"Dr. Beck was a young psychiatrist trained in Freudian
analysis when, in the late 1950s, he began prompting patients to focus on
distortions in their day-to-day thinking, rather than on conflicts buried in
childhood, as therapists typically did. He discovered that many people
generated what he called “automatic thoughts,” unexamined assumptions like “I’m
just unlucky in love” or “I’ve always been socially inept,” which can give rise
to self-criticism, despair and self-defeating attempts to compensate, like
promiscuity or heavy drinking.
Dr. Beck found that he could undermine those assumptions by
prompting people to test them out in the world — say, by socializing without
alcohol to observe what happens — and to gather countervailing evidence from
their own experience, like memories of healthy relationships. Practicing these
techniques, in therapy sessions and in homework exercises, fostered an internal
dialogue that gradually improved people’s mood, he showed.
Dr. Beck’s work, along with that of Albert Ellis, a psychologist working
independently, provided the architecture for what is known as cognitive
behavior therapy, or C.B.T. Over the past several decades, C.B.T. has become by
far the world’s most extensively studied form of psychotherapy. In England, it
forms the basis for a nationwide treatment program offering a number of related
talk therapies.
"The influence of cognitive therapy on the treatment of
mental disorders is hard to exaggerate. Researchers have adapted the approach —
originally developed for depression — to manage panic attacks, addictions,
eating disorders, social anxiety, insomnia and obsessive-compulsive disorder. Therapists teach a variation to help parents
manage children’s outbursts at home, and some have used it, in combination with
medication, to manage the delusions and hallucinations of schizophrenia. Sports
psychologists have made use of the principles for performance anxiety.
Dr.
Beck came across as an affectionate paterfamilias. Smiling softly beneath a rich sweep of white hair, wearing a bright bow
tie and tailored suit, he engaged patients gently, chipping away at
self-defeating beliefs with Socratic questions: Would you agree it is against
your interests to have this belief? Do you think it’s possible to ignore these
thoughts?
In the first chapter of his classic 1967 book, “Depression:
Causes and Treatment,” he observed: “There is an astonishing contrast between
the depressed person’s image of himself and the objective facts. A wealthy man
moans that he doesn’t have the financial resources to feed his children. A
widely acclaimed beauty begs for plastic surgery in the belief that she is
ugly. An eminent physicist berates himself ‘for being stupid.’”
In his last years Dr. Beck applied cognitive
techniques to help largely forgotten groups of people, like destitute drug
addicts and people with late-stage schizophrenia. “These people have some
capacity to do better, but they have all these defeatist attitudes and
expectations; they assume they’re going to fail,” he said in an interview with
The Times in 2009 in Bala Cynwyd."
