unique type of denial that can endanger your health. Indeed, In his latest study Dr. Abrams found that people with chronic illnesses like diabetes can be expect to have better outcomes if they are made aware of the irational components of their thinking.
Unlike most other health professionals psychotherapists are often self restrained by dogma derived from schools of thought. These include psychodyanamic, Rational Emotive, Cognitive, Cognitive Behavior, Interpersonal and so on. The consumer of mental health services needs to carefully evaluate the approach that each therapist applies and his or her ability to apply other approaches. Very often in reviewing psychologist websites one will find statements indicating that a psychologist is psychodynamic – applying a variation of Fredian Therapy – but that they also claim to use CBT when think it appropriate. This is very much like a physician saying that they use chiropractic healing but apply real scientific medici wehen necessary. First, one must ask is the therapist trained in all of these approaches that they claim to use. Second, it is helpful to know when they think switching approaches is beneficial to the client. The recent dominance in research of CBT has led many poorly trained therapists to claim to use this approach when in reality they have had no more than a weekend seminar. What is particularly vexing about this trend is that Cogntiive therapies are not functionally compatible with the traditional dynamic psychotherapies. The latter predicate their treatment on giving the client insight into the origin of his or her problems. And from this is posited that the insight cures. Categorically, this is absurd. If you were to find that you have low self esteem because you had poor bonding with your mother, do you really think that this discovery will make it go away? Sadly, things are not that easy; like all major life changes it requires hard work, practice, and commitment to change. Although the therapist’s talent is a key factor in therapeutic efficacy, there are certain factors that aid in healing. Blame is at the core of most emotional disturbances such as Irrational idea (e.g., I must be loved by everyone)➜ internalize ➜ self-defeating. We have a tendency to make ourselves emotionally disturbed by internalizing self-defeating beliefs. CBT hypothesizes that we keep ourselves emotionally disturbed by the process of self-indoctrination CBT holds that neurotic problems directly stem from magical, “unvalidated” thinking.
If one observes people carefully, virtually every action one witnesses will have some connection to sexuality. Of course, many of these connections will be quite abstractly associated with the physical acts of sex, but they will be sexual nonetheless. As will be made clear in this book, sex is more than procreation. It organizes our identities, the way we perceive others, and the way others judge us. It guides our vocational efforts and our quest for status and recognition. Sexuality guides our speech, our gestures, the way we walk, our willingness to fight or flee, and even our assessment of beauty. The following are a few examples of endeavors that may not seem sexual unless one examines them at the deepest level: men who spend hours in a gym to enhance their muscularity; women who mockingly refer to an expensive sports car as a compensation for manhood; women who enlarge their breasts and sculpt their buttocks; men who routinely take drugs to increase blood flow to their penises; people of all sexes who select clothing to either enhance their attractiveness or broadcast their social status; the relatives of a new mother who emphasize the baby’s facial similarity to the father; the prosperous men who go to great lengths to make sure that other people, especially women, are aware of their elite status; women who spend hours accoutering themselves to look as youthful and fertile as possible; individuals who use social media to disseminate negative gossip about sexual competitors and positive gossip about themselves; and those who, when told of a much older man courting a younger woman, reflexively respond with, “I’ll bet he has money.”
And I ask the reader, Do you really behave the same way with a person that you feel attracted to compared to one who does not pique your interest? In fact, sexual attraction alters perceptions such that the attractive person will seem more astute, appear emotionally more stable, be more interesting, and even smell better. These and countless other interpersonal exchanges are intimately connected to sex and reproduction. As will be made clear, these and other human behaviors that may not seem immediately connected to sexuality will be shown as deeply connected to our sexual imperative. The specific manifestation of any sexual expression will be shaped by culture, societal traditions, and even regulations. But when one peels away the veneer of norms, most of these will be found to be essential human expressions related to love, intimacy, and sexual reproduction.
There is no contradiction that the underlying forces that shape the multiform expression of our sexuality are distinct from our expressed reasons for having sex. Like many superficially volitional acts guided by nonconscious motivations, their explanation is often confabulated. This is because we are fundamentally explaining our actions to ourselves. We are prone to evade the apprehension that we do not always have access to the crucial reasons why we do things. Cindy Meston and the renowned evolutionary psychologist, David Buss (interviewed in this book), surveyed 1,549 college students about their reasons for having sex. The respondents initially provided more than 700 reasons that were distilled into 237 core reasons. These were further reduced to 4 factors and 13 subfactors. The finding shows that the respondents’ core motives were centered on physical desires such as stress reduction, pleasure seeking, attaining a desirable partner; goal attainment by way of accessing the resources of their partner, increasing social status, revenge against a competitor; reasons of personal insecurity in which sex elevated self-esteem; guarding their mate against potential competitors; and lastly, emotional reasons that included sex as an expression of love. Notably, the fourth factor, love, explained the least variance in women and none in men. What is most germane about this study is that the original 715 reasons given for having sex tended to be largely superficial and hedonic. That is, most students said they wanted to have sex simply because it was fun, it felt good, and it made them feel good about themselves. But when their reasons were factor-analyzed, deeper themes like revenge, mate guarding, resource acquisition, and acquiring an ideal partner were discovered. These are some of the key motives that evolutionary psychology not only predicts as ultimate sexual motives, but also suggests that they motivate most actions in life.
Despite the previous results in which people claim that their reasons for sex are straightforward, in actuality, sexuality is complexly insinuated into the fabric of all human striving. The universality of sexuality is the bedrock of the social nature of humans. Indeed, our social standing among others is important because it directly impacts our sexual viability. This reality belies the adage that one shouldn’t care about what others think. If people really didn’t care, BMWs would supplant Volkswagens, and Cadillacs would be exchanged for Chevrolets. Expensive jewelry would become quite rare. Students would be less willing to pay the costly tuitions of elite colleges, and would readily accept the education at their state university. Great poetry, literature, painting, and sculpture would be rare. And all the servers in restaurants, waiting for their big break in theatre, would instead concentrate on waiting on tables. For what purpose would fame, impressive cars, status, or impressive degrees perform if we didn’t care what the devotees think? In truth, we are deeply inclined to care what people think about everything we do; and this concern motivates us to achieve, create art, to discover scientific truths, and even climb mountains. Because fame, creativity, lavish clothing, and social status make us sexier.
A pansexual view such as I have been discussing was proposed a century ago by a creative writer and genius in self-promotion, who set out to make himself a legend, and at this he succeeded. He constructed explanations of individual motivation and a model of the structure of the psyche. He proposed an origin of myths and religion, and he purported to explain dreams, aggression, and the nature of love. In fact, he fabricated the most comprehensive psychosocial theory that had ever existed. His work had a fascinating appeal because it made each of us a unique composite of dynamic forces worthy of years of analysis. However, over time, every essential theory of Freud has been shown to be critically flawed or simply wrong,[1] except for the one that had led to the most contention. Specifically, Freud had asserted that libido, the source of all sexual drive, underlies everything we do. As we will see, he was right in principle and wrong in explanation. Sexuality does indeed inspire virtually all that we do. But it is not a result of the sexual life force called libido. Rather, sex became crucial through the natural selection of somatic and psychological traits that are all sexually conveyed. Since most of what we are and much of what we think is conveyed through sex, then sex must be the guiding force of life.
Over the past three decades, there has been an accelerating paradigm change in psychology that is providing fascinating revelations about human behavior. Prior to this new paradigm, evolutionary psychology, human behavior was described through a collection of competing schools of thought. Personality was modeled as an amalgam of representations such as a collection of factorial traits, repressed impulses, hidden replicas of significant others, or biological impulses. Intelligence was a function of speed of neural processing, dense and efficient cortical connections, or developmental reinforcement. Social actions were understood in terms of culture and vicarious or direct learning. And disordered thinking or behavior had even more competing explanatory schemes. Indeed, virtually every aspect of the human psyche was depicted by numerous and often mutually exclusive representations. And most of these were held apart from the rest of the person in a continuing Cartesian dualism. There were in effect numerous minds and a body, but there was no convincing means to integrate them. Then gradually a concept more than a century old was revealed to be the best means to both explore and understand our species. In 1858, Charles Darwin initiated a revolution that would ultimately show that every feature of every living thing arose from chance mutations. Each of these mutations was then selected or discarded based on their respective contribution to reproductive success. Consequently, the value of any contribution was never absolute, but had an importance contingent on environmental settings. In essence, there are no good traits or bad ones, only traits that best fit the particular environment in which the trait arises. The shape of the beak of a finch or the size of a mammal’s brain had relevance only in the context of how that feature aided the host’s survival in a given ecosystem. And if it aided survival, such that its host could produce more offspring, then that trait would be passed along.
From the time of Darwin, there were a few thinkers, including Darwin himself, who hinted that natural selection applied to behavioral traits; but it wasn’t until the latter part of the 20th century that people like E. O. Wilson, Michael Ghiselin, Robert Trivers, David Buss, Leda Cosmides, John Tooby, Robert Wright, Douglas Kenrick, and Gordon Gallup initiated a paradigmatic change in psychology, sociology, sexology, and all other social sciences. With this change, scientists of human behavior began looking to natural selection to explain all human thought, emotion, and behavior. The social sciences began to heed the declaration of biologist Theodosius Dobzhansky that nothing in biology makes sense except in the light of evolution. Now scientifically minded social scientists are increasingly following the allied principle that nothing in humanity makes sense except in the light of evolution. Arguably, the first sex therapist and the founder of modern psychotherapy, Albert Ellis, PhD, tacitly took an evolutionary approach to psychology and sexuality. Ellis recognized that sexual behavior has a strong innate component and that many of the thoughts or actions that are viewed as pathological are actually attributes that were adapted for earlier settings. Decades later, this principle would become the most significant scientific basis for understanding sexual behavior. And this book, while reviewing many perspectives, is research-based and will explore sexuality accordingly. Moreover, a careful review of the scientific evidence on sexuality leads one inexorably to the natural selection perspective. Quite simply, no other model explains the observations as well.
As Albert Ellis and I explained in our text on personality, there has long been a bias found in some experts against explaining human behavior in terms of adaptations, as these writers view this as opening a slippery slope to racism, eugenics, or antihumanism. However, to deny an essential truth because some might abuse it to justify bigotry comes at a great price. It is for this reason that I include an interview with the late J. Phillipe Rushton. He was a very gentle and pleasant man, but he presented theories that were tinged with insensitivity at best and racism at worst. However, by giving a forum to someone who indeed took evolutionary psychology to the extreme most feared by its detractors, I can help clarify that such extremes present no danger so long as they can be openly refuted. For Rushton used the logic of evolutionary psychology to propose models that instantiated the very worst fears of those who find it a potential danger. And as a result, Rushton was branded a racist and his ideas were marginalized. It is clear that any fears that evolutionary psychology will be used to justify social injustice are unfounded.
It is because our sexuality is the result of an incremental evolutionary process that it is comprised of forces both powerful and nonconscious. That is, all of us at some time in our lives will feel compelled by our sexual drives in ways that leave us chagrined by our own behavior. Surely, the reader has been in the throes of sexual arousal and made decisions in what must have seemed to be an altered state of consciousness. At the time of arousal, these decisions seemed perfectly rational. Then with the waning of the passion, many of us are left shaken or even ashamed by our behavior. In prior eras, this was explained by the unconscious forces of the libido and id. However, a research-supported model holds that our sexual drives are mediated by evolutionarily old mechanisms controlled by primeval brain centers. These ancient drives are frequently not compatible with the values embedded in the phylogenetically newer neocortex. These drives can be so alien to our self-image that we often have trouble recalling how we were feeling once we are back in a nonaroused state. In fact, as you read this, try to recall how you felt, and what you were thinking, when you were last strongly sexually excited. You may recall the source of the stimulation and where you were, but it is unlikely that you will recapture the state of mind. Clearly our sex drive is a powerful and often dominating force in our lives. But unlike our other appetitive drives, it has profound social, cultural, and even legal restrictions. With such dynamics being involved with it, and its being so intertwined with our psyche, the study of sex must be based on legitimate science and research, as even the best research on sexuality can be swayed by the powerful influence of sex on our thinking.
Anything that can subvert our thoughts or social judgments cannot be trusted to intuition or memory. As Elizabeth Loftus (interviewed in this book) has shown, memory must always be treated with skepticism. And none of us can be trusted to know ourselves when forces in our lives are sufficiently strong as to lead us to self-deception. Loftus and other memory researchers have shown that each of our realities is largely constructed in the form of a personal narrative that fits best with our self-image, our worldview, and our moral values. And this construction is particularly malleable when we confront our biases, fears, and fragile self-concepts. So, although this book does somewhat rely on the observations of a practitioner who has worked with and studied sexual matters for 30 years, these observations are always subordinated to the nearly 900 sources referenced in this book. Although not a perfect path to the truth, the scientific method is the best means we have of finding it. So the vast preponderance of the exploration of sexuality presented here will be based on scientific evidence. And when the evidence and personal experience are at loggerheads, the science always wins. Complementing the data and interpretations in this book are interviews with key figures in the world of sexuality. The interviews provide perspectives from people who have acquired either comprehensive or uniquely specialized knowledge about sexual behavior. Most of the people interviewed have earned international reputations for their accomplishments. It is strongly suggested that all of these interviews should be carefully read, as they are compelling complements to the text, and much of their content is not found anywhere else—in this book or any other.
More than a century ago physicians formalized a new treatment consisting of reassurance, supportive sympathy, and interpreting the sources of anguish. This talking treatment had always been a part of medicine; it had to be since historically medicine had few other options. There were no antibiotics, no vaccines, limited analgesics, and surgery came with grave risks. Thus, the physician’s most effective treatment usually involved palliatives and kind words. This essential component of medical care evolved into a distinct treatment, a treatment for problems with emotions, thinking, and living. With the advent of talking as a medical treatment a new approach to psychological suffering took hold. This method, no longer solely a province of medicine is now called psychotherapy, is applied in literally hundreds of forms and variations. Some of these variations are predicated on the conjectures of one man who is followed, often zealously, with little variation from its advent in the late 19th century. As it progressed as means to help people with emotional suffering, it has become increasingly based on science, clinical research, and improvement. Psychotherapy and the science supporting it, is primarily a province in the realm of psychology, a professional disciple with many components. An unfortunate consequence of psychology’s many subfields is the common tendency for many to give only cursory attention to advancements in their sister disciplines. One such advancement that has been growing within psychology has been the integration of psychological and evolutionary science.
This new field is both logical and necessary. Indeed, since every aspect of our being is at least partially a product of eons of natural selection, it follows understanding natural selection is a requisite for those interested in the functions and dysfunctions of the psyche. Very few argue that complex organs such as the human eye, the heart, and the brain are the result of eons of descent with modification. Even the most complex parts of our anatomy developed as a result of eons of beneficial mutations. Of course, mutations, often referred to as birth defects, are typically deleterious, given vast amounts of time and in the right environmental setting will yield incremental advantages. If this advantage provides even a very small increase in the likelihood of reproduction it will tend to be passed along to offspring. And over thousands of millennia these mutations will combine, or interact, with other genetic changes to produce new organs, new brain functions, or entirely new species. In an extremely distilled form, this is essence of Darwin’s model of species change or what is commonly referred to as evolution – a term that Darwin himself did not use (ref). Evolution refers to an unfolding process, one with an implied direction or purpose. This is not the spirit of this unique process. Instead, it has no direction, no goal, and no purpose. It is a natural process of trial and error in which those attributes that endow the inheritors with even the slightest advantage in reproductive survival will be among the last left standing.
Over the last few decades evolutionary principles have been shown to provident convincing explanations for many psychological phenomena. Like all paradigm changes in science it has elicited contention and debate, some examples will be discussed later in this chapter. However, the growing body of evidence has left little doubt that this approach to has offered powerful new ways to understand human thinking and behavior. Unlike many earlier schools of thought in psychology, the work in evolutionary psychology has almost exclusively been limited to explanations as opposed to applications. Such explanations, have provided new insights into jealousy (e.g. Buss & Abrams, 2016), aggression (Buss), sexual orientation (Abrams), anxiety (Price; Brune), reproductive anatomy (Gallup), Love (Fisher), and even psychosis (Price).
This book will show that evolution is at least as important to clinical psychology as it is to the developmental, biological, and neurological branches of the science. The study of natural selection has revealed, that evolutionarily adapted traits are best understood when considered as products of the environment that man resided in when those traits evolved. Evolutionary psychologists refer to this ancestral setting as the environment of evolutionary adaptiveness (EEA). Importantly, this does not refer to specific time but any epoch that was sufficiently different from the present so as cognitive or behavioral traits that do not necessarily remain as optimal. That is, many of our psychological inclinations evolved to aid survival in settings very much different from the one in which we now reside. This will be shown to be an essential premise of evolutionary cognitive behavior therapy or Adaptive CBT. Specifically, clinicians, as well as theoreticians need to be aware that people now live in settings radically different from the ones in which their distant progenitors developed. As a result, many of our methods of dealing with problems, perceiving our environment, judging others or even assessing ourselves don’t match the current demands of our world. As a result, many psychological problems are that superficially appear to be disorders may actually be functional solutions mismatched with a new environment (Gluckman & Hanson, 2006).
Jealousy when classified as pathological can be an exemplar of a mismatch disorder. As I will discuss at length later in the book, one consumed with jealously will often be diagnosed with any number of psychological disorders. However, this person although classified as psychologically ill, may very well possess innate predispositions that served him quite beneficially during earlier epochs. During eras in which there was no paternity testing, few consequences for violent acts, or no social welfare programs for single mothers, jealousy could have been quite beneficial. The unquestioning man in a primeval epoch took the catastrophic risk of contributing resources and reproductive time to unrelated offspring if he had been cuckolded. Most anthropologists (Marlowe, 2000) agree that early hunter gathers contributed to the upbringing of his offspring. However, small this contribution may have been, those that provided it after being deceived by their mate did so at a significant cost to their genetic legacy. ** if a man had a high confidence in his paternity, and helped their offspring through early development they were far more likely to have their genes permeate future generations.
This premise will require that mental health professionals become conversant not only the demands of daily living, but the demands of living eons ago. They will need to understand the role the EEA had on today’s thinking and behaving. It may surprise many to learn that this term was coined by developmental and attachment theorist John Bowlby (1982, p. 58). Bowlby’s attachment theory, now a foundation of many psychoanalytic writers, is actually a biological theory. According to Bowlby the need for attachment as an evolutionary old instinct. An early evolutionary psychologist, he considered a knowledge of evolution as requisite to comprehending human nature. According to Bowlby, humans are endowed with a large number of instinctual behaviors and inclinations that can only be fully appreciated when considering the environment in which they evolved. This is s the environment of evolutionary adaptiveness. If Bowlby is correct, many behaviors and psychological disorders that are superficially inscrutable, are only so, because we view them solely with a contemporaneous perspective.
In REBT the most effective interventions used to help people with sexual problems are those that identify beliefs, personal philosophies, and perceptions about love and intimacy that lead to distress or conflict. Consequently, the first step in counseling an individual for sexual problems is to explore his or her viewpoints and consequent emotions that arise before sexual encounters or in response to sexual problems. Specifically each person experiencing sexual distress needs to be helped to find any rigidity of thinking, demandingness, and damning nature of their beliefs. In short, their irrational beliefs need to be illuminated. Importantly, sexual problems commonly yield more intense irrational thinking than many other therapeutic issues. Very few sources of adversity are coupled with the stigma and shame that accompany sexual dysfunction. Consequently beliefs related to self-downing, awfulizing, and demandingness will be particularly salient. This is an essential reason that REBT is the approach I strongly advocate and apply. A key reason for this choice is t the fact that no treatment has been shown to be more effective. Furthermore, REBT has a compelling face validity that clients readily accept and can learn to apply.
Albert Ellis late in his career adopted a constructivist view of psychotherapy; this will be an integral component of my approach. To expand upon this, I will apply the extended theory of personality that he set forth in his 2009 textbook on the subject. Specifically, he added developmental forces, genetic inclinations, and personality factors in the expression of irrational beliefs. I will also apply Ellis’s assertion that sexual irrationalities are generated by innate (e.g. Ellis, 1971) qualities of the person. Finally, I will take a humanistic approach that Ellis long asserted was a critical component of REBT
Along with demonstrating that REBT is the essential treatment for all sexual problems, new methods explore evolutionary psychology’s essential role in both conceptualizing and addressing sexual dysfunction. Recently, Buss and Abrams (2016) and Abrams (2016) have advocated adding evolutionary psychological principles to traditional REBT/ CBT techniques. They proposed that doing so would add greater efficacy to the REBT based sex therapy first set forth by Albert Ellis in the 1950’s. Ellis had long asserted that the irrational beliefs or behaviors that impede intimacy were often a result of biologically innate tendencies. Ellis later clarified this assertion by stating that these innate tendencies were evolutionarily endowed adaptations. Consequently, by understanding the evolutionary origins of these problematic adaptations REBT therapists will be more effective in assisting clients with intimacy problems. This can include helping afflicted individuals better understand the origins of their irrational or self-defeating thinking relating to love or intimacy. This understanding will enhance the client’s commitment to contesting and altering beliefs leading to his or her sexual distress.REBT etiologies and treatments are offered for problems in arousal in both degree and direction, i.e. paraphilias. Such etiologies are utilized for dysfunctional jealousy, mate guarding, and problems in sexual bonding. In addition, techniques are provided for assisting clients who have difficulty with adjusting to problems related to sexual variations such as gay bias, gender identity, erotic target difficulties and physical disorders affecting sexual function.
Humans have evolved ways to non-consciously detect infidelity, as well as methods to both detect and deal with a love partner’s betrayal Jealousy is one such adaptation. Both infidelity and the jealousy that arises in anticipation of, or along with it are problems that bring couples to therapy. Categorizing jealousy as a sign of emotional dysfunction versus viewing it as a normal response turns out to be difficult for the clinician. This is partially a result of the evolution of infidelity to be concealed from the betrayed partner, Thus, the secrecy of infidelity makes the legitimately jealous partner seem inappropriate.
One solution is to view it as a signal detection problem. Because failing to detect a cheating partner has been more costly in evolutionary value than the social costs of falsely suspecting a partner of cheating. Thus, evolutionary natural selection has created a cognitive bias to overestimate a partner’s straying. Moreover, adaptations for jealousy become activated by predictors of infidelity, such as mate value discrepancies, when no actual infidelities have occurred. Cognitive-behavior therapy (CBT) offers several ways to deal with these complexities. One way is to highlight potential mismatches, distinguishing between jealous emotions that were functional in ancestral environments but are less so in modern environments. A second is to distinguish between the goal of personal well-being and reproductive outcomes. Understanding the evolutionary logic of jealousy, in short, provides people with procedural methods for cognitively reframing jealousy and infidelity.
As Kuhn observed all sciences experience oscillating progression marked with an occasional paradigm shift. This occurs when procedures that developed out of accepted truths and principles are rapidly replaced. And this is what has happened to much of scientific psychology with the advent of the evolutionary approach to psychological study. Prior to evolutionary psychology the field has been divided by overlapping subdisciplines, schools of thought, styles of research, and charismatic leaders. This vast diversity of specialty areas within one science has led to a both a wide range of research topics, generally a good thing, and a obscuring as to what the common denominator of the topics are. Indeed, asking a psychologist the very fundamental question: “what is psychology” will either lead her to be perplexed or give the one of the formulaic answers found in most introductory psychology textbooks. Biologist and geneticist Theodosius Dobzhansky said: “nothing in biology makes sense, except in the light of evolution.” His insight was cogent; it also established a guiding and coalescing principle for the life sciences. Of course, biology is predicated on chemistry, physics, but for it to discover now directions and comprehensive explanations, it needs the principles of natural selection.
Without the canons that natural selection provide, the life sciences would essentially be descriptive. For a science to explain, make hypotheses and predictions, an underlying premise is fundamental. This is found in the synthesis between the work of Charles Darwin and Gregor Mendel. They synthesis of their work illuminated the path for all future work in the study of life on this planet. It provided the answer to the questions about why things are the way they are, not merely descriptions of how they are. In its simplest form reproduction, especially sexual reproduction invariably leads to errors. In rare and opportune situations these errors are advantageous. These errors have no path, bias, or purpose. They are copying or combination errors that lead to offspring that are different from their progenitors. In most cases they do no harm are lost to reproductive posterity. In others they lead to unviable offspring. But when they offer even the slightest advantage, those that possess them will have an advantage when confronting the adversities of life and will consequently have a better chance at reproduction. Life that has a better chance at reproduction will invariably exploit this advantage and thereby pass these “errors” along with greater alacrity then their peers. A critical, often misunderstood, point that is critical to evolutionary psychology is these advantageous errors are neither good nor bad, they mere help reproduction. Darwin poignantly observed that when observed through the lens of human morality, traits that aid survival can be cruel or ugly. To be clear the processes that resulted in your existence and the existence of all living things, operated without direction, goals, or morality. Indeed, the term evolution is misleading as it implies an unfolding or a developmental trajectory. The fact that Darwin never used the word in his seminal work was very likely deliberate.
In RE/CBT the most effective interventions used to help people with sexual problems are those that identify beliefs, personal philosophies, and perceptions about love and intimacy that lead to distress or conflict. Consequently, the first step in counseling an individual for sexual problems is to explore his or her viewpoints and consequent emotions that arise before sexual encounters or in response to sexual problems. Specifically each person experiencing sexual distress needs to be helped to find any rigidity of thinking, demandingness, and damning nature of their beliefs. In short, their irrational beliefs need to be illuminated. Importantly, sexual problems commonly yield more intense irrational thinking than many other therapeutic issues. Very few sources of adversity are coupled with the stigma and shame that accompany sexual dysfunction. Consequently beliefs related to self-downing, awfulizing, and demandingness will be particularly salient. This is an essential reason that REBT is the approach I strongly advocate and apply. A key reason for this choice is t the fact that no treatment has been shown to be more effective. Furthermore, REBT has a compelling face validity that clients readily accept and can learn to apply.
Abstract Humans have evolved adaptations for infidelity, as well defenses against a partner’s betrayal—centrally the emotion of jealousy. Both create problems that bring couples to therapy. Diagnosing jealousy as pathological versus normal turns out to be difficult, in part because infidelity has evolved to be concealed from the betrayed mate, which creates a signal detection problem. Because missing an infi- delity committed by a mate has been more costly in evolutionary currencies than falsely suspecting a partner of cheating, selection has created an error management cognitive bias to over-infer a partner’s betrayal. Moreover, adaptations for jealousy become activated by predictors of infidelity, such as mate value discrepancies, when no actual infidelities have occurred. Cognitive-behavior therapy (CBT) offers sev- eral ways to deal with these complexities. One way is to highlight potential mis- matches, distinguishing between jealous emotions that were functional in ancestral environments but are less so in modern environments. A second is to distinguish between the goal of personal well-being and reproductive outcomes. Understanding the evolutionary logic of jealousy, in short, provides patients with conceptual tools for cognitively reframing jealousy and infidelity.
Keywords: Jealousy • Infidelity • Error management • CBT
& David M. Buss: dbuss@austin.utexas.edu
& Mike Abrams: mike.abrams@nyu.edu
Intense jealousy can be emotional acid that corrodes marriages, undermines self- esteem, triggers battering, and is a key motive in the murder of mates and ex-mates (Buss 2000a, b; Buss and Duntley 2011; Daly and Wilson 1988; Daly et al. 1982). Extreme jealousy has been given many names in the clinical and psychiatric literature—The Othello Syndrome, Morbid Jealousy, Psychotic Jealousy, Patho- logical Jealousy, Conjugal Paranoia, and Erotic Jealousy Syndrome. Jealousy, of course, can be pathological. It can destroy previously harmonious relationships, rendering them hellish nightmares of daily existence. Trust slowly built from years of mutual reliance can be torn asunder. Jealousy by romantic partners causes more women to flee in terror to shelters for battered women than any other cause (Wilson and Daly 1996).
