I first met Dr. Aaron T. Beck, the father of short-term psychotherapy who died at 100 on Sunday, during a psychiatry conference, at one of those awkward pre-launch cocktail parties that science writers around the world know too well.
It was the mid-2000s. I was a newly hired New York Times reporter, and Beck was by then a living legend, the closest thing to a celebrity in psychiatry this side of Freud or Jung. I knew what he looked like – the bowtie, the thick white hair, the tailored suit – but I was busy doing what I usually did at those meet-and-greets, trying to find a mid-career attendee who liked to laugh and could act as my guide through the morass of science presentations to come.
I felt a hand on my arm. It was Beck. In a reversal of the usual etiquette, he introduced himself to me and suggested we talk. He guided me into a neighboring conference room and then there we were, two strangers sitting across from each other in those straight-backed conference chairs, alone in that cavernous space.
What to say? I was more anxious than awestruck; I was two martinis deep and absurdly out of my depth in such company. Skeptical, too: Scientists often cozy up to the NY Times, for obvious reasons. Beck seemed to appreciate all of this. He sat back, crossed his legs, smiled and began asking me questions about myself. If I was wondering what on earth landed us in this room, so was he. How did I get into journalism? Why mental health? What sequence of events landed me at the Times? Listening, mostly.
He was playing the long game, at one level. In this era of science hype, where both researchers and university PR departments bombard reporters with “discoveries” that “change the way we think about” whatever, even someone as prominent as Beck had to make allies in the press. Yet looking back, I see that he was also showing me his quiet warmth, curiosity and patience – his presence. That presence was genuine, and it was central to what made him so effective in treating people in pain, and so beloved.
But I came to understand that it hid another quality, one that I believe was equally critical to his enduring influence and importance.
This quality took years to show itself, at least to me. Beck and I settled into a tacit understanding, of sorts. For my part, I took seriously every research finding he sent me and spent time thinking about whether it could be a story. About half the time, it was. In exchange, he was on call for me anytime I needed a Big Voice to put some relevant research by others in context.
Neither of us abused this relationship, and I remarked on two disarming qualities that only reinforced my respect. One was that he never hyped his work; he simply notified me, provided a sentence of context, and signed off (“Best, ATB.”) The other was that, every time, he insisted that I talk to his collaborators and especially his students. He wanted them quoted, not himself. In a world of towering science egos, this was rare indeed.
Along the way, I came to understand the depth of what he had accomplished. He and Albert Ellis, a New York psychologist working independently, developed the architecture for what came to be known as cognitive behavior therapy, or CBT. The therapy prompts people to deploy common-sense logic to defuse what Dr. Beck called “automatic thoughts” – self-defeating presumptions, like “I’m terrible at relationships,” or “I’ll always come up short.” The approach was anathema to Freudian analysts, who reigned over the psychiatric establishment well into the 1980s.
By the time I got my ticket punched at the New York Times, Beck had coauthored dozens of trials, demonstrating that his techniques eased mood disorders like depression and anxiety. He had then proceeded to adapt the principles to address a score of other diagnoses, including insomnia, eating disorders, addictions and panic attacks. He had trained thousands of younger psychologists in more than 130 countries, either at the University of Pennsylvania, where he spent his career, or through the nearby Beck Institute, a nonprofit run by his daughter, Judith. He had traveled the world, performing in auditoriums filled with clinicians –conducting CBT in real time, with a consenting (anonymous) adult in distress.
“It was something to see,” said David Clark, a professor of psychology at Oxford University. “He was the consummate clinician. He was gentle with people, he listened to what they said and believed it.” CBT became the centerpiece of a nationwide talk therapy service in England that Clark developed and helped implement.
