Aaron T. Beck
La
Terapia Cognitiva
Julio
Obst Camerini
INTRODUCCIÓN:
Aaron T: Beck inicia el desarrollo de la que denominó "Terapia Cognitiva" a principio de la década de los sesenta (1962) enla Universidad de
Pensylvania, como una psicoterapia para la depresión, breve y orientada al
presente.
El modelo coincidía con el concepto de la mediación cognitiva propuesto por Albert Ellis en 1956.
Aaron T: Beck inicia el desarrollo de la que denominó "Terapia Cognitiva" a principio de la década de los sesenta (1962) en
El modelo coincidía con el concepto de la mediación cognitiva propuesto por Albert Ellis en 1956.
La sede central de esta corriente, que durante muchos años fue el Center for
Cognitive Therapy de la
Universidad de Pennsylvania en Philadelphia,
Pennsylvania, actualmente es el “Beck Institute for Cognitive Therapy and Research” situado en Bala
Cynwyd (zona suburbana de Philadelphia, en el estado de Pennsylvania, USA),
fundado en 1994 por Aaron T. Beck, su actual presidente, y dirigido por su
hija, Judith S. Beck.
Actualmente la Terapia Cognitiva
en las mismas escuelas fundadoras ha superado algunas concepciones originales,
ha incorporado una visión constructivista, ha adoptado nuevos recursos y
se puede considerar "pos-racionalista".
EL MODELO COGNITIVO
CONCEPTOS
BÁSICOS:
“La
Terapia Cognitiva está basada en el modelo cognitivo que postula que las emociones y conductas de las personas están
influidas por su percepción de los eventos. No es una situación en y por sí
misma la que determina lo que una persona siente, sino más bien la forma en que
ella interpreta la situación (Ellis,
1962; Beck, 1964). .... Por lo tanto la forma en que se
sienten las personas está asociada a la forma
en que interpretan y piensan sobre una situación. La situación por
sí misma no determina directamente cómo se sienten; su respuesta emocional está mediada por su percepción de la situación.”
(Beck, J., 1995, Cognitive Therapy: Basics
and Beyond, p.14 ).
“La Psicoterapia Cognitiva destaca que lo que las personas piensan y perciben sobre sí mismos, su
mundo y el futuro es relevante e importante y tiene efecto directo en cómo se
sienten y actúan.”. (Dattilio & Padesky, 1990, Cognitive Therapy with Couples, p.6)
En otras palabras, las terapias cognitivas se basan en los siguientes supuestos básicos:
“
“
En otras palabras, las terapias cognitivas se basan en los siguientes supuestos básicos:
(1)
Las personas no son simples receptores de los estímulos ambientales, sino que
construyen activamente su "realidad".
(2) La cognición es mediadora entre los estímulos y las respuestas (cognitivas, emotivas o conductuales).
(3) Las personas pueden acceder a sus contenidos cognitivos.
(4) La modificación del procesamiento cognitivo de la información (sistemas de atribución, creencias, esquemas, etc.) es central en el proceso de cambio.
(2) La cognición es mediadora entre los estímulos y las respuestas (cognitivas, emotivas o conductuales).
(3) Las personas pueden acceder a sus contenidos cognitivos.
(4) La modificación del procesamiento cognitivo de la información (sistemas de atribución, creencias, esquemas, etc.) es central en el proceso de cambio.
En cuanto a su estilo las terapias
cognitivas enfatizan:
(1) La importancia de la alianza terapéutica y la colaboración y participación activa del paciente en el proceso.
(2) Un enfoque orientado al problema y los objetivos.
(3) El carácter educativo (o reeducativo) del proceso, capacitando al paciente para enfrentar por sí mismo futuras situaciones de manera más saludable y funcional.
(1) La importancia de la alianza terapéutica y la colaboración y participación activa del paciente en el proceso.
(2) Un enfoque orientado al problema y los objetivos.
(3) El carácter educativo (o reeducativo) del proceso, capacitando al paciente para enfrentar por sí mismo futuras situaciones de manera más saludable y funcional.
El sistema cognitivo:
Siendo "S" el estímulo o situación, "P" el sistema y procesamiento cognitivo (pensamientos) y "R" la respuesta o reacción. El modelo se representa por la relación:
S à P à R
Las reacciones pueden ser: emotivas, conductuales o fisiológicas.
Los pensamientos automáticos son los pensamientos evaluativos, rápidos y breves que no suelen ser el resultado de una deliberación o razonamiento, sino más bien parecen brotar automáticamente. Estos pensamientos pueden tener forma verbal (“lo que me estoy diciendo a mí mismo”) y/o visual (imágenes).
Los pensamientos automáticos surgen de las creencias. Estas creencias son ideas que son tomadas por la persona como verdades absolutas.
Las creencias más centrales o creencias nucleares son interpretaciones tan fundamentales y profundas que las personas frecuentemente no las expresan ni aún a sí mismas, no tienen clara conciencia de ellas. Estas creencias nucleares desarrolladas desde la infancia consisten en definiciones, evaluaciones o interpretaciones de sí mismos, de las otras personas y de su mundo.
Las creencias nucleares representan el nivel más profundo, fundamental, rígido y global de interpretación, que influye en los otros niveles. Los pensamientos automáticos o palabras e imágenes que están en nuestra mente son relativos a las situaciones y representan el nivel más superficial de cogniciones. Entre ambos niveles están las denominadas creencias intermedias, influidas por las nucleares (e influyentes sobre los pensamientos automáticos).
Las creencias intermedias están constituidas por: reglas (normas), actitudes y supuestos.
Siendo "S" el estímulo o situación, "P" el sistema y procesamiento cognitivo (pensamientos) y "R" la respuesta o reacción. El modelo se representa por la relación:
S à P à R
Las reacciones pueden ser: emotivas, conductuales o fisiológicas.
Los pensamientos automáticos son los pensamientos evaluativos, rápidos y breves que no suelen ser el resultado de una deliberación o razonamiento, sino más bien parecen brotar automáticamente. Estos pensamientos pueden tener forma verbal (“lo que me estoy diciendo a mí mismo”) y/o visual (imágenes).
Los pensamientos automáticos surgen de las creencias. Estas creencias son ideas que son tomadas por la persona como verdades absolutas.
Las creencias más centrales o creencias nucleares son interpretaciones tan fundamentales y profundas que las personas frecuentemente no las expresan ni aún a sí mismas, no tienen clara conciencia de ellas. Estas creencias nucleares desarrolladas desde la infancia consisten en definiciones, evaluaciones o interpretaciones de sí mismos, de las otras personas y de su mundo.
Las creencias nucleares representan el nivel más profundo, fundamental, rígido y global de interpretación, que influye en los otros niveles. Los pensamientos automáticos o palabras e imágenes que están en nuestra mente son relativos a las situaciones y representan el nivel más superficial de cogniciones. Entre ambos niveles están las denominadas creencias intermedias, influidas por las nucleares (e influyentes sobre los pensamientos automáticos).
Las creencias intermedias están constituidas por: reglas (normas), actitudes y supuestos.
LAS
DISTORSIONES COGNITIVAS:
Los pacientes
tienden a cometer persistentes errores en su forma de pensar. Con frecuencia se
observa un desvío negativo sistemático en la forma de procesar el conocimiento
en los pacientes que padecen un trastorno psicológico.
Las distorsiones cognitivas o formas no válidas de razonamiento más frecuentes que hemos encontrado mencionadas en la literatura de esta corriente son las siguientes (Beck, A., 1976, Cognitive Therapy and the Emotional Disorders) (Dattilio & Padesky, 1990, Cognitive Therapy with Couples) (Beck, J., 1995, Cognitive Therapy: Basics and Beyond):
Pensamiento “de todo o nada” (“pensamiento dicotómico”, o “en blanco y negro”).
Adivinación del futuro (“catastrofización”).
Descalificar o descartar lo positivo.
Inferencia arbitraria.
Razonamiento emotivo (“siento que...”).
Explicaciones tendenciosas.
Rotulación (“etiquetar”).
Magnificación / minimización. (Magnificar lo negativo y minimizar lo positivo).
Filtro mental (“abstracción selectiva”).
Lectura de la mente.
Generalización (o “sobregeneralización”).
Personalización.