A full 13 % of all homicides are spousal murders, and jealousy is overwhelm- ingly the leading cause (Buss 2005; Daly and Wilson 1988). When an adult woman is murdered, the odds are between 50 and 70 % that the perpetrator is a husband, boyfriend, ex-husband, or ex-boyfriend. A common sentiment expressed by these killers is ‘‘If I can’t have her, no one can.’’ Jealousy is a dangerous emotion that has driven lovers to such violent extremes that many cultures have laws specifically tailored to it—crimes of passion.
One pathological aspect of extreme jealousy, according to traditional psychiatric thinking, is not the jealousy itself. It is the delusion that a loved one has committed an infidelity when none has occurred. The rage itself upon the actual discovery of an infidelity is something people everywhere intuitively understand. In Texas until 1974, a husband who killed a wife and her lover when he caught them in flagrante delicto was not judged a murderer. In fact, the law held that a ‘‘reasonable man’’ would respond to such extreme provocation with acts of violence. Similar laws have been on the books worldwide. In France, Italy, the UK, Brazil, and Uruguay, for example, killing in this context typically resulted in reduced criminal charges, such as from murder to manslaughter, and reduced sentences if convicted. Extreme rage upon discovering a wife naked in the arms of another man is something that people everywhere find intuitively comprehensible. Criminal acts that would normally receive harsh prison sentences routinely get reduced when the victim’s infidelity or a mate poacher’s conduct are the extenuating circumstance. Why do people intuit that a ‘‘reasonable man’’ would be driven to such extremes? And are diagnoses of pathological jealousy destruction always warranted?
A professional couples’ therapist related the following story. A young couple we will call Joan and Richard came to her with a presenting complaint of irrational jealousy. Without provocation, Richard would burst into jealous tirades and accuse Joan of sleeping with another man. His uncontrollable jealousy was destroying their marriage. Richard and Joan both agreed on this point. Could the therapist help cure Richard of irrational jealousy?
A common practice in therapy for couples is to have at least one session with each member of the couple individually. The first question the therapist posed to Joan during this individual interview was: Are you having an affair? She burst into tears and confessed that, indeed, she had been carrying on an affair for the past 6 months. Having confessed to the therapist, Joan felt obligated to reveal this information to her husband. They ended up divorcing. Richard’s jealousy, it turned out, had not been irrational after all. Presumably, he had been picking up on subtle cues that triggered his jealousy. Since he trusted Joan and she had assured him of her fidelity, however, he became convinced, with Joan’s help, that his jealousy had been irrational. In a sense, Richard had failed to listen to his internal emotional wisdom.
In scientific surveys of jealousy, nearly all men and women report having experienced at least one episode of intense jealousy (Buss 2000a, b). Thirty-one percent say that their personal jealousy has sometimes been difficult to control. And among those who admit to being jealous, 38 % say that their jealousy has led them to want to hurt someone. This intense emotion, in short, is not limited to spouse killers.
Despite its dangerous manifestations, jealousy helped to solve critical reproductive quandaries for ancestral men and women. Consider first a fundamental sex difference in our reproductive biology—the fact that fertilization takes place inside women’s bodies and not men’s. Internal female fertilization is not universal in the biological world. In some species, such as the Mormon crickets, fertilization occurs internally within the male. The female takes her egg and literally implants it within the male, who then incubates it until birth. In other species, fertilization occurs externally to both sexes. The female salmon, for example, drops her collection of eggs after swimming upstream, the male follows and deposits his sperm on top, and then they die, having fulfilled the only mission in life that evolution gave them. But humans are not like salmon. Nor are we like Mormon crickets. In all 5416 species of mammals, of which we are one, and in all 350 species of primates, of which we are also one, fertilization occurs internally within the female, not the male. This posed a serious problem for ancestral men—the problem of uncertainty in paternity.
From an ancestral man’s perspective, the single most damaging form of infidelity his partner could commit, in the currency of reproduction, would have been a sexual infidelity. A woman’s sexual infidelity jeopardizes a man’s confidence that he is the genetic father of her children. A cuckolded man risks investing years or even decades in another man’s children. Lost would be all the effort he expended in selecting and attracting his partner. Moreover, he would lose his partner’s labors, now channeled to a rival’s children rather than his own.
Women, on the other hand, have always been 100 % sure that they are the mothers of their children—internal fertilization guarantees that their children are genetically their own. No woman ever gave birth and, watching the child emerge from her womb, wondered whether the child was really hers. One African culture captures this sex difference with a phrase more telling than any technical summary: ‘‘Mama’s baby, papa’s maybe.’’ Biology has granted women a confidence in genetic parenthood that no man can share with absolute certainty.Our ancestral mothers confronted a different problem—the loss of a partner’s commitment to a rival woman and her children. Because emotional involvement is the most reliable signal of this disastrous loss, women key in on cues to a partner’s feelings for other women. A husband’s one-night sexual stand is agonizing, of course, but most women want to know: ‘‘Do you love her?’’ Most women find a singular lapse in fidelity without emotional involvement easier to forgive than the nightmare of another woman capturing her partner’s tenderness, time, and attention (Shackelford et al. 2002). We evolved from ancestral mothers whose jealousy erupted at signals of the loss of love—mothers who acted to ensure the man’s commitment.
But who cares who fathers a child or where a man’s commitments get channeled? Shouldn’t we love all children equally? Perhaps in some utopian future, we might, but that is not how the human mind is designed. Husbands in our evolutionary past who failed to care whether a wife succumbed to sex with other men and wives who remained stoic when confronted with their husband’s emotional infidelity may be admirable in a certain light. Perhaps these self-possessed men and women were more mature. Some theories, in fact, propose that jealousy is an immature emotion, a sign of insecurity, neurosis, or flawed character. Non-jealous men and women, however, are not our ancestors, having been left in the evolutionary dust by rivals with different passionate sensibilities. We all come from a long lineage of ancestors who possessed the dangerous passion.
Jealousy, according to this theory, is an adaptation. An adaptation, in the parlance of evolutionary psychology, is an evolved solution to a recurrent problem of survival or reproduction. Humans, for example, have evolved food preferences for sugar, fat, and protein that are adaptive solutions to the survival problem of food selection. We have evolved specialized fears of snakes, spiders, and strangers that are adaptive solutions to ancestral problems inflicted by dangerous species, including ourselves. We have evolved specialized preferences for certain qualities in potential mates, which helped to solve the problems posed by reproduction. Adaptations, in short, exist in modern humans today because they helped our ancestors to combat all of the many ‘‘hostile forces of nature,’’ enabling them to better survive and reproduce. Adaptations are coping devices passed down over millennia because they worked—not perfectly, of course, but they helped ancestral humans to struggle through the evolutionary bottlenecks of survival and reproduction.
Many expressions of jealousy, according to this perspective, are not signs of immaturity, but rather important passions that helped out ancestors, and most likely continue to help us today, to cope with a host of real relationship and reproductive threats. Jealousy, for example, motivates us to ward off rivals with verbal threats and cold primate stares (Shackelford and Buss 1996). It drives us to keep partners from straying with tactics such as escalating vigilance or showering a partner with affection. And it communicates commitment to a partner who may be wavering, serving an important purpose in the maintenance of love. Sexual jealousy is often a successful, although sometimes dangerous, solution to persistent predicaments that each one of our ancestors was forced to confront.We are typically not conscious of these reproductive quandaries. Nor are we usually aware of the evolutionary logic that led to this dangerous passion. Men do not think: ‘‘Oh, if my wife has sex with someone else, the certainty that I’m the genetic father is jeopardized, thereby endangering my genetic legacy… I’m really mad!’’ Nor does a man whose partner uses birth control think, ‘‘Well, because Joan is taking the pill, it doesn’t really matter whether she has sex with other men; after all paternity is not an issue.’’ Nor does a woman think: ‘‘It’s really upsetting that Dennis is in love with that shrew instead of me; this jeopardizes my hold on his emotional commitments to me and my children, and hence hurts my overall reproductive success.’’ Instead, jealousy is an essential passion, just as our hunger for sweets and our craving for companionship are evolved adaptations. Jealousy can be considered a type of nonconscious emotional wisdom passed down to us over millions of years by our successful forebears.
Jealous men were more likely to reserve the expensive resource of parental investment for their biological children, rather than squandering it on the children of rivals. As descendants of a long line of men who acted to ensure their paternity, modern men carry with them the dangerous passion that led to their forebear’s reproductive success.
According to this hypothesis, jealousy represents a form of ancestral wisdom that can have useful as well as destructive consequences. The view of extreme jealousy as inevitably pathological ignores a profound fact about an important defense designed to combat three real threats to intimate relationships—infidelity, potential mate poachers, and a partner’s outright defection from the relationship. Jealousy is not always a reaction to an infidelity that has already been discovered. It can be an anticipatory response to adaptive problems such as a mate value discrepancy or to the sudden presence of potential mate poachers (Schmitt and Buss 2001). So it can be a preemptive strike to prevent an infidelity or defection that might occur. Labeling jealousy as delusional or pathological simply because a spouse has not yet strayed ignores the fact that jealousy can head off an infidelity that might be lurking on the horizon of a relationship.
Some expressions of jealousy clearly qualify as psychologically disordered. The DSM notes one form—Delusional Disorder-Jealous Type (Easton et al. 2008). This requires clear evidence of delusions of a partner’s infidelity when no infidelity has occurred. Consider this case. On Christmas eve, a man looked out of his living room window across the street, and noticed his neighbor’s Christmas tree lights blinking. When he compared them to the analogous lights his wife had set on their tree, he noticed that they were blinking in synchrony with those of the neighbor. He concluded that his wife was having an affair. His wife insisted that he see a psychiatrist, who diagnosed him with delusional jealousy. As it turned out, his wife was indeed having an affair. Moreover, she was having an affair with that specific neighbor. So is delusional jealousy the proper diagnosis? Clearly, there was a delusional component; it is extremely improbable that there existed Christmas tree light synchrony intentionally created by his wife and his neighbor. But his inference of his wife’s infidelity was perfectly on target and not delusional.
Some have offered criteria for distinguishing normal from pathological jealousy.
For example, Marazziti et al. (2003) identify these key criteria:
The difficulty with the application of these criteria is that they are overly broad. If a partner is indeed having an affair, or perhaps even considering having an affair, these expressions of jealousy may signal the normal operation of the adaptation of jealousy. Limiting the partner’s freedom and even extremes of checking on the partner’s behavior to the point of stalking are common manifestations of mate guarding (Buss 1988; Buss and Shackelford 1997a, b).
Kingham and Gordon (2004) offers these common symptoms of pathological jealousy:
Again, however, all of these behaviors have been documented as common mate guarding and retention tactics whose frequency is increased when someone faces one of the adaptive problems of partner infidelity, threat of mate defection, presence of mate poachers, or all three (Buss 2000a, b). Even threats of harm to self if a partner threatens to leave the relationship and verbal or physical violence directed a partner are common expressions of mate guarding across cultures (Buss 1988; Buss 2000a, b; Buss and Duntley 2011). A threat of suicide if a partner leaves sometimes solves an adaptive problem of mate retention and the partner stays. And often, violence and threats of violence cause a woman to stay in a relationship, even if she wants to get out, again solving the problem of mate retention. Although physical violence toward a spouse is illegal in some cultures, but by no means all, laws against wife-beating and spousal rape are relatively recent and have not characterized most of the centuries in which humans have had written laws. Four additional problems render a diagnosis of pathology problematic—the signal detection problem, the on-average effectiveness problem, error management logic, and sensitivity to predictors of infidelity even when none has occurred.
Although infidelity is often morally condemned and seen as a sign of dysfunction, a good case can be made that affairs evolved to solve adaptive problems. For men, the historical reproductive benefits of infidelity were fairly straightforward—increased sexual access to fertile women translated into more offspring and greater reproductive success (Symons 1979). For women, infidelity is more puzzling, since rarely could it have translated into higher reproductive output (the exception being married to a man who was impotent or infertile). The two leading evolutionary hypotheses for female infidelity are (1) securing good genes from an affair partner while securing investment from a regular partner (Gangestad and Haselton 2015), and (2) the mate switching function, by which affairs secure a backup mate, pave the way for exiting a bad relationship, trading up to a higher mate-value partner, or all three (Buss et al. in press).
Because it has been advantageous for some individuals to have an affair, and the affair comes at a potentially steep cost to the partner, defenses evolved to prevent its occurrence. The psychological complex of jealousy and its behavioral output in mate guarding and retention, as discussed above, are the primary co-evolved defenses. As defenses against a partner’s infidelity evolved, more sophisticated strategies for conducting affairs evolved. Chief among these were secrecy. As jealousy evolved and became more elaborate in design specificity, infidelity got driven underground, cloaked in great secrecy. As one sex became more and more sensitive to subtle cues of infidelity, such as unexplained absences, strange scents, changes in sexual interactions, and many others (Shackelford and Buss 1997), the other became more adept at concealing these cues. The resulting co-evolutionary arms race created a signal detection problem—how could a calamitous infidelity be detected when cues to its occurrence were so skillfully concealed? Consequently, motivated monitoring, seemingly paranoid suspicions, cutting off a spouse’s social contacts, isolating a partner, snooping through their belongings—all seen by some as signs of pathology— may instead be the normal behavioral output of an adaptation working effectively to detect intentionally concealed subtle signals. The signal detection problem, in short, poses a problem for distinguishing normal from pathological jealousy.
Another problem is that solutions to adaptive problems evolve because, on average across the sample space of instances, they solve or ameliorate the problem better than alternative designs extant in the population at the time of their evolution. Callus-producing adaptations are designed to protect the anatomical and physiological structures beneath the skin, but those structures sometimes still get damaged despite the presence of calluses. Adaptations for coalitional warfare can evolve, even if these result in the death of the attackers some of the time or even a lot of the time (Tooby and Cosmides 2010). In other words, there are many ‘‘instance failures’’ of adaptations, despite their on-average effectiveness (Cosmides and Tooby 1999).
Jealousy, an adaptation designed to defend against a partner’s infidelity and potential defection, also produces many instance failures. Some partners still cheat despite jealous mate guarding. Some partners still defect, despite the deployment of the most effective mate retention tactics at a person’s disposal. These instance failures do not falsify the hypothesis that jealousy is a well-designed adaptation, since all adaptations work based on their on-average success, not based on their success in each and every case in which the relevant problem is confronted. The inevitability of instance failures creates a second problem for distinguishing normal from pathological jealousy.
When faced with conditions of uncertainty, there are two ways to err—failing to detect a problem that exists and falsely detecting a problem when none exists. A rustling in the leaves may signal a poisonous snake or a harmless sound stemming from a gust of wind. The costs of inferential errors differ in this case. Inferring a snake’s existence when there is no snake produces relatively trivial caution and avoidance. Failing to infer a snake’s existence when there is one could result in death. In short, there is often a cost asymmetry in inferential errors under conditions of uncertainty. According to Error Management Theory, recurrent cost asymmetries of this sort result in the evolution of cognitive biases to err in the direction of avoiding the more costly error (Haselton and Buss 2000). A smoke alarm is set sensitively by design to produce many false positives because the cost of missing an actual fire is far steeper than the cost of dealing with annoying alarm sounds when there is no actual fire.
Error management theory logic applies with equal force to the evolved design of jealousy (Buss 2000a, b). Failing to detect an actual infidelity is generally costlier than falsely suspecting one that has not occurred. Jealousy-motivated vigilance or suspicion is generally less costly than being oblivious to an infidelity. Falsely suspecting a spouse of infidelity, of course, can have costs from small to large. It could produce relationship conflict, wasting valuable effort on a problem that does not exist. Persistent jealousy also sometimes drives a partner out of a relationship or into the arms of others. But if the on-average cost of erring by falsely suspecting infidelity exceeds the average cost of missing an infidelity or defection, jealousy thresholds will evolve to avoid the more costly error.
Jealousy is Triggered by Predictors of Infidelity When No Infidelity Has Occurred
The difficulty of diagnosing when jealousy is pathological becomes further compounded by the fact that jealousy is designed to be activated not just by cues to the actual occurrence of infidelity, but also to statistically recurrent predictors of infidelity when no infidelity has actually occurred. Consider mate value. People generally couple based on overall mate value; the 8s tend to pair up with other 8s, the 6s with other 6s (Buss 2003; Conroy-Beam & Buss 2016). Over time, however, mate value discrepancies can emerge. A man or woman might receive a large promotion at work or large status boost from a career breakthrough, dramatically improving their mate value. A man or a woman could become ill, suffer a debilitating injury, or suffer a status loss, dramatically lowering their mate value. Because the components that contribute to mate value are never static and always change over time, mate value discrepancies inevitably emerge. If they get large enough, they predict infidelity, defection, and mate switching (Buss et al. in press ; Buss and Shackelford 1997b). If jealousy is designed to be triggered by a mate value discrepancy, even if no infidelity or defection has occurred, it can seem pathological when it is not.
Mate value discrepancies are not the only statistical predictors. Other candidates include erectile dysfunction, orgasm difficulty, sexual dissatisfaction, decline in sexual desire or drive, the sudden introduction of new sexual positions, abrupt changes in clothing style, innocuous but unexplained absences, and many others (Buss 2000a, b; Shackelford and Buss 1997). A man who experiences erectile dysfunction or whose wife becomes sexually dissatisfied may suspect that she will seek sexual gratification elsewhere. Abrupt changes in clothing or sexual positions may signal infidelity, but may simply be innocuous attempts to spice up a life of quiet desperation. Since jealousy is designed to become activated by statistical predictors of infidelity, even if it has not occurred and might never occur, it can seem pathological when in fact it is functioning precisely as it was designed to function.
From an evolutionary perspective, a diagnosis of disorder requires that an evolved mechanism not function as it was designed to function (Wakefield 2005). In the case of jealousy, if it gets activated in contexts it was not designed to get activated, is triggered by drugs or alcohol that produce delusions or abnor- mally lower thresholds for suspicion for example, it is not functioning as it was designed to function and so can become pathological or disordered. But the signal detection problem, the on-average success of adaptations that produce many instance failures, the adaptive error management biases designed to avoid the more costly errors even at the expense of more frequent but less costly errors, and the fact that jealousy is activated by statistical predictors of events that have not occurred, render a diagnosis of jealousy as pathological diabolically difficult.
Cognitive behavior therapy, however, can produce insights into these difficulties and help patients with presenting problems of jealousy.
Although an evolutionary perspective compellingly depicts jealousy as an adapta- tion, it is one that can be perceived as maladaptive in many modern social settings. Until very recently, there were fewer normative values against violence, murder or any other socially disagreeable manifestations of jealousy (Pinker 2011). Prior to written laws, judges, juries, and jails, a jealous male could violently assault or kill any perceived competitor without formal consequences. Of course the victim’s family, tribe, or clan might seek retribution; but such reprisals were far less assured than those confronted by a violently jealous man today. From a purely adaptive point of view, it was advantageous for a male to use any effective means to remove a competitor, at least if one could implement this removal in a manner carried out to minimize the costs of doing so (e.g., victims fight back or even kill to prevent being killed). If a potential competitor were killed without consequence, the risk of being cuckolded or losing a mate plummeted. Moreover, women had little recourse when severely restricted or battered by a mate. Indeed, if women in some present cultures face restrictions in dress, social behavior, and sexual expression, one can only imagine what a social order exclusively dominated by the strongest males would impose on women.
Sex differentiated mating strategies have evolved in humans. These include sex- differentiated mate preferences, with men prioritizing cues to fertility such as physical appearance and youth, and women prioritizing a man’s willingness and ability to channel resources to herself and her children (Buss 1989). Both women and men share preferences for long-term mates who are healthy, kind, and intelligent. Given the large gender asymmetry in minimum obligatory parental investment, men have evolved stronger motivations to seek short-term sex, including a desire for partner variety, letting little time elapse before seeking sexual intercourse, a high sex drive, minimizing entangling commitments, and many others (e.g., Buss 2015; Jonason and Buss 2012; Schmitt 2003).
The male in his quest to gain sexual access to females had to compete with other males with the same agenda. This led males to be competitive, protective of their mates, and aggressive with competing males. A male who provided material support in the early stages of infant development would improve the survival chances of his offspring. So a strategy that included controlling, protecting, and providing some care for both the mother and his offspring was used (Buss 1988; Buss and Shackelford 1997a, b; Fisher 1992, 2004).
Of course, women evolved in parallel to men and also possess inclinations that are adaptations to the environments in which they evolved. Female evolution appears to include several strategies that increased their reproductive success. One of these included bonding with a male and fending off other females by actively seeking the male’s attention. And in ancestral settings, females would use verbal aggression to diminish the competing female’s standing in the social order—a strategy still present in modern times (Buss and Dedden 1990; Campbell 1999). Female jealousy evolved to take a more defensive and less physically risky style. Female jealousy evolved as a mate retention adaptation, functioning to protect against the hazard of committing reproductive resources in a male, nurturing his children (and genes), only to have him divert his resources to other females. Women who lost a man’s commitment to another woman would have faced the loss of protection and provisioning, putting themselves and their young at risk.
Women prone to jealousy are less likely to bear children from unfaithful mates. In other words, they will detect the men who are not committed to caring for them and their children during their most vulnerable time—from pregnancy until the offspring is approximately 4 years old and weaned from the mother (Fisher 1992, 2004). The jealous woman not only wards off female competitors for the male’s affections, but also continues to assess his commitment to the partnership. In effect, jealousy is a kind of vigilance to identify a deceptive male’s feigned commitment, developed to prevent the male from impregnating another female, leaving the partnership, and devoting his resources to another family.
Adaptations for infidelity under certain circumstances have evolved in both men and women (Buss 2015). The male who impregnated more females would have more descendants. Females whose reproductive potential is limited by long gestation and breast feeding, may still benefit from infidelity if it leads to procuring genes from males whose appearance suggests good health (Gangestad and Haselton 2015) or from using affairs to switch mates—to leave one mating relationship and trade up to a better or less cost-inflicting one (Buss et al. in press). For example, women are more attracted to men with greater physical symmetry, larger body size, superior physical strength (Puts 2010), and men who are successfully polygynous. This latter criterion may seem to be counterintuitive, but may be explained by the ‘‘sexy son hypothesis’’ (Weatherhead and Robertson 1979; Weatherhead 1979). Specifically, women who seek males who are highly polygynous, and otherwise desirable, will tend to produce a larger number of comparable sons. These polygynous sons will experience higher reproductive success, thereby increasing the reproductive success of the mothers who produced them.
The evolutionary perspective discussed here is critical in appropriately applying Rational-Emotive/Cognitive Behavior Therapy (RE/CBT) in cases of jealousy and infidelity. If the clinician dogmatically interprets jealousy as pathological and infidelity as immoral, the client will not be adequately aided. Clinicians not well versed in evolutionary theory often intuit that infidelity cannot be pathological simply because it is so common. The same is true for jealousy. The jealous person viscerally feels that he or she is protecting him or herself from a perceived danger (Buss and Shackelford 1997a, b; Buunk et al. 1996). Telling 0this person that they are pathological for being jealous, is neither helpful nor accurate. If a clinician understands and communicates that these desires and behaviors are often part of the proper functioning of human mating adaptations, then the client will be helped with attaining self-acceptance. A client who has self-acceptance is more able to objectively evaluate their actions and change to more adaptive behaviors in the current environment. Acceptance that a client’s perspective is natural does not necessarily endorse or encourage its perpetuation. Indeed, there are great many natural phenomena that are pernicious and harmful that are rejected by societal mores and laws (Curry 2006).
Jealously, and the infidelity it guards against, developed with concomitant strategies. The deceptive partner has evolved abilities to furtively deceive the partner, and the jealous suitor has evolved mechanisms to detect the deception. These strategies may be considered culturally immoral, but they are not pathological using Wakefield’s (1992) evolutionary definition of psychological disorder. Rather, both infidelity and jealousy in modern humans are ancestral reproductive strategies that may or may not be adaptive in the modern environment. Thus, jealousy and infidelity are closely related problems for the therapist. The former refers to the emotions and behaviors related to defending an intimate relationship. The latter involves the emotional distress that results when those defenses fail. Jealousy is not a pleasant emotion; it is perceived by most people as a type of urgent vigilance (Maner et al. 2009; Maner and Shackelford 2008), and certainly produces much subjective distress (Buss 2000a, b). The perceived necessity and non-agentic aspect of jealousy needs to be appreciated by clinicians. It needs to be viewed as an evolved emotion that feels necessary for the affected individual. The jealous person typically does not feel neurotic or foolish, despite the distress the emotion is evoking in him or her. The jealous person believes that he or she is inferring a risk of a great loss, and jealousy is the consequential emotion that is apprehended as necessary to defend against the potential loss.
In the mid-1950s Albert Ellis observed that the preponderance of clients seeking his help for sexual or relationship problems suffered from distortions of thinking. Despite his psychoanalytic education, he did not find repressions, libidinal cathexes, ill-formed psychic objects, or any of the other Freudian pathologies. Instead, he found a consistent pattern of people distressing themselves with their own rigid, demanding, or inflexible beliefs (Ellis 1957). His work led to the first cognitive behavior therapy that he would ultimately refer to as Rational-Emotive Behavior Therapy. By the mid-1960s Aaron Beck independently came to similar conclusions about psychopathology when working with depressed people. Over the next few decades their work, along with others like Arnold Lazarus, Donald Meichenbaum, and Michael Mahoney, led to the clinical approach now referred to as cognitive behavior therapy (CBT). In this article we will use the term RE/CBT to refer to these therapies, including elements of Ellis’s original approach, combined with more recent protocols.
The RE/CBT approach to jealousy and infidelity in couple therapy (Abrams 2012) seeks to uncover and modify each partner’s distinctive cognitions that contribute to the struggles that brought them to counseling. When RE/CBT is used to help people with jealousy it is usually after it has become a significant impediment to the relationship (De Silva 1997). The person seeking help often recognizes that jealousy is problematic, or may seek help because the partner is rebelling against the jealousy and insists on the mate getting help. In either case the treatment would be similar.
A different approach is taken for couples seeking help. Therapy for two people in conflict requires that all interventions consider the often competing interests of the participants. As the evolutionary perspective makes clear, there are usually evolved psychological adaptations operating behind the stated motives of each participant. Even if infidelity is viewed as offering an evolutionary advantage to one member, it needs to be addressed quite sensitively when both members are present. Evolutionarily endowed inclinations are explanations, but not moral justifications. Understanding evolved drives is frequently a starting point in the effort to control or redirect them.
After an initial session to obtain background information, the couple is instructed in the principles of RE/CBT, so each partner can recognize and help correct the irrational thinking or cognitive distortions in himself or herself, as well as the partner. However, RE/CBT has features that are invoked regardless of the specific problem. Unlike the purported ‘‘depth’’ or ‘‘insight’’ therapies, RE/CBT seeks to illuminate and change the cognitions in the form of beliefs, attitudes, philosophies or personal values that underlie all mental anguish responsive to talk therapy. These irrational cognitions typically take two forms: beliefs that are inflexible or absolutistic (A) and beliefs that are demanding (D) (e.g., Ellis 1997). They can take forms like:
The evolved nature of these jealous beliefs is supported by the intensity by which they are commonly held (Ellis 1987). The degree of rage and alienation felt by the jealous companion is directly proportional to their confidence in the truth of the kinds of beliefs stated above. That is, the more strongly one holds a distorted or irrational cognition, the more intense the emotion when that belief is violated. And when a member of a couple feels provoked to jealousy it may be precipitated without a cognitive appraisal, by means of automatic circuit-logic reactions. However, the only way the individual can consciously assess feelings is verbally. Therefore, it is the initial goal of the RE/CBT process to guide clients to express these jealous emotions verbally. It is through this process that the jealous individual will begin to apprehend that the intensity of their emotion may not be in proportion to any objective threat to immediate well being—even if his partner is actually cheating. RE/CBT interventions will help the client see that even if betrayed, responding with intense negative emotions may only make the situation worse. Thus, RE/CBT helps one see that while having an unfaithful partner is clearly undesirable, it does not have to be perceived as unalterably devastating. Evolution has selected us to be jealous in delimited contexts, but the contemporary interests of the individual do not always correspond with the interest of his or her genes. Stated differently, adaptations that historically led to reproductive success may currently conflict with personal happiness (Buss 2000b).
