Harry Stack Sullivan

Harry Stack Sullivan

Harry Stack Sullivan puts forward multi-axial formulations of human development. According to his cornerstone one-genus postulate, firstly, human beings resemble each other more than any other organism: “the differences between any two instances of human personality – from the lowest-grade imbecile to the highest-grade genius – are much less striking than the differences between the least-gifted human being and a member of the nearest other biological genus” (Sullivan, 1953: 32). Similarities rather than differences should therefore be emphasised.

The fundamental motivations of the person are construed by Sullivan as follows.

• The is an inherent drive towards psychological health.
• There is a universal need for others, with relationships essential for optimal personality development.
• Reduction of tension, especially anxiety, is a prime concern.
• Psychological development is totally explicable in terms of physical energy, with no distinction necessary or possible from mental energy.
• In agreement with Jung and Adler, behaviour is driven not only by past causation but also future purpose.

On a straightforward level, Sullivan advocates seven developmental epochs (described later). Unlike the Freudian equivalent sequencing (see Section 1.3), the thrust of all stages is interpersonal rather than psychosexual and each is characterised by a distinct change in interpersonal dynamics. Human psychological development is thereby fundamentally shaped through interactions with others. Indeed, Sullivan argues that any conception of personality beyond the interpersonal context is meaningless (this despite, or perhaps because of, his own by many accounts withdrawn personality). The most significant relationship is that between the mother and infant, characterised by an empathic linkage. Given that anxiety can be infectious, it is imperative to Sullivan that the mother consistently displays calm tenderness.

Sullivan also employed the concept of self (or self-system), which is considered not to be innate but as evolving from the child’s experiences with her own body and from the reflected appraisals of others. Hence, in Rogerian style (see Section 2.4), others’ evaluations of a child become internalised and form the basis of the way in which that child evaluates himself. Positive interactions with significant adults as the child is developing will lead to a positive self-view (the so-called good-me personification); negative interactions are conducive to low self-esteem (the bad-me personification). With his emphasis on the “good-me” and the “bad-me” and their development as a result of relationships with others, Sullivan was a precursor of object relations theory.

The self-system strives for consistency, stability and safety and may use selective inattention to ignore or reject threatening or incongruous data. As a result, it may be resistant to change. Although this alleviates anxiety, an individual’s experiences and aspects of self may be consigned to the unconscious level. In such a shadowy domain, unacceptable, split-off elements of the individual dissociate and coalesce into the not-me personification, which can then emerge in subjectively dreadful manner if the self-system’s safety operations fail.

Sullivan also identifies three modes of early human experience on the way to the child’s development of conceptions of causality and her place in a permanently existing universe.

• The prototaxic mode is characteristic of the first six months of infancy. It comprises a succession of sensory experiences upon which the infant is unable to impose order or meaning. Her awareness might be described as diffuse, sensory based (rather than cognitive) and egocentric. Temporal contiguity is the only conception of causality, while in line with Piagetian findings (see Section 4.2) there is a lack of “object permanence”: once an object has disappeared from view, as far as the infant is concerned it ceases to exist. The infant is incapable of distinctions and her prototaxic mode of experiencing cannot be communicated.

• The parataxic mode is developed during approximately the second half of the first year of life. It is characterised by use of private (autistic) symbols, though still a lack of significant understanding of cause and effect, especially consequences, and a rudimentary memory system. The infant discovers, however, that he can intend an action, though such intention tends to be construed through “magical thinking” to be causative. The self/not-self distinction begins to be drawn, with some sense of causality attributed to others.

• The syntaxic mode (literally meaning to place together in logical connected order) begins to evolve during the second year of life. The primary narcissism typical of the previous two modes fades to some extent and the use of socially understood symbols (e.g. words and numbers) emerges. The child learns to perceive the difference between physical and temporal connections, enabling the past, present and future to be integrated. Reality is interpreted on its own terms and interpersonal relationships become increasingly focal.

The seven developmental epochs are as follows. Each advances the person’s level of sophistication in experiencing reality and need for close relationships with significant others.

• Infancy extends from birth to the development of language. The primary mode of experiencing is the prototaxic. As also proposed by Freud (see Section 1.3), this epoch is marked by oral events (e.g. crying, nursing) and the rudiments of trust and self-esteem. Good-me, bad-me and not-me begin to be differentiated and defensive reactions of apathy and detachment emerge.
• Childhood extends from the child’s initial development of language to his interaction with playmates. The principal challenge for the child is dealing with parental rewards and punishments, possibly leading to a sense of loneliness. The primary mode of experiencing is the parataxic.
• The juvenile epoch is highlighted by the need for genuine co-operative play with other children. The child may even generate an imaginary playmate. The primary modes of experiencing are the parataxic and syntaxic. Successful passage through this period facilitates an adaptive, tolerant orientation for living with other people.
• In preadolescence, the need for extending play into close relationships with children (“chums”) of the same gender develops. Assisted by mutual validation, true collaboration may be learned, underlining the progression from previous egocentric concerns. The primary mode of experiencing from this stage onwards in the syntaxic.
• Early adolescence begins with puberty and includes desire for close relationships with members of the opposite sex. The awakening of sexual arousal provides a new arena for re-evaluation of the self-image, with potential experiences of awkwardness and ridicule to work through.
• Late adolescence provides the challenges of establishing adult friendships and relationships, vocational identity and increasing social responsibility. The individual may feel especially restricted at this time if previous phases have not been successfully negotiated.
• Adulthood is viewed as a stage of true maturity, which Sullivan in contrast to his otherwise reasonably optimistic orientation believes to elude most people. It is denoted in particular by the capacity for genuine, non-possessive love to facilitate the psychological development of others.

Sullivan focuses on two main areas of disturbed development. He attributed obsessive-compulsive disorder to excessive vulnerability to anxiety and a profound loss of self-esteem. He considers the associated ritualistic thoughts and actions to be essentially security operations defending against the conscious experience of anxiety at the potential emergence of the bad-me or not-me personifications. Sullivan believes schizophrenia is caused by early “uncanny” emotions – especially extreme anxiety signalled by the presence of the not-me personification – along with parataxic experiencing and traumatic jolts to self-esteem during later developmental epochs, especially adolescence. Personal development in Sullivanian style is education rather than cure. Fundamentally similar to most psychodynamic orientations, the principal goals are to reintegrate the dissociated (bad-me and not-me) aspects of the personality and expand the self-system.

PRIMARY REFERENCES

Sullivan, H S (1947). Conceptions of Modern Psychiatry. New York: Norton.

Sullivan, H S (1953). The Interpersonal Theory of Psychiatry. New York: Norton.

Sullivan, H S (1954). The Psychiatric Interview. New York: Norton.

Sullivan, H S (1956). Clinical Studies in Psychiatry. New York: Norton.

Sullivan, H S (1962). Schizophrenia as a Human Process. New York: Norton.

Sullivan, H S (1964). The Fusion of Psychiatry and Social Science. New York: Norton.

Sullivan, H S (1972). Personal Psychopathology. New York: Norton.