Years ago, I took a book to read during our family’s traditional vacation at the Outer Banks of North Carolina. The little I had previously read by Aaron Beck fascinated me. His book, Cognitive Therapy of Depression, stood out as an exceptional and original approach to mental health.
At the beach, it did not occur to me that I would become, years later, an extramural fellow in Cognitive Therapy with Dr. Beck, and I would spend 2 years of supervision by Dr. Judy Beck, Aaron’s daughter.
The training with the Drs. Beck changed the course of my psychiatric practice in mid-career from psychoanalytic to cognitive therapy. I came to admire and respect Dr. Aaron Beck, now deceased, who was one of the most kind, caring, and competent individuals I ever encountered.
Aaron T. Beck, an influential 20th-century thinker and esteemed psychoanalyst, was disheartened that lengthy analysis produced lasting improvement in only a limited number of patients. His main disappointment was the lack of objective methods to measure treatment response.
Courageously, Dr. Beck, Professor of Psychiatry, University of Pennsylvania, deserted psychoanalysis to develop a new, shorter, more effective theory and model of psychotherapy, initially called Cognitive Therapy.
What is more, he developed objective instruments to measure the effectiveness of treatment. He established training and examinations to certify students who accomplished competence in Cognitive Therapy, which is more recently called CBT or Cognitive Behavior Therapy.
Fundamentally, cognitive therapy is based on learning theory. The later description of CBT is simplified for our present purpose. As my former student and friend, Dr. Charles McLafferty, a scholar of Logo Therapy (“healing through meaning”), suggests, Dr. Beck and Dr. Viktor Frankl had much in common.
The objective of both Logo Therapy and CBT is to discover meaning. When meaning is discovered, it will be enduring and persistent.
Dr. Beck, using brief, relevant questions, assists the despondent patient, for example, from depressive, negative, irrationally guilty thoughts (automatic thoughts or self-talk) to a more rational meaning with fewer cognitive errors.
In the following example of a CBT session, Dr. Beck quietly introduces himself to a depressed woman who is weeping:
“I understand you have been feeling depressed. Please tell me your situation.”
“Yes, I feel tortured by my thoughts. This is the worst time of my life. After 10 years of marriage my husband left me. I cannot go on alone, helpless, unattractive, and depressed.”
“What thoughts are torturing you now?”
“I feel worthless.”
“What is the evidence you are worthless?”
“My husband left me.”
“What other evidence makes you think you are worthless?”
“I will be the first divorcee in my family.”
“Is there any evidence you are not worthless?”
“I have a good job.”
“Other evidence you are not worthless?”
“I made good grades in college and graduated with honors.”
“Any other evidence you are not worthless?”
“I am president of my homeowners association.”
“What does your accomplishments tell you about feeling worthless?”
“I must not actually be worthless.”
“Have you discovered today something important about yourself?”
“Yes.”
“Tell me what you discovered.”
“I am not a worthless person.”
“Do you believe it 100%?”
“I want to say yes, but there is still some doubt.”
“How much do you believe you are not worthless?”
“85-90%.”
“Can we agree you felt 100% worthless when you came in today?”
“Yes.”
“Correct my review if I am wrong. The husband you loved in all of the 10 years of your marriage left you unexpectedly. It was a terrible surprise and loss. You live alone now. It is a new, unwelcome stage of your life, but you have successfully managed changes in the stages of your life before. You changed successfully from grade school to junior high school. From high school, you successfully moved to college and graduated with honors. From college, you moved successfully to an excellent job. Do you believe you can successfully move from your present stage to an even better one?”
“Yes, I believe you have helped me discover a real meaning of my ability to perceive and accept the truth.”
“Will you return next week to work on the 10-15% of your unbelief you are a person of worth?
“Yes.”
“Come back with at least 3 things you wish to add to our agenda.”
Dr. Aaron Beck delivered a speech at a conference, which profoundly inspired me. I sought Dr. Beck and asked if others had commented on the apparent spiritual nature of his work. “I have been asked that question frequently,” he said, offering no explanation.
Jesus tells us to seek the truth, and the truth will set us free. “So Jesus said to the Jews who had believed him, “If you abide in my word, you are truly my disciples, and you will know the truth, and the truth will set you free.” John 8:31-32.
Jesus also referred to Himself as the Truth. “Jesus said to him, “I am the way, and the truth, and the life. No one comes to the Father except through me.” John 14:6.
Poets tell us “Beauty is truth, truth beauty—that is all ye know on earth, and all ye need to know.” John Keats (1795-1821), Ode on a Grecian Urn.
Dr. Frankl was fond of paraphrasing Nietzsche: “Those who have a why to live for can endure almost any how.”
Meaning is always truth. Truth is always spiritual. As you face a new year, ask how you can discover the why of your life, a most intriguing question.