Harry Stack Sullivan’s (1892 – 1949) Interpersonal Theory                                    - Most basic interpersonal
need
 Brief Information                                                                        -   Requires action from at least
       Name: Harry Stack Sullivan                                                              2 people
       Place of birth: Norwich, New York                                                   -   Infant: to receive
       Date of birth: February 21, 1892                                                    -   Mothering one: to give
       Religion: Catholic                                                       ii.   Physiological Needs (e.g. oxygen,
       Occupation: American Psychiatrist                                              food, etc.)
       Mother’s name: Ella Stack Sullivan                                  b) Zonal Needs (oral, genital, manual)
       Father’s name: Timothy Sullivan
       Date of Death: January 14, 1949                                2.   Anxiety
       Cause of death: heart attack/cerebral hemorrhage                    -   Disjunctive, vague and calls forth no consistent
                                                                               actions for its relief
 Some Events                                                              -   Chief disruptive force blocking the
      His mother protected him after the death of two                         development of healthy interpersonal relations
         other sons.                                                       -   Transferred from the mothering one to the
      His father was a shy and withdrawn farm                                 infant through empathy
         laborer/factory worker who did not speak to him                   -   Signs of anxiety may cause the mother to
         until his mother died and he became a physician.                      misunderstand it as needs
      On Harry’s 3rd birthday, her mother mysteriously                    -   Prevent people from learning from their
         went missing from home.                                               mistakes
      Sullivan had a lonely and isolated childhood.                       -   Keeps people pursuing childish wish for
      At 8 ½ years old, he formed a close friendship to a                     security
         13-year-old boy named Clarence Bellinger.
      He graduated high school at age 16.                       B.   Energy Transformations
      Undergraduate: Cornell University                              -   Tensions that are transformed into overt or covert
                                                                          actions
      Medicine Degree: Chicago College of Medicine and
                                                                      -   Behaviors that are aimed at satisfying needs and
         Surgery
                                                                          reducing anxiety
      Medical officer during and after World War I.
      St. Elizabeth Hospital: worked with a large number
                                                                 C.   Dynamisms
         of patients with schizophrenia
                                                                      -  Key concept in Sullivan’s overall personality theory
      Sheppard and Enoch Pratt Hospital: He was called
                                                                      -  Typical behavior patterns that are organized from
         the “clinical wizard”
                                                                         energy transformations
      James Inscoe: remained with Sullivan for 22 years;             -  Smallest unity of study in interpersonal
         his last name was changed to Sullivan and was                   relationships
         treated like his own son.                                    -  Pattern of behavior that endures and recurs, as
                                                                         such it may be equated to habit
 Basic Tenet                                                         -  2 classes:
           It emphasized the importance of interpersonal                  Related to the body (e.g. mouth, anus, genitals)
           relations; Personality is shaped almost entirely by
                                                                          Related to tensions (disjunctive, isolating,
           the relationships we have with other people.
                                                                              conjunctive)
 Sullivan’s Theory of Personality                                         1.   Malevolence
  > Sullivan saw personality as an energy system <                              -    Disjunctive dynamism of evil and hatred
  A. Tensions                                                                   -    Feeling of living among one’s enemies
       -    Potential for action                                                -    Take the form of timidity,
       -    May or may not be experienced in awareness                               mischievousness, cruelty of other kinds of
                                                                                     asocial/antisocial behavior
        1.   Needs                                                              -    Trust is affected in latter stages of not
             -  Tensions brought on by biological imbalance                          resolved
                both inside and outside the organism                            -    “Once upon a time everything was lovely,
             -  Episodic in nature: when satisfied, it will                          but that was before I had to deal with
                temporarily lose its power then recur after                          people”
                some time                                                  2.   Lust
             a) General Needs                                                   -    Isolating tendency
                   i.    Interpersonal Needs                                    -    Immediate goal: genital sexual activity
                          Tenderness
             -   Requiring no other person for its                        -   Consensually validated conceptions that are
                 satisfaction                                                 widely accepted by members of society handed
             -   Manifests itself as autoerotic behavior                      down from generation to generation
                 even when another person is the object of
                 it                                                  1.   Good-mother; bad-mother personifications
             -   Powerful during adolescence                              a) Good-mother
             -   Reduction of self-esteem                                     -    Tender and cooperative behaviors of the
             -   Hinders intimate relationships                                    mothering one
        3.   Conjunctive                                                  b) Bad-mother
             -   Positive and conjunctive dynamism                            -    Infant’s personification of not being fed
             -   Grows out of the earlier need for                            -    Nipple that does not satisfy hunger of the
                 tenderness                                                        infant
             -   Involves a close relationship between two                c) Overprotective mother
