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Christine Leuenberger, Paul E. Stepansky, Psychoanalysis at the Margins, Social History of Medicine, Volume 24, Issue 1, April 2011, Pages 185–186, https://doi.org/10.1093/shm/hkr016
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Psychoanalysis has fractured; psychoanalysts are ‘narcissistic’; the profession is near its demise. Long-term psychoanalytic editor, publisher and historian of ideas, Paul Stepansky, is therefore putting his professional colleagues on the historian's couch. He provides a window into the history of psychoanalysis in America by examining psychoanalytic book and journal publishing. The story he tells is about psychoanalysis' golden age and its descent into ‘near-demise’ (p. xi).
Psychoanalysis' golden age was between the 1940s and 1960s. At that time, it entered mainstream medical discourse, it was virtually synonymous with psychotherapy, and many ‘big’ psychoanalytic books reinforced the disciplines' cohesiveness. By the 1970s, psychoanalysis' renaissance gave way to its progressive marginalisation. Subsequent shifts within the mental health professions did not bode well for psychoanalysts. The DSM-III abandoned the psychodynamic paradigm. The rise of biopsychiatry went hand in hand with pharmaceutically-driven research agendas. Health insurers reimbursed, not long-term analytic therapies, but Prozac and short-term therapies. Changes in publishing and the rise of the internet led to a decline in psychoanalytic publications. At the same time, potential analytic trainees and analytic patients increasingly looked elsewhere for careers and treatments. The story might end here: changes in the external professional environment contributed to the demise of a profession. However, Stepansky is not letting his colleagues get away so easily. It is also internal professional practices and politics that contributed to the marginalisation of psychoanalysis.