On July 24th—after this article was published—Albert Ellis died at his flat on the top floor of the Albert Ellis Institute. This was the last interview he gave.
When I got in touch with Albert Ellis's office to arrange an interview with him later in the year, they told me that he was very old and ill and might not live that long. They said that I should come as soon as possible, so the next day I took a plane to New York. I was prepared to drop everything to interview Ellis. He is one of the few living legends of psychology. The magazine Psychology Today described him as the "greatest living psychologist," while the American Psychological Association voted him the second most influential psychologist of the 20th century (Carl Rogers came first; Freud was third).
Ellis is considered the father of the "cognitive revolution," which has caused a huge shift in the way we see mental disorders, and has led to the present popularity of cognitive behavioural therapy (CBT). He is also a colourful character, given to swearing like a fishwife (he has suggested that Freud's ideas were "horseshit from start to finish") and insistent on his view that "most human beings are out of their fucking minds." You could say he is a modern Diogenes: foul-mouthed, free-thinking, trying to liberate us from the mental habits that make us miserable.
Ellis has also had a huge personal influence on me. I had post-traumatic stress disorder for six years or so in my twenties. I developed this condition after reckless experimentation with psychedelic drugs. I've seen many other people my age develop similar mental problems through use of ecstasy, speed and LSD. The disorder, which manifested itself when I was at university as an almost permanent feeling of unease in social situations, brimming over into the occasional panic attack, laid waste to my self-esteem and ability to socialise. In my first years in the workplace, the effort to cope with and hide the disorder from others left me exhausted. Like the hundreds of millions of people with emotional disorders in western society, I was underachieving, alienated from society and very unhappy.
Ellis's ideas aren't a new fad, the next big thing after the Atkins diet. He read philosophy widely when he was growing up in the Bronx, and he was particularly struck by a comment of the Stoic philosopher Epictetus: "It's not events, but our opinions about them, which cause us suffering." This idea, Ellis told me, is at the heart of CBT. We can train ourselves, as Stoics and Cynics did, to change our opinions, our mental habits, so that we become robust and self-accepting enough to withstand external events that used to cause us suffering, such as getting rejected by a woman, or getting fired.
For example, we might say to ourselves, "I must be liked by everyone, and if someone doesn't like me, it's a catastrophe." We repeat this irrational opinion to ourselves so often it becomes an unconscious assumption, and it gets backed up by powerful negative emotions if we feel we have incurred someone's disapproval. We end up desperately anxious about what people think of us, and miserable if we feel we have failed to connect. Both stoicism and CBT teach you to become aware of these unconscious or automatic opinions. If you recognise how you choose to believe them, you can choose not to believe them, and replace them with more philosophical thoughts such as, "It's preferable if this person likes me, but it's not the end of the world if they don't." So our focus switches from worrying about things outside our control to changing our thoughts and opinions.
Replacing irrational opinions with more philosophical ones is not easy, because such opinions are deeply ingrained, so you have to wrestle with them, over and over again. And you can't solve your problems lying on a couch. You have to go out into the street, and train yourself to resist your habitual opinions in real situations, with the real threat of rejection or humiliation. Ellis himself used these techniques when he was growing up, to overcome his fear of talking to girls. He sat on a bench in the Bronx Botanical Gardens, and promised himself he'd try to talk to 100 girls. He did so, and managed to get one date. "She didn't turn up," he says, "but I did better on the next 100 girls, and eventually became one of the best picker-uppers in New York."
I discovered stoicism before CBT, and was drawn to how relevant Stoic ideas seemed to modern emotional problems. What CBT does is update stoicism and apply it to specific mental disorders, like depression or social anxiety. This is, perhaps, its greatest achievement. In an era of postmodernism and neuropsychology, it has managed to put Greek philosophy back at the heart of western society—CBT has persuaded millions to follow the principles first discovered by Diogenes 2,400 years ago.
When I get to New York, I find Ellis in a bad way. He's 93 now, in a nursing home on the upper east side, recovering from pneumonia, half his intestine cut out, unable to eat solid food, or even drink through his mouth. I felt I was intruding. But his wife, psychiatrist Debbie Joffe, insisted it was OK.
Like many a Stoic philosopher before him, Ellis is having a difficult last stage of his life. Socrates had to drink hemlock; Cato and Seneca committed suicide; and Ellis appears to be getting ripped off by the charitable foundation that he set up, the Albert Ellis Institute. He founded the institute amid the idealism of the 1960s, as a not for profit trust to spread his philosophy, which he calls rational emotive behaviour therapy (REBT), around the world. He bought a desirable house near Madison Avenue, and signed it over to the trust. He then channelled all his royalties from the 70 or so books he wrote, plus the earnings from the therapy and teaching he did every day, into the trust, withdrawing a salary for himself of around $12,000 a year. "He doesn't really care about money; he's an idealist," says Bill Knaus, a counsellor who helped set up the institute.
In 2005, at the age of 91 and after a serious illness, he married a teacher at the institute, Debbie Joffe, 40 years his junior. This seems to have startled some members of the board of the institute, who were perhaps wondering who would be in charge after Ellis died. Whatever the reason, the board called an extraordinary board meeting, at which Ellis was told that the institute could no longer pay his sizeable medical expenses without risking its not for profit status, so he had to be fired from the board. This, the present executive director of the institute, Robert O'Connell, tells me, was "the only solution."
