Journal of Rational-Emotive & Cognitive-Behavior Therapy

Volume 17, Number 2, Summer 1999

WHEN LADDERING AND THE

DOWNWARD ARROW CAN BE USED
AS ADJUNCTS TO INFERENCE
CHAINING IN REBT ASSESSMENT
Michael Neenan
Centre for REBT, Blackheath, London
Windy Dryden
Goldsmiths College, University of London

ABSTRACT: This paper looks at the ways in which laddering in Personal

Construct Therapy and the downward arrow in Cognitive Therapy can be
used as adjunctive techniques to inference chaining in locating a client's criti-
cal A or emotional core. We describe their use through a number of case ex-
amples and annotations. We conclude that these two methods require skilled
use if they are to be successfully integrated into inference chaining and are
offered as part of REBT's interest in theoretically consistent eclecticism. The
use of inference chaining in Rational Emotive Behaviour Therapy (REBT),
the downward arrow in Cognitive Therapy (CT) and laddering in Personal
Construct Therapy (PCT) are techniques which aim to help therapists and
clients gain rapid insight into the latters' core beliefs and values about them-
selves, others and the world. This article will show how each technique re-
veals underlying beliefs and then, from the REBT viewpoint, in what circum-
stances laddering or the downward arrow might be used as an adjunct to
inference chaining in the assessment stage of therapy.

GETTING TO THE HEART OF THE MATTER

Inference Chaining
This technique links the client's personally significant inferences
about an activating event (A) in order to find the one (sometimes
Address correspondence to Michael Neenan, Centre for Rational Emotive Behaviour Therapy,
156 Westcombe Hill, Blackheath, London, England SE3 7DH.
95 © 1999 Human Sciences Press, Inc.
96 Journal of Rational-Emotive & Cognitive-Behavior Therapy

called the critical A) which triggers her irrational belief (B) which
then, in turn, directly leads to her emotional reactions at C (Moore,
1983; Dryden, 1995; Neenan and Dryden, 1996). The client's infer-
ences are linked by a series of carefully crafted 'Let's assume . . . then
what?' questions. Before inference chaining is initiated, an unhealthy
negative emotion (e.g. anxiety) about the activating event is elicited
in order to anchor the chaining process in the client's emotional dis-
turbance:

Therapist: What is anxiety-provoking in your mind about your

husband dancing with another woman at the party?
Client: He might find her more desirable than me.
Therapist: Let's assume for the moment that he does find her more
desirable than you. Then what?
Client: He might leave me and go off with her.
Therapist: Let's assume that he does do that. Then what?
Client: I'll be all alone in the world and worthless.
Therapist: Why would you be worthless because you're all alone in
the world?
Client: Because I'm nothing without him.
Therapist: So are you most anxious about your husband leaving
you because you think you are 'nothing, worthless' without him?
Client: Yes, that's what I'm afraid of (the client's critical A, her
husband's departure, and her derivative irrational belief, that
she will be 'nothing, worthless without him', have been revealed
simultaneously).

The next step is for the therapist to help the client reveal her major
demand about the critical A, e.g. 'My husband must never leave me
because if he does I'll be worthless'. This irrational belief is then dis-
puted using logical, empirical and pragmatic arguments.

Downward Arrow

This method follows the logical implications of a client's key auto-

matic thought(s) in order to discover her dysfunctional beliefs or silent
assumptions (Burns, 1980; Blackburn and Davidson, 1990; Beck, 1995).
The client is asked for the meaning of each automatic thought in order
to reveal deeper cognitive layers. Beck (1985, p. 145) suggests that 'ask-
ing what a thought means to the patient often elicits an intermediate
Michael Neenan and Windy Dryden 97

belief [usually of an "if ... then" construction]; asking what it means

about the patient usually uncovers the core belief:

Therapist: Why was it upsetting for you when your husband danced
with another woman at the party?
Client: He might find her more desirable than me.
Therapist: Let's suppose this is true, what would it mean to you?
Client: He might leave me and go off with her.
Therapist: Okay, if he did go off with her, what would that mean
to you?
Client: If he doesn't want me any more then I'll be all alone in the
world (intermediate belief).
Therapist: What does that mean about you to be unwanted and all
alone in the world?
Client: That I'm nothing, worthless without him (core belief).

