Aaron T. Beck, M.D. (1921-2021)

On November 2, 2021, Aaron T Beck who developed Cognitive Behavior Therapy passed away. Much has been written about him in the past week as an extraordinary clinician, scientist, mentor, colleague, and person. We are adding our voices to this chorus, particularly to acknowledge Dr. Beck’s extraordinary devotion to mechanistic science, including his support for the neuroscience underlying CBT. Beginning as a neurology resident in the 1940’s, Dr. Beck was never far from the brain, but early on noted that “in neurology there wasn’t much you could do in terms of treatment” at that time (Kaylin, Yale Medicine, 2004). That said, he never gave up looking for ties. Dr. Beck was particularly vocal about the neural basis of his cognitive model and CBT in the past 15 years, e.g., as exemplified by his 2008 American Journal of Psychiatry paper on the neural correlates of the cognitive model, 2011 Nature Reviews Neuroscience paper (Disner et al, 2011) on neural mechanisms of the cognitive model, and 2013 article (Hofmann et al, Behavior Therapy) on the science of Cognitive Therapy. His 2010 book, Cognitive Therapy of Anxiety Disorders: Science and Practice, with David Clark, has a poignant chapter on neurophysiology. His seminal Clinical Psychological Science paper (Beck & Bredemeier, 2016) unifying clinical, cognitive, biological, and evolutionary perspectives was a particularly integrative step forward for the field. His support for, and interest in neuroscience did not end in his myriad publications. Dr. Beck would frequently speak with neuroscientists in the hallways of ABCT and in private emails about the biology of the cognitive model and treatment, chose neuroscientists as scholars to train at the Beck institute, and would introduce new therapists to the strong place of neuroscience in his conception of CBT, as recently as a July 2021 Beck Institute training workshop on the subject. When he heard about neuroscience-based interventions consistent with the cognitive model, Dr. Beck would want to try them for himself. Dr. Beck’s extraordinary lifelong journey in the cognitive model gave him unique insight into both the potential and challenges of incorporating neuroscience into treatment. For example, when asked what it would take for people to use neuroimaging to see whether they are likely to respond to CBT, he immediately considered an implementation science perspective beginning with the need to get clinicians on board with providing  empirical assessments such as the BDI. So many of us have felt supported, personally and professionally, by Dr. Beck in our integrative and translational journeys, spawning a next generation of scientists committed to understanding CBT from a neuroscience perspective. Dr. Beck has left us in a place where knowledge, technologies, and inspiration increasingly support a strong pathway to incorporating neuroscience in the future of CBT. We, of the NTTR, are intent on carrying on his work in advancing the neuroscience of the cognitive model, understanding of how CBT affects the brain, and how we can capitalize on neuroscience in next generation interventions.