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Dr. Aaron Beck: A foundational figure in Cognitive Behavioural Therapy

Dr. Aaron Beck passed away in November 2021. Dr. Kyle Burns explains the impact of Dr. Beck’s work.

On November 1, 2021, Dr. Aaron Beck died.

He was 100 years old. He was a psychiatrist and one of the most important foundational figures in Cognitive Behavioural Therapy (CBT).

He was a therapist, a psychoanalyst who worked with people whose anxiety and depression brought them to him for help. Contrary to prevailing psychoanalytic theory, he came to believe that it was not his patient’s dreams or their slips of the tongue that revealed the source of their problems. Rather, it was everyday thoughts that had a profound effect on the way people feel and behave. He thought that self-critical thoughts, distorted thoughts about others and negative thoughts about the future would lead to depressed withdrawal from the world and others. Like many revolutionary ideas Beck’s insight may seem obvious in retrospect. 

More importantly Beck also thought that these thinking patterns could be identified and changed. His contemporary, Albert Ellis, had similar ideas, and both believed that people could learn to think differently. A person could be taught to see the world and themselves through a different lens. To be clear, this was not about the power of positive thinking. They were not advocating that people will take their negative thoughts away and simply think positive thoughts in their place. Rather, it was a matter of attention. A person would have to learn to attend to their negative thoughts and then learn how to question and challenge these thoughts.  

When you consider the world of psychotherapy that Beck inhabited, his contribution is even more remarkable. Beck himself was a psychoanalyst which was the preeminent treatment for psychological problems at the time. The psychoanalysts believed that the source of psychological problems was hidden and obscured by a sophisticated defence system that would resist attempts to correct or even understand the problem. Therefore, there was little interest in the automatic, surface thoughts that had Beck’s attention. Then there were the behaviourists whose ideas would eventually be combined with Beck’s. The Behavioural stance was that the mind and its contents (including thoughts) could not be measured objectively and were essentially inaccessible to scientific study.

For Beck, neither of these were the case.  In fact, the problems that led to depression were entirely accessible to the therapist and, for that matter, to the patient as well. This transformed the role of the therapist in a way. It meant that the therapist was not in possession of arcane knowledge or insight but rather was a consultant and teacher.  Ideally a CBT therapist would work themselves out of a job when their clients gained the knowledge and skills necessary to combat their own depression and anxiety.  People could learn to become their own therapist. 

This raised the possibility that therapy could be much shorter than the years psychoanalysis might take. It also became a therapy that could be structured and studied. When Beck’s Cognitive Therapy was combined with behavioural treatments the new Cognitive Behaviour Therapy would grow to dominate both therapeutic research and clinical practice.

I have never had the pleasure of seeing Dr. Beck work but what stands out from his writing and videos is his interest in his patients and their experience. He seemed to have a genuine curiosity and desire to understand what was happening for his patients. This is something that seems to be necessary in any type of therapy and, for that matter, might be something we could use more of in our other human endeavours.  

– Dr. Kyle Burns, Psychiatrist, VanPsych Co-Director, and Anxiety Canada Board Director.