Expresiones con “debe” o “debería” (exigencias, demandas).
“Visión en túnel”.
Las distorsiones cognitivas o formas no válidas de razonamiento más frecuentes que hemos encontrado mencionadas en la literatura de esta corriente son las siguientes (Beck, A., 1976, Cognitive Therapy and the Emotional Disorders) (Dattilio & Padesky, 1990, Cognitive Therapy with Couples) (Beck, J., 1995, Cognitive Therapy: Basics and Beyond):
Pensamiento “de todo o nada” (“pensamiento dicotómico”, o “en blanco y negro”).
Adivinación del futuro (“catastrofización”).
Descalificar o descartar lo positivo.
Inferencia arbitraria.
Razonamiento emotivo (“siento que...”).
Explicaciones tendenciosas.
Rotulación (“etiquetar”).
Magnificación / minimización. (Magnificar lo negativo y minimizar lo positivo).
Filtro mental (“abstracción selectiva”).
Lectura de la mente.
Generalización (o “sobregeneralización”).
Personalización.
Expresiones con “debe” o “debería” (exigencias, demandas).
“Visión en túnel”.
---------------oooo0oooo---------------
|
Gracias a todos los que donaron en la
campaña de recolección de fondos de
|
Aaron T. Beck
De Wikipedia, la enciclopedia libre
Saltar a navegación,
búsqueda
El Doctor Aaron T. Beck, es el Presidente del Instituto
de Beck para la Terapia e Investigación Cognitiva y profesor de Psiquiatría
en El Dr. Beck desarrolló la terapia cognitiva a principios de los años 1960 cuando era psiquiatra en
Desde entonces, el Dr. Beck y sus colaboradoradores diseminados por todo el mundo, han investigado la eficacia de esta forma de psicoterapia para tratar un amplio abanico de trastornos, incluyendo la depresión, el trastorno bipolar, los trastornos alimentarios, las drogodependencias, los trastornos de ansiedad, los trastornos de personalidad y diferentes condiciones médicas en las que los componentes psicológicos son relevantes. Parte de su trabajo reciente se ha centrado en aplicar la terapia cognitiva a la esquizofrenia, el trastorno límite de personalidad y a pacientes que de forma repetida han intentado suicidarse.
Tabla de contenidos
[ocultar]
|
Biografía [editar]
Infancia [editar]
Aaron Beck nació en Providence, Rhode Island, el 18 de Julio
de 1921, siendo el más pequeño de sus tres hermanos. Los padres de Beck eran
inmigrantes judíos.
El nacimiento de Beck se vio seguido por el fallecimiento de su hermana como
consecuencia de una epidemia de gripe. Después de la muerte de su hermana, la
madre de Beck se sumió en una profunda depresión; esta depresión desapareció
con el nacimiento de Beck. Beck considera que fue aquí donde se arraigó su
necesidad de control. Beck se sentía estupido e incompente después de sufrir
una enfermedad grave causada por una infección en un brazo roto. Sin embargo,
Beck aprendió como afrontar cognitivamente sus miedos y problemas; esto fue lo
que inspiró en años posteriores su teoría y sus terapias.
Hijos [editar]
Beck está casado y tiene cuadro hijos: Roy, Judy, Dan y Alice,
y tiene ocho nietos. Su hija,
Formación [editar]
Beck fue a
Véase también [editar]
Enlaces
externos [editar]
- Beck Institute for Cognitive
Therapy and Research
- Convención 108 de la APA
- Convención 111 de la APA
- Exposición de los
fundamentos de la terapia cognitiva, (en inglés)
- Centro
de Psicología AARON BECK de España
Obtenido de "http://es.wikipedia.org/wiki/Aaron_T._Beck"
|
Nuestro
Centro cuenta con el beneplácito del Dr.
Aaron T. Beck, psicólogo y catedrático de Psiquiatría de
Este psicólogo es mundialmente conocido por haber
desarrollado
|
Aaron T. Beck
|
Según la
Teoría Cognitiva de Beck, existe una clara relación entre los
pensamientos de la persona (lo que se dice a sí misma sobre las situaciones que
vive, sobre los demás, sobre la vida, sobre sí misma y sobre los problemas que
presenta), y las emociones y los sentimientos que experimenta. A su vez, esta
reacción emocional influirá en la reacción comportamental de la persona ante
esa situación, ante la conducta de otro, o ante los síntomas que experimenta,
según el caso.
Cuando las emociones son muy
negativas e intensas, nuestro comportamiento se ve entorpecido o se vuelve
desadaptativo, de modo que los problemas se mantienen o empeoran.
Realmente, lo que ocurre,
desde esta teoría, es que no son las situaciones en sí las que producen
malestar (o la gran intensidad del malestar) directamente, sino las interpretaciones
personales que hacemos de ellas. Esto implica que, muchas veces, al no poder
ser objetivos en una situación, podemos distorsionar la información de la que
disponemos en un momento dado, o sacar conclusiones negativas sin información
suficiente o incluso ignorando otra información disponible más realista y
constructiva. Cuando esto ocurre, dice Beck, cometemos errores en la
interpretación o errores de razonamiento.
Hay personas que tienen más
tendencia a cometer estos errores, influidos también por algunas creencias de
base, que pueden ser rígidas o incorrectas, generalmente aprendidas a través de
la educación y de las experiencias previas. También se dan más errores de
interpretación cuando se desarrollan los diferentes trastornos psicológicos.
Esta explicación es importante de cara al tratamiento, dentro de
la llamada Terapia Cognitiva de Beck, que nosotros aplicamos de modo integrado
con otras técnicas. Lo básico en esta terapia (no lo único) sería enseñar a la
persona la relación situación-pensamientos automáticos ante la
situación-sentimientos /emociones-comportamiento resultante. La persona
practica la identificación de tales pensamientos, aprende a ver sus posibles
errores de interpretación y, siempre con la guía del psicólogo, aprenderá a
cuestionarse sus pensamientos, de modo que llegue a ver las cosas de otra
forma, más realista, más constructiva.
El objetivo es enseñar a la persona a pensar de otro modo ante los
problemas y síntomas que padece, lo que ayudará a reducir las emociones
negativas y a reaccionar ante los problemas de un modo que le lleve a su
solución, no al abatimiento.
Todo esto se integra dentro de un programa de tratamiento más
amplio, con técnicas conductuales y módulos como (según el problema y el caso),
mejora de la autoestima, entrenamiento en asertividad y habilidades sociales,
técnicas de control de ansiedad, técnicas de resolución de problemas, entre
otros. Este tipo de terapia se llama,
en su conjunto, Terapia Cognitivo-Conductual.
Aaron Beck 1934 -
School
of Psychology
Key Words: Cognitive Reconstructuring, Negative Cognitive Triad (For Depression)
Beck Institute
Cognitive Therapy Key Words: Cognitive Reconstructuring, Negative Cognitive Triad (For Depression)
Beck Institute
Like Albert Ellis, Aaron Beck also turned his back on psychoanalytical techniques. Psychodynamic theory saw depression along motivational-affective considerations, in other words, as misdirected anger, or swallowed anger, or "bottled up anger". In his session work, Beck found that his clients reported their feelings of depression in ways differing from these psychoanalytical conceptulations of depression. Like Ellis, Beck found his clients illustrated evidence of irrational thinking that he called systematic distortions. The basic premise of Beck's Cognitive-Behavioral Therapy concerns these disortions, and follows the philosphy of Epictetus: It is not a thing that makes us unhappy, but how we view things that make us unhappy. Therefore, if we avoid struggling to change things, and instead change our own interpretations of things, we change how we feel and how we act in the future.
What is a cognition?
What are you, some kind of idiot? Ok, fine. Cognitions are verbal or pictoral representations, available to the conscious, which form according to the interpretations we make about the things that happen to us. These interpretations and assumptions are shaped by a bunch of unconscious presuppositions we make about people, based on past experience - and when I say past experience, I mean experiences going all the way back to birth.
How Cognitions Form
Basically, when we are infants, we take in the whole world in a rather naive and unthinking fashion. William James saw this as the stream of consciousness.
In order to make any real sense of this, we form cognitive filters, schemas, or a set of assumptions and expectations of how events will transpire, and what they mean to us. And we begin by making the most illogical and irrational assumptions. It's years before we can even make the simplest logical inferences. (For more, see Piaget, or see my logic page for the fallacy section.)
