Trolley Problem: Distress or Disturbance

[DISCLAIMER]

When providing professional care for mental, emotional, and behavioral health (collectively “mental health”), I practice Rational Emotive Behavior Therapy (REBT). In this blogpost, I’ll discuss one of the major techniques regarding this psychotherapeutic modality.

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, REBT is steeped in Stoic philosophy. For instance, in a book on this method of rational living ancient Stoic philosopher Epictetus is quoted as having stated, “It isn’t events [Actions] themselves that disturb people, but only their judgments about them” (page 118).

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.

Nevertheless, with virtually any undesirable Action that occurs, it’s your unfavorable Beliefs which cause unpleasant distress or disturbance (Consequence). Given this B-C 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 upset themselves: global evaluations, low frustration tolerance, awfulizing, and demandingness. When contemplating these unproductive beliefs, think of the acronym GLAD.

For instance, on March 2, 2026, in a blogpost entitled There’s a War Goin’ on Outside, That’s Just the Way It Is, I stated:

Now, consider that one source states, “At least 175 people, most of them likely children, were killed in a strike on a girls’ elementary school in southern Iran on Saturday [2/28/2026], health officials and Iranian state media said.” For illustration purposes, suppose the U.S. [United States] killed the kids.

From an A-C perspective, U.S.-led bomb strikes on a children’s school (Action) may cause death (Consequence). According to Hume’s law, this simply is. Yet, when using a B-C approach to life, one may unproductively violate Hume’s guillotine by demanding what ought to instead be.

U.S.-led bomb strikes on a children’s school results in death (Action) and one Believes, “The U.S. is entirely worthless [G], and I can’t tolerate its warring activities [L]! It’s outright horrible that children were killed [A], because this absolutely oughtn’t to have happened [D]!”

Specifically, using an absolutistic ought form of demandingness along with other GLAD scripts, an individual then self-disturbs into enragement (Consequence). That’s precisely how one metaphorically loses one’s own head when violating Hume’s guillotine!

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.

Since having posted that blog entry, U.S. President Donald Trump apparently denied that our nation was responsible for the school bombing about which many people self-distressed or self-disturbed. However, a recent source now reports:

An ongoing military investigation has determined that the United States is responsible for a deadly Tomahawk missile strike on an Iranian elementary school, according to U.S. officials and others familiar with the preliminary findings.

The Feb. 28 [2026] strike on the Shajarah Tayyebeh elementary school building was the result of a targeting mistake by the U.S. military, which was conducting strikes on an adjacent Iranian base of which the school building was formerly a part, the preliminary investigation found. Officers at U.S. Central Command created the target coordinates for the strike using outdated data provided by the Defense Intelligence Agency, people briefed on the investigation said.

Unlike many other individuals who I’ve observed self-distressing or self-disturbing about the school strike, my concern regarding this matter isn’t founded in feminist ideology. I care about the loss of non-combatant lives, irrespective of whether or not they were female.

Therefore, personal practice of REBT has resulted in healthy negative emotions of distress such as frustration, annoyance, or disappointment. Specifically, I don’t appreciate that my involuntary tax money is used to kill civilians regarding a hostile military campaign in Iran (i.e., war).

Of course, my use of the ABC model has allowed me not to figuratively lose my head, in violation of Hume’s guillotine, which would result in unhealthy negative emotions of disturbance such as rage, aggression, or depressive symptoms (i.e., emptiness, hopelessness, agitation, etc.).

Using the ABC model, I have an Epictetian choice regarding how I’ll react to unwelcome Actions. Often, this option creates a dilemma (a usually undesirable or unpleasant choice). As an example, the trolley problem comes to mind. Regarding this matter, one source states:

The trolley problem is a series of thought experiments in ethics, psychology and artificial intelligence involving stylized ethical dilemmas in a scenario of whether to sacrifice one person to save a larger number.

The series usually begins with a scenario in which a runaway trolley (tram) or train is on course to collide with and kill a number of people (traditionally five) down the railway track, but a driver or bystander can intervene and divert the vehicle to kill just one person on a different track.

Then other variations of the runaway vehicle, and analogous life-and-death dilemmas (medical, judicial, etc.) are posed, each containing the option either to do nothing—in which case several people will be killed—or to intervene and sacrifice one initially “safe” person to save the others.

Photo credit (edited), Designed by Imgflip, fair use

Ethics (principles of conduct governing an individual or a group) are intertwined with Stoicism in which REBT is steeped. Therefore, regarding the ABC model, the trolley problem relates to an undesirable or unpleasant choice that governs one’s own reaction to unwelcome Actions.

On one hand, I’d rather not experience frustration, annoyance, or disappointment (i.e., healthy negative emotions). On the other hand, it isn’t in my interests or goals to endure rage, aggression, or depressive symptoms (i.e., unhealthy negative emotions). This is an ethical dilemma.

For some people, escapism and avoidance is the preferred step toward a cathartic existence. In fact, I’ve had clients who’ve actively maintained as little exposure to unwelcome Actions as possible, such as the bombing of a children’s’ school, so as to irrationally pretend that life is safe.

However, such an illogical and unreasonable perspective isn’t the method applied by a Stoic. Particularly, I don’t hide underneath proverbial blankets while covering my head and pretending that truth about reality doesn’t exist. Instead, I face it head-on!

Now, I invite you to consider the trolley problem as it relates to distress or disturbance by use of a disjunctive syllogism (either p or q; not p; therefore, q). Although I encourage healthy boundaries regarding unpleasant media exposure, not always are unwelcome stories avoidable.

Form (disjunctive) –

Either p or q; not p; therefore, q.

Example –

Either you’ll choose unhealthy negative emotions in the form of self-disturbance or healthy negative emotions in the form of self-distress. You don’t choose unhealthy negative emotions in the form of self-disturbance. Therefore, you choose healthy negative emotions in the form of self-distress.

You’re the one at the lever of choice in this trolley problem. There’s a negative emotional Consequence either way. Presuming you don’t hide underneath a proverbial blanket for the rest of your life, then you’ll often face the choice between distress or disturbance. Choose wisely.

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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Browne, M., Livni, E., and Mahoozi, S. (2026, March 1). Strike on girls’ school kills at least 175, Iranian state media says. The New York Times. Retrieved from https://www.nytimes.com/2025/03/01/world/middleeast/girls-school-strike-iran-video.html

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