Sullivan

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Harry Stack Sullivan
Once Sullivan began his work as a practicing psychiatrist, he quickly showed his extraordinary ability to
relate to patients suffering from schizophrenia. His later work involved extending his ideas relating to the
development and treatment of schizophrenia to a general theory of personality development.
Schizophrenia
Sullivan's work with those suffering from the psychosis schizophrenia began with his ability to
communicate with these patients. He believed that their mental functions, although disordered, were not
beyond treatment. Having been introduced to psychoanalytic techniques by Adolf Meyer, Sullivan began
to apply these to his hospitalized, psychotic patients, despite the fact that Sigmund Freud had originally
developed the techniques for use only with those suffering from neuroses.
Sullivan developed the technique of "participant observation," in which the psychiatrist was not just an
observer of the patient's behavior, but became a "significant other" in their life through their interactions.
In his sessions with patients, Sullivan also began to employ what later came to be known as "reality
testing." Questioning the patient about matters that could be verified, he caused them to see how their
own view of reality was distorted.
Theory of Personality Development
Sullivan's work became the foundation of interpersonal psychoanalysis, a school of psychoanalytic theory
and treatment that stresses the detailed exploration of the nuances of patients' patterns of interacting with
others.
Besides making the first mention of the "significant other" in psychological literature, Sullivan developed
the "self system," a configuration of the personality traits developed in childhood, and reinforced by
positive affirmation and the "security operations" developed to avoid anxiety and threats to self-esteem.
Sullivan further defined this self system as a steering mechanism toward a series of "I-You" interlocking
behaviors; that is, what an individual does is meant to elicit a particular reaction. Sullivan called these
behaviors "parataxic integrations," and noted that such action-reaction combinations can become rigid
and dominate an adult's thinking pattern, limiting his actions and reactions to relating to the world as he
sees it, not as it really is.
Sullivan saw anxiety as existing only as a result of social interactions. Sullivan described techniques,
such as selective inattention and personifications, similar to Freud's defense mechanisms, that provide
ways for people to reduce social anxiety.
Selective Inattention
Sullivan believed that mothers express their anxiety about raising their children in a variety of ways. The
child has no understanding or way to deal with this and so feels the anxiety himself. Selective inattention
is the child's reaction to this, ignoring or rejecting the anxiety, or any interaction that could produce
uncomfortable, anxious feelings in the child. Later as adults, this technique is used to focus our minds
away from stressful situations.
Through social interactions and our selective attention or inattention, we develop what Sullivan called
Personifications of ourselves and others. While defenses can often help reduce anxiety, they can also
lead to a misperception of reality. Again, he shifts his focus away from Freud and more toward a
cognitive approach to understanding personality.
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These personifications are mental images that allow us to better understand ourselves and the world.
There are three basic ways we see ourselves that Sullivan called the bad-me, the good-me and the not-
me. The bad me represents those aspects of the self that are considered negative and are therefore
hidden from others and possibly even the self. The anxiety that we feel is often a result of recognition of
the bad part of ourselves, such as when we recall an embarrassing moment or experience guilt from a
past action.

The good me is everything we like about ourselves. It represents the part of us we share with others and
that we often choose to focus on because it produces no anxiety. The final part of us, called the not-me,
represents all those things that are so anxiety provoking that we can not even consider them a part of us.
Doing so would definitely create anxiety which we spend our lives trying to avoid. The not-me is kept out
of awareness by pushing it deep into the unconscious.

Sullivan believed that people acquire certain images of self and others throughout the developmental
stages, and he referred to these subjective perceptions as personifications.
Bad-Mother, Good-Mother
The bad-mother personification grows out of infants„ experiences with a nipple that does not satisfy their
hunger needs. All infants experience the bad-mother personification, even though their real mothers may
be loving and nurturing. Later, infants acquire a good-mother personification as they become mature
enough to recognize the tender and cooperative behavior of their mothering one. Still later, these two
personifications combine to form a complex and contrasting image of the real mother.
Me Personifications
During infancy children acquire three “me” personifications: (1) the bad-me, which grows from
experiences of punishment and disapproval, (2) the good-me, which results from experiences with
reward and approval, and (3) the not-me, which allows a person to dissociate or selectively not attend to
the experiences related to anxiety.
Eidetic Personifications
One of Sullivan‟s most interesting observations was that people often create imaginary traits that they
project onto others. Included in these eidetic personifications are the imaginary playmates that
preschool-aged children often have. These imaginary friends enable children to have a safe, secure
relationship with another person, even though that person is imaginary.
Developmental epochs
Sullivan evolved a theory of personality that emphasized the importance of interpersonal relations. He
insisted that personality is shaped almost entirely by the relationships we have with other people.
Sullivan‟s principal contribution to personality theory was his conception of developmental stages.
In a similar fashion to Freud, Sullivan maintained that childhood experiences with other people are a large
contributor to the adult personality, the mother playing the most significant role. He differed from Freud in
his belief that the primary significance of the parent-child relationship was not predominantly sexual, but
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rather an early quest for security by the child. He also believed that the personality can continue to
develop past adolescence and even well into adulthood.
Sullivan called these stages "developmental epochs," occurring in a particular order but with their timing
determined by our social environment. The majority of Sullivan's focus revolved around the periods of
adolescence, and he suggested that many adulthood problems arise from the turmoils of adolescence.
The developmental epochs are:
 Infancy (birth to 1 year)
 Childhood (1 to 5 years old)
 Juvenile (6 to 8 years old)
 Preadolescence (9 to 12 years old)
 Early Adolescence (13 to 17 years old)
 Late Adolescence (18 to 22 or 23 years old)
 Adulthood (23 years old and on)

Sullivan's Developmental Epochs

Infancy
Age birth to 1 year
From birth to about age one, the child begins the process of developing,
but Sullivan did not emphasize the younger years to near the
importance as Freud.

