Sullivan: Interpersonal Theory
B Overview of Interpersonal Theory B Biography of Harry Stack Sullivan B Tensions
B Dynamisms Malevolence
B Personifications Bad-Mother, Good-Mother
B Levels of Cognition Prototaxic Level
B Stages of Development Infancy
B Psychological Disorders B Psychotherapy B Related Research
The Pros and Cons of “Chums” for Girls and Boys
B Critique of Sullivan B Concept of Humanity B Key Terms and Concepts
C H A P T E R 8
The young boy had no friends his age but did have several imaginary playmates.At school, his Irish brogue and quick mind made him unpopular among school- mates. Then, at age 81/2, the boy experienced an intimate relationship with a 13-year-old boy that transformed his life. The two boys remained unpopular with other children, but they developed close bonds with each other. Most scholars (Alexander, 1990, 1995; Chapman, 1976; Havens, 1987) believe that the relationship between these boys—Harry Stack Sullivan and Clarence Bellinger—was at least in some ways homosexual, but others (Perry, 1982) believed that the two boys were never sexually intimate.
Why is it important to know about Sullivan’s sexual orientation? This knowl- edge is important for at least two reasons. First, a personality theorist’s early life his- tory, including gender, birth order, religious beliefs, ethnic background, schooling, as well as sexual orientation, all relate to that person’s adult beliefs, conception of humanity, and the type of personality theory that that person will develop.
Second, in Sullivan’s case, his sexual orientation may have prevented him from gaining the acceptance and recognition he might have had if others had not suspected that he was homosexual. A. H. Chapman (1976) has argued that Sullivan’s influence is pervasive yet unrecognized largely because many psychologists and psychiatrists of his day had difficulty accepting the theoretical concepts and therapeutic practices of someone they suspected of being homosexual. Chapman contended that Sullivan’s contemporaries might have easily accepted a homosexual artist, musician, or writer, but, when it came to a psychiatrist, they were still guided by the concept “Physician heal thyself.” This phrase was so ingrained in American society during Sullivan’s time that mental health workers found it very difficult to “admit their indebtedness to a psychiatrist whose homosexuality was commonly known” (Chapman, 1976, p. 12). Thus, Sullivan, who otherwise might have achieved greater fame, was shackled by sexual prejudices that kept him from being regarded as American’s foremost psy- chiatrist of the first half of the 20th century.
Overview of Interpersonal Theory Harry Stack Sullivan, the first American to construct a comprehensive personality theory, believed that people develop their personality within a social context. With- out other people, Sullivan contended, humans would have no personality. “A per- sonality can never be isolated from the complex of interpersonal relations in which the person lives and has his being” (Sullivan, 1953a, p. 10). Sullivan insisted that knowledge of human personality can be gained only through the scientific study of interpersonal relations. His interpersonal theory emphasizes the importance of var- ious developmental stages—infancy, childhood, the juvenile era, preadolescence, early adolescence, late adolescence, and adulthood. Healthy human development rests on a person’s ability to establish intimacy with another person, but unfortu- nately, anxiety can interfere with satisfying interpersonal relations at any age. Per- haps the most crucial stage of development is preadolescence—a period when chil- dren first possess the capacity for intimacy but have not yet reached an age at which their intimate relationships are complicated by lustful interests. Sullivan believed that people achieve healthy development when they are able to experience both inti- macy and lust toward the same other person.
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Ironically, Sullivan’s own relationships with other people were seldom satisfy- ing. As a child, he was lonely and physically isolated; as an adolescent, he suffered at least one schizophrenic episode; and as an adult, he experienced only superficial and ambivalent interpersonal relationships. Despite, or perhaps because of, these in- terpersonal difficulties, Sullivan contributed much to an understanding of human personality. In Leston Havens’s (1987) language, “He made his contributions walk- ing on one leg . . . he never gained the spontaneity, receptiveness, and capacity for intimacy his own interpersonal school worked to achieve for others” (p. 184).
