Story of Psychology - Morton Hunt [388]
The therapist, who has done the most to advance and develop cognitive therapy did not originally owe anything to Ellis but later incorporated his fundamental premise—and often acknowledged his indebtedness to him. He is Aaron “Tim” Beck, whose name conjures respect and admiration throughout the world of contemporary psychotherapy.
At about the same time that Ellis was publishing his first papers on RET, Beck, a psychiatrist on the faculty of the department of psychiatry at the University of Pennsylvania, was taking his first step along a similar route. At that time a youthful man of modest height with a dense thatch of straight hair and a disarming smile, Beck practiced psychoanalysis, but in his own life he had earlier used behavioral and rational techniques on himself to conquer two severe phobias. As a child, he had had a series of operations, and from then on the sight of blood would make him feel faint. By the time he reached his teens he decided to defeat the phobia. “One of the reasons I went into medicine was to confront my fear,” he has said, and in his first year in medical school he made himself watch operations from the amphitheater and in his second year elected to be a surgical assistant. By making himself experience blood as a normal phenomenon, he dispelled his fear. Later in life he similarly tackled a fear of tunnels, manifested as involuntary shallow breathing and faintness (he attributes the phobia to a childhood fear of suffocation caused by a bad bout of whooping cough). He got rid of the fear by pointing out to himself repeatedly that the symptoms would show up even before he entered a tunnel. Proving to himself that they were unrealistic, he gradually reasoned the fear away.80
Beck, until his late thirties, believed in and used psychoanalytic therapy with his patients. He was particularly interested in depression, which, according to psychodynamic theory—as he interpreted it—is the result of hostility choked back and turned on oneself, where it takes the form of a “need to suffer.” The depressed person satisfies this need by behaving in ways that provoke others to reject or disapprove of him or her.
It troubled Beck that the theory was not well accepted by many psychiatrists and psychologists, and he set out to gather data from his own clinical experience to validate it. At first the evidence seemed to support the theory, but after a while he noticed contradictions and anomalies in his data. In particular, the depressed patients he was studying seemed not to be trying to be rejected by others but to win acceptance and approval. Beck underwent a loss of faith. “This marked discrepancy between laboratory findings and clinical theory,” he has written in retrospect, “led to an ‘agonizing reappraisal’ of my own belief system.”81
Beck, looking for a new faith, caught a glimpse of one when he resumed the study of the dreams of one depressed patient. In those dreams the patient was always a failure, unable to achieve some goal, losing an object of value, or appearing diseased, defective, or ugly. Beck had formerly interpreted the dreams as expressions of a wish to suffer; now he had an epiphany:
As I focused more on the patient’s descriptions of himself and his experiences, I noted that he consistently embraced a negative construction of himself and his life experiences. These constructions—similar to the imagery in his dreams—seemed to be distortions of reality.82
By means of a series of tests, Beck found that the patient “had a global negative view of himself, the outside world, and the future,