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THE STALWARTS

Harry Stack Sullivan

Raghuveer Reddy G. Post graduate of Psychiatry, Institute of Mental Health, Osmania Medical College, Hyderabad,
Andhra Pradesh. India.

ABSTRACT

Harry Stack Sullivan was one of the most important seminal thinkers in American psychiatry. His period was
marked by intense excitement over psychoanalysis and the emergence of sociology and anthropology as fields
of thought and endeavour. He synthesized the contemporary ideas of psychiatry and social science together to
form what has been called "social psychiatry." He was one of the first stalwarts in the field of community
mental health movement.
Key words: Harry Stack Sullivan

INTRODUCTION
Harry Stack Sullivan (1892 - 1949) was born to Irish
immigrants, and said to have grown-up in an anti-Catholic
town. The resultant social isolation might have laid to his
later interest in psychiatry. [13- ] He received his medical
degree from Chicago College of Medicine and Surgery in
1917. He was one of the founders of the William Alanson
White Institute, considered to be the World's leading
independent psychoanalytic institute, and of the journal
Psychiatry in 1937. [2, 3]
He headed the Washington School of Psychiatry (DC) from
1936 to 1947. [3] In 1940, Sullivan and his colleague
Winfred Overholser formulated guidelines for the
psychological screening of inductees to the United States
military. [3]
Contributions
Tensions and Sullivan [4]
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
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.
Address for correspondence Dr Raghuveer Reddy G.
Postgraduate, Department of Psychiatry, Institute of Mental Health,
Osmania Medical College, Hyderabad-500038. Andhra Pradesh. India.
Phone: 91-9700843200
Email: ragsmbbs@gmail.com
How to cite this article: Raghuveer Reddy G.
The stalwarts: Harry Stack Sullivan. AP J Psychol Med 2011;
12 (2): 87–9.
Anxiety
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.
Dynamisms and Sullivan [1, 4]
Sullivan used the term dynamism to refer to a typical
pattern of behaviour.
Malevolence
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
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
Lust is a self-cantered 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
The most inclusive of all dynamisms is the self-system,
or that pattern of behaviours that protects us against
anxiety and maintains our interpersonal security.
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Raghuveer : Harry Stack Sullivan
Security operations: These are the behaviours designed
to reduce interpersonal tensions, and include:
Dissociation: This includes all those experiences that we
block from awareness.
Selective inattention: This involves blocking only certain
experiences from awareness.
Personifications and Sullivan [1, 4]
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 pe r s onific ati on 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 behaviour 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 t hree "me"
personifications:
 the bad-me, which grows from experiences of
punishment and disapproval,
 the good-me, which results from experiences
with reward and approval, and
 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.
Modes of experiencing and thinking about the World
[2, 4]
Sullivan recognized three levels of cognition, or ways of
perceiving things:
Prototaxic Level
Experiences that are impossible to put into words or to
communicate to others are called prototaxic. This occurs
AP J Psychol Med Vol. 12 (2) Jul-Dec 2011
normally in infancy and also appears in patients with
schizophrenia.
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.
Syntaxic Level
Experiences that can be accurately communicated to
others are called syntaxic. Logical, rational, and most
mature type of cognitive functioning of which a person
is capable.
Sullivan pioneered the notion of the therapist as a
participant observer, who 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. [4]
Chum period
In preadolescence (9 - 12 yrs) the capacity for love and
for collaboration with another person of same sex
develops. This is called chum period, and it is the
prototype of sense of intimacy. This chum is often missing
in schizophrenia patients. [2]
Developmental Epochs (Table 1)
Another similarity between Sullivan's theory and that of
Freud's is the belief that childhood experiences determine,
to a large degree, the adult personality. Unlike Freud,
however, he also believed that personality can develop past
adolescence and even well into adulthood. He called the
stages in his developmental theory Epochs. He believed
that we pass through these stages in a particular order but
the timing of such is dictated by our social environment.
Much of the focus in Sullivan's theory revolved around the
conflicts of adolescence. [5]
Interpersonal therapy
Sullivan evolved a theory of personality that emphasized
the importance of interpersonal relations. He theorized
that personality is shaped almost entirely by the
relationships one has w i th ot her p eople. He
conceptualized developmental stages. According to him,
the therapist is a participant observer, who establishes
an interpersonal relationship with the patient. The
therapist understands patients, and helps them develop
foresight, improves interpersonal relations, and restores
their ability to operate mostly on a syntaxic level. [6]
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Raghuveer : Harry Stack Sullivan

