Running head: REBT AND SEXUAL ADDICTION 1

Rational Emotive Behavior Therapy and Sexual Addiction

Andrew J. Breland

William Carey University

REBT AND SEXUAL ADDICTION 2

Abstract

Rational emotive behavior therapy, better known as REBT, has been linked to be effective

therapy for addiction, like many other cognitive-behavioral based techniques. Sexual addiction

is a complex addiction that creates conflict with one’s neurological processes, physiological

functioning, psychological awareness, and physical behaviors. Sexual behavior disorders have

always been noticed, but have never truly been actualized as needing to be diagnosed as a

disease that is affecting and could affect most of, if not all, people. Recent studies have

determined that due to compulsive, impulsive, obsessive, and sexual natures, anxiety disorders,

mood disorders, depressive disorders, and several other comorbid disorders in association with

abnormal sexual behaviors, are finally being recognized as problems that have been caused by

problematic childhoods, societal views, religious views, and abuse. With the mode and modality

adaptability of REBT, transitioning a client’s behavior causing beliefs from irrational to rational

in a direct, forceful, and authentic manner may be one of the best starts to encountering sexual

addiction and maladaptive sexual behavior.

REBT AND SEXUAL ADDICTION 3

Rational Emotive Behavior Therapy and Sexual Addiction

REBT (Rational Emotive Behavior Therapy) has changed names throughout the years.

REBT has always included rational, cognitive, emotive, behavioral, holistic, and thoughtful

aspects within it’s therapy, but was originally called RT, then RET, and finally REBT. The

aforementioned aspects together create successful therapy, and the name rational emotive

behavior therapy is the most defined and appropriate. The term, “rational,” can be

misinterpreted as a form of logic based on proven research, or personal logic. REBT expects the

term “rational” to be seen as “cognition that is effective or self-helping.” (Jones, 1999, p. 154)

Just because one person sees a belief as “rational,” it does not mean that belief is helping that

person to lead the most effective life for their self. Albert Ellis (1999), who created the this

theoretical orientation, states this reason for using “rational” instead of “cognitive”:

If I were to rename RET today I might call it cognitive-emotive instead of rational-

emotive therapy; but it is a little late for that change, because cognitive therapy and

cognitive-behavior therapy are already well known, and REBT is recognized as different

from these other therapies. (p. 154)

REBT has advanced psychopathology as a whole because of its emphasized

understanding and use of cognition. With the roots of REBT being developed inside of

philosophy, sex, love, and marital therapy, REBT has unearthed a better knowledge regarding

the intimate relationships of humans. REBT proves that daily, humans tend to develop

relationships with selves, ideas, other humans, etc. (“Awards for,” 1986). Dryden and David

(2008) show that REBT’s theory allows it to be used for not just couple therapy, but also for

individual, family, and group therapy. Since REBT is effective for most clinical issues, REBT’s
REBT AND SEXUAL ADDICTION 4

emotional disturbances develop in response to the cognitive processes behind the interactions of

people and their self (“Awards for,” 1986).

One of the universal emotional disturbances that people have is considered as evaluating

self or others. Roberts (1987) speaks of Ellis saying people can’t consider their whole self or

another person’s whole self, good or bad, but that they can rate specific aspects of themselves or

others. Evaluating someone as a whole by one or more aspects would be considered an irrational

belief, and evaluating the individual aspects logically would be considered a rational belief.

REBT shows that for something to be considered rational, or to be rationally accepted, it has to

be able to be proven logically. Roberts (1987) also states, “[Ellis] sometimes suggests that there

is no such thing as a ‘self,’ that a human is nothing but a loosely tied bundle of acts, beliefs,

experiences, short-term abilities, and dispositions of widely disparate sorts” (p. 821). REBT

suggests that people must choose rational belief(s) over irrational belief(s), and that rational

belief(s) will create a better life and society.

Christopher (2003) proves that Zen and REBT are closely related because of the common

factors of suffering and emotional disturbance. Buddhists believe suffering is within life, life

enables desires, the suffering can be cured by getting rid of the desire, and staying on a right path

can rid one of the desires that cause the suffering. Tiba (2010) shows that REBT grounds

cognition by using its ABC-DE model. Farley (2009) describes the A as “an activating event that

one does not like; B, one’s belief about A; and C, the consequence,” and D as disputing “the

irrational beliefs, which will lead to the effective (E) new beliefs, emotions, and behavior”

(Farley, 2009, p. 216).

In reviewing my results from the Selective Theory Sorter in the Halbur and Halbur (2011)

text, I was more prone to share views of these specific theories: Individual Psychology,
REBT AND SEXUAL ADDICTION 5

Existential, Reality, Cognitive-Behavioral, and then REBT (pp. 27-31). I feel that I more closely

relate to REBT, but the reason that it was not number 1 on the results list was due to my feelings

of the client-therapist relationship and the view of problems stemming from just beliefs. I see

counseling as a way to regurgitate all of one’s problems that they may not want seen by general

society, friends, or family. So, the idea of developing a trusting lukewarm relationship between

therapist and client seems integral.

