Sullivan Final

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Interpersonal Theory ofPsychiatry

Harry Stack Sullivan



“Personality is the relatively enduring pattern of

recurrent interpersonal situations whichcharacterize a human life.”



Structure

o Dynamisms

o Personifications

o

Levels of Cognition



Dynamism the relatively enduring pattern of energy

transformations, which recurrently characterize aperson throughout a lifetime



Two Major Classes of

Dynamisms

Those related tospecific zones of thebody

Mouth

Anus

Genitals

Those related to

tensions

Disjunctive

Isolating

Conjunctive



Malevolence disjunctive dynamism of evil and hatred,

characterized by the feeling of living among one’s

enemies



Lust based solely on sexual gratification and requires

no other person for its satisfaction



Intimacy grows out of earlier need for tenderness but is

more specific and involves a close interpersonalrelationship between people who are more or lessof equal status

an integrating dynamism that tends to draw out

loving reactions from another person, therebydecreasing anxiety and loneliness



Self-System most complex and inclusive of all the dynamisms

a consistent pattern of behaviors that maintainspeople’s interpersonal security by protecting them

from anxiety

the principal stumbling block to favorablechanges in personality



Security Operations- purpose is to reduce feelings of insecurity or

anxiety that result from endangered self-esteem

- “ a powerful brake on personal and

human progress”



Dissociation

- all those experiences that we block fromawareness

- experiences do not cease to exist but continue toinfluence personality on an unconscious level

Selective Inattention

- control of focal awareness- a refusal to see those things that we do not wish

to see



Personification an image that an individual has of him- or herself

or of another person

a complex of feelings, attitudes and conceptionsthat grows out of experience with needsatisfaction and anxiety

they may be relatively accurate or may be grosslydistorted



Bad-Mother, Good-Mother

Bad Mother grows out of the infant’s experiences with the nipple that

does not satisfy their hunger needs

the infant’s vague representation of not being properly

fed

Good Mother

based on the tender and cooperative behaviors of themothering one

Both images are combine to form a complex

personification composed of contrasting qualities



Me Personifications

1. Bad-me- grows from experiences of punishment ordisapproval

- infants can learn that they are bad only from

someone else 2. Good-me

- results from experiences with reward andapproval

3. Not-me

- allows a person to dissociate or selectively not attendto the experiences related to anxiety

- denies the experiences to the me image so that theybecome art of the not-me ersonification



Eidetic Personifications unrealistic traits or imaginary friends that children

invent in order to protect their self-esteem

hinder communication and prevent people fromfunctioning from the same level of cognition



Stereotypes-personifications that are shared by a numberof people-consensually validated conceptions, ideasthat have wide acceptance among themembers of a society and are handed down

from generation to generation



Levels of Cognition refer to ways of perceiving, imagining and

conceiving

Three Levels of Cognition:

1. Prototaxic Level

2. Parataxic Level

3. Syntaxic Level



Prototaxic Level where the earliest and primitive experiences of an

infant take place

experiences are impossible to put into words or tocommunicate to others

beyond conscious recall

Adults frequently have preverbal experiences thatare momentary and incapable of being

communicated



Parataxic Level prelogical and usually result when a person

assumes a cause-and-effect relationship betweentwo events that occur coincidentally

can be communicated to others only in a distorted

form

Parataxic Distortion- an illogical belief that a

cause-and-effect relationship exists between twoevents in close temporal proximity



Syntaxic Level Experiences that are consensually validated

(those on whose meaning two or more personsagree) and that can be symbolicallycommunicated to others



Dynamicso

Tensiono Energy Transformation



Sullivan saw personality as anenergy system. Energy can exist

either as tension or as energy

transformations.



Tension A potentiality for action that may or may not be

experienced in awareness

Two Types:

tensions that arise from the needs of theorganism

tensions that result from an anxiety



Needs

tensions brought on by biological imbalancebetween a person and the physiochemical

environment, both inside and outside theorganism

are episodic – once satisfied, they temporarilylose their power, but after a time, they are likely torecur

can relate either to the:

general well-being of a person (General Needs)a. Interpersonal

b. Physiological

specific zones (Zonal Needs)



Anxiety experience of tension that results from real or

imaginary threats to one’s security

transferred from the parent to the infant throughthe process of empathy

chief disruptive force blocking the development ofhealthy interpersonal relations : blow on thehead



Euphoria

- complete lack of tension“the presence of anxiety is much worse

than its absence”



Energy Transformations tensions that are transformed into either overt or

covert actions

goal is the relief of tension : satisfying needs andreducing anxiety



Stages of Development

-7 Stages

-Thread of interpersonal relations runs throughoutthe stages.

-Change in personality are most likely to occur

during the transition from one stage to the next.



