Speaker 1: Here everyone Today is a very special episode of the
Speaker 1: Psychology Podcast. A few nights ago, the legendary psychiatrist, doctor
Speaker 1: Aaron tempkin Beck passed away peacefully in his sleep at
Speaker 1: the age of one hundred years old. Tim, as his
Speaker 1: friends and family affectionately called him, lived an exemporary, full life,
Speaker 1: well lived personally. He was a dear mentor and friend
Speaker 1: of mine. I used to live in the building next
Speaker 1: door to him in Philadelphia and we'd have tuna sandwiches
Speaker 1: together in Sundays at his place and have all sorts
Speaker 1: of discussions, including discussions about humanistic psychology and how to
Speaker 1: treat patients as humans. First. He was always so encouraging
Speaker 1: on my work, and I enjoyed our discussions about his
Speaker 1: life and work immensely. I will miss his amazing bow tie,
Speaker 1: our fist bumps together, and his sharp mind, which lastened
Speaker 1: all the way until the end. In my last in
Speaker 1: person meeting with him, just before the pandemic hit, I
Speaker 1: handed him a microphone and asked if he would talk
Speaker 1: about what research he was most excited about these days,
Speaker 1: and whether he could give any advice to young psychologists.
Speaker 1: That recording is what you will hear today on the podcast. Remarkably,
Speaker 1: Tim worked all the way up until his death. To
Speaker 1: many he is most known for his work in cognitive
Speaker 1: behavioral therapy, which is a time sensitive, structured present oriented
Speaker 1: psychotherapy that has been scientifically tested and found to be
Speaker 1: effective in more than two thousand studies for the treatment
Speaker 1: of many different health and mental health conditions. When implemented correctly,
Speaker 1: CBT can help individuals get better and stay better. Not
Speaker 1: many people know this, though, but Tim's work was much
Speaker 1: more than the seminal work he did pioneering CBT. Tim
Speaker 1: was recently working on a new form of psychotherapy with
Speaker 1: his colleagues Ellen and Verso and Paul Grant, called Recovery
Speaker 1: oriented cognive therapy, which deeply humanizes psychiatric patients. Guided by
Speaker 1: Tim's cognive model, Recovery oriented cognitive therapy is an evidence
Speaker 1: based practice that provides concrete, actionable steps to promote recovery
Speaker 1: and resiliency. Originally developed to empower individuals given a diagnosis
Speaker 1: of schizophrenia, Recovery oriented cognitive therapy applies broadly to individuals
Speaker 1: experiencing extensive behavioral, social, and physical health challenges. It is
Speaker 1: a highly collaborative, person centered and strength based approach as
Speaker 1: it focuses on developing and strengthening positive beliefs of purpose, hope, efficacy, empowerment,
Speaker 1: and belonging. The approach is specifically formulated and effective for
Speaker 1: individuals who have a history of feeling disconnected and distrustful
Speaker 1: of service providers, who are not help seeking, or who
Speaker 1: experience challenges that impede action towards aspirations. The reach of
Speaker 1: recovery oriented cognitive therapy extends to mental health professionals across
Speaker 1: all disciplines, families and loved ones, and peers with lived experience.
Speaker 1: One other thing I'd like to mention before before we
Speaker 1: get today's episode is the Beck Institute. In nineteen ninety four,
Speaker 1: Tim and his daughter, doctor Judith S. Beck, founded Beck
Speaker 1: Institute as a five h one c three nonprofit with
Speaker 1: the mission of improving lives worldwide through excellence and innovation
Speaker 1: in cognitive behavioral therapy, training, practice, and research. In twenty nineteen,
Speaker 1: Beck Institute opened the Beck Institute Center for Recovery Oriented
Speaker 1: Cognitive Therapy to train professionals and staff who work with
Speaker 1: individuals given a diagnosis of a serious mental health condition,
Speaker 1: such as schizophrenia. Beck Institute honors the legacy of doctor
Speaker 1: Aaron Beck by providing training and resources in both CBT
Speaker 1: and CTR to people around the world. In the nonprofits
Speaker 1: twenty seven year history, over twenty eight thousand health and
Speaker 1: mental health professionals have received training in CBT or CTR
Speaker 1: through a variety of programs. You can help honor doctor
Speaker 1: Aaron Beck's legacy by making a gift to the Aaron T.
Speaker 1: Beck Fund at Beck Institute. This enables the organization to
Speaker 1: continue doctor beckcas leadst work with the Center for CTR
Speaker 1: at Beck Institute, develop programs, fun scholarships for trainees, and
Speaker 1: everything in between. The Beck Institute website can be found
Speaker 1: at Beckinstitute dot org. Okay, now, without further ado, I
Speaker 1: bring you our guest today, doctor Aaron T. Beck. I
Speaker 1: have a mic and yeah, we're just do you want so?