You can also refer to all of this as Appraisal Theory.
Beck's Spin on Epictetus
Beck's therapy seeks to uncover instances where distorted, illogical thoughts and images lead to unwanted or unproductive emotions. We say unproducitve emotions, because these emotions can be either good or bad, for either can lead to unproductive behaviors.
What, precisely, is a Cognitive Distortion?
Beck's typology of cognitive distortions is somewhat like Ellis's irrational beliefs, they all represent evidence of emotion subsuming the logical thought process - i.e. logical fallacies. It's helpful for clients to just read about this stuff, so I list the distortions here:
Catastrophizing or Minimizing - weighing an event as too important, or failing to weight it enough.
Dichotomous Thinking - commiting the false dichotomy error - framing a phenomena as an either/or when there are other options.
Emotional Reasoning Feeling that your negative affect necessarily reflect the way a situation really is
Fortune Telling Anticapting events will turn out badly
Labeling This occurs when we infer the character of a person from one behavior, or from a limited set of behaviors. I.e. a person who forgets something one time is "an idiot
Mental Filter - We all have mental filters, but this distortion refers to specific situations where we ignore either positive or negatives to one issue.
Mind Reading - Believing that we can know what a person thinks solely from their behaviors.
Overgeneralization - One event is taken to be proof of a series or pattern of events
Personalization - Assuming that a person is at fault for some negative external event.
Should Statements - Statements that begin with "Shoulds" or "Musts" are often punishing demands we make on ourselves. Generally, the assumption that we Must or Should do something is absolutist, and therefore most likely false. Beck ripped this off from Ellis.
Guiding Principles For Cognitive Therapy
Short Term Therapy Beck's Cognitive Behavioral Therapy is short term. It focuses on symptom reduction. Yet, before the psychoanalyst in you begins to cry out, recognize that symptom reduction has been shown by empirical research to be an effective long term help - i.e. focusing on symptoms does help effect "core" character changes.
Therapist's Stance - Active
The therapist is active, didactic and directive. He tells you what he is doing, the reason why he is doing it, and and even teaches you how to do it for yourself. For example, if he assigns homework for a client, he tells the client the reasoning behind the homework. This also has the additional benefit of allowing the client to practice new behaviors in the actual environment where they will occur. The cognitive behavioral therapist can point to research that supports the efficacy of all of this.
The CB therapist uses systematic cognitive and behavioral techniques.
Patients recieve a toolkit of self help techniques from the therapist. The client himself becomes a specialist in dealing with his own problems. This can only help the client become more independent. So, unlike some other therapies, cognitive behavioral therapy helps clients free themselves from the need for therapy and actively plans for this event.
Typical Problems that CBT Addresses
Major Disorders treated by CBT include: Depression, panic disorder, obsessive-compulsive disorder, paranoid personality disorder, somatoform disorder. The treatment of depression often serves as the paradigm of the cognitive approach.
Structured Sessions
Sessions are structured and problem oriented. The therapist knows in advance the schedule of events for the session, and he shares this information with the client. This helps the therapist and the client make the most of each session.
Present Focus
Present and future focused. Yes, past events shape who we are, but cognitive behavioral therapy looks at what we can do now to change this.
Collaborative Relationship
Therapeutic relationship is collaborative, as opposed to authoritarian, adversarial or neutral. The cognitive behavioral therapist starts out as the authority - the teacher, but actively transfers the power of the relationship
Experiential Therapy
Use of self help homework, premack principle, for transfer of learning from the office to everyday life. Clients will see real life changes before therapy ends. They will experience successes early on.
Structure of Sessions
One thing that annoys me about any discussion of a therapy is how little time is spent discussing how therapy actually works in a session. The next section corrects this common problem.
Beck created a model for a typical initial session:
1) Set an agenda
2) Review self-report data
3) review presenting problem
4) Identify problems and set clearly definable and measurable goals
5) Educate patient on the cognitive model
6) Discuss the patient's expectations for therapy
7) Summarize session
8) Elicit feedback from the patient
What a thorough approach, right?
In later sessions, the above model is changed a bit. There, there is only an agenda setting period, a review of the presenting problem, and then work on the agenda, including reviewing homework, and eliciting feedback.
Cognitive Restructuring
While the CB therapist uses many techniques to aid his client: psychoeducation, relaxation training, coping skills, exposure, response prevention, cognitive restructuring is often the heart of the therapy.
If you've read my entry on Ellis, you have learned that he tends to focus his work on the client's core evaluative beliefs of himself. In this light, Ellis tends to remain truer to his roots as a psychoanalyst - he is still seeking out unconscious conflict, but with cognitive tools.
Beck, however, is a bit more empirical, and more concerned with working with observable behaviors. He therefore focuses more on what he refers to as "automatic thoughts".
Now, automatic thoughts are held to link back to core beliefs, but Beck chooses to work on changing these thoughts, rather than attacking the core belief directly , as Ellis does.
Here is how Beck views the mind:
We have automatic thoughts" - which, while unconscious, are directly accessible with some attention to them. Beck therefore does not view them as unconscious in a Freudian sense so much as he sees them as operating without our notice, hence the term "automatic."
Now, automatic thoughts occur, because of underlying assumptions and rules we make up concernin the world. These are more unconscious than automatic thoughts, because they require a great deal of work to elucidate. Typically, only philosophers and deep thinkers such as you, gentle reader, tend to be aware of them.
Finally, there are core beliefs about ourselves and others. These are highly emotionally charged, rigid views. They are unconscious roughly on a level with Freudian unconsciousness.
Collaborative Empiricism
In cognitive restructuring, Beck seeks to correct the cognitive distortions that appear in automatic thoughts, that point back to self defeating core beliefs. He does this by disputing the client's beliefs inherent in the automatic thoughts in a scientific manner: guided discovery, hypothesis testing, supporting through evidence, looking for alternative theories.
This is how the chain works:
Automatic thought: I can't do this, it is too hard.
Assumption: I will fail.
Core Belief: Because I am a loser.
Beck would look at the client's statement "I can't do this." and work with the client to see, for example, if the client has real evidence of his inability to perform the task. Often, the statement is not literally true - the client has performed the task, or he's having trouble because he's trying to do too much at once.
In the cognitive conceputalization of the client's conundrums, the cognitive caretaker cares for the client by considering these following common clinical concerns:
The patient's diagnosis is made through his or her identifiable symptoms
Current problems are the focal point - how did they develop and how are they maintained?
Their cognitions - automatic thoughts, assumptions and core beliefs, are key focus of change.
Core Beliefs
Beck tended to think there were only a few types of core beliefs.
Cognitive Restructuring
In the most general sense, we can discuss cognitive restructuring in the following fashion:
Perception and experiencing in general are active processes that involve both inspective and introspective data in that the clients's cognitions represent a synthesis of internal (mental filters) and external stimuli (the world about him.)
How people appraise a situation is generally evident in their cognitions (thoughts and visual images).
These cognitions constitue their stream of consciousness or phenomenal field, which reflects their configuration of themselves, their past and future, and their world.
Alterations in the content of their underlying cognitive structures affect their affective state and behavioral patterns.
Through psychological intervention, clients can become aware of their cognitive distortions. Correction of those faulty dysfunctional constructs can lead to clincal improvement.
According to cognitive theory, cognitive dysfunctions are the core of the affective, physical and other associated features of depression. Apathy and low energy are results of a person's expectation of failure in all areas. Similarly, paralysis of will stems from a person's pessimision an feelings of hopelessness. The cognitive triadof depression is a negative self-perception whereby peole see themselves as inadequate, deprived and worthless. They expereince the world as negative and demanding. They learn self-defeating cognitive styles, to expecte failure and punishment, and for it to continue for a long time.
The goal of cognitive therapy is to alleviate depression and to prevent its recurrence by helping clients to identify and test negative cognitions, to develop alternative and more flexible schemas, and to rehearse both new cognitive and behavioral responses. By changing the way people think, the depresssive disorede can be alleviated.
Strategies and Techniques
Goal: Identify and alter cognitive distortions that maintain symptons.