Many jealous people will have irrational or distorted beliefs that arise due to the evolutionary threats posed by infidelity. However, the evolved desire not to be cuckolded or lose a mate’s parental investment does not pose as great a danger to current reproductive success as it did for our distant ancestors. There is a mismatch between ancestral and modern environments in this respect. It is this paradox—that jealousy was once critical to reproductive success, yet may no longer essential—that must be addressed by the therapist. It is quite reasonable for the jealous person to feel hurt, disappointed, sad or alienated. But when the jealous person’s narrative makes real or imagined concerns intolerable or disruptive to everyday life, then the person’s concerns can be assumed to be based on cognitions that were once supremely functional, but may no longer be so in the modern world.
These beliefs are often accompanied by cognitive biases in which the person feeling jealous focuses only on those aspects of their environments that validate their disturbing beliefs. The jealous person will tend to reject alternative hypotheses for suspicious behavior, focus exclusively on behaviors deemed deceptive, exaggerate signs of disaffection on the part of the lover, and so on. So the disturbing beliefs will lead to confirmatory perceptions that will in turn intensify the irrational or distorted cognitions. The therapist must recognize and dissect the components of this cognitive feedback loop as experienced among individual clients to determine whether jealousy is or is not pathological.
For example, in our discussion of the error management and the signal detection models of jealousy, it is evident that in all cases except for the correct detection or incorrect rejection of infidelity (ruling it out when it is occurring), the individual may appear pathological. In these cases, jealous individuals will believe that they have correctly discovered a basis for jealousy, even when it has not occurred. An example might be the discovery of a partner having a friendly email or text message exchange, leading to the conclusion that their partner is having an affair. There are four possible outcomes for the potentially jealous person:
The intensely jealous person has irrationally made being cheated on so dreadful, that they are willing to perennially torment themselves and their partners with false alarms and false accusations.
The more catastrophizing an individual conceptualizes a negative outcome, the less likely the person is to rule out its possibility. Let’s compare those who apprehensively dread infidelity to individuals suffering from phobias. This may be best illustrated in individuals with aerophobia. The person afraid of flying is generally well acquainted with the vanishingly small probability of the flight crashing. Despite this, the person will persist in being afraid because he or she tends to pre-emptively experience the most appalling disaster imaginable. In short, if a person obsessively imagines a terrible outcome, the miniscule probability of its occurrence does little or nothing to offset the trepidation of the improbable. This can be seen in the client whose jealousy requires treatment. Over human evolutionary history, it would indeed pose potentially catastrophic risks to a man’s reproductive success if jealousy did not exist. However, these risks are far lower today with environmental changes like effective birth control and genetic testing. And even when infidelity does lead to extra-pair reproduction, the cost in reproductive success may matter less than to his or her ability to enjoy life. As Pinker once noted, he has chosen not to reproduce at all, so his genes can go jump in a lake. We do not need to be slaves to emotions that may have been supremely function in ancestral environments, but that currently impede modern-day well-being.
This leads a key therapeutic intervention, to address the separate the goals of the individual’s selfish genes and those of the individual’s current well-being. Consequently, even if the jealous person is not distorting the probability of a partner being unfaithful, the risks to the individual in the moment can be distinguished from the historical risks to reproductive success. These are essential the loci of treatment for the RE/CBT therapist treating a client who has problems with jealousy.
Jealousy evolved as an adaptation in males, as a defense against being genetically cuckolded or abandoned entirely. It minimized the risk of losing fitness due to parental investment wasted (from the perspective of gene replication) on a non- related offspring. Among females, jealousy evolved as a means of limiting the risk of a partner diverting his resources to another woman and children. Because jealousy is an evolved emotion, it will tend to feel logical and protective to the individual experiencing it. Consequently, the jealous man will typically react as though the therapist is attempting to get him to lower his guard. This is true in the case of other evolved fears such as the phobias associated with prepared classical conditioning (Seligman 1971.). These fears and phobias tend to arise with minimal consciously articulated cognition.
For example, people with phobic reactions to heights, insects, animals and other innately feared things, will often suffer these fears without the irrational or distorted beliefs that underlie social or self-worth fears. Thus, people with phobic fear of dogs or spiders will commonly display great fear without requiring a complicated cognitive appraisal of the danger. In contrast, an excessive fear of professional failure, loss of social status or rejection in love tend to require a cognitive appraisal because they involve more complex problem solving. Importantly, both kinds of fears will generate cognitions that are addressable through RE/CBT. Once a comfortable therapeutic relationship is established, individuals typically become more open to the possibility of having irrational or distorted cognitions; they are often motivated because this type of thinking makes people feel distressed and wretched. Indeed, addressing personal misery is a prime reason for seeking therapeutic help.
Since jealousy is almost always a problem between couples, couple’s treatment often will be the focus. Individuals rarely seek help for jealousy for the reasons related to jealousy’s evolutionary history. That is, when judging oneself, jealous people rarely feel that jealousy is a problem. Rather, they feel that the world, and those in it, are not to be trusted. More often, jealousy becomes a problem when it interferes with a couple’s union. Like other universal human qualities like aggression, anger or social pride, jealousy is normally distributed. There are those at one end of the distribution who feel little jealousy and those at the other who are consumed by it.
It is important for the clinician to be aware that wherever the individual falls on the jealousy spectrum it will feel rational to that individual. And that sudden outburst of jealousy might be resulting from changes in a partner’s behavior that had been previously suppressed. Despite these overall stable individual differences, it is also true that jealousy is sometimes relationship-specific or context-specific within relationships. A man involved with a flirtatious sexually provocative woman might be jealous with her due to the frequent male sexual attention she garners, but not when shifting to a relationship with a more introverted, less flirtatious woman. A woman whose husband received a dramatic job promotion might experience a sudden surge of jealousy, but the emotion might dissipate entirely when he loses his job.
When a couple seeks help, it is always best to conduct the first session seeing each member separately. All couples ultimately seek help because of some failure of communication, and psychotherapy at its essential core serves to facilitate communication (Abrams 2012). Indeed, if both members of a couple were able to perfectly communicate their perspectives and articulate a means to change or improve the relationship, a therapist would not be necessary. In addition to communication per se, couples also seek for barriers to communication, such as disputes over the accuracy of events and actions (Loftus 2007). Partners confabulate, spin, distort, advocate, and even lie when communicating with one another. These distortions often become deeply ingrained and are an essential topic of counseling. With the safety of confidentiality each member can more comfortably reveal concerns or actions that may have been withheld from the partner.
Among the concerns that the therapist is evaluating is the legitimacy of the jealousy. Humans have evolved means to detect cheating or deception in others. So the therapist needs to ascertain whether the jealous partner is overzealously protective or whether he/she is sensing behaviors that overlie diminishing commitment in their partner. If this is the case, the therapy needs to shift from jealousy as a primary problem to jealousy as a symptom of other problems with the relationship. However, if the relationship is being impeded by a partner whose suspicions are not based on changes to relationship or actual deceptions, the goal is to illuminate source of the distortions or exaggerations of the jealous partner.
The paradoxical aspect of problematic jealousy is that jealous partners sometimes are undermining the relationship they feel compelled to protect. A little jealousy can be beneficial, but extreme jealousy wreaks havoc on relationships. The joint session will have both partners taking time to discuss what they see as the problem in the relationship. In most cases, the jealous partner will complain about the inappropriate actions that are inciting their suspicions. And the partner under suspicion will complain of the distrust, accusations and restrictions coming from the jealous partner. It is generally, best to start with the accused partner to clarify that, despite the averseness of living under suspicion, it is not unbearable. They need to be shown that they are free to ignore the accusations, curtail commitment, or even leave the relationship. They will tend to believe that it is grossly unfair to be falsely accused or that it is deep violation of the relationship not to be trusted. In response, they can be guided to see that their jealous partner has elevated them to an exalted status by making their potential loss an obsessive fear. In justifying the jealousy this way, the jealous partner is also being made aware of their own jealousy.
The anguish induced by infidelity is not assuaged with the knowledge of its high prevalence (Barash and Lipton 2001) or its evolutionarily nature. As with jealousy, the victim of infidelity can seek help individually or as part of a couple. Working with people who have suffered infidelity differs in kind from those troubled solely by jealousy. Those in a jealous relationship will be troubled by emotions that anticipate a dreaded event, while the victim of infidelity will suffer passions that ensue after the aversive event has actually occurred. Consequently, RE/CBT for these occurrences will require different strategies, and will be addressed separately below.
It is not unheard of for the clinician to treat a couple in which both partners were unfaithful, but this is unusual. The modal case is a couple in which one partner has been unfaithful, so we will focus on this more typical case. It is important to note that there are differences in treating infidelity in Lesbian, Gay Male, and Heterosexual couples (e.g., Kleinplatz 2012). The cultures that these dyads arise from tend to have divergent perspectives on infidelity that will impact the response and subsequent treatment of people from the cultures. However, the RE/CBT approach can be applied, with minor modifications, to all groups.
Each member of the couple is seen separately to assess for level of anger, alienation, allegiance to the relationship, the individual’s willingness to move on or change their unfaithful behaviors, and commitment to the counseling process. If the therapist determines that the relationship remains viable then the treatment process can continue. In contrast, if it is made clear that the factors that led to the infidelity are intractable or either partner makes clear that the alienation is too great for the relationship to continue then the therapist must directly address this in the next session. During this subsequent session, the therapist must explicitly enumerate the reasons why the couple’s relationship is no longer viable, and make the case that it seems that the purpose of seeking counseling by one or both partners was to facilitate an exit from the relationship. If the therapist is correct, one or both partners will readily accept the judgment. Conversely, if the therapist is not correct then one or both partners will advocate for the continuation of therapy. In this case, the therapist is obliged to continue the treatment process until he or she, or the demurring couple, is proven wrong.
In the event that both partners support the continuation of the relationship, the next step is to address the negative emotions that invariably persist after the infidelity. In general, men are generally less willing to pardon sexual infidelity and women are less willing to pardon emotional infidelity (Shackelford et al. 2002). These evolved inclinations underlie cognitions similar to the following:
These distorted cognitions are not the unique pathology of the individual but, instead, are a modern evolutionary expression of millennia of development. Clients receiving RE/CBT should be made aware of the unnecessary dread that our adoptions evoke in us. The man no longer has to fear losing resources by unknowingly raising another man’s offspring, since modern birth control and paternity testing technology all but rules this possibility out. Most modern women no longer have to fear desperate impoverishment for her and her offspring if her partner leaves for another woman. In most contemporary societies around the world women can function without male support; they can work and, in dire situations, their children can receive societal subsidies. These realities that belie the historical dangers of infidelity need to be discussed with the clients.
Of course, the partners in the relationship will not immediately renounce their despair or anger, but acknowledging the realities of contemporary human life versus those of their ancestors will force them to examine the basis of their distress. The therapist will help the clients to verbalize the negative emotions that they are feeling. In doing so, the individuals will begin to understand the cognitive narratives to which they may be clinging—narratives that likely made more adaptive sense in ancestral than in modern environments.
Recently, individuals who have discovered that their significant other has been unfaithful are likely to have done so as a result of the increased ways to uncover deception of a partner (Abrams 2016). The Internet provides both greater access to extra-pair relationships, such as through internet dating sites, and many more ways to discover them, such as through cyberstalking. In addition, the vast number of sexual connection websites and social media like Facebook, Twitter, and LinkedIn, provide many means to find connections that can ultimately become sexual. Text messages, browser histories, social media communications, and emails all leave traces for a deceived partner to discover that their fears are realized (Mitchell 2007). When a person discovers that a partner has been unfaithful, their distress tends to be proportional to the trust and love that has been devoted to the offender. As a result, counseling is most often sought by the individual who was deeply committed to the relationship and strongly believed that their partner was similarly committed. Victims of a partner’s infidelity commonly suffer both grief and rage, sometimes alternating between the two. The goal of therapy is to elicit the basis of the client’s feeling of damage to their self worth, and the feelings of loss regarding the offending partner.
Aggrieved individuals tend to lament their own past failures or current diminished worth connected with the infidelity. If the relationship is irreparable, the individual will commonly mourn it as an irretrievable loss. A client afflicted by infidelity will often be simultaneously enraged at, and desirous of, their partner— splitting (or black and white thinking) is not the exclusive domain of the borderline personality and commonly occurs in distressed individuals (van Rijsbergen et al. 2015).
Many people in extreme interpersonal distress will tend to alternate from idealization to rebuke in their attempts to fathom the behavior of their lovers. The individual sufferer of infidelity commonly feels shamed, angry, and even depressed. As with anyone suffering a great personal loss, the distress is generally in direct proportion to the both the perceived importance of the loss, and with the perceived unfairness of their infidelity. A person strongly committed to, and deeply in love with unfaithful partner will be far more distraught than one with a more casual relationship. Such strong negative emotions are often associated with cognitions that generalize the event to all aspects of the person’s life, including their future and self- worth. The evolutionary aversion to infidelity plays a major role in the common tendency to catastrophize the event.
The therapist needs to make every effort to acknowledge the client’s anguish, but must then help them view it as circumscribed loss. One way to do so is help the client see the loss of a fidelity as a loss akin to any other loss–one that is sad, but not completely destructive. That client can be directed to take an economic view of the event, such that infidelity can be likened to stealing from a relationship. Trust, sexual resources, and intimacy were purloined from the deceived partner. If it is likened to any other pilfering in another kind of trusted relationship—such a commercial partner stealing from a business, it will be easier to discern the cognitive distortions that are arising from evolutionary inclinations. The intensity and range of negative emotions with sexual infidelity are far greater than if they were deceived by even the most trusted business partner.
The client is then guided to explore negative emotions that are painful or dysfunctional with the goal of finding the values, demands, or beliefs that have underlie them. The individual who was a victim of the infidelity may express that it feels wrong or risky to trust a partner who has strayed. This aspect needs to be openly discussed by both parties with the goal of explaining to both parties that the infidelity, although wrong, was not a maximally bad action. Rather, it is our psychological adaptations cause us to feel that it is catastrophic. This will become apparent with probing or Socratic inquiries about the viewpoints that underlie their most painful emotions. For example, in the case of the client who experiences anxiety about infidelity, exploratory questions will help clients clarify that the anxiety overlies judgments about their situation.
Inquiries such as the following will open up lines of discussion that will allow the RE/CBT therapist find and challenge to client’s beliefs that are exacerbating or prolonging his/her misery.
In most cases, even the most distraught clients will not overly affirm the beliefs and attitudes that underlie their heartache. They will be both distraught and angry; and in more emotional states will tend to vacillate between wanting retribution and wanting their lover back. In the discussions that such inquiries will provoke the client can be shown that their lover did something bad, but is not an atrocious human being. Their overt or tacit belief that ‘‘my partner absolutely should have been faithful,’’ can be guided to ‘‘I would have deeply preferred by my partner’s fidelity.’’ Similarly, the belief that ‘‘I cannot stand that this happened to me,’’ can be shifted to ‘‘I am deeply hurt and disappointed by this disloyalty, but I am fully equipped to move on in life.’’
The RE/CBT therapist can also use imagery techniques to have the client see themselves in a better situation, and in a time when they are not distraught. Their anxiety and anger can be attenuated with relaxation techniques that guide them to focus on the current moment. This is particularly import to clients who are ruminative about their lover’s behavior. They believe that they have been irrevocably damaged by the infidelity and will act on the delusory belief that recapitulation will somehow change the past. The client will also be helped by performing assignments in which they keep a log in which they challenge in writing any thoughts they have that support that their being betrayed by a loved one represents an irretrievable loss.
The inclusion of an evolutionary perspective adds clarity and focus to cognitive behavioral interventions for both jealousy or infidelity. The evolutionary view removes much of the pathologizing and moralizing associated with both as seen in many clinical publications that treat jealousy as a pathology (e.g., Mullen 1996; Stockdale et al. 2015). When seen as evolutionary inclinations that are most adaptive for a different epoch or setting, the therapist can change the focus from treating an aberrant behavior to helping the client see it’s self-defeating nature. Telling concerned lovers that they should abandon their neurotic jealousy is as effective as telling someone that fearing a war zone is foolish. The jealous person feels their jealousy is protective and judicious, and they will not relinquish it easily. Excessively jealous clients so fear the loss of the relationship that they will destroy it with hyper-vigilance. It is this self-defeating aspect of jealousy that RE/CBT most effectively targets.
The therapist faces conceptually similar problems in dissuading infidelity. The unfaithful client trades short-term sexual pleasures for the benefits of an enduring relationship, although sometimes infidelity functions as a mate-switching tactic (Buss et al. in press). And in risking the enduring relationship, there is attendant emotional harm that regularly ensues. Rather than moralize or invoke cultural mores, the RE/CBT therapist educates the client to the evolutionary logic of evolved emotions and desires and their possible irrationality in the modern environment. It is irrational because the overall costs of maintaining a disingenuous relationship is greater than the costs of the two alternatives: leave the relationship and seek novel partners or stay in the relationship that offers benefits greater than sexual variety.
Acknowledgments This article received no funding, nor was there any involvement with outside parties that may gain from the content of this article
Compliance with Ethical Standards
Conflict of interest The authors categorically state that they have no conflicts of interest.
— Abrams, M. (2012). Helping couples deal with intimacy and sexuality. In A. Vernon (Ed.), Cognitive and rational-emotive behavior therapy with couples. New York, NY: Springer.
— Abrams, M. (2016). Sexuality and its disorders: Development, cases and treatment. Thousand Oaks, CA: Sage.
— Barash, D. P., & Lipton, J. E. (2001). The myth of monogamy: Fidelity and infidelity in animal and people. New York, NY: Freeman.
— Buss, D. (2015). Evolutionary psychology: The new science of the mind (5th edn.). New York: Psychology Press.
— Buss, D. M. (1988). From vigilance to violence: Tactics of mate retention in American undergraduates.
Ethology and Sociobiology, 9(5), 291–317.
— Buss, D. M. (1989). Conflict between the sexes: strategic interference and the evocation of anger and upset. Journal of personality and social psychology, 56(5), 735–747.
— Buss, D. M. (2000a). The dangerous passion: Why jealousy is as necessary as love and sex. New York, NY: Simon and Schuster.
— Buss, D. M. (2000b). The evolution of happiness. American Psychologist, 55, 15–23.
— Buss, D. M. (2003). The evolution of desire: Strategies of human mating. New York, NY: Basic Books. Buss, D. M. (2005). The murderer next door: Why the mind is designed to kill. New York, NY: Penguin.
— Buss, D. M., & Dedden, L. A. (1990). Derogation of competitors. Journal of Social and Personal
Relationships, 7(3), 395–422.
— Buss, D. M., & Duntley, J. D. (2011). The evolution of intimate partner violence. Aggression and Violent Behavior, 16(5), 411–419.Buss, D. M., & Goetz, C., Asao, K., Conroy-Beam, D., & Duntley, J.D. (in press). The mate switching hypothesis. Personality and Individual Differences.
— Buss, D. M., & Shackelford, T. K. (1997a). From vigilance to violence: Mate retention tactics in married couples. Journal of Personality and Social Psychology, 72(2), 346.
— Buss, D. M., & Shackelford, T. K. (1997b). Susceptibility to infidelity in the first year of marriage.
Journal of Research in Personality, 31(2), 193–221.
— Buunk, B. P., Angleitner, A., Oubaid, V., & Buss, D. M. (1996). Sex differences in jealousy in evolutionary and cultural perspective: Tests from the Netherland, Germany, and the United States. Psychological Science, 7(6), 359–363.
— Campbell, A. (1999). Staying alive: Evolution, culture, and women’s intrasexual aggression. Behavioral Brain Sciences, 22(2), 203–214.
— Conroy-Beam, D., & Buss, D. M. (2016). Do mate preferences influence actual mating decisions? Evidence from computer simulations and three studies of mated couples. Journal of Personality and Social Psychology, 111, 53–66.
— Cosmides, L., & Tooby, J. (1999). Toward an evolutionary taxonomy of treatable conditions. Journal of Abnormal Psychology, 108, 453–464.
— Curry, O. (2006). Who’s afraid of the naturalistic fallacy? Evolutionary Psychology, 4, 234–247. Daly, M., & Wilson, M. (1988). Homicide. Piscataway, NY: Transaction Publishers.
— Daly, M., Wilson, M., & Weghorst, S. J. (1982). Male sexual jealousy. Ethology and Sociobiology, 3(1), 11–27.
— De Silva, P. (1997). Jealousy in couple relationships: Nature, assessment and therapy. Behaviour Research and Therapy, 35(100), 973–985.
— Easton, J. A., Shackelford, T. K., & Schipper, L. D. (2008). Delusional disorder—jealous type: How inclusive are the DSM-IV diagnostic criteria? Journal of Clinical Psychology, 64(3), 264–275.
— Ellis, A. (1957). Rational psychotherapy and individual psychology. Journal of Individual Psychology, 13(1), 38
— Ellis, A. (1987). The impossibility of achieving consistently good mental health. American Psychologist, 42(4), 364–375.
— Ellis, A. (1997). Must masturbation and demandingness lead to emotional disorders? Psychotherapy: Theory, Research, Practice, Training, 34(1), 95–98.
— Fisher, H. (1992). Anatomy of love: A natural history of mating, marriage, and why we stray. New York, NY: Random House.
— Fisher, H. (2004). Why we love: The nature and chemistry of romantic love. New York, NY: St. Martins Griffin.
— Gangestad, S. W., & Haselton, M. G. (2015). Human estrus: Implications for relationship science.
Current Opinion in Psychology, 1, 45–51.
— Haselton, M. G., & Buss, D. M. (2000). Error management theory: A new perspective on biases in cross- sex mind reading. Journal of Personality and Social Psychology, 78, 81–91.
— Jonason, P. K., & Buss, D. M. (2012). Avoiding entangling commitments: Tactics for implementing a shortterm mating strategy. Personality and Individual Differences, 52(5), 606–610.
— Kingham, M., & Gordon, H. (2004). Aspects of morbid jealousy. Advances in Psychiatric Treatment, 10(3), 207–215.
— Kleinplatz, P. J. (Ed.). (2012). New directions in sex therapy: Innovations and alternatives (2nd ed.). New York, NY: Routledge/Taylor and Francis Group.
— Loftus, E. F. (2007). Memory distortions: Problems solved and unsolved. In M. Garry & H. Hayne (Eds.), Do justice and let the sky fall: Elizabeth F. Loftus and her contributions to science, law, and academic freedom (pp. 1–14). Mahwah, NJ: Lawrence Erlbaum Associates.
— Maner, J. K., Miller, S. L., Rouby, D. A., & Gailliot, M. T. (2009). Intrasexual vigilance: The implicit cognition of romantic rivalry. Journal of Personality and Social Psychology, 97(1), 74–87.
— Maner, J. K., & Shackelford, T. K. (2008). The basic cognition of jealousy: An evolutionary perspective.
European Journal of Personality, 22(1), 31–36.
— Marazziti, D., Di Nasso, E., Masala, I., et al. (2003). Normal and obsessional jealousy: A study of a population of young adults. European Psychiatry, 18, 106–111.
— Mitchell, J. (2007). Sex, lies, and spyware: Balancing the right to privacy against the right to know in the marital relationship. Journal of Law & Family Studies, 9, 171.
— Mullen, P. E. (1996). The clinical management of jealousy. In The Hatherleigh guides series. The Hatherleigh guide to marriage and family therapy (Vol. 6, pp. 241–266). New York, NY: Hatherleigh Press. Pinker, S. (2011). The better angels of our nature: Why violence has declined. New York: Viking.
— Puts, D. A. (2010). Beauty and the beast: Mechanisms of sexual selection in humans. Evolution and
Human Behavior, 31(3), 157–175.
— Schmitt, D. P. (2003). Universal sex differences in the desire for sexual variety: Tests from 52 nations, 6 continents, and 13 islands. Journal of personality and social psychology, 85(1), 85–104.
— Schmitt, D. P., & Buss, D. M. (2001). Human mate poaching: Tactics and temptations for infiltrating existing mateships. Journal of Personality and Social Psychology, 80(6), 894.
— Shackelford, T. K., & Buss, D. M. (1996). Betrayal in mateships, friendships, and coalitions. Personality and Social Psychology Bulletin, 22(11), 1151–1164.
— Seligman, M. (1971). Phobias and preparedness. Behavior Therapy, 2(3), 307–321.
— Shackelford, T. K., & Buss, D. M. (1997). Cues to infidelity. Personality and Social Psychology Bulletin, 23(10), 1034–1045.
— Shackelford, T. K., Buss, D. M., & Bennett, K. (2002). Forgiveness or breakup: Sex differences in responses to a partner’s infidelity. Cognition and Emotion, 16(2), 299–307.
— Symons, D. (1979). The evolution of human sexuality. New York, NY: Oxford University Press.
— Stockdale, L. A., Coyne, S. M., Nelson, D. A., & Erickson, D. H. (2015). Borderline personality disorder features, jealousy, and cyberbullying in adolescence. Personality and Individual Differences, 83, 148–153.
— Tooby, J., & Cosmides, L. (2010). Groups in mind: The coalitional roots of war and morality. In Human morality and sociality: Evolutionary and comparative perspectives (91–234).
— van Rijsbergen, G. D., Kok, G. D., Elgersma, H. J., Hollon, S. D., & Bockting, C. L. H. (2015). Personality and cognitive vulnerability in remitted recurrently depressed patients. Journal of Affective Disorders, 173, 97–104.
— Wakefield, J. C. (1992). The concept of mental disorder: On the boundary between biological facts and social values. American Psychologist, 47(3), 373–388.
— Wakefield, J. C. (2005). Biological function and dysfunction. In D. M. Buss (Ed.), The handbook of evolutionary psychology. Hoboken, NJ: Wiley.
— Weatherhead, P. J. (1979). Mixed mating strategies by females may strengthen the sexy son hypothesis.
Animal Behavior, 47, 1210–1211.
— Weatherhead, P. J., & Robertson, R. J. (1979). Offspring quality and the polygyny threshold: ‘‘The sexy son hypothesis’’.
— American Naturalist, 11(3), 201–208.
— Wilson, M. I., & Daly, M. (1996). Male sexual proprietariness and violence against wives. Current Directions in Psychological Science, 5(1), 2–7.
David Buss is foremost among theories that take an evolutionary approach to love and all mating behavior of humans. Evolutionary approach considers sexual behavior as tailored to provide solution to specific problems (Buss, 2003). Buss explains in his works underlying rationality that influences and shapes our mating behavior. This term, “mating behavior”, suggests that Buss’s work is primarily focused on sexuality and its manifestations. This is not completely true – he describes and explains a much wider scope of behaviors, but evolutionary theory is essentially tightly related to sexuality, especially when referring to underlying mechanisms of behavior. However, Buss also dedicated a significant portion of his work to social influences, sex differences and love.
Our mating behavior is shaped by evolution; more precisely, it is shaped by the circumstances and rules that affected lives of our ancestors. Thousands of years ago, men and women faced challenges that were quite different from those that we face today. Those who were successful in handling those challenges became our ancestors; those who had failed faced a not so bright destiny. The main goals of our ancestors were personal survival, dissemination of genes and survival of offspring. Those who had managed to survive, but without children, obviously didn’t become our ancestors. Also, considering rather significant child mortality in the past, those who had only one child risked being cut off from the gene pool as well.
Having sex is much more costly for women than it is for men, and this was especially true for our ancestors. Women are able to give birth to only one child a year (more if they get twins, but it is a relatively rare event), and they put tremendous resources into pregnancy, delivery and raising a child. Bear in mind that our ancestors lived in a much more dangerous surrounding, with fewer resources, and that women were often heavily dependent on men. Those women who had managed to choose a partner willing to dedicate resources and time to his mate and children survived; other were in much more difficult position, and often faced harsh consequences. On the other hand, men are not directly endangered by the wrong choice of a partner, and paternity is not a great burden for them – which is why they can have multiple children with different women each year. However, they face an issue of cuckoldry – possible investment of resources into offspring that is actually fathered by another man.