Biography of Harry Stack Sullivan Harry Stack Sullivan was born in the small farming town of Norwich, New York, on February 21, 1892, the sole surviving child of poor Irish Catholic parents. His mother, Ella Stack Sullivan, was 32 when she married Timothy Sullivan and 39 when Harry was born. She had given birth to two other sons, neither of whom lived past the first year. As a consequence, she pampered and protected her only child, whose survival she knew was her last chance for motherhood. Harry’s father, Timothy Sul- livan, was a shy, withdrawn, and taciturn man who never developed a close relation- ship with his son until after his wife had died and Sullivan had become a prominent physician. Timothy Sullivan had been a farm laborer and a factory worker who moved to his wife’s family farm outside the village of Smyrna, some 10 miles from Norwich, before Harry’s third birthday. At about this same time, Ella Stack Sullivan was mysteriously absent from the home, and Sullivan was cared for by his maternal grandmother, whose Gaelic accent was not easily understood by the young boy. After more than a year’s separation, Harry’s mother—who likely had been in a mental hos- pital—returned home. In effect, Sullivan then had two women to mother him. Even after his grandmother died, he continued to have two mothers because a maiden aunt then came to share in the child-rearing duties.
Although both parents were of poor Irish Catholic descent, his mother re- garded the Stack family as socially superior to the Sullivans. Sullivan accepted the social supremacy of the Stacks over the Sullivans until he was a prominent psychia- trist developing an interpersonal theory that emphasized similarities among people rather than differences. He then realized the folly of his mother’s claims.
As a preschool child, Sullivan had neither friends nor acquaintances of his age. After beginning school he still felt like an outsider, being an Irish Catholic boy in a Protestant community. His Irish accent and quick mind made him unpopular with his classmates throughout his years of schooling in Smyrna.
When Sullivan was 81/2 years old, he formed a close friendship with a 13-year- old boy from a neighboring farm. This chum was Clarence Bellinger, who lived a mile beyond Harry in another school district, but who was now beginning high school in Smyrna. Although the two boys were not peers chronologically, they had much in common socially and intellectually. Both were retarded socially but ad- vanced intellectually; both later became psychiatrists and neither ever married. The relationship between Harry and Clarence had a transforming effect on Sullivan’s life. It awakened in him the power of intimacy, that is, the ability to love another who was more or less like himself. In Sullivan’s mature theory of personality, he placed heavy emphasis on the therapeutic, almost magical power of an intimate relationship dur-
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ing the preadolescent years. This belief, along with many other Sullivanian hypothe- ses, seems to have grown out of his own childhood experiences.
Sullivan was interested in books and science, not in farming. Although he was an only child growing up on a farm that required much hard work, Harry was able to escape many of the chores by absentmindedly “forgetting” to do them. This ruse was successful because his indulgent mother completed them for him and allowed Sullivan to receive credit.
A bright student, Sullivan graduated from high school as valedictorian at age 16. He then entered Cornell University intending to become a physicist, although he also had an interest in psychiatry. His academic performance at Cornell was a disas- ter, however, and he was suspended after 1 year. The suspension may not have been solely for academic deficiencies. He got into trouble with the law at Cornell, possi- bly for mail fraud. He was probably a dupe of older, more mature students who used him to pick up some chemicals illegally ordered through the mail. In any event, for the next 2 years Sullivan mysteriously disappeared from the scene. Perry (1982) re- ported he may have suffered a schizophrenic breakdown at this time and was con- fined to a mental hospital. Alexander (1990), however, surmised that Sullivan spent this time under the guidance of an older male model who helped him overcome his sexual panic and who intensified his interest in psychiatry. Whatever the answer to Sullivan’s mysterious disappearance from 1909 to 1911, his experiences seemed to have matured him academically and possibly sexually.
