Last week, we reviewed Ellis’ ABC model as a means for understanding our negative responses to situations. As a quick refresher, it goes like this:

A-Activating event 

B-your Belief about the event

C-the Consequence (your response to our beliefs about the event)

Previously, we discussed that our negative belief about the activating event causes the negative reaction, not the event itself. This week, we’re going to discuss the D and E additions to this model, and how they can help combat our negative reactions. Let’s review and define some terms:

A-Activating event 

B-your Belief about the event

C-the Consequence (your response to our beliefs)

D: Dispute (your attempt to look at the event objectively and challenge your negative beliefs/responses to the event)

E: The Effect of challenging/defeating your initial belief.


So, where to begin?  When challenging/disputing a belief you hold, here are some questions to ask yourself:

  • Is the belief logical/rational? How would an objective observer view this situation?
  • What evidence do I have for and against my belief?
  • If the event isn’t all that positive, is my response to the event reasonable, or is it excessive?
  • Is this truly my belief or a belief that was taught to me by my elder(s)? For example, people often joke that, as children, if Mom was cold we all had to put on a sweater. What if your Mom was afraid of thunderstorms when you were a child? As an adult, would you then be afraid of thunderstorms yourself or would you engage in specific avoidant behaviors or express strong negative emotions when it rained because that’s what Mom always did?
  • Am I expressing a strong negative emotion/reaction that I really don’t believe but that allows me to avoid doing something I’d rather not?
  • Is my belief beneficial or disadvantageous to my ability to achieve what I want?
  • How can I change this belief?


Let’s start with an example from last week: fear of needles.

A- Activating event 

You need a shot or to have blood drawn.

B- your Belief about the event. 

Fill in your personal thoughts about the event here.

C: the Consequence (your response to our beliefs) 

Fill in your specific reactions here. For example, hyperventilating, panicking, becoming oppositional or just plain combative with medical personnel, avoiding medical care altogether, etc.

D: Your attempt to Dispute your belief/response 

For example: 

  • Most people don’t like to be stuck with a sharp object but, realistically, the process does not take very long and needles will not cause that much pain. 
  • Tensing up or becoming oppositional will not make the process go any faster or easier; in fact, it will do the opposite. 
  • The more I can relax, the faster and less painful the process will be. 
  • Avoiding medical care is not in my best interest. Lots of medical conditions are treatable if diagnosed early. 
  • Many other people are able to do it, so can I! 
  • To stay calm, I can (find something that works for you. Maybe it helps to not look at the needle, or maybe you feel better if you can watch. Maybe you need to do a countdown in your head, or find a distraction like listening to music or watching a video).

E: The Effect of your dispute 

Ideally, in this example, you’d feel less anxious about needles and develop positive coping mechanisms for the future. 

Bear in mind, an emotional response to a not-so-positive situation is normal, and ignoring or eliminating your emotions entirely is not the point of this exercise. It’s all about keeping things in perspective. Emotions only become problematic when they are excessive for the situation, all-consuming, or prevent you from engaging in necessary tasks. As a personal example, while I’m not afraid of needles, I have tiny little veins and often have to be stuck multiple times. Once the technician even brought in a sonogram machine to help them see my veins. It still took him three tries. Needless to say, having blood drawn is definitely not the highlight of my day. But I can, and do, let technicians draw my blood, despite my very real not so great past experiences, because the pros still outweigh the cons. Do I like it? No. Do I do it? Yes.  

The most important thing is to be mindful of your emotions and make sure they don’t become excessive or unrealistic. The next time you’re confronted with a situation you find daunting, try mapping out the ABCDE of what you’re facing, and see how your experience changes!

This blog is not designed to diagnose, treat, or prevent illnesses or trauma, and Dr. Emick is not responsible for your use of this educational material or its consequences. Furthermore, reading this blog does not create a doctor-patient relationship. The information contained within this blog is not intended to dictate what constitutes reasonable, appropriate, or best care for any given physical or behavioral health issue, nor does it take into account the unique circumstances that define the health issues of the reader. If you have questions about the diagnosis, treatment, or prevention of a condition or illness, you should consult your personal health care professional. As always, consult with your personal health care professional before beginning or changing any fitness or nutrition program to make sure that it is appropriate for your needs. Dr. Emick reserves the right to modify her positions on a subject based upon new research or data as it presents.