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the life and work of Aaron Beck — Offline on vc.ru

The creator of cognitive behavioral therapy helped people fight depression and become more self-confident. He worked until the last day of his life and died at the age of 100.

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Aaron Temkin Beck, psychologist, scientist

Childhood, phobias and medicine

Future psychologist Aaron Temkin Beck was born in July 1921 in Providence, USA. His parents, Harry Beck and Elizabeth Tiomkina, are Jews from what is now Ukraine, who moved to the United States in the early 1900s. His father was a journalist and his mother was a housewife.

Beck was a shy and withdrawn child, often sick and in hospitals, which made him afraid of blood and anesthesia. Despite this, Beck wanted to go to study medicine, he also considered journalism, which he initially settled on.

In 1942 he received a degree in English from Brown University. There, Beck served as deputy editor of The Brown Daily Herald and received a number of awards for essays and public speaking. And then he entered the medical faculty of Yale University, from which he graduated at 1946 year.

One of the reasons for choosing this direction was the desire to overcome phobias associated with diseases and hospitals. He began to specialize in neurology, but then moved on to psychiatry and studied psychoanalysis.

When I was in medical school, I got weak and dizzy because of the sight of blood. But I specifically went to the operating room to overcome my fears. Perhaps this is how my idea was born that through endurance and willpower, even the most serious symptoms can be overcome.

Aaron Beck

In 1954, Beck entered the University of Pennsylvania, where he studied psychiatry. He conducted research on psychoanalytic theories of the development of depression, worked with people who suffered from this disease. At first, Beck was sure that psychoanalysis was the only system that could help a person deal with mental problems. However, by the end of the 1950s, he began to develop his own psychological theory, which differed from Freud's.

Beck and Freud

Followers of Freud's theory believed that depression is the result of anger turned inward, at oneself. Psychoanalysts agreed that "deeper factors" were at work in a person with this disorder, but no one could determine which ones. Beck loved accuracy, so he decided to back up this concept with evidence.

Work with patients did not bring him the expected confirmation. The scientist noticed that many people did not feel angry, but rather simply considered themselves losers.

Aaron discovered that many people have "automatic thoughts" - deeply ingrained assumptions that affect their mental state, such as "I'm constantly unlucky", "I've always been unsociable" and others. They lead to the fact that a person thinks distortedly, criticizes himself too much and often despairs.

The psychologist believed that working with negative attitudes can transform thinking. He called his method cognitive therapy and began to put it into practice with clients.

Beck encouraged patients to focus on negative beliefs in their daily lives, rather than on childhood conflicts and an innate need to suffer, as Freudian analysis did. He invited people to refute their assumptions, test them in life and collect evidence that supports a positive alternative. This practice promoted the patients' internal dialogue and gradually improved their mood.

Later, Beck recalled with humor that when he began to use his own approach instead of the psychoanalytic one, his pockets began to empty. Because people began to feel better much faster and said: "Thank you, doctor, your services are no longer needed."

Since 1959, Beck has led funded research into the psychopathology of depression, anxiety, panic, and other disorders, and their cognitive therapy. The psychologist was focused on investigating the effectiveness and efficiency of his method.

Beck also conducted experiments that disproved the theory of psychoanalysis. He came to the conclusion that depression is due to low self-esteem. The psychologist said that "there is more on the surface than meets the eye."

There is a striking contrast between the depressed person's self-image and the objective facts. A rich man complains that he does not have the financial resources to feed his children. A famous beauty begs for plastic surgery, believing she is ugly. An eminent physicist scolds himself for being "stupid".

Aaron Beck, Depression: Causes and Treatment, 1967

Freudian analysts and other contemporary researchers criticized Beck's theory for its "superficiality" and pointed out the lack of evidence base. Pharmaceutical firms were also attacked, whose profits from psychotropic drugs he threatened.

Beck didn't antagonize critics, he was patient, persuasive, and responded with new research, writes the New York Times.

In 1977, a psychologist conducted trials with depressed patients that proved that CBT worked better than imipramine, the most effective antidepressant of the day.

Aaron Beck took a hundred year old dogma, found it broke, and invented something simple, durable, and effective to put it in its place. He actually saved psychotherapy from itself.