In 1911, with only one very unsuccessful year of undergraduate work, Sulli- van enrolled in the Chicago College of Medicine and Surgery, where his grades, though only mediocre, were a great improvement over those he earned at Cornell. He finished his medical studies in 1915 but did not receive his degree until 1917. Sulli- van claimed that the delay was because he had not yet paid his tuition in full, but Perry (1982) found evidence that he had not completed all his academic require- ments by 1915 and needed, among other requirements, an internship. How was Sul- livan able to obtain a medical degree if he lacked all the requirements? None of Sul- livan’s biographers has a satisfactory answer to this question. Alexander (1990) hypothesized that Sullivan, who had accumulated nearly a year of medically related employment, used his considerable persuasive abilities to convince authorities at Chicago College of Medicine and Surgery to accept that experience in lieu of an in- ternship. Any other deficiency may have been waived if Sullivan agreed to enlist in the military. (The United States had recently entered World War I and was in need of medical officers.)
After the war Sullivan continued to serve as a military officer, first for the Fed- eral Board for Vocational Education and then for the Public Health Service. How- ever, this period in his life was still confusing and unstable, and he showed little promise of the brilliant career that lay just ahead (Perry, 1982).
In 1921, with no formal training in psychiatry, he went to St. Elizabeth Hospital in Washington, DC, where he became closely acquainted with William Alanson White, one of America’s best-known neuropsychiatrists. At St. Elizabeth, Sullivan had his first opportunity to work with large numbers of schizophrenic pa- tients. While in Washington, he began an association with the Medical School of the University of Maryland and with the Sheppard and Enoch Pratt Hospital in Towson, Maryland. During this Baltimore period of his life, he conducted intensive studies of
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schizophrenia, which led to his first hunches about the importance of interpersonal relationships. In trying to make sense out of the speech of schizophrenic patients, Sullivan concluded that their illness was a means of coping with the anxiety gener- ated from social and interpersonal environments. His experiences as a practicing cli- nician gradually transformed themselves into the beginnings of an interpersonal the- ory of psychiatry.
Sullivan spent much of his time and energy at Sheppard selecting and training hospital attendants. Although he did little therapy himself, he developed a system in which nonprofessional but sympathetic male attendants treated schizophrenic pa- tients with human respect and care. This innovative program gained him a reputation as a clinical wizard. However, he became disenchanted with the political climate at Sheppard when he was passed over for a position as head of the new reception cen- ter that he had advocated. In March of 1930, he resigned from Sheppard.
Later that year, he moved to New York City and opened a private practice, hop- ing to enlarge his understanding of interpersonal relations by investigating non- schizophrenic disorders, especially those of an obsessive nature (Perry, 1982). Times were hard, however, and his expected wealthy clientele did not come in the numbers he needed to maintain his expenses.
On a more positive note, his residence in New York brought him into contact with several psychiatrists and social scientists with a European background. Among these were Karen Horney, Erich Fromm, and Frieda Fromm-Reichmann who, along with Sullivan, Clara Thompson, and others, formed the Zodiac group, an informal organization that met regularly over drinks to discuss old and new ideas in psychia- try and the related social sciences. Sullivan, who had met Thompson earlier, per- suaded her to travel to Europe to take a training analysis under Sandor Ferenczi, a disciple of Freud. Sullivan learned from all members of the Zodiac group, and through Thompson, and Ferenczi, his therapeutic technique was indirectly influenced by Freud. Sullivan also credited two other outstanding practitioners, Adolf Meyer and William Alanson White, as having had an impact on his practice of therapy. De- spite some Freudian influence on his therapeutic technique, Sullivan’s theory of in- terpersonal psychiatry is neither psychoanalytic nor neo-Freudian.
During his residence in New York, Sullivan also came under the influence of several noted social scientists from the University of Chicago, which was the center of American sociological study during the 1920s and 1930s. Included among them were social psychologist George Herbert Mead, sociologists Robert Ezra Park and W. I. Thomas, anthropologist Edward Sapir, and political scientist Harold Lasswell. Sullivan, Sapir, and Lasswell were primarily responsible for establishing the William Alanson White Psychiatric Foundation in Washington, DC, for the purpose of join- ing psychiatry to the other social sciences. Sullivan served as the first president of the foundation and also as editor of the foundation’s journal, Psychiatry. Under Sul- livan’s guidance, the foundation began a training institution known as the Washing- ton School of Psychiatry. Because of these activities, Sullivan gave up his New York practice, which was not very lucrative anyway, and moved back to Washington, DC, where he remained closely associated with the school and the journal.