Three components of Cognitive Restructuring
Didactic aspects
The therapy begins by explaining to the client the theoretical concepts of CBT, focusing on the belief that faulty logic leads to emotional pain. Next, the client learns the concept of joint hypothesis formation, and hypothesis testing. In depression, the relationship between depression and faulty, self defeating cognitions are stressed, as well as the connection of affect and behavior, and all rationales behind treatment.
Eliciting automatic thoughts
Every psychopathological disorder has its own specific cognitve profile of distorted thought, which provides a framework for specific cognitive intervention. In depression, we see the negative triad: a globalized negative self view, negative view of current experiences and negative view of the future. Here are some examples of cognitive profiles for other disorders:
In hypomanic episodes we see inflated views of self, experience and future.
In anxiety disorder we see irrational fear of physical or psychological danger.
In panic disorder we see catastrophic misinterpretation of body and mental experiences
In phobias, we see irrational fear in specific, avoidable situations
Paranoid personality disorder: negative bias, interferene by others
Conversion disorder: concept of motor or sensory abnormality
Obsessive-compulsive disorder: repeated warning or doubting about safety and repetitive rituals to ward off these threats
Suicidal behavior: hopelessness and deficit in problem solving
Anorexia nervosa: Fear of being fat.
Hypochondriaseis: attribution of serious medical disorder
Testing automatic thoughts
Acting as a teacher, the therapist helps a clent test validity of automatic thought. The goal is to encourage the client to reject incurate or exaggerated thoughts. Clients often blame themselves for things outside their control. "Self defeating attributions". Alternate explanations are considered.
Identifying maladaptive thoughts
As client and therapist continue to identify automatic thoughts, patterns usually become apparent. The patterns represent rules of maladapive general assumptions that guidea client's life. "In order to be happy, I must..."
Primary assumption: If I am nice, suffer for others, bad things wont happy to me
Secondary assumption: It is my fault when bad things happen to me, because I was not nice (or nice enough) SO, Life is unfair, because I am nice and still bad things happen
Automatic thoughts: I caused my loved one to behave badly/Why dont I have a nice loved one?
Such rules inevitably lead to disapointment, depression, and ultimately, depression.
Depression: Causes and Treatment (1967)
Beck first presented a model of depression, but it now represents how psychopathology works in general.
Emotional disorders are the reults of a distorted thinking or unrealistic cognitive appraisal of life events. How an individual structures reality determines his emotional state. a reciprocal relation exits beteween affecta nd cognition one reinforces the other, resulting in esculations of emotional and cognitive impairment.
Schemata - cognitive structures that organize and filter incoming data, acquired in early development, according to one's epistemology. Too disconsonant distortions lead to malajustment.
Negative cognitive triad: view of self, world and future in a negative manner.
cognitive therapy applies empirical procedures to cognitive, behavioral and affective processes - a model that is pervasive today.
Treatment goals are as with REBT. Therapy involves learning experiences for the client that allow them to monitor distorted thinking to realize the relation between thoughts, feelings and behavior and to test the validity of automatic thoughts tosubstitute more realistic cognititions and to learn to identify and later the underlying assumptions that predispose the client to the distorted thoughts in the first place.
You will often see Beck's list of Cognitive Distortions, which comprises a list of logical fallacies. However, Beck, like Ellis, also presented a list of the components of Mature Thinking a set of ways of thinking about yourself, the world, and the future, that lead to cognitive, emotional and behavioral success in life. Here they are:
Beck's "Primitive thinking" Vs. "Mature thinking"
Primitive thinking is Nondimensional and
global:
I am the living embodiement of failure
Mature thinking is multidimensional and
specific:I am the living embodiement of failure
I make mistakes sometimes, but otherwise I can be clever at many things.
Primitive thinking is absolutistic and moralistic:
I am a sinner, and I will end up in hell.
Mature thinking is relativistic and nonjudgemental:
I sometimes let people down, but but there is no reason I can't make amends.
Primitive thinking is invariant:
I am hopeless
Mature thinking is variable:
There may be some way...
Primitive thinking enters into "character diagnosis":
I am a coward
Mature thinking examines behaviors - behavior diagnosis:
I am behaving like a coward right now
Primitive thinking is irrevesrible and sees things as immutable:
There is just nothing I can do about this
Mature thinking is reversible, flexible and amerlioritive:
Let's see what I can do to fix this...
American Psychological Association
111th Convention
Toronto
![[Aaron T. Beck]](file:///C:/Users/rober/AppData/Local/Temp/msohtmlclip1/01/clip_image004.jpg) |
|
Photo by Fenichel: Aaron T.Beck, 7 August 2003
|
|
Getting it Right -- Legend Aaron T.
Beck in Conversation with Frank Farley
|
This event was
actually titled "Getting It Right -- Legends Albert Ellis (90) and Aaron
T. Beck (82)". However, due to illness, Ellis could not be with us.
Nevertheless, Beck - legendary pioneer in cognitive therapy for depression, and
recently active in cognitive treatment of other serious disorders -- was there,
and the audience was treated to a more in-depth Q&A with Beck than
expected. After several questions by long-time moderator Frank Farley, Beck,
who had been prepared to answer questions from Ellis and Farley, asked now if
he could take questions directly from the audience. He got some excellent
questions, diverse and often difficult. Beck unflinchingly complimented each
question and proceeded to demonstrate a wide breadth of knowledge about a full
spectrum of theories and approaches to treatment.
Before the presentation began, the audience was told about Ellis' health situation and how the discussion would proceed in his absence. Dr. Beck began by graciously acknowledging Ellis as "a major pioneer in the field of psychotherapy, a David who went out to slay Goliath; he gave no quarter". [Non Americans: "give no quarter" is an idiom meaning he remained 100% firm in what he said, never backing off...]
Questioning began with a request for Dr. Beck to say a few words about his thinking on terrorism, a big topic now and the subject of a new book by Beck.
"I've seen the dynamics of couples who hate each other and observed how they feel vulnerable, victimized.... Both people feel this..... Caesar said the same thing [and] similarly with terrorists, the only way they can defend their ideals is to attack first."
[Anyone else see a great similarity between his observation and that of Robert Sternberg?]
The next question was about cognitive therapy as a treatment technique for schizophrenia. Beck notes that his preliminary work and that which he's seen elsewhere, such as a major work in the U.K., has been "very exciting.... the addition of cognitive approaches to standard treatment manages to take the patient one whole step higher" according to outcome analysis. For example, cognitive therapy, for someone with "some functioning but with delusions or hallucinations... it can help attenuate" the symptoms. If someone has "only negative symptoms" such as listlessness, "it helps too".
Now it was time, at Beck's request, to hear from the audience.
Beck, who is an MD, was asked how he understands the brain physiology and how he thinks his verbally mediated treatments affect the brain as opposed to say, pharmacotherapy alone. Beck replied that "the physiological, neurochemical changes are the same with cognitive therapy versus pharmacotherapy. However, the *root* was different. To simplify, with pharmacotherapy it's subcortical but with cognitive therapy it's via the frontal lobes. But [the changes, despite the root] ended up in the same areas."
Asked next about treatment of Borderline Personality Disorder, which is commonly considered one of the more difficult therapeutic endeavors, Beck replied that in his experience, "each of our disorders has a particular paradigm or profile. With borderlines , based on in-depth analysis, we see acting out a great a deal, being destructive, and doing damage to things important in their lives." He sees the dynamic as often entailing a viscious cycle of stress leading to self-defeating behavior. "If the stress is great, perhaps it will lead to suicide. If feeling put upon, perhaps they will attack". The cognitive style is characterized by a "certain extreme ways of thinking" and a "dichotomous way of carving up their own lives and those of others, while seeing situations through black and white lenses. Everything is extreme, with at least one crisis every day. Like terrorists, they're all good and others are all bad-- but they can be the opposite too. They're all bad and others are all good." This can lead at worst to "slit wrists" but also, in everyday life, difficulties with "affect control and impulse control".
Beck described the underlying beliefs which are at the core of many problems. He referred to...
The 3 Attitudes:
Before the presentation began, the audience was told about Ellis' health situation and how the discussion would proceed in his absence. Dr. Beck began by graciously acknowledging Ellis as "a major pioneer in the field of psychotherapy, a David who went out to slay Goliath; he gave no quarter". [Non Americans: "give no quarter" is an idiom meaning he remained 100% firm in what he said, never backing off...]