Speaker 1: Do you want to take this? It's right here, and
Speaker 1: just put as close to your mouth as possible, Okay, okay,
Speaker 1: and just say hello, Hello, Hello, Yeah, I think this
Speaker 1: would be good. Hello, No, this is great. Okay. So
Speaker 1: Tim Beck, it's so great to be here with you today.
Speaker 1: Such a legend in the field of psychology and one
Speaker 1: of my personal heroes. I just wanted to talk to
Speaker 1: you a little bit about some of the work you're
Speaker 1: up to. I've been working with two psychologists. One of
Speaker 1: them is Paul Grat, and we've been working together the
Speaker 1: last twenty years. He formed one of three groups that
Speaker 1: I was supervising, so his group was eventually in SUPERI
Speaker 1: mental illness. And then there was a second group, which
Speaker 1: I had to do with the application of cognitive therapy
Speaker 1: to the community, and then the third has to do
Speaker 1: with the prevention of suicide. And there has been a
Speaker 1: transformation in the department so that well, I'm still supervising
Speaker 1: the other two, Paul Grants having depart of the department
Speaker 1: with his group and gone to the Beck Institute. Despite that,
Speaker 1: I'm still supervising the three teams, but the team that
Speaker 1: I'm most interested in is as Paul Grant's team. Okay,
Speaker 1: now he's been working with a severely mentally ill He
Speaker 1: and his group they have been actually developing a new
Speaker 1: treatment which they are calling a recovery oriented cognitive therapy.
Speaker 1: And the way that got started was around twoy eleven,
Speaker 1: the Commissioner of Mental Health for the City of Philadelphia
Speaker 1: said he had to give a talk at the APA
Speaker 1: and it was going to be about recovery orientation. And
Speaker 1: I said, well, I haven't worked with addicts, oh, in
Speaker 1: the field of addiction for a long time. And he said, oh, oh,
Speaker 1: this is a different type of recovery. This is not
Speaker 1: the old fashioned recovery. But this has to do with
Speaker 1: an improvement and well being, socialization, doing things that are
Speaker 1: worthwhile in one's own had and creative and enjoyable and
Speaker 1: so on. And he said that this is where we
Speaker 1: want our metal patients to be mm and I said, well,
Speaker 1: that's a great goal, but how how do you propose
Speaker 1: to get them from running around in the unit hearing
Speaker 1: voices or maybe smearing things around? And uh, I say,
Speaker 1: how do you get them from this highly regressive state
Speaker 1: to the state of recovery And he said, well that's
Speaker 1: your job. So I said, okay, so the other challenge,
Speaker 1: that's a challenge. So Ever, since then we've been working
Speaker 1: with mental patients and we have gradually developed a treatment
Speaker 1: which is based on the recovery being the outcome of
Speaker 1: the treatment. But of course the treatment itself involves much
Speaker 1: more than just having an outcome. And so we had written,
Speaker 1: we had written a book and had a contract on
Speaker 1: evidence based therapy for the mentally ill. Around twenty and twelve,
Speaker 1: the book was finished, but it was not recovery oriented.
Speaker 1: It was like the old fashioned cognitive therapy. And then
Speaker 1: Paul and then one of his students who now became
Speaker 1: his associate, works on writing up a new book. And
Speaker 1: this new book has been completed and it's in the
Speaker 1: hands of the publisher right now. And this new book
Speaker 1: describes in detail just what the therapy is like. And
Speaker 1: so this is the idea of the therapy. You first
Speaker 1: try to find out what the person's aspirations are. I
Speaker 1: love that, and you go over it and over their
Speaker 1: aspirations and how they would feel about meeting their aspirations.
Speaker 1: And when they really have their aspirations fixed in their
Speaker 1: own mind, their motivation to reach that area becomes increased.
Speaker 1: And the next thing that we do is we try
Speaker 1: to find out what the individual sweet spot is. So
Speaker 1: every individual that we've had has something that he's really
Speaker 1: good at, something that they have done in the past,
Speaker 1: and we find that they're actually doing it in the
Speaker 1: present but it has gone on recorded. So we tell
Speaker 1: the staff between this week and next week, I want
Speaker 1: you to tell it how the patients are acting at
Speaker 1: their best, and they say, oh, they're never at their best.
Speaker 1: They're all hitting other people, they're throwing food around while
Speaker 1: they're in the corner hose landing. So we say, okay, well,
Speaker 1: it's just keep your eye open. And then we found
Speaker 1: out that in a unit of fourteen patients they're all fourteen,
Speaker 1: had an experience at their best when they seemed to
Speaker 1: be completely normal. And so this was the key thing.
Speaker 1: And so one person would be teaching dancing to some
Speaker 1: of the other patients, another one would be drawing pictures
Speaker 1: of the other patients, another person was making a shoe
Speaker 1: fe for them. And the interesting thing is one they
Speaker 1: are in their sweet spot, then they seem particularly normal.