Ellis was shell-shocked. They hadn't discussed the issue with him before. They hadn't warned him what the subject of the meeting was, or advised him to have a lawyer present. At a stroke, he was kicked off the board of the institute he had spent his life setting up, which still made millions of dollars from his teachings. His credit cards were cancelled. And he has now spent most of his savings on his healthcare.
He was also banned from giving his usual Friday night group sessions in the institute, where any member of the public could turn up and receive free counselling. The get-togethers were famous, like some sort of Stoic academy, with Ellis waving his cane and shouting at people to stop being so irrational, in the way Epictetus would shout at students and call them slaves for following conventional ideas.
But O'Connell tells me Ellis had become a liability: "He was verbally abusing people. He was thrashing around with his cane." Ellis's followers point out that Ellis has always sworn at patients for their irrational thinking. That's his style. But that maverick approach has now apparently become a threat to the smooth running of the Albert Ellis Institute.
O'Connell says that the board is unrepentant. "We must fulfil our fiduciary responsibility to the trust," he says, even though a New York judge recently ruled they had acted improperly and "disingenuously," and should reinstate Ellis to the board (he's back on, but as a minority member). Ellis demands the board should resign, stop using his name and give him his institute back. Most of the CBT community support him. But O'Connell stands firm. "We've got to have some rationality here," he says, with a benevolent smile.
Ellis himself manages to stay stoical about the whole nasty business. "They [the board] have behaved abominably," he says. "But they're fucked-up, fallible human beings, just like everyone else." He has continued soldiering on, even teaching students from his bed just a few hours after an operation.
CBT, meanwhile, goes from strength to strength, thanks in part to the work of the other great pioneer of the movement, Aaron Beck. Beck is very different to Ellis—quietly spoken, punctiliously dressed, circumspect in his pronouncements.
While Ellis has concentrated on teaching and spreading his personal philosophy, Beck and his followers have been conducting hundreds of clinical trials that have helped earn CBT legitimacy in the eyes of western medicine and governments. The British government is a big believer, and recently announced a new programme to bring CBT to the masses via therapy websites.
The literary and intellectual world, however, has yet to take CBT to its bosom, in the way that it did with psychoanalysis or Lacanism. A handful of New York writers are fans: Saul Bellow was a patient of Ellis's, while Dalton Trumbo, the scriptwriter for films like Spartacus and Roman Holiday, described Ellis as "the greatest humanitarian since Gandhi." But many intellectuals remain rather snobbish about CBT, seeing it as too simplistic, too rational, perhaps too American, with none of the continental chic of Lacan or Freud. Ellis's books have titles like How to Stubbornly Refuse to Make Yourself Miserable About Anything... Yes, Anything!, which sound as if they belong in Tesco. It is unlikely that a school of literary criticism will emerge from his theories.
Some psychologists accuse CBT of spreading a simplistic American philosophy of "think positive." Oliver James, for example, in his new book Affluenza, dismisses CBT as "the artificial boosting of self-esteem" and the propagation of American "faux happiness." But James is here confusing positive psychology, invented by Martin Seligman, with CBT, invented by Ellis and Beck. It's not clear if he has read anything by these latter authors.
It is possible to say of CBT, as you can of stoicism, that it can lead to political quietism. You learn to accept and tolerate everything around you, and never get angry about the injustices you encounter. But actually, if you look at Stoics or Cynics through the ages, they have a distinguished history of standing up to tyrants, precisely because they are not afraid to let go, not afraid to die. Diogenes stood up to Alexander the Great, Socrates stood up to the Athenian mob, Cicero and Cato stood up to Caesar, Seneca stood up to Nero. The history of Stoic resistance to power extends to our own day. The jailed Russian businessman Mikhail Khodorkovsky, who is in a Siberian prison as a result of standing up to Putin, has called for a new generation of "Stoical warriors of liberalism." American vice-admiral James Stockdale says it was the ideas of Epictetus that enabled him to withstand seven years of imprisonment and torture by the north Vietnamese, without ever capitulating or even agreeing to be paraded as a captured trophy. Perhaps if our troops were taught more Stoic values, they would be less inclined to cry when someone took away their iPods.
What will Ellis's legacy be? Well, there are millions of people, like me, who have got better thanks to CBT. But I hope the legacy will be deeper than that. Geoff Mulgan, the founder of Demos, called in a Demos pamphlet a few years ago for the return of the philosophical idea of the "good life," for a re-examination of what he calls the "timeless values" found in ancient philosophy, and their application to the stresses and problems of modern life. CBT has helped to rediscover and reintroduce some of those timeless values; or not values exactly so much as ways of thinking. And Mulgan is right—similar methods have been discovered all over the world. Just as stoicism has marked similarities with Buddhism, Taoism or Sufism, so CBT is now being applied in different parts of the world, in combination with home-grown philosophies. Thus in China, panic disorders are increasingly being treated with a combination of CBT and Taoist philosophy, while the main Japanese school of psychology, Morita, combines some CBT-style techniques with the ideas of Zen Buddhism.
Ellis has said that he always saw the place of CBT as "in the schools, in the educational system." It makes sense, as the neo-Stoic philosopher Martha Nussbaum has suggested, for us to teach our children not just how to pass exams but how to stand their ground and withstand external pressures to conform or consume.
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