REBT For Anger Management

What Is Rational Emotive Behavior Therapy (REBT)?

Rational emotive behavior therapy (REBT) focuses on how thoughts, emotions, and behaviors are connected.¹ Based on this, the goal is to teach clients how to shift maladaptive patterns by changing their thoughts to create emotional and behavioral improvements.²

REBT theory explains that deeply held core beliefs guide how we understand the world. Many of our core beliefs are healthy, but some invariably are irrational or maladaptive. When maladaptive core beliefs are addressed, we can find better mental health. REBT shows clients that they have more control over their emotions than they think.

The REBT A -> B -> C Model highlights the idealogy that backs sessions. (A)ctivating events call forth (B)eliefs, which lead to emotional and behavioral (C)onsequences. In turn, Cs can end up becoming further activating events.

Rational emotive behavior therapy can be used to treat disorders such as:

• Depression
• Intermittent explosive disorder
• Oppositional defiant disorder
• Borderline personality disorder
• Paranoid personality disorder

Can REBT Help With Anger?

While anger can serve a valuable function, it is often misplaced and leads to more pain than benefit. Because REBT techniques are designed to work on emotional and behavioral issues stemming from irrational beliefs, it is suited to helping people have a more adaptive form of anger.

The DSM-5 does not list ‘anger problems’ as a diagnosable condition. However, over 30 diagnoses in the DSM-5 involve anger in some regard, so there is plenty of opportunity to use REBT to alleviate anger problems.³ 

According to Albert Ellis, the core problem in anger management stems from holding on to the idea that everything is catastrophic because things are frustrating or unfair.⁴ He urged patients to see that things can get bad but are rarely catastrophic. Instead, we choose to make ourselves miserable by insisting things are worse than they are. Here, REBT Irrational Core Beliefs come into play, helping a person determine if the beliefs creating their anger and responses are justified.

Common REBT Techniques for Anger Management

Many REBT techniques for anger management aim to modify thoughts, emotions, and behavior. Doing so can help clients learn healthy ways to respond to situations that trigger anger. Depending on the severity of symptoms, the therapist-client relationship, and additional factors, an REBT therapist may focus on other interventions.

Below are REBT techniques that may be used for anger management:⁵

Cognitive (Thought) Techniques

• Disputing: A REBT therapist will use direct challenges or questions to challenge irrational or false beliefs. Because anger often starts and increases due to false or exaggerated beliefs, we need to take the time to challenge our views about the world.
• Rational coping statements: Your therapist may share statements that realistically encourage you to reinforce healthy, rational beliefs.
• Modeling: This involves being asked to identify a person to model your behavior after. Asking yourself how a figure in your life would respond to a situation can provide behavior to copy in anger-inducing situations. It also offers a moment to reshape your thinking about the circumstance.
• Referenting: Your therapist may ask you to list the pros and cons of keeping or changing irrational beliefs. This reference can help you stay motivated the next time something goes wrong.

Emotive Techniques

• Rational emotive imagery: Your therapist asks you to imagine a recent time when you experienced unhealthy anger. Once you begin feeling angry again, your therapist asks you to use cognitive techniques to shift into a healthier emotional state.
• Forceful coping statements: While rational coping statements can work wonders when repeated, they often help to make them forceful by yelling them out. Try saying, “I shall overcome!”
• Humor: If you and your therapist have a good connection, they may playfully tease some of your irrational beliefs to show you how unimportant and burdensome they are. For example, “You got picked last for kickball? So what? Kickball is just fake baseball!”
• Unconditional acceptance by the therapist: At times, you may become enraged in the presence of your therapist. If this happens, you can expect nothing but caring acceptance. This reinforces the idea that you are not your beliefs, emotions, or actions. You are worth the effort to make changes.

