The father of cognitive behavioral therapy, Dr. Aaron Beck, dies at 100

AUDIE CORNISH, HOST:

Dr. Aaron Beck died yesterday at age 100. He revolutionized the field of psychotherapy by introducing cognitive behavioral therapy, CBT, which became more widely used than Freudian analysis. To understand Beck's work, NPR's former Invisibilia host Alix Spiegel introduced her then-co-host Lulu Miller to the evolution in the mental health field in a 2015 episode. Here's a bit of her explanation.

ALIX SPIEGEL, BYLINE: Phase one, door one.

JONATHAN SHEDLER: Thoughts have meaning.

SPIEGEL: Thoughts have meaning.

SHEDLER: So every thought is the tip of an iceberg.

SPIEGEL: This is Jonathan Shedler. Shedler is a psychologist in Colorado who sees thoughts the same way that Freud proposed that we see thoughts and, because Freud was so influential, very likely the way that you see your own thoughts today, which is that your thoughts are very intimately related to who you are.

SHEDLER: And there can be tremendous value, profound value in understanding where they come from.

SPIEGEL: To explain, Shedler gave me this example of this patient that he saw recently, a man who was overrun with violent thoughts.

SHEDLER: These gruesome images of people being waterboarded. And they seem to come out of the blue.

SPIEGEL: So Shedler says to this man, tell me about your thoughts. Let's explore why they are there. So the guy starts talking, and eventually it came up that his sister had recently died.

SHEDLER: She was walking across a frozen lake, and she had fallen through the ice and drowned. Where his thoughts led were to horrific images of what the last few minutes of her life must have been like. As he talked, it became obvious to both of us that what he was describing about his sister and these gruesome images of people being waterboarded, you know, were almost identical, except he had never made the connection.

SPIEGEL: But once he did...

SHEDLER: His entire demeanor changed because all of a sudden, what had been this unpleasant, inexplicable, frightening symptom all of a sudden made sense to him. So if I had told him that his thoughts had no meaning and could be ignored, I think it would have cost him down the road.

SPIEGEL: All right. So that's the traditional view of thoughts, probably how you think about your own thoughts.

LULU MILLER, BYLINE: Yeah.

SPIEGEL: But now, my friend, it is time to mosey our way down to door No. 2...

MILLER: OK.

SPIEGEL: ...Because the tides have changed. And there's now a new way of thinking about thoughts that started to become popular around 1980, largely because of this man, Aaron Beck.

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SPIEGEL: All right. I just need to check your levels here.

In 2004, when I was new to NPR, just a baby reporter...

MILLER: I think I can hear your pigtails.

SPIEGEL: Shut up. One of my first assignments was to go to Pennsylvania to talk to Dr. Beck.

First, tell me what you had for breakfast.

When I met him, Beck, I think, was around 80, this kind of white-haired old man in an Orville Redenbacher bow tie who, like everyone else in his generation, had started his career practicing Freud's therapy, psychoanalysis.

AARON BECK: I then had a couple of experiences which made me shift gears.

SPIEGEL: You see; one day in the late '60s, Beck was in a session with a patient, a woman who was explaining to him she'd been at a party where she'd been having a difficult time connecting to people and had found herself overcome by these thoughts.

BECK: Nobody cares for me. I'm just a social outcast. Nobody will ever care for me.

SPIEGEL: And for some reason that day, Beck did not go down the traditional path. He turned to the woman, and he asked, how do you know that those thoughts are true just realistically?

BECK: Explore the evidence for nobody cares for me. And she then could list a dozen people who obviously did care for her.

SPIEGEL: Which made Beck think something which, in his world, was revolutionary. Maybe people shouldn't always take their thoughts so seriously, particularly a certain subset of their thoughts.

UNIDENTIFIED PERSON: I'll always be alone. No one will love me.

SPIEGEL: You remember these thoughts, right?

BECK: You are stupid.

UNIDENTIFIED PERSON: I'm stupid.

BECK: They're going to dislike you.

UNIDENTIFIED PERSON: I'm a failure.

BECK: And so on.

SPIEGEL: Beck had a special name for them - automatic negative thoughts.

BECK: What's interesting about the automatic thought - and this is true of everybody - is that people tend to accept them at their face value.

SPIEGEL: So Beck started trying this with all of his patients. Don't trust the thought. Challenge the thought.

BECK: To test out to see whether they're really true.

SPIEGEL: And what he found was that when his patients contradicted their negative thoughts...

BECK: The patient started to get better sooner.

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SPIEGEL: Instead of it taking years, as it often did with Freudian therapy, they were getting better in a couple of months.

BECK: Well, Dr. Beck, you've helped me a lot, and I don't think I need any more therapy.

SPIEGEL: And thus began what is now called cognitive behavioral therapy, or CBT, a new system of therapy that does not believe that the thoughts in your head are necessarily indicative of anything deep about you. And over the last 30 years, this kind of therapy has slowly but surely been displacing Freudian-based therapies.

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CORNISH: Alix Spiegel, former host of NPR's Invisibilia in 2015. She introduced us to the work of Dr. Aaron Beck, who added cognitive behavioral therapy to the psychotherapy field. Beck died yesterday at 100 years of age. Transcript provided by NPR, Copyright NPR.