Previously described problems influenced the mating behavior of our ancestors. More importantly, Buss (2003) states that strategies that were developed to help our ancestors respond to these problems also shape sexual and romantic behavior nowadays. Apparently, we have the same taste as our ancestors when it comes to potential partners (and the same ways to attract them).
Short-term and long-term mating are known to exist throughout the history. While they can be more or less socially acceptable, depending on the moment and the culture, these two mating types are always present. Short-term and long-term mating have different rules, as they respond to different adaptive problems (Buss & Schmitt, 1993). Men and women differ greatly in respect to these two types of mating behavior – men favor short-term mating in most contexts, but it is very costly for women. Long-term mating is preferential for women, while men sacrifice a lot when entering a monogamous relationship, but also receive some benefits. Men and women have developed distinct psychological mechanisms related to these adaptive problems and their solutions.
Long-term mating is mostly intertwined with monogamy, although not necessarily. This kind of unity is nowadays available through long-term relationships, partnership or marriage. While modern couples face somewhat different challenges than our ancestors, Buss claims that romantic behavior nowadays has similar causes as it did in the past (Buss and Schmitt, 1993; Buss, 2003) . For long-term mating, women desire men able to provide sufficient resources, and also willing to invest those resources into their family. When it comes to ancestral women, physical protection was another major incentive for entering a long-term relationship (depending on a culture and circumstances, this can also be important nowadays). Men, on the other hand, search reproductive value in potential long-term mates, but they also require mates who will be committed to them and their offspring, good mothers and especially those who will not stray – that is, they try to avoid uncertainty concerning paternity. Both, men and women, search for cues that will reveal value of a potential mate. Sometimes they are successful; but since the goals of different sexes are not always compatible, men and women also have strategies aimed at deceiving potential partners about their intentions (Buss, 2003). For example, a woman can agree to enter a casual relationship with an agenda to further charm her partner and turn dating into a long-term relationship or even marriage. On the other hand, men often express emotions they don’t actually have, just to gain sexual access to women. Extended courtship is women’s way of handling these attempts of deception.
Psychologists NJ Drs’ Mike and Lidia Abrams have expertise in the methods originated by CBT founder Dr. Albert Ellis. Below is an article written by Dr. Mike Abrams and Dr. Ellis explaining that all stress responses are a result of perception, a person’s life philosophy, and the view one takes of things.
Dr. Mike Abrams and Dr. Albert Ellis
British Journal of Guidance & Counselling; Feb94, Vol. 22 Issue
ABSTRACT Rational emotive behavior therapists view stress-related disorders as originating in irrational beliefs (iB’s), philosophies and attitudes, as opposed to the stressor. People who suffer from stress differ from people who suffer from emotional or neurotic problems mainly in that the stressed people have iB’s about specific, short-term or more readily identifiable events, as opposed to the more mundane and diffuse difficulties suffered by the neurotic individual. Both the conscious and unconscious antecedents to stress difficulties and how they relate to distorted thinking and psychophysiological disorders are discussed from an information-processing perspective. Rational emotive behaviour treatments for stress-related disorders are detailed and explained.
When mental health professionals examine stress as an object of treatment, we are really talking about the distress, both physical and emotional, that ensues from a series of interpersonal and environmental irritants, or a particularly compelling one. The term `stress’ is a broad or generic term applying to many different states and situations that act on the psyche and body to reduce homeostasis (Elliot & Einsdorfer, 1982). The lack of a consistent definition of stress makes any discussion of treatment difficult. After all, stress is not always bad. Yerkes & Dodson demonstrated this over a generation ago. Stress-related arousal frequently serves to enhance performance. In clinical work we typically use the term to apply to those pressures and strains of living that reduce the quality of life, and require changes in the individual to restore homeostasis. We shall also use the term to represent the result of several kinds of dysfunctional or irrational thinking.
The key issue for the rational emotive behaviour therapist is: how does the environmental irritation become oppressive? The answer is largely found within the stressed individual, not in the events. It is quite clear that the very same event will produce physiological or emotional arousal in one set of individuals and virtually no reaction in others. How then do the dysfunctional emotional and physical states that we call stress come about?
The answer is simple: stress does not exist. There is no iconoclasm intended here. We mean it quite literally: stress does not exist in itself. Stress is like good or evil: it exists only in its perceptions and reactions of the beholder (or the stressee). To quote Shakespeare:
Hamlet: Why, then ’tis none to you; for there is nothing either good or bad but thinking makes it so….
The evidence proves the same for stress. There is nothing intrinsically stressful or assuaging but thinking makes it so (Ellis & Abrahms, 1978). This is the foundation of the rational emotive behaviour treatment for stress-related and most emotional disorders (Ellis, 1962). Specifically, the rational emotive behaviour therapist works to bring the individual who is quite distressed by events in his or her environment to a state of mind similar to that of one who does not respond excessively to the same putative stressors. Only on rare occasions can a therapist help his or her client by eliminating their problem for them. The therapist is most effective in changing the client’s reaction to the problem, which will tend to persist despite the best efforts of most clients and therapists. Specifically, the REBT therapist will seek first and pre-eminently to change the client’s philosophies, attitudes and beliefs which lead to disturbance.
Those who react to activating events (A’s) with severe stress differ from those who have other disturbances in several key ways. First, stress tends to be more associated with physical illnesses or symptoms than do other psychological reactions. Second, stress reactions tend to be based on a single `catastrophic’ event or a group of noxious events that linger over time. This is in contrast to someone who suffers from, for example, chronic anxiety in which there tend to be a large array of activating events that ultimately lead to anxiety. In REBT terms, in stress reactions the A’s are often more salient in the formula than the B’s (the person’s beliefs). This is particularly true of a particular kind of stress, post-traumatic stress disorder (PTSD), where the A’s are so stark, unpredictable and harmful (such as rape, incest, or torture) that a large percentage of `normal’ people, who would take less noxious events in good stride, tend to upset themselves severely and bring on terrifying flashbacks and nightmares for a period of years (Warren et al., 1989, 1990; Ellis, 1993).
Thus people with generalised anxiety require very little in the way of activating events (A’s) to perpetuate their anxiety: their own compelling belief system about possible A’s is usually sufficient. In contrast, the person suffering from a stress reaction can usually point to some objectively bad events that are the impetus of his or her malaise. This has the disadvantage of reinforcing the apparent connection between the A and the C. The stressed individual will conclude that `my job is giving me an ulcer’, or `my husband’s temper is giving me these migraines’, and so on. As we will show later on, one prime goal of rational emotive behaviour therapy is to demonstrate to the client that the activating event does not by itself cause his or her psychological or psychophysiological consequence: his or her beliefs about the event do!
Irrational beliefs and self-defeating styles are the essential origin of stress (Decker et al., 1982; Vestre & Burnis, 1987; Forman et al., 1987). However, the individual’s particular reaction to stress tends to be constitutional. Let us examine for a moment the psychophysiological disorders that develop or worsen as a direct result of stress. These include digestive system ulcers, hypertension, migraine and tension headaches, lower back pain, temporo-mandibular joint syndrome, sciatica, lupus, multiple sclerosis, and others. We do not suggest that there is a linear correspondence between these stress-related illnesses and irrational beliefs. Rather, we have found that irrational beliefs are the foundation of the prolonged arousal and the emotional anguish that has been shown to be the prime cause of most ills associated with stress (Larbig, 1978; Woods & Lyons, 1990; Hart et al., 1991).
The process by which irrational beliefs lead to psychophysiological disorders closely follows Selye’s general adaption syndrome. The process begins with some activating event in the person’s environment. The person then either consciously or unconsciously evaluates this event as good, bad, dangerous, or unjust, based on his or her belief systems. At this point there follows arousal of the autonomic nervous system. With continued arousal, the weakest systems in the body begin to break down. The unconscious aspects of this process also makes stress disorders more difficult to treat than those disorders in which there is a reaction to an overt problem.
Since REBT is a cognitive-behavioural therapy, let us clarify what we mean by `unconscious’. We do not refer to any dynamism (such as the id or the superego) taking direct action or direct control of behaviour. Instead we refer to several cognitive processes that are rapid and require minimal capacity. This principle was set forth by Donald Broadbent more than 35 years ago. He described the mind as a processing system with a limited capacity. That is, we can perceive only a small portion of what we sense, and we can consciously apprehend less than that. Just as we cannot be aware of all the external stimuli to which we are continually exposed, we cannot be simultaneously aware of all of our internal information.
The vast array of experiments utilising priming methods and implicit learning methods demonstrate that we are not always at one with our mental data base. Priming experiments reveal that our memorial stores can become activated without our awareness (Scarborough et al., 1979; Jacoby & Dallas, 1981; Jacobs & Nadel, 1985). Implicit learning and memory experiments have shown that humans can acquire complex information without any knowledge of having done so (Abrams & Reber, 1988; Reber, 1989). Other cognitive processes that are not always accessible to consciousness are attitudes, biases, schemata, and scripts that are quiescent and unconscious until activated. At that time they influence consciousness rapidly and indirectly, but they are not independent of will. With effort they can be ascertained and, if appropriate, disputed, and replaced with new attitudes, scripts and schemata.
Kahneman et al. (1982) demonstrated that most of us form judgements based on what may be faulty heuristics. They further warned that our acquisition of these heuristics may be involuntary. They and their co-workers have failed to show, however, that if a person is made aware that he or she is making judgements based on a faulty heuristic, and is given an alternative means of making a judgement, he or she will not do so. In most cases, he or she will.
We all possess these underlying prejudices but are only aware of them if they are addressed in some fashion. Most people do not think about how they feel about thin people or fat people until they come upon one of them. Their unconscious attitudes are not inaccessible but can act directly on behaviour without directly entering verbal awareness. Other unconscious cognitive processes involve more specific judgements about individuals. We frequently make assessments about a person’s nature, beauty or honesty after only a brief view of his or her face. These assessments, too, tend to be based on unconscious judgements (Lewicki, 1985, 1986). Another important phenomenon is based on the declarative-procedural-knowledge distinction. This model shows that we have the ability and knowledge necessary to perform many tasks without any conscious awareness of having it (Cohen & Squire, 1980; Cohen & Corkin, 1981; Jacoby & Witherspoon, 1982). In fact, there is research which indicates that many experts really do not know how they are able to do what they do so well (Nisbett & Wilson, 1977).
In general, then, what we call unconscious, the experimental psychologists tend to refer to as those stages of information processing that occur outside of awareness. In almost all cases these unconscious processes can be made conscious with effort. A similar process occurs in somatoform disorders which tend to occur with high frequency among stress sufferers (Lipowski, 1988; Frost et al., 1988). In these cases the stressed individual begins to exhibit physical symptoms that cannot be clearly pinned down. Of course, many people actually become ill, but are not accurately diagnosed. But those who feel ill without actually being so, do so because of their own beliefs. One of our clients exemplifies this.
Gaetano was referred to the clinic of the Institute for Rational-Emotive Therapy in New York. He had been suffering from severe pains in his neck and jaw. He had consulted an otolaryngologist and a neurologist as well as his family physician. Exhaustive medical testing failed to discover any organic basis for his symptoms.
During therapy Gaetano revealed that he had come from Italy as an adolescent, and was raised in this country with conservative Italian values. He eventually did quite well as a construction manager, and married an American-born businesswoman. Over time the conflict between their two cultures began to greatly distress Gaetano. His wife, Gloria, was `too domineering and too independent’. She came and went as she pleased, and never accepted his authority as `the man’ of the household. This led him to create an increasingly violent rage that he had great trouble acknowledging. After a few sessions, he said he had fantasies of killing her. When asked why he did not simply divorce her, he said he could not do so.
The house they lived in was where Gaetano had been raised, and the house his father had died in. To give it up would be both painful and humiliating. He said he could not stand the idea that Gloria could end up owning it: this would be a terrible indignity he could not bear. Thus Gaetano had locked himself into what Miller (1944) called an avoidance-avoidance conflict. He strongly `needed’ to avoid his wife, but he also `needed’ to avoid the hassles inherent in ending his hated marriage. He began picking up women in bars and sleeping with them in motels. By doing this he felt he was getting justice for the pain his wife was putting him through, but in turn he suffered great guilt. So, feeling trapped, he began to express himself through his neck and jaw pains.
The process by which his situation was converted to physical symptoms began with his irrational beliefs. Some of these were:
The irrational beliefs about Gaetano’s marriage were like a series of cur-de-sacs. He was trapped, and his growing rage led to increased anxiety and physical tension. But two other factors led to the symptomology, the first being constitutional. Some people appear to possess the innate tendency to express emotions through physical symptoms (Templer & Lester, 1974; Suls & Rittenhouse, 1987). This notion is not new. Alexander (1950) proposed that people with these disorders have a biological predisposition to bring them on. Gaetano probably had this tendency: otherwise he would have probably expressed his distress in more traditional ways.
The second factor was Gaetano’s beliefs and feelings about inescapable catastrophe. He saw this as too terrible to be real, so he literally denied its existence, and instead focused on a part of his body that was reacting in a typical way to his stress. The muscle tension in his jaw and head that commonly accompanies many stress reactions was interpreted as an illness. The focus on his illness distracted him from, even relieved him of, the pain of his apparently inescapable dilemma.
Thus when people perceive stressors as being so terrible as to fall outside the domain of any conceivable life event, they may tend to dissociate. In REBT terms, psychophysiological and somatoform disorders often result from extreme awfulising, combined with some additional irrational beliefs. These beliefs may be to the effect that `something bad absolutely will happen to me!’ or `any physical symptom proves something terrible is happening to my body!’
Gaetano’s therapy focused on three aspects of his difficulty. The first was the system of beliefs that he was in a terrible situation. He was helped to see that although his situation was bad, it was far from so bad as to make life unbearable. He was shown how to increase his frustration tolerance so that he could `stand’ to be with his wife until a way out of his circumstances could be found.
His second set of irrational beliefs, that he absolutely must not be enraged and have fantasies of revenge, led to his self-downing. He was shown that although it would have been preferable for him to accept his wife’s disagreeable ways without rage, he was not a bad person for feeling enraged. He was also shown that his wife was not the absolutely bad person he was making her out to be, simply because she differed from him and because he could no longer tolerate her.
The final aspect of Gaetano’s therapy helped him to work on practical solutions. He was encouraged to tell his wife how he felt and to consult an attorney. After a couple of painful months of legal and domestic negotiations, she agreed to a divorce, and he was able to keep the house. His symptoms vanished.
Rational emotive behaviour therapy (REBT) predicates its treatment of most neurotic problems on the hypothesis that humans, to varying degrees, endorse and act on convictions that are self- and socially-defeating. These partially learned and partly constructed irrational beliefs lead to a significant portion of psychological difficulties. There are other factors involved in mental disorders, but these can only be partially addressed with psychotherapy. The other causes are genetic, biochemical, and structural. Psychotherapy indirectly treats these other ailments in the same way that it helps with other problems of life that are unyielding–by helping people change what they can change, and accept and endure what they cannot change.
REBT uses a simple model in its system of therapy: the ABCDE model. The A refers to an unfortunate activating event in people’s lives that results in a dysfunctional behavioural or emotional reaction. B is the belief system that largely determines or regulates their response to the A. C is their disturbed consequence to the A and B. D refers to the disputing that challenges their irrational disturbance-creating beliefs. Finally, E is their effective new philosophy that they are encouraged to adopt.
In most discussions of REBT, the C (consequences) refers to emotional reactions. However, in the case of stress the C is often organic or physical symptoms. This is very similar to the model of stress adopted by the National Academy of Sciences (Dollahite, 1991) which expressed stress reactions in terms of an xyz model. In their version they refer to the x as the potential activator, the y as the individual’s reactions to the potential activator, and the z as the consequence of the x’s and y’s. The authors also label interactions between the x’s and y’s as mediators. These researchers came to the same conclusion that I (AK) came to in 1955. External events do not by themselves result in disturbance-whether stress or any other kind. The range of reactions to unpropitious events is so wide that people’s perceptions and evaluations of these events are the prime mediators of their reaction (Ellis, 1962, 1978, 1985a, 1988, 1991; Ellis & Dryden, 1987).
The cognitive process that facilitates the creation of stress almost always involves irrational beliefs (Woods, 1987; Vestre & Burnis, 1987; Forman, 1990; Henry et al., 1991). These have been detailed extensively in previous articles and books, but briefly they include rigid, inflexible, and usually unexamined beliefs, personal philosophies and attitudes that we all possess to varying degrees. These can take the form of unconditional demands, such as: `I have to be successful!’; `All people who have hurt me must be severely punished!’; `I absolutely must be physically competent and healthy or life is terrible!’
Negatively distorted judgements (awfulising) are also efficient stress producers. Some typical ones are: `It would be awful if I were to lose this case!’; `I couldn’t stand to be fired’; `I am totally worthless if I lose my business!’
Beliefs based on absolute social needs commonly produce stress reactions. People create traps for themselves with musts that often cannot be satisfied: `I must get the respect of or love from all significant people!’; `Other people must respect my needs!’
Stress reactions to irrational thinking differ in one important way from other disturbed consequences (C) in that the stressed individual tends to link a number of irrational conclusions together into an overwhelming whole. The woman who is vying for a promotion and is asked to produce a key business report on a near-impossible deadline, all the while seeking to get home early enough to get her child out of day care, will tend to experience stress. But let us examine the underlying beliefs and demands that transform these social pressures into her experience of stress. The stress process begins with her compelling desire to get the promotion, which becomes the demand: `I must get a promotion and I will be a total failure if I blow it!’ or `I must get the promotion or I’ll never get anywhere!’ Next, she becomes aware of the deadline, and further elevates her arousal with a belief like: `If I don’t get the report in by tonight, they’ll know I’m not competent, and that would be awful!’, or `I’ll never get it done right in the time they have given me, and they’ll see what an incompetent person I am!’
Research has provided compelling evidence that complex cognitive processes, like speech, becomes automatic and extremely rapid with repetition (Posner & Snyder, 1974). Thus habitual statements, like the preceding, will at times be subtle and rapid. So it requires effort to first bring them into awareness and then to practice disputing them once we clearly see them. Without the effort to understand these irrational cognitions, we are at their mercy. As noted above, experimental psychology has demonstrated that many judgments occur rapidly, and sometimes outside of awareness, and that they often result in emotional changes (Foster & Grovier, 1978; Kunst-Wilson & Zajonc, 1980; Zajonc, 1984). It is difficult, if not impossible, to physically control these reactions. But a change in personal philosophy ultimately leads to the cognitive changes that can bring them under control.
Rational emotive behaviour therapy uses a large number of cognitive, emotive and behavioural techniques to help people who over-react to stressors and who add to their appropriate feelings of concern, displeasure, and frustration about these stressors, inappropriate, self-defeating feelings of severe stress, anxiety, and panic. Thus, rational emotive behaviour practitioners often use biofeedback and relaxation techniques (Fried & Golden, 1989; Fried, 1990), hypnosis (Ellis, 1985b; Stanton, 1989), self-instructional training (Meichenbaum, 1977), meditation and yoga (Benson, 1975; Ellis, 1984; Goleman, 1993), behavioural exercises (Ellis & Abrahms, 1978) and other methods that other therapists use.
In addition to these traditional methods, REBT usually includes a number of special cognitive techniques, especially active-directive disputing (D) of clients’ dysfunctional and irrational beliefs (B). Thus, when a rational emotive behaviour therapist works with someone suffering from stress-related disorders, the first step usually involves finding the events that the client is making stressful. The next critical step involves finding the beliefs, attitudes and personal philosophies by which clients convert the perceptions to dysphoria. It is this aspect of REBT that most tests the skill of the therapist.
Many clients seeking help for stress-related disorders feel trapped by the events that are distressing them. They typically have strong convictions in the absolute badness of these happenings. Therapists therefore need to be sensitive and cautious in challenging these beliefs. Clients suffering from severe stressors are convinced, either overtly or implicitly, that these `terrible’ things are the direct and only cause of their problems. Helping them come to see that the things are indeed bad but that their `terribleness’ is largely their own creation will be resisted unless therapists first establish that they empathetically accept the clients’ suffering as real. Perhaps the worst thing any therapist can do is to dismiss a particular stressor as `insignificant’ or `minor’. If the client perceives it as monumental, the therapist had better accept this as the starting point.
The next step is to find the specific beliefs, philosophies, and attitudes that create stress. This can be accomplished by interviewing clients about their feelings when they encounter stressors. Once their disturbed emotions are clarified, the therapist in collaboration with the client probes for the irrational beliefs and dogmas that create stress reactions, and shows clients how to actively and forcefully dispute (D) these beliefs (B).
More specifically, REBT teaches clients how to do the following disputing:
As REBT shows people how to look for their absolutist shoulds, oughts, and musts, and for their awfulising, can’t-stand-it-itis, and self-downing about the stressors that they experience, it also employs a number of other cognitive methods that it has invented or adopted to help people change their dysfunctional thinking for more effective and less disturbing thinking. Thus it uses reframing, and shows clients how to find good things in some of the bad things that happen to them and how to accept the challenge of not upsetting themselves when they are under unusual stress. It helps them, when they procrastinate or are addicted to harmful feelings and behaviours, to referent a number of disadvantages of what they are doing and to forcefully go over them several times a day, so as to plant them into their consciousness. It `works out’ with clients’ coping rational self-statements, particularly philosophical ones, that they keep using to face some of the worst stressors and to refuse to upset themselves about. Such as: `Yes, I am really under great strain right now and there is nothing that I can do about relieving some of it, but I don’t have to eliminate it and I can lead a reasonable happy life even if these difficulties continue.’
Rational emotive behaviour therapy encourages clients to do cognitive homework, including the steady filling out of the REBT Self-Help Form (Sichel & Ellis, 1984). This helps them to find and dispute their irrational beliefs. It provides them with psychoeducational materials, such as pamphlets, books, and audiovisual cassettes, that show them how to use rational-emotive anti-disturbing and problem-solving methods (Ellis, 1978, 1988; Ellis & Harper, 1975). It encourages them to record their therapy sessions and to listen to these several times. It pushes them to learn REBT methods and to teach them to others, so as to implant them into their own hearts and heads. It shows them how to model themselves after other individuals who have coped well with stressors.
Rational emotive behaviour therapy always uses a number of emotive-evocative, dramatic methods to help individuals cope with stress situations. Thus it teaches them how to use rational-emotive imagery (Maultsby, 1971), in the course of which they work on their disturbed feelings when they imagine a very stressful event happening, and change these to appropriate feelings of sorrow, regret, and frustration. It encourages them to do its famous shame-attacking exercises (Ellis, 1973, 1988) and learn to deliberately do foolish and ridiculous acts in public and not to upset themselves or put themselves down when others disapprove of them for doing these acts. It show them how to create and use very forceful and dramatic coping statements to change some of their disturbance-creating thoughts and feelings. It encourages them to tape-record some of their worst irrational beliefs and to strongly dispute them on tape, and then let their therapists and other people listen to their disputations to see how forceful they really are. It provides them with rational humorous songs and other humorous ways of interfering with their taking stressors too seriously (Ellis, 1987).
Behaviourally, REBT employs a number of action methods to help people overcome their overly stressful reactions to the difficulties of their lives. Thus, it encourages them to use in vivo desensitisation and exposure methods to overcome some of their irrational fears. It shows them how they can deliberately stay in poor situations (e.g. remain in a job where their supervisor is hostile and negative) until they give up their own feelings of horror and terror-and then decide whether to leave these situations. It shows them how they can reinforce themselves when they do REBT homework that they agree to do and penalise themselves when they fail to do it. It gives them skill training in important areas where they feel very stressed, so that they will function better and enjoy themselves more in these areas. Thus it often provides clients with assertion, communication, relationship, and social skills training.
As usual, then, rational emotive behaviour therapy uses a good number of cognitive, emotive, and behavioural methods, some of which are special to REBT, to help people make their lives less stressful and to cope with stressors that they cannot change. It especially tries to help them push themselves to improve unpleasant social and environmental situations; but to unconditionally accept themselves, other people, and the world, even when unusually stressful conditions persist. As Hauck (1977) points out, when people are faced with unpleasant situations, they have three main choices: to change, stay with, or leave them. Whichever of these choices them make, REBT endeavors to help them accomplish it with a minimum of stress or emotional disturbance. Severe stressors are often inevitable; undue stress about them is not.
Although there is variation depending on the studies, a commonly cited statistic is about 2% of pre-pubescent children and up to about 8% of adolescents meet the criteria for depression. The symptoms of depression can vary in both age and gender.
However, irrespective of age or sex, depression is always accompanied by changes in behavior or personality style. For example, if an outgoing child suddenly becomes withdrawn, or a passive child becomes combative, or a confident child suddenly acts shy, the child may be depressed.
A leading sign of depression in adolescent or teenaged boys is hostility or anger. In contrast, girls may display depression with changes that are more obvious. These include ready tears, evident sadness, and explicitly stating that they are depressed. Many children may appear emotionally normal but begin to complain of a wide range of physical symptoms. In addition, the child may appear lethargic, or complain of fatigue. If these symptoms are combined with either a marked reduction or increase in sleep time, depression is a possible cause.
In pre-adolescent kids, the signs include increased or decreased appetite, a sudden loss of interest in social activity or increases in self-deprecating statements. Since a depressed child will often begin to feel worthless or inadequate, he or she will tend to make comments about how worthless or hopeless they are – in extreme cases the child may even question the point of living at all. Such statements must be taken seriously and professional help must be enlisted as soon as possible.
A depressed child is one who is suffering a great deal and who can feel worthless and alone even in the midst of a loving family. It is best to offer patient support, while avoiding exhortations to “snap out of it” or “cheer up.” Remember, if the child could make him or herself happy he or she would. Be patient and when in doubt, get the child help.
Love and sex are universal themes in almost every aspect of art and culture. Unfortunately, many couples have a great deal of difficulties living up to the ideal portrayed in art and literature. Indeed, sex frequently fails to live up to its romantic apotheosis and couples often end up disappointed or distressed. In literary depictions of romance, couples in love fall into each other’s arms and make effortless love and they go on loving and making love until the end of their days. Sadly, the ideal of the synchrony of love and sex is not as common as one may hope. And when love and sex are indeed coalesced the bond between the two is often short lived. Why does this happen? In examining this question we can turn to both Albert Ellis and Aaron Beck. Beck (1989) predicated much of his couples therapy techniques on his observation that romantic passions that begin with the intensity of drug intoxication frequently wear off, as do drug induced highs. He noted that this fading leads to changes in the partner’s perceptions of each other. As romance begins to fade, the partners begin to suffer an increase in cognitive distortions about each other. His prescription is quick and appropriate. He details a range of cognitive changes and exercises to give the couple tools to attenuate the conflict that ensue from these distorted cognitions. However, what he fails to adequately address is why after a few years of bonding, do couples that saw each with blurry-eyed passion suddenly become overwhelmed with distorted cognitions.
There is a theoretical drawback with most counseling for sex and intimacy problems. In essence, they all help couples make changes to address a degrading bond but none clearly explain that why this so frequently occurs. This includes Cognitive Couples Therapy, Emotionally Focused Couples Therapy (Johnson, 2004), Acceptance and Commitment Therapy (Jacobson & Christenensen, 1996) and other approaches. However, as far back as the early 1940s, Albert Ellis recognized that a significant portion of couples’ conflict has to do with waning sexuality. Importantly, he noted that sexuality is derived for evolutionary and biological reasons (Ellis, 1957) and the contributing factors to the experience of sexuality are not static. Consequently, he counseled counselors to treat sexual issues with an understanding of psychology, sexology and anthropology (Ellis, 1954). Early in the development of sex therapy, Ellis recognized that sexual desire and choice are both malleable and ephemeral. It is for this reason that he saw sexual compatibility as often requiring outside sources of stimulation (Ellis, 1972). He did so in recognition of the problem discussed above—sexual passion and romantic love are often fleeting. This is the fundamental problem faced by counselors treating couples for sexual difficulties.
