Harry Stack Sullivan

Interpersonal Theory of Psychiatry

Personality is the relatively enduring pattern of recurrent interpersonal situations which characterize a human life.

Structure
Dynamisms o Personifications o Levels of Cognition
o

Dynamism
the relatively enduring pattern of energy

transformations, which recurrently characterize a person throughout a lifetime

Two Major Classes of Dynamisms

Those related to Those related to

specific zones of the body

Mouth
Anus Genitals

tensions

Disjunctive
Isolating Conjunctive

Malevolence
disjunctive dynamism of evil and hatred,

characterized by the feeling of living among ones 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 interpersonal relationship between people who are more or less of equal status an integrating dynamism that tends to draw out loving reactions from another person, thereby decreasing anxiety and loneliness

Self-System
most complex and inclusive of all the dynamisms

a consistent pattern of behaviors that maintains

peoples interpersonal security by protecting them from anxiety the principal stumbling block to favorable changes 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 from awareness - experiences do not cease to exist but continue to influence 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 conceptions that grows out of experience with need satisfaction and anxiety they may be relatively accurate or may be grossly distorted

Bad-Mother, Good-Mother
Bad Mother
grows out of the infants experiences with the nipple that

does not satisfy their hunger needs the infants vague representation of not being properly fed

Good Mother
based on the tender and cooperative behaviors of the

mothering one

Both images are combine to form a complex personification composed of contrasting qualities

Me Personifications
1. Bad-me - grows from experiences of punishment or disapproval - infants can learn that they are bad only from someone else 2. Good-me - results from experiences with reward and approval 3. Not-me
- allows a person to dissociate or selectively not attend to the experiences related to anxiety - denies the experiences to the me image so that they become part of the not-me personification

Eidetic Personifications
unrealistic traits or imaginary friends that children

invent in order to protect their self-esteem hinder communication and prevent people from functioning from the same level of cognition

Stereotypes
-personifications that are shared by a number of people -consensually validated conceptions, ideas that have wide acceptance among the members 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 to communicate to others beyond conscious recall Adults frequently have preverbal experiences that are momentary and incapable of being communicated

Parataxic Level
prelogical and usually result when a person

assumes a cause-and-effect relationship between two 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 two events in close temporal proximity

Syntaxic Level
Experiences that are consensually validated

(those on whose meaning two or more persons agree) and that can be symbolically communicated to others

Dynamics
oTension o Energy Transformation

Sullivan saw personality as an energy 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 the organism tensions that result from an anxiety

Needs
tensions brought on by biological imbalance

between a person and the physiochemical environment, both inside and outside the organism are episodic once satisfied, they temporarily lose their power, but after a time, they are likely to recur 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 ones security transferred from the parent to the infant through the process of empathy chief disruptive force blocking the development of healthy interpersonal relations : blow on the head

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 and reducing anxiety

Stages of Development
-7 Stages -Thread of interpersonal relations runs throughout the 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 tenderness that they receive from the mothering one. The emphatic link between mother and infant leads inexorably to the development of anxiety for the baby.

 First anxiety always associated with the Oral Zone

and Nursing Situation. Infants repertoire of behaviors is not adequate to handle anxiety. Expresses hunger and anxiety through crying.

 When tension approaches terror, the infant

experiences difficulty in breathing. Built-in protections of apathy and somnolent detachment 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 of

various phonemes.

Childhood
Begins with the advent of syntaxic level until the

appearance of the need for playmates of an equal status. The mother remains the most significant other person, but her role is different from what it was during 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 to

have a safe, secure relationship that produces little anxiety. - Also known as the Imaginary friend - Not a sign of pathology but a positive event that helps children become ready with intimacy.

 Also known as the period of rapid acculturation.

Two processes:
Dramatizations: Preoccupations:

attempts to act or sound like important authority figures especially the mother and the father.

strategies for avoiding anxiety and fearprovoking situations by remaining occupied with an activity that has earlier proved rewarding.

Juvenile Era
Begins with the need for peers or playmates of

equal status and ends when one finds a single chum 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 task confronting 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 have

developed an orientation toward living that makes it easier to handle anxiety, and satisfy zonal and tenderness needs.

 Orientation toward living readies a person for

the deeper interpersonal relationships.

Preadolescence
Begins at age 8 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 partners

validate one anothers worth.

Love
Exists when the satisfaction or the security of

another person becomes as significant to one as is ones own gratification or security. (Sullivan, 1953a, pp. 42-43)

 Relationships involve another person of same

gender and of equal age or status. Boy-boy or girl-girl chumships.

 The free exchange of personal thoughts and

feelings initiates the preadolescent into the world of intimacy.

 Experiences during this stage are critical for the

future development of personality.

Early Adolescence
Begins with puberty and ends with the need for

sexual love with one person. Marked by the eruption of genital interest and the advent of lustful relationships.

 Intimacy, lust, and security often collide with one

another, bringing stress and conflict to the young adolescent 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 lust

and intimacy towards the same person and ends in adulthood when they establish a lasting love relationship. Period of self-discovery

 Outstanding feature = fusion of intimacy and lust.

Attempts at self-exploration.
Completely determined by interpersonal relations

 Successful late

Unsuccessful late

adolescence: - Includes a growing syntaxic mode.

adolescence: - Rely heavily on the parataxic mode.

Adulthood
A period when people can establish a love

relationship with atleast one significant other.

 Beyond the scope of interpersonal psychiatry

Mature adults are perceptive of other peoples

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 avoided

getting personally involved with the patients Friendship is not a condition since the therapist must be a trained expert 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 organize

knowledge - because of the extreme emphasis on 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