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Paul E. Stepansky (2009), Psychoanalysis at the Margins. New York: Other Press.
In Psychoanalysis at the Margins, Paul E. Stepansky directs not only a wide but also a dark lens on the current marginal state of psychoanalysis in America. In his view, psychoanalysis is in decline and serious trouble. This is an important book for anyone who values the field and cares about its future: practitioners; patients; and the general, educated public.
Stepansky identifies some familiar factors that have contributed to the decline of psychoanalysis: for example, how new findings and ideas about psychological functioning and treatment—cognitive–behavioral
therapy, drug therapy, and neuroscience–have supplanted psychoanalysis in cultural importance. More important, he also brings a novel historical perspective to the problem, tracing historical tendencies in psychoanalysis toward fractiousness and the construction of closed systems. He also explains the sorry state of the profession by emphasizing its lack of empirical validation, by comparing its history with that of medicine and other contemporary scientific disciplines, by indexing the decline of psychoanalysis with the sharp drop in analytic book sales and journal subscriptions beginning in the 1970s, and by cataloguing the proliferation of what he calls “part journals”—that is, sectarian publications that speak only to adherents of particular theoretical views or charismatic figures. These part journals reflect a more general fragmentation of the profession:
[E]ach such journal, no less than the institute or society out of which it arose, provides anchorage for a particular kind of psychoanalytic identity that, for institutional, economic, and “social defensive” reasons, has come to be conflated with a psychoanalytic identity writ large [p. 130].
In Margins, Stepansky especially emphasizes this balkanization of psychoanalysis. He describes competing, sectarian psychoanalytic schools—orthodox Freudians, Adlerians, Kleinians,