The client is then shown how to modify her disturbance-producing

beliefs by examining the evidence for and against them and question-
ing the utility of holding on to them.

Laddering

This technique, which is used most frequently in Personal Construct

Therapy, reveals a client's personal constructs (hypotheses) at increas-
ingly higher levels of abstraction (Hinkle, 1965; Bannister and Fran-
sella, 1986). The client may be asked to examine a specific bipolar
construct of herself (e.g. loved versus unwanted) by describing which
pole of the construct she would prefer to be described by. The therapist
asks 'Why?' about the preferred side of the construct which then, in
turn, reveals a new construct. This procedure is repeated until the
client reaches a superordinate construct which reveals a philosophy of
living or core values:

Therapist: Why is it preferable for you to be loved rather than

unwanted?
Client: Because that means I have importance and value to my
husband rather than being all alone in the world.
Therapist: Why is it important for you to have importance and
value to your husband rather than be all alone in the world?
Client: Well if he values me then he won't abandon me.
Therapist: As opposed to. . . ?
98 Journal of Rational-Emotive & Cognitive-Behavior Therapy

Client: Abandoning me because he doesn't value me.

Therapist: Why is it important to you to be valued by your hus-
band rather than not valued by him?
Client: Because that will prove I'm not worthless (superordinate
construct).

The client, in the role of a personal scientist, would be helped to

experiment with alternative interpretations (reconstruing) of herself
and the problem in order to create a wider choice of potential behav-
iours that would now be available to her.

WHEN THERE IS NO CHAIN REACTION

What's the Emotion?

In the thirteen step counselling sequence (Dryden and DiGiuseppe,

1990), step three is to elicit an unhealthy negative emotion about the
client's presenting problem in order to initiate inference chaining at
step four. However, some clients will not be able to identify a disturbed
emotion and will plump for vague descriptions of their feelings like
'bad' or 'miserable'. Therapy need not be stymied because no emotions
in the REBT lexicon of negative feelings have been uncovered or frus-
tration set in because therapy cannot move on to step four (assessing
the A). To find an emotion, the therapist can ask the client 'What passes
through your mind when when you feel bad?' and then use the down-
ward arrow to ascertain the meaning of each cognition:

Client: I can't always afford to buy my kids the things they need
for school.
Therapist: And what does that mean to you?
Client: The other kids at school will have everything and my kids
will be going without.
Therapist: Let's assume they are going without, what would that
mean to you?
Client: If I'm failing my children, then I'm failing as a father. Also
what will the other parents think of me when they are providing
adequately for their children?
Therapist: Let's suppose you are failing as a father, what would
that mean about you?
Client: That I'm a very bad father.
Michael Neenan and Windy Dryden 99

Therapist: And if the other parents see that you are not providing
adequately for your children, what would that mean to you?
Client: That the whole world can see my failings as a father.

Following this dialogue, the REBT therapist, guided by her knowl-

edge of the themes in emotional disorders, can help the client to clarify
which unhealthy negative emotions are implicated in his presenting
problems: breaking his moral code as a good father by not providing
what he absolutely should do for his children—this theme is usually
present in guilt; revealing publicly his perceived failings as a father
which he believes he must not have—this theme is usually present in
shame. At this point, the therapist may want to refine further the
cognitive data of each emotion at step four in order to determine if
their respective critical A's have been located and which emotion might
be primary or secondary in the client's psychological disturbance.

