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Aaron Beck, Glen Gabbard Share Insights on Psychotherapy Approaches
“When I’m with a patient, I don’t care too much about theory. I want to help the patient. It’s much better to take a flexible approach.” “Research can help us know which therapies work best for which patient. . . . People need to understand themselves, but if they have a few techniques and tools [for dealing with their lives], so much the better.” Did a psychoanalyst or a cognitive therapist utter these statements? The second comment, emphasizing people’s need to understand themselves, was said by Aaron Beck, M.D., the renowned father of cognitive-behavior therapy; the first—eschewing theory and advising a “flexible approach”—came from Glen Gabbard, M.D., whose name has become synonymous with psychodynamic therapy. The two psychotherapy masters, who have many decades of experience between them, sat down for an informal, friendly, and discursive exchange at the Opening Session of APA’s 2012 annual meeting in Philadelphia. The conversation was titled, “Cognitive Therapy and Psychodynamic Therapy: More Alike Than Different?” In the session, moderated by APA President John Oldham, M.D., Beck and Gabbard agreed that published research on psychotherapy has increasingly demonstrated its effectiveness as an evidence-based treatment for many psychiatric disorders, in categories ranging from mood and anxiety disorders to personality disorders. But psychotherapy, even “manualized,” standardized psychotherapy, comes in many varieties. Not uncommonly, adherents to a form of psychotherapy advocate for its unique effectiveness, as if the field is a racetrack where there is only one winner. In this spirit, the most frequent “either/or” comparison is between cognitive therapy and psychodynamic therapy, often viewed as radically different treatment approaches. Different in theoretical and practical approaches, the two therapies nevertheless both alter neurochemistry and hence human understanding and behavior. “Neuropsychiatric research has demonstrated that psychotherapy changes the brain,” Gabbard said. “This legitimizes the treatment for skeptics.” |
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