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To cite this article: Albert Ellis (1961) The Treatment of a Psychopath with Rational
Psychotherapy, The Journal of Psychology: Interdisciplinary and Applied, 51:1,
141-150, DOI: 10.1080/00223980.1961.9916466
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Published as a separate and in The Journal of Psychology, 1961, 61, 141-150.
T H E T R E A T M E N T OF A PSYCHOPATH WITH
RATIONAL PSYCHOTHERAPY*
Priwate Practire, N e w Yark
ALBERT
ELLIS
Downloaded by [University of North Carolina] at 19:57 08 October 2014
* Received in the Editorial Office on September 20, 1960, and published immediately
at Provincetown, Massachusetts. Copyright by The Journal Press.
141
142 JOURNAL OF PSYCHOLOGY
critical of his behavior, and if I a t first allied myself with him (if necessary)
against the authorities of the institution in which he was incarcerated (and
whom he almost invariably saw as being persecutory), a notable degree of
rapport could be established between us. T h e n , once the prisoner felt that
I was really on his side, it was often possible to show him that his pattern
of criminal behavior was not merely immoral and antisocial (which he of
course knew without my telling him so) but that, more importantly, it was
self-defeating. If I could convince him, which I often could, that however
much society might be (from his standpoint, justifiably and revengefully)
hzrmed by his crimes, he himself was invariably even more self-sabotaged
by these acts and their usual consequences, then I had a fairly good chance
of getting him to change his behavior in the future.
M y many investigatory and therapeutic relationships with criminals taught
me, then, that socalled hardened psychopaths, like other disturbed human
beings, act in an irrational and self-defeating manner because they believe,
quite falsely, that they are helping themselves thereby ; and when they are
calmly, unblamefully, and yet vigorously disabused of this belief, they are
often capable of radically changing their philosophic orientation and their
antisocial behavior which springs from that orientation. Because many or
most of the classic psychopaths are, as Cleckley points out, basically psychotic,
they are often most difficult to treat ; and one must usually be contented with
reasonably limited gains. Nonetheless, remarkable improvements in their
general living patterns, and particularly in the reduction of their antisocial
behavior, may result from proper treatment.
Partly as a result of my experience in treating youthful and older offenders,
as well as considerable experience in working with run-of-the-mill neurotics
and psychotics, I have in recent years developed a technique of psychotherapy,
called rational therapy, which is particularly applicable to the treatment of
severely neurotic and borderline psychotic individuals with whom psycho-
analytic and other treatment methods have had poor success. Rational
therapy, as I have explained in several previous publications (Ellis, 1957a,
1957b; 1958a, 1958b, 1958c), is based on the assumption that human beings
ALBERT ELLIS 143
telling themselves illogical and irrational sentences, or ideas, which they have
previously learned from their parents and their culture, and have internalized
and keep ceaselessly-and senselessly-repeating. T h e main emphasis of the
therapist who employs rational technique is on analyzing the patient’s current
problems-especially his feelings of anger, depression, anxiety, and guilt-and
concretely showing him that these emotions arise not from past events or
external situations but from his present irrational attitudes toward or illogicaI
fears about these events and situations.
Thus, the patient is shown that he has one o r more basic philosophic
assumptions underlying his behavior and that if this behavior is self-defeating
these assumptions must necessarily be ill-grounded. T h e main illogical
assumptions which most patients have a t the base of their disturbances include
the following: ( a ) that it is a dire necessity for an adult human being
to be approved or loved by almost everyone for almost everything he does;
( b ) that an individual should o r must be perfectly competent, adequate,
talented, and intelligent in all possible respects and is utterly worthless if
he is incompetent in any way; ( c ) that one should severely blame oneself
and others for mistakes and wrongdoings; ( d ) that it is terrible, horrible,
and catastrophic when things are not the way one would like them to be;
and ( e ) that most human unhappiness is externally caused or forced on one
by outside people and events and that one has virtually no control over one’s
emotions and cannot help feeling badly on many occasions. These misleading
assumptions are continually revealed and attacked by the rational therapist.
Where, in psychoanalytic techniques, considerable time is spent on showing
the patient how he originally became disturbed, in rational analysis much
more emphasis is placed on how he is sustaining his disturbance by still be-
lieving the nonsense, o r illogical ideas, which first led him to feel and act
in an aberrated fashion. Rational therapy differs from psychoanalytic pro-
cedures in that ( a ) not merely the facts and pschodynamics of the client’s
behavior are revealed but, more to the point, his underlying philosophies
or ideas which lead to and flow from these historical facts; ( b ) a concerted
attack is made on the irrational beliefs that are disclosed in the course of
114 JOURNAL OF PSYCHOLOGY
attention from his peers and his teachers at an early age by nasty, show-off
behavior; and had only been able to get along reasonably well with girls,
one or more of whom he usually managed to have serve him while he
sadistically exploited her masochistic tendencies.
Although the patient was quite intelligent, and could easily understand
psychodynamic explanations of his behavior-such as the possible connection
between his failing to satisfy his father’s high standards of excellence and
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his trying to prove to others, by quite opposite antisocial actions, how “great”
he was-no attempt to interpret or clarify such connections was made. For
one thing, he stoutly opposed such “psychoanalytic crap” whenever the psy-
chodynamics of his situation were even hinted a t ; for another thing, the
rational therapist frequently makes relatively little use of this kind of histor-
ical clarification, since he deems it highly interesting but not necessarily
conducive of basic personality change.