Behavioral Techniques

• Paradoxical homework: It can be fun and enlightening to be asked to purposefully make yourself angry at situations that do not call for it. For example, forcing yourself to be enraged at your favorite comedy can show you how you create unnecessary problems.
• In vivo desensitization: Your therapist wants you to know that avoiding situations that make you angry will not solve your issues. By safely exploring such situations, you can learn that irrational beliefs cause your pain. Thus, you can learn to resist the urge to feed into those beliefs at triggering times.

Examples of REBT for Anger

The following are examples of REBT in action for disorders that can cause anger in people.

REBT For Major Depressive Disorder

Major depressive disorder is what people typically think of as depression. Fundamentally, depression is characterized by at least two weeks of a depressed mood, a loss of pleasure from formerly enjoyable activities (anhedonia), or both. A depressed mood sometimes shows up as irritability, intense frustration, and outbursts of anger. This is especially noted in children and teenagers.

For REBT therapists, the idea is to understand what their patient is assessing so negatively. Doing so allows the client to uncover the irrational beliefs supporting or leading to that judgment. For example, many people may become depressed from losing a significant relationship, such as a romantic partner. Heartbroken people may have rather intense thoughts of blame, such as, “I’m such an idiot,” “Why can’t I ever get it right,” etc. These beliefs come from irrational core beliefs of being “unloveable” or underserving of affection.

Below are steps used by REBT therapists for treating major depressive disorder:

• Verbalizing beliefs: A REBT therapist will first ask the client to verbalize negative beliefs. Next, they will begin the work of disputation and getting a series of rebuttals ready for these feelings. The client will examine these beliefs while the therapist offers realistic assessments of their accuracy. The patient is likely to accept some of the rational replacements as they get acclimated to the process.
• Reality testing: A therapist may also invite the patient to do reality testing as the REBT process progresses. The client goes out into the world and tries embracing healthier beliefs to take note of the results. Other cognitive interventions, such as referenting and coping statements, usually dovetail with reality testing.
• Building a client-therapist relationship: The client may feel some relief after a few sessions of REBT. The results will be much more stable if the client-therapist relationship is built with emotive tools such as unconditional positive regard, humor, and forceful coping statements for really tough days.
• Individual work: As REBT sessions continue, the client is encouraged to practice for a few weeks. If the patient and therapist agree progress is happening, it would be prudent to suggest some in vivo work to help solidify early gains.
• Lessening sessions:  Self-regard increases as the client begins to think clearly and replace maladaptive beliefs. This cascades into rationally believing that future connections are possible. The therapist may decrease sessions or move to another issue if the client and therapist are satisfied with the client’s ability to maintain improvements.

REBT For BPD

REBT for borderline personality disorder (BPD) should start with neutral, accurate descriptions of reality. While depression and other mood disorders are painful and debilitating, they often respond to treatment more rapidly than personality disorders. While the basic formula for treating BPD would be similar to depression, the exact timeline would not apply.

Personality disorders are lifelong conditions. The goal of REBT is not complete elimination of the disorder but significant improvement and management of symptoms through the development and repeated reinforcement of skills. There will be flare-ups, but REBT can leave you well-prepared to deal with them.

The core theme of BPD is a foreboding sense of abandonment, leading to intense attempts to avoid it. The terror of abandonment is so strong that it tends to lead to behaviors that become intolerable to others, including inappropriately intense anger or borderline rage. This tragically leads to the abandonment the person was trying to avoid.⁶ Another component of BPD is impulsive behavior that can be self-damaging, such as unhealthy sexual activity or substance use.

Is REBT Effective for Anger Management?

Albert Ellis argued in his scholarly work that REBT works for anger issues related to BPD. Current REBT practitioners continue to make the same case, stating that its concepts and philosophy fit very well in treating these issues.^7,8 However, recent research found that dialectical behavioral therapy (DBT) is an excellent treatment option, particularly for severe cases. Although REBT has not been researched as widely as DBT, both DBT, and REBT are cognitive therapies, thus there are plenty of similarities between them.^9,10

Final Thoughts

REBT can be an effective treatment for anger issues in many individuals. If you are considering this therapy approach, consider asking your primary doctor, family members, or friends for local referrals.