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The notable humanist and scientist Aaron Beck (1921-2021), the revolutionary founder of cognitive therapy

Mauro V. Mendlowicz Michelle N. Levitan Antonio E. Nardi Edward Shorter About the authors

Aaron Beck, MD (1921-2021).

Aaron Temkin Beck, MD, was born on July 18, 1921 in Providence, Rhode Island, USA, the youngest of three surviving children. Aaron was fondly known by friends and family as Tim. His parents, Harry Beck, a printer, and Elizabeth Temkin, a seamstress and store clerk, were Ashkenazi Jewish immigrants from Ukraine.

Aaron Beck’s early life was marked by loss. Two siblings passed away before his birth, an older brother died who during childhood and an older sister who died in the influenza pandemic. Partially due to this sequence of tragedies, Beck’s mother became chronically depressed, which may have had a marked influence on his future profession.

Tim was a Boy Scout and played basketball and football. At age 8, after surgery for a broken arm, he developed a serious infection and had to spend a whole month in a hospital, where he acquired his lifelong taste for reading and writing. He also developed a fear of injury and blood, and learned to manage his phobias by focusing his mind elsewhere.

After finishing high school, Beck attended Brown University where he majored in English and political science, graduating magna cum laude in 1942. He earned a medical degree from the University School of Medicine in New Haven, Connecticut in 1946, and started his neurology residency training at the Cushing Veterans Administration Hospital in Framingham, Massachusetts. However, while doing a six-month rotation in the psychiatric ward, Beck became fascinated with psychoanalysis, which radically changed his professional trajectory. He finished his medical internships and residencies in 1950, was a fellow in psychiatry at the Austen Riggs Center until 1952, and completed military service as assistant chief of neuropsychiatry at Valley Forge Army Hospital.

In 1954, Beck became a faculty member in the Department of Psychiatry at the University of Pennsylvania, where he combined research and clinical assistance. At the same time, he started his psychoanalytic training at the Philadelphia Psychoanalytic Institute.

Throughout the 1950s, Beck adhered to the Department of Psychiatry’s then prevailing psychoanalytic theories. Meanwhile, he pursued clinical research and experienced steadily growing private doubts about the tenets and practice of psychoanalysis, which he shared only with his wife and intellectual partner, Phyllis Whitman Beck, who became the first woman to serve in the Pennsylvania Superior Court.

Beck’s intellectual trajectory began to change directions. He realized that depression was related to feelings of loss and rejection rather than “inverted hostility,” as predicated by Freudian psychoanalytic theory. Eventually, he came to understand that these underlying beliefs were consistent with a person’s automatic thoughts and cognitive distortions and that these could be evoked and examined during therapy sessions. By helping patients identify and correct negative information processing biases, Beck found that they felt better and engaged in more adaptive behaviors. He named this radically new therapeutic approach “cognitive therapy.” He also developed scales and questionnaires to assess these beliefs, such as the popular Beck Depression Inventory.11. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-71.

Beck’s theories were first tested in 1977, when a major clinical trial compared cognitive therapy to antidepressant medication.22. Rush AJ, Beck AT, Kovacs M, Hollon S. Comparative efficacy of cognitive therapy and pharmacotherapy in the treatment of depressed outpatients. Cognit Ther Res. 1977;1:17-37. This study concluded that cognitive therapy was more efficacious than antidepressants for depression, and these results were replicated a few years later.33. Blackburn IM, Bishop S, Glen AI, Whalley LJ, Christie JE. The efficacy of cognitive therapy in depression: a treatment trial using cognitive therapy and pharmacotherapy, each alone and in combination. Br J Psychiatry. 1981;139:181-9. Beck and his colleagues soon started applying cognitive therapy to other mental disorders and conditions, such as anxiety states, personality disorders, substance abuse, and suicidality.

