IMAGINACIN EMOTIVO-RACIONAL

En la Imaginacin Emotivo-Racional (IER), los pacientes intentan atenuar las emociones no

deseadas de ansiedad, depresin, culpa e ira utilizando la reestructuracin cognitiva para sentirse
menos perturbados al imaginar situaciones problemticas especficas.

Este procedimiento normalmente se presenta a un paciente despus de que se hayan explicado

minuciosamente los fundamentos bsicos y los principios de la terapia emotivo-racional. En ese
contexto, IER es una forma particularmente vvida y dramtica de ilustrar el papel de las
cogniciones en la alteracin de los sentimientos angustiantes.

Procedimiento: se les pidi a las personas que imaginaran una situacin en la que tendan a
sentirse excesivamente afligidos de una forma u otra, y se los inst a que se sintieran menos
molestos mientras continuaban imaginando la escena.

La mayora de las veces, sucedieron dos cosas: primero, los pacientes informaban que haban
cambiado sus sentimientos de la manera deseada; segundo, explicaran su xito refirindose a un
cambio cognitivo activo, como "supongo que me di cuenta de que no sera el fin del mundo" o
"pens que probablemente podra superar de alguna manera si empeoraba lo peor".

Despus de eso, fue un asunto sencillo el sealar que las actitudes intiles podan discutirse
directamente por medio de los procedimientos de RET, y que las autodeclaraciones de
afrontamiento podan ensayarse activamente.

Dos componentes del procedimiento IER, entonces, pueden identificarse.

El componente cognitivo implica dar al cliente un marco sistemtico para comprender, disputar o
ensayar ciertas actitudes o auto declaraciones (siguiendo un formato RET tradicional o utilizando
los mtodos de ensayo cognitivo de Meichenbaum (1977), etc.).

El componente emotivo implica pedir al cliente que imagine la situacin problemtica y que
intente atenuar activamente la reaccin emocional excesiva durante la fantasa. Tomados en
conjunto, estos componentes cognitivos y emotivos forman el procedimiento IER habitual. Debido
a que el aspecto de las imgenes emotivas haba demostrado ser til incluso de forma aislada al
introducir conceptos cognitivos a los pacientes hospitalizados, diseamos estudios para examinar
la efectividad relativa de estos componentes.
EL ENTRENAMIENTO EN AUTOINSTRUCCIONES

El entrenamiento en autoinstrucciones es una tcnica cognitiva cuyo objetivo principal es

ensear al paciente a usar autoverbalizaciones (verbalizaciones internas o pensamientos)
en forma de autoinstrucciones para cambiar y controlar conductas. Se le entrena a
introducir inicialmente un cambio en sus autoverbalizaciones para modificar finalmente su
comportamiento manifiesto, con la finalidad de mejorar su habilidad o aumentar su nivel
de control o solucionar su problema.

Los antecedentes histricos de la tcnica del Entrenamiento en Autoinstrucciones, se

remontan a los trabajos llevados a cabo por Meichenbaum en los aos sesenta con nios
hiperactivos y agresivos, sin embargo, su preocupacin por el papel del lenguaje como
controlador de la conducta motora surge a raz de los estudios sobre autores como Vygotski
(1962) y Luria 1961 y ms tarde, sobre Piaget. Meichenbaum propone en 1977
definitivamente su entrenamiento en autoinstrucciones en el marco de las tcnicas
cognitivo-conductuales.

A diferencia de la Terapia Racional Emotiva (RET), el entrenamiento se centra ms en la

capacidad para modificar la conducta y las emociones mediante las autoverbalizaciones, y
menos en el sistema de creencias e ideas irracionales del paciente. Meichenbaum incluye
autoinstrucciones de autorrefuerzo para las respuestas encaminadas a resolver los
problemas y o autoinstrucciones de afrontamiento ante el fracaso (autocorreccin).
Basndose en el supuesto de que podramos modificar el comportamiento mediante el
cambio de las propias verbalizaciones, las autoinstrucciones positivas, flexibles y
adaptativas generaras sentimientos positivos y comportamiento adaptativo; en cambio
autoinstrucciones negativas provocaran malestar y conducta desadaptativa.