Stephen Hollon, psychologist at Vanderbilt University

Cognitive behavioral therapy

According to The American Scholar, cognitive behavioral therapy is the most popular and well-researched psychotherapy in existence in the 21st century. About 200 clinical trials have confirmed its effectiveness. Beck therapy is taught in most US clinical psychology and psychiatric residency programs. It is also included in the educational program of the US Army, the purpose of which is to increase the mental stability of soldiers.

Beck proved the effectiveness of the cognitive-behavioral method through rigorous research. This trend has spread throughout psychotherapy as a whole. Scientists began to develop psychological concepts on evidence. In the early 2000s, overseas public health systems spent hundreds of millions of dollars to distribute scientifically proven psychotherapy.

Beck's classical concept suggests that the cause of a person's mental disorders lies in the errors of his thinking. The task of the therapist is to help the patient change destructive attitudes and beliefs. He teaches to recognize them and invites a person to become a scientist who tests a hypothesis in order to test his perception and ultimately change behavior.

For example, Beck spoke about cases from his practice of cognitive therapy:

The woman suffered from depression, low self-esteem, increased self-criticism. At the sessions, she said: "If I stop punishing myself, God will go crazy." Beck replied: “This assumption can be tested. You can make sure that if you stop punishing yourself, nothing bad will happen.”

In cases where patients were sure that they should be perfect in everything, that their spouses were inattentive to them, and their bosses hated them, Beck asked: “Do you agree that these attitudes interfere with you? What are their disadvantages for you? Can you refuse them?"

In sessions, the therapist identifies the thought that worries the client in a particular situation. Then it reveals the beliefs that underlie it, and helps to abandon them.

For example, when a patient says that perhaps his wife no longer loves him because she does not kiss him before leaving, the therapist asks leading questions. They lead to the attitude "I am not worthy of love", which the patient needs to check and change.

Cognitive Behavioral Therapy requires fewer sessions than most other methods. It is most commonly used to treat depression, eating disorders, anxiety, and addictions.

Standard treatment for mental disorders should be done with a specialist. However, some research suggests that bibliotherapy and self-help may also be helpful for mild emotional distress and when specialist referral is not possible.

In 2008, US psychologists identified the 50 most effective self-help books for anxiety, depression, and trauma-related disorders. The books on cognitive-behavioral therapy received the highest ratings from experts.

Success and legacy

Success and recognition came to Beck in the 1980s, when cognitive psychotherapy began to spread around the world.

It has become a short-term and affordable format of psychological assistance. Beck's research provided an evidence base for mental disorders and destigmatized them. For many people, this has made it easier to seek help.

Aaron Beck, 1981 Photo: Den Miller for NYT

Beck himself called his biography the main proof that cognitive psychotherapy really works. He showed by his own example how from a shy and nervous boy with a fear of blood and hospitals, he turned into one of the most influential psychotherapists in the country and even the world.

In the personal archives of the scientist there are records of his self-therapy, which he conducted regularly throughout his life. At 40, Beck wrote that he had a successful career, a loving wife, four wonderful children and many close friends, but was constantly looking for approval from the outside and was afraid that he would not get it.

This was a period in the scientist's life when his theory was rejected and criticized, and he struggled with the tendency to self-criticism. However, Beck was determined and believed that with hard work and a rational approach, any neurotic tendencies could be eradicated.

For Aaron Beck, the image with a signature bow tie was fixed, as once with a cigar at Freud Photo: Ryan Donell for NYT

In his lifetime, Beck co-authored about 600 articles and 25 books, developed systems for measuring the symptoms of various psychological disorders and assessing the risk of suicide. His most recent work was on "recovery-focused cognitive therapy" aimed at helping people cope with schizophrenia.

Aaron Beck with daughter Judy Beck

Aaron Beck Achievements and Awards:

In 1994, Beck, along with his psychologist daughter Judith, founded the Beck Institute for Cognitive Behavioral Therapy in Philadelphia to train and develop therapists.

In 2003, Beck received the $20,000 Sarnath International Mental Health Award "in recognition of the international dimension and significance of his contributions to psychiatry and mental health."