Why do couples suddenly notice the flaws and blemishes that they have not seen in the early stages of the relationship? Why are they often exasperated by their lover’s personality that they had once found charming and engaging? The answer is found in very old brain circuits that alter perception when in passionate states. Sexual arousal can subvert many limbic survival defenses. Disgust is attenuated when one is sexually aroused (Stevenson, Case, & Oaten, 2011). For example, think about your typical reaction to finding saliva on the rim of a soda bottle offered to you by a stranger—it most likely is handed back with haste and a grimace. Yet when sexually aroused we greedily suck the saliva of our paramour—this popularly known as French kissing. Also, when aroused we will orally stimulate portions of the body immediately adjacent to the sources of urine and feces. The same people who passionately make oral love will stop taking mints offered near the restaurant cashier when they are told that most restaurant patrons don’t wash their hands. Sexual arousal even attenuates rational caution. The most sociopathic outlaw appears caring and loving when a woman is strongly attracted to him.
These biological predicates of love and sex need to be understood by counselors treating couples with sexual and physical intimacy problems. Too often sexual problems are viewed as primarily social, cultural or learned. In contrast, the overwhelming evidence presented by sex researchers indicates that love is a biological phenomenon that bonds couples only long enough to mate and rear a child (Fisher, 2004). Studies have shown that romantic love is a result of activation of brain reward circuits such as the right ventral tegmental area, the right postero-dorsal body and the medial caudate nucleus (Aron et al., 2005) , primitive brain regions that regulate motivation and pleasure. Importantly, romantic or sexual love is a cross-cultural universal constant that can best be explained by innate neuropsychological systems. These systems evolved to produce intense sexual yearnings and subsequent bonding. These cravings emanate from the reward centers of the brain and lead to intense withdrawal-like cravings for the absent lover. In addition, they tend to attenuate all negative judgments about the lover. Sadly, for many couples these love bonds fade in a year or two (Fisher, Brown, Aron, Strong, & Mashek, 2010). Love scientist Helen Fisher pointed out those early prehumans in tribal groups began to lose interest in their mates after a child was old enough to integrate into the tribe.
Sometimes love lasts just long enough for sex, sometimes long enough to wean a child and in rare and very romantic cases. Love and sex remain intimately connected for a lifetime. Sadly, the third case is rare. The dismal reality, based on the high rate of divorce and relationship dissolution is that the transition from romantic love to an enduring conjugal love commonly fails to evolve. Although, divorce rates remained fairly constant in the last two decades, there has been a trend towards fewer couples marrying (Kreider & Ellis, 2011). For example, approximately 85% of people born from 1940 to 1944 were married by the age of 30 in contrast to the 65% of people born from 1970 to 1974. Estimated divorce and separation rates range from 40% to higher rates as those found by Martin and Bumpass (1985) who concluded that when allowing for under reporting the actual rate is closer to 66%. Whatever the precise rate of divorce, it likely understates the rate of relationship dissolution as many relationships fail before marriage is achieved.
It is difficult to precisely measure the proportion of non-conjugal relationships that dissolve but it is reasonable to assume that it is no better than for married couples. Studies that did manage to yield some estimates found the prospect of successful ongoing relationships to be somewhat bleak. In an Internet survey of 3,000 people, 35% reported having had a relationship breakup in the past 10 years. And of those between 18 and 34, 59% reported recently having had a recent relationship breakup (Fetto, 2003). This is concordant with the finding of Simpson (1987) who surveyed 234 non-married individuals with an average age just under 20. In a follow-up just 3 months later, 42% of those surveyed had broken up.
Irrespective of marital status, it seems that the strength of the coupling bond is enhanced by time spent together, personal commitment to the relationship, level of love, degree of social support and assessment of availability of better mates (Felmlee, Sprecher, & Bassin, 1990). This last variable is one that is often ignored. That is, on some level, partners are always vigilant for mates who can offer more. This was illustrated in a study of lesbian couples in relationships in which partners who perceived few alternatives to their mate tended to be more committed (Beals, Impett, & Peplau, 2002). The social exchange perspective of relationships appears to be supported by the high rates of relationship dissolution and in fidelity (Byers & Wang, 2004). In short, it posits that relationships, irrespective of love, are founded on an exchange of perceived value. In the starkest terms, most members of loving relationships remain vigilant for a better mate. Couples’ counselors often overlook this unfortunate reality.
Most relationships traverse several phases: the first is the initial excitement of romance, then a fading of passion, followed by a change in the way a partner perceives his or her mate. This perceptual change is such that physical and character flaws that were obscured by passion now become visible. Romantic attraction tends to mask the defects, blemishes and idiosyncrasies of the partners. With the imperfections more salient, there is often a surge in complaints and criticisms that typically leads to conflict. In order to apply rational emotive/cognitive behavioral solutions to the problems of marriage and love, it is first important to understand the essential nature of these two fundamental components of social interplay. As Nobel laureate Daniel Kahneman pointed out, we are prone to like or feel we have knowledge with things that are familiar (Tversky & Kahneman, 1973, 1974). Love relationships, coupling and marriage are so ubiquitous that they seem quite scripted. In fact, couples are bound together by a complex of none conscious, social, cognitive and personality factors that take a bit of analysis to fully grasp. A therapist who fails to address the hidden forces contributing to difficulties in relationships will undermine his or her best efforts to help.
In 1895 Breuer and Freud published a book titled Studies in Hysteria that paved the way for a century of psychoanalytic explanations of human behavior. The theme of the explanations is that expressed or repressed sexuality and aggression underlie and direct all human behavior. Indeed, even the most creative acts are viewed as resulting from disguised sexual intentions in the form of sublimation. Although, psychoanalytic theory has largely failed to meet research support (e.g., Ellis & Abrams, 2008), it seems to have stumbled onto a key principle of today’s zeitgeist evolutionary psychology. Evolutionary psychology supports the idea that sex does permeate most every aspect of our lives. A man does not buy the expensive sports car only because he wants to drive fast. A woman does not dye her hair or buy a snug fitting dress because she wants to look good for herself. Even someone cramming for college entrance exams might be trying to bring his or her grades up for reasons other than college admissions. Entrance into a better school leads to increase income and consequently better access to a mate.
Supporting this perspective, psychologist David Buss (2005) theorized that virtually all male violence has a sexual basis. This point was compellingly detailed by authors Malcolm Potts and Thomas Hayden (2008) who cogently argue that most wars can be traced to innate sexual competition. This evolutionary perspective of violence is based on both direct and indirect sexual jealousy. Direct sexual jealousy usually involves a male guarding his mate, whereas indirect jealousy extends to encounters that are tangential to the love relationship. For example, the rage a man feels when slighted is abstractly sexual as it may result in his losing prestige or social standing. Since all men are potential sexual competitors, loss of face typically leads to a diminution in a man’s access to females. Indeed, many evolutionary psychologists opine that homicidal jealousy is an evolutionary adaption since killing a direct or indirect sexual competitor was an efficient solution during human evolution. Why not? There were no jails, lawsuits or any consequences save for revenge by the slain man’s kin. Killing one’s sexual competitor smoothed the path towards passing one’s genes to future generations. In short, evolution may have made it more adaptive to kill than be cuckolded.
The need to take an evolutionary view of sex is emphasized by Dobzhansky (1973), who said “nothing in biology makes sense except in the light of evolution.” By logical extension it follows that nothing in sexuality makes sense except in light of evolution. Psychologists who attempt to understand and treat couples in distress must at least make an attempt to understand human social behavior in terms of our evolutionary past. Usually one can infer the underlying meaning of human behavior by looking at how that behavior would have been adaptive during our early evolution. Human sexuality during our distant past was unlikely to follow the Western ideal of long-term monogamous relationships. Indeed, sexual monogamy in nature is quite rare. Birds that are often cited as forming pair bonds for life often do so, but they rarely maintain sexual monogamy. Extra pair copulations (EPC’s) or what married couples would denote as adultery, seems to be remarkably common among birds in pair bonds. Birds like the passerine and the cockatiel, which are known to be socially monogamous have a substantial number of their offspring fathered by males outside the pair bond (Fossøy, Johnsen, & Lifjeld, 2006 ; Spoon, Millam, & Owings, 2007). Why do birds “cheat” on their mates? It seems that a pair bond is beneficial for raising the hatchlings that includes protection and procuring food. It is also beneficial for the female’s genetic legacy to obtain genes from males that offer the best genes possible. It seems that female birds have developed the ability to discern good genes in males and in turn male birds work very hard at trying to highlight their genetic endowments. This is accomplished through extravagant displays such as that of the peacock (Loyau, Jalme, & Sorci, 2005), the ability to acquire prime territory as in the case of the bowerbird (Pruett-Jones & Pruett-Jones, 1994) and the ability to fight (Edler & Friedl, 2010). In short, sexual behaviour in almost all species includes a strong tendency for females to seek males with the best genetic endowment. There is little doubt among evolutionary psychologists that this is case for humans.
This pattern is also observed in apes, animals that are quite genetically similar to humans. The most similar, Bonobos and chimpanzees are both none monogamous and highly sexually competitive. When a female chimpanzee is in estrus, she will mate with numerous males in short order. If there is ever a semblance of monogamy, a chimp pair will go off for a few days on what primatologists label consort relationships (Fisher, 1992; McGinnis, 1979). However, upon their return the pair bond tends to rapidly dissolve. It is more common for chimpanzee sexuality to involve what amounts to mating frenzies with multiple male-female pairings. During these encounters there is rarely internal aggression so long as the dominant male’s access to females is not impeded. Despite the restrictions of the male hierarchy, females in estrus will mate with eight or more different males per day. Like their larger cousins, Bonobos also are quite promiscuous with virtually no sexual pair bonding. These close human relatives are not only extremely promiscuous but also seem to include both heterosexual and homosexual sex in all their social interactions (Parish & De Waal, 2000 ; Ryan & Jethá, 2010).
Primates who don’t form pair bonds use a vicarious method of sexual rivalry; they let their sperm compete for them. A chimpanzee produces approximately 223 times more sperm than a gorilla (Fujii-Hanamoto, Matsubayashi, Nakano, Kusunoki & Enomoto, 2011). Why is this the case? Gorillas live in small groups in which one male mates with multiple females—no sperm competition, hence their small testicles. Chimpanzees are much smaller animals, tipping the scales at around 120 pounds but they have large testicles that together weigh about four ounces (Kenagy & Trombulak, 1986). Since female chimpanzees in estrus mate with several males a day, the male chimpanzees have evolved to be large and to produce a large number of sperm cells in order to increase the chance of fertilization. Humans have a testicular size that falls between gorillas and chimpanzees. This suggests that humans have evolved a mating system that is neither as promiscuous as that of the chimpanzee, nor as exclusive as that of the gorilla. Nevertheless, all indicators denote that humans are a promiscuous species whose sexual impulsiveness can be briefly held in check by romantic love.
In their book the Myth of Monogamy, Barash and Lipton (2001) compellingly argue for the innate human tendency for polygamy. They point out that virtually no animals are monogamous, including birds – the genus most often cited as emblematic of monogamy. This is also the disillusioning case for the paradigm of pair bonding, the prairie vole. These mate-for-life rodents do indeed stay together for life but the female very often finds the time to mate with other males (Ledford, 2008). What about human cultures? C.S. Ford and psychologist Frank A. Beach studied 185 human societies (1951) and found 39% approved of extramarital sexual relationships. More recently, Helen Fisher and her coworkers observed that 84% of human societies permit some form of polygyny (Tsapelas, Fisher & Aron, 2011).
What does all this mean? In distilled form, it means that monogamy, especially sexual monogamy, is not the norm for primates—and every bit of social data demonstrate that this strongly applies to human primates. Indeed, the evidence points to the fact that serial monogamy with a substantial degree of infidelity is something that we are evolutionarily primed for. This being the case, couples are likely to confront many sexual challenges that are expressions of a biological rather than a psychodynamic unconscious. This fact is particularly important for the counselor working with sexual problems. The evolutionary tendency to lose sexual passion is just one of the problems couples face. Some of the more vexing ones will be subsequently discussed.
Just as humans seem to be evolutionarily primed for sexual interpersonal diversity, we need to be primed to be aroused by other people. However, for men there seems to be far more variety in this priming than in women. This greater variation in sexual arousal cues is in part due to the male’s reliance on visual signals for sexual arousal. Ideally, the source of arousal would be the shape and form of another person’s face and body. For a heterosexual man it will be the face and body of a woman for a homosexual it will be that of a man. However, men are extraordinarily more prone to paraphilias than women. That is, some men are not aroused by a person’s attributes but by peripheral aspects, by social situations, or other cues that make the other individual largely irrelevant.
In contrast to animals, in which the mechanics of sex vary very little, with humans the range of sexual expression is far more diverse. Indeed, sometimes it is hard to recognize certain lustful behaviors as sexual at all. Some sexual acts are so far from the archetypal theme of physical intimacy that misses the target completely. Hence the term paraphilia, which is derived from Greek words meaning beside or to the side of love. Thus, the individual who has a paraphilic sexual focus is often denied the intimacy that sex can bestow. And for some, sexual arousal cues are so inconsistent with affection or tenderness that they serve to alienate potential lovers. It is this manner of paraphilic sex that is most often categorized as a disorder (American Psychiatric Association, 2000) . Here the paraphilic individual is so focused on a sexual arousal cue that it is nearly completely divorced from the person who possesses it. Interestingly, as divorced as a paraphile may be from intimacy, he or she will almost always require a person consistent with his or her gender choice for the paraphilic act. For example, if a heterosexual man requires degradation for arousal, he will always want that degradation to come from a woman. For most people with paraphilias, the need for the fetish object or the paraphilic act is linked to no shame, distress or social impairment. This fact is the basis for those who argue that paraphilias should not be categorized as sexual disorders. A cogent proponent of this position is Charles Moser (Moser, 2009 ; Shindel & Moser, 2011). In a study conducted prior to common access to the Internet, Moser and his colleagues (Moser & Levitt, 1987) took a survey of 178 men recruited at a sadomasochism support group, through an ad placed in a sadomasochism magazine. A portion of the findings are presented in Table 7.1 below.
Table 7.1 details the type of paraphilic interests found in those who were active in a fetish lifestyle. It shows that people who are active in a paraphilic lifestyle tend to be aroused by acts that are commonly considered shocking or offensive. Moser surveyed people who led active paraphilic lifestyles. An estimate of the prevalence in the general population was found in an informal ongoing Internet sex survey in which more than 70,000 anonymously responded (http://www.survey.net/sv-sex.html). The check list has three levels for each arousal cue—curious, mild, and heavy. Respondents were permitted to make multiple choices so that someone aroused by mild pain could also select both curious and heavy pain. The results set forth in Table 7.2 indicate that paraphilic interests are quite common and therefore normal. However, like any sexual proclivity, when taken to an extreme, it becomes an acute barrier to sexual intimacy.
Normal or not, paraphilias present a particularly difficult problem to heterosexual couples, due to the fact that the great preponderance of women do not find most paraphilias arousing or even acceptable. In some cases an accommodating lover will indulge the paraphile, but more often the paraphilia becomes a shameful secret that is exercised outside the relationship or is relegated to fantasy. In either case it creates a sexual distance in the relationship. Interestingly, it appears that sadomasochistic sexuality or other paraphilias are far more accepted among gay men. In lesbians they are both less common or tend to be attenuated in intensity. This is in contrast to many male paraphiles who absolutely require the paraphilic cue for arousal or orgasm.
Paraphilia, an almost exclusively male disorder may allow for a relationship with genuine love but typically has little in the way of sexual communication and intimacy. As noted earlier, the paraphile’s lover will virtually never directly arouse him. Instead, the lover becomes one of several “props” that are necessary for sexual arousal. It is important for the counselor to be aware that paraphilias are as refractory to change as one’s sexuality. That is, it is no easier for a man with a foot fetish to change to become aroused by a whole woman than it is for a straight man to become visually aroused by a penis.
Since more paraphiles have learned to keep their propensities secret, they will typically be exposed in a relationship when their guard is down. A man is caught masturbating to fetishistic pornography; his wife discovers sexual implements, women’s undergarments or membership on a fetish site like FetLife. When exposed, fear and shame often lead to denial, explanations of experimentation or if inescapable vows to change. The essential fact that the shocked partner must be guided to accept is that her partner will not change. Counseling for this couple with this problem must include an assessment of the severity of the paraphilia. In the more severe forms it tends to exclude all traditional sexual intimacy and be obsessively consuming. In such cases the relationship is in great peril unless the non-paraphilic partner is extraordinarily accommodating. In less severe forms, if both members are willing, the couple needs to be helped to build a sex life that includes the fetish. Common beliefs among women who discover their mate is a paraphile are “He is a pervert and a terrible person for having these desires,” “He completely deceived me about his love, and our relationship is a total lie,” “He should be able to be turned on by me without his fetishes” or “If he really loved me, he would be attracted to me without needing his sex games.”
The response of the male lover when his mate discovers his predilection is often shame, guilt and denial. Counseling for a couple facing this difficulty needs to address this aspect of the problem. Men “outed” as paraphiles will suffer beliefs like: “I am a pervert and terrible person for having these desires,” “I am not a real man if I need to be aroused in such a sick way” or “I can never be happy with these desires.” The counselor should help the client challenge these irrational beliefs. Counseling for the woman must address beliefs about shame, rebuke and betrayal. The woman needs to be helped to challenge beliefs that the paraphilia is a volitional betrayal of the relationship or that her lover’s sexual desires denote a lack of love. If this can be successfully conveyed, then the next phase of counseling can commence.
This second phase of the counseling must involve strategies to help the couple develop a sexual compromise that permits limited expression of the paraphilia. For example, if the man has a lingerie fetish such that he is aroused by wearing women’s undergarments, his spouse must find her comfort range with his dressing this way prior to or during sex. If she finds it offensive or distracting, a compromise can be reached in which he uses the lingerie for arousal prior to coitus. The therapist can facilitate the process by helping the paraphile’s spouse explore the basis for her aversion to his arousal cues.
The most common source of failure of sexual arousal is the fundamental gender difference in arousal cues. Men are visually aroused and tend to be less discriminating in that arouses them and when. Women typically require displays of emotional commitment, affection, stability and quality from those who would arouse them. Both of these general rules have exceptions, but they are important starting points for inquiry in counseling couples with arousal difficulties.
One arousal problem that is particularly dreaded yet easy to treat is erectile dysfunction. Studies have shown that this is more common a problem than most afflicted men may think. And this fact is something that needs to be conveyed in couples’ counseling. For example, in one study which surveyed the top sexual problems in men, these were listed as follows: problem getting an erection, problem maintaining an erection, premature ejaculation, and inhibited enjoyment (Dunn, Croft, & Hackett, 1999) . The high prevalence of erectile dysfunction, especially among older men, was measured in a study of men over 40 by Laumann et al. (2007) . The authors found that the prevalence of moderate to severe erectile dysfunction was 8.8% for men 40–49, 15.2% for men 50–59 and 29.2% for men 60–69. These rates among older men may not be surprising. However similar prevalence was found in a survey of younger men (Heruti, Shochat, Tekes-Manova, Ashkenazi, & Justo, 2004) in which 19% of men 25–28 reported mild erectile dysfunction and 5% reported a moderate to severe condition. Prior to the advent of the phosphodiesterase inhibitor (PDE5) medications, which include Viagra, Levitra, and Cialis, the predominant problem addressed in sex therapy for men was erectile dysfunction. Clearly, this is no longer the case.
For many couples, the problem is more complex than erectile dysfunction. One or both partners have ceased to find the other sexually interesting. This problem needs to be addressed by seeking sources of anger, resentment, and other negative emotions that may be barriers to finding new ways for the couple to excite each other again. As noted earlier, the waning of romantic love is usually linked to a decline in sexual arousal. Of course with all sexual problems, especially those with recent onset, organic bases must be ruled out. These can include endocrine problems—especially reduced free testosterone levels. Having ruled out organic bases for the problem, psychotherapeutic interventions can proceed.
Any therapeutic intervention must take into consideration the natural tendency to habituate to one’s lover over time. As suggested above, men tend to habituate to lovers relatively rapidly, and women, although a bit slower in losing interest, will tend to do so when romance fades. When romantic love fades, arguments increase, the idiosyncrasies of one’s lover become more vexing, and a partner may begin to attend to other possibilities. These tendencies conspire to make sex with one’s mate less exciting. It is important that a couple’s counselor ascertain whether problems like erectile dysfunction or anorgasmia result from a fundamental loss of attraction rather than organic problems. If attraction has indeed faded, the counselor then needs to determine if both members of the couple are committed to their partner. A relationship can survive a diminution of passion if there is a conjugal love and friendship. If such bonds have developed, then the counselor can help by exploring irrational beliefs that will invariably make the problem worse, such as: “It is a terrible affront that my lover does not get excited by me!” “I can’t stand that she doesn’t excite me anymore,” “I am a terrible person for fantasizing about other men,” or “This relationship is a complete failure because he/she doesn’t want sex.”
The first approach in counseling for loss of sexual interest in a relationship is to explore the beliefs and emotions consequent to the change in sexual response. Then each partner needs to be helped to see the tacit rigidity, demanding, and damning nature of their irrational beliefs. Ideally, each partner is guided to disavow the belief in front of his or her paramour. This will reduce much of anxiety, hurt, and guilt associated with loss of sexual interest. When this has been accomplished, the couple then benefits from tools that enhance the sexual response.
Hillary and Mark had a romantic wedding, which was appropriate because they were very much in love. Hillary was senior administrator for a pharmaceutical company and Mark was a structural engineer with both a full time job and a part-time consulting practice. According to Hillary, sex in the first two years of their marriage was frequent and intensely pleasurable. It resulted in a daughter, Sara, and all remained well as they became increasing affluent and close as a family. Unfortunately, by the fourth year of the marriage, Hillary began to complain about Mark’s assertiveness, his masculinity, and his ability to discipline their daughter. Mark said he was frustrated and hurt, as he felt that he had not changed in any way. Exacerbating the problem, Hillary had completely withdrawn from Mark sexually. She initially denied that this was the case, citing a single sexual encounter a month earlier. However, when questioned further, she responded with complaints about Mark’s annoying behavior at home—especially his inconsistent parenting of Sara. Mark was articulate and clearly intelligent; but he was also quite shy and passive. He was frustrated and angry with Hillary’s constant complaining and her sexual withdrawal. Yet he never expressed these feelings to her. Instead, he became sullen and passive aggressive.
Initially in counseling, Hillary insisted on enumerating Mark’s flaws and failings avoided the topic of sex, which was very important to Mark. In an individual session Hillary acknowledged that Mark did not arouse her anymore, but insisted it was a result of his behavior. In Mark’s individual session he repeatedly insisted he could see no changes in the relationship that would account for Hillary’s complaints about him, nor her sexual withdrawal. His tacit belief was “Hillary should act lovingly and be attracted to me because she is my wife.” In response to this, the counselor suggested that he change his demeanor with Hillary. He asked Mark to be direct when distressed about relationship and parenting issues instead of avoiding conflict. Mark had also acknowledged that he felt that he could no longer be open with Hillary about his anxieties and life stressors. The therapist told him that this was indeed unfortunate, but the nature of the relationship had changed. Hillary had begun to see his frequent requests for succor and consolation as unattractive weakness. When together, Hillary acknowledged this and stated that in the past Mark’s need for emotional support and reassurance evoked maternal feelings, but now it was sexually alienating. Hillary’s irrational demand was that Mark should know that she found his behavior a turn-off and should change without her having to ask. The therapist helped Hillary see that both she and Mark had changed in the relationship and that acceptance was required for growth. Mark was still not happy that he had to maintain a façade of machismo to keep Hillary sexually attracted. And Hillary continued to feel that she was compromising by staying with Mark. Nevertheless, the relationship continued and sex improved once the couple dealt with their irrational beliefs.
When one is emotionally and sexually committed to another person, there are few life events that are as traumatic as discovering that the loved one has been intimate with someone else. This intimacy is usually sexual, but it can be romantic sans sex. The latter is more common with a woman who might develop a deep romantic bond with a man (on occasion with a woman) without ever having sex. Although husbands and lovers tend to find this disturbing, it does not approach the emotional firestorm that ensues when the infidelity is indeed sexual. David Buss’ contention that violent jealousy in the face of sexual infidelity is a male adaption is supported by the fact that a negative relationship between the length of the second finger to the fourth finger and increased anger at sexual jealousy (Fussell, Rowe, & Park, 2011). The second digit to fourth digit ratio is a correlate of prenatal testosterone levels such that men or women with ring fingers being longer than their index fingers were usually exposed to higher levels of testosterone. Thus, a masculinized brain is one that experiences greater distress at sexual infidelity.
As with all couples’ therapy, treatment for a couple with an unfaithful partner should begin with an individual session with each partner. Very often one or both members of the dyad will use the couples’ therapy as an exit strategy. It is painful to leave a relationship for reasons that include guilt, inertia, social responsibility, or feelings obligation. Thus, the difficulty in leaving is not based on a sincere desire to remain with the paramour. In this case the counselor is placed in a no win situation in which the partner who secretly desires a way out can claim that he or she has tried everything to make it work. Failing that rationale, the therapist’s interventions can be blamed for pulling the relationship asunder. A requisite of doing couple counseling is being thick skinned, but the job does not include billing for wasted time. Thus, it is essential that the counselor make a determination if both partners are really committed to continuing the relationship. The research previously presented is important in that a great deal of sexual motivation is innate, evolutionarily old, and not immediately accessible to the individual. As Beck (1989) emphasized, couples radically change their judgments when romantic passion attenuates. The role of the couples’ counselor is to accurately assess the factors that led the one of the partners to seek sexual satisfaction from another.
A brief history of the sexual trajectory of the relationship needs to be compiled. This is to ascertain whether the infidelity is a result of problems such as: Diminished attraction on the part of one or both partners. Pairing for reasons other than sexual attraction such that one or both were never compellingly sexually attracted to each other. Succumbing to a brief intense temptation. Anger at the lover or spouse leading retribution through infidelity. Undisclosed sexual performance issues. Undisclosed sexual pathology.
When and if a change has taken place and becomes evident in counseling, the counselor must assist each partner to understand and accept the change. Such changes can include loss of sexual passion, the development of anger or resentment, or the introduction of a third party. When a change such as loss of passion leads to infidelity, the counselor must insist that the offended partner understand his or her hurt, anger, and vengefulness in terms of his or her demands and other irrational beliefs. The offended partner must be helped to see that retribution and rage are not compatible with restoring the relationship. To accomplish this, irrational beliefs must be elicited and collaboratively challenged, as illustrated in the following case study. Similarly, the irrational beliefs that led the unfaithful partner to stray must be identified. If the unfaithful partner hopes to remain in the relationship, the irrationality of his or her actions needs to be explored and challenged. Both partners must be helped to see that creating a new relationship without the ruminations about the past is the best path to resolution. If both can view the infidelity act as bad, but not terrible or unredeemable, it can eventually become no more relevant than the sexual encounters that took place prior to the relationship.
Sal is a Latino who takes great pride in his physical prowess and his ability to manage tough laborers. His hobby is martial arts and he notes that he is quite proficient in self-defense and fighting when necessary. His manner and mien convey that this is not bluster. At the time of treatment he was cohabitating with Donna, an administrative secretary in the main office of a national corporation. Her job requires her to work late on many nights as well as attend corporate functions. Despite not being married, Donna and Sal have three children under age ten who are cared for by Donna’s mother when both parents are at work. The couple sought treatment as a result of an increasing number of arguments about Donna’s late hours at work and Sal’s growing discomfort with her socializing with men at corporate functions.
When asked if he was jealous of any specific coworker, he said no, but he was not comfortable with her being away from home for several hours during the evenings. Donna insisted that attending these functions was essential for her career, but Sal angrily argued that her job was secretarial, not social. She responded, a bit dismissively, that he didn’t understand the corporate world.