El objetivo principal en el entrenamiento en autoinstrucciones ,como dira Jos Santacreu ,

no es otro que ensear correctamente un tipo general de instrucciones que puedan
facilitar al sujeto una rpida y eficaz actuacin, teniendo en cuenta sus caractersticas
principales ,fomentando en el paciente una actitud de resolucin de problemas y generar
autoinstrucciones ms tiles y positivas para llevar a cabo una tarea o afrontar una situacin
conflictiva con el menor coste posible (J C. Sierra.).2005.

En primer lugar se entrena al paciente en verbalizar la autoinstruccin en voz alta y, ms

tarde, de forma interiorizada. Al final del entrenamiento, el paciente puede emplear las
autoverbalizaciones para controlar su conducta generalizando lo aprendido a otras
situaciones. En cierto modo el entrenamiento en autoinstrucciones consiste en modelar una
serie de pensamientos y verbalizaciones destinados a controlar la conducta.

La seleccin de las autoinstrucciones, se hace normalmente en funcin del tipo de problema

y abarca las distintas secuencias o fases de la conducta objetivo. En su entrenamiento, se
utiliza en la medida de lo posible las autoinstrucciones propias, enfatizando sobre todo, en
aquellas que el paciente ha utilizado previamente con cierta eficacia en el control de su
conducta. Es recomendable que sean precisas, especficas, centradas en el presente, que
fomenten la competencia y que anticipen consecuencias positivas, centrando al paciente
en los aspectos ms positivos de su conducta.

Una vez que el paciente ha asimilado el planteamiento de la tcnica segn Meichenbaum

