Had Tony Soprano been under his care, Aaron Beck says he could have cured his panic attacks in two sessions.

Bada-bing that, Sigmund Freud.

Instead, Dr. Melfi kept the Sopranos mob boss on the couch for years with traditional psychoanalysis, delving into his childhood and deconstructing his dreams.

Beck, the University of Pennsylvania psychiatrist who founded the burgeoning field of cognitive therapy, says he and Tony together would have set up short-term goals, then strategized behavior changes to attain them.

A therapeutic drive-by.

As for Dr. Melfi, "she was just following the old road - it's all due to his mother - rather than getting from him what he feels and thinks."

Old roads don't interest Beck. His development of cognitive therapy in the early 1960s revolutionized psychiatry and triggered serious anger issues in classical Freudians.

Two months shy of his 87th birthday, Beck - Tim to his friends - continues to forge new paths.

He has five books in progress: updates of his seminal 1967 and 1979 volumes on depression and new studies on cognitive therapy and schizophrenia, cognitive therapy and suicide, and cognitive therapy and anxiety. The first three are due out this year, the latter two in 2009.

Psychiatrist John Rush, a leading authority on depression, calls Beck the most important figure in the history of the field, ahead of even Freud.

Rush says that Freud made a monumental contribution, unquestionably, but that Beck's therapy treats a broader range of mental illnesses and has been proved in clinical trials to be more effective.

"His work changed the paradigm - how we do things, how we think about things," says Rush, 65, a professor at the University of Texas Southwestern Medical School and a former resident under Beck.

"Somebody like him comes along every 50, 100 years. We're talking about a rare bird."

Nobel-worthy work

With Beck in the running for a Nobel Prize last year, Penn booked a limo to drive the bow-tied professor from his Wynnewood home to a celebratory news conference on campus.

The call never came. Some claim he was robbed. Others, including Beck, knew he was a long shot. Absent a separate category, psychiatry is judged under the rubric of "physiology or medicine."

"As great as my dad is, he's competing against people who cure cancer," says Dan Beck, 52, a cognitive therapist in Boston.

University of Scranton psychologist Brad Alford, 55, who trained under Beck in the 1980s, says the Nobel committee should expand its parameters.

"People somehow think the mind is less real than physiology. We view the mind as part of the body. They are equally important. I don't want to jinx it, but the Nobel committee should recognize that."

Beck may get another shot.

Seventy-five winners of the Lasker Award, considered the country's most prestigious medical prize, have gone on to become Nobelists. Beck won in 2006, for clinical research.

He insists he's not pining for a Nobel. "I think it's lovely that they're talking about it. It's like winning the lottery. If it happens, it happens."

In the early days, psychoanalysts considered cognitive therapy so heretical that some would leave the room when Beck presented papers at professional conferences.

Academic journals rejected much of his work, so he started his own periodical, Cognitive Therapy and Research. (He has 520 published papers to his credit.) When grants fell through, he wrote books. Eighteen at last count.

It's not difficult to understand why cognitive therapy flipped out Freudians, who focus on unconscious motivations, sometimes for decades.

"The patient talks or free associates forever. The therapist listens and interprets," Alford says. "If the patient rejects the therapist's interpretation, he's labeled 'in denial.' "

Cognitive therapy works on conscious thoughts, restructuring them to spur behavior changes. The process generally takes six to 12 sessions.

For example: A depressed patient says "it's too hard" to get out of bed, and, besides, he knows his day will be awful. Using cognitive therapy, a therapist would help him "reframe" his negative thinking and suggest practical solutions.

For starters, he could move the alarm clock so he has to get up to turn it off. He could set fewer, more attainable daily goals.

With such techniques, cognitive therapy can reverse serious mental illnesses including major depression, panic disorder and substance abuse, allowing the patient to feel and function better.

Ironically, cognitive therapy grew out of Beck's early attempts to prove, by analyzing patients' dreams, Freud's theory of depression as repressed anger.

Instead of anger, he found "a sense of defeat, failure or loss," says Marjorie Weishaar, 58, a Brown University psychiatrist who studied under Beck at Penn and wrote his biography.

The discovery "gave him the idea of parallel lines. We report one thing when something else is also going on. He began to demystify therapy. Teaching people to be their own therapists gave them access to deeper thoughts and feelings."

Keeping his own mind fit

After 50-plus years of digging into other people's feelings, how how do you feel, Dr. Beck?

"Aside from a few infirmities [hip replacement, cataract surgery] that are part of the aging process, as far as I'm concerned I'm 50," he says, relaxing in the historic home he shares with his wife of 57 years, retired Superior Court Judge Phyllis Beck.

"I have lost most of my friends my age. Phyllis gets upset. I just accept it as part of life. It's tough. It leaves a gap. I have made younger friends. I have a lot of friends in their 70s."

Giving up night driving is about the only concession that Beck, an eight-time grandfather, has made to age. Unless you count forgoing his beloved peanut brittle.

He plays tennis twice a week. (Ever the pragmatist, he used to wear tennis shorts under his trousers to save time.) He loves the movies. He travels, alone, to a European conference every year. His hair and teeth are his own.

"We just assume he'll go on forever," says daughter Judy Beck, 54, director of the Beck Institute for Cognitive Therapy and Research in Bala Cynwyd. Founded with her father in 1994, it trains more than 200 therapists a year.

Part of her father's genius, she says, is his "wonderful ability to focus, single-mindedly, on whatever he's doing at the moment."