Questioning began with a request for Dr. Beck to say a few words about his thinking on terrorism, a big topic now and the subject of a new book by Beck.
"I've seen the dynamics of couples who hate each other and observed how they feel vulnerable, victimized.... Both people feel this..... Caesar said the same thing [and] similarly with terrorists, the only way they can defend their ideals is to attack first."
[Anyone else see a great similarity between his observation and that of Robert Sternberg?]
The next question was about cognitive therapy as a treatment technique for schizophrenia. Beck notes that his preliminary work and that which he's seen elsewhere, such as a major work in the U.K., has been "very exciting.... the addition of cognitive approaches to standard treatment manages to take the patient one whole step higher" according to outcome analysis. For example, cognitive therapy, for someone with "some functioning but with delusions or hallucinations... it can help attenuate" the symptoms. If someone has "only negative symptoms" such as listlessness, "it helps too".
Now it was time, at Beck's request, to hear from the audience.
Beck, who is an MD, was asked how he understands the brain physiology and how he thinks his verbally mediated treatments affect the brain as opposed to say, pharmacotherapy alone. Beck replied that "the physiological, neurochemical changes are the same with cognitive therapy versus pharmacotherapy. However, the *root* was different. To simplify, with pharmacotherapy it's subcortical but with cognitive therapy it's via the frontal lobes. But [the changes, despite the root] ended up in the same areas."
Asked next about treatment of Borderline Personality Disorder, which is commonly considered one of the more difficult therapeutic endeavors, Beck replied that in his experience, "each of our disorders has a particular paradigm or profile. With borderlines , based on in-depth analysis, we see acting out a great a deal, being destructive, and doing damage to things important in their lives." He sees the dynamic as often entailing a viscious cycle of stress leading to self-defeating behavior. "If the stress is great, perhaps it will lead to suicide. If feeling put upon, perhaps they will attack". The cognitive style is characterized by a "certain extreme ways of thinking" and a "dichotomous way of carving up their own lives and those of others, while seeing situations through black and white lenses. Everything is extreme, with at least one crisis every day. Like terrorists, they're all good and others are all bad-- but they can be the opposite too. They're all bad and others are all good." This can lead at worst to "slit wrists" but also, in everyday life, difficulties with "affect control and impulse control".
Beck described the underlying beliefs which are at the core of many problems. He referred to...
The 3 Attitudes:
- "If I feel
something strongly I should express it"
- " I feel I
shouldn't express myself but I have to" and
- "If I
express myself people will listen to me"
He might focus
on this triad and has seen some successful treatments which entail a sort of
"re-parenting" whereby discussion of these reactions might be
underpinnings.
Beck answered some questions about Rogers (a "benign figure") and recalled that Ellis had ridiculed him once for being that benign figure during a session, someone who listens quietly and then returns the client to the same $!%# situation at home or work.
The next question came from someone who said that after studying Beck's work for years, and the work of Ellis, he's concluded that "Ellis talks a lot about must-erbation being the rock-bottom dynamic" which drives dysfunctional behavior. Beck recalled that "years ago Ellis wrote in a book that MUSTerbation causes mental problems", but the proofreader caught the "error" and corrected it, with the resulting statement not at all what Ellis intended. Beck went on to point out that the whole concept truly dates to Karen Horney's "Tyranny of the Shoulds" (one of my most profound influences, too!). "I should do this and others should do that... and they're tyrannized!" Beck noted that "shoulds are not inherently bad. We should get up in the morning, for example. But...we need to focus on rigid thinking with *dysfunctional* shoulds". As opposed to Horney or Ellis, for himself Beck said that "our rock-bottom is *fear*. 'I must avoid this'.... With borderlines, they feel very vulnerable so they have a whole series of demands on other people. As a way of protecting themselves." He said he's known patients who have made a point of counting and cataloging a long list of "shoulds".
Question: What about outcome research suggesting a role for the therapeutic relationship?
Answer: The relationship is *obviously* important. It gets lost in the cognitive approach. When I wrote my first book, the very first chapter was 'The Therapeutic Relationship'. A sense of affiliation has been worked out as very important. But where does it come in? Do I need to prove how wonderful I am or is it a technical problem? One study demonstrated the positive regard did not come in until *after* the technique. Or in other words, after the patient begins to feel better and see the therapy is working, they begin to feel better and to feel better about the therapist."
Question: Any long-term studies? How are the results?
Answer:"With pharmacotherapy sometimes very good, but with cognitive therapy, for example with depression, the relapse rate is lower. With schiziphrenia too, if in combination with pharmacotherapy." A five year study at his Center found continued improved functioning at 5-years follow up, which is a "very strong track record".
Question: Any thoughts on the role of "mindfulness" as it impacts on treatment?
Answer: Based on research it does have an important role and it may even be that meditation, in general, does. We need to do a controlled study", one group receiving mindfulness training and teaching to "decenter", and compare it with a control group.
A question was posed: Noting that Ellis tends to deal with surface cognitions while Beck tends to go deeper, how might Beck deal with a client's consciousness of splitting, aside from addressing the "victim" aspects. For example, DBT [See http://www.fenichel.com/behavior.shtml for a basic primer] as I now understand it, looks at the issues of control but also tries to teach skills to see how everything is *not* black and white, and that sometimes there are middle shades which can be stress-reducing and acceptable. [My question, and happy he said it was a good one!] :-)
Beck noted that "the Borderline can switch momentarily" so a careful approach is required. One approach which in fact Ellis might use is to "dimensionalize", to make something more dimensional than a simple good/bad judgement. For example, "I'm a terrible mother because I forgot to give my child lunch today. I deserve to die". OK, maybe "I'd say, on a scale of 100, where are you" in terms of being terrible. She'd say 100. So then he'd ask, "What then would you be if you cut off your child's arms and legs?" The hope is to force some "dimensionalizing", teaching her to "think dimensionally rather than categorically". Beck added that he might also offer an alternative conclusion rather than the mother being terrible and deserving to die. "Maybe I just forgot" to pack lunch on that day.
Question: How have cognitive approaches worked with pain management?
Answer: "Let's say someone thinks (1) 'I have a terrible back ache. I can't work on the yard.' The more thinking about it, the more pain. The next step is (2) thinking 'I'm a bad husband'. Finally this escalates to (3) 'I'm a bad husband and I can't do *anything*, I'm no good.' And then often this person begins exclusively focusing on pain." He is exploring this and currently co-authoring a book about this.
Question:Will we have an integrated therapy in the future or is cognitive therapy going to be the therapy of choice?
Answer: I once wrote an article, "Cognitive Therapy: The Integrative Model". Where therapies won't meet is in the theory. If we have the notion that the world is round and others say it's flat, one result can be compromise: The world is oblong.
============
And that was that, Aaron Beck at the 111th APA convention, taking questions solo, while several times acknowledging Ellis too.
Coming soon: Cyberslacking (Young,Greenfield , Davis, Mastrangelo)
Regards fromToronto
:-)
Michael
Beck answered some questions about Rogers (a "benign figure") and recalled that Ellis had ridiculed him once for being that benign figure during a session, someone who listens quietly and then returns the client to the same $!%# situation at home or work.
The next question came from someone who said that after studying Beck's work for years, and the work of Ellis, he's concluded that "Ellis talks a lot about must-erbation being the rock-bottom dynamic" which drives dysfunctional behavior. Beck recalled that "years ago Ellis wrote in a book that MUSTerbation causes mental problems", but the proofreader caught the "error" and corrected it, with the resulting statement not at all what Ellis intended. Beck went on to point out that the whole concept truly dates to Karen Horney's "Tyranny of the Shoulds" (one of my most profound influences, too!). "I should do this and others should do that... and they're tyrannized!" Beck noted that "shoulds are not inherently bad. We should get up in the morning, for example. But...we need to focus on rigid thinking with *dysfunctional* shoulds". As opposed to Horney or Ellis, for himself Beck said that "our rock-bottom is *fear*. 'I must avoid this'.... With borderlines, they feel very vulnerable so they have a whole series of demands on other people. As a way of protecting themselves." He said he's known patients who have made a point of counting and cataloging a long list of "shoulds".