After these pioneering studies, numerous research groups followed suit. Cognitive therapy was also found to be effective for treating panic disorder and agoraphobia, social phobia, OCD, PTSD, insomnia, and eating disorders. Eventually, cognitive therapy became the most commonly practiced44. Knapp P, Kieling C, Beck AT. What do psychotherapists do? A systematic review and meta-regression of surveys. Psychother Psychosom. 2015;84:377-8. and extensively researched55. David D, Cristea I, Hofmann SG. Why cognitive behavioral therapy is the current gold standard of psychotherapy. Front Psychiatry. 2018;9:4. form of psychotherapy in the world.

Two years after retiring from the University of Pennsylvania and becoming an emeritus professor (1992), Beck and his daughter, Dr. Judith Beck, founded the nonprofit Beck Institute for Cognitive Behavior Therapy, whose mission was “improving lives worldwide through excellence in cognitive behavior therapy.” True to its mission statement, the Beck Institute has trained more than 28,000 health and mental health professionals from 130 countries through both in-person and online programs and remote supervision.66. Beck JS, Fleming S. A brief history of Aaron T. Beck, MD, and cognitive behavior therapy. Clin Psychol Eur. 2021;3:1-7.

During a career spanning more than seven decades, Dr. Beck published over 600 scientific articles and authored or co-authored 25 books. He also received many awards, honors, and recognition for his work as a researcher, clinician, and institutional leader, including the 2006 Albert Lasker Award for Clinical Medical Research and the Gustave O. Lienhard Award from the Institute of Medicine for “outstanding national achievement in improving personal health care services in the United States.” Beck was listed among the 10 individuals who helped shape American psychiatry77. Talbott JA. Dix personnalités qui ont changé le visage de la psychiatrie américaine: la psychiatrie nord-américaine. Inf Psychiatr. 2002;78:667-75. and in 1989 the American Psychologist, the journal of the American Psychological Association, named him “one of the five most influential psychotherapists of all time.”

Although Beck dedicated his life to alleviating human suffering through evidence-based psychological therapy, he never considered his mission complete. His son Roy recalled that at the time of his death, despite being bedridden and feeling weak, Beck was still working on a new article: “Most days, when I asked how his day went, he would say, ‘I had a good day.’” In a 2017 interview, Beck reported “I’ve never retired because I love what I’m doing [...] All the time I’m on to new discoveries and applications. So there hasn’t been any phase in my professional career where I wasn’t working on something new.”

On November 1, 2021, Dr. Aaron T. Beck passed away peacefully at the age of 100 in his home in Pennsylvania, surrounded by his family. According to his Jewish faith, the soul that departs while one is asleep has the smoothest passage to the afterlife. Indeed, a passage. His legacy is eternal.

References

  • 1
    Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-71.
  • 2
    Rush AJ, Beck AT, Kovacs M, Hollon S. Comparative efficacy of cognitive therapy and pharmacotherapy in the treatment of depressed outpatients. Cognit Ther Res. 1977;1:17-37.
  • 3
    Blackburn IM, Bishop S, Glen AI, Whalley LJ, Christie JE. The efficacy of cognitive therapy in depression: a treatment trial using cognitive therapy and pharmacotherapy, each alone and in combination. Br J Psychiatry. 1981;139:181-9.
  • 4
    Knapp P, Kieling C, Beck AT. What do psychotherapists do? A systematic review and meta-regression of surveys. Psychother Psychosom. 2015;84:377-8.
  • 5
    David D, Cristea I, Hofmann SG. Why cognitive behavioral therapy is the current gold standard of psychotherapy. Front Psychiatry. 2018;9:4.
  • 6
    Beck JS, Fleming S. A brief history of Aaron T. Beck, MD, and cognitive behavior therapy. Clin Psychol Eur. 2021;3:1-7.
  • 7
    Talbott JA. Dix personnalités qui ont changé le visage de la psychiatrie américaine: la psychiatrie nord-américaine. Inf Psychiatr. 2002;78:667-75.

Publication Dates

  • Publication in this collection
    14 Mar 2022
  • Date of issue
    May-Jun 2022

History

  • Received
    7 Dec 2021
  • Accepted
    17 Dec 2021
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