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Frustration Intolerance: Therapy Issues and Strategies

Article  in  Journal of Rational-Emotive and Cognitive-Behavior Therapy · March 2011

DOI: 10.1007/s10942-011-0126-4

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J Rat-Emo Cognitive-Behav Ther
DOI 10.1007/s10942-011-0126-4

ORIGINAL ARTICLE

Frustration Intolerance: Therapy Issues and Strategies

Neil Harrington

 Springer Science+Business Media, LLC 2011

Abstract This article aims to provide an overview of the Rational Emotive

Behavior Therapy (REBT) concept of frustration intolerance. Therapeutic issues
regarding these beliefs are discussed, including engagement, the use of disputation,
and behavioral techniques.

Keywords Low frustration tolerance (LFT)
Frustration intolerance
Rational

emotive behavior therapy

Introduction

Frustration intolerance is central to the theory and practice of rational emotive

behavior therapy (REBT). However, clinical experience suggests these beliefs are
more difficult to recognize and change, compared to those of self-worth. One reason
may be the greater complexity and range of frustration intolerance beliefs. The
purpose of this article is to provide a brief overview of the concept of frustration
intolerance, and to examine issues involved in assessment and treatment.

The Concept of Frustration Intolerance

There is a scene in the film Zulu, in which a small group of British soldiers,
surrounded at Rorke’s Drift, face almost certain annihilation. A young private
voices his fear and disbelief: ‘‘Why is it us, why us?’’ A sergeant looks over, and
replies, as if this were self-evident: ‘‘Because we’re here lad.’’ We have all
entertained similar thoughts, although probably in less dramatic circumstances: the

N. Harrington (&)
Psychology Department, Stratheden Hospital, Cupar, Fife Health Board KY15 5RR, UK
e-mail: neil@nharr.freeserve.co.uk

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 N. Harrington

idea that we should be spared the frustrations and discomforts of life, and disbelief
at having been unfairly singled out. The sergeant’s reply also encapsulates a
philosophy of how we might approach such difficulties in life: it suggests the key is
the acceptance of harsh reality. Yet this is not a plea for passive resignation, but an
encouragement to make the most of a situation, and take whatever action we can.
Such ideas are not new. The Stoic philosophers argued that emotional
disturbance arose from trying to shoehorn reality into fitting our desires. For peace
of mind, we should aim to live in accordance with reality, and not attempt to control
the uncontrollable. This was later echoed by Freud, who suggested neurosis was
essentially the turning away from a reality we considered unbearable. Nevertheless,
whilst acknowledging these influences, REBT was the first therapy to explicitly
describe frustration and discomfort intolerance, and to incorporate these beliefs into
a systematic cognitive model (Ellis 1979, 1980; Ellis and Dryden 1987).
de Botton (2000), in discussing Stoicism and frustration, notes that, ‘‘at the heart
of every frustration lies a basic structure: the collision of a wish with an unyielding
reality’’ (p. 80). However, REBT argues that frustration, by itself, is insufficient to
create psychological disturbance. To become disturbed by frustrating events, an
additional belief is required: that reality must conform to our wishes, or it will not be
tolerated. In other words, frustration intolerance arises, not just from the wish that
reality was different, but from the collision of a demand with reality. The purpose of
REBT is to challenge our demands and intolerance, and to strengthen an alternative
belief. This alternative belief is that, whilst we may never like frustration and
discomfort, we had better accept they exist.
Unfortunately, the terms toleration and acceptance are both prone to misinter-
pretation. Toleration, as used by REBT, is not giving up or passively accepting
events, but involves strengthening our resolve to overcome problems. Clients may
also confuse toleration with condoning bad behaviour. In REBT, toleration implies
that we may dislike a situation and want to change it, but to achieve our goals we
often have to tolerate frustration and discomfort, at least in the short term. We also
need to accept that some things are unchangeable, or require considerable time and
effort to change. Furthermore, since our goals are frequently in conflict, we are often
required to tolerate the frustration of choosing priorities. Yet whilst the importance
of acceptance of negative emotions and thoughts has been recognised by several
types of therapy, extending this to the acceptance of external events has been
questioned (e.g., Hayes 1994). In particular, determining what is to be accepted,
rather than changed, is problematic: how do we decide whether a tyrannical regime
or an abusive relationship is to be tolerated or opposed?
However, the idea that toleration and change are mutually exclusive is to
misunderstand the REBT concept of frustration intolerance. Tolerance is the
acknowledgement of reality, whether or not we attempt to change this reality (Ellis
and Robb 1994). Thus, we might decide to (1) live with an overcritical partner, (2)
try to change them, or (3) leave. However, each option can be approached in a
disturbed or non-disturbed way, depending on our beliefs. For example, if we
believe we are entitled to better treatment, and such behavior is unbearable, we are
likely to feel angry—whatever the option chosen. On the other hand, if we accept
people are not perfect, and tolerate this frustration, we can act more assertively and

