Aaron Beck

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Aaron Temkin Beck (July 18, 1921Template:SndNovember 1, 2021) was an American psychiatrist who was a professor in the department of psychiatry at the University of Pennsylvania.<ref name="Grawemeyer">2004 - Aaron Beck Template:Webarchive, The Grawemeyer Awards, Louisville, KY: University of Louisville/Louisville Presbyterian Theological Seminary, 2009, Retrieved February 21, 2014.</ref><ref name="heinzawards">Aaron Beck bio, The Heinz Awards Undated, Retrieved February 21, 2014.</ref> He is regarded as the father of cognitive therapy<ref name="Grawemeyer" /><ref name="heinzawards" /><ref>Template:Cite journal</ref> and cognitive behavioral therapy (CBT).<ref>Folsom, Timothy D., et al. "Profiles in history of neuroscience and psychiatry." The Medical Basis of Psychiatry. Springer, New York, NY, 2016. 925-1007.</ref> His pioneering methods are widely used in the treatment of clinical depression and various anxiety disorders. Beck also developed self-report measures for depression and anxiety, notably the Beck Depression Inventory (BDI), which became one of the most widely used instruments for measuring the severity of depression.<ref name="Measuring">Template:Cite journal</ref> In 1994 he and his daughter, psychologist Judith S. Beck, founded the nonprofit Beck Institute for Cognitive Behavior Therapy, which provides CBT treatment and training, as well as research.<ref>About Beck Institute: Leadership Template:Webarchive, Beck Institute for Cognitive Behavior Therapy, Bala Cynwyd, PA: Beck Institute for Cognitive Behavior Therapy, 2014, Retrieved February 21, 2014.</ref> Beck served as President Emeritus of the organization up until his death.

Beck was noted for his writings on psychotherapy, psychopathology, suicide, and psychometrics. He published more than 600 professional journal articles, and authored or co-authored 25 books.<ref name=":0">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> He was named one of the "Americans in history who shaped the face of American psychiatry", and one of the "five most influential psychotherapists of all time" by The American Psychologist in July 1989.<ref>Template:Cite journal</ref>

Early life and educationEdit

Aaron Temkin Beck was born in Providence, Rhode Island, on July 18, 1921. He was the youngest of four children born to Elizabeth Temkin and Harry Beck, Jewish immigrants from Ukraine.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>Template:Cite book</ref> Harry worked as a printer and Elizabeth's family found financial success in tobacco wholesaling; the family belonged to the upwardly-mobile vanguard of Providence's Eastern European-Jewish immigrant community. At the time of Aaron's birth, the Temkin-Becks lived a "comfortable, lower-middle class lifestyle" and were in the process of putting down roots on Providence's East Side. In 1923, when Aaron was two years old, the family purchased a house at 43/41 Sessions Street in the city's Blackstone neighborhood.<ref name=":1">Template:Cite journal</ref>

File:Aaron T. Beck, 1939.jpg

Beck's Hope High School yearbook photograph

Beck attended John Howland Grammar School, Nathan Bishop Junior High, and Hope Street High School, where he graduated as valedictorian in 1938. As an adolescent, Beck dreamed of becoming a journalist.<ref name=":1"/> Beck matriculated at Brown University, where he graduated magna cum laude in 1942.<ref name=CAO>Template:Cite book</ref> At Brown, he was elected a member of Phi Beta Kappa society, was an associate editor of The Brown Daily Herald, and received the Francis Wayland Scholarship, William Gaston Prize for Excellence in Oratory, and Philo Sherman Bennett Essay Award.<ref name="Beck" /> Beck attended Yale Medical School, planning to become an internist and work in private practice in Providence. He graduated from Yale with a Doctor of Medicine in 1946.<ref name=doctor/>

CareerEdit

After receiving his M.D., Beck completed a six-month junior residency in pathology at Rhode Island Hospital and a three-year residency in neurology at Cushing Veterans Administration Hospital in Framingham, Massachusetts. During this time, Beck began to specialize in neurology, reportedly liking the precision of its procedures.<ref name=doctor/> However, due to a shortage of psychiatry residents, he was instructed to do a six-month rotation in that field, and he became absorbed in psychoanalysis, despite initial wariness.<ref name=doctor/>