Childhood
Ages 1 to 5
The development of speech and improved communication is key in this
stage of development.

Juvenile
Ages 6 to 8
The main focus as a juvenile is the need for playmates and the
beginning of healthy socialization

Preadolescence
Ages 9 to 12
During this stage, the child's ability to form a close relationship with a
peer is the major focus. This relationship will later assist the child in
feeling worthy and likable. Without this ability, forming the intimate
relationships in late adolescence and adulthood will be difficult.

Early Adolescence
Ages 13 to 17
The onset of puberty changes this need for friendship to a need for
sexual expression. Self worth will often become synonymous with
sexual attractiveness and acceptance by opposite sex peers.

Late Adolescence
Ages 18 to 22 or 23
The need for friendship and need for sexual expression get combined
during late adolescence. In this stage a long term relationship becomes
the primary focus. Conflicts between parental control and self-
expression are commonplace and the overuse of selective inattention in
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previous stages can result in a skewed perception of the self and the
world.

Adulthood
Ages 23 on
The struggles of adulthood include financial security, career, and family.
With success during previous stages, especially those in the adolescent
years, adult relationships and much needed socialization become more
easy to attain. Without a solid background, interpersonal conflicts that
result in anxiety become more commonplace.


Tensions
Sullivan conceptualized personality as an energy system, with energy existing either as tension
(potentiality for action) or as energy transformations (the actions themselves). He further divided
tensions into needs and anxiety.
 Needs
o Needs can relate either to the general well-being of a person or to specific zones, such
as the mouth or genitals. General needs can be either physiological, such as food or
oxygen, or they can be interpersonal, such as tenderness and intimacy.
 Anxiety
o Unlike needs—which are conjunctive and call for specific actions to reduce them—
anxiety is disjunctive and calls for no consistent actions for its relief. All infants learn to be
anxious through the empathic relationship that they have with their mothering one.
Sullivan called anxiety the chief disruptive force in interpersonal relations. A complete
absence of anxiety and other tensions is called euphoria.
Dynamisms
Sullivan used the term dynamism to refer to a typical pattern of behavior. Dynamisms may relate either to
specific zones of the body or to tensions.
 Malevolence
o The disjunctive dynamism of evil and hatred is called malevolence, defined by Sullivan as
a feeling of living among one‟s enemies. Those children who become malevolent have
much difficulty giving and receiving tenderness or being intimate with other people.
 Intimacy
o The conjunctive dynamism marked by a close personal relationship between two people
of equal status is called intimacy. Intimacy facilitates interpersonal development while
decreasing both anxiety and loneliness.
 Lust
o In contrast to both malevolence and intimacy, lust is an isolating dynamism. That is, lust
is a self-centered need that can be satisfied in the absence of an intimate interpersonal
relationship. In other words, although intimacy presupposes tenderness or love, lust is
based solely on sexual gratification and requires no other person for its satisfaction.
 Self-System
o The most inclusive of all dynamisms is the self-system, or that pattern of behaviors that
protects us against anxiety and maintains our interpersonal security. The self system is a
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conjunctive dynamism, but because its primary job is to protect the self from anxiety, it
tends to stifle personality change. Experiences that are inconsistent with our self-system
threaten our security and necessitate our use of security operations, which consist of
behaviors designed to reduce interpersonal tensions. One such security operation is
dissociation, which includes all those experiences that we block from awareness.
Another is selective inattention, which involves blocking only certain experiences from
awareness.

 Bad-mother, good-mother
 The bad-mother personifications grows out on infants’ experiences with a nipple that does not satisfy their
hunger needs. All infants experience the bad mother personification, even though their real mothers may be
loving and nurturing. Later, infants acquire a good mother personification as they become mature enough to
recognize the tender and cooperative behavior of their mothering one. Still later, these two personifications
combine to form complex and contrasting image of the real mother.
 Me personifications
 During infancy children acquire three “me” personifications: (1) the bad-me, which grows from experiences of
punishment and disapproval, (2) the good-me, which results from experiences with reward and approval, and
(3) the not-me, which allows a person to dissociate or selectively not attend to the experiences related to
anxiety.
 Eidetic personifications
 One of Sullivan’s most interesting observations was that people often create imaginary traits that they project
onto others. Included in these eidetic personifications are the imaginary playmates that preschool-aged
children often have. These imaginary friends enable children to have safe, secure relationship with another
person, even though tht person is imaginary.
 Levels of cognition
 Sullivan recognized three levels of cognition, or ways of perceiving things – prototaxic, parataxic, and
syntaxic.
 Prototaxic Level
 Experiences that are impossible to put into words or to communicate to others are called prototaxic. Newborn
infants experience images mostly on a prototaxic level, but adults, too, frequently have preverbal experiences
that are momentary and incapable of being communicated.
 Parataxic Level
 Experiences that are prelogical and nearly impossible to accurately communicate to others are called
parataxic. Included in these are erroneous assumptions about cause and effect, which Sullivan termed
parataxic distortions.
 Sysntaxic Level
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 Experiences that can be accurately communicated to others are called syntaxic. Children become capable of
syntaxic language at about 12 to 18 months of age when words begin to have the same meaning for them that
they do for others.
 Psychological disorders
 Sullivan believed that disordered behavior has an interpersonal origin and can only be understood with
reference to a person’s social environment.
 Psychotherapy
 Sullivan pioneered the notion of the therapist as a participant observer, which establishes an interpersonal
relationship with the patient. He was primarily concerned with understanding patients and helping them
develop foresight, improve interpersonal relations, and restore their ability to operate mostly on a syntaxic
level.