                 people who are more or less of equal                         -    Stems from the mother’s anxiety
                 status                                              2.   Me personifications
             -   Must not be confused with sexual interest                a) Bad-me personification
             -   Integrating dynamism that tends to draw                      -    Punishment and disapproval
                 out loving reactions from the other person                   -    Negative aspects of the self
             -   Rewarding experience that most health                        -    Hidden from others and possibly from the
                 people desire                                                     self
                                                                          b) Good-me personification
             Self-System                                                      -    Reward and approval
             -    Most complex and inclusive of all                           -    Mother’s expression and approval
                  dynamisms                                                   -    Everything that we like about ourselves
             -    Consistent pattern of behaviors that                    c) Not-me personification
                  maintains people’s interpersonal security                   -    Caused by sudden severe anxiety
                  by protecting them from anxiety                             -    So anxiety-provoking, we cannot even
             -    Develops at about 12 – 18 months of age                          consider them to be a part of us
             -    (+): serves as a signal, alerting people to                 -    Adults: dreams, schizophrenic episodes
                  increasing anxiety and giving them an                            and other dissociative reactions
                  opportunity to protect themselves                           Personified self – single, integrated self-image
             -    (-): resistant to change and prevent people        3.   Eidetic personifications
                  from profiting from anxiety-filled                      -   Unrealistic traits or imaginary friends that
                  experiences                                                 many children invent in order to protect their
             -    People form a consistent image of                           self-esteem
                  themselves                                              -   Adults: see fictional traits in others
              Security Operations                                        -   Hinder communication and prevent people
                  -     To reduce feelings of insecurity or                   from functioning on the same level of cognition
                        anxiety that result from endangered
                        self-esteem                             E.   Levels of Cognition
                  a) Dissociation                                    1. Prototaxic level
                        -    Impulses, desires and needs that            -    Impossible to communicate
                             a person refuses to allow into              -    Earliest and most primitive experience of an
                             awareness                                        infant
                  b) Selective Inattention                               -    Beyond conscious recall
                        -    Control of focal awareness and              -    “stream of consciousness”
                             refusal to see those things that        2. Parataxic level
                             we do not wish to see                       -    Usually results when a person assumes a
                                                                              cause-and-effect relationship between two
D. Personifications                                                           events that occur coincidentally
   -   Images that one has of himself or of another                      -    Prelogical and personal experiences that are
   -   Complex web of feelings, attitudes and conceptions                     communicated in distorted form
       that grows out of experiences with need                       3. Syntaxic level
       satisfaction and anxiety                                          -    Meaningful interpersonal communication
   -   May be relatively accurate or distorted depending                 -    Consensually validated experiences and can be
       on our needs and anxieties                                             symbolically communicated
    Stereotypes                                                         -    Formal language
       -    Personifications shared by a number of people
 Stages of Development
      STAGE             AGE               SIGNIFICANT          INTERPERSONAL PROCESS                 IMPORTANT LEARNINGS
                                            OTHERS
      Infancy              0–2           Mothering one                   Tenderness                          Good/Bad
     Childhood             2–6              Parents                 Imaginary playmates                 Synataxic language
    Juvenile Era          6–8½         Playmates of equal             Living with peers             Competition, compromise,
                                             status                                                         cooperation
   Preadolescence        8 ½ – 13         Single chum                    Intimacy                Affection and respect from peers
  Early Adolescence       13 – 15        Several chums          Intimacy and lust toward           Balance of lust, intimacy and
                                                                    different persons                   security operations
  Late Adolescence         15 –              Lover             Fusion of intimacy and lust          Discovery of self and world
   1.   Infancy                                                                     Compromise – giving in, when overdone, will
        -    Birth until when the child develops                                     handicap the child in the socialization process
             articulate/syntaxic speech                                           Cooperation – critical step to becoming
        -    First anxiety: nursing situation and the oral zone                      socialized
        -    Oral zone: primary zone of interaction between the              -   Orientation toward living: readies a person for
             baby and its environment                                            deeper interpersonal relationships to follow
        -    Apathy and somnolent detachment: built-in
             protections to keep the baby from dying                    4.   Preadolescence
        -    Autistic language: private language that makes no               -    Personality transformation because of taking interst
             sense to other people                                                in another person
   2.   Childhood                                                            -    “genesis of the capacity to love”
        -    Period of acculturation (how to act)                            -    Intimacy and love: essence of friendship
        -    Personifications of the mother are fused into one as            -    Most untroubled and carefree time of life
