ABSTRACT
The process of identifying the speci®c problem areas in cognitive therapy began one day during the late 1950s when Beck, then still practising psychoanalytic therapy, was listening to a client talk about her sexual experiences (Beck, 1976). She had previously done this without being upset but now suddenly expressed much distress and shed tears. An orthodox analytic stance would have suggested that the distress came from surfacing repressed feelings or memories, and yet she revealed nothing new. Curious, Beck began to ask her about her experiences and found that alongside her thoughts about her sexual experiences was a `second stream' of thoughts, such as `He will think badly of me' and `I am boring him.' These types of thoughts Beck came to de®ne as `negative automatic thoughts' (NATs), and he began to ®nd that they were omnipresent in the way that clients, when asked, described the inner process while experiencing psychological distress. The idea of a second stream of thoughts is similar to Albert Ellis's view, which sees clients as quite often having `insane sentences' running parallel to their
thought may systems, `impli-systems can help us understand con¯icts between `head and heart' ± e.g., a client may say, `I know I should give up, but I feel that I should go on.'