Question: What about outcome research suggesting a role for the therapeutic relationship?
Answer: The relationship is *obviously* important. It gets lost in the cognitive approach. When I wrote my first book, the very first chapter was 'The Therapeutic Relationship'. A sense of affiliation has been worked out as very important. But where does it come in? Do I need to prove how wonderful I am or is it a technical problem? One study demonstrated the positive regard did not come in until *after* the technique. Or in other words, after the patient begins to feel better and see the therapy is working, they begin to feel better and to feel better about the therapist."
Question: Any long-term studies? How are the results?
Answer:"With pharmacotherapy sometimes very good, but with cognitive therapy, for example with depression, the relapse rate is lower. With schiziphrenia too, if in combination with pharmacotherapy." A five year study at his Center found continued improved functioning at 5-years follow up, which is a "very strong track record".
Question: Any thoughts on the role of "mindfulness" as it impacts on treatment?
Answer: Based on research it does have an important role and it may even be that meditation, in general, does. We need to do a controlled study", one group receiving mindfulness training and teaching to "decenter", and compare it with a control group.
A question was posed: Noting that Ellis tends to deal with surface cognitions while Beck tends to go deeper, how might Beck deal with a client's consciousness of splitting, aside from addressing the "victim" aspects. For example, DBT [See http://www.fenichel.com/behavior.shtml for a basic primer] as I now understand it, looks at the issues of control but also tries to teach skills to see how everything is *not* black and white, and that sometimes there are middle shades which can be stress-reducing and acceptable. [My question, and happy he said it was a good one!] :-)
Beck noted that "the Borderline can switch momentarily" so a careful approach is required. One approach which in fact Ellis might use is to "dimensionalize", to make something more dimensional than a simple good/bad judgement. For example, "I'm a terrible mother because I forgot to give my child lunch today. I deserve to die". OK, maybe "I'd say, on a scale of 100, where are you" in terms of being terrible. She'd say 100. So then he'd ask, "What then would you be if you cut off your child's arms and legs?" The hope is to force some "dimensionalizing", teaching her to "think dimensionally rather than categorically". Beck added that he might also offer an alternative conclusion rather than the mother being terrible and deserving to die. "Maybe I just forgot" to pack lunch on that day.
Question: How have cognitive approaches worked with pain management?
Answer: "Let's say someone thinks (1) 'I have a terrible back ache. I can't work on the yard.' The more thinking about it, the more pain. The next step is (2) thinking 'I'm a bad husband'. Finally this escalates to (3) 'I'm a bad husband and I can't do *anything*, I'm no good.' And then often this person begins exclusively focusing on pain." He is exploring this and currently co-authoring a book about this.
Question:Will we have an integrated therapy in the future or is cognitive therapy going to be the therapy of choice?
Answer: I once wrote an article, "Cognitive Therapy: The Integrative Model". Where therapies won't meet is in the theory. If we have the notion that the world is round and others say it's flat, one result can be compromise: The world is oblong.
============
And that was that, Aaron Beck at the 111th APA convention, taking questions solo, while several times acknowledging Ellis too.
Coming soon: Cyberslacking (Young,
Regards from
:-)
Michael
![[Back]](file:///C:/Users/rober/AppData/Local/Temp/msohtmlclip1/01/clip_image006.jpg){kind=small}
![[New]](file:///C:/Users/rober/AppData/Local/Temp/msohtmlclip1/01/clip_image008.gif){kind=small}
Copyright
© 2003-2005 Michael Fenichel. All Rights Reserved.
www.fenichel.com/Beck2003.shtml
www.fenichel.com/Beck2003.shtml
Current
Research
|
|
Community
Based Cognitive Therapy for Suicide Attempters
|
|
|
|
Investigators: Aaron T. Beck, M.D. and Gregory K. Brown, Ph.D.
|
|
|
|
Project Director: Danielle Farabaugh, Psy.D.
|
|
|
|
This
randomized, controlled clinical trial aims to evaluate the efficacy and
effectiveness of a targeted 10-session cognitive therapy intervention
protocol for recent suicide attempters as delivered in “real world” community
settings by trained mental health professionals. Our plan is to randomize 140
recent suicide attempters to one of two conditions: (1) Enriched Care or (2)
Cognitive Therapy + Enriched Care. The Enriched Care condition consists of
assessment and referral services provided by our study case managers, in addition
to the usual care that these patients receive. The Cognitive Therapy
condition consists of a 10-session structured manualized treatment protocol
administered by a trained community mental health professional, in addition
to the enriched care services. The primary goal of the cognitive intervention
is to reduce subsequent suicide attempts by focusing treatment on the attempt
as well as decreasing psychological risk factors for suicidal behavior (i.e.,
depression, ideation, and hopelessness). Clinical trial data indicate that
the re-occurrence of subsequent suicide attempts can be reduced by
approximately 50% with the implementation of this cognitive program. Other
goals of the intervention include increasing patients’ adaptive use of social
support as well as use of and compliance with adjunctive medical, substance
abuse, psychiatric, and social services. |
|
|
|
Cognitive
Therapy for Suicide Attempters with Drug Dependence
|
|
|
|
Investigators: Aaron T. Beck, M.D., Gregory K. Brown, Ph.D., and Amy
Wenzel, Ph.D.
|
|
|
|
Project Director: Megan Spokas, Ph.D.
|
|
|
|
This study is a randomized, controlled
clinical trial comparing the effectiveness of the cognitive therapy
intervention described above when administered by addictions counselors. The
therapy is administered in community mental health centers and drug
rehabilitation facilities by counselors with at least a master degree.
Participants who are recent suicide attempters with concurrent drug
dependence are randomly assigned to receive either cognitive therapy plus usual
care or usual care alone.
|
|
|
|
Cognitive Therapy for Individuals with Borderline Personality Disorder
|
|
|
|
Investigators: Aaron T. Beck, M.D. and
Gregory K. Brown, Ph.D.
|
|
|
|
Project Director,
Rolando Vega, B.A.
|
|
|
|
This study
is a randomized, controlled clinical trial comparing cognitive therapy to
other psychotherapy in the treatment of borderline personality disorder with
suicidal ideation. All participants receive six months of weekly treatment
with a Ph.D. level psychologist. In a previous uncontrolled trial of the
cognitive therapy intervention, significant decreases in suicide ideation,
hopelessness, depression, and borderline personality disorder symptoms were
found at 12 and 18 month follow up assessments.
|
|
|
|
Cognitive
Therapy for Suicidal Older Men
|
|
|
|
Investigators: Aaron T. Beck, M.D. and
Gregory K. Brown, Ph.D.
|
|
|
|
Project Director: Sunil Bhar, Ph.D.
|
|
|
|
This is
a treatment development study which will determine the feasibility of
conducting a randomized, controlled clinical trial of cognitive therapy for
older men with suicide or death ideation. The goal of the study will be to
evaluate whether cognitive therapy is more efficacious for reducing suicidal
ideation than the treatment typically received by older men at a high risk
for suicide. Men, aged 60 and above, who are experiencing thoughts of
suicide, will be recruited from primary care medical practices. The
participants will receive twelve sessions of cognitive therapy with a Ph.D.
level psychologist. Once the study progresses to a randomized, controlled
clinical trial, participants will be randomly assigned to receive either
cognitive therapy plus usual care or usual care alone. |
|
|
|
Drug Abuse, Psychological Variables and Suicide Attempts
|
|
|
|
Investigators: Gregory K. Brown, Ph.D and Aaron T.
Beck, M.D.
|
|
|
|
Project Director: Megan Spokas, Ph.D.
|
|
|
|
The purpose of this study is to use an
existing database to examine prospectively the relationship among drug abuse,
clinical and psychological variables, and repeated suicide attempts. Detailed
clinical narratives of the suicide attempts are systematically analyzed to
develop a psychological model that describes the patterns that typically
precede a suicide attempt.
|
|
|
|
|
|
Albert Ellis
From Wikipedia, the free encyclopedia
Jump to: navigation,
search
|
Albert
Ellis
|
|
 |
|
|
Born
|
September 27, 1913
Pittsburgh |
|
Died
|
|
|
Residence
|
|
|
Nationality
|
|
|
Field
|
Clinical psychologist
|
|
Known for
|
|
|
Notable prizes
|
2003 award from the Association
for Rational Emotive Behaviour Therapy (UK), Association
for Behavioral and Cognitive Therapies 2005 Lifetime Achievement
Award, Association
for Behavioral and Cognitive Therapies 1996 Outstanding Clinician
Award, American Psychological
Accociation 1985 award for Distinguished professional
contributions to Applied Research, American Humanist Association 1971 award for
"Humanist of the Year", New
York State Psychological Association 2006 Lifetime Distinguished
Service Award, American Counseling Association 1988 ACA
Professional Development Award
|
|
Religious stance
|
Nontheistic humanism
|
Albert Ellis (September
27, 1913 – July 24, 2007) was an American psychologist
who in 1955 developed Rational Emotive Behavior Therapy.
