Harry Stack Sullivan

Sullivan promoted interpersonal psychoanalysis (1953, 1962). His theory was that all psychological phenomena have interpersonal roots and that psychic existence begins with the internalization of important connections. "Demands for fulfillment" are biological needs entrenched in our instincts, and "needs for security" are rewarding relationships with others that reinforce our sense of self-efficacy, personal safety, and inherent goodness, according to Sullivan. Satisfying needs increases security, positivity, and emotional development. However, excessive pleasure desires undermine security. Anxiety and, if strong, a sense of personal "badness" are caused by excessive frustration with the emotional drive to bond to significant others, even when fundamental needs are supplied. \n

Anxiety caused by insecurity causes emotional illness. Sullivan says "reflected appraisal by others" decides if a person has a positive self-image and is incorporated into achieving their security needs. Sullivan described relationship evaluation phases. Early life is marked by "prototaxic" experiences before one can distinguish oneself from others. Psychotherapy affects transference due to "parataxic" early experiences with others.

\ These are alternative ways of articulating Freud's fundamental and secondary processes, just as Sullivan's classification of satisfaction and security demands replaced drive theory. Sullivan also offered "selective inattention" as an early self-defense that approximates Freud's preconscious and "dissociation" as a more extreme self-erasure that resembles Freud's repression mechanism. Healthy and unfavorable early object relationships led Sullivan to three developmental phases. A feeling of "euphoria" and inner goodness from rewarding internalized object interactions fosters emotional development and the extension of both the external and interior universe of object relations. "Good me" comes from them. Unsatisfactory relationships characterized by stress and annoyance over security lead to a "poor self" perception. Projecting a disconnected "bad self" might cause paranoia. The person "personifies" significant persons, especially "good moms" and "bad mothers," in personal interactions to "good me" and "bad me." Sullivan identified all object relations theories' intrapsychic structures. Psychosis' basic distortion and destruction of intrapsychic experience, "not me," is expressed in profoundly frustrating experiences that create anxiety and substantial psychological disarray. Paranoid psychoses involve "malevolent modification" of all object interactions, according to Sullivan.

In an empathic, stable, and sensitive interpersonal setting, Sullivan's treatment technique reactivated the patient's dissociated "bad me" and "not me" experiences in the transference so they might finally endure the activation of dissociated parataxic relationships. Practically, Sullivan focused on comprehension, ventilation, and interpretive resolution of negative trans-ferences to help the patient regain his capacity for satisfying object relations and allow for positive growth experiences in the psychotherapeutic relationship, self-consolidation, and emotional development.

\ Frieda Fromm-Reichmann (1950,1959), Otto Will (1959), and Harold Searles (1965, 1986) were all significantly impacted by Sullivan's approach to the psychoanalytic therapy of psychotic, particularly schizophrenic, patients. Searles has integrated Kleinian concepts, particularly those of Rosenfeld and Bion (both of whom had worked with psychotic patients within a Kleinian frame of reference), with his Sullivanian background in developing a general theory of the treatment of patients with psychotic and borderline illness. Sullivanian thought, along with Fairbairn's method, has had a significant impact on current interpersonal psychoanalysis, as represented by Greenberg and Mitchell (1983).

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