PHILOSOPHICAL PRACTICE, Vol. 10.2

PHILOSOPHICAL PRACTICE1553 Journal of the APPA

Volume 10 Number 2 July 2015

Editor Articles Lou Marinoff Kate Mehuron Reviews Editor The Depathologization of Everyday Life: Leslie Miller Implications for Philosophical Counseling

Evgenia V. Cherkasova Associate Editor Sartre on Bad Faith and Existential Responsibility: Dena Hurst Theory and Practice

Technical Consultant Galia Patt-Shamir Greg Goode A Way of Practice: On Confucian Learning as a Communal Task

Legal Consultant Interview Thomas Griffith Montse Rovira Rational Emotive Behavioral Therapy: An Existential Therapy Conversation with John Viterito

Reviews

Cracked: Why Psychiatry is Doing More Harm than Good reviewed by Stephen J. Costello

Philosophy A to Z. Essays for Cafe Philosophy reviewed by Luisa de Paula

Teaching Mindfulness: A Practical Guide for Clinicians and Educators reviewed by Leslie C. Miller

Biographies of Contributors

www.appa.edu Nemo Veritatem Regit ISSN 1742-8181 Nobody Governs Truth Philosophical Practice, July 2015, 10.2: 1597-1604 1597

Rational Emotive Behavioral Therapy: An Existential Therapy Conversation with John Viterito

Montse Rovira Licensed Clinical Psychologist, Barcelona, Spain

Abstract

John Viterito is an applied philosopher, a licensed professional counselor and a member of the Al- bert Ellis Institute and the Viktor Frankl Institute. In this interview, he explains how his passion for helping people through clinical practice led him to study two disciplines that he has been able to incorporate in an extraordinary way into his work with his clients. John Viterito is the only person in the world who has double qualifications in Rational Emotive Behavioral Therapy (REBT) and Logotherapy and Existential Analysis. With these methodologies, he has developed a singular psychotherapeutic style, far apart from conventional approaches in this field.

Keywords: Rational Emotive Behavioral Therapy (REBT), logotherapy, applied philosophy

New York – July 23, 2014

In the Albert Ellis Institute during the breaks the students find themselves having coffee amongst the others students and supervisors in the common space where breakfast is served. It is a good time to get everyone’s feedback about the workshops. Students from many other states and countries brought together by the same interest: to be trained to help and teach people how to live a fuller life.

While going to get a coffee, I bump into a man who I immediately recognize. “John Viterito!” He looks at me with astonishment and asks, “Do we know each other?” I tell him I know about his work, I’ve seen him on the Friday Night Live videos posted on the Institute’s website. The Friday Night Lives are public psychotherapy sessions in which volunteers can be treated by one of the supervisors from the Institute, in other words, by the best REBT professionals in the world.

John makes a joke saying he didn’t know that he was so famous outside of America, and tells me he is going to supervise me in my training session group. I’m delighted. All the supervisors are amazing at their jobs, but John has a particular way and style of leading his sessions and an incredible ability to connect with the client. His sessions are full of wisdom, a sense of humor and sensitivity …they are a true wonder. That’s the reason why I chose one of his videos and I published it on my web as an example of a psychotherapy session. Now I feel glad to be supervised by him. Taking advantage of having met him, I ask if I could interview him. He suggests we meet the following week, when the course is finished.

His surname gives him away. John is an American with Italian roots, and he is very proud of this. Being so far away from our origins and both of us having Mediterranean blood, it is inevitable that we start our conversation talking about music, cinema (“The Godfather”), the Cinquecento’s artists and the Amalfi Coast. John is talkative by nature, and we could easily and with pleasure surrender to a long conversation about art, history, or life, but the interview fosters a psychological goal and, although we are reluctant to stop talking about banal things, we get down to business. When I start recording,

John stares at me, as if he was a boy who has no choice but to start doing his homework. He explains how he got into REBT.

