溫故知新 Old wisdom, today’s insight — ONGO
Cognitive Therapy: Thoughts Make Emotions, Not the Other Way Around
Aaron Beck 1960s — leaving psychoanalysis to discover automatic thoughts
A Freudian Dissident
In the 1950s, Aaron Beck, a psychiatrist at the University of Pennsylvania, was a psychoanalyst. He sought to validate Freud's theory that depressed patients harbored "internalized anger." Beck had his patients record their dreams and analyzed their free associations. However, the data did not align with the Freudian hypothesis. Instead of anger, patients' dreams were filled with negative self-perceptions, seeing themselves as failures, incompetent, or abandoned. Beck was initially perplexed. Then, during a session when a patient suddenly became despondent, he asked her, "What thought just came to your mind?" She replied, "I think you find me boring."
The Discovery of Automatic Thoughts
Beck then instructed his patients to keep diaries, noting down any thoughts that came to mind just before they felt depressed. A clear pattern emerged: patients were automatically, rapidly, and unconsciously repeating the same negative thoughts. Beck named these "automatic thoughts." He hypothesized that the root cause of depression was not unconscious anger, but rather these negative thought patterns operating just below the level of conscious awareness. In 1967, he published his seminal work, "Depression: Causes and Treatment." The psychoanalytic community vehemently opposed his ideas, and Beck was effectively ostracized from his own school of thought.
Changing Thoughts Changes Emotions
Beck's therapeutic approach was straightforward. After patients wrote down their thoughts, he guided them to examine those thoughts against evidence. When a thought like "I am a failure" arose, questions would follow: "Is there truly evidence that I have failed in every aspect?" "What have I done well in the past month?" "Would another person in the same situation judge themselves so harshly?" This process, known as cognitive restructuring, proved highly effective. By the 1970s, controlled clinical trials demonstrated that CBT yielded results equivalent to or even superior to medication. Cognitive Behavioral Therapy (CBT) subsequently became a primary treatment for depression, anxiety disorders, PTSD, and obsessive-compulsive disorder. It is also a core model for mental health centers and psychological counseling in South Korea. Aaron Beck passed away peacefully in 2021 at the age of 100, leaving behind a legacy of countless individuals who found recovery through his work.
Understanding Thought Through Hanja
The Chinese character "念 (nyeom)" combines "今 (geum)," meaning "now" or "present," with "心 (sim)," meaning "heart" or "mind." It signifies "what comes to mind in the present moment." In Book 7 of the Analects, Confucius states: "君子坦蕩蕩, 小人長戚戚" — "The superior person is open and at ease; the inferior person is constantly anxious." When his disciple Zigong inquired how one could achieve such openness, Confucius taught the importance of examining one's own mind. Beck's instruction for patients to keep diaries—to observe and examine their own "nyeom"—is, in essence, a clinical application of the self-reflection taught by Confucius 2,500 years ago. While "nyeom" cannot be stopped from arising, one can choose whether to be carried away by it or to observe it from a distance. This capacity for choice is the very freedom of the mind.
