Individuals may respond very differently to similar events. Jane dreads her upcoming examination so intensely that she can’t sleep the night before, and walks into the examination hall shaking with terror. Her friend Barbara, who’s taking the same test, remains quite unruffled. Clearly, a person’s response to events is not entirely explained by the events themselves, but owes something to the person. However, instead of looking at that person’s conscious beliefs, for example Jane’s beliefs about the test, psychiatrists often try to explain the person’s feelings and actions through their “unconscious” minds.
Sigmund Freud developed this way of explaining human behavior early in the twentieth century, a method popularized by many Hollywood movies from the 1930s on. Freud believed that our feelings and actions are caused by “unconscious” impulses—things that are in our minds but that we don’t know about. Our minds are filled with dark, disguised forces of which we’re normally quite unaware. How did these mysterious forces get there? They allegedly originated in our childhood experiences.
Jane’s fear of the test might be explained by incidents in her early childhood. Freud believed that the way to cure Jane is to uncover the buried memories of those incidents, have Jane relive those incidents, and show how they cause Jane’s present anxiety about tests. This excavation of Jane’s “unconscious mind” can be a long and expensive process.
Psychiatrists overworked by their own hectic schedules, or by managed care, can find themselves allotted a mere 15 minutes—or less—for conducting their therapy sessions. However, the length of standard therapy remains 45-60 minutes.Three Minute Therapy (TMT) solves this dilemma. The length of these therapy sessions is flexible, and can be conducted in three to fifteen minute bites over the course of a few appointments. TMT is based on Rational Emotive Behavior Therapy (REBT), which was developed by Dr. Albert Ellis in 1955. TMT’s comprehensive approach works best for individuals desiring a scientific, present- focused, and active treatment for coping with life’s difficulties, rather than one which is mystical, historical, and largely passive.
The basic principles of TMT can be communicated by the psychiatrist, and understood by patients, quickly and easily in the first meeting: 1. Humans are responsible for their own emotions and actions, 2. Their maladaptive emotions and dysfunctional behaviors are largely the product of their own irrational thinking, 3. They can learn more realistic views and, with practice, make these a part of them, 4. Individuals will experience a greater acceptance of themselves, and a deeper satisfaction in life, by developing a reality-based perspective.
The next stage involves teaching your patients the Problem Separation Technique. TMT distinguishes clearly between two very different types of difficulties: practical problems and emotional problems. Our patient’s flawed behavior, their unfair treatment by others, and their frustrating situations, represent practical problems. Regrettably, their human tendency is to upset themselves about these practical problems, thereby unnecessarily creating a second order of problems—emotional suffering.
TMT addresses the latter by helping upset individuals take responsibility for their distress. This lesson in healthy emoting and relating was stated by the Roman philosopher Epictetus more than 2000 years ago: only you can upset yourself about events– the events themselves, no matter how undesirable, can never upset you. Recognize that neither another person, nor an adverse circumstance, can ever disturb you—only you can. No one else can get into your gut and churn it up. Others can cause you physical pain–by hitting you over the head with a baseball bat, for example–or can block your goals. But you create your own emotional suffering and self-defeating behavioral patterns, about what others do or say.
Once they admit that they distort their own emotions and actions, then, in this session, help them determine precisely how. The culprit usually lies in one of the three core “musts:”
“Must” #1 (a demand on oneself): “I MUST do well and get approval, or else I’m worthless.” This demand causes anxiety, depression, and lack of assertiveness.
“Must” #2 (a demand on others): “You MUST treat me reasonably, considerately, and lovingly, or else you’re no good.” This “must” leads to resentment, hostility, and violence.
“Must” #3 (a demand on situations): “Life MUST be fair, easy, and hassle-free, or else it’s awful.” This thinking is associated with hopelessness, procrastination, and addictions.
Help your patients ascertain what they’re demanding of themselves, of their significant others, or of their circumstances. Not until they’ve uncovered the “must” can they then go on effectively to reduce their distress.
In the final session, help your patients dispute their “musts.” The only way they can ever get undisturbed about adversity is by vigorously and persistently challenging one of these three “musts.” Thus, once they’ve bared them, then they can relentlessly confront and question their demands. They would begin by asking themselves: “What’s the evidence for my `must?'” “How is it true?” “Where’s it etched in stone?” And then by seeing: “There’s no evidence.” “My `must’ is entirely false.” “It’s not carved indelibly anywhere.” They would conclude, therefore:
Preference #1: “I strongly PREFER to do well and get approval, but even if I fail, I can accept myself fully,”
Preference #2: “I strongly PREFER that you treat me reasonably, kindly, and lovingly, but since I don’t run the universe, and it’s a part of your human nature to err, I, then, cannot control you,”
Preference #3: “I strongly PREFER that life be fair, easy, and hassle-free, and it’s very frustrating that it isn’t, but I can bear frustration and still considerably enjoy life.”
Once they make their views “must”-free, their emotions will heal.
Assuming that they take the above suggestions to heart and thereby greatly reduce their anxiety, hostility, depression, and addictions, what remains? Will they exist robot-like, devoid of human feeling and motivation? Hardly! Without their turmoil, they’ll more easily experience love, involvement, and joy. And without their addictions, they’ll be freer to engage in the gratifying experiences of spontaneity, commitment, and self-actualization.
TMT will appeal to psychiatrists who have brief therapy appointments, yet wish to help patients quickly take control of their own lives. By giving them tools for identifying and overcoming the true source of their difficulties, you will prepare your patients for tapering off their medication. And by helping them to reinforce realistic, self-benefiting beliefs, you will enable them to eliminate present emotional and behavioral problems, and to avoid future ones.
These simple, but powerful principles can be explained briefly, and will usually lead to a positive outcome for both psychiatrist and patient.