(1991), las fases recomendables para llevarla a cabo son:
Modelado cognitivo: El terapeuta hace de modelo y realiza una tarea o afronta una
situacin problemtica mientras se hable a s mismo en voz alta, el paciente presta atencin
y aprende por observacin como enfrentarse a la situacin aversiva
Gua externa en voz alta: El paciente realiza la tarea bajo las instrucciones del
terapeuta.
Autoinstrucciones en voz alta: El paciente afronta la situacin y emplea las
autoinstrucciones en voz alta, mientras el terapeuta orienta y refuerza las mismas.
Autoinstrucciones enmascaradas: El paciente dice las autoinstrucciones
enmascarndolas en voz muy baja, el terapeuta refuerza las mismas.
Autoinstrucciones encubiertas: El paciente realiza todo el proceso solo y con
autoinstrucciones encubiertas, el terapeuta orienta y refuerza las autoinstrucciones
encubiertas.
Para facilitar el aprendizaje y la generalizacin de la tcnica, se anima al paciente a practicar
la tcnica ,adems , para recordar la secuencia de autoinstrucciones en caso de
experimentar ansiedad o malestar, se le facilita por escrito el esquema nemnico de
Altaimer y cols (1982) basado en Meichenbaum (1987) citado en G. Buela-Casal y J.C. Sierra
2005:
S (Sens) Percibir la ansiedad cuando aparezca.
T (Think) Pensar en la conversacin con uno mismo.
I (Instruct) Autoinstruirse para cambiar los pensamientos de afrontamiento
negativos por otros alternativos. R (Relax) Relajarse.
R (Reward) Autorreforzarse por el afrontamiento exitoso o en cualquier caso por
haberlo intentado.
Finalmente cabe sealar que, la aplicacin de la tcnica en adultos con trastornos de
ansiedad, estrs, llev a incluir nuevos elementos y fases durante el tratamiento y una
nueva conceptualizacin del estrs en cuatro etapas (Preparacin para el estresor;
Confrontacin con el estresor; Momentos crticos y Autorreflexin), cambios que daran
lugar, posteriormente al desarrollo del conocido Entrenamiento en Inoculacin del Estrs
de Meichenbaum.
Using Rational Emotive Imagery (Maultsby, 1975; Maultsby and Ellis, 1974), I showed
Jane how to imagine some of the worst things she could think of, such as meeting a man
she found very attractive, having him speak to her, and then being struck dumb and
unable to talk intelligibly. Imagining this, she would feel exceptionally depressed and self-
hating. She then would work on making herself only feel appropriately disappointed and
sorry rather than inappropriately depressed and self-downing. She would practice this
kind of rational emotive imagery several times each day for thirty or more days in a row
until the image of this kind of social failure (or actual in vivo failure) quickly and
automatically brought on the appropriate feelings of disappointment and regretnot
anxiety and feelings of inadequacy.
Shame-Attacking Exercises. Jane derived a good deal of benefit from the shame-attacking
exercises I created in the 1960s that have since been used by RET and several other forms
of therapy (Ellis, 1969b; Ellis and Abrahms, 1978; Ellis and Becker, 1982; Ellis and Grieger,
1977). She first picked several silly thingssuch as yelling aloud the stops in the New York
subway and singing at the top of her voice on the streetand forced herself to do them
while working to make herself feel unashamed. When she could succeed at this, she then
spoke to a number of strange (and attractive) men on buses, in elevators, in the
supermarket, and in other public places, tried to get into conversations with them, and
asked whether they would like to call her for lunch or a date. She was terrified to do this
at first, but after she had done it about twenty times, she lost almost all her anxiety and
shame and was able to meet several suitable men in this manner and to begin dating one
steadily.
Roleplaying. I roleplayed several job-interview and social-encounter situations with Jane. I
discussed with her what she was telling herself to make herself anxious and shy in these
situations and what she could tell herself instead, and I brought out some negative
feelings of which she was not fully aware and helped her change them. I also critiqued her
skills in these situations and got her to reconsider and revamp them. Even better, when
the members of one of my therapy groups, which she attended for six months, did
roleplaying routines with her, they were able to get her to bring out more apprehensive
feelings and to give her some excellent suggestions on how to deal with these feelings and
how to improve her social skills. I often find it valuable for shy and inhibited people like
Jane to join one of my RET therapy groups for a while, because they have more social
learning opportunities in the group than they usually have in one-to-one therapy. In group
she also learned to talk other members out of their irrational Beliefswhich helped her to
dispute her own irrational Beliefs (Ellis, 1982).
Group Socializing. In one of my groups, Jane also learned to relate better to several of the
other members, to call on them for help in between therapy sessions, and to try
socializing activities with some of them that she might not have done by herself.
Forceful Self-Statements. RET theorizes that people disturb themselves not only by ideas,
thoughts, attitudes, and philosophies but also by holding onto their musturbating beliefs
strongly, forcefully, and vehemently. It therefore encourages clients like Jane to
deindoctrinate themselves forcefully and vividly with dramatic impact (Dryden, 1984; Ellis,
1979a, 1979b, 1984a, 1984b, 1985a, 1985b). Jane was shown how to devise rational self-
statements and to powerfully repeat them to herself (and to others) many times until she
solidly began to feel them and to be convinced of their truth. Thus, she often vigorously
told herself, Its a pain in the ass to get rejected socially or in a job interview, but its not
awful! I want very much to find a suitable mate, but I dont have to! If people see how
anxious I am, they will hardly run away screaming. And if they do, tough shit! I can talk
to attractive men, no matter how uncomfortable I feel! Forceful Self-Dialogue. Another
RET emotive technique Jane used was to have a forceful rational dialogue with herself and
record it (Ellis and Becker, 1982). She would start with an irrational Beliefsuch as that
she must speak easily and spontaneously, without effortand then rationally, but with
real vigor, argue against this belief, so that her rational voice finally won out over her
irrational one and her feelings changed appropriately. She would listen to these tapes
herself or let friends or therapy group Members listen to them and check with them to see
whether her rational arguments were good and to see how powerfully she put them
across to her irrational self. Sometimes, doing role reversal, I or a member of her group
would play Janes irrational self. She would play her rational self and try to argue us
vigorously out of our dysfunctional thinking.
Unconditional Self-Acceptance. I always unconditionally accepted Jane, as this is an
integral part of RET, no matter how badly she behaved inside and outside therapy. Even
when she came late to sessions or got behind in paying her bill to the institute, I firmly
showed her that her behavior was bad but that I never considered her a bad person.
Going further, I taught her how to fully accept herself under all conditions and to rate only
her acts and traits and never her totality, her being, or her self (Ellis, 1962, 1972, 1973b,
1976; Ellis and Becker, 1982; Ellis and Harper, 1975; Hauck, 1973; Miller, 1983). Of all the
things she learned in RET, unconditional self-acceptance, she thought, was the most
useful.