JV: The first of my three degrees was in Philosophy and when I finished University I was going to do my Ph.D. in Philosophy. But I decided that what really moved me was helping people and I wanted to study Applied Philosophy and use it in my clinical practice. But there was a little problem. There was no such thing as Applied Philosophy as a discipline thirty-five years ago. There is now, and it is in New York City by the way. So I decided to take a graduate program in Mental Health Counsel- ing. That was how I started studying Rogers, Freud, Perls, the psychoanalysts, the behaviorists, they were all interesting. But when I read about Ellis and REBT, this was truly applied philosophy. It fit perfectly with my philosophical background and my professional goals. So I don’t consider myself a psychologist or a counselor or a scientist/practitioner. I’m different from the folks at the Institute. I don’t emphasize or have an interest in doing research. I consider myself to be an applied philosopher, or as we call it in the United States now, a “philosophical practitioner.”

MR: A philosophical practitioner who uses REBT or a practitioner of REBT who uses philosophy?

JV: Well, REBT is considered by the American Philosophical Practitioners Association to be one of the two traditional psychotherapies that is applied philosophical practice. The other is Logotherapy, which I have also studied. I am referring to Frankl’s Logotherapy and Existential Analysis. Philo- sophical practice fits with disciplines such as Epistemology, Ethics, Logic, and applies it to human concerns. This is how I practice REBT.

MR: What is a philosophical practitioner doing at the Albert Ellis Institute?

John’s smile becomes slightly enigmatic, which makes me think of a masculine version of the Gioconda.

JV: To be honest, what I do is a bit different than what others do.

MR: You mix REBT and Logotherapy ingredients and apply them together.

JV: That´s exactly it.

MR: Is it a homogeneous mix?

JV: REBT and Logotherapy share other aspects in addition to their philosophical component. REBT was at one time considered by Ellis to be an existential therapy. As a matter of fact one of his best books in the 70s was called Humanistic Psychotherapy: The Rational Emotive Approach, and if you read it, you will see it is a text about existential psychotherapy. When we say “existential” both in REBT and in Logotherapy we are touching on what Frankl called “attitudinal values.” In Logother- apy it is about finding meaning in our life, which is unique and specific to each of us and concrete in every moment of our existence. It changes but never stops. This meaning can be found in three ways: what we experience, what we do, and our attitude when confronted with a situation that can’t be changed. Rational Emotive Behavioral Therapy: An Existential Therapy 1599

Another similarity between REBT and Logotherapy is their insistence on personal responsibility. Although Logotherapy and REBT have a cognitive aspect, I personally think that REBT is not solely a cognitive psychotherapy, but also an existential one. I consider any psychotherapy that stresses personal responsibility and choices we have in some aspects of our lives to be existential. In Logotherapy we have the responsibility of finding the meaning of our life. In REBT we have the responsibility to choose how we think and feel in response to circumstances. So they really do over- lap regarding responsibility. When you compare Frankl´s and Ellis’s work, you see that the process is very, very similar.

MR: Did Dr. Ellis use any concepts from Logotherapy in his work with clients?

JV: Yes, of course. Ellis was a great admirer of Frankl. Quite often when he worked with clients he talked to them about Frankl’s experience in the concentration camps, and how Frankl decided to adopt a specific attitude towards the great suffering he experienced of losing his parents and his wife. That attitude allowed him to really get by and survive. If you look at Ellis’ bibliographies, in many of his books you will see that he often cites Frankl. So he used to turn to Frankl all the time to help him make his REBT points.

MR: John Viterito is the only psychotherapist in the world who has qualifications in both Logother- apy and REBT.

JV: How do you know that? Have you been investigating me?

MR: Yes.

I see surprise and maybe some embarrassment in John’s expression. He explains to me that he may be the only supervisor in the Institute that mentions—although briefly—Logotherapy during his supervi- sions. I show my interest about the practical aspect of Logotherapy, and I tell him that it is sometimes considered more theoretical than methodological.