He held M.A. and Ph.D. degrees in clinical psychology from Columbia University
|
Contents
[hide]
|
[edit] Early life
Ellis was born
to a Jewish family in Pittsburgh, Pennsylvania. He was the
eldest of three children. Ellis' father was a businessman, often away from home
on business trips who reportedly showed only a modicum of affection to his
children.
In his
autobiography, Ellis characterized his mother as a self-absorbed woman with a bipolar
disorder. At times, according to Ellis, she was a "bustling chatterbox
who never listened". She would expound on her strong opinions on most
subjects but rarely provided a factual basis for these views. Like his father,
Ellis' mother was emotionally distant from her children. Ellis recounted that
she was often sleeping when he left for school and usually not home when he
returned. Instead of reporting feeling bitter, he took on the responsibility of
caring for his siblings. He purchased an alarm clock with his own money and
woke and dressed his younger brother and sister. When the Great
Depression struck, all three children sought work to assist the family.
Ellis was sickly
as a child and suffered numerous health problems through his youth. At the age
of five he was hospitalized with a kidney
disease. [3]
He was also hospitalized with tonsillitis, which led to a severe streptococcal infection requiring
emergency surgery. He reported that he had eight hospitalizations between the
ages of five and seven. One of these lasted nearly a year. His parents provided
little or no emotional support for him during these years, rarely visiting or
consoling him. Ellis stated that he learned to confront his adversities as he
had "developed a growing indifference to that dereliction".
Albert Ellis had
exaggerated fears of speaking in public and during his adolescence he was
extremely shy around women. At age 19, already showing signs of thinking like a
cognitive-behavioral therapist, he forced himself to talk to 100 women in the
Bronx Botanical Gardens over a period of a month. Even though he didn't get a
date, he reported that he desensitized himself to his fear of rejection by
women.
[edit] Education and early
career
Ellis entered
the field of clinical psychology after first earning a Bachelor
of Arts degree in business from the City University of New York. He began a
brief career in business, followed by one as a writer. These endeavors took
place during the Great Depression that began in 1929, and Ellis found that
business was poor and had no success in publishing his fiction. Finding that he
could write non-fiction well, Ellis researched and wrote on human
sexuality. His lay counseling in this subject convinced him to seek a new
career in clinical psychology.
In 1942, Ellis
began his studies for a Ph.D. in clinical psychology at Teachers College, Columbia
University, which trained psychologists mostly in psychoanalysis.
He completed his Master of Arts in clinical psychology from Teachers College, Columbia
University in June 1943, and started a part-time private practice while
still working on his Ph.D
degree – possibly because there was no licensing of psychologists in New York
at that time. Ellis began publishing articles even before receiving his Ph.D.;
in 1946 he wrote a critique of many widely-used pencil-and-paper personality
tests. He concluded that only the Minnesota Multiphasic
Personality Inventory met the standards of a research-based instrument.
[edit]
Development of Rational Emotive Behavior Therapy (REBT)
After the
completion of his doctorate, Ellis sought additional training in
psychoanalysis. Like most psychologists of that time, he was interested in the
theories of Sigmund Freud. Shortly after receiving his Ph.D. in
1947, Ellis began a personal analysis and program of supervision with Richard
Hulbeck (whose own analyst had been Hermann
Rorschach, a leading training analyst at the Karen Horney Institute.) Karen
Horney would be the single greatest influence in Ellis's thinking, although
the writings of Alfred Adler, Erich Fromm
and Harry Stack Sullivan also played a role in
shaping his psychological models. Ellis credits Alfred
Korzybski[4]
and his book, Science and Sanity[5],
for starting him on the philosophical path for founding rational-emotive
therapy.
By January 1953
his break with psychoanalysis was complete, and he began calling himself a
rational therapist. Ellis was now advocating a new more active and directive
type of psychotherapy. By 1955 he dubbed his new approach Rational Therapy
(RT). RT required that the therapist help the client understand — and act on
the understanding —that his personal philosophy contains beliefs that lead to
his own emotional pain. This new approach stressed actively working to change a
client's self-defeating beliefs and behaviors by demonstrating their
irrationality and rigidity. Ellis related everything to these core irrational
beliefs such as "I must be perfect" and "I must be loved by
everyone". Ellis believed that through rational analysis, people can
understand their errors in light of the core irrational beliefs and then construct
a more rational position.
In 1954 Ellis
began teaching his new technique to other therapists, and by 1957 he formally
set forth the first cognitive behavior therapy by proposing
that therapists help people adjust their thinking and behavior as the treatment
for neuroses. Two years later Ellis published How to Live with a Neurotic,
which elaborated on his new method. In 1960 Ellis presented a paper on his new
approach at the American Psychological Association
convention in Chicago.
There was mild interest, but few recognized that the paradigm set forth would
become the zeitgeist within a generation. At that time the prevailing interest
in experimental psychology was behaviorism,
while in clinical psychology it was the psychoanalytic
schools of notables such as Freud, Jung, Adler,
and Perls.
Despite the fact that Ellis' approach emphasized cognitive, emotive, and
behavioral methods, his strong cognitive emphasis provoked almost everyone with
the possible exception of the followers of Alfred
Adler. Consequently, he was often received with hostility at professional
conferences and in print.[6]
Despite the slow
adoption of his approach, Ellis founded his own institute. The Institute for
Rational Living was founded as a not-for-profit
organization in 1959. By 1968 it was chartered by the New
York State Board of Regents as a training institute and
psychological clinic. This was no trivial feat as New York State had a Mental
Hygiene Act which mandated "psychiatric management" of mental health
clinics [7] Ellis had broken ground by founding an institute purely
based on psychological control and principles.
In 1965 Ellis
published a book entitled Homosexuality: Its Causes and Cure, which saw
homosexuality as a pathology and therefore a condition to be cured. He was
writing a decade after the Kinsey Reports, which had found homosexual behavior
was relatively common in both men and women. In 1973 the American Psychiatric Association
declared that homosexuality was no longer a mental disorder and thus not
properly subject to cure and in 1976 Ellis repudiated his earlier views in Sex
and the Liberated Man, going on to become strongly supportive of the rights
of gays, lesbians, and others.
In 2003 Ellis
received an award from the Association for Rational Emotive Behaviour Therapy
(UK
[edit] Albert Ellis and
religion
In his book Sex
Without Guilt, Ellis expressed the opinion that religious restrictions on
sexual expression are needless and often harmful to emotional health. He
famously debated religious psychologists, including O. Hobart Mowrer
and Allen Bergin, over
the proposition that religion contributes to psychological distress. Because of
his forthright espousal of a nontheistic humanism, he
was recognized in 1971 as Humanist of the Year by the American Humanist Association. Ellis
most recently described himself as a probabilistic atheist, meaning that while
he acknowledged that it is impossible to be certain that there is no god, he
believed that the likelihood that a god exists is so small that it was not
worth his [or anyone else's] attention [8].
While Ellis’
personal atheism remained consistent, his views about the role of religion in
mental health changed over time. In early comments delivered at conventions and
at his institute in New York City, Ellis overtly and often with
characteristically acerbic sarcasm stated that devout religious beliefs and
practices were harmful to mental health. In The Case Against Religiosity,
a 1980 pamphlet published by his New
York
Ellis was
careful to state that REBT is independent of his atheism, noting that many
skilled REBT practitioners are religious, including some who are ordained
ministers. In his later days he significantly toned down and re-evaluated his
opposition to religion. While Ellis maintained his atheistic stance, proposing
that thoughtful, probabilistic atheism is likely the most emotionally healthy
approach to life, he acknowledged and agreed with survey evidence suggesting
that belief in a loving God is also psychologically healthy [9].