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calmly. REBT is unable to answer the moral or practical question as to which option
to take; Stoicism would suggest this decision is based on our judgement regarding
the likelihood of change, our own values, and desired outcomes. However,
increased tolerance of frustration and discomfort enables us to be better placed to
make this decision. Indeed, it can be argued that only through our experience of
frustration and discomfort do we truly understand the world and ourselves. Whilst
we may read about love and loss, it remains an intellectual notion until experienced
first hand; and without healthy negative emotions, arising from frustration, our
choices would be bloodless, empty, and lacking motivation. As Sherman (2005) has
noted, our feelings of healthy outrage at abuse and injustice are what define our
humanity, and not something to be treated and removed.

Preparation for Therapy

Assessment

REBT distinguishes frustration intolerance beliefs from those of self-worth. Whilst

both types of belief involve demands, they are considered separate categories of
disturbance, and to represent different kinds of cognition. For frustration intolerance
problems, the demand is that reality must be as we want it to be; whereas, for self-
worth problems, the demand is that certain conditions must be met to consider
ourselves worthwhile. The first type of belief represents a distortion of reality,
whilst the second is based on a conditional, absolutistic, definition of self-worth
(DiGiuseppe 1996).
Therefore, an important part of therapy assessment is the determination as to
whether a problem reflects issues of frustration intolerance or self-worth.
Unfortunately, it is not possible to distinguish between these two categories of
belief from the ‘‘must’’ alone, since both categories can involve demands that refer
to the domain of the self (Dryden 1996). For example, ‘‘I must do well in my exam’’
may reflect self-worth (‘‘If I fail, it means I am stupid’’), or frustration intolerance
(‘‘I couldn’t bear the hassle of re-sits’’). The former is an absolute rating of worth,
whilst the latter reflects intolerance of future discomfort. Dryden (1996) suggests the
best way of determining the belief category is by exclusion: if there is no self-worth
belief, or if this is comparatively weak, then the problem is one of frustration
intolerance.
Although frustration intolerance is often considered a single dimension, several
different areas of belief content are included in this concept (Dryden 1999; Dryden
and Gordon 1993). As such, it can be useful to distinguish between different forms
of frustration intolerance (Harrington 2007), such as discomfort intolerance
(‘‘I can’t stand the hassle’’), emotional intolerance (‘‘I can’t bear feeling anxious’’),
entitlement (‘‘I can’t stand lack of respect’’), and achievement perfectionism
(‘‘I can’t stand having my goals frustrated’’). For instance, beliefs regarding
certainty and control may refer to several different content areas, such as emotional
intolerance (‘‘I must control my panic’’), achievement frustration (‘‘I must be certain

