Psychoanalysis at the Margins (review)

In Psychoanalysis at the Margins, Paul Stepansky provides an extensively documented, academically acrobatic, and historically hefty overview of the quandary psychoanalysis finds itself in, presenting the field as increasingly marginalized, diminished by infighting, and unsuccessful at presenting its usefulness or relevance to a medical, academic, or popular audience alike. This work, deceptively mild mannered in cover and appearance, with footnotes almost doubling its length, is a powerfully angry cry of anguish and admonition by an unusually erudite critic, one whose visceral disappointment in the field is too intelligent, too well supported, and too passionate to ignore. Stepansky was the editor of Analytic Press from 1984 to 2005, when it ended, giving him a front-row view of the mechanics and exigencies of the psychoanalytic market. That much recent psychoanalytic work has been increasingly ignored, languishing unnoticed and unsold, is rendered disturbingly concrete by Stepansky's listing of the precise number of copies of particular works actually sold. These numbers are fascinating and distressing, while Stepansky's revelation of them feels both angry and intentionally provocative: he uses the dramatic contraction of the psychoanalytic book market as a prism through which to understand the past several decades of psychoanalytic development.

Stepansky is certainly able to describe in detail how psychoanalytic publishing has worked over the years as well as how psychoanalytic journals developed their identities and how changing rules and funding affected how libraries and academia bought and paid for different psychoanalytic productions. He discusses how the Internet changed book and journal publishing and presents a sociology and economics both of publishing and of psychoanalytic readership and authorship. One clearly senses how frustrated Stepansky has been with many of the authors he worked with; he describes the shortsightedness and arrogance of authors bemoaning their poor sales while being unwilling to acknowledge the increasing fractionating of the field and the contraction of their audience, one they contributed to by their own myopia. Stepansky's perhaps impolitic anger at his authors is interesting in light of the largest criticism of his own book, which is how poorly edited it is. Stepansky appears unable to resist including every piece of knowledge he has ever accumulated, and he has accumulated a great deal of it. The footnotes almost double the length of the text, muffling, distracting, and dissipating the movement and flow of the arguments. The footnotes function variously as an autobiography of the author's catholic education and interests, a memoir of his encounters with psychoanalytic luminaries, a review of philosophy, a history of medical instrumentation, and a primer in cardiac anatomy. Stepansky's footnotes seem both to enact the idea that the most interesting things can indeed be found in the margins and to provide a stuffed-luggage solution to the reality of limited psychoanalytic book publishing by squeezing multiple books into what could have been a single, more streamlined one.

Stepansky argues that being at the "margins" provides certain opportunities and potentials that have been neglected by a field trying in vain to make itself fit into a mainstream medical and psychological world that has moved in significantly different, irreconcilable directions. He looks at homeopathy and osteopathy and the history of alternative medicine in America to consider strategies for how approaches outside the medical mainstream, where psychoanalysis was not always but now surely is situated, can help the field to flourish on its own terms. Stepansky makes an important argument about how to engage in a dialogue across different psychoanalytic schools including criticism of the pseudo-eclectism and false dialogue that currently passes for points of contact and, even more importantly, for how to consider making psychoanalysis more relevant to the culture at large. He unravels in close detail the various strategies that have been employed to knit together an increasingly diverse field (which he lists as the effort to reestablish common ground, theoretical pluralism, use of research from nonclinical disciplines to provide an integrative, scientific framework, and comparative psychoanalysis) and outlines the difficulties and potential...