That can mean schizophrenia in the morning, suicide in the afternoon, anxiety in the evening, and depression at night. The grand slam of mental illness.

"His mind is as sharp as ever. He hasn't lost one iota," says son Roy Beck, 55, an epidemiologist in Tampa, Fla. According to Alice Beck Dubow, 49, a Philadelphia Family Court judge, her father can quote poetry he read in high school.

Beck's insatiable curiosity doesn't brake for religious holidays, either.

At the family's Passover seder last month, Papa Beck delivered a detailed scientific explanation for each of the biblical Ten Plagues.

"It was typical Dad," Dan says fondly. "He can turn any occasion into a treatise on natural selection."

You can't take the scientist out of the seder . . .

Same with Penn, whose faculty Beck joined when Eisenhower was in his first term. Though rarely on campus, he carries a full load at home - videoconferencing with the University of Manchester in Britain about a joint research project, supervising Penn therapists via their DVDs, combing through student e-mails.

Also, he directs Penn's Psychopathology Research Unit and Center for the Treatment and Prevention of Suicide.

"I've had residents walk down the hall and just stare at his nameplate on the door," says Barbara Marinelli, 70, his secretary of 30 years. "If they don't see him as a god, they see him as a rock star."

A rock star with a perfectionist's standards.

"Man, we had to be on our toes," Weishaar remembers. She and her colleagues called their weekly meetings with Beck " anxiety seminars - because we were all so anxious."

Says Penn's Rob DeRubeis, 54, Beck's friend and collaborator: "Tim can be sharply critical if he doesn't get a very high level of performance. His general tone is so avuncular, it can surprise people."

A key moment

The fifth child of Russian immigrants, Aaron Temkin Beck was born July 18, 1921, in Providence, R.I.

A sickly boy, he was held back in first grade. In third grade, he almost died when a broken arm became infected. He spent two months in a hospital, celebrating his eighth birthday there.

His depressive mother, who had lost a son and a daughter in infancy, was so protective of Aaron that he became a hypochondriac, he says.

He developed phobias about blood and tunnels, both of which he overcame by "really examining my thinking" - a precursor to cognitive therapy.

All three Beck sons had to work. Aaron sold Fuller brushes door to door, a job he continued as an undergraduate at Brown and into his first year at Yale medical school.

Beck wanted to be a neurologist, but fate had other plans.

In 1949, as a first-year neurology resident at a veterans hospital outside Boston, he had to do a six-month rotation in psychiatry. There weren't enough therapists to handle the influx of GIs returning from World War II.

What he saw in the wards appalled him.

"There were patients who were recently lobotomized. They looked like a bunch of zombies," he recalls. "There were people receiving shock treatments. They were either convulsing or in a coma. I thought I was in the Middle Ages."

He began treating veterans on an outpatient basis. It was frustrating, particularly for a scientist who considered psychology "a little fluffy."

"I could work with them, but I had absolutely no structure," he says. The traditional method was "to just sit back and listen to the patient go on and on and unravel like a ball of yarn."

Still, Beck was so intrigued by the challenge, he decided to pursue psychiatry.

One day, at the end of a session with an attractive, middle-aged woman who "regaled him" regularly with tales of her sexual adventures, he asked her how she was feeling. She said she felt anxious.

He assumed it was because she was afraid of his judgment about her sexuality.

No, she said, she was afraid she was boring him. She had the same feeling all the time, with everyone, she said.

It was a key moment for Beck. Suddenly, he realized that, along with more directed thoughts, people have an almost continuous, parallel stream of "automatic thoughts." More closely connected to emotions, they can be distorted and negative.

Over time, Beck's theories began to bear fruit. He conducted clinical trials, slowly convincing skeptics of cognitive therapy's success in treating numerous disorders.

Today, cognitive therapy is the most-practiced and fastest-growing form of psychotherapy in the world. In this country, it is required training for psychiatric residents.

'It's all up here'

If the clutter of one's physical environment is inversely proportional to the clarity of one's thought, it's obvious why Beck is a genius.

"There are people who are appalled at how untidy I am," he acknowledges. "If I start putting things away, it diverts my time and energy from working on papers and doing research."

Beck's home office, in two rooms on the second floor, is a pack rat's paradise.

There are towers of hand-scribbled notebooks, folders, letters, magazines, catalogs, cardboard boxes, file cabinets, old bottles of medicine, a fly swatter. His wife's exercise machine occupies most of the floor space.

A book-laden shelf in a plastic bookcase has been broken for some 20 years. Five unused phones lie atop another bookcase. He cannibalizes parts when one of his breaks.

Several years ago, a squirrel got into the office and chewed through some of Beck's papers. (Yes, he had duplicates.) It took an exterminator three days to nail the varmint.

"I don't pay much attention to my physical surroundings. It's all up here," says Beck, pointing to his noggin. "I'm very functional. Aesthetics are not important to me."

His internal filing system is a source of wonderment to his children. "He can put his hands on anything. It astounds me," Judy Beck says.

Like any respectable genius, Beck is forever losing his keys, his eyeglasses, his wallet, his cell phone. If food in the refrigerator is moved, it might as well be invisible.

Naturally, the scientist has a scientific explanation.

"People who are creative oftentimes are not good at details. It's as though one part of the brain is overdeveloped at the expense of another part of the brain.

"Creativity is a type of intelligence. Remember, Einstein couldn't find his way home."

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Contact staff writer Gail Shister at gshister@phillynews.com or 215-854-2224. Read her recent work at http://go.philly.com/gailshister.