JV: However, it isn´t like that. It is interesting that you say this because a lot of people say the same. Logotherapy has a very definite treatment procedure. It’s been developed by some of Frankl’s top students, notably Elisabeth Lucas, and we use three basic processes in order to assist students or clients.

MR: Let’s see them.

JV: First, we try to get the person to distance themselves from the symptoms, and we do this with humor. Do you remember if I used humor when I supervised your group?

MR: I don´t think I will ever forget it.

I remember clearly that evening when my training group started the supervision time with John. It was our first supervision and all the students felt nervous. It is not easy to change from the role of the therapist to the client in such a short space of time. As therapists we have to show the skills and knowledge we have learned. As clients we have to get rid of them and be ourselves just the way Montse Rovira 1600 we are in front of our colleagues and supervisor, naked of intellectual abilities, coming up with our thoughts and emotions related to the problem we are exposed to. It is about dealing with real issues, never fake or invented. They are micro-sessions of real psychotherapy. It is very easy for this mix of academic and emotional tension to burst, for instance, when students cry; we are humans first and then professionals. Using smooth irony and a sense of humor, John calmed our mood, and it lasted all day long. It was a memorable supervision.

One day, someone asked Viktor Frankl the difference between Psychoanalysis and Logotherapy. Frankl asked for a one sentence abstract about the essence of Psychoanalysis, and this is what he got: “In Psychoanalysis, the client lays on a couch and tells the therapist things that are sometimes very hard to say.” Frankl answered: “Okay, in Logotherapy, the client sits upright and has to listen to things that are sometimes very hard to listen to.”

JV: Both in REBT and Logotherapy, we believe in the wonderful power of humor and we use it with clients.

MR: Can humor be used as an emotional lubricant?

JV: Yes, that’s it. A sense of humor helps us to put into practice the job of distancing ourselves from the symptoms we experience. To do this we use something called “paradoxical intention.” Once they can get away from their symptoms, another technique we use is the modification of attitude. Modification of attitude in Logotherapy is a little different from REBT, but it is similar. It is different in that we don’t look for categorical thinking: “should,” “oughts,” musts.” But it is similar because we also use Socratic dialogue to try to help the person to find some meaning in their life through modification of the client’s attitude.

And the last step is what we call “dereflection.” We help the person to minimize hyper-reflection— hyper-reflection being the over-focusing on a permanent idea, being over concerned about it. So we get them to move themselves towards some meaningful goal, activity, or experience. It is not just about getting distance from symptoms, but also changing one´s attitude and being involved in what gives meaning to their life.

MR: What are the differences between REBT and Logotherapy confronting automatic thoughts?

JV: In Logotherapy we don’t concern ourselves with automatic thoughts as theorized by the Becki- ans. Can you give me an example?

MR: A person with high anxiety can have a panic attack. The symptoms may be strong, like breath- ing fast or having tachycardia. In those circumstances the automatic thought says: “I’m going to die.” Even when the person knows this is not going to happen, the fear of dying generates that recurrent thought.

JV: It is a good example to explain how paradoxical intention works. Instead of going to and trying to intervene on a client’s automatic thoughts, what we get the person to do with anxiety is to try to amplify their anxiety and to increase it paradoxically. In your example, if you go to a cognitive therapist, somebody embedded with panic looks for automatic thoughts, “I’m going to die.” And Rational Emotive Behavioral Therapy: An Existential Therapy 1601 the cognitive therapist will say, “Well, let’s do an experiment, let’s look at this: “How many times have you died before?” The person says: “Well, never,” and the cognitive work starts.

In REBT we say, “Well, let’s assume you die, let’s assume the worst scenario, what makes you think that you should not die?” The client will see the irrational beliefs and we will dispute them.

In Logotherapy we get the person to distance themselves from the symptoms of panic through humor using paradoxical intention. So instead of doing what Beck would do or what Ellis would do, we would say: “Look, I don’t think you are anxious enough. What I want you to do is the next time you start to feel anxiety and panic, say to yourself: If I’m gonna panic, I’m gonna be the world champion of panicking.”

