Seamus O'Mahony's book starts by drawing parallels and contrasts between three men at the turn of the 20th century. First, there is Ernest Jones, a young hospital doctor who is quite enamoured (as all his colleagues seem to be) with his senior colleague and British surgeon, Wilfred Trotter. Their burgeoning friendship meets the hard gravity of Sigmund Freud's revolutionary writings on the unconscious, which yank Ernest Jones in one direction (he later goes on to become a psychoanalyst and President of the International Psychoanalytic Association), whilst repelling Trotter who is characterised throughout this book as more sceptic, more scientifically minded and a thoroughly ‘good’ man. Trotter himself made a significant contribution to psychology and group dynamics with his book Instincts of the Herd in Peace and War in which the term ‘herd instinct’ is famously coined, but this was enough for him, and he spent the rest of his life operating (mostly quietly, with a few royal clients here and there). Freud, as we know, went on to produce an astonishing amount of work which is still widely studied today, as is his clinical legacy which has been picked apart in various treatises and books.

O'Mahony's work could be seen as part of this grand unpicking, as it spends many chapters focusing on the colourful and disturbing private lives of various 20th-century analysts. There is Otto Gross who suffered an apparent drug-induced psychotic episode and whose salvo (‘Repress nothing!’) later tipped him into becoming an anarchist. Joan Riviere is one of many ‘couch jumpers’ who made the move from patient to clinician; a move which O'Mahony rightly observes was not rooted in any actual clinical experience. Melanie Klein is somewhat lambasted for analysing her children. Meanwhile, throughout, there are an array of boundary violations as Freud and his cohort are portrayed as miscreants, dreamers and, at worst, possibly dangerous. If it wasn't obvious enough, this is a book that doesn't view psychoanalysis fondly.

There is something of an enforced splitting going on, though, with Trotter continually painted as a surgeon-hero less interested in celebrity than he is in just doing the work. The split certainly makes the book entertaining and propulsive, as we are shocked and gladdened as readers by the sway of its characters over time (Jones in particular feels like someone out of a novel), but I'm less sure of its value as critique. O'Mahony writes finely in often beautiful and well researched prose, but the book as a whole feels biased, and it fails to understand the importance of psychoanalytic ideas and, indeed, their ongoing place in psychiatric practice today. It's an unfortunately skewed approach that reduces men to categories like ‘guru’, ‘bagman’ and ‘sceptic’ but doesn't seem to go further than this in its analysis.