Speaker 1: And actually Paul has subjects it to the word normal,
Speaker 1: so we use the word adaptive. So they are adapting
Speaker 1: totally to this. And during this period of adaptation, as
Speaker 1: apparent that these people are perfectly capable of behaving adaptively,
Speaker 1: that they have not despite their apparent craziness. Ah, they
Speaker 1: have not lost at all their ability to be quote normal,
Speaker 1: are adaptive. So my task a few weeks ago, about
Speaker 1: three or four weeks ago, was to write a paper
Speaker 1: explaining the adaptiveness of these people and we said, and
Speaker 1: so the type of the initial title of the paper
Speaker 1: would be adaptiveness, and it's a really mentally ill most
Speaker 1: of the schizophrenic or all sorts of different things. Well,
Speaker 1: so there are only two categories of patients, those who
Speaker 1: were diagnosed with schizophrenic and they are hearing voices and
Speaker 1: the delusional. The other type that go in are in
Speaker 1: the hospital because they are assaultive. And this is uncontrollable
Speaker 1: on the outside I see. So they're assault shive or
Speaker 1: self injurious, and so in the self injurious they're taking
Speaker 1: they swall hard objects like force and knives. And a
Speaker 1: couple of the people who we have demonstrated widely came
Speaker 1: from where they're they're actually their death. They were going
Speaker 1: back and forth for surgery to the hospital and are
Speaker 1: now accommodated. So anyhow, getting back to the theory, I
Speaker 1: wanted to prepare a theory as to why these people
Speaker 1: get better. And then as I worked at the cases,
Speaker 1: it seems that you do try to activate their humanity.
Speaker 1: Excuse me, activate their humanity. Yeah, in a way, Well,
Speaker 1: we activate their humanity, and it turns out that they
Speaker 1: love doing things for patients, for the other patients, or
Speaker 1: for the staff that they they have a strong urge
Speaker 1: to do things for other people, and when they are
Speaker 1: doing these things, they are totally adaptive. However, this does
Speaker 1: not last, otherwise they'd be out of the hospital within
Speaker 1: a week. The therapy consists of extending the period of
Speaker 1: adaptiveness short of day by day, and we we do
Speaker 1: a well of the work with the staff rather than
Speaker 1: with the patients per se, and the staff then gets
Speaker 1: the patients much more into the adaptive mode. And so
Speaker 1: I then developed a theory of modes, and the idea
Speaker 1: is that the personality consists of various sexes, and you
Speaker 1: see these molds and a wide variety of cases for example,
Speaker 1: and multiple personality to sort of which I think is
Speaker 1: a real disorder. The people can operate at times being
Speaker 1: very hostile and bellisering when they're one person, and when
Speaker 1: they shift to another person, they change the name and
Speaker 1: they are say, humble, self effacing, very passive. In working
Speaker 1: with these people, we realize that these are different aspects
Speaker 1: of the personality and this is something that we've labeled modes,
Speaker 1: and the mental patients are perfectly capable of getting into
Speaker 1: an adaptive mold. Then try to provide opportunities for them
Speaker 1: to remain in this mold. So the next step in
Speaker 1: my theorizing, Yeah, I think of what is the function
Speaker 1: of personality? And these modes seem to be very adaptive
Speaker 1: and the most are different sectors of the personality. So
Speaker 1: my next step was I came to the conclusion that
Speaker 1: the function of personality in general as adaptation. Oh but
Speaker 1: the function, but the people, because of their constructions of things,
Speaker 1: are in maladaptive modes. And so the therapy consists of
Speaker 1: changing from and we're doing an experiment now and which
Speaker 1: we recognize that people who are not going to believe
Speaker 1: that this is happening. Of our administrators of hospitals believe,
Speaker 1: but the profession won't believe it. So, yeah, a precious
Speaker 1: headset and the headset as you say, eeg, And we
Speaker 1: put the headset on when there are they're worse, and
Speaker 1: then when they're solemnly in the adaptive mode, and already
Speaker 1: we see that there's a change, a different part of
Speaker 1: the brain is activated when they're in the adaptive mode. Wow,
Speaker 1: that's huge, so so very terrific. And so that's the
Speaker 1: subjects of our paper. So you can't wait to eat it. Yeah,
Speaker 1: I was appreciate your feedback. Paul had a number of
Speaker 1: very good suggestions for the paper. I was using words
Speaker 1: like normal and so on. He says, that's too world
Speaker 1: is an expression, and a lot of people will rejectful
Speaker 1: use of their normal. I think so, so we use
Speaker 1: the word adaptive, and I like adaptive constructive, right, so
Speaker 1: when they're doing construction things, they're in the adapt from more. Yes,
Speaker 1: and so my very latest has to do with looking
Speaker 1: back at how the original therapy depicted itself and how
Speaker 1: a new therapy the self depicting at all. So the
Speaker 1: third type of therapy, which has to do with basing
Speaker 1: exercises or distancing once so or something that's called better cognition.
