Psychoanalysis at the Margins

Psychoanalysis at the Margins

Psychoanalysis at the Margins

Why has American psychoanalysis been relegated to the margins of American mental health care? In this masterful summing up of three decades of experience as a psychoanalytic editor and publisher, Paul Stepansky tells the story of a once cohesive discipline that has splintered into rivalrous “part-fields” and now struggles to survive in a postanalytic world of cognitive-behavioral interventions, brief therapy, psychopharmacology, and managed care. Simultaneously, it is a cautionary tale of the inevitable marginalization of any profession that resists integration into the scientific mainstream of its time and place.

Beyond its self-evident importance to psychoanalysts and other proponents of “talking” therapy, Psychoanalysis at the Margins provides an in-depth case study of the role of books, journals, and publishing in the rise and fall of a historically insular profession.  For Stepansky, the near-demise of psychoanalytic publishing in America is a microcosm of the crisis of small scholarly and professional publishing in an era that has witnessed the ascendancy of internet chat groups, online seminars, Amazon.com, and electronic journal subscriptions.

Positioning present-day psychoanalysis as an alternative healing modality, Stepansky explores the initiatives that have enabled other alternative professions to survive and even thrive in the face of mainstream opposition. Is it possible, he asks, that the lessons of alternative medicine can guide psychoanalysis to an “optimal marginality” that draws the mainstream to it? Pursuing pathways to this goal, Stepansky enjoins analysts to undertake a host of initiatives in the public interest that bring analytic knowledge to bear in those contexts where it can do the most good.

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3 Comments so far »

  1. Bluesbury said,

    Wrote on January 16, 2013 @ 2:54 pm

    3 of 3 people found the following review helpful
    4.0 out of 5 stars
    Not a solution but a very worthwhile view of the problem, December 29, 2009
    By 
    Bluesbury (St Albans, England) –

    This review is from: Psychoanalysis at the Margins (Hardcover)

    This is a very interesting, highly readable and unusual take on the decline of psychoanalysis in the past couple of decades. Stepansky is a rare breed – an `outsider’ who is not himself an analyst but, as a key publisher of analytic books, someone who has been closely involved with analysts and the analytic world for many years and is therefore well-informed without having his own analytic axe to grind. As a publisher, though, he seems like a disappointed, frustrated and possibly embittered man as he charts the relentlessly falling sales of analytic books as the discipline declined and fractured into competing schools who do not read each other’s books.
    One of the most interesting features of the book is Stepansky’s scholarly immersion in U.S. medical history in the nineteenth century: he makes many trenchant comparisons between the unregulated chaos of competing theories and approaches in medicine then and the current state of psychoanalysis. For him, the great failing of analysis is its `fractionation’ into many competing `schools’ with no apparent possibility of uniting under a single banner. Drawing on Kuhn’s theory of `paradigms’, Stepanksy argues that psychoanalysis has failed to cohere around a single paradigm in accord with the dictates of `normal science’ – hence its loss of public authority. Whether or not one agrees with this diagnosis, it provides a very thought-provoking comparative study. Of course, it merely illustrates his point that many would argue that analysis is neither a science nor a health profession in any `normal’ way.
    Nor is the doctor’s proposed remedy particularly convincing: while I would strongly support his plea for psychoanalysts to leave their ivory consulting towers and apply their insights to issues of wider public and social significance, in the UK there has been a strong tradition of such applications for decades, particularly associated with the Tavistock Clinic and, formerly, the Tavistock Institute of Human Relations. Outside the U.S., its nothing new for psychoanalysis to be `on the margins’ but nor has it prevented its decline. Nevertheless, this book is a very worthwhile contribution to a non-partisan, reflective and self-critical view of psychoanalysis.

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  2. David C. Newman said,

    Wrote on January 16, 2013 @ 3:26 pm

    2 of 2 people found the following review helpful
    5.0 out of 5 stars
    An Extraordinarily Valuable, Incisive Cultural History, June 17, 2010
    By 
    David C. Newman (New York, NY) –

    This review is from: Psychoanalysis at the Margins (Hardcover)

    Paul Stepansky’s new book is an extraordinarily valuable cultural history of psychoanalysis from the unique perspective of a prominent editor and publisher deeply involved in the field for the last several decades. Stepansky gracefully and lucidly writes of his personal experience and of his extensive research into the history of psychoanalytic publishing. The author presents research that can be found nowhere else, including facts and figures of book sales and distribution, and the ascendancy and demise of independent publishing.
    At the same time, Stepansky provides a broader cultural context in which he situates this history. He addresses many of the principal questions facing all psychotherapists and psychoanalysts today and offers suggestions regarding the future prospects of the field.
    Psychoanalysis at the Margins should be read by anyone interested in broad questions of cultural history, as well as those readers specifically interested in American history, the history of medicine and science, the role of books and publishing, and, of course, the history of psychoanalysis.

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  3. Louis Berger said,

    Wrote on January 16, 2013 @ 4:06 pm

    0 of 1 people found the following review helpful
    4.0 out of 5 stars
    excellent chronicle and analysis — as far as it goes, January 19, 2012
    By 
    Louis Berger (GA, USA) –
    (REAL NAME)
      

    This review is from: Psychoanalysis at the Margins (Hardcover)

    The detailed, comprehensive, informative reporting of psychoanalysis’s history (mostly as it happened in the US)is excellent, beautifully written, as expected from this bright, experienced, well-informed scholar and editor. However, I strongly disagree with his vision of how psa might be “unmarginalized” — as I read him: by more and better science, especially by more and better biologizing/medicalizing (see his comments and recommendations concerning analysts’ resistance to the current craze about the brain — which he laments). What he, just like just about all the MH professionals, ignores completely is the incoherent Cartesian-dualistic-mind/body conceptual framework that underlies and pervades psychiatry, psa, and psychology in numerous familiar and also unfamiliar, unrecognized, unexamined ways (e.g., with respect to language). In my view, that ultimately crippling incoherence must be confronted and dealt with if any real advances are to be possible, and so advocating this mainstream, traditional but philosophically indefensible onto-epistemological ground does no long-term service to the field.

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