Al Ellis: Courageous and Integrative Empiricist
John C. Norcross, Ph.D.
University of Scranton
In my brief tribute, I will attend to 3 of Al’s many remarkable features – his courage, his integration, and his empiricism. Each anchored in a vibrant and memorable personal experience.
My first contact with Al served to reinforce his image in my mind as the Lenny Bruce of psychotherapy. I was a doctoral student attending my 1st APA convention in 1980 or 81s. Al was one of four presenters on a symposium on the interface of religion and psychotherapy. The presenter before Al delivered an eloquent plea for the inescapable confluence of spirituality and psychotherapy. Quite moving and uplifting. Al then stood up and said as his opening line: “Religion and psychotherapy: I say fuck it!” Half the crowd gasped in horror and half of the crowd roared its approval. An atheist suggesting that a belief in God was an irrational idea.
Here was a courageous man, unafraid to speak his mind. Back in that day, Al was a pioneer in sex therapy – along with Havelock Ellis and then Masters & Johnson. He advocated for public education on sex – a position that nearly got him arrested on multiple occasions for violating decency statues. Sex without guilt in 1958. Early on, he preached acceptance of homosexuality – seen as controversial, if not demonic, at that time. He was one of the first to take on the psychoanalytic establishment, then the most powerful political force in psychotherapy. Thomas Paine once wrote: He who dares not offend cannot be honest. That characterizes Al: an honest and courageous man.
Fast forward to the early 1990s, when I was heavily involved in the psychotherapy integration movement. Al and the Institute organized in Manhattan a two-day conference entitled A meeting of the minds. Psychoanalysis and cognitive-behavior therapy: Is integration possible? Two psychoanalysts – Otto Kernberg and Ethel Persons. Two CBTs -- Al and David Burns. And one integrative, monkey in the middle – me – for 2 days. Although the meeting would have been more accurately characterized as not a meeting of the minds, but as butting of the heads, it turned out that Al was sympathetic toward integration.
In fact, as the record will demonstrate, Al was one of the modern pioneers of integration. He began obviously with a cognitive or rational base. Influenced by the 1960s thrust on feelings, and thus titled it rational-emotive. The behavioral and CBT revolution led Al to add the Behavioral to RET – the finished REBT, a specialized form of CBT. And anyone who has ever read his books or watched him work knows fully well that he was an integrationist at heart – not only combining therapy methods traditionally associated with disparate theoretical orientations, but also blending therapy formats (individual, couples, group), treatment modalities (psychotherapy with pharmacotherapy), and, of course, self-help with psychotherapy. While the research demonstrates that 80% plus of contemporary psychotherapists now recommend self-help to some of their patients, Al was there before anyone. Back in the days when self-help was described as “dangerous”
But not everything should be integrated. In an article we initially wrote together, Al argued that we should not integrate those therapy methods or systems lacking scientific support. He was famously critical of superhybrid systems that purported to integrate, say, TA, NLP, Jungian, and existential therapies. As he wrote: None have substantial scientific support beyond a credible placebo. 0 + 0 + 0 + 0 still equals 0, integrative or not. Ouch.
That brings me to my third and final point: Al Ellis as relentless empiricist. The purportedly new evidence-based practice is nothing new at all to REBT. He was always committed to collecting empirical data on the success of RET in general and his patients in particular. Indeed, Al was one of the first clinicians to conduct outcome research. In the mid-1950s, Al took his closed case files and compared his own success using psychoanalysis, psychoanalytic psychotherapy, and RET. He noted improvement in 50% of his patients receiving psychoanalysis, 53% receiving PA psychotherapy, and yes, you guessed it, an even higher 90% success receiving RET. Of course, only a single therapist potentially biased toward his own therapy system and hardly a RCT, but nonetheless a model of empiricism in the 1950s. Since the 1970s, at least 100 outcome studies on the effectiveness of RET and REBT with various disorders and populations.
When I was asked 2 weeks ago, following Al’s death, to be interviewed on NPR’s Weekend Edition, I deferred, saying that dozens upon dozens of people knew Al much better than I did. But Scott Simon and his producer persisted, saying they wanted someone to talk about him but also about his larger legacy. For me, Al’s courage, integration, and empiricism embody that legacy – revolutionizing psychotherapy and helping literally millions of fellow humans through life. In a simple exclamatory sentence: That’s quite a fucking legacy!