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I have done things correctly’’), entitlement (‘‘People must do as I say’’), and

discomfort intolerance (‘‘I must be sure there will be no hassles’’).
These content areas are strongly correlated with each other, and complex
disorders may involve several frustration intolerance beliefs. For example, a client
may complain of anger regarding bullying at work (‘‘I shouldn’t have been treated
so unfairly’’), or of frustration intolerance depression (‘‘Life’s so unfair. I don’t
deserve these problems’’). These two frustration intolerance beliefs may flip
between each other, as well as with self-worth beliefs. For instance, the frustration
intolerance beliefs relating to anger and depression both refer to unfairness, but
involve different content areas (entitlement-discomfort), and have different
emotional consequences (anger-depression). It is also possible that ‘‘self-pity’’
depression related to discomfort intolerance may flip to over to depression based on
self-blame (‘‘I deserved to be treated badly—I’m just useless’’). It has been
suggested, that disputing one set of beliefs may leave the other belief areas intact.
Thus, having helped a client to see they are not to blame for their situation, their
depression may then turn to anger due to a shift of blame to the other person
(DiGiuseppe and Tefrate 2007; Yapp and Dryden 1995).

Therapy Engagement

Compared to self-worth, frustration intolerance presents a greater challenge

regarding therapy engagement. One reason is that, rather than blaming themselves
for their problems, those suffering from frustration intolerance blame the world and
other people. It follows from this view, that the world and other people should
change, and not the client—who remains a victim of unfairness, injustice, and
intolerable events. In addition to this external focus is the belief that disturbed
emotion or behavior is justified. Thus, the angry client believes that they are entitled
to be righteously furious at injustice. Likewise, the emotional intolerant client will
be incredulous at the suggestion that distress might be tolerated; the discomfort
intolerant will point to the overwhelming difficulty of taking action; and
achievement perfectionists will argue that high standards are absolutely necessary
to further their goals.
A related difficulty, and a common cause of therapeutic failure, is that goals
associated with frustration intolerance are often contrary to those of the therapist.
The therapist wants to teach coping strategies, whilst the client wants to remove or
control the source of frustration or discomfort. This reflects the absolute nature of
frustration intolerance beliefs, in that, events are not perceived as simply
undesirable, but as absolutely unbearable. To overcome these barriers to progress,
it is necessary to pay particular attention to validation and goal setting.

Validation

Validation is central to engaging frustration intolerance problems. These problems

do not exist in a vacuum, but are often associated with genuinely difficult and
unpleasant events. The failure to acknowledge these experiences as real difficulties
is likely to leave the client feeling misunderstood and their suffering dismissed.

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For the therapist to immediately sweep in with suggestions for change, can imply
the client and their reactions are wrong. This will almost certainly lead the client to
justify their beliefs and emotions, and to therapy dropout. Acknowledging negative
events, whilst suggesting the client is ultimately responsible for their emotional
reactions, clearly requires considerable care. Central to this task is the distinction
between healthy and unhealthy negative emotions. This distinction enables events to
be accepted as emotional distressing, but not necessarily psychologically disturbing:
T: Nobody likes to be unfairly criticised. However, there are two ways in
which we can react to a bad situation. We could react in a healthy way – by
feeling very annoyed, but not letting this get to us. Or we could react in an
unhealthy and counterproductive way, by feeling furious over the top anger.
Can you think of situations where you have been annoyed but not over-
the-top?
C: Well yes, my mother criticised me on the phone last week, but I remained
in control.
T: How did you do that?
C: I just thought, ‘‘Here she goes again. It’s just the way she is. Why get
angry?’’
T: So, by thinking differently, you prevented yourself becoming furious whilst
still remaining annoyed.
Similar care is required with behavioral problems, given that clients may find it
shameful to admit to a ‘‘lack of self-discipline’’, and may instead focus on irrelevant
issues or beliefs. There can also be considerable secondary gains involved, which
the client may be reluctant to expose. However, when problems such as
procrastination are identified, there is often a sense of relief, since these hidden
patterns of behavior are recognised as causing significant long-term difficulties.

