"If you’re going to live, leave a legacy. Make a mark on the world that can’t be erased"
– Maya Angelou
We were saddened to read about the recent death of Aaron T. Beck who was widely considered to be ‘the father of Cognitive Behavioural Therapy (CBT.) He had reached the great age of 100!
Aaron T. Beck was professor emeritus in the department of psychiatry at the University of Pennsylvania. He published more than 600 professional journal articles and authored or co-authored 25 books. He was noted for his writings on psychotherapy, psychopathology, suicide, and psychometrics but is perhaps best known for spearheading the revolutionary approach to psychotherapeutic intervention that is CBT.
We both regularly use CBT in our clinical practise and the underlying principles are evident in all that we teach and write about. Without the words and research of Aaron T. Beck, our work would undoubtedly be very different. The legacy he leaves behind is immense.
Let us explore the principles of CBT:
Aaron T. Beck describes the Cognitive Behavioural Cycle as follows:
Thoughts create feelings. Feelings create behaviours. Behaviours reinforce thoughts.
Cognitive Behavioural Therapy operates on the principle that, when we observe these cycles at play within our lives, we can choose to consciously intervene and break the cycle at some point within it.
For example, If I worry that my friend does not like me, this may drive the behaviour of my constantly texting to ask that friend for reassurance. The consequences of that behaviour may well lead to that friend turning off her phone or avoiding contact with me. That consequence is likely to reinforce my fears and lead to further feelings of rejection. Here is where I may fall into a negative cycle which could have disastrous consequences for the friendship.
A cognitive behavioural approach would be to intervene in the cycle by consciously reframing the thought using evidence to the contrary, or to consciously choose an alternative behaviour. We might also seek to explore the emotions that have been triggered.
At the root of our thoughts are core beliefs. We all hold core beliefs about the world around us and about ourselves. They are formed in childhood as a result of our conditioning.
The thoughts in the above example are likely to originate from the negative core belief that ‘I am not good enough.’ This is an issue of self-worth common to most of us, maybe even Aaron T. Beck!
Because the thoughts in the example have their roots in a core belief, they are unlikely to be confined to one relationship. If I allow this cycle to run on unchecked, I may well find myself alone with little confidence in my ability to retain friendships and certainly having reinforced that negative core belief.
When we engage in CBT, we are wise if we address the negative core beliefs that lie beneath the thoughts. When we do this, the nature of our thinking is changed.
CBT has revolutionised talking therapy and can even be performed successfully alone with the right guidance. It has grown hugely in popularity since its beginnings and, increasingly patients find themselves being referred to address a wide variety of issues including, depression, panic, anxiety, bipolar disorder, phobias (including agoraphobia and social phobia), stress, eating disorders, obsessive compulsive disorder, post-traumatic stress disorder, and psychosis.
It is very important to remember however, that the legacy that Aaron T. Beck leaves behind teaches a change in mindset.
We have both spoken to patients who reported that they underwent a course of CBT, but it was not effective
"I've done that course before."
A course of CBT alone may effect a temporary positive change but for that change to become permanent, we must adopt a permanent new way of thinking and consequently feeling and behaving.
If you are interested in the concept of CBT, you will find reference to it in our book along with a thought diary which will help you to spot the cognitive behavioural cycles that you are running and a tool to help reframe negative core beliefs.