A Copyright Harvard Health Publications
Few individuals have had as great an impact on psychiatry as Dr. Aaron T. Beck, who is often referred to as the father of cognitive therapy (CT).
In the 1950s, when Dr. Beck was beginning his career in psychiatry, psychoanalytic theory dominated the field. Psychoanalysis recognizes that the relationships and circumstances of early life continue to affect people as adults, and that human behavior results from unconscious as well as conscious or rational motives. Psychoanalysts and patients engage in an extended, often years-long effort to make the unconscious conscious, the aim being to understand and resolve (or at least to help the patient bear) the conflicts at the root of suffering.
Although originally a devotee of the psychoanalytic method, Dr. Beck began to develop an alternative approach to working with depressed patients. Over time, Dr. Beck appreciated that many of them were prone to automatic streams of negative thought. Building on the insights of two predecessors, psychologists George Kelly and Albert Ellis, Dr. Beck developed a theory of depression based on the way people processed information. He believed that each individual sometimes interprets external events in a way that is biased or distorted, and that this may contribute to their mood disturbance.
In 1963, Dr. Beck published a paper in which he identified specific cognitive distortions, such as catastrophizing (making something out to be worse than it actually is) and overgeneralization (making the leap from a specific incident , like making a mistake, to a general principle, such as concluding “I never do anything right”). The next year, he described a new therapy to help patients learn to recognize automatic thoughts and cognitive distortions and, more significantly, to consciously evaluate and learn to correct them.
The therapy he described eventually became known as cognitive behavioral therapy (CBT), to reflect the fact that it addressed both cognition and behavior. And while it has undergone refinement over the years, its focus remains the same. CBT seeks to modify biased thinking and observable behaviors by helping patients to become more aware of them.
Although CBT was initially used only to treat depression, Dr. Beck and other CBT pioneers have since extended the reach of this therapy. Today CBT is used to treat virtually every type of psychiatric disorder, including anxiety disorders (such as panic disorder and phobias), bipolar disorder, personality disorders, eating disorders, and substance use disorders. It is being tested in schizophrenia and somatoform disorders. CBT is also useful in helping people without psychiatric disorders to gain more insight into their thinking and more control over their reactions, in short, in improving their mental health.
Thus, it is not far-fetched to suggest that Dr. Beck ushered in a new chapter in psychotherapy. In depression, CBT works as well as drugs, but has a more durable effect. It relies on helping patients learn to enlist the power of their own thinking to overcome mental challenges.
In recognition for his many contributions, Dr. Beck has amassed awards from some of the leading organizations in American medicine. But perhaps the greatest testament to Dr. Beck’s work is provided by the multitude of patients who have benefited from CBT, the life-changing and often life-enhancing therapy he created.