Agreement on Goals

Frustration intolerance beliefs are dysfunctional because they block personal goals.
Therefore, agreement on personal goals is vital, and can be used as a reference point
when challenging these beliefs (‘‘How does the belief, ‘I must do everything
perfectly well’, help you achieve your goal of work satisfaction?’’). Specific therapy
goals will differ, depending on the type of frustration intolerance involved. For
instance, discomfort and emotional intolerance are associated with passivity and
avoidance, whilst entitlement and achievement frustration tend to be associated with
action and confrontation. Therefore, the therapy goal in achievement perfectionism
might be to increase tolerance for delegating jobs and limiting workloads. In
contrast, for discomfort intolerance, the goal might involve greater persistence and
commitment to difficult tasks.
Determining the therapeutic goal in frustration intolerance problems can be
difficult. For example, a lack of ‘‘self-confidence’’ is frequently mentioned by
clients as a reason for not undertaking tasks. However, this may well reflect
frustration intolerance, rather than poor self-worth (‘‘I must be certain a job will be
easy and straightforward before I can do it’’). A similar misleading goal is the

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request by clients for greater control. Frequently, such goals are unrealistic, and
reflect a need to control aspects of the world over which we have little direct
control. For instance, the Stoics argued that we can influence, but not control, other
people’s actions. And yet clients with entitlement beliefs commonly attend therapy
with the goal of changing other people. Similarly, clients with emotional intolerance
will demand control over unpleasant thoughts and emotions. REBT suggests we can
change our emotions by changing our thinking and behavior, but does not suggest
all types of thinking are controllable. Rather, it focuses on challenging absolute
evaluative beliefs. Thus, we may not be able to dismiss an obsessive thought, but we
can change our evaluation of the thought from, ‘‘this thought is unbearable, and
must be controlled’’ to ‘‘this thought is unpleasant, but can be tolerated’’. Evidence
suggests that attempting to control some types of thinking is counterproductive, and
indeed, REBT would argue that any demand to think or feel in a certain way risks
emotional disturbance.
Having agreed a goal, a client has to commit time and effort to achieve this goal.
Unfortunately, the Catch-22 is that lack of persistence, effort, and commitment is
often the central presenting problem. There are no easy solutions to this dilemma,
and as DiGiuseppe (1991) has noted, novice therapist underestimate the amount of
persistence, repetition, and time required, to dispute frustration intolerance beliefs.
Many novice therapists, having obtained ‘‘I can’t stand it’’ beliefs, will run out of
ideas for disputation and move on to other issues. Clearly, the client also needs to
persist at tasks, and in this regard, it is helpful to encourage commitment to the
process of working on a goal, rather than the goal outcome itself (Trower and
Dryden 1989). If outcome is the focus, then any failure or difficulty will trigger
further frustration intolerance beliefs (‘‘I knew this wouldn’t work, it’s too
difficult’’). On the other hand, focusing on working towards a goal includes the
recognition that frustration and discomfort are inevitable aspects of this process,
rather than signs of failure (‘‘There will be problems, I can’t expect it to work first
time’’).

Therapeutic Style and Language

Terminology can be unhelpful, and the traditional REBT term, low frustration
tolerance (LFT), is particularly open to negative interpretations (Dryden 1999). LFT
can carry undertones of moral condemnation, and is reminiscent of the label LMF
(‘‘lack of moral fibre’’), as used by the RAF during World War II for those unable to
face further combat. As Muran and DiGiuseppe (1994) note, to suggest to someone
who has suffered difficulties or trauma that they are frustration intolerant, devalues
the person’s attempts to cope with adversity.
Therapists also need to focus on meaning, rather than rushing to dispute any
irrational sounding words that poke their head above the parapet. Such overzealous
disputing has been highlighted in regard to ‘‘shoulds’’, which often have a benign
meaning when used in everyday speech (Neenan and Dryden 1999). The therapist
needs to establish whether ‘‘shoulds’’ truly represent absolute demands, and are not
just recommendations or preferences. This caution also applies to the characteristic
expression of frustration intolerance—‘‘I can’t stand it’’, since this term can be used

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to mean something unpleasant or disliked, rather than absolutely intolerable.

