The ABC of Therapy

What we can learn from a successful and much-used form of cognitive therapy.

The basic idea behind cognitive therapy is that rational thoughts of the client can overcome their irrational beliefs. Therapists will “force” clients to think from different angles by asking many questions or by stating observations that contradict the beliefs of the client.

American psychologist Albert Ellis (1913–2007) fell out of love with psychodynamic therapy in the 1950s. Instead of the elaborate therapy, Ellis introduced his now widely used ABC theory of emotions — in which A stands for Activating event, B for Belief, and C for Consequent emotion. With that, Ellis meant that the client was at one point triggered by an Activating event to a certain Belief, that led to a Consequent emotion.

For instance, one of your colleagues said “hi!” to another colleague this morning in the hallway on the way up to the coffee machine, but the “ hi!” was not returned. Your colleague now has the belief that nobody likes them at work and is therefore sad and a bit angry. The saying hi and the subsequent not returning of the hi is the Activating event. The Belief is that nobody likes them, and sadness and anger are the Consequent emotions.

The therapist will now address the irrational belief that “nobody likes them” by disputing that belief. Ellis was one to ridicule irrational beliefs with a sense of humor. He might have told our colleague to stop “awfulizing” — to stop making things worse than they truly are. One could question if the other colleague even heard the “hi”, or if they were sunken in thoughts instead. Or, even if this one colleague truly didn’t like them, that wouldn’t mean “nobody” liked them. The disputation by the therapist would eventually have to lead to a new belief in our client, namely that it is actually not the case that “nobody likes them”. Some have extended the ABC of Ellis to ABCDE, with the D standing for the Disputation, and the E for the Effective new belief.

Even though the therapist goes against the irrational belief of the client, the cognitive therapist will do so from an empathic and caring point of view, more in line with the humanistic therapy approach than with the psychoanalytic approach. Hence Ellis’ use of humor to dispute the…