I see John’s expression. I also imagine the client’s expression and I start laughing. And so does John.

JV: You’re laughing. Now when we say this to clients they do the same as you. They laugh and as soon as they laugh they gain some distance from their symptoms. Now they do not over identify with their symptoms. So we don’t attack automatic thoughts or categorical thinking, okay? We distance them. Asking the client to do precisely the thing that they want to avoid makes the symptom disappear.

MR: I see many similarities with REBT.

JV: Yes, of course there are. For instance, with logotherapeutic modification of attitudes. If you come to me with a diagnosis of brain cancer that cannot be operated on and you are going to die, we would say to you: “Okay, what attitude can you adopt? How can you look at this tragedy in such a way that you can get by with it? What stand can you take in the face of this unavoidable personal tragedy?”

Logotherapy does not go into categorical cognitive process or catastrophic evaluation in a manner that “pure” REBT might. However, REBT and Logotherapy have the same goal: adopting an attitude, a mindset, a philosophy that will work for the client. In Logotherapy we leave the modification of attitude up to you with the goal of you finding it for yourself. We attempt to lead you in that direction utilizing Socratic questioning, a technique also extensively used in REBT.

MR: Is this tendency to involve different psychological approaches developing towards a new and more versatile methodological model?

JV: Not necessarily. Lately what some approaches are doing is looking more and more at neuroscience as a basis for understanding cognitive processes.

MR: “Meaning,” “purpose”… they are concepts far away from neuroscience.

JV: From a psychotherapeutic perspective, I’m completely against, and I’m concerned about an overemphasis on the neurobiological basis of behavior and affect. I understand and applaud the scientific perspective, but if I see you as my client I don’t want to reduce your depression or your existential problems to neurosynaptic processes. You are a human being with biology (body), psychology (mind), but also knowledge (spirit). The word “spiritual” has no religious connotation; it talks about the specific human dimension. Montse Rovira 1602

Neuroscience can never understand the spiritual dimension of what it is to be human. When we love, I suppose that we can look at the chemical processes and the hormonal reactions that contrib- ute to love, but I don’t want to know about these things. I think there are some human experiences in life that transcend the biological and psychological dimensions, such as music, art, love and po- etry. If we look at our client as a collection of biochemical and electrical processes, we don’t look at them as humans. They become objectified, objects not dissimilar from any other machine.

MR: People often find it helpful to understand how cognitive processes determine our emotions and our behavior.

JV: I know what you mean and I don’t disagree with that, but I think there are more than automatic thoughts and irrational beliefs. Let me refer back to Frankl and to what he calls “dimensional ontology.” Dimensional ontology considers three dimensions to the human being: biology, psychology, and spirit (“existentiality”). Traditionally, the discipline of psychology has focused on the first two dimensions. The way in which we are different from other animals is in the spiritual, or existential, dimension. And in the spiritual dimension we have the distinctly human capacity of “choice.” The human being is, and remains, an animal. But this is not the whole story. Neuroscience gives us the ability to understand A or B, but it will never explain why human beings, given their biology, choose A over B, or why we create music, or why we love.

MR: “Logos” is a Greek word that indicates “meaning,” “significance,” “purpose.”

JV: Exactly. Logotherapy focuses on existential meaning as being a distinct aspect of being human. It is a holistic, personalistic view of the human being as it considers the spiritual dimension. Meaning and purpose are not invented, as Sartre contends; Logotherapy argues that meaning is discovered.

MR: Does this mean we have to dare to go into the existential dimension to get a more meaningful life?

JV: Yes. We had better not discount or ignore any dimension in psychotherapy, particularly the existential dimension! When human beings go to therapy they quite often need help on a biological and psychological level. Maybe there is a biochemical imbalance that leads to their depression, for example. If they have a psychological problem, if they condition themselves to think in certain way, neuroscience may have something to offer our understanding of conditioning processes. But don’t forget, even in cognitive therapy we have something called “will.” Will exists in the third dimension and in order to change cognition you have to engage your will.