Distinguishing irrational ‘‘I can’t stand it’’ beliefs requires assessment of the
emotions and behavior associated with the belief (‘‘When you say, ‘I can’t stand it’,
does this mean you would do anything to avoid it, or do you just dislike it?’’).

Cognitive Change

Disputing Musts

With clients who are ambivalent about change, it is important to review short- and
long-term costs and benefits—what Ellis terms hedonic calculus. Unfortunately, it is
the nature of frustration intolerance that costs are often distant, uncertain, and weak;
whilst perceived benefits are immediate, tangible, and strong. To act against this
diabolically uneven balance requires more than a cost and benefit analysis, since
many clients are aware their behavior is destructive in the longer term. The difficult
is that, given an absolute ‘‘need’’, obtaining this need will be considered paramount
by the client, and therefore any costs involved will be of marginal importance.
Therefore, highlighting the benefits of change in the face of strong frustration
intolerance beliefs is equivalent to discussing healthy eating with someone who is
starving. It is better to challenge the ‘‘need’’ itself, by questioning whether this
represents something that is unpleasant but tolerable, or if it is truly a threat to
existence.
A ‘‘need’’ is one of several ways demand beliefs are expressed. As with other
types of demand, a need is an absolute requirement, as opposed to a desire or
preference. Clients may not fully understand this distinction, since demands include
strong desires. For example, a client may complain that being deprived of a
relationship makes life so impoverished it constitutes a need. However, whilst
relationships are important and strongly desirable, people do survive and are happy,
despite such deprivation. The belief, ‘‘I must not be deprived’’, can be associated
with several types of frustration intolerance. For instance, it could reflect
entitlement, (‘‘I must not be deprived of things I want now’’). On the other hand,
it may indicate discomfort intolerance (‘‘I should not be deprived of happiness by
these problems’’). Although both of these beliefs refer to deprivation, different
emotional consequences are likely to be involved, with entitlement leading to anger
and discomfort intolerance to low mood (Harrington 2006).
In disputing needs and demands, it is useful to distinguish between the ideal and
the real world. A useful analogy is for the client to imagine a holiday in Scotland,
where it (invariably) rains:
T: Would it be sensible to stand in the rain shouting ‘‘It shouldn’t be raining’’,
and becoming increasingly angry or distressed?
C: No. If it rains, there’s nothing you can do about it.
T: In other words, you would think, ‘‘In an ideal world, holidays would always
be sunny. But tough, it rains, I’ll buy an umbrella’’.
C: That would be more sensible.

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T: But, aren’t your thoughts about your job, similar to being angry with the
rain – ‘‘I shouldn’t be treated like this, I should get more money!’’ Can you
make your boss give you a pay rise, any more than you can stop the rain?
Clients readily accept the idea that physical reality exists, and ‘‘you can’t change
the laws of physics’’, as Scotty in Star Trek would exclaim. However, applying this
to situations involving people, presents greater difficulty. Clients will argue, that
unlike an act of God, people ‘‘should know better’’. One way of challenging this
belief is by noting people are also part of the natural world: they are prone to
making mistakes and acting unfairly. Whilst we may want people to act perfectly, to
demand that they do so would require us to be omnipotent. It is, in other words, the
distinction between: ‘‘Ideally my teenage son would treat me with respect, and clean
his room’’, compared with ‘‘My son absolutely must clean his room and be
respectful’’. As Seneca notes, wrongdoing is commonplace, and if we reacted to all
injustice with anger, our lives would be consumed.
It is also sometimes useful, rather than to directly question the belief that
‘‘people should act differently’’, to suggest instead, that people ‘‘should’’ act
exactly as they do. It can be pointed out that friends and relations have continued
to act the same way over many years. Indeed, given their personality and
background, this is exactly how they would be expected to behave. It is easy, with
hindsight, and by selectively forgetting the constraints existing at the time, to
believe things in our life could have been different. The Dutch philosopher,
Spinoza, noted we become emotionally disturbed about the past by believing
things should have been different. He argued we can free ourselves of becoming
emotionally disturbed about the past by our reason: by recognising what did occur
was the only possible outcome when all the factors associated with the situation
are taken into account.
One feature of frustration intolerance problems is that the same triggers occur
with monotonous regularity. Although clients often complain their anger, anxiety, or
low mood, ‘‘comes out of the blue’’, they often describe predictable patterns. Such
predictability has its benefits, since it enables us to plan and rehearse our responses
to frustration intolerance. As Marcus Aurelius suggests: ‘‘Begin each day by saying
to yourself: Today I shall be meeting with interference, ingratitude, insolence,
disloyalty, ill-will, and selfishness.’’(Meditations, II: 1). His advice is a form of
philosophical defensive driving: rather than expecting other drivers to be skilled and
thoughtful, we should instead expect frustration and human error.