After completing his medical internships and residencies from 1946 to 1950, Beck became a fellow in psychiatry at the Austen Riggs Center, a private mental hospital in the mountains of Stockbridge, Massachusetts, until 1952.<ref>Template:Cite journal</ref> At that time, it was a center of ego psychology with an unusual degree of collaboration between psychiatrists and psychologists, including David Rapaport.<ref>Template:Cite journal</ref>

Beck then completed military service as assistant chief of neuropsychiatry at Valley Forge Army Hospital in the United States Military.<ref name="archives.upenn.edu">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Penn psychiatryEdit

Beck then joined the Department of Psychiatry at the University of Pennsylvania in 1954.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref name=atbb>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> The department chair was Kenneth Ellmaker Appel,<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> a psychoanalyst who was president of the American Psychiatric Association,<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> whose efforts to expand the presence and relatedness of psychiatry had a big influence on Beck's career. At the same time, Beck began formal training in psychoanalysis at the Philadelphia Institute of the American Psychoanalytic Association.<ref name=atbb/><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Beck's closest colleague was Marvin Stein, a friend since their army hospital days to whom Beck looked up to for his scientific rigor in psychoneuroimmunology.<ref name=splendid/> Beck's first research was with Leon J. Saul, a psychoanalyst known for unusual methods such as therapy by telephone or setting homework, who had developed inventory questionnaires to quantify ego processes in the manifest content of dreams (that which can be directly reported by the dreamer). Beck and a graduate student developed a new inventory they used to assess "masochistic" hostility in manifest dreams, published in 1959.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> This study found themes of loss and rejection related to depression, rather than inverted hostility as predicted by psychoanalysis.<ref name=splendid/> Developing the work with funding from the National Institute of Mental Health, Beck came up with what he would call the Beck Depression Inventory, which he published in 1961 and soon started to market, unsupported by Appel.<ref name=splendid>Template:Cite journal</ref> In another experiment, he found that depressed patients sought encouragement or improvement following disapproval, rather than seeking out suffering and failure as predicted by the Freudian anger-turned-inwards theory.<ref name=doctor/>

Through the 1950s, Beck adhered to the department's psychoanalytic theories while pursuing experimentation and harboring private doubts.<ref name=splendid/> In 1961, however, controversy over whom to appoint the new chair of psychiatry—specifically, fierce psychoanalytic opposition to the favored choice of biomedical researcher Eli Robins—brought matters to a head, an early skirmish in a power shift away from psychoanalysis nationally.<ref name=splendid/> Beck tried to remain neutral and, with Albert J. Stunkard, opposed a petition to block Robins.<ref name=splendid/> Stunkard, a behaviorist who specialized in obesity and who had dropped out of psychoanalytic training, was eventually appointed department head in the face of sustained opposition which again Beck would not engage in, putting him at bitter odds with his friend Stein.<ref name=splendid/>

On top of this, despite having graduated from his Philadelphia training, the American Psychoanalytic Institute rejected Beck's membership application in 1960, skeptical of his claims of success from relatively brief therapy and advising he conduct further supervised therapy on the more advanced or termination phases of a case, and again in 1961 when he had not done so but outlined his clinical and research work.<ref name=doctor/> Such deferments were a tactic used by the institute to maintain the orthodoxy in teaching, but Beck did not know this at the time and has described the decision as stupid and dumb.<ref name=doctor>Template:Cite journal</ref><ref name=splendid/>

Beck usually explained his increasing belief in his cognitive model by reference to a patient he had been listening to for a year at the Penn clinic.<ref name=doctor/> When he suggested she was anxious due to her ego being confronted by her sexual impulses, and asked her whether she believed this when she did not seem convinced, she said she was actually worried that she was being boring, and that she thought this often and with everyone.<ref name=doctor/><ref>Scientist At Work: Aaron T. Beck, Erica Goode, The New York Times, January 11, 2000</ref>

Private practiceEdit

In 1962, Beck requested a sabbatical and would go into private practice for five years.<ref name=splendid/> In that same year, he was already making notes about patterns of thoughts in depression, emphasizing what can be observed and tested by anyone and treated in the present.<ref name="beckmd" /> He was engaged by George Kelly's personal construct theory and Jean Piaget's schemas.<ref name="eor">{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Beck's first articles on the cognitive theory of depression, in 1963 and 1964 in the Archives of General Psychiatry, maintained the psychiatric context of ego psychology but then turned to concepts of realistic and scientific thinking in the terms of the new cognitive psychology, extended to become a therapeutic need.<ref name="splendid" />

