Freud, Surgery, and the Surgeons by Paul E. Stepansky: The Vicissitudes of Freud's Surgical Metaphor

Paul Stepansky's study of Freud's surgical metaphor provides an illuminating chapter in the intellectual history of psychoanalysis. He first describes the context and development of the surgical metaphor in Freud's early theorizing. He then develops a complex aftermath that includes on the one hand Freud's own abandonment of the metaphor and on the other hand the post-Freudian history of surgery and psychoanalysis, including psychoanalytic responses to those psychiatric concretizations of the metaphor in shock therapy and lobotomy. Following an exposition of Stepansky's study of the surgical metaphor, the reviewer comments on the twin questions of why Freud adopted the metaphor and why he abandoned it, questions on which Stepansky dwells at length. Regarding the first, the reviewer suggests that Stepansky's historical analysis can be expanded to include Freud's use of the metaphor to sustain misogynistic impulses of 19th-century gynecologists. Regarding the second, the reviewer further develops Stepansky's point that, because of its inherent limitations, the metaphor outlived its usefulness and was thus abandoned.