Speaker 1: So I think that the therapy that we're doing with
Speaker 1: the hospital and patients is inevitable because they are not
Speaker 1: capable of the type of discussions that we're part and
Speaker 1: partial of the original therapy. So that we can call
Speaker 1: the new therapy recovery oriented therapy, or we can call
Speaker 1: by the fact that people become better adjusted. So that's
Speaker 1: one type of therapy. The original therapy was based mostly
Speaker 1: on the individuals distortions and the negative biases about their
Speaker 1: experiences and so the original therapy which is now being
Speaker 1: practiced bioledged by the people I have trained prior to
Speaker 1: Paul Grants, so that therapy is based on negating the
Speaker 1: negative biases or correcting the now adaptive constructions of situations.
Speaker 1: And the third type, the third approach, which I think
Speaker 1: is valuable, has to do with the breathing exercises that
Speaker 1: people do. And it seems that that by being occupied
Speaker 1: with their breathing, the people are able to distance themselves
Speaker 1: from their negative constructions of situations. So I therefore promoting
Speaker 1: the idea of three therapies. And we don't know as
Speaker 1: yet what the application of the initial therapy was that
Speaker 1: is changing the misconceptions of people, and how afflication that's
Speaker 1: gonna be regod to the more humanistic and holistic Sarah
Speaker 1: Bath that I've been talking about love it today. And
Speaker 1: we also don't know the full application of the breathing exercisers,
Speaker 1: which has become very popular, and there has to be
Speaker 1: some validity to it. Mm hmm. So that's it. That's
Speaker 1: all I know, you know, that's not all. That's not
Speaker 1: all you know. I just want to say something about
Speaker 1: the humanistic approach you're taking when you started your career.
Speaker 1: You were influenced by some of the humanistic psychologists, right
Speaker 1: like Abraham Masl and Karen Horney and various folks. You
Speaker 1: told me that they were the Carl Rogers. They had
Speaker 1: an impact on you, right, Well, they did, but the
Speaker 1: structure of my Sarah, they wish more and correcting the negative, right,
Speaker 1: rather than accentuating the positive. Right. But it sounds like
Speaker 1: now you've you've really kind of come full circling. Yeah, yeah,
Speaker 1: I comfort full cycle as far as the severe and patience.
Speaker 1: But we still have to see, uh where the three approaches.
Speaker 1: Yeah have an application. Sure, you're such a treasure. And
Speaker 1: you know, I just won't if give any advice to
Speaker 1: any young psychologists that want to make an impact in
Speaker 1: the world such as you have. So I can't look
Speaker 1: back to the impact and what I did to make
Speaker 1: that impact. But I would say that I wear from
Speaker 1: my patients, and then I would figure out what was
Speaker 1: going on within the patients and what the mechanisms were.
Speaker 1: For example, I observed that depressed people would be very
Speaker 1: self critical after they had an event, that that I
Speaker 1: pinched it and pinched on their self esteem, and so
Speaker 1: I then would use a technique, oh, such as looking
Speaker 1: at the distortions, and then I would test the shadow
Speaker 1: laboratory and when that worked, then I would write up
Speaker 1: a solabers and when I found a publisher, then I
Speaker 1: would publish the sold as a book. So what I
Speaker 1: would propose to the buddy your psychologists is you have
Speaker 1: to you have to see the raw material. You have
Speaker 1: to see individuals, and it could be as simple as
Speaker 1: being in a counseling center, but you have to get
Speaker 1: your raw material from your observations. Then you have to
Speaker 1: test out what the evidence is that you have discovered
Speaker 1: the truth. And then you have to demonstrate that your
Speaker 1: approach actually makes the people better. And then when you've
Speaker 1: done that, then you go on to the next problem next.
Speaker 1: Thank you so much. Okay, thank you you ready for lunch?
Speaker 1: Now I'm going to have lunch. Let's do it. Little
Speaker 1: fist bump saying it's the end of the episode. Thank you,
Speaker 1: Do you want to eat a little bit? Yeah? Oh
Speaker 1: that's so interesting, okay, and killing me so in case
Speaker 1: we don't record anymore, let me just say thank you
Speaker 1: so much for sharing that with me and your latest work.
Speaker 1: I think it's going to be so foundational. And helps
Speaker 1: them make me able to thank you for talking with me.
Speaker 1: Oh good, Thank you. Thanks for listening to this episode
Speaker 1: of The Psychology Podcast. If you'd like to react in
Speaker 1: some way to something you heard, I encourage you to
Speaker 1: join in the discussion at the Psychology podcast dot com.
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