In employing Rational Emotive behavior Therapy with this couple, the therapist helped each partner understand the irrationality or in flexibility of his or her demands. For example, Donna would insist that late work was necessary, but would make no offers of compromise about setting some limits. Her tacit irrational beliefs were to the effect “he has absolutely no right to restrict my behavior; he doesn’t work in a corporate setting and is making completely unfair demands based on ignorance.” Consequently, Donna was shown that her rigid stance only provoked Sal to become more demanding and hostile. Sal labored under beliefs to the effect, “she is the mother of my children and absolutely should make being with them a priority. Her failure to compromise is an absolutely unacceptable affront to my masculine role in this relationship.” Sal was helped to see that although he had a strong desire to be in control of the relationship; Donna did not have to completely accept his standards for female behavior. In addition, Sal was helped to see that being less angry and demanding might yield more room for compromise. There was moderate success with this approach and treatment ended after five sessions, with both Sal and Donna agreeing to work on several homework assignments. The respite in conflict, along with helping the couple identify and dispute irrational beliefs such as those cited above did not completely attenuate Sal’s suspicions about his partner’s activities.
Sal continued to complain that Donna seemed indifferent and unaffectionate. She increasingly avoided sex and any forms of physical intimacy. She became quite dismissive of Sal’s interest in sports and would criticize him for being unsophisticated and excessively machismo—some of the very qualities that had initially attracted her to him. In counseling sessions he would complain that she was pulling away from him and always putting him down, something Donna would consistently deny. So in spite of the reduction in conflict that counseling had accomplished, Sal continued to feeling increasingly frustrated with Donna. He insisted that these changes in the way she related to him were making him increasingly suspicious about the times she insisted she was working late. He hired a private detective who did his job, showing Sal a series of photos that stunned and enraged him—photos of the woman he loved entering hotels and restaurants with an executive in her company. Not only that, but she was very affectionate towards this man in the photos… the type of man Sal feared and resented.
Sal called this author in a state of agitated rage. He was hurt and very angry, criticizing the therapy and ranting about how all the work on communication, anger control, and irrational demands was worthless because all the while Donna was having sex with an executive coworker. The object of Donna’s passions was almost as vexing as the infidelity. Sal, although a manager, managed labor. Although earning a respectable salary, he was very jealous of the educated high status male coworkers with whom Donna worked. This jealousy was frequently stoked when she would discuss these men with admiring adulation. Now the men he had been covertly competing with had won, and in his eyes had humiliated him.
Sal’s Irrational Beliefs
“I have been completely humiliated and must retaliate to save my honor.”
“Donna is a completely worthless slut and I must punish her.”
“I can never trust a woman again.”
“I must punish Donna by fighting her for the kids.”
“I cannot stand the idea that people will know she cheated on me.”
“I absolutely must get the guy that stole my wife.”
“I am a worthless lover and cannot satisfy a woman.”
“Donna is tainted and I cannot be with her.”
“My marriage is a total failure.”
“Donna deceived me and everything she ever said must be a lie.”
After meeting with Sal, this author requested that Donna come in for a solo session. She agreed, if for no other reason than that she wanted a means to communicate with Sal who had already confronted her in an angry and menacing way. During the session, she insisted that she still loved Sal but “not in the same way.” She stated that he had changed and had become more demanding, “primitive,” and suspicious. Donna insisted that it was Sal’s behavior that drove her into someone else’s arms. Her explanation was no doubt visceral, but might very well have reflected a change in perspective brought about by the type of change in romantic love discussed previously. Specifically, as the passion for Sal faded, flaws that to that point were tempered by passion became far more noticeable, leading to an increasing loss of sexual attraction.
Donna’s Irrational Beliefs
“I have an absolute right to pursue sexual gratification if Sal refuses to meet my needs.”
“It is completely Sal’s fault that he let himself deteriorate. He has forced me into • arms of someone else.”
“My new lover completely understands me and loves me far more than Sal, so I am doing absolutely nothing wrong in seeking his affections.”
“He is not the man I married. I had to find someone like Sal used to be.”
“I shouldn’t have to be with man this bad, when there are nice men who like me.”
“Sal should understand that I needed to do this.”
“Sal made me lonely and dissatisfied, I have an absolute right to be happy.”
“It is very common to have an affair, I’m sure Sal wouldn’t mind that much.”
Even though these irrational or demanding beliefs are likely to arise due to innate factors, they can nevertheless be addressed through a Rational Emotive approach. Donna has to learn that her alienation from Sal is in part a result of a change in her perception. This can be accomplished by encouraging her to specify the exact nature of his change that is troubling her and to explore the reality of his alleged change.
A significant percentage of those suffering from infidelity will never forgive the offense (Cann & Baucom, 2004; Shackelford, Buss, & Bennett, 2002 ) . This needs to be explored early in treatment. If indeed it seems that infidelity represents an unforgivable transgression, then the couple needs to be counseled accordingly. Specifically, the unfaithful partner needs to be warned that staying in the relationship will tend to be associated with ongoing hostility and resentment.
As the therapy proceeded, Donna accused Sal of changing for the worse, but she was unable to specify the exact nature of these changes. The therapist helped to see that it was her change in perception, not a change in Sal that led to the disaffection. The irrational or demanding beliefs set forth above were elicited over several sessions of counseling. One by one they were directly challenged by the counselor or by the counselor guiding Donna or Sal to challenge the beliefs themselves. This is illustrated with a session excerpt with Donna; her irrational beliefs are identified in italics.
Therapist: “Donna, I guess if you weren’t happy with Sal’s behavior you had no choice but to find someone else?”
Donna: “Of course I had a choice, but…”
Therapist: “Oh, so you had other options; can you give me an idea what some were?”
Donna: “I guess I could have told Sal that I was unhappy.”
Therapist: “But you were unable to do this?”
Donna: “No, I could have. I could have spoken to him, but he made it too hard.”
Therapist: “I see. He made it too hard to talk to him; how did he do this?”
Donna: “Well, he’s not the type of man you can talk to; he also gave me the impression that he didn’t want to talk about things.”
Therapist: “So because you had this impression, you thought you needed to someone else?”
Donna: “I didn’t have to…. He just pushed me away and I needed to.”
Therapist: “You needed to have an affair?”
Donna: “I guess it’s something I wanted because he always turned me off with his macho behavior and his anger. I just didn’t think he was into me anymore.”
Therapist: “But it he wasn’t “into” you, why do you think he agreed to come to counseling? Didn’t that indicate that he cared to some degree?”
Donna: “Well, maybe he cares, but he’s very angry. He’s just so hard to deal with and I can’t stand it when he acts so macho and ignorant.”
Therapist: “It appears as if you could stand it during the early part of the relationship. Did he change so much that now you can’t bear it at all?”
Donna: “I guess I can bear it; I think we’ve both changed.”
In this session segment, Donna exhibited some irrational demands and low frustration tolerance. She was helped to see that although she still loved Sal, she had become less attracted to him and took the easy way out by finding another lover. Consequently, some of Sal’s actions that were either acceptable or even attractive had now become off-putting, resulting in more negative judgments from Donna towards Sal. When made aware of this, she realized that Sal’s change was largely based on her perceptions.
Helping Sal was considerably more problematic as he was very angry and ambivalent about continuing the relationship. In fact, he stated that he hated the fact that he still loved Donna. He felt trapped by a desire to stay with her and a vengeful anger. His anger alternately was directed at Donna and the man with whom she had strayed. The therapist initially focused on the pragmatics of staying with Donna and his children. He helped Sal challenge his irrational beliefs to the effect “I must hurt Donna or the man she cheated with or I am not a man. I absolutely cannot stay with Donna because a man who stays with an unfaithful wife is worthless. She must be punished and contrite or I would be a fool to stay with her.” Over several individual sessions Sal was helped to identify these demanding, irrational beliefs and was taught how to challenge them. At this writing Sal is still with Donna, but remains somewhat suspicious and bitter. The maintenance of the relationship requires some behavioral changes on both of their parts. Sal needs to become more attentive and less exaggeratedly masculine. Donna needs to be more attentive to Sal and reassure him that her infidelity does not negate her love for him. At this point the relationship is showing some gradual improvement.
Sexual intimacy in relationships is comprised of a complex interaction of ancient biological drives, unique personalities, and cultural forces. Treatment of couples with sexual problems must always begin with a cognizance of the range and complexity of the many expressions of sexuality. It is particularly important that the counselor eschew his or her own values of sexual propriety. Instead, the goal is to perform a differential evaluation of the couple’s unique approach to sexuality and the basis of its malfunction. It is also important to be cognizant of the fact that a couple consists of two unique individuals, each of whom may have very different values and desires than his or her partner. The counselor needs to explore how these differences initially coalesced and how they began to unfold. This understanding is best accomplished by eliciting the beliefs each partner has about him or herself, the partner, and relationships in general. When the demanding, rigid, in flexible, or other irrational beliefs are exposed, disputing them collaboratively offers the best hope for the couple with sexual and intimacy problems.
Many articles and books have been written which purport to show that psychoanalysis is an ineffective form of psychotherapy. Behavior therapists, existentialists, physical scientists, rational philosophers, Marxists, and many other kinds of thinkers have held that psychoanalytic therapy rests on unverified assumptions and that it is largely a waste of time. Relatively few critics, however, have objectively pointed out some of the actual harm that may occur if an individual enters classical psychoanalysis or even undergoes intensive psychoanalytic psychotherapy.
To give and to document all the main reasons why virtually any form of truly psychoanalytic therapy is frequently injurious to clients would take a sizable book; and someday I may write it. For the present, let me briefly and inadequately outline some ways in which analysis does more harm than good.
Probably the greatest harm that psychoanalysis does its tendency to sidetrack clients from what they had better do to improve and to give them a “good” excuse not to work hard at helping themselves. What disturbed people preferably should do is fairly simple (although it is not at all easy); namely, to understand precisely what are the self-defeating irrational ideas they firmly believe and to vigorously contradict them, both verbally and actively. Thus one of the main senseless notions they usually hold is, “Unless I am remarkably competent and popular, and unless I am superior to others, I am rather worthless as an individual.” They can strongly contradict this philosophy by asking themselves, ‘Why am I no good just because many of my performances are poor? Where is the evidence that I cannot accept myself if others do not like me? How is my self-acceptance really dependent on external criteria?” And they can actively work against their self-defeating attitudes by performing, even when they may not do very well; by risking social disapproval when they want to achieve a desired goal; and by experimenting with potentially enjoyable pursuits in spite of the possibilities of failure and rejection.
Psychoanalysis sidetracks health-seeking individuals verbally by encouraging them to concentrate on innumerable irrelevant events and ideas such as what happened during their early years, how they came to have an Oedipus complex, the pernicious influence of their unloving parents, what are the meanings of their dreams, how all-important are their relations with the analyst, how much they now unconsciously hate their mates, etc. These may all be interesting pieces of information about clients. But they not only do not reveal, they often seriously obscure, their basic irrational philosophies that originally caused, and that still instigate, their dysfunctional feelings and behaviors. Being mainly diagnostic and psychodynamic, analysis is practically allergic to philosophy, and therefore often never gets around to the basic ideological assumptions and value systems with which humans largely create their symptoms.
To make matters much worse, psychoanalysis is essentially a talky, passive, insight-seeking process which encourages clients mainly to lie on their spine or sit on their behinds in order to get better. Sensible unorthodox analysts frequently supplement this passive procedure by giving advice, directing the clients to do something and helping them change their environment etc. But they do so against psychoanalytic theory, which stoutly insists that they do otherwise. Meanwhile, the poor analysands, who probably have remained disturbed for most of their lives largely because they will not get off their asses and take risk after risk, are firmly encouraged, by the analytic procedure and by the non-directive behavior of the analyst, to continue their avoidant behavior. They now, moreover, have the excuse that they are “actively” trying to help themselves by being analyzed but this is of course a delusion if anything like classical procedures are being followed and they consequently tend to become more passive, and possibly even more disturbed than before.
Most clients are overly dependent individuals who are afraid to think and act for their selves and to risk being criticized for making mistakes. Psychoanalysis is usually a process that greatly fosters dependency. The sessions are often several times a week or they continue for a period of years. The analyst frequently forbids the clients to make any major changes in their life during treatment a positive transference between the analyst and analysand is usually encouraged. The clients are constantly brainwashed into accepting analytic interpretations, even when they seem to have a far-fetched relationship to the facts of their lives and in analytic group therapy. A family-like setting is often deliberately fostered and maintained, while many forms of therapy also abet the client’s being dependent on the therapist. Classical analysis is surely one of the worst and psychoanalytically-oriented psychotherapy one of the second-worst modes, in this respect. Several activity-directed forms of therapy, on the other hand — such as assertiveness training therapy, rational emotive behavior therapy and structured therapy — urge clients as soon as feasible into independent action and teach them how to think clearly for themselves.
Because it heavily emphasizes free association, dream analysis, the involvement of the client, therapist in transference, counter-transference relations and psychoanalysis inevitably puts a premium on the expression of feelings rather than the changing of these feelings and the self-defeating philosophies behind them. A good deal of the improvement in analytic therapy seems to come from clients’ feeling better, as a result of catharsis and abreaction, and because they believe that the analyst really understands and likes them. This tendency of clients to “feel better,” however, frequently sabotages their potentiality to “get better.”
Thus, the analysand who is terribly depressed about his being refused a job and who gets these feelings off his chest in an individual or a group session will often come away relieved and feel that at least his analyst (or the group) heard him out that someone really cares for him and that maybe he’s not such a worthless slob after all. Unfortunately, in getting himself to “feel good,” he forgets to inquire about the self-defeating beliefs he told himself that maintain his depression. Namely, “If this employer who interviewed me today doesn’t like me, probably no employer will hire me and if I can’t get a very good job like this one, that proves that I’m incompetent and that I don’t really deserve anything good in life.” The expressive, cathartic-abreactive method that is such a common part of analysis doesn’t encourage this client to stop and think about his philosophic premises; instead, it enables him to “feel good” — at least momentarily — in spite of the fact that he strongly retains these same premises and in spite of the fact that he will almost certainly depress himself because of his holding them again and again.
In the expression of hostility that psychoanalysis encourages, the situation is even worse. Starting with the assumption that it is bad for the client to feel hostile and to hold in her hostile feelings — which is a fairly sensible assumption, since there is empirical evidence to support it — psychoanalysts usually derive from this view another and rather false assumption that the expression of hostile feelings will release and cure basic hostility. Nothing of the sort is probably true; in fact just the opposite frequently happens. The individual who, in analytic sessions is encouraged to express her hatred for her mother, husband or boss may well end up by becoming still more hostile, acting in an overtly nasty fashion to this other person, engendering return hostility and then becoming still more irate.
Expression of hostility is one of the best psychological cop-outs. By convincing herself that other people are awful and that they deserve to be hated, the client can easily ignore her own maladaptive behavior and self-loathing and can nicely avoid doing anything to look into her own heart and to change her irrational thinking and her dysfunctional feelings and acts. One of the main functions of an effective therapist is to help the client minimize or eliminate her hostility (while keeping her dislike of unfortunate events and nasty people, so that she can do something to solve her problems connected with them). Psychoanalysis, because it falsely believes that present hostility stems from past occurrences (rather than largely from the individual’s philosophic attitude toward and consequent interpretations about those occurrences) has almost no method of getting at the main sources of hatred and eradicating them. By failing to show the client how to change her anger-creating views and by encouraging her to become more hostile in many instances, it tends to harm probably the majority of analytic clients (or should we say victims?).
The main reasons why many human beings feel sufficiently disturbed to come for therapy are their misleading beliefs that they need the love and approval of others, that they can’t possibly be happy at all when they are alone, and that unless they are successful they are no damned good. Because psychoanalysis is essentially non-philosophic and because it does not show clients how to distinguish clearly between their wanting and their needing to be approved and successful, most analysands wind up at best by becoming better adapted to the popularity and achievement demanding culture in which they live rather than becoming persons in their own right who give themselves permission to think and to enjoy themselves in uncomforting ways. Psychoanalysis basically teaches the client, “Since your parents were overly-critical and therefore made you hate yourself and since you are able to see that your analyst uncritically accepts you in spite of your poor behavior, you can now accept yourself.” And also: “Since you have been achieving on a low level because you were afraid to compete with your father or your brother and I have helped you gain insight into this reason for your doing poorly you can now compete successfully with practically anyone and make the million dollars you always wanted to make.”
What psychoanalysis fails to teach the individual is: “You can always unqualifiedly accept yourself even if your analyst does not particularly like you because your value to yourself rests on your existence, on your being and not on how much anyone approves you.” And: “There are several reasons why succeeding at vocational or avocational activities is usually advantageous; but you don’t have to be outstanding, ultra successful or noble in order to accept yourself” because analysis is largely concerned with historical events in people’s lives rather than their ideological reactions to these events. It encourages passivity and dependency and it over-emphasizes the personal relationship between the analyst and analysand — for these and other reasons it often encourages clients to be more successful conformers rather than evergrowing, courageously experimenting and relatively culture-free persons. The analyst himself, rigidly-bound as he often is by the orthodox rules of the therapeutic game he is playing and selfcondemned by following these rules to be a non-assertive, undaring individual himself, tends to set a bad example for the client and to encourage her or him to be a reactor rather than an actor in the drama that we call life.
Clients’ basic problems often stem from assuming irrational premises and making illogical deductions from these premises. If they are to be helped with their basic disturbance, they had better learn to question their assumptions and think more logically and discriminate more clearly about the various things that happen to them and the attitudes they take toward these happenings. In particular, they’d better realize that their preferences or desires are not truly needs or demands and that just because it would be better if something occurred, there is no reason why it absolutely should, ought, or must occur.
Instead of helping clients with this kind of realistic and logical analysis, psychoanalysis provides them with many unverified premises and irrationalities of its own. It usually insists that they must be disturbed because of past events in their lives that they need to be loved and have to become angry when thwarted, that they must have years of intensive analysis in order to change significantly, that they must get into and finally work through an intense transference relationship with their analyst etc. All these assumptions — as is the case with most psychoanalytic hypotheses are either dubious or false and analysands are given additional irrationalities to cope with over and above their handicapping crooked thinking with which they come to therapy. In innumerable instances, they become so obsessed with their analytic nonsense that psychoanalysis becomes their religious creed and their be-all and end-all for existing and though it may somewhat divert them from the nonsense with which they first came to therapy, it does not really eliminate it but at best covers it up with this new psychoanalytic mode of ‘positive thinking.” Rather than becoming less suggestible and more of a critical thinker through analysis, they frequently become worse in these respects.
When clients come for psychoanalysis, they are usually reasonably young and have considerable potential for achieving mental health even though they are now disturbed. Psychoanalysis, particularly in its classical modes is such a long-winded, time-consuming and expensive process that it often takes many of the best years of clients’ lives and prevents them from using these years productively. To make matters much worse, analytic therapy leads in most instances to such abysmally poor results that analysands are often highly discouraged, are convinced that practically all the time and money they spent for analysis is wasted that there is no possibility of their ever changing and that they’d better avoid all other types of psychotherapy for the rest of their lives and adjust themselves as best they may to live with their disturbances. An untold number of ex-analysands have become utterly disillusioned with all psychological treatment because they wrongly believe that psychoanalysis is psychotherapy and that if they received such poor results from being analyzed nothing else could possible work for them. If the facts in this regard could ever be known, it is likely to be found that analysis harms more people in this way than in any of the other many ways in which it is deleterious. The number of people in the United States alone who feel that they cannot afford any more therapy because they fruitlessly spent many thousands of dollars in psychoanalysis is probably considerable.
The two main functions of psychotherapy when it is sanely done are:
Instead of these two goals, psychoanalysis largely follows a third one:
Humans in contradistinction to the analytic assumptions do not usually modify their basic thoughts and behaviors by insight into their past by relating to a therapist or even by understanding their present irrational assumptions and conflicting value systems. They change mainly by work and effort. They consequently had better be helped to use their insights — which usually means to concretely understand what they are believing and assuming right now in the present and to actively challenge and question these self-defeating beliefs and assumptions until they finally change them. They also had better be helped to act, to experiment, to accept discomforts and to force themselves to do many things of which they are irrationally afraid, so that their actions effectively depropagandize them to give up their dysfunctional beliefs.
Psychoanalytic therapy, instead of devoting much time to encouraging and teaching clients to dispute and act against their self-defeating thoughts, feelings and behaviors, takes them up the garden path into all kinds of irrelevant (though sometimes accurate) in-sights which gives them a lovely excuse to cop Out from doing the work, the practice, the effort and the self-deprivation by which alone they are likely truly to change their basic self-sabotaging philosophies of life. Even if it were a good method of psychological analysis (which it actually is not), it is an execrable method of synthesis. It does not notably help people make themselves whole again and it particularly does not show them how to live more fulfilling when they have, to some degree, stopped needlessly upsetting themselves. Because it implicitly and explicitly encourages people to remain pretty much the way they are though perhaps to get a better understanding of themselves (and often to construct better defenses so that they can live more efficiently with their irrational assumptions about themselves and others), it frequently does more harm by stopping them from really making a concerted attack on their fundamental disturbances than the good that well might come to them if they received a non-analytic form of psychotherapy or even if they resolutely tried to help themselves by reading, talking to others and by doing some hard thinking.
Psychoanalysis in general and classical analysis in particular are mistaken in their assumptions about why human beings become emotionally disturbed and what can and should be done to help them become less anxious and hostile. Consequently, analytic therapy largely wastes considerable time teaching clients often-mistaken theories about themselves and others. Although these theories are frequently highly interesting and diverting, they at best may help the client to feel better rather than to get better.
The one thing that analysis usually insures is that analysands will not understand the philosophic core of their disturbance-creating tendencies and consequently will not work and practice in both a verbal-theoretical and active-motor way to change their basic assumptions about themselves and the world and thereby ameliorate their symptoms and make themselves less disturb. Although ostensibly an intensive and ultra-depth-centered form of psychotherapy, analysis is actually an exceptionally superficial palliative form of treatment. Because it deludes clients that they are truly getting better by following its rules and because it dissuades them from doing the difficult reorganizing of their underlying philosophical assumptions, psychoanalysis usually (though, of course, not always) does more harm than good and is contraindicated in the majority of instances in which it is actually used.
My rather biased opinion is that analysts frequently help people by sneaking non-analytic or antianalytic forms of treatment into their “psychoanalysis.” But the closer they stick to truly psychoanalytic theory and practice, the more harm they tend to do.
Is there nothing good that can be learned and used from psychoanalysis? No; several aspects of analysis can be used by effective therapists, and especially Rational Emotive Behavior and Cognitive Behavior practitioners who want to help their clients – as I show in my recent book, Overcoming Resistance: A Rational Emotive Behavior Therapy Integrative Approach.
Thus, you can ignore many of the psychoanalytic theories and practices but still follow other analytic procedures such as:
In this manner, your using some selected psychoanalytic concepts may at times be useful. But eating the whole psychoanalytic hog may give you acute indigestion!
Albert Ellis, Ph.D., founder of the Albert Ellis Institute in New York City, practiced psychotherapy and marriage and family counseling for over 60 years before his death at age 93 in 2007. He was a Fellow and officer of the American Psychological Association and several other professional associations and he won many scientific and social service awards. He published over 700 articles and more than 72 books including Reason and Emotion in Psychotherapy, A Guide to Rational Living, The Practice of Rational-Emotive Therapy, and Feeling Better, Getting Better and Staying Better.
Why Our Compulsive Drive for “Self-Esteem” Is Anxiety-Provoking, Socially Inhibiting and Self-Sabotaging.
by David Mills with an afterword by Albert Ellis, Ph.D.
Twenty years ago when a person complained of depression or unhappiness helpful friends or therapists might have offered the following counsel:
“Don’t dwell on your own misfortune. Try instead to become creatively absorbed in outside interests and external activities. Stop obsessively contemplating your own navel. Develop rewarding interpersonal relationships. Get your mind off yourself. If you merely focus attention elsewhere, your self-centered emotional problems will die of neglect.”
Today, however the same individual suffering the same depression or unhappiness would likely hear radically different and quite contradictory suggestions and guidance such as this:
“Stop worrying about other people. Try instead to build up your own sense of self-worth. Take pride in yourself! Work toward elevating your own self-respect and enhancing your self-image. Your feelings of unhappiness and depression will surely evaporate if you only esteem yourself more highly!”
Clearly something has changed in the kind of popular advice being given to the forlorn. Instead of espousing that mental health be realized through more objective appraisal of the external world we now seem preoccupied with the wholly internal effort to elevate our own self-appraisal or “self-worth.” Forget our former effort to perceive the universe objectively; today we simply want to feel good about ourselves. It has become increasingly irrelevant whether or not an individual’s critical reasoning accurately map external reality. All that matters it seems is his or her internal self-image.
Because of this shift in popular emphasis from external preoccupation to internal self contemplation, we find our libraries and bookstores stacked with radically different self-help texts from those published a few decades ago. Each new volume proclaims a “breakthrough technique” or “revolutionary method” for conquering our ever-present doubts about our “true” value. Best-selling books such as I’m OK You’re OK, have sought to instill within the doubtful individual a belief that although he may not be perfect he is at least okay and can thus bestow upon himself a modest allotment of self-respect and happiness.
Yet despite the wide distribution of such popular texts and despite our tireless efforts to build within ourselves and our children a sense of self-worth, it seems that the average person today is as confused as ever (perhaps more so!) about her so-called “self-worth.”
Our lofty sermons deifying self-esteem have produced few if any tangible results. In practical terms, the average person doesn’t know what to believe about her “self” nor how she is supposed to establish such a “positive self-image.” The entire concept of “personal worth” has become hopelessly ill-defined and philosophically empty.
It is my contention that the promotion of “self-esteem” has done demonstrably more harm than good, and that the prudent individual will resist the arrogant and childish temptation to “esteem himself.” Put another way we shall learn in this article why an individual would enjoy increased emotional stability and contentment and suffer far less anxiety and inhibition by abandoning his drive for self-esteem.
Unfortunately, the entire discussion in many psychological circles has now focused on how best to teach self-esteem, rather than on whether self-valuation or self-rating is emotionally healthy. Our blind devotion to self-esteem has become a virtual religion a religion in which the worshiper and the worshiped are the same individual! The nobility of self-esteem has become a sacred, unchallenged article of faith. And just as the non-Christian is perceived as immoral by the fundamentalist believer, so too the proposal to abandon self-esteem must appear a dangerous and obscene heresy to those preaching the self-esteeming gospel.
We tend to ascribe many of our social maladies, such as drug abuse to a lack of self-esteem among teenagers. Criminals we say have little self-respect; otherwise they would not behave as they do. Religious institutions especially have proposed an inextricable link between morality and self-respect: a person without self-respect is thought to be a person without ethical standards. It is popularly believed that the poor the downtrodden and the homeless individual put herself in her sorry condition through a lack of self-pride. “Pride goes before a fall.” We harbor no doubt that a fallen person, completely unaided, can pick herself up by the bootstraps if she only regains her self-esteem
Dale Carnegie, the genius of human relations observed over fifty years ago that each person craves a “feeling of importance” and longs to be recognized praised and appreciated by his peers. Freud himself proposed that virtually all human behavior can be traced ultimately to two basic instincts: the sex drive, and the “desire to be great.” The contemporary psychotherapist, Nathaniel Branden along with his mentor the late philosopher, Ayn Rand hammers home one point repeatedly: that the “psychology of self-esteem” is indispensable to an individual’s intellectual growth and overall psychological well-being.
Why then would we want to abandon self-esteem? Isn’t such an idea fundamentally flawed, if not downright immoral? Wouldn’t society soon wither and decay if such a twisted suggestion were adopted? How could a person conceivably enjoy his life without some measure of self-esteem?
Let’s begin with a precise definition of terms. When we say that an individual has self-esteem or self-respect, self-love, self-admiration or self-worth we do not mean that he values himself without any proposed justification. People do tend to view themselves positively for a reason the basis for which is usually that they perceive correctly or incorrectly that they possess admirable personal traits (e.g. high intelligence, creative talent, physical attractiveness) or have accomplished some outstanding personal achievement (e.g. graduated from medical school, married well, landed a prestigious job). Self-esteem, it appears, is conditional; it comes through perceived individual accomplishment or through supposed possession of desirable personal characteristics.