Overfocusing on Feelings

As mentioned earlier, inference chaining is anchored in an un-

healthy negative emotion. Some REBTers, particularly novices, may
become so absorbed in the 'textbook' ordering or correct construction of
the questions designed to peel away the client's layers of emotional
distress that the questioning can become circular:

Therapist: What was anger-provoking in your mind when your col-

league parked his car in your designated space?
Client: Well, it's my space isn't it?
Therapist: But as he didn't pay any attention to the fact that it's
your space, what was anger-provoking in your mind about that?
Client: Just that—that he didn't pay any attention.
Therapist: But he didn't pay any attention, did he? So let's move
forward by finding out what was anger-provoking in your mind
about him not paying attention?
Client: (fed up) This is getting us nowhere. We're going round in
circles. I've told you the answer already!
Therapist: (sheepishly) We do seem to be stuck.

In these circumstances, the therapist can put aside the standard

inference chaining format because it is being used to guide her rather
than helping the client to gain greater insight into his anger. Teasing
100 Journal of Rational-Emotive & Cognitive-Behavior Therapy

out the idiosyncratic meaning of each inference instead of hammering

away at the emotion may prove more profitable for both sides:

Therapist: Can I come at this issue from another angle?

Client: Okay.
Therapist: What does it mean to you when he parks in your space?
Client: That he has no respect for me.
Therapist: Let's assume that's true, what would that mean to you?
Client: That he sees me as weak.
Therapist: And if he does see you that way, what would that mean
to you?
Client: It's true, I am weak because I won't confront him over the
parking. He knows that.
Therapist: And if you don't confront him because you're weak,
what would that mean about you?
Client: That the whole office would know what a weak and despi-
cable man I really am. I wouldn't be able to hold my head up at
work.
Therapist: So if I can summarise: would you say that what you are
most angry about is that through parking in your space and you
not confronting him about it, this man has exposed you to the
rest of the office as 'weak and despicable'?
Client: Yes, that's it exactly.

By changing tack and dropping the insistence on mentioning 'anger'

in every sentence, the therapist is able to shift the client's attention to
the private meanings he attaches to having his parking space usurped.
In the therapist's final comments, she returns to the inference chain-
ing format, without any objection from the client, to clarify with him
that his critical A has been uncovered.

Ladder to the Rescue

Some clients express their goals for change in very vague terms,
e.g. 'I want to understand why I sit about all day doing nothing'. As
Walen, DiGiuseppe and Dryden (1992, p. 52) point out, such goals
are expressed 'in terms of therapeutic process rather than outcome'.
However, trying to establish what outcomes such clients would like to
achieve are often met with repeated replies of 'I don't know'. As the
client in the above example has intimated that he does not want to be
Michael Neenan and Windy Dryden 101

so idle, the therapist can ask how he wants to be rather than how he
actually is in order to establish a bipolar construct:

Client: Be more active, I suppose

Therapist: Why is it preferable to be more active than idle?
Client: Well, then you get your life moving.
Therapist: As opposed to . . . ?
Client: Being stuck.
Therapist: Why is it important to you to get your life moving rather
than be stuck?
Client: Because it's better to make your mark in life than pass
through unnoticed.
Therapist: Why is it important to make your mark in life rather
than pass through unnoticed?
Client: Because that means you have been a somebody instead of
a nobody. I want to be a somebody.

At this point, the therapist can revert to REBT to clarify the client's
goal for change, target for exploration the unhealthy negative emotion
associated with his presenting problem and refine further, if neces-
sary, the client's self-depreciation:

Therapist: So is your goal of change that you become a 'somebody'?

Client: Yes, that's what I'd like.
Therapist: And what does becoming a 'somebody' actually mean?
Client: Filling my life with purposeful things like having a job and
a social life.
Therapist: And how do you feel when you sit around all day not
filling your life with 'purposeful things'?
Client: Depressed. That's what holds me back.
Therapist: We may have touched on this already, but what are you
most depressed about when you're sitting about all day?
Client: I've already said—I'm a nobody.
Therapist: In whose eyes: yours or other people's?
Client: Mainly mine. That's where it hurts the most.