In 2004, the University of Louisville Grawemeyer Award of $200,000 for outstanding ideas in the field of psychology.

In 2006, the Albert Lasker Clinical Medical Research Award, worth $100,000, is considered the most prestigious medical award in the United States.
The scientist also received awards from Sigmund Freud, Adolf Mayer, the Kennedy Society, the Morselli Medal and others.
In 2007, Beck was shortlisted for the Nobel Prize in Physiology or Medicine. He was the only nominee in history who did not conduct biological research and did not invent a physiological or biological device.
In 2017, the medical portal Medscape named Beck the fourth most influential physician of the last century.

The psychologist died on November 1, 2021 at the age of 100. Beck is survived by a wife with whom they lived together for over 70 years, three children, and 10 grandchildren and 10 great-grandchildren.

Aaron Beck continued to work until the last days of his life: he met with students at the Institute of Cognitive Behavioral Therapy and did research.

Aaron Beck Cognitive Psychotherapy | Psychology 108

Brief Biography of Aaron Beck.

Aaron Tyomkin Beck was born in 1921 in Providence, USA, to a Jewish family that emigrated in 1906 from western Ukraine.

Three years before the birth of their son, his parents lost their daughter, who died of the flu, and Aaron's mother never recovered from this loss. This led to the fact that the boy was brought up and grew up in an atmosphere of hopelessness and constant depression, in which his mother constantly stayed. Perhaps for this reason, after graduating from high school, he enters the Department of Psychiatry at the University of Pennsylvania.

After graduating from university, Beck started his own practice and worked for quite some time within the framework of the psychoanalytic concept in which he was educated. Over time, he becomes disillusioned with psychoanalysis and begins to look for his own path, which leads him to a theory that was very original for that time, explaining the origin of psychological problems in a different way.

In psychoanalysis, the main cause of the neurotic manifestations of the individual are the factors of the unconscious, which, entering into an explicit or hidden contradiction with the super ego, give rise to neurotic manifestations (frustrations that appear as a result of destructive reactions to the surrounding world). The solution to the problem within this school is seen as a therapeutic method of psychoanalysis, which consists in the patient's awareness of his unconscious manifestations and the direct connection of neurosis with early traumatic experiences. The key to successful psychoanalysis is the subsequent reappraisal of the initially traumatic event and the reduction of its significance to the patient.

Within the framework of behaviorism, the cause of neurotic manifestations was considered to be the patient's maladaptive behavior, which was developed gradually in the course of personal history due to repeated influences (stimuli). The influences (stimuli) that gave rise to such behavioral strategies lay in the patient's past, but behavioral therapy did not emphasize the importance of memories, as was the case in psychoanalysis. Within the framework of the practical application of behavioral psychology, it was believed that a sufficient solution to psychological problems was the use of special learning techniques to change the patient's behavior, that is, changing a maladaptive strategy to an adaptive one. Behaviorists believed that developing the right behavior was the key to success.

As for Aaron Beck, his new concept lay outside the limits of the mentioned methods and for that time was very original.

Theoretical substantiation of cognitive therapy.

Beck considered the cause of patients' problems in the way in which they interpreted the events of the world around them. The scheme he proposed for human reaction to these events was as follows.

External event => cognitive system => mental interpretation (idea about what happened) => reaction to the event (feelings and (or) behavior).

If we recall the basic principles of behaviorism, then there, the human consciousness was considered as a black box, about which no conclusions should be drawn, because what happens inside cannot be detected by an objective scientific method.

This was both a great advantage of the behavioral approach, since it moved psychology into the category of a scientific discipline, and a great disadvantage, since it excluded stimulus => reaction from the chain such an obviously important component of the process as consciousness and what happened in it from the point of view of the individual (albeit subjective).

As regards psychoanalysis, which was dominant at that time in Europe, the situation was exactly the opposite. This teaching took into account what was happening in the patient's field of consciousness, based only on Freud's scientific assumption about the structure of this consciousness, and even undertook to interpret the cause-and-effect relationships of these essentially virtual processes. The very behavior of the patient was determined by his neurotic tendencies, which lay in the past history.

