Examination of Consequences and Allowing for Time Outs

[DISCLAIMER]

I recently spoke with client X about the examination of consequences, as well as allowing for time outs when practicing Rational Emotive Behavior Therapy (REBT). As it can be challenging to provide this information in a session with limited time, I’ll now share it with you herein.

First, the American Psychological Association (APA) defines examination as “a test, observation, or other means of investigation carried out on a patient to evaluate physical or mental health or detect the presence or absence of signs or symptoms of diseases, disorders, or conditions.”

Second, the APA defines a consequent as “an event, state, or circumstance that follows from some other event, state, or circumstance.” In a moment, I’ll illustrate the distinction between psychological consequences and the consequents which occur in the naturalistic world.

Last, the APA defines a time out as “a technique, originating from behavior therapy, in which undesirable behavior is weakened and its occurrence decreased, typically by moving the individual away from the area that is reinforcing the behavior.” Now, let’s discuss REBT.

REBT uses the ABC model to illustrate that when an undesirable Action occurs and you Believe an unhelpful narrative about the event, it’s your unfavorable assumption, not the occurrence itself, that causes an unpleasant Consequence. This is known as distress or disturbance.

Noteworthy, with virtually any undesirable Action that occurs, it’s your unfavorable Beliefs which cause unpleasant distress or disturbance (Consequence). Given this framing of self-distress and self-disturbance, it’s worth noting that one REBT source states (page 71):

REBT conceptualizes [distress] as healthy even though it is intense. Other approaches to therapy have as their goal the reduction of the intensity of negative emotions. They take this position because they do not keenly differentiate between healthy negative emotions (distress) and unhealthy negative emotions (disturbance).

Now, REBT keenly distinguishes between healthy distress and unhealthy disturbance. Healthy distress stems from your rational beliefs about a negative activating event [Action], whilst disturbance stems from your irrational beliefs about the same event.

Complete elimination of distress is highly unlikely in an impermanent and uncertain world wherein people conceptually suffer, struggle, and battle with, or merely experience hardship. Still, individuals often make matters worse for themselves by disturbing about such instances.

In particular, there are four predominate irrational beliefs which people often use to distress or disturb themselves: global evaluations, low frustration tolerance, awfulizing, and demandingness. When contemplating these unproductive scripts, think of the acronym GLAD.

Additionally, from a psychological standpoint, people distress or disturb themselves using a Belief-Consequence (B-C) connection. Of course, this isn’t to suggest that in the context of the naturalistic or physical world there is no Action-Consequence (A-C) connection.

From an A-C view, client X hypothetically endures impaired sleep at night (Action), as this person is then sleepy during the following day (Consequence). Still, it is client X’s B-C outlook about a lack of sleep that causes an unhealthy self-disturbed or healthy self-distressed outcome.

Imagine that when experiencing sleepiness (Action), client X unproductively Believes, “Life is meaningless [G], because I can’t stand living with a lack of sleep [L], as sleepy days are terrible [A], so either something better change, or else I’m going to take drastic measures [D]!”

When using this unaccommodating Belief, client X then endures unpleasant Consequences in the form of rumination (i.e., cognitive), despair (i.e., emotive), tingling throughout the body (i.e., sensation), and client X avoids sleeping later that night, as to exhaust oneself (i.e., behavioral).

Addressing how people upset themselves with unhelpful attitudes, the ABC model incorporates Disputation of unproductive philosophies of life in order to explore Effective new beliefs. Whereas rigid beliefs cause self-disturbance, flexible beliefs result in an un-disturbed condition.

Now, imagine that client X productively Disputes unhelpful Beliefs which cause negative and unhealthy disturbance. When doing so, this person achieves an Effective new belief that results in the un-disturbed condition of negative and healthy distress (i.e., a normal human condition).

“Although I preferably shouldn’t experience sleepless nights,” client X Effectively believes, “I’m not guaranteed restful nights, so it isn’t as though I absolutely mustn’t endure restless sleep.” With this self-narrative, client X then experiences disappointment (Consequence).

Remember, healthy distress stems from your rational Beliefs about an unwanted Action, as unhealthy disturbance stems from your irrational Beliefs about the same event. “How do I know what type of Beliefs I’m using,” client X plausibly may ask. I’m glad you’ve asked!

The answer is simple: examination of Consequences. This means that client X can investigate what cognitive, emotive, sensational, or behavioral results occur when using Beliefs. If the presence of signs relate to unwanted conditions, then one is using irrational scripts.

Yet, if tolerably distressed Consequences occur, then one is using rational self-narratives. For instance, it’s logical and reasonable (collectively “rational”) to prefer or use hopeful anticipation for a restful night. Still, disappointment is a healthy outcome if this preference isn’t met.

Now, suppose that client X has already tripped into a cycle of negative and unhealthy self-disturbance. This unpleasant reaction has Consequences. For example, if experiencing despair, client X may not be able to Dispute irrational Beliefs, because Consequences are too strong.

In this case, I’d encourage client X to take a relatively brief time out so that one’s cognitive, emotive, sensational, or behavioral Consequences can subside. For instance, client X could momentarily practice mindfulness (awareness of one’s internal states and surroundings).

I prefer the five senses exercise: notice five things that you can see, four things that you can feel (i.e., sensation), three things you can hear, two things you can smell, and one thing you can taste. The goal here is to take oneself out of chaotic Beliefs and into oneself and/or surroundings.

Therefore, I’d invite client X to search the Internet for the hundreds, if not thousands, of mindfulness exercises which are available for free. Also, this form of time out is intended for a relatively brief pause in self-disturbance, as to allow oneself to then reengage Disputing.

Photo credit, Designed by Magnific, fair use

Ultimately, examination of Consequences and allowing for time outs may increase one’s ability to effectively practice the ABC model, as I encourage you to engage in daily practice of REBT. Bear in mind that the aim isn’t to completely eliminate distress, though to target disturbance.

If you’re looking for a provider who tries to work to help understand how thinking impacts physical, mental, emotional, and behavioral elements of your life—helping you to sharpen your critical thinking skills, I invite you to reach out today by using the contact widget on my website.

As a psychotherapist, I’m pleased to try to help people with an assortment of issues ranging from anger (hostility, rage, and aggression) to relational issues, adjustment matters, trauma experience, justice involvement, attention-deficit hyperactivity disorder, anxiety and depression, and other mood or personality-related matters.

At Hollings Therapy, LLC, serving all of Texas, I aim to treat clients with dignity and respect while offering a multi-lensed approach to the practice of psychotherapy and life coaching. My mission includes: Prioritizing the cognitive and emotive needs of clients, an overall reduction in client suffering, and supporting sustainable growth for the clients I serve. Rather than simply trying to help you to feel better, I want to try to help you get better!

Deric Hollings, LPC, LCSW

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