Aaron Beck Wins Lasker Award

Aaron Beck, generally credited as the father of cognitive behavioral therapy, was awarded the Lasker Prize last week. It's not common for a psychiatrist, which Beck is, to win this nation's premiere medical research award. In fact, it so uncommon that the New York Times saw fit to headline its article "Psychiatrist Is Among Five Chosen For Medical Award." The others were biologists and such.

But it does happen, although usually to some flavor of research neuroscientist, as opposed to straight-up psychiatrists. For example, Seymour Kety, who did important genetic work in schizophrenia and the mapping of cerebral blood flow, won a Lasker in 1999. He was NIMH's first scientific director and is credited as being one of the prime movers in getting psychiatry away from the squishy land of psychoanalysis and onto the dry land of brain-based science. Not that the latter works that much better than the former, but I digress.

It's long overdue recognition for Beck from the medical academy, especially since many in the psych research world pooh-pooh the use of CBT in treating mental illnesses. Whether you can read into this that the medical research elite are turning their eyes in other directions when it comes to addressing mental illnesses is not a place I have the expertise to go.

The reality is that CBT has not been used widely in this country, because America likes its paradigms all or nothing and the dominant paradigm is the pharmacological one. As a result, CBT is not widely available (there are a lot of kissing cousin therapies out there, but none are quite as hard-assed as CBT is about making people address thought patterns) and can be pricey where it is. Nor is CBT as well-researched for its effectiveness as it ought to be.

Where it has been researched, it's generally been found to be effective in treating depression, with or without adjunctive psych meds. Good for depression is what most people will tell you about CBT. But there is some evidence out there that in can be useful in addressing schizophrenia, especially for patients for whom meds aren't cutting it (the old half-working phenomenon). There is also evidence of its efficacy in treating bipolar disorder.

But again there hasn't been nearly enough study of CBT to say how effective it really is. And there are others in the research world who have attacked CBT and the few studies of its effectiveness by calling the studies poorly-constructed. All's fair in love and war, I guess.

As I have noted on this blog on numerous occasions, psych researchers in Britain are now openly questioning the effectiveness of the psychopharmacological paradigm, particularly in treating depression, and that nation's state health system is starting to back off the use of anti-depressants and beginning to embrace the use of CBT. We'll see how that plays out over time.

As I have also noted on this blog to the point of broken-recordom, the molecular era that Kety ushered into being hasn't proved out the way any of us would like it to. Still, American psych researchers, mental health advocates, policy makers and the media all act as if taking mental illness to the level of mental wellness is simply a matter of everyone taking their meds, better meds being developed and the brain being better understood. That's silly. We've been going down that path to the exclusion of any other way of thinking for almost two generations now.

Has anyone got some staggering population-wide results that show just how the current paradigm has redeemed the mentally ill over the long-term? I am not talking about just keeping someone alive and now-psychotic, for example, by doping them to the max. I am talking in lives lived well and lives rehabilitated above the status of janitor. We've been doing shit this way for closing on 30 years. Where are the results? Can anyone show me where the rate of suicide has radically decreased in this country in the last 50 years?

Beck is now 85-years-old. He deserves to be awarded the Nobel Prize in Medicine before he dies.