[From Bill Powers (2005.09.23.1035 MDT)]
Mary picked up a used book called "Cognitive Therapy and the Emotional Disorders," by Aaron T. Beck. M.D. New American Library (Meridian) 1976. I just opened it for the first time. Here are some excerpts.
[Re: my theory of emotion, which Beck also puts forth}
"It is difficult to conceive how a person can react emotionally to an event before he has [cognitively] appraised its nature." (p. 28)
[Re: MOL]
"I had been practicing psychoanalysis and psychoanalytic psychotherapy for many years before I was struck by the fact that a patient's cognitions had an enormous impact on his feelings and behavior. All my patients ... expressed rather freely feelings, wishes, and experiences they had concealed from other people because of fear of disapproval....
"In time, however, I began to suspect that patients were not reporting certain kinds of ideation. ... A patient in the course of free association had been criticizing me angrily. After a pause, I asked him what he was feeling. Her responded "I feel very guilty."... According to the conventional psychoanalytic model.. his hostility led directly to guilty feeling.
"But then the patient volunteered the information that while he had been expressing anger-laden criticisms of me, he had also had continual thoughts of a self-critical nature. He described two streams of thought occurring at about the same time: one stream having to do with his hostility and criticisms, which he had expressed in free association, and another he had not expressed. He then reported the other stream of thoughts: 'I said the wrong thing ... I shouldn't have said that ... I'm wrong to criticise him ... I'm bad ... he won't like me ... I'm bad ... I have no excuse for being so mean.'
"This case presented me with my dirst clear-cut example of a train of thought running parallel to the reported thought content. ...
" When I checked subsequently with other patients who had been following the rule of free association for many months or years, I discovered they also had streams of thought they had not been reporting. ... In order to probe into their unexpressed thoughts, I had to quide the patients to be especially attentive to certain ideas and to report them to me."
An example follows on page 31 ff. A woman had been freely discussing her sexual problems. It wasn't clear why she seemed anxious in each session, so Beck "decided to direct her attention to her thoughts about what she had been saying."
"She then reported the following sequence: 'I am not expressing myself clearly ...He is bored with me ... He probably can't follow what I am saying ...This probably sounds foolish to him ...He will probably try to get rid of me.'
"After she was able to pinpoint and to correct her unrealistic thoughts, she no longer felt anxious during the therapy sessions."
Beck, unfortunately, was too deeply immersed in the "me doctor, you patient" culture to see fully what he had discovered. To him, the problem was "unrealistic thoughts" which had to be "corrected". And he was the one who had to do the correcting.
However, he did explore this phenomenon further and incorporated it into his practice. As soon becomes evident, however, he missed the point. To him, the background thoughts were simply evidence of "thinking disorders," and he spends a great deal of this book classifying the cognitive problems associated with various classical categories of disorders such as depression, anxiety, guilt, and so on. He attributes the improved success he experienced after having made these discoveries to his "highly-structured, problem-oriented approach" which seemed to be working better than other methods he had tried. The idea that simply calling attention to the background thought was, by itself, the essential part of the process clearly never occurred to him.
Beck contrasts his cognitive approach to both psychoanalysis and behaviorism, and in many ways would be a natural ally, though I doubt whether he's still alive. If he had followed a slightly different path, he surely would have come up with the Method of Levels. I wonder what influence he had on others.
Best,
Bill P.
