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Section 18
Commonalities between Alcoholics Anonymous & Rational-Emotive Behavior Therapy

Question 18 | Test | Table of Contents

Although Alcoholics Anonymous (AA) differs markedly from Albert Ellis's rational emotive behavior therapy (REBT) and its self-help derivatives, AA and REBT-based recovery groups share important rational objectives and numerous cognitive-behavioral methods. As well, AA and REBT emphasize a philosophical shift as a principal ingredient for change. AA attributes such change to spiritual experiences, whereas REBT and its derivatives attribute it to normal human efforts and talents. Many conceptualizations of spirituality overlap with "self-actualization," which REBT promotes through its advocacy of self-reliance and self-acceptance, its attitude toward the past, and its constructivist view of personality. REBT remains unique in psychotherapy and counseling in integrating a secular humanistic philosophy of life with cognitive-behavior therapy.

In this article, I make a case for the rationality of Alcoholics Anonymous (AA) and the spirituality of rational emotive behavior therapy (REBT). Why this seemingly odd pairing? Not odd at all, when you consider that Albert Ellis's REBT has parented or grandparented four of the nonspiritual alternatives to AA and the other 12-step programs, if you count separately the two distinct versions of Rational Recovery.

Jack Trimpey founded Rational Recovery (RR) in 1986 and extrapolated it from what then was rational emotive therapy (RET; Ellis, 1988; Ellis, McInerney, DiGiuseppe, & Yeager, 1988; Trimpey, 1992; Trimpey, Velten, & Dain, 1992; Velten, 1989). Audrey Kishline, an RR advocate in Indiana, recognized that large numbers of problem drinkers do not define themselves as alcoholics or as addicted, but nevertheless have problems with alcohol. She saw that RR's absolute insistence on abstinence, as much as AA's, turned off many such individuals. She believed it could be useful to have a moderated drinking alternative to RR and founded MM, Moderation Management, which is almost entirely a practical application of cognitive-behavioral techniques (Kishline, 1994). Then, in 1994, Trimpey changed RR in ways that led to a split in its ranks. Several of his new positions were diametrically opposed to positions that had originally attracted many of RR's main proponents (Trimpey, 1994). He solidified his theory that a specific physical structure in the brain is responsible for overindulgence in alcohol, advocated abolishing substance abuse treatment and research, scoffed at the idea that depression and other psychological problems contributed to substance abuse, declared that only people who had had drinking problems could understand those with such problems, and stated that one's life philosophy had nothing to do either with addiction or recovery from it. These radical changes in RR left many RR advocates, and most of its board members, with nowhere to go. They founded Self Management And Recovery Training, known as SMART Recovery, which has retained a close alliance with Ellis and REBT (Tate, 1995).

Albert Ellis's (1996) article on humanistic psychology and REBT in this special issue of The Journal of Humanistic Education and Development illustrates his approach as a secular humanistic psychologist and describes some of REBT's goals, purposes, and methods. REBT is a prime example of a self-help methodology, having been used in many self-help books, including several that have sold in the millions. SMART Recovery is an application of REBT for people seeking secular tools they can learn and use in their efforts to overcome addictions.

There are several fundamental differences between REBT (and its derivative SMART Recovery) and AA. For example, REBT strongly emphasizes individual human power and capacity for self-growth and self-development, and AA equally emphasizes strongly permanent disease status, personal powerlessness, and reliance on a Higher Power and God as you understand Him. A number of articles and books have described these differences from the REBT viewpoint (Ellis & Velten, 1992; Tate, 1993; Velten, 1992, 1993a, 1993b), as well as from the perspective of a social psychological critique of the 12-step ideology (Fingarette, 1988; Peele, 1989; Peele & Brodsky, 1991).

Although AA and REBT have radical differences, Ellis's view is that the central aim of AA's spiritual healing approach is rational (Ellis &Velten, 1992).AA's purpose to help people stay alive (by abstaining from alcohol) and suffer less is, by definition, the core of the word rational in REBT. Ellis and Velten have pointed out and used a number of practical ideas, sayings, and procedures from the 12-step traditions that easily could spring from the cognitive-behavioral therapies. This article looks at some of these other ways in which AA is rational (as in REBT). A more surprising question that this article addresses is whether there are some ways in which REBT and its addiction self-help extrapolation (SMART Recovery) are spiritual and, therefore, humanistic even from the present-day nonsecular perspective. Instead of their differences, then, this article presents the similarities between the AA approach and the approach of REBT and its derivative SMART Recovery. In particular, it delineates their similarities on the dimension (or the characteristics at least) on which they seem to differ most, namely spirituality rationality.

