The Third Wave of Therapy

Beck hypothesizes that the cognitive parts of the therapy—challenging thoughts, developing new beliefs—add value to the changes in everyday behavior and routine that the therapy encourages. But he acknowledges that no trial has proved that. In fact, a team at the University of Washington has shown in two studies that the cognitive elements of the therapy add nothing. Among more severely depressed patients, behavioral techniques like setting up new routines and scheduling activities worked as well as an antidepressant and significantly better than cognitive therapy. When I asked Beck about the studies, he called them "intriguing" but—since no other lab has yet produced similar results—"not yet proven."

Reno, Nev., does not immediately come to mind as home base for a mindfulness guru, but Hayes has taught at the University of Nevada campus in Reno for 20 years. Driving to his house took me past a number of sad old casinos where you can find haggard gamblers trying their luck at 6 a.m., the lights from the slots lambent in their expressionless eyes.

Hayes is tall, completely bald and fond of odd sartorial combinations. One day when we met, he wore black leather shoes with an unfashionably large buckle, gray pants that were too short and a gigantic double-breasted jacket. He once lived on a commune, and he still wears an oversize ring that he said was made by Zuni Indians. "I traded it for some contraband in the '60s in Taos," he told me. His critics will be delighted to learn that Hayes attended two est trainings in Atlanta years ago. He admits that he also dabbled in meditation seminars, "eco-freak" rallies, druggy parties and all the other appurtenances of a radical '70s lifestyle.

Although he has an anti-Republican bumper sticker on his car, the car is a red-state Chevrolet Avalanche. The most prominent feature of his office is a set of gym equipment, and he has one of those Sharper Image massage chairs. His days off are spent gurgling over his fourth child, 5-month-old Steven Joseph, or—not infrequently—building additions to his house. These days Hayes is a bit embarrassed by the excesses of his youth.

Hayes' reputation as more mystagogue than scientist is reinforced partly by how he and his colleagues teach ACT workshops: they do the hard science, but they also ask the participating therapists, usually roomfuls of Ph.D.s, to do things like repeat the word milk over and over (to show how meaningless words can become—try it with I'm depressed). And although Hayes teaches mindfulness at ACT workshops around the world, he epitomizes "the absent-minded professor," according to Barlow, the psychologist who taught Hayes at Brown in the '70s. Hayes is famous at Nevada-Reno for passing students in the hall without so much as a nod. But it's worse than they think. According to Hayes' wife Jacqueline Pistorello, in December the couple went to the mall to buy Christmas gifts. They split up so they could shop for each other, but at one point Hayes literally bumped into his wife. He didn't notice her, even though she was cradling their newborn in her arms. ("I call those his black holes," says Pistorello, a clinical psychologist for the university. Hayes sheepishly explains: "I was just in my place.")

Pistorello is Hayes' third wife; his panic attacks began not long after he and his first wife separated in 1977. Hayes grew up in El Cajon, Calif., as the younger son of parents who had a loving but somewhat volatile marriage. His Irish-Catholic father was a salesman who washed out of semi-pro baseball and drank too much. Hayes says his first panic attack was "not too different from some spaces that are very old, in the sense of watching destructive things happen at home—hide under the bed while Dad throws things." Hayes' father died in the '70s; his mother is remarried and lives in Arizona. Ruth Sundgren describes the young Hayes as a sensitive kid who always said things like, "Mom, can I get you a pillow?"

It took Hayes about three years to realize that his panic disorder got worse when he tried to process it cognitively. "Unfortunately, the wrong things that you need to do to build [panic disorder] are the logical, sensible, reasonable things—focus on the situations in which it might happen, and try to control them. Well, you might as well put your finger in a wall socket."

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