Today, we recognize CBT as one of the most widely used and evidenced-based modalities of mental health treatment. But when Dr. Beck developed this model in the 1960s, it ran quite counter to the standard psychiatric practice of the day – which was Freud’s theory of psychoanalysis.
You’ll likely remember from your studies that psychoanalysis focuses on the client’s unconscious or repressed thoughts and feelings, often stemming from early childhood experiences.
However, Cognitive Behavior Therapy focuses more on the current day by helping clients challenge patterns in their thinking and beliefs, such as catastrophizing and over-generalizing.
This article in the Philadelphia Inquirer tells of a powerful moment in Dr. Beck’s career when one of his psychoanalysis patients became worried that her stories about her sexual experiences were boring him.
As the article states, Dr. Beck was not bored at all. This experience led him to begin asking other patients to describe the automatic thoughts that were running through their minds about what he thought about them. Dr. Beck found that “they, too, were feeding themselves a diet of negative thoughts.”
It was at this point that Dr. Beck began developing the belief that people could challenge negative patterns in their thinking through greater examination, increased awareness, and thought-stopping. He found that teaching clients to challenge these thoughts had a direct impact on the overall mental wellbeing of his patients.
Cognitive Behavior Therapy has had a meaningful impact on the lives of countless people, as well as my own. I often find myself rehearsing negative thought patterns by asking myself things like, “Am I good enough?”, “Does my work matter?” and the question nearly every person I know asks, “Do I look okay?”
CBT provides us with the opportunity to challenge these unhelpful automatic thoughts by asking ourselves, or our clients, things like:
- What evidence is there that this thought is true?
- What would I tell someone I loved if they were in this situation and had these thoughts?
- If my automatic thought is true, what is the worst that could happen?
- Is there an alternative way of thinking about the situation?
- Would I agree it is against my interests to have this belief?
- Do I think it’s possible to ignore these thoughts?
Psychologist and founder of positive psychology, Martin Seligman said that Dr. Beck is “the single most important psychiatrist in the world of the 20th century.”
I’m curious, has Dr. Beck’s work had an impact on your therapeutic modality?
If you have anything you’d like to share, I’d love to hear your thoughts about how CBT has shaped your work as a therapist.
Rachel McCrickard, LMFT