Aaron Beck was one of the first who complicated (expanded) the behavioral scheme of a person and introduced consciousness into it as a cognitive (cognitive) component of the process stimulus => reaction , thus, in fact, improving the behavioral approach. Also, he approached human consciousness in a completely different way than in psychoanalysis (and much simpler), reducing it to purely cognitive processes and their results.

Even more important was the fact that Beck's theory, due to its simplicity, made it possible to easily translate it into the field of practical psychology and make it an instrument of psychological help to people.

Principles of cognitive psychology.

Consider the basic principles of his approach. According to Aaron Beck, the source of a person's reactions to surrounding events was his ideas about the world around him, which had been formed earlier and were not only ideas about the outside world, but also the inner world, in other words, the individual's ideas about himself in the context of his being in society.

Here is a quote from Beck that illustrates his approach quite vividly.

"Human thoughts determine his emotions, emotions determine appropriate behavior, and behavior in turn shapes our place in the world around us." "It's not that the world is bad, but how often we see it that way." - A. Beck.

If we have clear ideas about the world, then their discrepancies with reality will inevitably lead to a negative psychological reaction (frustration), and in case of strong discrepancies, to serious psychological problems.

Aaron Beck, as a psychologist, worked quite a lot with patients suffering from depression and in the process of such observations he deduced their main emotional manifestations, which were often dominated by the theme of hopelessness, guilt, loss.

Based on the experience of studying such patients, Beck suggested that neurotic manifestations appeared largely due to the perception of the world in negative colors, that is, the cognitive system of his patients was initially tuned to precisely this type of reaction. According to Beck, the neurotic manifestations of such people had three features.

— Regardless of what is happening, a person highlights mainly the negative aspects of external events, belittling the significance of the positive side or even not noticing it at all.

— Due to the peculiarities of this perception of the events of the outside world, these people are also characterized by a pessimistic view of the future, which, in their opinion, cannot bring them anything positive, because the expected events also do not bring anything good.

— Many of these people are characterized by low self-esteem, that is, a person initially considers himself as unworthy, failed, hopeless.

In addition, all of the above often leads to purely cognitive distortions, when a person builds his behavior based on erroneous generalizations. An example of such generalizations is cognitive assumptions - “no one needs me”, “I am good for nothing”, “the world is unfair”, etc.

Of course, the human cognitive system is not formed suddenly and not from scratch, it happens gradually and as a result of the impact of quite certain external events.

When such events occur constantly and are of a negative nature, which often happens during the period of an individual's growth and maturation, then one often speaks of the formation of persistent behavioral strategies that quickly acquire an automatic character and, being quite adaptive during the period of their appearance, become completely destructive under other conditions and circumstances, for example already in adulthood. But in reality, due to the life circumstances mentioned above, it is the cognitive system of a person that first forms, which determines his behavior.

According to Aaron Beck, the human cognitive system is formed mainly in childhood. Children, in this early period of life, think in polar categories according to the type of all or nothing, this way of thinking is called black and white thinking, under certain circumstances, this type of thinking persists into adulthood, which leads to maladaptive behavior, an erroneous perception of the world and subsequent psychological problems.

Of course, people's tendency to erroneous thinking, generalizations, stereotyped perception of the world is by no means always the cause of neurotic symptoms, let alone depression. A huge number of people (if not the vast majority) have a cognitive system (map of consciousness) that is largely built on erroneous assumptions, however, most people can hardly be called neurotic. This means that the causes of serious psychological problems such as depression are, of course, not limited to a tendency to primitive thinking.

Therapeutic method of Aaron Beck.

This type of therapy is a logical continuation of the ideas of the founder, and their transposition from the field of scientific assumptions into the category of practical psychology, or otherwise, the method of psychological assistance.

This is a systematic approach based on the practical task of solving specific client problems. The appeal of the method specifically to the conscious processes of the individual does not mean at all that Beck completely ignored psychoanalytic methods. In addition, behavioral techniques were actively used in the system, which eventually led to the development of a combined method of cognitive-behavioral psychotherapy.

Working with a client in the framework of cognitive psychotherapy.

First of all, the psychologist, together with the client, determines the range of problems on which they will work, after which the practical task of this work is set - the solution of a specific problem. This specificity is very important for the formation of the client's intention and his readiness for routine therapy. A number of requirements are put forward for the therapist, in fact, these are principles taken from humanistic psychology - empathy, naturalness, integrity, acceptance of the client in an unconditionally positive way.

