Aaron T. Beck, MD, Positively Cropped Psychotherapy


The history of psychotherapy can conveniently be divided into 2 parts over the 100 years of Beck’s life. It is important to understand psychotherapy from about his birth year 1921 to 1971. Meanwhile, Sigmund Freud seemed to be the father of the new field of psychotherapy. Freudian psychotherapy, which ranged from weekly psychoanalysis to daily psychoanalysis, was based on its psychodynamic principles, including the importance of the relationship between therapist and patient in terms of the often unconscious countertransference and transference, respectively. . The interpretation of the therapeutic relationship, which, for example, might be related to an unresolved father-son oedipal conflict, has been found to be essential for insight and improvement. Certainly, it should be noted that Freud believed his theories were more useful for understanding the mind than for actually dealing with problems.

Such was the dominance of Freudian ideas and psychotherapy during my own residency training from 1972 to 1975. I was not taught cognitive therapy, the new emerging therapeutic modality that Beck had developed. However, as soon as I was alone on a military base in the south, I needed psychotherapeutic techniques that could work quickly and that I could teach my staff. Cognitive therapy to the rescue! I was soon to embrace that new model and modality that dominated psychotherapy for the next 50 years, from 1971 to about 2021.

After Beck had his own experience of Freudian concepts and clinical work, he came to recognize the importance of mistaken and negative cognition, especially in patients with depression. Often times, it can start after a childhood trauma. Instead of the Freudian idea that masochism leads to depression, Beck pointed to low self-esteem. Slowly, but surely, and overcoming his disbelieving colleagues, he developed techniques to positively reframe these negative and inaccurate cognitive patterns, and what could be accomplished in a much shorter therapeutic period. Their application then spread to a variety of other psychiatric disorders. Eventually, cognitive therapy became known as Cognitive Behavioral Therapy (CBT) because behavior, like substance abuse, often improved as cognition changed.

Although it was said that it could not be used for psychotherapy because it was too complex and variable, Beck was able to research the process and results of cognitive therapy so that it became reproducible and based on proofs. Psychodynamic psychotherapy, with its complexity and variations, has proven to be much more difficult to perform. Beck and his colleagues have also developed manuals to learn and use, symptom inventories to monitor results, and hundreds and hundreds of articles and books. The rewards were numerous. To institutionalize a CBT resource center, he and his psychologist daughter, Judith S. Beck, PhD, founded the nonprofit Beck Institute for Cognitive Therapy in 1994.

At the end of his life, Beck was working to incorporate the model of recovery into his model of CBT – recovery-oriented cognitive therapy (CT-R) – so that patients with so-called serious mental illnesses like schizophrenia feel empowered. and precious. Some of its concepts have also spread in society at large. In politics, its cognitive principles can be seen when one side or the other tries to positively reframe an issue to their liking.

Beck and Freud

Despite the differences in the approaches of Freud and Beck, they had some interesting commonalities, including on the religious level. Both were Jews, and their findings fit well with Judaic teachings, including Freud’s unconscious mystical meanings and realistic optimism despite Beck’s trauma. Especially when it comes to CBT and Rabbinic Judaism, both conceptually share the belief that humans can use their reason to improve, control, and discipline themselves. Freud remained involved with the B’nai B’rith, while Beck remained involved with the Philadelphia Jewish community and the Beth Hillel-Beth El temple.

On a family and interpersonal level, the two have been blessed by daughters – Anna Freud and Judith Beck, PhD – who have become professionals in the field and have worked with their fathers to help disseminate and expand their ideas. Their concepts were not only picked up by other fellow psychiatrists, but they were delighted to see how well their ideas were received by those of other disciplines in mental health care.

In their inner research, both Freud and Beck used self-assessment to develop their concepts: Freud in his interpretations of his own dreams and Beck with notebooks in which he wrote at least twice a day for several. years on his own “negative” thoughts. . Both are over the age of 75, both remaining productive.

To look positively at their particular ideas, it is better to consider Freud and Beck not as one or the other, but both / and. Paradoxically, Beck’s, perhaps ironic, assertion that sometimes there is more to the surface than it appears is an in-depth approach to conscious cognitive thinking in itself, whereas Freud’s was an in-depth approach. in-depth inner unconscious beliefs. Both can be important and useful. The two concepts have led to related innovations in psychotherapy. The two psychiatrists also had other people who influenced them; in Beck’s case, it was especially Albert Ellis, PhD, founder of Rational Emotional Behavior Therapy.

With such revolutionary ideas, both Beck and Freud were subject to criticism. Cognitive therapy has been accused of being too superficial, ignoring emotionality, and being just a temporary morale booster. However, its strong validation of the research has rendered most of the reviews harmless over time. Nonetheless, Beck did not seem to engage in denigrating Freud and sometimes said he was neo-Freudian. No professional oedipal conflict here!

A lasting legacy

I was inspired to write this eulogy the day after Beck died. Coincidentally, it is November 2, the traditional Mexican Day of the Dead, where the souls of ancestors are welcomed again. You don’t have to have a special day to remember Dr. Beck. Even though he and his more sane ideas did not gain public attention like these interpretations of Freud, it can be said that he has been the father of psychotherapy for the past 50 years. His ideas have permeated psychiatry so much that he is with us every day of our work.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and lecturer, he received the Unique Designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to climate instability, exhaustion. professional, Islamophobia and anti-Semitism. for a better world. He sits on the editorial board of Psychiatric schedulesMT.


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