Disputing ‘‘I can’t stand it’’

As with demands, three general strategies are used to dispute frustration intolerance
beliefs (DiGiuseppe 1991). Firstly, ‘‘I can’t stand it’’ can be challenged empirically,
by highlighting how this belief is inconsistent with reality (‘‘You say you can’t stand
feeling anxious, but you were anxious on the aircraft, and survived—so you did
stand it, even though it was unpleasant’’). Secondly, frustration intolerance beliefs
are open to logical dispute (‘‘Although a difficult task, how does it follow it is too
difficult?’’). Finally, a belief can be challenged pragmatically, in terms of the

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consequences of holding the belief (‘‘If I was to believe, ‘This job is too difficult.
I’ve got to be in the right mood’, how would it help my motivation?’’).
Frustration intolerance beliefs are also characterised by inflexibility, and for
some types of frustration intolerance it is very useful to focus on increased
flexibility as a therapy goal. For example, achievement frustration perfectionists are
particularly resistant to changing their behavior, since perfectionism has often been
associated with success, although with significant personal costs. In contrast to
discomfort intolerance, perfectionistic demands encourage a single minded pursuit
of goals, but make it difficult to modify these goals when they become
counterproductive. Most dramatically, we read of climbers who have died, having
been unwilling to abandon a climb despite bad weather.
In challenging these beliefs, a distinction between positive and negative
perfectionism is helpful, since it highlights that not all perfectionism is dysfunc-
tional, only that linked to irrational demands (Terry-Short et al. 1995). A preference
for high standards only becomes dysfunctional when it is converted to a demand that
these high standards must be achieved, no matter what. By challenging only
negative perfectionism, the client is not confronted with the daunting prospect of
changing their overall personality, but of reducing aspects of perfectionism blocking
realistic achievement. Commonly, perfectionists will attend for treatment because of
stress resulting from conflicting work, social, and family pressures. Tolerating the
frustration of not doing perfectly well on all these tasks, whilst maintaining a desire
to do well on some, is often a more acceptable goal than of being ‘‘average’’.
Furthermore, recognition by the therapist, that positive perfectionism and the pursuit
of high standards can be functional, enables validation of the client’s personality.
Another potential area of confusion lies in the distinction between achievement
perfectionism, entitlement, and narcissism. The psychological literature often refers
to these traits as if they were all facets of narcissistic personality (Beck and Freeman
1990). However, it can be argued that the beliefs involved in these three areas are
distinct. Whilst achievement perfectionists are intolerant of having their goals
blocked, this does not necessarily arise from a sense of being special or superior.
Indeed, narcissism is perhaps more associated with self-indulgence, and a belief that
hard work is unnecessary for success. This is contrary to perfectionists, who are
intolerant of low standards and lack of effort. Narcissism may also differ from
entitlement, in that expecting special treatment is not the same as believing one is
entitled to such treatment. Although research is limited, there is empirical evidence
to support this distinction. For instance, Witte et al. (2002) found that anger was not
correlated with global narcissism scores, but was highly correlated with entitlement.
This might suggest narcissism represents a self-worth disorder, and whilst
frequently co-existing with entitlement beliefs, that these self-worth and frustration
intolerance beliefs are best treated separately.
When disputing emotional intolerance beliefs, it is probably better to dispute
grossly distorted inferences first, particularly if these refer to ‘‘catastrophic’’
symptoms (Dryden 1995). For example, to suggest that breathlessness and chest
pains are not ‘‘awful’’, when being misinterpreted by the client as a heart attack, is
unlikely to be well received. On the other hand, by first re-evaluating these chest
pains as unpleasant anxiety symptoms, tolerance of these symptoms is more likely