John smiles and gesticulates while he is talking. He is the kind of person who talks to you for the first time with the same spontaneity as if you were old friends. Sometimes he looks at me with an interrog- ative silence. I look at him patiently and wait. He breaks the silence to explain that love and humor are essential in psychotherapy and in life.

JV: A sense of humor doesn’t operate only on a biological level, neither only on a psychological level. Dogs and cats have psychology and biology, but neither of them can laugh. Have you ever seen a cat or a dog laughing? A sense of humor and the ability to laugh is distinctly human. Now, I see Rational Emotive Behavioral Therapy: An Existential Therapy 1603 you laughing and when you laugh you are engaged and existing in the third dimension, the human dimension, the distinctly human dimension.

MR: Sometimes we do want to enjoy life but we don’t know how. We just know we are not on the correct path but still keep on wandering.

JV: It is not about living without tension, but looking for a goal, some purpose, that is worth living for. Existential therapies sometime stimulate tension in a person to aid their growth. If we are anxious, depressed, or we have irrational thoughts, we experience these conflicts in the psychological dimension. If we are frustrated, unsatisfied, in permanent search for answers, these conflicts ema- nate from the existential dimension. A person’s interest, including our desperation to find out what is valuable in life, is spiritual/existential in nature. A sense of an empty existence, an “existential vacuum,” is often manifested in a state of boredom and lack of hope.

MR: A paradigmatic example is “Sunday evening neurosis,” the affliction experienced when the daily grind stops and the inner emptiness shows up.

JV: Precisely. As an existential therapist I say to these people: “Okay, you can avoid feeling like this. You have a choice. You can choose to live and think this way or not.” They say: “I don’t believe that; it is very hard for me to change.” I say to them: “I think it boils down to your choosing to change.” They insist they don’t think I am right, and that they would do it if they could.

MR: And this is when the existential debate comes into play.

JV: I say: “Let me prove it to you. Who would you do anything in the world for? Who would you die for? Who’s the most important person in your life?” They may answer: “My wife.” Then I say: “If I put a gun on your wife’s head and told you to change your attitude within 24 hours or I would kill your wife, and if we could measure you’re attitude, would you change it?” And the client always, always says: “Oh, absolutely!” They have found a reason. From their existential dimension they find meaning that will give them the strength to change in the name of the love they feel, in that case.

MR: “All you need is love,” John Lennon sang.

JV: We have to jump from the first and second dimensions, which are fine, but these two dimensions don’t explain the whole story. Love is in the third dimension. If it is love that gives meaning to our lives, we have to follow and pursue it. It can be love for your family, your job, for life itself, that’s up to you. Biologically and psychologically we have the capability to change our attitude, but we have to be engaged. We have to touch the third dimension. It can be through your beliefs, what you do in life, your work, your creation. It can be through your experience, what you receive from life. It can be through your worthy and brave attitude in the face of suffering.

MR: Existential therapies like REBT and Logotherapy are the most holistic.

JV: I think amongst psychological therapies in general, and specifically the cognitive therapies, REBT is the most complete. REBT talks about what most people need. It doesn´t only deal with conditioning and cognitive change processes; it also deals very, very strongly with existential con- Montse Rovira 1604 cerns. For me REBT is really a wonderful therapy; it really is the most complete. It looks at the psychological dimension, sometimes also the biological one, and ventures at times into the spiritual one.

If you have a brain tumor that cannot be operated on and your automatic thought is “I’m going to die,” well … I´m afraid the automatic thought is correct. You cannot change the situation, but you can accept it and adopt an attitude to cope with the suffering. This is REBT. An REBT therapist can talk about this using REBT.

MR: Ellis said that people with healthy emotions would ask themselves how they would like to live their life and go on that way.