Through over 20 years of traveling, living, learning, and yearning for an understanding of

those young and old, I have noticed that people develop strong friendships with people who

share common ideas that are not usually apparent to the general public. That has taught me that

trust is a major factor in being able to understand others. Trust seems to be gained not only

through true warmth towards others, but strict honesty and authentic interactions. Since REBT

does not necessarily see warmth as an important aspect of successful therapy, I do disagree with

that idea. I have experienced that warmth helps to create trust, and trust can cause a relationship

that allows one to understand the other more wholly. REBT sometimes uses humorous, forceful,

and direct techniques, approaches, and language to cause clients to notice their own irrational

beliefs (Becker and Rosenfeld, 1976). Just like any natural interaction with a friend, a

humorous, forceful, or direct interaction allows both people to understand, listen, and opinionate

more thoroughly. I believe counseling should consist of natural interactions, so that it does not

feel unnatural, or forced, if it is not needed.

I believe that people change through learning, and thinking for one’s self. People are too

often in awe at the thought of not living right, or not believing what another person or group may

feel. In sharing with REBT the idea of irrational beliefs causing emotional disturbances, I feel

that guiding a client to understanding why their irrational beliefs are detrimental to their
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happiness throughout life is an essential part of therapy. From personal crisis of myself I have

realized that thoughts, actions, ideas, beliefs, consequences, and other aspects relating to REBT

are dependent upon one another, and they all affect one another. Like REBT I believe in dream

analysis to help clients tap into their power of psyche, which affects the belief and thought

process. REBT deals mostly with the present situations of a client, and I see that as what must

change so that it may positively affect the client’s future. I believe that people change by

recognition, or through knowledge. For example, a 45-year-old Southern Baptist male may find

it hard to believe that his 20-year-old son is homosexual. Instead of accepting his son’s belief,

he estranges himself from his son because his son does not decide to accept his father’s Southern

Baptist idea of homosexuality as his own. If the father had been more accepting of other ideas,

and had accepted the Southern Baptist teachings as a pure suggestion of a way to live, he would

more than likely be more accepting of his son having his own personal views. I believe

acceptance and admiration of knowledge, given by others and self, is the only way to become

truly happy with life.

Like REBT, I believe one must be guided to open up to change and view beliefs and

opinions from different angles. Personally, I believe people should introduce themselves to a

positive outlook for every thought and situation, even ones that are negative, but be aware of the

negative outlook. Looking back at research of Becker and Rosenfeld (1976), I agree that humor,

force, directness, arguing, exaggerations, and rapid-fire feedback will have to be used in many

cases to help clients understand their irrationality. Because REBT is highly adaptable to other

therapies, I believe that the results given by Halbur and Halbur (2011) guide me to non-REBT

specific techniques and approaches, but still validate my use of REBT for treating clients.

Dryden and David (2008) speak of the effectiveness of REBT on addictions such as sexual
REBT AND SEXUAL ADDICTION 7

addiction, something that is just beginning to be classified and specifically recognized by

therapists.

Garcia and Thibaut (2010) delve into the differences of classified sexual behavior

disorders, including: “hypersexuality,” “sexual addiction,” “compulsive sexual behavior,”

“impulsive sexual behavior,” “total sexual outlet,” “excessive nonparaphilic sexual behavior,”

“hyperesthesia sexual,” and various others. All of the disorders mentioned are basically defined

as a sexually based behavior, or thought, that is in excess of what is considered normal by

society and/or self (Kaplan & Krueger, 2010). Despite the singular aspects that result in the

specific labeling of clients, the DSM-V lacks consensus and sufficient research to properly

identify this phenomenal disorder (Hagedorn, 2009; Kaplan & Krueger, 2010). Sexual addiction

could be used as a universal label since Carnes defines the list of sexual addiction symptoms as:

(a) a pattern of out-of-control behavior, (b) severe consequences, (c) an inability to stop

the behavior(s) despite adverse consequences, (d) an ongoing desire or effort to limit

sexual behavior, (e) sexual obsession and fantasy as a primary coping strategy, (f)

increasing amounts of sexual experience because the current level of activity is no longer

sufficient, (g) severe mood changes around sexual activity, (h) inordinate mounts of time

spent in obtaining sex, being sexual, or recovering from sexual experience, and (i) neglect

of important social, occupational, or recreational activities because of sexual behavior.

(as cited in Hertlein & Jones, 2012, p. 119)

In reviewing Sussman’s (2010) research on love addiction, the simplified

symptomatology of sex addiction could possibly be brought to light. Since it is suggested that if

a love relationship, where both partners love, work, play, and learn in a way that is mutually

compromising, beneficial, and progressive, is considered mature, then a mature sexual

REBT AND SEXUAL ADDICTION 8

relationship could fit the same criteria. Vice versa, if one or more ongoing immature sexual

relationships exist, then one or both individuals involved are primarily focused on self-gains

versus healthy mutual gains, and those self-gains create: uncontrolled repetitive behavior, day-to-

day obsessive-type thoughts, and negative societal and personal consequences, which are all due

to beliefs regarding the relationship which could turn into an addiction. Hertlein and Jones

(2012) prove that the new DSM-V “validates the concept of behavioral addictions…not yet

recognized” (p. 117), such as sex addiction.

