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This is a splendid, scholarly book: meticulously researched, beautifully written, absorbing from the first to the last page. Its author, the respected editor-in-chief of The Analytic Press, has added another important contribution to his list of publications on psychoanalysis. This one is a must for all those who are passionate about psychoanalysis and its history.
Stepansky devotes his book to the exploration of the meaning, place, and history of the surgical metaphor of psychoanalysis—a long-awaited undertaking, given the fact that this analogy has been with us for all these decades. Given too the fact that psychoanalysis was born of medicine, one can only wonder why this metaphor was for so long considered so self-evident as to obviate any questioning of its validity. With this book, the author is not only answering questions about the metaphor itself, but also making us think about the cultural, intellectual, and therapeutic adventure called psychoanalysis. He does this, ranging over a number of disciplines, with the impartiality and sense of proportion that is the hallmark of a quintessential historian.
Stepansky soundly starts his exploration by placing the surgical metaphor in the realm of “psychoanalytic discourse … on technique,” i.e., in the realm of method rather than theory. Much of the current sound and fury in the attacks on Freud and psychoanalysis centers on Freud's theories and neglects his method. The surgeon wielding the scalpel to excise the tumor or inflamed appendix is not at that point worrying about the theories of causation of the disease; his job is to cure the patient with a proven method of treatment—surgery. Stepansky's opening quote from Freud's 1912 paper on technique says it all: there Freud advises analysts “to model themselves during psychoanalytic treatment on the surgeon, who puts aside all his feelings, even his human sympathy, and concentrates his mental forces on the single aim of performing the operation as skillfully as possibl