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Cognitive Behavioral Therapy

We Need The Next Aaron Beck

Personal Perspective: We're overdue for another breakthrough.

Tumisu, Pixabay, Public Domain
Source: Tumisu, Pixabay, Public Domain

Aaron Beck, father of cognitive-behavioral therapy, recently died at the admirable age of 100.

Beck advanced clinical psychology from Freudian psychoanalysis, which was impractically long for all but the wealthy who have lots of time on their hands. As bad, psychoanalytic theory was based mainly on one man's anecdote. Much of that theory, proposed more than 100 years ago, seems rather preposterous in retrospect.

For example, the model asserts that too strict toilet training causes adults to be “anal-retentive:” rigid and obsessive. If toilet training is too lax, the child may well become an "anal-expulsive" adult: messy, wasteful, or destructive. Perhaps most head-shaking, Freud asserted that young girls have penis envy, which later translates into sexually desiring their father.

Aaron Beck went beyond the anecdotal to more rigorous empiricism, including randomized trials. The result was support for the more logical contention that, for example, depressed people respond better to encouragement than would be predicted by Freud’s anger-turned-inward theory. The latter posits that depression is caused by people shifting their resentment of others onto themselves.

Beck also found that much mental illness is ameliorable, not by exploration of childhood, but by helping clients to identify distortions in their thinking, what Beck called automatic thoughts. These are deeply held, too-global assumptions about themselves, for example, "I'm a loser." Beck also found that brief therapy can often be effective. That democratized therapy, which as mentioned, made therapy accessible to people who could not afford years on the Freudian psychoanalytic couch.

But like many methodologies, Beck's cognitive-behavioral therapy has its limits. Alas, too many mental health practitioners, in their desire for a single model that could govern their work, have bought cognitive-behavior therapy as the way.

Psychotherapy, indeed most counseling, is in its adolescence and so requires practitioners to practice it as an art as much as a science. Practitioners are wise to draw from a palette of modalities. Sometimes, it makes sense to use CBT. Sometimes, it's wise to spend time revisiting past trauma. Sometimes, it is important to look at the effects of the client’s current and/or past social or familial constellation. Sometimes, medication, exercise, and suppress-and distract are appropriate tools.

So, thank you Aaron Beck for moving us ahead from couch-years of exploring incest-driven desires, phallic stages, oral phases, anal phases, penis envy, and dreams' latent themes. Yes, sometimes a cigar is a cigar.

But cognitive-behavioral therapy, while a breakthrough 60 years ago, has not sufficiently moved the field ahead from there. While CBT is helpful to many people, we need better. Perhaps Beck’s most important legacy is to inspire psychology researchers and other people to think radically differently, to search for the next breakthrough, to become the next Aaron Beck.

I read this aloud on YouTube.