Infancy From birth until the development of Syntaxic

speech (usually until 2 years.)

Infants become human through the tendernessthat they receive from the mothering one.

The emphatic link between mother and infantleads inexorably to the development of anxiety forthe baby.



First anxiety – always associated with the Oral Zone and Nursing Situation.

Infant’s repertoire of behaviors is not adequate to

handle anxiety.

Expresses hunger and anxiety through crying.



When tension approaches terror, the infantexperiences difficulty in breathing.

Built-in protections of apathy and somnolentdetachment keep the infant from death.

Mother-infant relationship - two-sided coin.



Autistic Language – develops around midinfancy- Private ; makes no sense to other people.

- Expression: facial expressions and sounding ofvarious phonemes.



Childhood

Begins with the advent of syntaxic level until theappearance of the need for playmates of an equalstatus.

The mother remains the most significant other

person, but her role is different from what it wasduring infancy.



They can no longer distinguish the bad-me or good-me at the same time.

Emotions become reciprocal The relationship between the child and the mother

become one-sided.



Imaginary playmate – enables the children tohave a safe, secure relationship that produceslittle anxiety.

- Also known as the “Imaginary friend”

- Not a sign of pathology but a positive event thathelps children become ready with intimacy.



Also known as the period of rapid acculturation.



Two processes:

Dramatizations:attempts to act orsound like importantauthority figuresespecially the motherand the father.

Preoccupations:strategies for avoidinganxiety and fear-provoking situationsby remainingoccupied with anactivity that has earlierproved rewarding.



Juvenile Era

Begins with the need for peers or playmates ofequal status and ends when one finds a singlechum to satisfy the need for intimacy

Children should learn to compete, compromise

and cooperate.



Degree of competition varies with culture. Cooperation – a critical step in becoming

socialized and is the most important taskconfronting children in this stage of development.



Children associate with others of equal status. One-to-one relationships are rare.



By the end of this stage, a child should havedeveloped an orientation toward living that makesit easier to handle anxiety, and satisfy zonal andtenderness needs.



Orientation toward living – readies a person forthe deeper interpersonal relationships.



Preadolescence

Begins at age 8 ½ and ends with adolescence. Time for intimacy with one particular person,

usually of the same gender.

“Quiet miracle of preadolescence”



Outstanding genesis: Capacity to love. Love and Intimacy become the essence of

friendships.



Intimacy

involves a relationship in which two partnersvalidate one another’s worth.



Love

Exists “when the satisfaction or the security of another person becomes as significant to one asis one’s own gratification or security.” (Sullivan,

1953a, pp. 42-43)



Relationships involve another person of samegender and of equal age or status.

Boy-boy or girl-girl chumships.



The free exchange of personal thoughts andfeelings initiates the preadolescent into the worldof intimacy.



Experiences during this stage are critical for thefuture development of personality.



Early Adolescence

Begins with puberty and ends with the need forsexual love with one person.

Marked by the eruption of genital interest and theadvent of lustful relationships.



Intimacy, lust, and security often collide with oneanother, bringing stress and conflict to the youngadolescent in at least three ways:



1. Lust interferes with security. 2. Intimacy interferes with security.

3. Intimacy and lust are frequently in conflict.



Late Adolescence

Begins when young people are able to feel lustand intimacy towards the same person and endsin adulthood when they establish a lasting loverelationship.

Period of self-discovery



Outstanding feature = fusion of intimacy and lust. Attempts at self-exploration.

Completely determined by interpersonal relations



Successful lateadolescence:

- Includes a growingsyntaxic mode.

Unsuccessful lateadolescence:

- Rely heavily on theparataxic mode.



Adulthood

A period when people can establish a loverelationship with atleast one significant other.



Beyond the scope of interpersonal psychiatry Mature adults are perceptive of other people’s

anxiety, needs and security.

They operate predominantly on the Syntaxic level

and find life interesting and exciting.



Psychopathology

Interpersonal origin Disorders are with reference to social

environment

Self Esteem Problems

“Everyone is simply Human no matter what ails

the patient he/she is still human”



Sullivan as a therapist avoidedgetting personally involved with

the patients

Friendship is not a condition since

the therapist must be a trainedexpert in making observations



Critique

Ranks Low on its ability to generate research- lack of popularity- more associated with psychiatry- isolation from any university setting

Ranks Low on Falsifiable- Psychological health received moderate

support



Moderate rank on its ability to organizeknowledge

- because of the extreme emphasison intrapersonal relations

Moderate In Practicality

Not Parsimonious

- Awkwardness of his writings- Creating his own terms



Concept of Humanity

Neither Optimist nor Pessimist Neither Uniqueness or Similarity

Social

- focused on personal relations

Biological

- being a psychiatrist

Sullivan Final

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