Beck's notebooks were also filled with self-analysis, where at least twice a day for several years he wrote out his own "negative" (later "automatic") thoughts, rated with a percentile belief score, classified and restructured.<ref name=splendid/>

The psychologist who would become most important for Beck was Albert Ellis, whose own faith in psychoanalysis had crumbled by the 1950s.<ref name=eor/> He had begun presenting his "rational therapy" by the mid-1950s.<ref>Template:Cite journal</ref> Beck recalled that Ellis contacted him in the mid-1960s after his two articles in the Archives of General Psychiatry, and therefore he discovered Ellis had developed a rich theory and pragmatic therapy that he was able to use to some extent as a framework blended with his own, though he disliked Ellis's technique of telling patients what he thought was going on rather than helping the client to learn for themselves empirically.<ref>Who Influenced Dr. Aaron Beck's Work? (Students Ask Dr. Beck - Part Two) Beck Institute for Cognitive Behavior Therapy, CBT Workshop on Depression and Anxiety for students and post-doctoral fellows, August 15–17, 2011</ref> Psychoanalyst Gerald E. Kochansky remarked in 1975 in a review of one of Beck's books that he could no longer tell if Beck was a psychoanalyst or a devotee of Ellis.<ref name=splendid/> Beck highlighted the classical philosophical Socratic method as an inspiration, while Ellis highlighted disputation which he stated was not anti-empirical and taught people how to dispute internally.<ref>Rational-emotive therapy and cognitive behavior therapy: Similarities and differences Template:Webarchive Albert Ellis, Cogn Ther Res (1980) 4: 325. {{#invoke:doi|main}}</ref> Both Beck and Ellis cited aspects of the ancient philosophical system of Stoicism as a forerunner of their ideas. Beck cited Epictetus as an influence from Stoicism.<ref name="Robertson_2010">Template:Cite book</ref>

In 1967, becoming active again at University of Pennsylvania, Beck still described himself and his new therapy (as he always would quietly) as neo-Freudian in the ego psychology school, albeit focused on interactions with the environment rather than internal drives.<ref name=splendid/><ref>On Therapy-- A Dialogue with Aaron T. Beck and Albert Ellis reported by Michael Fenichel, American Psychological Association, 110th Convention Chicago, August 22–25, 2002</ref> He offered cognitive therapy work as a relatively "neutral" space and a bridge to psychology.<ref name=splendid/> With a monograph on depression that Beck published in 1967, according to historian Rachael Rosner: "Cognitive Therapy entered the marketplace as a corrective experimentalist psychological framework both for himself and his patients and for his fellow psychiatrists."<ref name=splendid/>

Cognitive therapyEdit

{{#invoke:Labelled list hatnote|labelledList|Main article|Main articles|Main page|Main pages}} Template:Further Working with depressed patients, Beck found that they experienced streams of negative thoughts that seemed to arise spontaneously.<ref name=att>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> He termed these cognitions "automatic thoughts", and discovered that their content fell into three categories: negative ideas about oneself, the world, and the future. He stated that such cognitions were interrelated as the cognitive triad.<ref name=att/> Limited time spent reflecting on automatic thoughts would lead patients to treat them as valid.<ref name="past and future">Template:Cite journal</ref>

Beck began helping patients identify and evaluate these thoughts and found that by doing so, patients were able to think more realistically, which led them to feel better emotionally and behave more functionally.<ref name="past and future" /> He developed key ideas in CBT, explaining that different disorders were associated with different types of distorted thinking.<ref name="past and future"/> Distorted thinking has a negative effect on a person's behavior no matter what type of disorder they had, he found.<ref name="past and future"/> Beck explained that successful interventions will educate a person to understand and become aware of their distorted thinking, and how to challenge its effects.<ref name="past and future"/> He discovered that frequent negative automatic thoughts reveal a person's core beliefs. He explained that core beliefs are formed over lifelong experiences; we "feel" these beliefs to be true.<ref name="past and future"/>