In January 1949, Sullivan attended a meeting of the World Federation for Men- tal Health in Amsterdam. While on his way home, January 14, 1949, he died of a cerebral hemorrhage in a Paris hotel room, a few weeks short of his 57th birthday. Not uncharacteristically, he was alone at the time.
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On the personal side, Sullivan was not comfortable with his sexuality and had ambivalent feelings toward marriage (Perry, 1982). As an adult, he brought into his home a 15-year-old boy who was probably a former patient (Alexander, 1990). This young man—James Inscoe—remained with Sullivan for 22 years, looking after his financial affairs, typing manuscripts, and generally running the household. Although Sullivan never officially adopted Jimmie, he regarded him as a son and even had his legal name changed to James I. Sullivan.
Beyond Biography Was Sullivan a homosexual? For information on Sullivan’s sexual orientation, see our website at www.mhhe.com/feist7
Sullivan also had ambivalent attitudes toward his religion. Born to Catholic parents who attended church only irregularly, he abandoned Catholicism early on. In later life, his friends and acquaintances regarded him as nonreligious or even anti- Catholic, but to their surprise, Sullivan had written into his will a request to receive a Catholic burial. Incidentally, this request was granted despite the fact that Sulli- van’s body had been cremated in Paris. His ashes were returned to the United States, where they were placed inside a coffin and received a full Catholic burial, complete with a requiem mass.
Sullivan’s chief contribution to personality theory is his conception of devel- opmental stages. Before turning to Sullivan’s ideas on the stages of development, we will explain some of his unique terminology.
Tensions Like Freud and Jung, Sullivan (1953b) saw personality as an energy system. Energy can exist either as tension (potentiality for action) or as actions themselves (energy transformations). Energy transformations transform tensions into either covert or overt behaviors and are aimed at satisfying needs and reducing anxiety. Tension is a potentiality for action that may or may not be experienced in awareness. Thus, not all tensions are consciously felt. Many tensions, such as anxiety, premonitions, drowsiness, hunger, and sexual excitement, are felt but not always on a conscious level. In fact, probably all felt tensions are at least partial distortions of reality. Sullivan recognized two types of tensions: needs and anxiety. Needs usually re- sult in productive actions, whereas anxiety leads to nonproductive or disintegrative behaviors.
Needs Needs are tensions brought on by biological imbalance between a person and the physiochemical environment, both inside and outside the organism. Needs are episodic—once they are satisfied, they temporarily lose their power, but after a time, they are likely to recur. Although needs originally have a biological component, many of them stem from the interpersonal situation. The most basic interpersonal need is tenderness. An infant develops a need to receive tenderness from its primary caretaker (called by Sullivan “the mothering one”). Unlike some needs, tenderness requires actions from at least two people. For example, an infant’s need to receive
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tenderness may be expressed as a cry, smile, or coo, whereas the mother’s need to give tenderness may be transformed into touching, fondling, or holding. In this ex- ample, the need for tenderness is satisfied through the use of the infant’s mouth and the mother’s hands.
Tenderness is a general need because it is concerned with the overall well- being of a person. General needs, which also include oxygen, food, and water, are opposed to zonal needs, which arise from a particular area of the body. Several areas of the body are instrumental in satisfying both general and zonal needs. For exam- ple, the mouth satisfies general needs by taking in food and oxygen, but it also sat- isfies the zonal need for oral activity. Also, the hands may be used to help satisfy the general need of tenderness, but they can likewise be used to satisfy the zonal need for manual activity. Similarly, other body zones, such as the anus and the genitals, can be used to satisfy both kinds of needs.
Very early in life, the various zones of the body begin to play a significant and lasting role in interpersonal relations. While satisfying general needs for food, water, and so forth, an infant expends more energy than necessary, and the excess energy is transformed into consistent characteristic modes of behavior, which Sullivan called dynamisms.
Anxiety A second type of tension, anxiety, differs from tensions of needs in that it is dis- junctive, is more diffuse and vague, and calls forth no consistent actions for its re- lief. If infants lack food (a need), their course of action is clear; but if they are anx- ious, they can do little to escape from that anxiety.