Coleman, Miner, and Raymond (2003) developed a multi-instrument study that proved

the importance of thorough evaluation for clients claiming to have compulsive sexual behavior,

which one could consider the behavioral part of sexual addiction. The study determined that

compulsive sexual behavior consists of compulsive and/or impulsive traits that can lead to

addiction, and a type of axis I and/or II disorder will probably accompany it. The main

comorbidity was either a mood or anxiety disorder. 22 of the 25 clients committed compulsive

sexual behavior, and all clients claimed to have compulsive sexual urges and thoughts.

In general it has been discovered that men are more prone to commit/admit sexually

addictive behavior than women (Blain, Morgenstern, Muench, & Parsons, 2012; Coleman et al.,

2003), people that grow up in family environments without proper love, attention, and/or value

are more likely to develop a type of sexually addictive behavior or dysfunction (Billingham,

Finn, Monahan, Perera, & Reece, 2009), the majority of people who were sexually abused as a

child will develop an addiction to sexual behavior or chemical substance (Billingham et al.,

2009; Blain et al., 2012), an individual’s ability to go against society could create any (or

multiple) axis I and/or axis II disorders (Farris & Williams, 2011; Kaplan & Krueger, 2010), and

social media/Internet tend to cause a higher increase in sexual thoughts, urges, and/or behaviors
REBT AND SEXUAL ADDICTION 9

(Hertlein & Jones, 2012; Sussman, 2010). Neurological effects of compulsive sexual behavior

share common effects with a chemical substance addict, and sexual addiction/behavior is not

gender or age specific (Farris & Williams, 2011; Kaplan & Krueger, 2010).

REBT therapists understand that treating a sexual addict could very well entail unearthing

several other problems that stem from not only sexual beliefs, but about beliefs towards others,

and what beliefs others may have brought to mind for the client. Being sensitive to the approach

and treatment of comorbid disorders before and during the treatment of compulsive sexual

behavior, or sexual addiction, is integral to therapeutic success (Coleman et al., 2003). Since

rational emotive behavior therapy is understanding of disorders which create one to not feel

normal, they would recommend not being aggressive right off the bat. Being sensitive and open

to diverse treatments for sexual addiction is crucial. At the initial meeting, the present problem

surrounding the irrational beliefs behind the sexual behavior would be discussed. An assessment

of previous, present, and future events that the client sees as disturbing would be taken.

Authenticity would be used to invoke natural conversation, banter, and trust, and to teach the

process of REBT. Once the client gains the therapist’s trust, the true irrational and rational

beliefs of the client would finally rear. This process may take two sessions depending on the

amount of sensitivity towards beliefs, the relationship established with the client, and the amount

of comorbid disorders/beliefs present. It is hopeful to gain full understanding of the irrational

beliefs at the first session, but highly unlikely due to the specific society-caused properties of

sexual addiction.

The REBT therapist would strive to complete most cases within 12-24 sessions,

consisting of one session per week, but with addiction they would be prepared for many more

than 24 sessions. Also, the therapist would understand that the irrational beliefs associated with
REBT AND SEXUAL ADDICTION 10

addiction could be triggered by knowledge of several other irrational beliefs placed through

society throughout time (Ellis, 1998; James, 2008). Dream analysis would take place as needed,

and medicine may also be prescribed in conjunction with REBT (Kaplan & Krueger, 2010).

During the 3rd -6th sessions, the REBT therapist may question the irrational beliefs of sexual

behavior with the client, and use abrupt, inquisitive statements and reactions regarding their

childish views. These integral sessions would also consist of obnoxious suggestions to keep on

with the self-defeating behavior(s), and make sure to keep demanding the trigger(s) that cause

the behavior(s) if the client feels he/she has to. This is done so that client may place perspective

on irrational versus rational beliefs. During the 7th- 9th sessions behavior-based techniques,

focused primarily on suggesting rational beliefs for irrational beliefs, would begin.

At the 10th session the REBT therapist would begin to “up the ante” by betting that

between the current and 12th session, no sexual behavior will take place. This would instill a

“can-do” attitude. The 11th session would be focused on helping the client realize that getting

past the withdrawal symptoms of the addiction are definitely more worthy than relapse. The 12th

session would hopefully be the final session for this particular phase of the addiction, and the

client will have developed the ability to rationalize instead of irrationalize the beliefs which

cause the behavior. Also, the client would hopefully be rewarded with the prize for making it to

the 12th session without committing sexual behavior.

If planned goals where not achieved within the increments of sessions planned, then the

REBT therapist would stay on the same course until the client is ready to progress. If the client

feels the need to resolve other beliefs, or demands, then the plan of treatment would start over

after resolution of the original problem. Therapy would function at a more rapid pace, and the

client would be encouraged to only speak of the presenting problems, and the beliefs behind it.
REBT AND SEXUAL ADDICTION 11

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