Five lessons from the father of CBT

Next week marks the second anniversary of the death, aged 100, of Dr Aaron Beck. Here are five lessons we can all learn from the man known as the father of CBT.



Having led a rich life, and having considered the meaning of life, Beck was asked on his 90th birthday what message he would give to people. His reply: 'Keep things in proportion' and avoid catastrophising.


It's a simple message but the fact Beck chose to make it, as opposed to something that might seem more profound, shows the importance of this point.



Life can be tough, but sometimes we make things unnecessarily difficult for ourselves by thinking in catastrophised, absolutist terms. "Everything is ruined", "I'll never get over this", "I failed and will always be a failure", "Things will never get better" – such thoughts add to our suffering and make things seem worse than they really are. Take Beck's advice; keep things in proportion.



Beck liked to emphasise how people can often turn a disadvantage into an advantage. He practised what he preached. A keen tennis player, Beck played the game into his 80s, but was eventually forced to give it up. Instead of bemoaning his loss, Beck focused on how he now had more time for other things – for example, other hobbies like reading, or having lunch with his tennis friends and having the time to 'actually talk'. It's important to remember there can be opportunities even in disappointing situations.



A friend and associate of Beck's, Prof Robert DeRubeis, used to play tennis with Beck. He relates how when Beck was in his early 70s, he asked him to hit him some high balls at the net, because he wanted to develop a net game! Within months, Beck was adept at the net.


Decades later, at the age of 100, Beck was working with Prof DeRubeis on an academic paper. Indeed, Beck was excited by his work right to the end – just two days before his death, he was working on a paper on how best to help people with severe mental illness.


The point? Challenge limiting thoughts ("I'm too old to do XYZ) about ageing. Stay active and do what you like doing for as long as you like doing it.



Often, we engage in negative self-talk, barely pausing to reflect on whether these negative automatic thoughts (NATs) are true or exaggerated and unhelpful. Beck emphasised the importance of catching these NATs, which usually fall into three particular categories -- negative ideas about ourselves ("I'm useless"), the world ("no one cares", "they won't like me"), and the future ("things will never get better").


These negative thoughts drive negative feelings (anxiety, sadness, anger, etc); negative feelings drive negative behaviours (avoidance, excessive preparation, excessive drinking, etc); these behaviours then reinforce the initial negative thoughts, thus perpetuating the vicious cycle.


It's important, then, to catch and challenge those NATs. Keep an eye out for cognitive distortions like catastrophising, black-and-white thinking, jumping to conclusions, mind-reading, labelling, and over-generalising.


Beck was a careful and considered thinker: aim to do likewise and your mental health will benefit.



Psychiatry professor Dr. John Rush once described Beck as 'an unusual person', saying he 'is willing to test his own beliefs, just like he asks patients to test theirs'. Another academic made the same point, writing: 'He (Beck) did not care what the truth turned out to be, but he wanted to know the truth whatever it was. He did not do studies to demonstrate that his theories were correct or that his therapies worked, he did studies to find out whether his theories were correct and if his treatments worked. If they did not, he revised his theories or modified his therapies'.


Beck encouraged people to be similarly open and scientific in their own lives, to test their beliefs, to be personal scientists. As Dr Rush noted, cognitive therapy 'is about testing your assumptions and beliefs and letting the evidence speak. He put that into action in a way that many would not dare.'

(First published in Southern Star on 26/10/2023)