Since that time, Beck and his colleagues worldwide have researched the efficacy of this form of psychotherapy in treating a wide variety of disorders including depression, bipolar disorder, eating disorders, drug abuse, anxiety disorders, personality disorders, and many other medical conditions with psychological components.<ref name="past and future" /> Cognitive therapy has also been applied with success to individuals with schizophrenia.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> He also focused on cognitive therapy for schizophrenia, borderline personality disorder, and for patients who have had recurrent suicide attempts.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Beck's recent research on the treatment of schizophrenia has suggested that patients once believed to be non-responsive to treatment are amenable to positive change.<ref>Template:Cite journal</ref> Even the most severe presentations of the illness, such as those involving long periods of hospitalization, bizarre behavior, poor personal hygiene, self-injury, and aggressiveness, can respond positively to a modified version of cognitive behavioral treatment.<ref>Template:Cite journal</ref><ref>Template:Cite journal</ref>

Although Beck's approach has sometimes been criticized as too mechanistic, modern CBT stresses the importance of a warm and encouraging therapeutic relationship and tailoring treatment to the specific challenges of each individual.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Beck's work was presented as a far more scientific and experimentally-based development than psychoanalysis (while being less reductive than behaviorism), Beck's key principles were not necessarily based on the general findings and models of cognitive psychology or neuroscience developing at that time but were derived from personal clinical observations and interpretations in his therapy office.<ref name=beckmd>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> And although there have been many cognitive models developed for different mental disorders and hundreds of outcome studies on the effectiveness of CBT—relatively easy because of the narrow, time-limited and manual-based nature of the treatment—there has been much less focus on experimentally proving the supposedly active mechanisms; in some cases the predicted causal relationships have not been found, such as between dysfunctional attitudes and outcomes.<ref>Template:Cite journal</ref>

OrganizationsEdit

Beck was involved in research studies at the University of Pennsylvania, and conducted biweekly Case Conferences at Beck Institute for area psychiatric residents, graduate students, and mental health professionals.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> He met every two weeks with conference participants and generally did two to three role plays. He was elected a Fellow of the American Academy of Arts and Sciences in 2007.<ref name=AAAS>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Beck was the founder and President Emeritus of the non-profit Beck Institute for Cognitive Behavior Therapy, and the director of the Aaron T. Beck Psychopathology Research Center, which was the parent organization of the Center for the Treatment and Prevention of Suicide, which is now known as the Penn Center for the Prevention of Suicide.<ref name=":0" /> In 1986, he was a visiting scientist at Oxford University.<ref name="Grawemeyer" />

He was a professor emeritus at Penn since 1992,<ref name=":0" /> and an adjunct professor at both Temple University and University of Medicine and Dentistry of New Jersey.<ref name="Grawemeyer" /> During his time at Penn, he pioneered the development of Recovery-Oriented Cognitive Therapy.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> While the Center for CT-R was created at Penn, it was later absorbed by Beck Institute.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Personal life and deathEdit

Beck was married in 1950 to Honorable Phyllis W. Beck (ret.), and they had four children together: Roy, Judy, Dan, and Alice.<ref name="Beck">Aaron T. Beck, M.D., Aaron T. Beck Psychopathology Research Center, Philadelphia, PA: Aaron T. Beck Psychopathology Research Center, 2014, Retrieved February 21, 2014.</ref> Phyllis was the first woman judge on the appellate court of the Commonwealth of Pennsylvania.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Her youngest daughter, Alice Beck Dubow, is a judge on the same court,<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> while the older daughter Judith is a prominent CBT educator and clinician, who wrote the basic text in the field<ref name=beckins/> and is a co-founder of the non-profit Beck Institute.<ref name=beckins>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> He turned 100 on July 18, 2021, and died later in the year on November 1 in his sleep at his home in Philadelphia.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>Template:Cite news</ref><ref>Template:Cite news</ref><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

QuestionnairesEdit

Along with the Beck Depression Inventory (BDI), Beck developed the Beck Hopelessness Scale,<ref>Beck A.T. (1988). Beck Hopelessness Scale. San Antonio, TX: The Psychological Corporation.</ref> Beck Scale for Suicidal Ideation (BSS), Beck Anxiety Inventory (BAI), Beck Youth Inventories,<ref>"Beck Scales for Adults and Children" Template:Webarchive Beck Institute for Cognitive Therapy and Research. Retrieved January 11, 2007.</ref> Clark-Beck Obsessive-Compulsive Inventory (CBOCI),<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref> Personality Belief Questionnaire (PBQ), Dysfunctional Attitude Scale (DAS), Suicide Intent Scale (SIS), Sociotropy-Autonomy Scale (SAS), Cognitive Therapy Rating Scale (CTRS), Beck Cognitive Insight Scale (BCIS), Satisfaction with Therapy Questionnaire (STQ) and BDI–Fast Screen for Medical Patients.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