             well as me-personifications (single self-dynamism)              -    Characterized with unselfish love not yet
        -    Labelling good or bad is now because of social or                    contaminated by lust
             moral value and not anymore based on the anxiety                -    Most crucial stage of development
             of the child                                                    -    Chums: able to express self without fear of
        -    Mother-child relationship becomes personal                           humiliation
        -    2 important processes:                                          -    Intimacy: relationship between two partners
             a) Dramatizations – attempts to act like authority                   consensually validating one another’s personal
                  figures                                                         worth
             b) Preoccupations – remain occupied with an                     -    Love: exists when the satisfaction/security of
                  activity that has earlier proved useful or                      another person becomes a significant to one as in
                  rewarding                                                       one’s own satisfaction/security
         Imaginary friends                                             5.   Early Adolescence
             -    Eidetic friend                                             -    Marked by the eruption of genital interest and the
             -    Enables children to have a safe, secure                         advent of lustful relationships
                  relationship that produces little anxiety                  -    Conflict of intimacy, lust and security operations
             -    Sign of a positive event that helps children                     Lust vs security operations: genital activity =
                  become ready for intimacy with real friends                          anxiety, guilt and embarrassment
                  during the preadolescence stage                                  Intimacy vs security operations: self-doubt,
         During preschool years:                                                      uncertainty and ridicule (low self-esteem, high
             -    Malevolent attitude                                                  anxiety)
             -    Evolved self-dynamism to handle anxiety                          Intimacy vs lust: powerful genital tensions seek
                  better]the self-system introduces much                               outlet without regard for intimacy needs
                  stability that it makes future changes very                -    Lust dynamism: biological
                  difficult                                                  -    Turning point in personality development
   3.   Juvenile Era                                                    6.   Late Adolescence
        -    Playmates are of equal status                                   -    Period of self-discovery
        -    Able to make discriminations                                    -    People of the other gender are viewed as people
        -    Learnings:                                                           who are capable of being loved nonselfishly
              Competition – to be successful                                -    Includes a growing syntaxic mode
                  (overemphasized)                                           -    Begin exchanging ideas with others and having their
                                                                                  opinions and beliefs either validated or repudiated
         -   Only the mature person has the capacity to love;        Critique
             others merely go through the motions of being “in             Strengths:
             love” in order to maintain security                           -   Asserted the importance of society and interaction
    7.   Adulthood                                                             on personality
         -   A period when people can establish a love                     -   Emphasized the concept of the self
             relationship with at least one significant person             -   Focused on the interpersonal rather than
         -   Developed intimacy: principal source of satisfaction              psychosexual
             in life
         -   Beyond the scope of interpersonal psychiatry                    Weaknesses:
         -   Characteristics of people in this stage:                        -  Intense concern for working for a world free of
              Operate predominantly on the syntaxic level                      tensions and conflicts
              Find life interesting and exciting                            -  Concept of self grows out of the “reflected
                                                                                appraisal” of others
 Psychiatric interview                                                      -  Merely elaborated Freud’s ego and defenses
   Psychiatry
      -    The study of processes involve or go on between           References:
           people                                                     Morgan, J.H. (2014). The Interpersonal Psychotherapy of
      -    The field of interpersonal relations, under any and             Harry Stack Sullivan: Remembering the Legacy. J Psychol
           all circumstances in which relations exist                      Psychother. 4(6): 162. DOI: 10.4172/2161-0487.1000162
   Interview – interpersonal, face-to-face situation that            Feist, J. & Feist, G.J. (2008). Theories of Personality (7th ed.).
      takes place between patient and therapist                            pp. 212-241. USA: McGraw-Hill Higher Education.
   Interviewer’s role                                                Tria, G.E. & Limpingco, D.A. (2016). Personality (4th ed.). pp.
      -    Participant observer                                            77-83. Quezon City, PH: Pantas Publishing & Printing
      -    Helps patients give up some security in dealing with            Inc.
           other people and to realize that they can achieve
           mental health only through consensually validated
           personal relations
      -    Communicate on the syntaxic level to reduce
           anxiety
      -    Avoid getting involved with patients
      -    Convince patients of expert abilities
        Stages of interview
         1. Formal Inception
             -    Vocal communication between patient and
                  therapist
             -    Promotes confidence in the patient by
                  demonstrating interpersonal skills
             -    Patient express reasons for seeking therapy
         2. Period of Reconnaissance
             -    Finding out who the patient is
             -    General personal and social history is
                  established
             -    Open-ended questions are asked to invite the
                  patient to feel free to express the patient’s
                  emotional state at the time
         3. Detailed Inquiry
             -    Attempt to know which among the formulated
                  hypotheses during the first two stages is more
                  substantial
         4. Termination Stage
             -    Interviewer makes an assessment of what
                  he/she learned and prescribes a course for the
                  patient to follow including its effects
             -    Gives he client “homework”