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Aaron T. Beck - A pragmatic approach to therapy, A family affair

cognitive depression fears patients

1921-
American neurologist and father of cognitive therapy.

A pragmatic approach to therapy

Aaron T. Beck was born in Providence, Rhode Island, on July 18, 1921, the third son of Russian Jewish immigrants. His father was a printer by trade who seriously abided by his socialist ideals. His rather overbearing mother was known for her extreme mood swings. Beck had two siblings who died before he was born. Beck's childhood typified middle-class America, complete with his involvement in Boy Scouts and athletics.

From this mediocrity rose one of America's ground-breaking psychotherapists. Beck developed what is known as cognitive therapy, which is used for cases ranging from depression and panic attacks to addictions, eating disorders, and even the most severe psychiatric illnesses. Beck's childhood strongly influenced his approach to therapy. A life-threatening staph infection at the age of eight changed his life. At this point, Beck was transformed from a very active young man to a quiet one who preferred reading to playing football. As a child, he developed a fear of hospitals, blood, and even the scent of ether, which made him feel as if he would faint. Eventually, he overcame those fears rationally. "I learned not to be concerned about the faint feeling, but just to keep active," he later recounted.

Beck graduated from Brown University in 1942. In 1946 he received his Ph.D. in psychiatry from Yale University. During his residency in neurology he began to investigate psychotherapy and cognition. Beck served as Assistant Chief of Neuropsychology at Valley Forge Hospital in Pennsylvania during the Korean War (1950–53). Even with his doubts about Freud and psychoanalysis, Beck attended the Philadelphia Institute of Psychoanalysis, graduating in 1958. Not long into his work with patients using psychoanalysis, Beck began to alter his approach. Beck joined the faculty of the University of Pennsylvania (Penn) in 1954, where he began to search for empirical evidence supporting Freud's theories. In his research, Beck attempted to discover a correlation between depression and masochism. Beck and his colleagues failed to find this correlation. Within two years his cognitive approach to therapy had taken shape.

Beck would go on to establish the Beck Institute for Cognitive Therapy and Research in Bala Cynwyd, a suburb of Philadelphia. Beck's determination was simple. For him, the unconscious does not play the role that Freud proposed. One of Beck's favorite maxims is "there's more to the surface than meets the eye." The cognitive method involves a person using rational thoughts to overcome fears rather than delving into the unconscious causes of those fears. In cognitive therapy the fears of the client are carefully examined and confronted rationally.

A family affair

Beck and his wife, Phyllis, a Superior Court Judge in Philadelphia, have four children and eight grandchildren. One of his children, Dr. Judith Beck, became director at the Beck Institute, working closely with her father. As a younger man he was driven by his work. As an older man he became more driven by his family. For years his main supporter was his wife, at a time when his beliefs were not popular. Throughout his career he has continued to meet his critics by encouraging them to test his theories and his results. Rather than being a boorish scientist too smug to be proven wrong, Beck welcomes any challenges in his pursuit of what is best for his patients.

What was originally a method to solve depression has now evolved further. According to his daughter, Prozac and other modern anti-depressant drugs have changed the clientele they see at the Institute. More complicated problems bring people to their doors at the beginning of the twenty-first century. These are problems that might take more than the usual eight to ten sessions a relatively simple case of depression would take to resolve. Beck insists that his cognitive approach can be used to treat psychotic disorders, even those as serious as schizophrenia. Beck's research conducted with Dr. Neil A. Rector of the University of Toronto has indicated that patients suffering from schizophrenia showed greater improvement through a combination of drug and cognitive therapies than patients receiving drug therapy alone.

Beck's theories are constantly evolving through his continued research efforts. A prolific writer, Beck has authored several books and articles both on his own as well as under collaboration. His books include Prisoners of Hate (1999), Depression: Clinical, Experimental, and Theoretical (1980), Cognitive Therapy and the Emotional Disorders (1979), and Depression: Causes and Treatment (1972). The Beck Depression Inventory and Scale for Suicide Ideation are among two of the widely used tools that he developed for use by therapists. The Beck Depression Inventory II in 1996 followed his long-successful original as an assessment tool for clinicians in diagnosing depression.

Jane Spear

Further Reading

Beck, Aaron T., M.D. Prisoners of Hate: The Cognitive Basis of Anger, Hostility, and Violence. New York: Harper-Collins Publishers, 1999.

Goode, Erica. "A therapy modified for patient and times." The New York Times (January 11, 2000).

Goode, Erica. "Pragmatist embodies his no-nonsense therapy. (Dr. Aaron T. Beck and his 'cognitive therapy.')" The New York Times (January 11, 2000).

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