Aaron Beck's Cognitive Behavior Theory

Aaron Temkin Beck, an American psychiatrist pioneered research on psychotherapy, psychopathology, suicide, and psychometrics, and developed the cognitive therapy. He became interested in psychiatry during an internship at the Rhode Island hospital, where he studied neurology as a specialty. Aaron Beck is considered as the father of cognitive behavior therapy.

Cognitive Behavior Theory

According to Beck,"If beliefs do not change, there is no improvement. If beliefs change, symptoms change. Beliefs function as little operational units," which means that one's thoughts and beliefs (schema) affect one's behavior and subsequent actions. He believed that dysfunctional behavior is caused due to dysfunctional thinking, and that thinking is shaped by our beliefs. Our beliefs decide the course of our actions. Beck was convinced of positive results if patients could be persuaded to think constructively and forsake negative thinking.

On the basis of this theory, a therapy was devised that could effectively treat a variety of disorders. Cognitive behavioral therapy is beneficial for treating several psychological, psychiatric and medical disorders. Patients with psychological disorders like uncontrollable anger and compulsive gambling can be treated with this therapy. Psychiatric problems like depression, substance abuse, personality disorders, etc., can also be dealt with it. Though most health problems are treated using medications, some of them having a psychological component like obesity, pre-menstrual syndrome, chronic pain etc., are also addressed using this therapy. This article covers the use of this therapy for one of the most common psychiatric problems, which is depression.

Cognitive Approach to Depression

Behavioral theorists suggest that depression results from faulty and irrational psychological perception, causing distorted learning and reasoning. These depressive cognition could be a result of traumatic experience or incapability of adaptive coping skills. Depressive people have a negative perception or belief about themselves and their environment. More the severity of one's negative thoughts, more is the severity of depression symptoms.

Beck devised the negative cognitive triad, which includes the following three main dysfunctional belief themes, a depressive person experiences.

• A depressed person sees himself as inadequate, incapable of success, and always as a victim of circumstances.
• He considers all past and present experiences through the kaleidoscope of negativity, constantly emphasizing on defeats, failures, and a victim mentality.
• He envisions the future, just as he interprets the past and present, and sees only despair and hopelessness.

These beliefs focus attention towards negative aspects of life and the way information is processed. As perception becomes more distorted, selective attention is placed on failures and everything is approached negatively. The depressed person maneuvers all his feelings towards hopelessness unconsciously. In 1961, Beck developed the Beck Depression Inventory (BDI) that has a 21 item scale that uses a Likert scale to determine the severity of depression. It is one of the most widely used scales to measure depression.

Treating Depression

Aaron Beck laid major emphasis on understanding and changing core beliefs as an approach to treating depression. By restructuring destructive thinking, he believed that positive changes could be brought in the patient. He considered the role of a therapist as crucial in the treatment. The therapist involves the patient in setting realistic goals and taking responsibilities for action and thought. By changing thought and perception, a change can be brought in behavior and emotional responses. A course is outlined to educate the patient on the concept of faulty thinking. New ideas and ways are generated to develop a positive outlook of oneself, experiences and the environment around. Sometimes, home assignments are also given to help the depressed person review and understand the impact of faulty thinking on his behavior and emotional well-being.

Beck combined Sigmund Freud's psychoanalysis with his own understanding and observations of schema and developed the cognitive behavioral therapy. He further developed Beck Scale for Suicidal Ideation, Beck Hopelessness Scale, Beck Anxiety Inventory, and Beck Youth Inventories to help treat all kinds of mental disorders. Today, psychiatrists worldwide use his cognitive behavior theory and various scales to treat patients suffering from depression.