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The Top 10 - Page 7

 

It was a revelation—her anxiety and need to impress people may have had roots in early childhood, but it was clearly maintained by her constant belief that she bored people. Once Beck knew this, he could help her examine the evidence for her entrenched idea, and when it was found to be entirely lacking—all the evidence pointed in the opposite direction—she could begin to see that she was, in fact, quite an interesting person. It was, apparently, the key that cured her depression.

Beck began having his other depressed patients sit up and face him (rather than lie down on the couch), so he could see their expressions and body language, and asked them what they were thinking. All responded by saying things like, "I'm stupid," or "I'm boring," or "I'm a terrible failure." The constant drip, drip, drip of these automatic thoughts poisoned their entire existence. Amazingly, however, as Beck recalled in an interview with Sidney Bloch in 2004 for the Australian and New Zealand Journal of Psychiatry, "when I focused on these negative thoughts, patients got better fairly soon, in 10 or 12 sessions." From these almost incidental beginnings, a mighty empire grew.

Enthusiasts for CBT have often been subject to accusations that they do therapy by rote, and give short shrift to all the old virtues of therapy, like compassion, empathy, and the like. Not Beck, however. "Therapists who are good at the technical end of cognitive therapy fall flat on their faces when it comes to the more complex case," he said in the same interview. "Empathy, sensitivity, considerateness—together with the ability to put them together with technical aspects—is the combination needed." So, it appears, the father of cognitive therapy—the most "mental" of therapies—is another Rogerian!

3. Salvador Minuchin

Salvador Minuchin's background is as unusual for a therapist as the family therapy methods he pioneered in the 1960s and 1970s. Born in 1921, he was a street-fighting Jewish kid in the anti-Semitic culture of Argentina. As a college student, he was jailed for three months for protesting the government of Juan Perón. He served as a doctor in the Israeli army during that country's first wars. Later, studying psychoanalysis in New York City, he worked with black and Hispanic street toughs, whom he had the background to understand.

The traditional therapeutic techniques he'd been taught didn't work with his young clientele. To reach these rebellious and unhappy youths, Minuchin hit upon the idea of treating them not individually, but with their entire families. He and his colleagues had no theories to draw upon in doing this—they observed and acted on their observations, experimenting audaciously. In Minuchin's words, they "gradually articulated a correct method of working. We weren't dealing with the way people think about relationships, but the relationships themselves." Using this new approach, Minuchin and his colleagues changed the lives of youngsters who'd previously been considered clinically unreachable.

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