Definition of Rational(ity)
To determine in what ways AA is rational, it is necessary to define rational. According to The Random House Dictionary of the English Language, 2nd Edition, Unabridged, rational has eight meanings. Two of them are strictly mathematical and of no interest in this connection, leaving six:

On the other hand, the particular definition of rational used in Albert Ellis's REBT and by its derivative, SMART Recovery, as well as the original version of Rational Recovery, is closest to the dictionary meanings of rational, which include the words "sound judgment" and "good sense."

The rational and the irrational of REBT and SMART Recovery are defined in the context of the individual's goals and objectives. Rational beliefs are those that (a) promote healthy emotions, whether negative or positive, and self-helping action tendencies, which are those that tend to help one reach long-term and short term goals including happiness, good health, and continued life; (b) avoid unnecessary conflict with others; and (c) motivate one to solve life problems more effectively and to constructively cope with what cannot be changed. Irrational beliefs, on the other hand, are those that (a) promote unhealthy emotions, whether negative or positive, and self-defeating action tendencies; (b) contribute to unnecessary conflict with others; and (c) compound life problems or otherwise help defeat one's purposes.

Thus, rational and irrational in REBT are relative to the individual's particular goals, purposes, motivations, priorities, and options. What showed sound judgment or good sense for an individual at one time, may be foolish or irrational at another time. Rational beliefs (those that are helpful to the individual in a particular context) are not always logical or factually supported, but many, probably most, are. For example, the belief that crystals combat cancer may not be logical or empirically supported; yet, if belief in crystals produces optimism, the cancer victim might feel better. Feeling more hopeful might possibly also help combat the cancer, but if so, a belief, not the crystals, would have produced the effect. On the other hand, belief in the efficacy of crystals could work against the person's goal of staying alive and, therefore, would be irrational. The person might ignore effective treatments or waste so much money on quackery that he or she could not afford legitimate treatment.

How AA is Rational and a Cognitive-Behavioral Therapy
Despite some radical differences of AA from REBT and SMART Recovery in their assumptions about alcohol dependence and what is required to recover from it, AA also shares many of the same REBT and other cognitive-behavioral components used in SMART Recovery. Some of these main rational (as in REBT) components of AA include the following:

AA is like REBT in advising people to put into practice, by helping others, their new self-helping philosophy. People help themselves maintain their new ways of thinking and acting by helping others. In AA, this is called "Twelfth-stepping", while Albert Ellis calls it "common sense," given the irrational tendencies and marked fallibility of human nature.
- Velten, Emmett; The Rationality of Alcoholics Anonymous and the Spirituality of Rational-Emotive Behavior Therapy; Journal of Humanistic Education & Development; Dec 1996; Vol. 35, Issue 2.

FIVE YEARS, TWELVE STEPS, AND REBT IN THE TREATMENT OF DUAL DIAGNOSIS

- Penn, Patricia & Brooks, Audrey. (2000). Five Years, Twelve Steps, and REBT in the Treatment of Dual Diagnosis. Journal of Rational-Emotive and Cognitive-Behavior Therapy. 18. 197-208. 10.1023/A:1007883021936.

Personal Reflection Exercise #4
The preceding section contained information about commonalities between Alcoholics Anonymous and rational-emotive behavior therapy. Write three case study examples regarding how you might use the content of this section in your practice.
Reviewed 2023

Update
Effectiveness of rational emotive behavior
therapy in reducing depression among
undergraduate medical students

Victor-Aigbodion, Vera PhDa; Eseadi, Chiedu PhDa; Ardi, Zadrian PhDb; Sewagegn, Abatihun Alehegn PhDa,c,*; Ololo, Kennedy PhDd; Abonor, Lazarus Bassey PhDe; Aloh, Henry Egi PhDf; Falade, Temitope Ayodeji BEdg; Effanga, Offiong Asuquo MEdg. Effectiveness of rational emotive behavior therapy in reducing depression among undergraduate medical students. Medicine 102(4):p e32724, January 27, 2023. | DOI: 10.1097/MD.0000000000032724

Peer-Reviewed Journal Article References:
Davis, H., & Turner, M. J. (2020). The use of rational emotive behavior therapy (REBT) to increase the self-determined motivation and psychological well-being of triathletes. Sport, Exercise, and Performance Psychology, 9(4), 489–505.

Ellis, A. (1999). Why rational-emotive therapy to rational emotive behavior therapy? Psychotherapy: Theory, Research, Practice, Training, 36(2), 154–159.

Ward, J. J. (2012). The accidental practitioner: Principles of rational emotive behavior therapy in the works of Kurt Vonnegut. Journal of Humanistic Psychology, 52(1), 105–131.

Waugh, C. E., Running, K. E., Reynolds, O. C., & Gotlib, I. H. (2019). People are better at maintaining positive than negative emotional states. Emotion, 19(1), 132–145.

QUESTION 18
What are four similarities between REBT and AA? To select and enter your answer go to Test.