Though Aaron Beck’s cognitive model is still considered to be a relatively contemporary approach to treating depression, the idea, that a man’s emotional difficulties can stem from what he believes about his circumstances, is not a new one. Beck is considered one of the foremost modern practitioners in the field of cognitive therapy. His approach to the treatment of depression, developed in the late 60’s, continues to be viewed as an innovation, deviating from other mainstream therapies that have been heavily influenced by Freudian thought. Beck boldly advocates confronting the client with his irrational thinking and challenging him to take responsibility for his own recovery.
The link between thought and emotional response was forged by early philosophers like Cicero and Epictetus. Epictetus, a Greek who lived somewhere between 50 and 150 A.D. wrote these words within the pages of his notable work, “The Enchiridion:”
“Men are not disturbed by things, but by the views which they take of them.”
Like other stoic philosophers of his time, Epictetus paved the way for Beck’s cognitive therapy with his rationale that feelings could and should be controlled by thought.
Cognitive therapy has been shaped and redefined by many theorists along its developmental road. Freud, considered by the proponents of modern psychotherapy to be the father of psychology, espoused the notion that thinking processes occurred not just consciously, but unconsciously. This idea fostered the notion that belief systems exist on two planes of thought; one in the individual’s consciousness, and the other, his unconsciousness, where life’s experiences have been imprinted. Piaget contributed his understanding of the role of human development in thought and behavior. Lazarus, contended that a correction of faulty thinking would produce a behavioral change. Ellis, the father of Rational Emotive Therapy, built upon earlier theories and linked irrational beliefs with unhealthy emotional responses.
Though Beck is not the first to link faulty behavior with irrational thought and unhealthy emotions, his model for cognitive therapy as an approach for treatment of depression has revolutionized the field of therapy. He has allowed the psychological community to see a natural progression occurring in a individual who regularly engages in negative thought processes.
Beck began the development of his model for treating depression with cognitive therapy in clinical trials, where he observed that depressed individuals seemed to engage in a pattern of behavior which included three steps or stages.
1. The depressed individual expressed a decidedly negative view of himself. He saw himself as incapable, inadequate, and frequently, as a victim of his circumstances.
2. The depressed individual interpreted his life’s past and present events through the same filter of negativity that he used to view himself. This gave birth to an attribute that is frequently seen in those who have been abused; “the victim mentality.”
3. The depressed individual interpreted his future in much the same way as his past and present. He postulated that future experiences would only serve to validate the sum total of his negative existence.
Based upon Beck’s assumptions, he laid the constructs for a form of therapy that would address the individual’s “stuck” way of thinking and help him to begin to generate alternatives ways of conceptualizing himself and his world. Beck believed that by changing the individual’s thought life, that his depression would lift.
Beck’s model for treating a depressed individual begins by educating the client to the reality that he is largely held captive, in a state of depression, due to faulty thinking processes. The next step is to outline a course of therapy that will help him redefine his past and generate new ways of thinking about himself, and his life’s experiences. The cognitive model incorporates homework assignments that are designed to help the client see how emerging patterns in his faulty thinking can affect his behaviors and the way he feels.
Beck uses imagery to help a depressed individual see the relationship between what he tells himself and how he feels and acts. To illustrate this truth, he guides his client through a negative visual experience and then elicits the client’s negative responses. Then he re-frames the scenario, giving a positive explanation for what the client is visualizing. When the client is asked how he feels after the second exercise, he invariably experiences a different set of more positive emotions. This exercise helps the client realize how his perceptions and thoughts shape his feelings.
Beck’s model is not without its drawbacks. The weakest link in the therapeutic process is the risk of the therapist jumping too quickly into a solution-oriented modality, before taking the time to bridge to the client through establishing empathy and building trust.
An overview of Beck’s model would not be comprehensive without acknowledging his awareness of the role of psychopathology in more complicated mood disorders such as bipolar disorder. Beck tends to favor cognitive therapy over the role of antidepressants and mood stabilizers, but recognizes the efficacy of drug intervention in cases of multiple relapse or where the severity of mood makes cognitive therapy difficult to accomplish.
In summary, Aaron Beck has made a significant contribution to the treatment of depressive symptoms. His research and clinical trials have led to the recognition that negative thought processes propagate self deprecation and lead to a negative world view. Beck’s model for treating depression with cognitive therapy has resulted in individuals being helped to change negative patterns of thought, leading to a significant decrease in overall depressive symptoms as well as in subsequent depressive episodes.