A businessman may enjoy self-esteem because from his viewpoint he is professionally successful and treats his family well. A teenage girl boasts self-esteem because she earned straight A’s on her report card and made the varsity cheerleading squad. A politician may feel self-esteem because she won a lopsided victory in the last election and sponsored a popular congressional bill to help her constituents. Nearly always, people rate or esteem themselves on the basis of certain achievements.
Not only do most individuals believe that self-esteem must be earned, but also that it must be reinforced repeatedly and tirelessly if it is to survive within their psychological framework. As an illustration think for a moment about your own personal achievements. Select three lifetime accomplishments of which you are most proud. Take ample time; give this question careful reflection before continuing.
Now after recalling your three most celebrated successes, ask yourself this question: “How long did I esteem myself following each of these achievements?” Your probable answer is “Not very long.”
Regardless of how magnificent our performance at any specific endeavor our feelings of increased self-worth following such an accomplishment are almost invariably short-lived. No feat of bravery, act of heroism or display of superior intellectual acumen will bless the individual with permanent self-esteem. He must savor the moment: for soon his expanded ego will deflate and, once again, he will feel driven to prove himself worthy of life and happiness.
A majority of people seem to believe that if they could gloriously achieve X or Y in their lifetime such an accomplishment would forever rid them of intermittent feelings of inadequacy. They might aspire to be chief executive officer of their corporation. They might envision themselves discovering a cure for cancer. Or they might fantasize about marrying a highly desirable person of the opposite sex. But whatever the objective it is folly to believe that this “ultimate” triumph will provide more than a temporary, fleeting sensation of self-esteem.
It is no surprise, for example, that many long-retired boxers feel compelled to reenter the spotlight (e.g., Mohammed Ali, Joe Frazier, George Foreman, and Sugar Ray Leonard). Financial compensation however important was not the primary motivation inspiring their return to the ring. These champions sought to resurrect within themselves that former feeling of self-pride, which came through defeating a weaker opponent and through being the focus of public adoration. Not only the champion boxer, but many of us find it disheartening or even depressing when forced to retire from a job, the performance of which is integral to our self-esteem.
Presidents Nixon, Ford, Carter and Reagan all disclosed in their respective memoirs that even becoming President of the United States soon became a routine often boring affair. All four Presidents wrote that despite being at the pinnacle of power they sometimes lacked full confidence in their executive decisions and as a result suffered occasional feelings of insecurity and self-doubt.
So even famous and powerful individuals become discontent quickly if future goals are not continually established pursued and realized. Accomplishing X or Y, even when X or Y literally means winning the U.S. Presidency will provide only a temporary emotional glow. President Nixon in fact described his disillusionment when on the night of his 1972 re-election landslide he inexplicably felt no pleasure or emotional excitement of any kind. By 1972, Nixon had already been President for four years and no longer derived self-esteem merely through being chief executive.
Famous individuals whether they are politicians, movie stars, athletes or whatever, do not permanently feel their fame in the way imagined by the factory worker or the housewife. Even the Queen of England would probably soon feel despondent if separated from relationships and challenging activities essential to her self-esteem. Likewise for us commoners.
When people base their self-esteem on specific behaviors or accomplishments they must constantly strive for and perpetually achieve new goals if their ego intoxication is to continue.
If self-esteem is realized through the successful completion of a particular task or goal and if additional achievement must be eternally forthcoming then it follows logically that all of us mortal human beings live in constant peril of losing our self-esteem: for at any moment we may fail to perform adequately our exalted task. Worse yet we may neglect to maintain those character traits or the desired physical appearance which we have so thoroughly incorporated into our personal tabulation of self-worth.
The football player esteeming himself for his athletic ability feels humiliated and self-loathing after repeatedly fumbling the ball. The college professor priding herself on her eloquence in public debate feels disgraced when her opponent’s arguments are clearly superior to her own. The teenage boy, deriving self-esteem exclusively through his girlfriend’s adoration, suffers the tortures of the damned when rejected by his beloved.
It appears that the only theoretical means by which an individual could enjoy consistent self-esteem would be for him to become incapable of failure. He would in addition, have to live in an environment where disappointment is impossible. He must in other words transcend his mortal limitations and become a godlike being immune from innate human fallibility, and possessing virtual omniscience and omnipotence. He must reside in some kind of heaven, where no rejection or behavioral inadequacies can occur. Otherwise his fragile self-esteem is vulnerable to human failure and weakness and to the terrestrial terrors impinging upon him from without.
Dr. Albert Ellis the innovative creator of Rational-Emotive Behavior Therapy (REBT) has suggested that “self-esteem” is simply a manifestation of what he calls a “Jehovah complex.” According to Ellis a person may observe that she has performed a certain task well or that she possesses some desirable character trait; and these self-perceptions may be quite realistic and accurate. But the “Jehovah complex” rears its grandiose head when the individual follows up her flattering conclusions with an arrogant non sequitur or “magical leap” in her thinking. Instead of believing (accurately) that she is simply a person whose performance excelled or whose traits are commendable she will globally rate herself as a superior person. She sees no distinction whatever between herself and her behavior; to her, they are one and the same. If her performance is good, then she becomes good. Since her achievement was superior she considers herself a superior, godlike individual far above the lowly slobs she defeated. She will, for a time, revel in self-esteem and feel much happier than if she concluded merely that her external behavior was superior.
Unfortunately for the individual who is globally rating her entire worth on the basis of the behavior, her self-esteem will not be sustained for long. The person, who feels noble and godlike today for succeeding will feel equally hellish and self-despising tomorrow for the slightest failure. Her entire self-perceived “value” as a human being is determined by satisfying some external goal and when she fails to achieve this majestic external goal (as she invariably will do from time to time) her life seems worthless and pointless to her.
The successful individual concluded not only that she performed well, but also that she was transformed thereby into a superior human being. Likewise the individual failing to achieve her goal may conclude not only that her performance was inadequate, but also that she herself is a failure as a human being. Instead of feeling moderately disappointed that she failed at her task she feels utterly devastated that she is an “inferior” person. Sooner or later the self-esteeming individual will pay the price for making her self-worth contingent upon outstanding achievement. Metaphorically at least the universe will serve justice upon the sin of pride.
There is a curious theory circulating that self-rating and striving for “self-respect” encourage moral behavior; and that unless a person condemns his entire self for any immoral acts, he soon becomes decadent. In fact, however a person’s “self-respect” far from promoting ethical standards may actually predispose the offending individual to deny the immorality of his acts: for example the preschooler he beat “learned a good lesson.” The cab driver he murdered “deserved to die.” The coed he raped “enjoyed it.” The convenience store he robbed “didn’t need the money.”
To preserve his own “self-respect” even the most heinous criminal can quickly rationalize excuses for his deplorable conduct. A philosophy of self-esteem therefore does not guarantee moral behavior. On the contrary, self-rating often encourages the individual to redefine morality in self-serving ways, to guarantee the survival of his self-respect.
The opposite of self-esteem is not self-hatred. In actuality, self-esteem and self-hatred are twin incarnations of the same underlying philosophy: that one must appraise himself in relation to his achievements. Self-esteem and self-hatred therefore are two sides of the same self-appraising coin. If you view yourself as exalted and lordly for your successes, then you will automatically view yourself as paltry and worthless when failing. It is a package deal: you cannot enjoy self-worship without very soon suffering self-damnation. The tacit logic upholding your self-esteem can just as easily document your abject worthlessness. The individual who lusts after self-esteem will forever ride an unstable emotional roller coaster, up and down, up and down. He may indeed soar quickly to great heights. But he will inevitably sink rapidly into the depths of despair and dejection, because it is a single philosophy, his philosophy of contingent self-rating that produces both his positive and his negative self-image.
Even if we grant that a compulsion for self-esteem occasionally produces adverse side effects doesn’t the average individual still derive much more benefit than harm from pursuing a positive self-image? Isn’t the small price worth paying?
The short answer to this question is no: the price usually is not worth paying. The expense we incur for esteeming ourselves is by no means limited to feelings of humiliation when we fail at something. If that were the case (that is if the only unpleasant consequence of self-esteem were an occasional feeling of disgrace when failing), then one could legitimately argue that self-esteem often benefits individuals who are exceptionally successful, attractive, or talented. Artistic individuals we say are motivated by pride in their creative projects. If a person paints a breathtaking masterpiece or writes a poignant novel, then surely she will esteem herself; and it is this sought-for feeling of glorification and achievement that seems to inspire many creative pursuits.
To a limited extent, the drive for self-esteem probably does spur some individuals to productive and creative activity. This reality, in fact, seems to be a popular “selling point” for self-esteem. Unfortunately, however instead of stimulating genius and creativity, the theology of self-esteem more often results in severe behavioral inhibition and debilitating anxiety. With his entire self-worth at stake, the average individual will desperately avoid all “dangerous” situations in which his self-esteem is perceived to be at risk.
Take, for example, the average-looking, average-intelligence single male, who feels romantically and sexually attracted to a woman of extraordinary brilliance. This gentleman may fantasize vividly about dating or marrying such a desirable woman and his self-esteem would no doubt be temporarily elevated if his fantasies were realized. But this man’s self-rating philosophy (i.e., his belief that self-worth flows from success) virtually guarantees that he will never befriend the woman he considers most desirable. Why? Because his precious self-esteem would be destroyed if he were rejected openly by such an accomplished female. He cannot risk the “danger.” He will play it safe, asking out a less intelligent woman. This way, the likelihood of rejection will decline and the threat to his self-esteem will diminish.
This single male’s ego therefore inhibited rather than abetted his search for cultured female companionship. If he simply forgot the “danger” to his pride (which of course is completely in his head and represents no actual danger in the empirical world) then he could telephone the woman he strongly desires and might indeed make her acquaintance. Should she rebuff his advances, he would naturally feel disappointed but because his entire value as a human being is not in jeopardy he would not feel ashamed or humiliated.
When a person views herself as “worthless” and feels humiliated, she is then inclined to view herself as incapable of correcting her poor performances. She will then tend to give up and to rationalize her withdrawal from outside activities or interpersonal relationships. After all she reasons how could a worthless bum such as I succeed at anything truly significant? On the other hand if an individual views her current behavior rather than herself as deficient, she will likely have the view that “through more practice and effort, I may in the future rectify my previously deficient behavior.”
Pause to ask yourself this question: Does your long nose or your poor complexion really prevent you from asking out potentially desirable partners? Or rather is it your fear of ego-deflation that deters you from asking? It would be beneficial for women especially to give careful thought to similar questions because in our silly society it is still considered more “risky” for a woman to ask out a man than vice versa.
Likewise our “self-esteem” inhibits us from participating in any activity in which failure is deemed disgraceful. And because failure in virtually any endeavor is deemed disgraceful by the self-esteeming individual, he becomes distinctly afraid to try anything unfamiliar. He passively goes through life doing what he’s always done, rarely involving himself in enterprises and human relationships whose success is not guaranteed in advance. Far from inspiring productive behavior and social interaction, the concept of self-esteem is the most inhibiting philosophy imaginable. That “most men lead lives of quiet desperation” can perhaps be traced to our chilling fear of losing self-esteem and to our resulting tendency toward a mundane routine “safe” existence.
I don’t mean to suggest that a philosophy of self-esteem inevitably leads to passive behavior; for clearly such an assertion would be absurd. Even the most timid person occasionally throws caution to the wind and accepts the challenge of new adventure. Tragically however this person’s actual enjoyment of her bold adventure will usually be minimal. Her anxieties moreover will often be intense, for she still believes devoutly that her entire value as a human being depends upon her success at this new activity or relationship. And with so much at stake (i.e. her entire worth as a person), she cannot possibly enjoy the intrinsic pleasures of the moment. She lives in constant terror of “making a fool out of herself.”
Returning to our previous illustration: The average-looking average-intelligence bachelor may indeed build up enough courage to telephone the beautiful and brilliant woman. But he will clutch the telephone nervously as he dials. His hands and forehead will sweat profusely as her number rings. And his heart will palpitate uncontrollably as she picks up the receiver. Regardless of how smoothly the conversation flows he will derive little intrinsic pleasure from the experience, because he fears that at any moment he might say the wrong thing and his self-esteem would surely die a tortured death.
Perversely an individual’s self-esteem-related anxiety usually hinder, rather than enhances her progress toward her chosen goal the goal which ironically she seeks to accomplish in order to merit self-esteem! So she thoroughly defeats herself by maintaining this silly ego-bolstering philosophy. Her anxieties sabotage her objectives, because she concentrates principally on how she is doing, rather than on what she is doing. Her drive for self-esteem can be described accurately as a built-in self-destruct mechanism.
The male with erectile difficulties for example often creates for himself the specific sexual dysfunction he seeks to avoid so desperately. Instead of focusing in bed on his female partner and thereby becoming sexually aroused he obsessively monitors his own body for signs of potency. He must demonstrate his “manliness”; he must prove himself “worthy.” He does not pleasurably concentrate his thinking on sexually exciting images; instead, he literally terrifies himself with exaggerated visions of sexual failure and the resulting insufferable humiliation. His drive for self-esteem therefore is an impediment rather than an asset in bed. If this individual stopped distracting himself with meaningless self-rating tabulations he might find it considerably easier to focus attention on his girlfriend and thereby become satisfyingly aroused. But because of his ego centered fixation his thoughts will converge only on himself and his holy self-esteem.
The inexperienced public speaker also suffers self-esteem-related anxieties. She imagines herself becoming tongue-tied or failing to recall her memorized text. She sees ghastly images of the audience laughing at her and ridiculing her dismal performance. She foresees her face becoming red and her voice quivering. She thus concentrates not on the content of her speech, but on the need to preserve her self-esteem by avoiding such embarrassments. She suffers anxiety because her self-esteem is in danger of being lost. And this same disquieting anxiety will render almost impossible a smooth professional delivery of her speech.
We now find ourselves boxed in completely. If our self-worth depends upon external achievement, then naturally we believe that we must achieve. But if we must achieve, then our anxiety becomes so distressing and burdensome that we often withdraw from the activities and relationships that we might enjoy the most. We withdraw in dreadful fear of an ego-crushing failure or rejection. If however we do not withdraw our self-esteem related anxiety often makes our behavior inept and our social relations inelegant; and when we perceive these behaviors and relationships to be faltering, we bestow upon ourselves not self-esteem but self-damnation. The self-damnation, in turn, makes us feel unworthy and incapable of future success. And since we are “therefore” incapable of ever achieving our chosen goal, we lose hope and withdraw once again from a potentiall enjoyable part of living.
Quite a pickle indeed! But can we somehow escape our boxed-in predicament? Is there an alternative to this self-defeating philosophy?
Yes! We can help ourselves immeasurably toward greater happiness and emotional stability. We can fairly rapidly overcome our needless anxieties, while profoundly enriching our enjoyment of life. We can conquer our social and behavioral inhibitions with surprisingly meager effort. Yes, we can indeed annihilate our self-sabotaging philosophy but only if we are willing to pay the price. That is the all-important point so I’m going to say it twice. We definitely can prevail over anxiety and inhibition, but only if we are willing to make a sacrifice: surrendering our compulsive drive for self-esteem. There is no other way to help ourselves in this regard.
We are easily misled however. We simplemindedly think that we can get something for nothing: that somewhere there is a Garden of Eden where bountiful fruit may be harvested without corresponding work or sacrifice. Through the physical sciences, we learn that energy cannot be created out of nothing. In economic theory we know there is no “free lunch.” It is therefore somewhat naive to propose that genuine emotional or psychological benefit may be realized without some expenditure of work or sacrifice. In my opinion this is why the “positive self-image” manuals usually fail to help the reader.
These books claim to remedy self-condemnation without extracting the corresponding sacrifice of self-esteem. The reader in other words is promised something for nothing.
Since an individual temporarily enjoys an exhilarating euphoria when “esteeming himself,” he may understandably be reluctant to sacrifice this intoxicating, positive self-image. On the other hand, he will probably be quite eager to rid himself as quickly as possible of inhibition anxiety and feelings of self-deprecation when he fails or is rejected. He must therefore make a choice: His choice however is not a choice between self-esteem and self-condemnation, for both attitudes are inseparable manifestations of the same self-rating philosophy. Rather his choice is whether he will (or will not) rate himself at all positively or negatively. He must choose between having a self-image and having no self-image.
Instead of labeling herself as honorable or as foolish an individual can more accurately and specifically rate the efficiency or inefficiency of her external actions, a subtle yet critical difference in perception. Instead of speculating emptily that she is intrinsically noble or that she is intrinsically worthless she can more scientifically view her outside behavior as advantageous or as disadvantageous to her chosen goals. She can in other words refuse to entertain any self-image. She can restrict herself to observing and evaluating the empirical universe, of which her behavior is a part, and forget about inventing and perpetuating any kind of self-image, which exists only as an egocentric vapor in her head. There is no law of science nor of psychology that requires an individual habitually to calculate her “self-value.” She does not have to continually monitor her “worth.” She can simply refuse to go along with the anxious inhibited self-appraising crowd.
Let us go back to our illustration of the average-looking average-intelligence male attracted to the brilliant and accomplished female. So long as he abstains from consciously rating himself he can pursue the relationship even though success is far from guaranteed. If he is rejected then his “ego” suffers no agony, though his romantic and sexual desires will of course be frustrated. If on the contrary he does consciously rate himself as a human being, then a rejection will be viewed as painful humiliation and as incontrovertible evidence of his essential worthlessness.
So, remember Key Point #6: To overcome self-esteem-related anxiety and inhibition, recognize that your choice is not between self-esteem and self-condemnation. Your choice, rather, is between establishing an overall self-image and establishing no self-image. That is, you can choose to view your external actions and traits as desirable or undesirable, but abstain from esteeming or damning yourself as a whole.
In practice, the average person appears to spend only a scant few moments each day consciously tabulating her “self-worth” (though these brief periods of self-appraisal are quite sufficient to establish and reinforce an overall psychological inclination toward self-rating.) She spends most of her hours however observing her external environment and trying to do something interesting or productive within that environment. If, then, she already spends most of her time not contemplating her self-worth, why can she not, through resolution and industry, eliminate virtually all of her self-rating? The answer of course is that she can eliminate her self-rating once she recognizes that such an absence of self-image is possible and is, in fact, preferable to her frequent anxiety and inhibition.
Other members of the animal kingdom do not seem to ruminate much over their “self-worth.” One rarely sees a self-esteeming alligator or a self-despising kangaroo. Animals other than man seem completely content as egoless creatures, simply observing the outside world. They seem entirely free from the anxieties and hang-ups suffered so often by their self-centered human cousins.
It may be convincingly argued that other animals are intellectually inferior to man and thus possess no capacity for self-esteem. Perhaps so, but the “dumb” animals also possess no capacity for astrology, for superstition, nor for bigotry. Neither do the “inferior” animals devote themselves fanatically to a crackpot religion. So it is amply apparent that the superior human intellect often invents and adheres to unhealthy philosophical systems. It is just possible that the philosophy of self-esteem fits neatly and properly into that category.
David Mills is author of the book Science Shams & Bible Bloopers, available onAmazon.com. David claims to have no self-esteem whatever. His office is located at 2236 Washington Avenue, Huntington, West Virginia 25704. You may email David at millsdavid@hotmail.com.
I am delighted that David Mills has taken off from some of my main ideas about human worth and self-esteem and has written this important essay. If people follow the views that he has presented, I cannot give them a guarantee but can give them a high degree of probability that they will make themselves less anxious and, as he shows, more achieving. Even if they achieve little during their lives, they will enable themselves to live more peacefully and happily with themselves and others. Again, in all probability!
However the solution to the problem of self-worth that David Mills gives –rating only one’s deeds, acts and performances and not one’s self being or essence — is what I call the elegant solution. Because most humans seem to be born with a strong tendency to make misleading global evaluations of their “self” as well as to make fairly accurate specific evaluations of their performances, I have found clinically that my rational emotive behavior therapy (REBT) clients often have great difficulty in not rating their self and in only rating their thoughts, feelings, and behaviors in regard to the results they achieve by creating and engaging in these responses. I therefore teach most of them the “elegant” philosophic solution that David Mills has beautifully outlined; but I also give them the choice of “inelegant” or practical solution to their self-concept. Thus somewhere during the first few sessions of REBT I say something like this to my clients:
“You very likely were born and reared with both self-actualizing and self-defeating tendencies and you can use the former to overcome the latter. Self-actualizing, you are born to think, to think about your thinking and to think about thinking about your thinking. Consequently whenever you defeat yourself, you can observe your conduct, think differently and free yourself to change your feelings and your habits. But it’s not easy and you’d better keep working at it!
“Perhaps your main self-helping tendency is to sanely rate or evaluate what you do – this is whether your acts are ‘good’ and helpful or ‘bad’ and unhelpful. Without measuring your feelings and acts, you would not repeat the ‘good’ and not change the ‘bad’ ones. Unfortunately, however, you are also biologically and socially predisposed to rate yourself, your being, your essence as ‘good’ or ‘bad’ and by using these global ratings to get yourself into trouble. For you are not what you do as general semanticist Alfred Korzybski pointed out in 1933. You are a person who does millions of acts during your life — some ‘good’ and some ‘bad’ and some ‘indifferent.’
As a person, you are too complex and many-sided to rate yourself (or rate any other pluralistic human) and to do so totally, globally, or generally. When you make this kind of global rating of your ‘youngest’ you end up as a ‘good person’ and presumably better than other people and that is a grandiose godlike view. Or more frequently because you are indubitably fallible and imperfect you view yourself as a “bad person” presumably undeserving worthless and incapable of changing your behaviors and of doing better. So self rating leads to deification or devil-ification. Watch it! And go back to only measuring what you do and not what you supposedly are.
“I, however you have difficulty refusing to rate yourself, your being, you can arbitrarily convince yourself, ‘I am “good” or “okay” because I exist, because I am alive, because I am human.’ This is not an elegant solution to a problem of self-worth, because I (or anyone else) could reply, ‘But I think you are “bad” or “worthless” because you are human and alive.’ Which of us is correct? Neither of us: because we are both arbitrarily defining you as ‘good’ or ‘bad’ and our definitions are not really provable nor falsifiable. They are just that: definitions.
“Defining yourself as ‘good’ however will give you much better results than believing that you are ‘bad’ or ‘rotten.’ Therefore, this inelegant conclusion works and is a fairly good practical or pragmatic solution to the problem of human ‘worth.’ So if you want to rate yourself or your being, you can definitionally, tautologically, or axiomatically use this ‘solution’ to self-rating. Better yet, however, as I have pointed out in Reason and Emotion in Psychotherapy, Humanistic Psychotherapy, A Guide to Rational Living, and a number of my other writings, and as David Mills emphasizes in this essay, you can use the ‘elegant’ REBT solution to rating yourself. That is, give up all your ideas about self-esteem, stick only to those of unconditional acceptance, and choose to accept yourself, your existence, your humanity whether or not you perform well, whether or not you are loved by significant others,and whether or not you suffer from school, work, sports or other handicaps.”
This is what I usually say to my therapy clients. As David Mills aptly points out, you can recognize that your absence of self-image is possible and is, in fact, preferable to frequent anxiety and inhibition. Your goal can be to enjoy, rather than to prove yourself for the rest of your un-self-esteeming life!
Dr. Albert Ellis, Ph.D.
Albert Ellis Institute, 2003
Perhaps the most common self-defeating belief of disturbed people is their conviction that they are worthless, inadequate individuals who essentially are undeserving of self-respect and happiness. This negative self-evaluation can be tackled in various ways —such as by giving them unconditional positive regard (Carl Rogers), directly approving them (Sandor Ferenczi), or otherwise giving them supportive therapy (Lewis Wolberg). I prefer, as I have indicated in my books Reason and Emotion in Psychotherapy and How to Stubbornly Refuse to Make Yourself Miserable About Anything — Yes, Anything! an active-directive discussion of the clients’ basic philosophy of life and teaching them that they can view themselves as okay just because they exist, and whether or not they are competent or loved. This is a central teaching of rational emotive behavior therapy (REBT).
As may well be imagined, I often have great difficulty in showing people that they are merely defining themselves as worthless. For even if I show them, as I often do, that they cannot possibly empirically prove that they are valueless they still may ask, “But how can you show that I do have value? Isn’t that concept an arbitrary definition, too?”
Yes, it is, I freely admit: For, philosophically speaking all concepts of human worth are axiomatically given values and cannot be empirically proven so (except by the pragmatic criterion that if you think you’re worthwhile — or worthless — and this belief “works” for you, then you presumably become what you think you are). It would be philosophically more elegant, I explain to people, if they would not evaluate their self at all but merely accept its existence while only evaluating their performances. Then they would better solve the problem of their “worth.”
Many people resist this idea of not evaluating themselves for a variety of reasons — particularly because they find it almost impossible to separate their selves from their performances and therefore insist that if their deeds are rotten they must be rotten people. I maintain that no matter how inefficient their products are, they are still an ongoing process, and their process or being (as Robert Hartman and Alfred Korzybski have shown) simply cannot be measured the way their products can be.
I have recently added a cogent argument for convincing people that they are much more than their acts. Instead of only showing them that their self is not to be measured by the criterion used for assessing their performance, I also demonstrate how their (or anyone’s) good creations are not a measure of their self.
“Did you ever realize,” I ask a person, “that almost all emotional disturbance comes from inaccurate or unoperational definitions of our terms about ourselves and our deeds and that it could be minimized if we would force ourselves vigorously to define our self descriptions?”
“How so?” she usually asks.
“Well,” I reply “let’s take Leonardo da Vinci. We usually call him a genius or even a universal genius. But that’s nonsense— he of course wasn’t anything of the sort.”
“He wasn’t?”
“No. To call him — or Michelangelo, or Einstein, or anyone else — a genius is to indulge in slipshod thinking. Leonardo, admittedly had aspects of genius. That is, in certain respects and for a specific era of history he did remarkably well.”
“But isn’t that what a genius is — one who does unusually well in certain ways?”
“That’s what we carelessly say. But, actually using the noun genius clearly implies that a person to whom this title is given is generally an outstanding performer; and of course no one, including Leonardo, is. In fact he did many silly, asinine things. He fought with several of his patrons and frequently depressed himself and made himself very angry. So he often behaved stupidly and uncreative — which is hardly what a true genius should do. Isn’t that right?”
“Well— uh— perhaps.”
“Moreover let’s even consider his best work— his art. Was he really a thoroughgoing genius even in that respect? Were all — or even most — of his paintings great examples of color and composition and draughtsman ship and contrast and originality? Hardly! Again, if the truth is admitted and accurately described we’d better admit that only certain aspects of Leonardo’s art were masterful; his work as a whole was not.”
“Are you saying then that there are no real geniuses?”
“I definitely am. Nor are there any heroes or heroines, any great people. These are fiction, myths which we fallible humans seem determined to believe in order to ignore the fact that we presently are, and probably will always be, highly inefficient, mistake making animals. So if we want to be sensible, we’d better honestly admit that there are no geniuses or extraordinary people; there are merely individuals with exceptional deeds. And we’d better sensibly evaluate their acts rather than deifying— or as the case may be devil-ifying— their personhoods. People are always human not gods or devils. Tough! — but that’s the way it is.”
So I now continue, demonstrating as best I can to people that they will never except by over generalized definition, be a hero or an angel — or a louse or a worm. Does this new tack always convince them that they are not the worthless, hopeless slobs they usually think they are? Hell no! But it has so far proved to be a useful tool in rational emotive behavior therapy (REBT).
This approach does not help a person to work through his original experiential bases for his sense of worthlessness; It tends to encourage people to avoid responsibility for the guilt that may be involved; It overemphasizes the therapist’s intellectual prowess and may enhance a client’s sense of inadequacy; It fails to stimulate a client’s own potentialities for health or to make use of his own ability to think through his problems; and One has reason to doubt that an individual’s sense of personal worth can really be enhanced by the sort of arguments presented here. Since this is claimed to be a report of effective psychotherapeutic techniques, perhaps the reader may want to see some evidence of the effectiveness which is entirely missing.
