Psychology: Essential Thinkers, Classic Theories, and How They Inform Your World - Andrea Bonior 2016

Aaron Beck
Psychotherapy
The Canon

BORN 1921, Providence, Rhode Island

Educated at Brown University and Yale Medical School

BIG IDEA

Aaron Beck is a giant in the field whose work sits at the intersection of cognitive research and psychotherapy. In fact, many see him as the founder of cognitive therapy.

Beck began as a psychoanalyst and wanted to see how psychoanalysis could be helpful for depressed people. Discouraged by the lack of empirical evidence in this area, he was soon led to seek out more concrete and quantifiable types of interventions, and he began to focus on interventions that examine and even challenge specific ways of thinking. He developed cognitive therapy independently of Albert Ellis’s work on rational-emotive behavior therapy, though both approaches overlap in their time frames.

Beck identified particular ways in which people who are depressed tend to think of themselves, their worlds, and their futures. Not surprisingly, their views tend toward the negative. But their thoughts also prove to be automatic—they are so ingrained that they’re often taken as truth, without being the least bit challenged. The problem, as Albert Ellis showed, is that such thoughts are not necessarily aligned with reality, or even rational. They are examples of errors and distortions in thinking, and yet they rule the way depressed people see themselves and the world around them.

Beck’s cognitive theory of depression says that such automatic thoughts and distorted interpretations are a fundamental part of being depressed, and that they represent a systematic bias in depressed people’s thinking that serves to maintain and perpetuate their depression. But if such thoughts can be challenged and identified, then perhaps healthier patterns of thinking—and thus improvements in mood—can be attained.

Beck proposed that frequent negative thoughts often reflect a person’s core beliefs. They are cognitive patterns, or schemas (schemata), that come from early experiences like being harshly criticized throughout childhood, losing a parent, or being rejected by peers. These core beliefs are neither helpful nor accurate, but they persist and are felt to be real and fundamental parts of life. And they tend to be self-fulfilling; the depressed person, believing that things will go badly, tends to create a set of circumstances that will indeed lead to things going badly.

Beck showed that additional cognitive errors are common among those who are depressed. Arbitrary inferences prompt people to make connections between things that are not really connected. And in dichotomous thinking, people see things in all-or-nothing or black-and-white terms. Overgeneralizing (blowing something out of proportion rather than seeing it as a specific, singular event) and paying selective attention to the negative (while tuning out the positive) are also patterns of thought frequently seen among those with depression. For Beck, every one of these cognitive errors represents a distortion that not only may contribute to the emergence of depressed thoughts but also may keep the depression from lifting later on.

Thankfully, Beck’s development of cognitive therapy shows a way out of such thinking. The therapist’s role is to challenge these thoughts in a caring way, illuminating just how irrational they are. These silent assumptions may never have been challenged before. This in turn will help a person learn to think more positively, creating automatic thoughts that are more realistic and adaptive. Positive thoughts will also be more goal-directed, making the person more active in ways that will solve problems and help him or her move forward, and making the self-fulfilling prophecy of failure less likely.

Beck also designed measures to assess symptomatology, so as to better quantify a person’s progress in cognitive therapy. The Beck Depression Inventory has been used for decades to measure the signs and symptoms of depression in research settings as well as in clinical settings. Once again, the thinking is that breaking depression down into concrete thoughts, feelings, and behaviors promotes further understanding of what, exactly, depression consists of, and that this can help immensely with treatment. Beck’s cognitive interventions have also been shown to have benefits beyond the treatment of depression. They have become implemented in standard treatment protocols for anxiety disorders, obsessive-compulsive disorders, and eating disorders as well.

THEN WHAT?

Beck directly influenced Martin Seligman, whose theories of depressed attributional styles and learned helplessness further expanded what we know about the depressed mind. Cognitive therapy created a completely new direction in treatment, leading to further therapies like cognitive behavioral therapy, which has branched out into additional formulations (including acceptance and commitment therapy) that are used to treat dozens of different psychological disorders.

WHAT ABOUT ME?

Let’s say that you are walking down the street and you pass a colleague with whom you have been developing a friendship. The colleague seems to see you but doesn’t acknowledge you at all. How do you interpret this situation? And how does it make you feel?

Some of us would come up with an explanation that doesn’t involve negative thoughts about ourselves in the least: “Wow, she must not have seen me. She’s probably distracted. Perhaps it wasn’t her I saw at all, but someone who looks like her.” But others among us—and most likely the ones most prone to depression—will make it not only all about us but also all about our presumed flaws: “She’s embarrassed to say hello to me! She doesn’t like me after all! I must have insulted her somehow!” Of course, in any given situation, the truth is still unknown, and it could fall anywhere along the spectrum of these two different ways of thinking. Yet depressed people systematically and chronically think in terms of negative interpretations that involve them, and such automatic negative thinking is likely both a cause and an effect of being depressed.

The other two fundamentally negative ways of thinking that Beck identified— about the world at large, and about one’s future—can also be seen quite easily in the everyday lives of those who are depressed. If the roof on your newly built home starts leaking, do you view it as a specific problem, or do you think more generally that the entire house must be a dump? If you have an uncomfortable confrontation with your manager at work, do you quickly assume that you’ll get fired? And if you do get fired, do you assume that your career is ruined and that you’ll never find fulfilling work again? Beck’s work further shows us that it is not what happens to us in life that determines our feelings. It is our interpretation of what happens that matters, along with how we carry these thoughts around with us.

Specific cognitive errors may be so common that you don’t even notice them in yourself. Perhaps you’re not even depressed, but you engage in all-or-nothing thinking. It seems to play a role in myriad ways of feeling bad, from anxiety and panic to low self-esteem, perfectionism, and hopelessness. Such dichotomous thinking locks you into a rigid way of seeing the world, and if that perspective is already negative, then the bad gets magnified immensely: “My kid has been talking back sometimes—she’s completely disrespectful!” “My boss put in one comment about me needing to be more prompt—I got an awful review!” “I had a second dessert—my diet is totally ruined!” All these thoughts represent cognitive leaps that are illogical and negative, and they will keep us on the path of feeling bad instead of finding ways to work toward our goals and overcome the initial problem. More realistic and adaptable methods of thinking could help us better address the challenges we face, be less angry and desperate about our kids’ behavior, and feel less demoralized and awkward at work. Certainly, more realistic and adaptable thinking can help us keep two desserts from turning into a dozen.

Maybe you have a friend or family member who is particularly good at playing devil’s advocate and showing you the errors of your thinking, especially when you are mentally spinning out and getting down on yourself about a setback that you’ve experienced. That confidante, by playing the role of a gentle but firm interlocutor, is challenging your automatic thoughts and supporting you in restructuring them into more rational and less depressing ways of thinking that actually make sense and make you feel better. And that person has a lot in common with a cognitive therapist.