Table 1 Sullivan's Developmental Epochs
Infancy From birth to about age one, the child
Age birth begins the process of developing, but
to 1 year Sullivan did not emphasize the
younger years to near the importance
as Freud.
Childhood The development of speech and
Ages 1 to 5 improved communication is key in
this stage of development.
Juvenile The main focus as a juvenile is the
Ages 6 to 8 need for play mates and t he
beginning of healthy socialization
Preadolescence During this stage, the child's ability
Ages 9 to 12 to form a close relationship with a
p eer is t he major focus. T his
relationship will later assist the child
in feeling worthy and l ikable.
Without this ability, forming the
intimate relationships in late
adolescence and adulthood will be
difficult.
psychotherapy lost popularity in coming years. 'In
summary, his theory rates very low in falsifiability, low
in its ability to generate research, and average in its
capacity to organize knowledge and to guide action. In
addition, it is only average in self-consistency and low in
parsimony. Because Sullivan saw human personality as
largely being formed from interpersonal relations, his
theory rates very high on social influences and very low
on biological ones. In addition, it rates high on
unconscious determinants; average on free choice,
optimism, and causality; and low on uniqueness.' [5]
Acknowledgments: Nil
References
1. Sadock VA, Sadock BJ, Ruiz P, editors. Harry Stack Sullivan. In:
Comprehensive Text book of Psychiatry. 9th Ed. Vol 2. Lippincott Williams
and Wilkins: 2009: 864–7.
2. Sadock VA, Sadock BJ, editors. Synopsis of Psychiatry, Behavioural
Sciences/ clinical Psychiatry.10th Ed.: 2007: 225–6.
3. Harry Stack Sullivan. Wikipedia. Cited 2011 Aug 18. Available from: http:/
/en.wikipedia.org/wiki/Harry_Stack_Sullivan.
4. Harry Stack Sullivan. In: Personality synopsis. Psychodynamic and Neo-
Freudian theories. Cited 2011 Aug 18. Available from: http://allpsych.com/
personalitysynopsis/stack_sullivan.html.

5. Sullivan and Interpersonal theory. Cited 2011 Aug 18. Available from: http:/
Early Adolescence The onset of puberty changes this /www.theglaringfacts.com/sullivan-interpersonal-theory/
Ages 13 to 17 need for friendship to a need for 6. Sullivan: interpersonal theory. Cited 2011 Aug 18. Available from: http://
sexual expression. Self worth will highered.mcgraw-hill.com/sites/0072316799/student_view0/part2/
chapter8/chapter_outline.html
often become synonymous with
sexual attractiveness and acceptance Source of Support : Nil Conflict of Interest : None declared
by opposite sex peers.
Late Adolescence The need for friendship and need for
Ages 18 to 22 or s exual expression get
23 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
previous stages can result in a
skewed perception of the self and the
world.
Adulthood The struggles of adulthood include
Ages 23 on financial security, career, and family.
With success during previous stages,
especially those in the adolescent
years, adult relationships and much
needed socialization become easier to
attain. Without a s olid background,
interpersonal conflicts that result in
anxiety become more commonplace.
Criticism of Sullivan's Interpersonal theory
Though Sullivan gave much importance to interpersonal
relations, his theory of personality and his approach to

AP J Psychol Med Vol. 12 (2) Jul-Dec 2011