Leon J. Saul,Aaron T. Beck,and the story of recovery inside the Beck Depression Inventory

Abstract

This article offers historical context for psychiatrist Aaron T. Beck's creation of the Beck Depression Inventory (BDI), a widely celebrated patient-rated depression scale. Beck built the BDI in the late 1950s as part of a large psychoanalytic depression research project. Although he later broke with psychoanalysis and rose to fame as father of cognitive behavior therapy (CBT), the meaning he attributed to lowered BDI scores post-CBT bore the stamp of his psychoanalytic mentor, Leon J. Saul, a pioneer in the quantitative study of psychoanalysis. Saul endowed lowered scores on his own rating scales with a political story of recovery, a tale of hostile forces tamed, reason restored, democracy safeguarded. Rather than abandon Saul's political recovery story, Beck interwove it into a medical recovery story (a return to pre-morbid functioning) commensurate with the era of randomized controlled trials and the DSM-III. This persistence of a Saulian recovery story in Beck's interpretive framework for lowered BDI scores post-CBT suggests that further historical inquiry is warranted into the quantitative strains of American psychoanalysis, and that Beck's quantitative revolution with CBT may not have been as clear a break with psychoanalysis as has been assumed.