Book
The Interpersonal Theory of Psychiatry
The Interpersonal Theory of Psychiatry (New York: Norton, 1953) is the fullest statement of Harry Stack Sullivan's theory of personality development, published four years after his death. Helen Swick Perry and Mary Ladd Gawel edited it from recordings of the lecture series he gave at the Washington School of Psychiatry in 1946–47 and from the notebooks in which he outlined those lectures; where a lecture had not been recorded, they rebuilt it from his outline. Mabel Blake Cohen's introduction warns that the chapters on infancy are hypotheses about what must happen to every infant rather than direct observations. Sullivan defines psychiatry as the study of interpersonal relations. Personality is the relatively enduring pattern of recurrent interpersonal situations that characterize a life, and it shows itself only in what passes between people, real or imagined. The book opens with definitions and postulates, among them the one-genus postulate that human beings are far more alike than different. Its long middle part follows the developmental epochs. In infancy the baby's needs call out tenderness in the mothering one, while her anxiety reaches the baby through empathy. The avoidance of anxiety becomes the mainspring of development. Experience is organized in three modes. The prototaxic is an undifferentiated flow. The parataxic links things that merely occur together, and it is the source of later parataxic distortions of other people. The syntaxic is consensually validated in shared language. Out of approval, disapproval and overwhelming anxiety the infant forms the personifications good-me, bad-me and not-me. From them grows the self-system, an organization of security operations, chiefly selective inattention and dissociation, that keeps anxiety down at the cost of learning from experience. Childhood brings speech and socialization. A child whose need for tenderness is met with rebuff may come to expect hostility and turn malevolent. The juvenile era teaches competition, compromise and cooperation among peers. Preadolescence brings the first capacity for love, in intimacy with a same-sex chum. Early adolescence brings the lust dynamism and its collisions with intimacy and security, and late adolescence the full range of adult relations. Personality is not settled in the first years, and each era offers a chance to repair earlier warps. A third part treats schizophrenic and paranoid states, sleep, dreams and myths as patterns of inadequate or inappropriate interpersonal relations, continuous with ordinary living. A closing chapter, drawn from Sullivan's 1948 paper, calls for a psychiatry of peoples that would address tensions between nations. The book became a founding text of interpersonal psychoanalysis.
Main ideas
- Psychiatry is the study of interpersonal relations: personality is the relatively enduring pattern of recurrent interpersonal situations in a life, and it can be observed only in what goes on between people, real or imagined.
- The one-genus postulate holds that human beings are far more alike than different, so the theory attends to what people share rather than to individual differences.
- The infant's needs arouse a complementary tension in the mothering one, felt as tenderness; needs that require her cooperation merge into a general, interpersonal need for tenderness.
- Anxiety is interpersonal from the start: the mothering one's anxiety is conveyed to the infant through empathy, and the effort to avoid anxiety becomes the mainspring of development.
- Experience is organized in three modes: the prototaxic, an undifferentiated flow; the parataxic, which links what merely occurs together and gives rise to parataxic distortions; and the syntaxic, consensually validated in shared language.
- Personality is a hierarchy of dynamisms, relatively enduring patterns of energy transformation such as the self-dynamism and the lust dynamism.
- From approval, disapproval and overwhelming anxiety the infant forms the personifications good-me, bad-me and not-me, and from them the self-system, which wards off anxiety through security operations such as selective inattention and dissociation, at the cost of learning from experience.
- Development runs through epochs, each with its own interpersonal needs: infancy, childhood, the juvenile era, preadolescence, early and late adolescence. Development can be arrested at any point, but personality is not fixed early, and later eras can repair earlier damage.
- When a child's bids for tenderness are repeatedly rebuffed, the child may come to expect hostility and answer with malevolence, hatred and isolating techniques.
- In preadolescence the capacity for love first appears, in intimacy with a same-sex chum whose satisfaction and security matter as much as one's own; it allows consensual validation and the correction of earlier distortions.
- Schizophrenic and paranoid states are patterns of inadequate or inappropriate interpersonal relations, differing from ordinary living in degree only, and dreams and myths show the same processes at work.
- The book closes by calling for a psychiatry of peoples, applying interpersonal understanding to the tensions between nations.
What it shows
Harry Stack Sullivan introduced Interpersonal psychoanalysis
Sullivan defined psychiatry as the study of what goes on between people, and built his theory of personality, development and mental disorder on that definition; the 1939 lectures published as Conceptions of Modern Psychiatry were its first systematic statement.
Harry Stack Sullivan introduced Parataxic distortion
Sullivan illustrated the term with a patient who, after hundreds of hours, discovered that she had been seeing him as a fat old man with white hair.
Harry Stack Sullivan introduced Self-system
Sullivan used self dynamism and self-system interchangeably for the part of personality organized around avoiding anxiety; its fullest account is in the lectures posthumously published as The Interpersonal Theory of Psychiatry.
Harry Stack Sullivan introduced Security operations
Security operations are central to Sullivan's account of how anxiety shapes conduct, from everyday life to schizophrenia.
Harry Stack Sullivan introduced Modes of experience
The prototaxic, parataxic and syntaxic modes are Sullivan's coinages; Mullahy's exposition in the same volume sets them out as Sullivan taught them.
Harry Stack Sullivan introduced Consensual validation
Sullivan tied consensual validation above all to the preadolescent friendship with a chum.