Story of Psychology - Morton Hunt [391]
P: No…he has another woman. He doesn’t want me.
T: Then what have you actually lost if you break up the marriage?
P: I don’t know (crying). I guess the thing to do is just make a clean break.
T: Do you think that if you make a clean break, you will be able to get attached to another man?
P: I’ve been able to fall in love with other men before.88
Following this session the patient no longer felt suicidal; she began questioning her assumption “Unless I am loved, I am nothing,” and after thinking over the questions Beck had asked her, she decided to seek a legal separation. Eventually she got a divorce and went on to lead a normal life.
Although by the 1970s many therapists had tinkered with Beck’s detailed prescriptions, cognitive therapy technique had become fairly standardized. It generally required anywhere from six sessions (Beck prefers to call them “interviews”) to many months. At each one, the therapist and patient review the latter’s reactions to the previous session and its results, plan the coming steps in therapy, agree on the next tasks and homework, and apply logic, investigation, and reality testing to the patient’s current perceptions and thoughts about what is happening to him or her.
By the 1980s, cognitive psychotherapy had become part of the mainstream, and in addition to the one third of all psychotherapists who were primarily cognitive-behavioral, about another third were eclectic, most of them using cognitive-behavior therapy at times.89 It had become widely considered the treatment of choice for certain problems, particularly depression and low self-esteem. Beck, by then white-haired and benign, had become a doyen of psychotherapy. In 1989 the American Psychological Association gave him its Distinguished Scientific Award for Applications of Psychology, citing him thus:
For advancing our understanding and treatment of psychopathology. His pioneering work on depression has profoundly altered the way this disorder is conceptualized. His influential book, Cognitive Therapy of Depression, is a widely cited, definitive text on the subject. The systematic extension of his approach to conditions as diverse as anxiety and phobias, personality disorders, and marital discord demonstrates that his model is as comprehensive as it is rigorously empirical.90
That’s not all. In 2004 the Grawemeyer Foundation of the University of Louisville gave him its annual $200,000 prize for outstanding ideas in the field of psychology—and in 2006 he was the recipient of the prestigious Lasker Award for Clinical Medical Research, which consisted of $100,000 and acknowledgment of the “major advance” he had made in psychotherapy.
By the time of Beck’s APA award in 1989, cognitive therapy and cognitive-behavior therapy were on the rise, and since then their use has caught on almost throughout the field among professionals of many orientations. For several decades, but especially the past one, Beck, his colleagues, and other cognitive therapists have been modifying and expanding cognitive therapy to enable them to apply it to a wide variety of disorders. His original focus was on the use of cognitive therapy (CT) to treat depression, but by now special variants of it have been developed to treat such disparate problems as suicidal tendencies, anxiety disorders and phobias, panic disorder, personality disorders, substance abuse, and the psychical miseries engendered by a variety of physical ailments.
Among these variant forms of cognitive therapy are, for instance, teaching emotional regulation skills to highly reactive patients, having phobic or anxious patients expose themselves to feared situations, restructuring the meaning of early trauma through imagery, and working through a fear hierarchy with a panic disorder patient (getting the patient to tolerate a minimal fear object, then a slightly worse one, and so on step by step).91
A mass of research has validated the use of CT, CBT (cognitive behavior therapy), and their variants. There are now some four hundred research reports of outcome studies of CT and nearly as many