Dr. Dai’s discussion of my paper is brief but highly pertinent. Let me see if I can briefly answer it. No, my approach does not help people work through their original experiential bases for their sense of worthlessness; and in my estimation it is only an unverified (and almost unverifiable) assumption that it is necessary or even desirable to do this. Whatever the original cause of their self-depreciation, the present cause is largely their belief that they are still slobs because they are, and should and must not be, imperfect. I think that they were born with a predisposition to think this nonsense and then were raised to give into this predisposition. No matter! They are capable of giving it up — or else psychotherapy of any sort is useless. The belief that they can only change their ideas about their worth by understanding the complete origin of these ideas is only a theory hardly a fact.
Teaching people that they are worthwhile just because they exist does not encourage them to avoid responsibility for any immoral act they may have committed. On the contrary by showing them that they are not bad people even if some of their acts are wrong encourages them to be responsible for their acts to admit that they have been mistaken and to focus on changing their behavior for the better in the future. Guilt or self-blame encourages repression and depression. Unconditional self-acceptance (USA) even when one is fallible encourages honest confession and greater responsibility in the future. Clients who feel more inadequate because their therapist displays intellectual prowess do so precisely because they falsely believe that they are worthless if someone else even their own therapist excels them.
The technique advocated in REBT teaches them that they are never “no good” no matter how bright their therapist (or anyone else) is. It thereby helps appreciably to de-crease their feelings of inadequacy. It is Dr. Dai’s hypothesis that teaching peoples how to think straighter fails to stimulate their own potentialities for health or make use of their own ability to think through their problems. The entire history of education would tend to show otherwise. If Dr. Dai were correct every client (and every high school and college student) should be left to muddle through on his or her own rather than be helped to acquire various kinds of helpful knowledge.
Dr. Dai are quite right in asking for evidence of the effectiveness of my briefly stated technique. I can only say that I have now used it on about 20,000 clients; that about 20 percent seemed to be little affected by it and 80 percent seemed to be significantly helped. One young female patient was so greatly helped by a single session consisting almost entirely of this kind of material that she seemed to surrender her deep-seated feeling of worthlessness got out of a severe state of depression and began to function much better in her love life and her work. Case histories, however are not very good evidence for the efficacy of any kind of psychotherapy, because the therapist, who is obviously biased in favor of her or his methods, mainly evaluates the “effectiveness”. Moreover, only “successful” cases are usually presented while less successful ones are commonly omitted.
Psychotherapy research, how- ever studies groups of clients who have been treated with one method of therapy and another control group who were not treated or with whom therapists used another method. REBT along with Aaron Beck’s cognitive therapy (CT), Donald Meichenbaum’s cognitive behavior therapy (CBT), Arnold Lazarus’ multimodal therapy (MT) and several other similar kinds of treatment that follow some of the main principles and practices of REBT have been tested in over 2,000 studies of people with anxiety depression and other aspects of self-deprecation. The great majority of these studies have shown that REBT-oriented techniques have significantly helped people to feel less worthless and more self-accepting.
Try REBT and see for yourself! This brief article only describes a few of its methods. Others will be found in the books and tapes listed at the end of this pamphlet, most of which can be obtained from the Albert Ellis Institute in New York.
For starters however, let me repeat in more detail two of the main REBT solutions that you, as an individual can use to make yourself feel worthwhile or that you as a therapist facilitator or teacher can teach others to help them achieve unconditional self-acceptance (USN):
Decide to define yourself as a “good” or “worthwhile” person just because you exist just be-cause you are alive just because you are human. For no other reason or condition! Work at — that is think and act at — unconditionally accepting yourself whether or not you perform “adequately” or “well” and whether or not other people approve of you. Acknowledge that what you do (or don’t do) is often mistaken foolish or immoral but still determinedly accept you, yourself with your errors and do your best to correct your past behavior. Don’t give any kind of global generalized rating to yourself, your essence or your being. Only measure or evaluate what you think you feel or you do. Usually evaluate as “good” or “healthy” those thoughts, emotions and behaviors that help you and the members of the social group in which you choose to live and that are not self-defeating or antisocial; and rate as “bad” those that are self-defeating and socially disruptive. Again, work at changing your “bad” behaviors and continuing your “good” behaviors. But stubbornly refuse to globally rate or measure yourself or being or personhood at all. Yes, at all!
Will USA solve all of your (or your clients’) emotional problems? Most likely not, because rational emotive behavior therapy sees you and other people as having three basic neurotic difficulties: (1) Damning or deprecating yourself, your being and thereby making yourself feel inadequate or worthless. (2) Damning or putting down other people for their “bad” behaviors and thus making you enraged hostile, combative or homicidal. (3) Damning or whining about conditions under which you live and thereby producing low frustration tolerance (LFT) depression or self-pity.
If as this article suggests you work at achieving unconditional self-acceptance (USA), you will have an easier time also achieving unconditional acceptance of others (but not of what they often do!). And you can achieve unconditional acceptance of poor external conditions that you do your best to change but are clearly not able to change. For anger at yourself sometimes comes first and is basic to rage at other people and at the world. Thus if you demand that you absolutely must do better than others do at work, Relationships, or sports, you will tend to strongly hate yourself when you don’t perform as well as you presumably must. But because damning yourself leads you to feel highly anxious and/or depressed, and because you may easily horrify yourself about having such feelings by insisting, “I must not be anxious! I’m no good for being depressed!” — You will then feel anxious about your anxiety depressed about your depression, and will be doubly self-downing.
Sensing this, you may choose to think, instead, “Other people must not make me fail, and they are no good!” If som you will make yourself enraged at these others. Or you may think “The conditions under which I live are so lousy and must not be. It’s awful that they are so bad! I can’t stand it!” You will then create low frustration tolerance (LFT).
So conditional self-acceptance and consequent feelings of worthlessness may encourage (1) Damning yourself for your failures, (2) feelings of severe anxiety and/or depression, (3) Downing yourself for having these disturbed feelings, (4) defensively damning others who “make” you fail and (5) defensively damning conditions that are “responsible” for your failing. Quite a kettle of (rotten) fish!
Feelings of worthlessness are not worth it. You largely bring them on yourself and you can choose — and help your clients choose — to replace them, when you behave “badly” with healthy feelings of sorrow and regret. Then as a “goodnik” rather than a “no-goodnik” you are in a much better position to change what you can change. By unconditionally accepting yourself you increase your chances of being able to change harsh reality or as Rheinhold Niebuhr said to have the serenity to accept but not to like bad conditions that you cannot change.
Albert Ellis, Ph.D. is President of the Albert Ellis Institute in New York City, and author of over 800 articles and over 60 books.
If you want to increase your rationality and reduce your self-defeating irrational beliefs, you can spend at least ten minutes every day asking yourself the following questions and carefully thinking through (not merely parroting!) the healthy answers. Write down each question and your answers to it on a piece of paper; or else record the questions and your answers on a tape recorder.
ILLUSTRATIVE ANSWER: I must receive love from someone for whom I really care.
ILLUSTRATIVE ANSWER: No.
ILLUSTRATIVE ANSWER: Many indications exist that the belief that I must receive love from someone for whom I really care is false:
a) No law of the universe exists that says that someone I care for must love me (although I would find it nice if that person did!).
b) If I do not receive love from one person, I can still get it from others and find happiness that way.
c) If no one I care for ever cares for me, which is very unlikely, I can still find enjoyment in friendships, in work, in books, and in other things.
d) If someone I deeply care for rejects me, that will be most unfortunate; but I will hardly die!
e) Even though I have not had much luck in winning great love in the past, that hardly proves that I must gain it now.
f) No evidence exists for any absolutistic must. Consequently, no proof exists that I must always have anything, including love.
g) Many people exist in the world who never get the kind of love they crave and who still lead happy lives.
h) At times during my life I know that Techniques for Disputing Irrational Beliefs (DIBS) © 1974 by Albert Ellis Institute. Revised 2001.2I have remained unloved and happy; so I most probably can feel happy again under unloving conditions.
i) If I get rejected by someone for whom I truly care, that may mean that I possess some poor, unlovable traits. But that hardly means that I am a rotten, worthless, totally unlovable individual.
j) Even if I had such poor traits that no one could ever love me, I would still not have to down myself as lowly, bad individual.
ILLUSTRATIVE ANSWER: No, not really. Considerable evidence exists that if I love someone dearly and never am loved in return that I will then find myself disadvantaged, inconvenienced, frustrated, and deprived. I certainly would prefer, therefore, not to get rejected. But no amount of inconvenience amounts to horror. I can still stand frustration and loneliness. They hardly make the world awful. Nor does rejection make me a turf! Clearly, then, no evidence exists that I must receive love from someone for whom I really care.
ILLUSTRATIVE ANSWER: If I don’t get the love I think I must receive:
a) I would get deprived of various possible pleasures and conveniences.
b) I would feel inconvenienced by having to keep looking for love elsewhere.
c) I might never gain the love I want, and thereby continue indefinitely to feel deprived and disadvantaged.
d) Other people might down me and consider me pretty worthless forgetting rejected—and that would be annoying and unpleasant.
e) I might settle for pleasures other then and worse than those I could receive in a good love relationship; and I would find that distinctly undesirable.
f) I might remain alone much of the time; which again would be unpleasant.
g) Various other kinds of misfortunes and deprivations might occur in my life—none of which I need define as awful, terrible, or unbearable.
a) If the person I truly care for does not return my love, I could devote more time and energy to winning someone else’s love—and probably find someone better for me.
b) I could devote myself to other enjoyable pursuits that have little to do with loving or relating, such as work or artistic endeavors.
c) I could find it challenging and enjoyable to teach myself to live happily without love.
d) I could work at achieving a philosophy of fully accepting myself even when I do not get the love I crave.
You can take any one of your major irrational beliefs — your should, ought, or musts — and spend at least ten minutes every day, often for a period of several weeks, actively and vigorously disputing this belief. To help keep yourself devoting this amount of time to the DIB method of rational disputing, you may use operant conditioning or self-management methods (originated by B.F.Skinner, David Premack, Marvin Goldfried, and other psychologists).Select some activity that you highly enjoy that you tend to do every day—such as reading, eating, television viewing, exercising, or social contact with friends. Use this activity as a reinforce or reward by ONLY allowing yourself to engage in it AFTER you have practiced Disputing Irrational Beliefs (DIBS) for at least ten minutes that day. Otherwise, no reward!
In addition, you may penalize yourself every single day you do NOT use DIBS for at least ten minutes. How? By making yourself perform some activity you find distinctly unpleasant—such as eating something obnoxious, contributing to a cause you hate, getting up a half-hour earlier in the morning, or spending an hour conversing with someone you find boring. You can also arrange with some person or group to monitor you and help you actually carry out the penalties and lack of rewards you set for yourself. You may of course steadily use DIBS without any self-reinforcement, since it becomes reinforcing in its own right after a while. But you may find it more effective at times if you use it along with rewards and penalties that you execute immediately after you practice or avoid practicing this rational emotive behavior method.
1. WHAT SELF-DEFEATING IRRATIONALBELIEF DO I WANT TODISPUTE AND SURRENDER?
2. CAN I RATIONALLY SUPPORT THIS BELIEF?
3. WHAT EVIDENCE EXISTS OFTHE FALSENESS OF THISBELIEF?
4. DOES ANY EVIDENCE EXIST OFTHE TRUTH OF THIS BELIEF?
5. WHAT ARE THE WORST THINGSTHAT COULD ACTUALLY HAPPENTO ME IF I DON’T GETWHAT I THINK IMUST (OR DOGET WHAT I THINK I MUST NOTGET)?
6. WHAT GOOD THINGS COULD IMAKE HAPPEN IF I DON’T GETWHAT I THINK I MUST (OR DOGET WHAT I THINK I MUST NOTGET)?
Disputing (D) your dysfunctional or irrational Beliefs (I Bs) is one of the most effective of REBT techniques. But it is still often ineffective, because you can easily and very strongly hold on to an I B (such as, “I absolutely must be loved by so-and-so, and it’s awful and I am an inadequate person when he/she does not love me!”). When you question and challenge this I B you often can come up with an Effective New Philosophy (E) that is accurate but weak: “I guess that there is no reason why so-and-so must love me, because there are other people who will love me when so-and-so does not. I can4therefore be reasonably happy without his/her love.” Believing this almost Effective New Philosophy, and believing it lightly, you can still easily and forcefully believe, “Even though it is not awful and terrible when so-and-so does not love me, it really is! No matter what, I still need his/her affection! ”Weak, or even moderately strong, Disputing will therefore often not work very well to help you truly disbelieve some of your powerful and long-held I B’s; while vigorous, persistent Disputing is more likely to work. One way to do highly powerful, vigorous Disputing is to use a tape recorder and to state one of your strong irrational Beliefs into it, such as, “If I fail this job interview I am about to have, that will prove that I’ll never get a good job and that I might as well apply only for low level positions!”
Figure out several Disputes to this I Band strongly present them on this same tape. For example: “Even if I do poorly on this interview, that will only show that I failed this time, but will never show that I’ll always fail and can never do well in other interviews. Maybe they’ll still hire me for the job. But if they don’t, I can learn by my mistakes, can do better in other interviews, and can finally get the kind of job that I want.”
Listen to your Disputing on tape. Let other people, including your therapist or members of your therapy group, listen to it. Do it over in a more forceful and vigorous manner and let them listen to it again, to see if you are disputing more forcefully, until they agree that you are getting better at doing it. Keep listening to it until you see that you are able to convince yourself and others that you are becoming more powerful and more convincing.
Additional copies of this pamphlet are available at:
10 copies for $5.00
50 copies for $20.00
100 copies for $35.00
From the ALBERT ELLIS INSTITUTE
45 East 65th Street, New York, N.Y. 10021-6593
Phone: (212) 535-0822
Fax: (212) 249-3582
www.rebt.org
Call for ordering information.
Journal of Psycholinguistic Research, Vol. 17, No. 5, 1988
Dr. Michael Abrams and Dr. Arthur S. Reber
The performance of a group of psychiatric inpatients on two different cognitive tasks was compared with that of a control group of college undergraduates. The task in the first experiment was implicit learning of a complex, synthetic grammar; the task in the second experiment was explicit learning of relatively simple letter-to-number matching rules. In the first experiment, differences between the normals and the psychiatrically impaired were found on the preliminary memorization task but not on the implicit grammar learning task; in the second experiment, differences were observed on all phases of the experiment, with the inpatients performing no better than chance. These findings provide support for the hypothesis that, under appropriate conditions, individuals suffering from serious disorders may show no deficits when working with complex and abstract stimulus domains while showing serious performance problems when working with relatively simple, concrete stimuli. The key factor is that the former were presented as tasks that tap nonreflective, implicit processes, whereas the latter were put forward as ones that recruit conscious, explicit processes.
For some 20 years now the term implicit learning has been employed to characterize the manner in which people develop intuitive knowledge of the underlying structure of a complex stimulus environment.
The experiments are based in part on studies reported in Abrams (1987). Preparation of this article was supported in part by a grant from the City University of New York PSC-CUNY Research Award Program, Brooklyn College of CUNY.
Brooklyn College and the Graduate Center of CUNY, Brooklyn, New York 11210. Address all correspondence to Michael Abrams, Psychological Medicine Corporation, Jersey City, New Jersey 07306, or to Arthur S. Reber, Brooklyn College of CUNY, Brooklyn, New York 11210.
1967, 1988; Schacter, 1987). In the standard representation, an implicit process is marked by two essential features: The acquisition operation is unconscious and automatic, and the resulting knowledge base is abstract and rule-governed.
The classic paradigm used to study implicit learning has evolved the use of complex stimulus displays whose properties are defined by a rich rule system that generates the displays. The earliest work here used artificial grammars based on finite-state (Markovian) systems (Reber, 1967), and most of the subsequent research on these implicit, nonreflective processes has used such synthetic, semantic-free systems (Brooks, 1978; Dulany, Carlson, & Dewey, 1984; Fried & Holyoak, 1984; Howard & Ballas, 1980; Morgan & Newport, 1981; Reber, 1976; Reber & Allen, 1978; Reber, Kassin, Lewis, & Cantor, 1980). The generality of the findings, however, is well known, and a number of other stimulus environments has also been used by various researchers with congruent results. Broadbent and his colleagues showed that people learn to control complex, simulated economic and production systems in an implicit manner (Berry & Broadbent, 1984; Broadbent, FitzGerald, & Broadbent, 1986), Lewicki has reported similar automatized processes in tasks as diverse as those involving stochastic predictions of the location of visual stimuli and the acquisition of person perception dispositions (Lewicki, 1985, 1986a, 1986b), and Reber and Millward have found implicit processes operating in the classic probability learning task (Millward & Reber, 1968, 1972; Reber, 1988; Reber & Millward, 1968, 1971).
A perusal of this literature makes it quite clear that these implicit, automatic, nonreflective cognitive processes differ in significant and important ways from the more typically studied explicit, conscious, reflective ones of problem solving, concept formation, associative learning, and the like, where the learning is conscious and explicit and the resulting knowledge base can be reasonably well communicated to others (Reber, 1988; Schacter, 1987).
Recently, Hasher and Zacks and their co-workers (Hasher & Zacks, 1979, 1984; Zacks, Hasher, & Sanft, 1982) have pursued ~/ line of research that can be seen as conceptually parallel to that on implicit learning. They have argued that information about particular classes of stimuli is also encoded without any cognitive or attentional effort. The kinds of stimulus information that they have worked with, however, are considerably less complex than those used in the implicit learning literature. Specifically, they have proposed that information about the frequency and temporal and spatial location of events is acquired without conscious effort or reflection. They also, interestingly, proposed that this kind of information acquisition is extremely robust and can be seen in undiminished form in severely impaired individuals.
This last suggestion has received considerable attention recently and has been supported by a substantial body of research indicating that individuals suffering from a wide range of mental disabilities can automatically encode information to essentially the same extent as people without impairments. Students with learning handicaps (Ceci, 1982, 1983), adults with depressive disorders (Remien, 1986; Roy, 1982), and even those with the severe memory impairments of Alzheimer’s disease and Korsakoff’s syndrome (Knopman & Nissen, 1987; Strauss, Weingartner, & Thompson, 1985; Hirst & Volpe, 1985) show markedly less impairment in automatic encoding of event frequency than in effortful memory tasks. Newman, Weingartner, Smallberg, and Calne (1984) even showed that artificially induced impairments effected by the administration of 1-dopa had an impact on effortful cognitive processes but not on automatic frequency encoding.
The fact that the automatic induction of fundamental information is resistant to impairments raises the question as to whether the processes of implicit learning are similarly immune. The inference here derives from the argument put forward in several places that implicit learning should properly be viewed as a complex, covariational form of frequency counting.
For example, in an earlier paper (Reber & Lewis, 1977) it was noted that the subjects’ underlying representation of an implicitly learned system like a Markovian grammar was captured by bi- and trigram covariations of a relational form. A recent report by Mathews, Buss, and Stanley (1987) confirmed this characterization; subjects typically code the complex letter sequences into two- and three-letter clusters on the basis of the degree of covariation that these letters display in the rule system and marked for location. Using a somewhat different context, Lewicki came to a similar conclusion about the importance of the encoding of covariations of events. In his recent review of nonconscious cognitive processes in social settings (Lewicki, 1986a), he asserted that the most basic operation involved in processing information about episodes is the encoding of cooccurrence and covariation of events. He has put forward the even stronger argument that there is no other way to acquire a concept than to discover cooccurrences between (some of) its features, and there is no other way to evaluate novel instances for its category membership than to check whether the exemplars’ features occur properly.
In light of considerations such as these, it seemed not unreasonable to hypothesize that implicit learning of a system as complex as a synthetic grammar might, like the Hasher and Zacks type of encoding of fundamental information, be robust in the presence of various forms of psychological disorders. To explore this hypothesis, two experiments were carried out in which performance of psychiatric patients was compared with that of normal college students on a standard implicit learning task as well as on tasks that required explicit, reflective cognitive processing. Following the line of reasoning above, we anticipated large differences between our populations on the explicit tasks but more muted differences on the implicit.
This study is a direct comparison between a mixed group of psychiatric patients and a group of college undergraduates on the standard grammar learning task that has been used on numerous other occasions by a variety of researchers.
SubjectsPsychiatric Patients. This group consisted of 25 male inpatients at the Brooklyn Veteran’s Administration Hospital. All either had been hospitalized for major disorders, primarily schizophrenia and depression, or were inpatients in treatment for chronic alcoholism. All of the alcoholics exhibited some signs of organic brain impairment. In all cases, the diagnosis made by the hospital staff was accepted as accurate.
Some comments on this rather unusual subject population are called for here. First, we were not particularly concerned with distinguishing between various diagnostic categories in this study. The primary interest here was to provide, if we could, a kind of “existence demonstration.” That is, we wanted to explore whether the line of reasoning that led us to this experiment had a basic validity to it. To that end, any subtleties that may exist between the cognitive capacities of these various psychiatric categories were bypassed in this study.
Control Subjects. The comparison group consisted of 36 undergraduate students at Brooklyn College who served as part of the requirements of a course in introductory psychology.
Generally speaking, the demographic characteristics of the groups differed considerably. The average age of the psychiatric patients was 39 years; of the undergraduate students, 21 years. In addition, the student population, not surprisingly, was better educated and healthier, and, of course, did not spend their time in an institutional setting. These differences are important in that they make the comparison in performance between the two groups that much more stringent a test of the overall hypothesis.
****Image****Fig. 1. Schematic diagram of the finite-state grammar used to generate the stimuli for Experiment 1. Stimuli are generated by following any path of arrows leading from the initial state to any of the possible terminal states.
MaterialsLearning Stimuli. The stimuli for the learning phase of the study consisted of letter strings of lengths 2 through 6 using combinations and permutations of the letters J, T, V, X. These strings were produced by the simple, finite-state grammar shown in schematic form in Figure 1. Each of these “grammatical” strings is generated by entering the system at State 1 and following the arrows that define permissible transitions, arriving at States 3, 4, or 5, all of which can terminate the string. Twenty-five strings were selected at random from those the grammar can generate and served as the learning stimuli.
Testing Stimuli. The stimuli for the testing phase were 50 letter strings made up using the same four letters. Of these, 25 were grammatical strings and 25 were not. These “nongrammatical” items were created by introducing a violation into a grammatical string. Of the 25 grammatical strings, four were “old” strings, which were used as learning stimuli.
ProcedureLearning. Letter strings were presented one at a time on a computer screen with a 3-second exposure time, after which the screen went blank and the subject was prompted to reproduce the string on the keyboard. Each string was presented up to three times if a subject failed to reproduce it correctly. The full list of 25 strings was run through twice.
Testing. Letter strings were presented on the computer screen for 7 seconds each. Following each presentation, the subject was prompted to categorize that string as either a correct (or acceptable) string or one that contained an error and was unacceptable. Responses were made by pressing either the Y or the N key. The notion of correctness was described by telling subjects to regard the first 50 strings that they had reproduced as examples of acceptable or correct strings.
The full set of 50 strings was presented twice, resulting in a total of 100 of these “well-formedness” trials for each subject. Subjects were informed about the 50-50 split in grammatical and nongrammatical strings but were not told about the repetition of the items, nor were they given any feedback about the correctness of their responses. After the full testing session was over, subjects were queried as to the basis of their well-formedness decisions.
Instructions. At the beginning of the learning phase, half the subjects in each group were given neutral instructions in which the task was described as a simple memory task and half were given instructions informing them about the rule-governed nature of the stimuli and were encouraged to try to figure out what the rules were. These instructions appeared on the computer screen and were simultaneously read aloud by the experimenter. After the learning phase was complete, all subjects were told about the rule-governed nature of the letter strings prior to beginning the testing phase. For the neutrally instructed subjects, this was the first time any explicit information about the letter strings was provided.
ResultsLearning. An analysis of variance revealed a significant difference between the two subject populations in the amount of time it took to complete the learning task, with the normal student group taking much less time (11.4 vs. 15.6 seconds) than the inpatient population (F(1, 59) = 7.7, p < .01, MSe = 34.5).
****Image****Owing to a computer failure, we were unable to retrieve complete data on the number of trials to criterion and the number and type of errors made by the subjects during this task. The only data available were total times to learn. While not entirely satisfactory, this measure does provide a rough estimate of the difficulty that individual subjects had with this task. The learning task is one that taps overt, conscious processes, the kinds of cognitive functions usually under the control of conscious, reflective operations. As such, we take this difference to be an indication that on such tasks the impaired subject population performs relatively poorly. There were no differences between the instruction groups and no interaction between instructions and population. There were, in fact, no effects of instructional set anywhere in the experiment, and in all analyses these subgroups have been combined.
Testing. Both groups were significantly above chance on the well-formedness task. The student group had a mean proportion correct of 66.4 (t(35) = 17.1, p < .001) and the inpatient group a mean of 65.3 (t(24) = 10.4, p < .00i). There was no difference between the groups in this ability to discriminate well-formed from ill-formed strings. There was a slight but nonsignificant tendency for both groups of subjects to accept the “old” strings from the learning phase as well formed more frequently than the novel, grammatical strings, but the groups did not differ from each other. There was no bias toward accepting and/or rejecting grammatical and nongrammatical strings in either group. As is displayed in Table I, even when the various subject populations are subdivided into those with primary diagnosis of psychosis and those on the special ward for alcoholics, no differences are found either between the impaired subgroups or the normals in their ability to discriminate between strings that conformed to the grammar and those that did not. In fact, as is shown in Table I, there were no significant differences in subjects’ performance on any of the measures of string discrimination.
The post experimental debriefing session, during which we attempted to get as much detail as possible from our subjects concerning the basis upon which they were making their decisions, yielded few data of value. Neither group of subjects was particularly introspective, and few accurate characterizations of the actual rule system were given. Not surprisingly, the normal control subjects were considerably more coherent and expressive than the inpatient population, but, surprisingly, they were no more accurate in presenting justifications for their well-formedness judgments. This general finding using this interrogation technique is in keeping with results reported elsewhere (Reber, 1967; Reber, Allen, & Regan, 1985), although we recognize that compared with procedures used by Dulany et al. (1984) and Mathews et al. (1987), it may yield an underestimate of subjects’ conscious knowledge.
DiscussionThe key finding is the significant difference in performance between the two subject populations when confronted with a task that calls on explicit and conscious cognitive systems combined with the lack of a difference when they are presented with one that recruits implicit, nonreflective processes. These results are in keeping with the characterization of implicit learning sketched above. They also represent a very interesting finding: Individuals suffering from serious psychological disorders that disrupt “ordinary,” overt, cognitive processes, such as short-term memory, perform with virtually no deficits when dealing with stimulus environments of the complexity of the synthetic grammar used here. As outlined above, a number of recent studies (for reviews, see Hasher & Zacks, 1984; Schacter, 1987) lend support to the proposition that relatively simple, nonreflective processes, such as frequency encoding of single events, are robust in the face of serious psychiatric disorders. These results imply that an extension of this robustness hypothesis can be made to complex processes, such as the implicit learning of an artificial grammar.
While we find these results quite exciting, we want to emphasize that we regard this experiment as a sophisticated pilot study–a compelling one to be sure, but still one whose findings should be regarded as preliminary in nature. There is a number of reasons for our caution. First, we feel that any unprecedented result needs confirmation and replication before it is taken unquestioningly. Second, we recognize that this study is flawed, first, by the failure to have a specific overt and conscious task where differences between our subject populations might be observed and, second, by the loss of the fine-grain data from the learning phase. To pursue these issues in a more concrete fashion, a second experiment was run using a relatively simple problem-solving task, one where the application of overt, conscious processes should yield success. Here, we anticipated finding differences between our two populations.
©2024. Psychological Estates. All Rights Reserved.