In this exchange, the laddering technique has 'opened up' the client
by elaborating the personal meaning of 'sitting about' which then elic-
ited his counselling goals and pointed the way to his critical A. This
enabled the therapist to construct eventually an ABC assessment of
the client's presenting problems.
102 Journal of Rational-Emotive & Cognitive-Behavior Therapy

Climbing Out of an Impasse

Often in the inference chaining process the therapist's attempts to

encourage greater client introspection falter. This is usually due to the
client venturing into an unknown or previously avoided cognitive land-
scape. If such an impasse does occur, the REBT therapist can use lad-
dering to escape from it by offering the client a different perspective in
order to collect further assessment information:

Therapist: What were you anxious about when you were sitting at
your desk trying to start your essay for college?
Client: Well, I'm not sure what is really required of the essay.
Therapist: And if you're not sure, then what?
Client: I don't know. I just feel stuck.
Therapist: Let's say you weren't stuck. Then what?
Client: I'd be able to complete the essay but I'd still be anxious.
Therapist: What would you be still anxious about?
Client: I really don't know.
Therapist: (musing) Hmm.

The therapist pauses here because she is uncertain how to formulate

the next question in her attempts to draw out more client inferences.
However, what does suggest itself to the therapist is to ascend the
construct system that the client has partially revealed:

Therapist: What for you is the opposite of 'stuck'?

Client: Unstuck.
Therapist: Okay, let's say you are stuck here and unstuck over
here (therapist uses her hands to suggest opposite poles of the
construct). Now which side would you prefer to be?
Client: I suppose unstuck because at least I'd finish my essay.
Therapist: As opposed to . . . ?
Client: Not finishing my essay.
Therapist: Why is it important to you to finish your essay as op-
posed to not finishing it?
Client: So I can get my degree.
Therapist: As opposed to . . . ?
Client: Not getting it.
Therapist: Why is it important to you to get your degree as op-
posed to not getting it?
Client: To prove to my parents that I'm a success.
Michael Neenan and Windy Dryden 103

Therapist: As opposed to . . . ?
Client: Proving to them that I can't cut it.
Therapist: Why is it important to prove to your parents that you
are a success as opposed to that you can't cut it?
Client: Who doesn't want their parents to be proud of them? But
I'd still be anxious even if they were proud of me. This is what I
don't understand.
Therapist: (reverting to inference chaining) Okay, what would still
be anxiety-provoking in your mind despite having your parents'
approval which is something you obviously desire?
Client: They would want me to go on to do a master's degree, then
probably a PhD.
Therapist: Let's assume that's true. Then what?
Client: My life would be an endless academic slog in order to keep
my parents proud of me. I fear that I will fail or give up at some
stage and my parents would be very upset. I couldn't bear to see
them upset.
Therapist: Is that what you are most anxious about: having to see
your parents upset because of your perceived failure?
Client: Yes. That's why completing this essay won't give me any
real peace of mind.
Therapist: And not completing it will bring that day of failure
much closer.
Client: I'm trapped both ways.

In this final section of dialogue, when the therapeutic utility of lad-

dering has been exhausted the therapist returns to inference chaining
to complete the cognitive examination of the client's anxiety. Ladder-
ing provided the organic link to keep the chain unfolding and help
reveal to the client what was previously puzzling him as to why essay
completion would not give him 'peace of mind'.

CONCLUDING COMMENTS

REBT therapists who wish to use these adjunctive techniques of lad-

dering and the downward arrow should be skilled in their use and not
simply seen as afterthoughts if inference chaining becomes blocked in
some way. As we hope we have shown in this article, these additional
techniques are integrated into inference chaining rather than substi-
tutes for it. Some REBTers, even many, may protest that there are a
104 Journal of Rational-Emotive & Cognitive-Behavior Therapy

number of REBT methods to get inference chaining moving again when

it stalls that we have not mentioned. This is true. Other REBT thera-
pists could demonstrate this by rewriting this paper without mention-
ing laddering or the downward arrow. We offer this paper in the spirit of
theoretically consistent eclecticism (Dryden, 1987; Dryden and Neenan,
1995) whereby outside borrowings can bring a fresh perspective to tra-
ditional REBT practice. We hope that REBTers will not object to having
two more techniques to add to their existing armamentarium.

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