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to be accepted. DiGiuseppe (1991) has made a similar point in regard to the level of
abstraction at which beliefs are challenged, and suggests moving up a ladder from
the concrete to the general. Thus, it would be more effective to dispute the belief,
‘‘I can’t stand my children not cleaning their room’’ before moving on to the more
abstract ‘‘The world must be as I want, and people must do as I say’’. It is also
important to be realistic regarding the degree of philosophical change that can be
expected of clients. For instance, clients are more willing to tolerate discomfort as
long as it is relatively short lived. Therefore, it may be better to aim for limited
tolerance, rather than a more general acceptance of discomfort. Indeed, discomfort
is usually time limited, and the thought that discomfort will last for ever, may be a
distorted inference arising from frustration intolerance beliefs.
C: I need a cigarette to relax.
T: But you described yourself as relaxed before you became a smoker.
C: I suppose so. But if I don’t smoke, I feel really tense - I couldn’t stand
feeling like that all the time if I stopped.
T: But that is a reaction to withdrawal from nicotine. It is unpleasant, but it
will only last a few weeks.
Unfortunately, a common response to therapeutic suggestions is ‘‘buts’’. These
are rationalisations for not taking action arising from frustration intolerance beliefs.
Rather than becoming sucked into supplying ever more solutions, only to be
rejected in turn, it is probably more productive for the therapist to use these excuses
to highlight core irrational beliefs (T: ‘‘Every time I make a suggestion, you
describe why you can’t do it. It sounds as if you are saying, ‘It’s too difficult’.’’)
Dryden (1990) also uses a technique called the ‘‘terrorist dispute’’, to explore under
what circumstances a client would be willing to tolerate discomfort. He asks,
‘‘Would you tolerate this discomfort if terrorists threatened to kill your family?
Then why not tolerate it for your own health?’’ Similarly, the ‘‘LFT splash’’
technique encourages clients to generate rational beliefs that would enable them to
tolerate short periods of discomfort in order to achieve a specific goal.

Behavioral Change

Behavioral Goals

Ellis (2002) has noted the most frequent cause of resistance in therapy is frustration
intolerance, and not completing homework is particularly linked to therapeutic
failure. Therefore, behavioral tasks need to be carefully negotiated and understood.
A common misunderstanding by clients is that the aim of therapy is to help them
become more effective at avoiding or controlling discomfort. This is often revealed,
for instance, when clients report homework tasks ‘‘failed’’ because they experienced
anxiety.
REBT encourages the use of vivid and dramatic assignments to challenge the
philosophy of frustration intolerance. A good example is the advice to anxiety
sufferers to take every opportunity to experience panic, thus directly confronting the

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belief that anxiety is dangerous and must be controlled. Indeed, Ellis (1983) has
argued that gradual desensitisation approaches may actually reinforce frustration
intolerance by implying the client is a ‘‘delicate flower’’, needing protection from
discomfort. However, whilst such vigorous methods are ideal, in practice many
clients require a flexible approach, and setting ‘‘challenging but not overwhelming’’
homework tasks has been suggested as a compromise (Dryden 1995). Whatever the
approach used, a firm commitment from the client is required: as Yoda in Star Wars
said, ‘‘Do or do not, there is no try’’. Behavioral methods used in REBT are well
described in many therapy guides (e.g., Walen et al. 1992). However, the following
can be highlighted as being particularly relevant to frustration intolerance.