Psychological session is based on the principle of cooperation with the client, while, in contrast to humanistic methods, the therapist's expressed directiveness towards the client is allowed.

- First of all, the range of problems with which to work is clarified.

- Next, the main events that led to the problem are analyzed and their connection with a specific strategy of the client's behavior, as well as the relationship of these strategies with cognitive attitudes, is revealed.

- The chain of events leading to the problem is evaluated, namely, the therapist makes it clear to the client how a particular cognitive distortion leads to maladaptive behavior, and this in turn leads to a problem.

This is where the conditionally diagnostic part ends and the actual work to eliminate the problem begins, which usually consists in teaching the client other ways of thinking and behaving.

In this case, as a result, the client must master the following skills:

— Detection and tracking of destructive thoughts.

- Detection and tracking of the connection between thinking, subsequent emotional reactions and behavior.

— An independent analysis of automatic thinking expressed in an assessment of its consequences, namely, to what extent certain thinking models are adaptive or, on the contrary, destructive.

- To the extent possible, determine the origins of automatic ways of thinking, their historical background and causes.

- Gradually change maladaptive automatic ways of thinking, that is, differently, develop habits of thinking differently.

It is easy to see that it is the last point that marks the beginning of really effective work, since it leads to personal changes - a change in ways of thinking and behavioral strategies.

It should be mentioned that in cognitive therapy, personality change is not the goal of therapy, although it is they that lead to the result, the goal here is defined at the level of a specific problem, which helps to direct the efforts of both the client and the therapist.

Methods of working with a client in cognitive psychotherapy.

Identification of automatic thinking.

This type of thinking is based on false premises that can be expressed in primitive thinking (black and white thinking without halftones), erroneous beliefs and stereotypes, false conclusions, which are most often based on a violation of logic due to the inability to think logically. The way of thinking is wrong and is the cause of neurotic problems, so the main methods of cognitive therapy lie around identifying the habits of thinking automatically.

1. Experimental methods.

- Experience test of maladaptive judgment - The therapist teaches the client to view a belief as a hypothesis, not as the ultimate truth. Based on this approach, you can model an experiment - for example, take a typical situation in which the client behaved in a certain way due to an incorrect belief and ask the client to imagine that he handled his belief more flexibly, evaluate the possible consequences and compare them with those that actually happened.

- Ask the client to rate their specific behavior that led to the problem in terms of polarizing pros and cons. Draw conclusions.

- Find examples of appropriate behavior in cinema, literature, analyze well-known events that happened to real people.

- Find logical errors and contradictions in maladaptive beliefs.

2. Decentration. Often a client with neurotic manifestations feels as if he is a target due to the fact that his cognitive model is very egocentric. This means that, for example, being in society, a person feels that the world revolves around him alone, feels himself in the center of attention, it seems to him that everyone around is paying attention to him. This reaction often leads to discomfort and even social phobia.

This kind of egocentricity underlies many psychological problems and getting rid of it is an important task of therapy. For this, exercises can be used that allow the client to look at himself or the world around him through the eyes of other people, accept and understand precisely their point of view, try to feel for himself what the other person feels, including in relation to the client himself.

3. Self-observation. This method is universal and allows the client to independently monitor the cognitive and emotional processes occurring in his mind. Observing his reactions to a particular stimulus, the client also identifies causal relationships that lead to just such behavior or emotional manifestation.

4. Decastrofication. With depression, anxiety disorders, and simply with cognitive distortions, many people tend to view events that are not consistent with their expectations as a disaster. At the same time, it can be either a loss of work or a cup of tea tipping over on a clean tablecloth. With such symptoms, the therapist suggests considering the possible real consequences of the "catastrophe", which most often turn out to be only temporary difficulties, but by no means the end of the world.

5. Teaching desired behavior. Through repeated repetition of the desired behavior, the client develops an adaptive behavioral strategy. For example, a timid client is given the task of gradually expanding their ability to communicate in society.

We have listed the basic principles of cognitive therapy and mentioned several common ways of working with a client.

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