Based on this later approach to religion, he reformulated his professional and
personal view in one of his last books The Road to Tolerance, and he
also co-authored a book with two religious psychologists, Stevan Lars Nielsen
and W. Brad Johnson, describing principles for integrating religious material
and beliefs with REBT during treatment of religious clients, Counseling and
Psychotherapy with Religious Persons: A Rational Emotive Behavior Therapy
Approach.
[edit] Later life
In 2004 Ellis
was taken ill with serious intestinal problems, which led to hospitalization
and the removal of his large intestine. He returned to work after a few months
of being nursed back to health by Debbie Joffe, his assistant, who later became
his wife.
In 2005 he was
subjected to removal from all his professional duties, and from the board of
his own institute after a dispute over the management policies of the
institute. Ellis was reinstated to the board in January 2006, after winning
civil proceedings against the board members who removed him. [10]
On June 6, 2007, lawyers acting
for Albert Ellis filed a suit against the Albert Ellis Institute in the Supreme
Court of the State of New York 45 East 65th
Street
In April 2006,
Ellis was hospitalized with pneumonia, and spent more than a year shuttling between
hospital and a rehabilitation facility. He eventually returned to his residence
on the top floor of the Albert Ellis Institute. His final work, a textbook on
Personality Theory, was completed shortly before his death. It will be
posthumously published by Sage Press in early 2008.
[edit] Published works
This list is incomplete; you can help by expanding
it.
·
The
Folklore of Sex, Oxford , England
·
The
Homosexual in America
·
The
American Sexual Tragedy.
NY: Twayne, 1954.
·
Sex
Life of the American woman and the Kinsey Report. Oxford ,
England
·
The
Psychology of Sex Offenders. Springfield , IL
·
How
To Live With A Neurotic. Oxford , England
·
Sex
Without Guilt. NY:
Hillman, 1958.
·
The
Art and Science of Love.
NY: Lyle Stuart, 1960.
·
A
Guide to Successful Marriage, with Robert A. Harper. North
Hollywood , CA
·
Creative
Marriage, with Robert A.
Harper. NY: Lyle Stuart, 1961.
·
The
Encyclopedia of Sexual Behavior, edited with Albert Abarbanel. NY: Hawthorn,
1961.
·
The
American Sexual Tragedy,
2nd Ed. rev. NY: Lyle Stuart, 1962.
·
Reason
and Emotion In Psychotherapy. NY: Lyle Stuart, 1962.
·
Sex
and the Single Man.
·
If
This Be Sexual Heresy.
NY: Lyle Stuart, 1963.
·
Nymphomania:
A Study of the Oversexed Woman, with Edward Sagarin. NY: Gilbert Press, 1964.
·
Homosexuality:
Its causes and Cures. NY:
Lyle Stuart, 1965.
·
Is
Objectivism a Religion.
NY: Lyle Stuart, 1968.
·
Murder
and Assassination, with
John M. Gullo. NY: Lyle Stuart, 1971.
·
A
Guide to Rational Living.
Englewood
·
Handbook
of Rational-Emotive Therapy, with Russell Greiger & contributors. NY: Springer Publishing, 1977.
·
Overcoming
Procrastination: Or How to Think and Act Rationally in Spite of Life's
Inevitable Hassles, with
William J. Knaus. Institute for Rational Living, 1977. ISBN
0917476042.
·
Overcoming
Resistance: Rational-Emotive Therapy With Difficult Clients. NY: Springer Publishing, 1985. ISBN
0826149103.
·
When
AA Doesn't Work For You: Rational Steps to Quitting Alcohol, with Emmett Velten. Barricade Books,
1992. ISBN
0-942637-53-4.
·
The
Art and Science of Rational Eating, with Mike Abrams and Lidia Abrams. Barricade Books, 1992. ISBN
0-942637-60-7.
·
Reason
and Emotion In Psychotherapy, Revised and Updated. Secaucus ,
NJ
·
How
to Keep People from Pushing Your Buttons, with Arthur Lange. Citadel Press, 1995. ISBN
0-8065-1670-4.
·
Alcohol:
How to Give It Up and Be Glad You Did, with Philip Tate Ph.D. See Sharp Press, 1996. ISBN
1-884365-10-8.
·
How
to Control Your Anger Before It Controls You, with Raymond Chip Tafrate. Citadel Press, 1998. ISBN
0-8065-2010-8.
·
Optimal
Aging: Get Over Getting Older, with Emmett Velten. Chicago
·
Making
Intimate Connections: Seven Guidelines for Great Relationships and Better
Communication, with Ted
Crawford. Impact Publishers, 2000. ISBN
1-886230-33-1.
·
The
Secret of Overcoming Verbal Abuse: Getting Off the Emotional Roller Coaster and
Regaining Control of Your Life, with Marcia Grad Powers. Wilshire Book Company, 2000. ISBN
0-87980-445-9.
·
Counseling
and Psychotherapy With Religious Persons: A Rational Emotive Behavior Therapy
Approach, with Stevan
Lars Nielsen and W. Brad Johnson. Mahwah , NJ : Lawrence
·
Overcoming
Destructive Beliefs, Feelings, and Behaviors: New Directions for Rational
Emotive Behavior Therapy.
Prometheus Books, 2001. ISBN
1-57392-879-8.
·
Feeling
Better, Getting Better, Staying Better: Profound Self-Help Therapy For Your
Emotions. Impact
Publishers, 2001. ISBN
1-886230-35-8.
·
Case
Studies In Rational Emotive Behavior Therapy With Children and Adolescents,
with Jerry Wilde. Upper Saddle River ,
NJ
·
Overcoming
Resistance: A Rational Emotive Behavior Therapy Integrated Approach, 2nd ed. NY: Springer Publishing, 2002. ISBN
082614912X.
·
Ask
Albert Ellis: Straight Answers and Sound Advice from America
·
Dating,
Mating, and Relating. How to Build a Healthy Relationship, with Robert A. Harper. Citadel Press
Books, 2003. ISBN
0-8065-24-54-5
·
Rational
Emotive Behavior Therapy: It Works For Me -- It Can Work For You. Prometheus Books, 2004. ISBN
1-59102-184-7.
·
The
Road to Tolerance: The Philosophy of Rational Emotive Behavior Therapy. Prometheus Books, 2004. ISBN
1-59102-237-1.
·
Rational
Emotive Behavior Therapy: A Therapist's Guide (2nd Edition), with Catharine MacLaren. Impact
Publishers, 2005. ISBN
1-886230-61-7.
·
How
to Make Yourself Happy and Remarkably Less Disturbable. Impact Publishers, 1999. ISBN
1-886230-18-8.
·
Theories
of Personality, with Mike Abrams,
and Lidia Abrams. New York
·
Rational Emotive
Behavioral Approaches to Childhood Disorders · Theory, Practice and Research
2nd Edition. With Michael E. Bernard (Eds.). Springer SBM, 2006. ISBN
978-0-387-26374-8
[edit] See also
[edit] References
2.
^ Anthony Ramirez (December 10, 2006) "Despite Illness and Lawsuits, a Famed
Psychotherapist Is Temporarily Back in Session". New York
Times. Retrieved on December 16,
2006
5.
^ Alfred Korzybski "Science
and Sanity An Introduction to Non-Aristotelian Systems and General
Semantics", Preface by Robert P. Pula, Institute of
General Semantics, 1994, hardcover, 5th edition, ISBN 0-937298-01-8
8.
^ Nielsen, Stevan Lars &
Ellis, Albert. (1994). "A discussion with Albert Ellis: Reason, emotion
and religion", Journal of Psychology and Christianity, 13(4),
Win 1994. pp. 327-341
9.
^ Ellis, Albert. (2000). "Can
rational emotive behavior therapy (REBT) be effectively used with people who
have devout beliefs in God and religion?", Professional Psychology:
Research and Practice, 31(1), Feb 2000. pp. 29-33
[edit] Further reading
·
Albert
Ellis, Mike
Abrams, and Lidia Abrams. Theories of Personality. New York
[edit] External links
No hay comentarios:
Publicar un comentario