The first evidence that Beck was in fact human, and not the embodiment of angelic humility, came when I wrote about a review of the effectiveness of longer-term therapy, including Freudian analysis. Beck’s entire career was an open revolt against psychoanalysis, and by the 2000s he was taking victory laps. He had rigorous studies showing that CBT was effective against mood problems; psychodynamic therapies, by contrast, were in retreat. His work was ascendant, in an era when psychiatrists were trying to move the field to a more scientific footing, based in randomized, controlled trials.
But the review was interesting, for a couple reasons. One was that it existed at all. It was a meta-analysis, a computational summing-up of effect sizes from scores of studies of longer-term therapy. More importantly, for me, was where the review appeared: in the Journal of the American Medical Association, a voice of the medical establishment which rarely published anything on psychiatry, never mind Freudian therapy.
I bit. I emphasized not so much the paper’s conclusion (that longer-term therapy was effective) but what the publication represented. Long pronounced dead by the modern medical establishment, Freudian therapy might have a heartbeat. All caveats about the dicey nature of study “findings” were included.
Beck was furious. He sent a terse and nasty (for him) email, asking in effect why I would pay any attention to such obvious charlatanism. I responded, explaining my reasoning. He didn’t bother to answer. He went dark, for many months. I was sure I’d lost him for good, over something I considered minor. He didn’t reengage for at least a year. That was how long it took him, apparently, to forgive me.
The second clue to how naïve I had been in my judgment of Beck came a few years later, after the Times launched a video obituary project. I loved the idea: older, prominent people went on camera, talking about their life and contributions, for posthumous release. (In one, the humorist and columnist Art Buchwald barked, “If you’re watching this, I’m dead!”)
I thought Beck would be perfect. His life and work had had a heroic element, after all, given that he had bucked a then-entrenched Freudian establishment. Freudian analysis is a guild, and its defenders were and are particularly adept at firing arrows precisely where they’ll draw the most blood. Beck had worked for years, well into his 40s, in relative obscurity, with few but his wife, Phyllis, believing in and listening to him. When he was confident enough to publicly described his therapeutic approach, he was met with scorn. His perceived betrayal was hung around his neck, as some kind of character flaw. Some analysts suggested that he was “not well analyzed,” the ultimate insider’s put-down, suggesting he was not competent to help others because he didn’t fully know himself through analysis.
That would be a great story, I thought, and in 2009, back on good terms again, I wrote to him, proposing that he sit for a video obit. He was approaching 90 at the time; surely he had to be thinking about his legacy. Again, he didn’t respond. I waited, for months, assuming he was thinking about it. Nothing. Then I tried again, this time speaking with his assistant and making sure he got the message. Again, no reply.
I began worrying about his health. He was in a wheelchair, and I knew he was not going into the office very often, if at all. I decided to call Martin Seligman, a longtime colleague at the University of Pennsylvania, and ask him what was going on.
Beck was fine, Seligman said. Still doing great work. “In fact, I have lunch with him once a month, near where he lives. Do you want to join us next month?”
So it was that I sat down with Beck and Seligman at a deli in suburban Philadelphia. We talked, over sandwiches and sodas, Beck softly relating how he’d launched a project to use CBT to help older people with late-stage schizophrenia (almost no one does this), and people battling drug addiction and suicidal urges (ditto).
Seligman, trying gamely to assist me, kept prompting his friend to reminisce, to philosophize, to reflect on his life. That is, until Beck lifted his head – and glared, first at Seligman, then at me. He wasn’t going along with the program. He wasn’t dying. He was alive.
Startled, Seligman put his hand on the table and said the equivalent of, “So how about those Phillies. You think they’ll make the playoffs?”
Beck went silent. The lunch was over. And there it was again – the fury, the hard eyes. All those years in the cold. All those years, with only Phyllis believing in him, both uncertain whether the work would come to anything. And then, on top of it, the insults and mockery he endured later.
That kind of exclusion can make a person embittered, defeated – or implacable. Beneath the quiet warmth, Aaron Beck was ready to go to war, for all the others who’d endured some of what he must have.