Risk Taking Activities

To counter restricted life experience arising from demands for certainty, comfort,
and freedom from emotional distress, clients are encouraged to take calculated risks,
by engaging in activities they consider potentially threatening. For example, a client
suffering from fear of anxiety symptoms, such as increased heart rate, might be
encouraged to take the scariest rides at the theme park.

‘‘Stay in there’’ Activities

Exposure treatments for anxiety have long advocated remaining in situations until
anxiety has decreased. Clearly, leaving at the first signs of distress or discomfort
reinforces ‘‘I can’t stand it’’ beliefs.

Courting Discomfort

For clients who habitually take the easiest option, it is useful to suggest they
purposely search out discomfort. Opportunities to increase frustration are every-
where, but suggestions have included joining the longest supermarket queue and
stalling a car at traffic lights. This method overlaps with shame attacking exercises,
in which the client is encouraged to act in a way considered shameful, but to tolerate
the emotional discomfort involved and without putting themselves down. Such
exercises include standing in an elevator the wrong way, asking for silly directions,
and wearing outlandish clothes. As with all these exercises, continued practice is
important.

Behavioral and Imagery Methods

REBT employs a wide range of behavioral methods (Ellis 1976). These include
stimulus control techniques (e.g., reducing temptation in procrastination or comfort
eating), the use of rewards and penalties (e.g., engaging in pleasurable activity after
completing uncomfortable tasks, or sending a cheque to a hated organisation if tasks
are not completed), and breaking down tasks into more manageable chunks.
The use of structured cognitive rehearsal techniques is also applicable to a wide
range of frustration discomfort problems. For example, in rational-emotive imagery,

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 N. Harrington

frustrating or uncomfortable situations can be imagined, and unhealthy negative

emotions (and behaviors) changed to more constructive alternatives, by employing
rational beliefs. The use of models from popular culture, such as films, has also been
suggested for anger problems (DiGiuseppe and Tefrate 2007), and is applicable to
other types of frustration intolerance.

Beyond Disturbance

Finally, REBT is not the royal road to happiness. REBT proposes that frustration
and discomfort are facts of life, but by denying this reality we risk even greater
misery. Therefore, a primary aim of therapy is to change our response to life’s
misfortunes from unhealthy to healthy (although still negative) reactions; or as
Freud said, from ‘‘misery into common unhappiness’’. Nevertheless, challenging
frustration intolerance beliefs will enable greater involvement in life and pursuit of
personal goals, and will therefore increase happiness if this is a function of
achieving valued goals (Power and Dalgleish 1997). Sustained happiness also seems
related to our commitment to long-term goals rather than immediate gratification, to
which we quickly habituate. REBT also suggests that happiness derives, not from
goal achievement in itself, but from the process of being committed to meaningful
activity. As Richard Byrd said, having flown across the South Pole in 1929:
‘‘Nothing there but the fancy of men. It is the effort to get there that counts.’’
However, the desire for happiness can be easily transformed into a demand. As
Ellis (1987) has cautioned, perfect mental health is impossible, the pursuit of which
has been linked to the increase in anti-depressant medication and pathologising of
healthy negative emotions in Western society (Furedi 2003). More generally, the
lesson of history over the past century suggests the pursuit of utopia often ends in
even more injustice and inhumanity than it was meant to replace. The belief that we
are entitled to happiness and freedom from discomfort will almost inevitably lead to
resentment, self-pity, and frantic attempts to attain this illusory state. More
importantly, the avoidance of frustration and emotional discomfort risks losing that
which makes us human. As John Passmore (1970), in reviewing the philosophy of
human perfectibility, concluded: ‘‘Men, almost certainly, are capable of more than
they have ever so far achieved. But what they achieve… will be a consequence of
their remaining anxious, passionate, discontented human beings’’ (p. 326).

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