A variety of studies have shown REBT to be effective in treating disorders including depression, assertiveness, social anxiety, marital problems, borderline personality disorders, suicide, exhibitionism, and low self-esteem. A review surveying 31 treatment outcome studies of REBT, for example, demonstrated positive results (Engels, GI, Garnefski, N, & Diekstra, RF, 1993.)
Dr. Edelstein is a Training Faculty Member of the Albert Ellis Institute, past president of the Association For Behavioral and Cognitive Therapy, and a Diplomate in Cognitive-Behavioral Therapy. He is the author of Three Minute Therapy: Change Your Thinking, Change Your Life, for which the National Association of Cognitive-Behavioral Therapists awarded him “Author of the Year.” Dr. Edelstein has a private practice in clinical psychology in San Francisco.
Edelstein MR, Steele DR (1997), Three Minute Therapy: Change Your Thinking, Change Your Life. Lakewood, CO: Glenbridge Publishing Ltd.
Ellis A (1996), Better, Deeper, and More Enduring Brief Therapy: The Rational Emotive Behavior Therapy Approach. New York: Brunner/Mazel, Inc.
Engels, GI, Garnefski, N, & Diekstra, RF (1993), Efficacy of Rational-Emotive Therapy: A Quantitative Analysis. Journal of Consulting and Clinical Psychology 61:1083-1090.
The holidays provide a special opportunity for reaching out to loved ones, appreciating what we have, and expressing good will toward others.
Though not without a cost! Our finances may be stretched, our social engagements may seem unmanageable, and we may feel tempted to eat and drink excessively.
If you feel anxious and stressed about this adversity, apply the Problem Separation Technique. First determine which of these problems are practical (reality) problems and which are emotional (psychological).
Practical problems: our stretched finances, our overbooked–or underbooked–social schedules, temptations to eat and drink excessively.
Emotional problems: anxiety, stress, guilt, depression, resentment, procrastination, feeling overwhelmed, compulsive eating and drinking.
Use practical problem solving strategies to solve the former: risk-taking, trial and error, delicious circles, diets, divorce, making lists, no future regrets, Premack’s principle, prioritizing, Three Minute Relaxation, referenting, self-monitoring, Three Minute Wake-up Imagery, (See THREE MINUTE THERAPY: CHANGE YOUR THINKING, CHANGE YOUR LIFE for the instructions. Each technique is listed in the index.)
Solving practical problems requires careful thinking and persistent effort. These get hampered by distraught emotions.
Consequently your first step involves emotional problem-solving. The Three Minute Exercise, Three Minute Imagery, and Three Minute Refutations, are designed for this purpose. Once you’ve minimized your emotional problems, you can then more easily and effectively address your practical problems. Finally you are free to significantly enjoy this wonderful season!
In the aftermath of the tragic New York and Washington terrorist attacks, some individuals continue to experience paralyzing feelings of anxiety, hysteria, panic, phobias, and depression.
Three Minute Therapy (TMT), based on the pioneering work of psychologist Dr. Albert Ellis, offers a simple process for overcoming these debilitating feelings. TMT is based on clear principles having profound implications: 1. You are responsible for your own emotions and actions, 2. Your harmful emotions and dysfunctional behaviors are the product of your irrational thinking, 3. You can learn more realistic views and, with practice, make them a part of you, 4. You’ll experience a deeper acceptance of yourself and greater satisfactions in life by developing a reality-based perspective.
Follow these simple steps:
Step I. Recognize that you create your anxiety, phobias, and depressions.Events themselves, no matter how tragic, never can. Such disasters lead to appropriate sadness, grief, and mourning.However, unrealistic thinking distorts these adaptive emotions.
Step II. Identify your “musts.” Once you admit that you disturb your own emotions and actions, then determine precisely how. The culprit usually lies in demands you place on yourself, others, or situations, for example: 1. I MUST function perfectly normally right now or else I’ll never return to my prior normal state. Functioning abnormally turns me into an inadequate failure. 2. The world MUST be completely free of extreme tragedies and since it’s not, I can’t bear it. This proves the world is a horrible, terrible place. 3. I MUST have a guarantee I’m absolutely safe from danger or else I’m not safe at all. I can never be happy without certainty.
Step III. Dispute your “musts.” The only way you can ever get undisturbed about adversity is by vigorously, persistently challenging and contradicting your flawed view. Once you’ve bared them, then relentlessly confront and question your demands.
Begin by asking yourself: “What’s the evidence for my `must?'” “How is it true?” “Where’s it etched in stone?” And then by seeing: “There’s no evidence.” “My `must’ is entirely false.” “It’s not carved indelibly anywhere.” Make your view “must”-free, and then your emotions will heal. TMT (www.ThreeMinuteTherapy.com <http://www.ThreeMinuteTherapy.com> ) details effective ways to achieve this most important step.
Step IV. Reinforce your preferences. Conclude, therefore: 1. I strongly PREFER to function normally right now, but even if I don’t, I will accept myself unconditionally. At worst, all this proves about my personhood is that I’m an imperfect human who acts imperfectly, never an inadequate failure. 2. I deeply PREFER that the world be completely free of extreme tragedies but since it’s not, I can still enjoy life somewhat, although I would enjoy it more in a perfect universe. 3. I keenly PREFER to have a guarantee that I’m absolutely safe from danger and it’s uncomfortable not to have such guarantees, but I can live happily in an uncertain universe as long as I refuse to demand more.
Assuming that you take the above suggestions to heart and thereby greatly reduce your anxiety, panic, and depression, what remains? Will you exist robot-like, devoid of human feeling and motivation? Hardly! Without your turmoil, you’ll more easily experience involvement, satisfaction, and joy in a deeply flawed world.