JV: And this is a quintessentially existential question. Ellis was very passionate. Many of us went to Ellis back in the 60s, 70s and 80s because of his passionate personality and way of working. We were so excited about the way he presented his philosophy to his clients. It was not only his theory, but also his way of performing it that enthralled so many of us.

MR: In the field of psychology, is there now greater interest in investigation than in philosophy?

JV: Research and empiricism, though essential in the fields of psychology and psychotherapy, are not my primary concern. I am a phenomenologist. The person sitting in front of me is the one that counts, not statistics. I attempt to help the unique, existing person in front of me. If some technique for panic disorder works 75% of the time according to empirical investigation, it still may not work for the person sitting in front of me. Frankl was fond of saying, “If you treat two different people with the same diagnosis, you will have treated at least one of them incorrectly.” A client who comes to therapy wants to find someone to connect with, someone who can teach him or her how to live day by day. Psychotherapy is a human to human connection. I would like REBT to be presented to people as a philosophical way of life because that’s what it is.

John and I are in front of Penn Station, where he is going to take a train back to Princeton, the town he lives close to. He recommends that I visit Philadelphia, “the place where it all began,” because it was the original capital of the United States and the biggest city during colonial times. “Philadelphia” means “the city of brotherly love,” a beautiful name. I ask John if he thinks that in psychotherapy “everything is beginning,” and he answers: “I don’t know. I’m just a philosophical practitioner.”

Epilogue

The twentieth century has been prolific in the psychotherapy field. Great masters such as Albert Ellis and Viktor Frankl lived through tumultuous periods and dramatic social and personal circumstances. This undoubtedly had an effect on their work. Times have changed, but emotional disturbances and existential concerns still persist. Looking at things nowadays, the wisdom of those who knew how to transform their personal lives into an example of overcoming has to help us, in every case, to select the most meaningful and most relevant things we need to reach the existential serenity that we are all looking for.

Correspondence: [email protected] PHILOSOPHICAL PRACTICE1618 Journal of the APPA

Volume 10 Number 2 July 2015

Aims and Scope

Philosophical Practice is a scholarly, peer-reviewed journal dedicated to the growing Editor field of applied philosophy. The journal covers substantive issues in the areas of Lou Marinoff client counseling, group facilitation, and organizational consulting. It provides a forum for discussing professional, ethical, legal, sociological, and political aspects Reviews Editor of philosophical practice, as well as juxtapositions of philosophical practice with Leslie Miller other professions. Articles may address theories or methodologies of philosophical practice; present or critique case-studies; assess developmental frameworks or Associate Editor research programs; and offer commentary on previous publications. The journal Dena Hurst also has an active book review and correspondence section.

Technical Consultant APPA Mission Greg Goode The American Philosophical Practitioners Association is a non-profit education- Legal Consultant al corporation that encourages philosophical awareness and advocates leading Thomas Griffith the examined life. Philosophy can be practiced through client counseling, group facilitation, organizational consulting or educational programs. APPA members apply philosophical systems, insights and methods to the management of human problems and the amelioration of human estates. The APPA is a 501(c)(3) tax-ex- empt organization.

APPA Membership

The American Philosophical Practitioners Association is a not-for-profit educational corporation. It admits Certified, Affiliate and Adjunct Members solely on the basis of their respective qualifications. It admits Auxiliary Members solely on the basis of their interest in and support of philosophical practice. The APPA does not discriminate with respect to members or clients on the basis of national- ity, race, ethnicity, sex, gender, age, religious belief, political persuasion, or other professionally or philosophically irrelevant criteria.

Subscriptions, Advertisements, Submissions, Back Issues

For information on subscriptions, advertisements and submissions, please see the front pages of this document. For information on back issues, APPA Memberships and Programs, please visit www.appa.edu.

www.appa.edu Nemo Veritatem Regit ISSN 1742-8181 Nobody Governs Truth