Behavioral Methods of RET

As with virtually all my clients, I used several behavioral methods of RET with Jane
particularly the following.
Activity Homework. From the start of her therapy, Jane was given activity homework
assignments: to talk to men she found attractive, to go on job interviews, to make some
public talks, and to tell her lovers she no longer wanted to see them once she was fairly
sure they were not for her (Ellis, 1962, 1979c, 1984a, 1984b). She did many of these
assignments even though she felt uncomfortable doing themand thereby learned the
RET maxim Theres little gain without pain. Whenever she did them, she soon got over
her discomfort and even started enjoying some of themsuch as talking to and flirting
with suitable males. By doing these assignments, she also clearly observed how anxious
and ashamed she was at first, and she was able to zero in on the irrational Beliefs behind
her anxiety.
Reinforcements and Penalties. Jane was shown how to reinforce herselfusually with
reading or going to a concertafter she did her homework and to refrain from this kind of
reinforcement if she did not do it. She found reinforcements especially useful for helping
her do rational emotive therapy, because she would do it for several days in a row and
then slack off and forget about it if she had no reinforcer.
RET uses penalties as well as reinforcers for clients who do not do their homework (Ellis
and Abrahms, 1978; Ellis and Becker, 1982; Ellis and Grieger, 1977; Ellis and Whiteley,
1979). When Jane did not carry out her assignments, she chose to burn a twenty-dollar
bill, and that quickly worked to help her do them.
Skill Training. Jane was given, in individual sessions, in group therapy, and in several
workshops for the public that are regularly held at the New York Institute for Rational
Emotive Therapy, instruction in assertion training, in social encountering, in writing a
rsum, and in communication skills. Skill training helped her in various areassuch as
communicating better with her motherthat she never directly brought up as serious
psychological problems. And partly because of it, she said, toward the close of her
sessions, I am very happy that I started RET for my social anxiety and other emotional
difficulties. But the great bonus of these sessions has been my being able to actualize and
better enjoy myself in several ways that I never even realized therapy could benefit me.
But I am delighted to say that it really has!
SUPER-ROMANTIC LOVE

Romantic, passionate love, or intense in-lovedness has existed from time immemorial but received
an enormous boost in the Middle Ages and has become a near-requisite of mating or marriage in
the twentieth century (Burgess & Locke, 1953; de Rougemont, 1956; Ellis, 1954; Ellis & Harper,
1961a, Finck, 1887; Folsom, 1935; Hunt, 1959; Lucka, 1915; Murstein, 1974). It has enormous
advantages, in that romantic lovers often experience extremely pleasurable feelings and are
motivated to great efforts and outstanding performances.

Romantic love generally is acknowledged to include several strong factors, especially idealization
of the beloved; a high degree of exclusivity; intense feelings of attachment, usually with a strong
sexual component; the powerful conviction that the love will last forever; obsession with thoughts
of the beloved; a strong desire to mate with the beloved; an urge to do and to sacrifice almost
anything to win the beloved; the conviction that romantic love is the most important thing in the
world; and the belief that one can practically merge with one's beloved and become one with him
or her (Christie, 1969; Ellis, 1949a, 1949b, 1949c, 1950, 1951, 1954; Hunt, 1959; Katz, 1976;
Kremen & Kremen, 1971; Stendhal, 1947; Tennov, 1979).

Devotees of romance tend to create and maintain a number of irrational Beliefs (iBs) or myths that
interfere with their intimate relationships and with their happiness. Here, for example, are some
of the cornmon romantic myths of our culture:

1. You can passionately love one, and only one, person at a time (Ellis, 1954).

2. True romantic love lasts forever.

3. Deep feelings of romantic love insure a stable and compatible marriage.

4. Sex without romantic love is unethical and unsatisfying. Sex and love always go together (Bach
& Wyden, 1969; Ellis, 1954).

5. Romantic love can easily be made to develop and grow in marital relationships.

6. Romantic love is far superior to conjugal love, friendship love, nonsexual love, and other kinds
of love, and you hardly exist if you do not experience it intensely.

7. If you lose the person you love romantically you must feel deeply grieved or depressed for a
long period of time and cannot legitimately fall in love again until this long mourning period is
over.

8. It is necessary to perceive love all the time to know someone loves you (Katz, 1976).