Beck collaborated with psychologist Maria Kovacs in the development of the Children's Depression Inventory, which used the BDI as a template.<ref>Kovacs, M. (1992). Children's Depression Inventory. North Tonawanda, NY: Multi-Health Systems, Inc.</ref><ref>Kovacs, M., & Beck, A.T. (1977). "An empirical-clinical approach toward a definition of childhood depression." In Schulterbrandt, J.G., & Raskin, A. (Eds.). Depression in children: Diagnosis, treatment, and concept models. New York, NY: Raven.</ref>

Selected awards and honorsEdit

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The 7th Annual Heinz Award in the Human Condition<ref name="heinzawards" />
The 1992 James McKeen Cattell Fellow Award
The 1999 Joseph Zubin Award
The 2004 University of Louisville Grawemeyer Award for Psychology<ref name="Grawemeyer" />
The 2006 Lasker-DeBakey Clinical Medical Research Award<ref>{{#invoke:citation/CS1|citation

|CitationClass=web }}</ref>

The 2010 Bell of Hope Award<ref name="heinzawards" />
The 2010 Sigmund Freud Award<ref name="Awards">Template:Cite journal</ref>
The 2010 Scholarship and Research Award<ref name="Awards"/>
The 2011 Edward J. Sachar Award<ref name="Awards"/>
The 2011 Prince Mahidol Award in Medicine<ref name="Awards"/>
The 2013 Kennedy Community Mental Health Award<ref name="Awards"/>

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Beck received honorary degrees from Yale University, University of Pennsylvania, Brown University, Assumption College, and Philadelphia College of Osteopathic Medicine.<ref name="Beck" /><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref><ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

In 2017, Medscape named Beck the fourth most influential physician in the past century.<ref>{{#invoke:citation/CS1|citation |CitationClass=web }}</ref>

WorksEdit

Selected booksEdit

Beck, A.T. (1967). The diagnosis and management of depression. Philadelphia, PA: University of Pennsylvania Press. Template:ISBN
Beck, A.T. (1972). Depression: Causes and treatment. Philadelphia, PA: University of Pennsylvania Press. Template:ISBN
Beck, A.T. (1975). Cognitive therapy and the emotional disorders. Madison, CT: International Universities Press, Inc. Template:ISBN
Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1979). Cognitive therapy of depression. New York, NY: Guilford Press. Template:ISBN
Beck, A.T., Wright, F.D., Newman, C.F., & Liese, B.S. (1993). "Cognitive therapy of substance abuse." New York: Guilford Press. Template:ISBN
Beck, A.T. (1999). Prisoners of hate: The cognitive basis of anger, hostility, and violence. New York, NY: HarperCollins Publishers. Template:ISBN
Newman, C., Leahy, R. L., Beck, A. T., Reilly-Harringon, N. A., Gyulai, L. (2002). Bipolar disorder: A cognitive therapy approach. Washington, DC: American Psychological Association. Template:ISBN
Beck, A.T., Freeman, A., & Davis, D.D. (2003). Cognitive therapy of personality disorders. New York, NY: Guilford Press. Template:ISBN
Beck, A.T., Emery, G., & Greenberg, R.L. (2005). Anxiety disorders and phobias: A cognitive perspective. New York, NY: Basic Books. Template:ISBN
Beck, A.T., Rector, N.A., Stolar, N., & Grant, P. (2008). Schizophrenia: Cognitive theory, research, and therapy. New York, NY: Guilford Press. Template:ISBN
Beck, A. T. & Alford, B. A. (2009). Depression: Causes and Treatments (2nd ed). Philadelphia: University of Pennsylvania Press. Template:ISBN

Selected articlesEdit

Beck, A.T., & Haigh, E. A.-P. (2014). "Advances in Cognitive Theory and Therapy: The Generic Cognitive Model". Annual Review of Clinical Psychology, 10, 1–24. {{#invoke:doi|main}}
Beck, A. T., & Bredemeier, K. (2016). "A Unified Model of Depression Integrating Clinical, Cognitive, Biological, and Evolutionary Perspectives". Clinical Psychological Science, 4(4), 596–619. {{#invoke:doi|main}}
Beck, A. T. (2019). "A 60-Year Evolution of Cognitive Theory and Therapy". Perspectives on Psychological Science, 14(1), 16–20. {{#invoke:doi|main}}