Instead, the patient’s current circumstances were first focussed upon, and
he was quickly and intensively shown that he kept defeating himself in the
present-as well as in the past. Thus, he kept discussing with the therapist
the possibility of his violating the terms of his bail and “skipping out of
town.” T h e therapist, without being in the least moralistic about this notion
or taking any offence at the implied concept that therapy was not going to
help the patient and that therefore he might as well go on living the kind
of life he had always lived, calmly and ruthlessly showed Jim that ( u ) he
had very little likelihood of being able to skip town without being caught in
short order; ( b ) he would only lead a life of desperate evasion during the
time he would remain free; and ( c ) he would most certainly know no mercy
from the court if and when he w a s recaptured. Although, at first, the
patient was most loathe to accept these grim facts, the therapist patiently
persisted in forcing him to do so.
At the same time, the therapist kept showing Jim the silly and totally
unrealistic philosophies behind his self-defeating notions of trying to skip
bail. H e was shown that he was grandiosely and idiotically telling himself
that he should be able to do what he wanted just because he wanted to do SO;
that it was totally unfair and unethical for others, including the law, to
stand in his way; and that it was utterly catastrophic when he was frustrated
in his one-sided demands. And these assumptions, the therapist kept insisting,
were thoroughly groundless and irrational.
“But why,” asked Jim at one point in the fourth session, “shouldn’t I
want things to go my way? W h y shouldn’t I try to get what I want?”
Therapist: No reason at all. T o want what you want when you want it
146 JOURNAL OF PSYCHOLOGY
them on to do all kinds of things they didn’t want to do, really, by your
misleading them as to your feelings for them. T h e girls you got pregnant
and deserted, for instance. T h e partners in crime you double-crossed. T h e
parents whose help you’ve always run back for after breaking promise after
promise to them? Would you call that lowe you felt for these people?
Affection? Kindliness?
Patient : Well-uh-no, not exactly.
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Therapist: And the hostility, the resentment, the bitterness you felt for
these people-and must keep perpetually feeling, mind you, as you keep
“getting away” with crime after crime-did these emotions make YOU feel
good, feel happy?
Patient: Well-at times, I must admit, they did.
Therapist: Yes, at times. But really, deep down, in your inmost heart,
does it make you feel good, happy, buoyant, joyous to do people in, to hate
them, to think that they are no damned good, to plot and scheme against
them?
Patient: No, I guess not. Not always.
Therapist: Even most of the time?
Patient: No-uh-no. Very rarely, I must admit.
Therapist: Well, there’s your answer.
Patient: You mean to the thick skin business? You mean that I thicken my
skin by hating others-and only really hurt myself in the process.
Therapist: Isn’t that the way it is? really is? Isn’t your thick skin-like
the lamps made of human skin by the Nazis, incidentally-built of, nourished
on little but your own corrosive hatred for others? And doesn’t that hatred
mainly, in the long run, corrode you?
Patient: Hm. I-. You’ve given me something to think about there.
Therapist: By all means think about it. Give it some real, hard thought.
I n a similar manner, the therapist, in session after session with this intel-
ligent psychopath, kept directly bringing up, ruthlessly examining, and
forthrightly attacking some of his basic philosophies of living, and showing
him that these philosophies underlay his antisocial thoughts and behavior.
No criticism of o r attack on the patient himself was made; but merely on
his ideas, his thoughts, his assumptions which (consciously and unconsciously)
served as the foundation stones for his disordered feelings and actions.
After 22 sessions of this type of rational therapy, the patient finally was
able to admit that for quite a long time he had vaguely sensed the self-
defeatism and wrongness of his criminal behavior, but that he had been
unable to make any concerted attack on it largely because he was afraid
ALBERT ELLIS 149
that he couldn’t change it-that ( a ) he had no ability to control his antisocial
tendencies; and ( b ) he felt that he would not be able to get along satisfac-
torily in life if he attempted to live more honestly. T h e therapist then
started to make a frontal assault on the philosophies behind these defeatist
feelings of the patient. H e showed Jim that an individual’s inability to
control his behavior mainly sterns from the idea that he cannot do s-that
long-standing feelings are innate and unmanageable and that one simply has
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REFERENCES
1. CLECKLEY, H. T h e Mask of Sanity. St. Louis: Mosby, 1950.
2. ELLIS,A. Rational psychotherapy and individual psychology. J . Indioid. Psychol.,
1957, 13, 38-44. ( a )
3. -. Outcome of employing three techniques of psychotherapy. 1. Clin.
Psychol., 1957, 15, 344-350. ( b )
4. .- Neurotic interaction between marital partners. J . Counsel. Psychol.,
1958, 6, 24-28. ( a )
5. .- Rational psychotherapy. J . Grn. Psychol., 1958, 69, 35-49. ( b )
6. -. Hypnotherapy with borderline schizophrenics. J . Gen. Psycho/., 1958,
69, 245-253. (c)
7. LINDNER,R. Rebel Without a Cause. New York: Grune & Stratton, 1944.
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