How does anxiety originate? Sullivan (1953b) postulated that it is transferred from the parent to the infant through the process of empathy. Anxiety in the moth- ering one inevitably induces anxiety in the infant. Because all mothers have some amount of anxiety while caring for their babies, all infants will become anxious to some degree.
Just as the infant does not have the capacity to reduce anxiety, the parent has no effective means of dealing with the baby’s anxiety. Any signs of anxiety or inse- curity by the infant are likely to lead to attempts by the parent to satisfy the infant’s needs. For example, a mother may feed her anxious, crying baby because she mis- takes anxiety for hunger. If the baby hesitates in accepting the milk, the mother may become more anxious herself, which generates additional anxiety within the infant. Finally, the baby’s anxiety reaches a level at which it interferes with sucking and swallowing. Anxiety, then, operates in opposition to tensions of needs and prevents them from being satisfied.
Anxiety has a deleterious effect on adults too. It is the chief disruptive force blocking the development of healthy interpersonal relations. Sullivan (1953b) likened severe anxiety to a blow on the head. It makes people incapable of learning, impairs memory, narrows perception, and may result in complete amnesia. It is unique among the tensions in that it maintains the status quo even to people’s over- all detriment. Whereas other tensions result in actions directed specifically toward their relief, anxiety produces behaviors that (1) prevent people from learning from their mistakes, (2) keep people pursuing a childish wish for security, and (3) gener- ally ensure that people will not learn from their experiences.
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Sullivan insisted that anxiety and loneliness are unique among all experiences in that they are totally unwanted and undesirable. Because anxiety is painful, people have a natural tendency to avoid it, inherently preferring the state of euphoria, or complete lack of tension. Sullivan (1954) summarized this concept by stating simply that “the presence of anxiety is much worse than its absence” (p. 100).
Sullivan distinguished anxiety from fear in several important ways. First, anx- iety usually stems from complex interpersonal situations and is only vaguely repre- sented in awareness; fear is more clearly discerned and its origins more easily pin- pointed. Second, anxiety has no positive value. Only when transformed into another tension (anger or fear, for example) can it lead to profitable actions. Third, anxiety blocks the satisfaction of needs, whereas fear sometimes helps people satisfy certain needs. This opposition to the satisfaction of needs is expressed in words that can be considered Sullivan’s definition of anxiety: “Anxiety is a tension in opposition to the tensions of needs and to action appropriate to their relief ” (Sullivan, 1953b, p. 44).
Energy Transformations Tensions that are transformed into actions, either overt or covert, are called energy transformations. This somewhat awkward term simply refers to our behaviors that are aimed at satisfying needs and reducing anxiety—the two great tensions. Not all energy transformations are obvious, overt actions; many take the form of emotions, thoughts, or covert behaviors that can be hidden from other people.
Dynamisms Energy transformations become organized as typical behavior patterns that charac- terize a person throughout a lifetime. Sullivan (1953b) called these behavior patterns dynamisms, a term that means about the same as traits or habit patterns. Dynamisms are of two major classes: first, those related to specific zones of the body, including the mouth, anus, and genitals; and second, those related to tensions. This second class is composed of three categories—the disjunctive, the isolating, and the con- junctive. Disjunctive dynamisms include those destructive patterns of behavior that are related to the concept of malevolence; isolating dynamisms include those be- havior patterns (such as lust) that are unrelated to interpersonal relations; and con- junctive dynamisms include beneficial behavior patterns, such as intimacy and the self-system.
Malevolence Malevolence is the disjunctive dynamism of evil and hatred, characterized by the feeling of living among one’s enemies (Sullivan, 1953b). It originates around age 2 or 3 years when children’s actions that earlier had brought about maternal ten- derness are rebuffed, ignored, or met with anxiety and pain. When parents attempt to control their children’s behavior by physical pain or reproving remarks, some chil- dren will learn to withhold any expression of the need for tenderness and to protect themselves by adopting the malevolent attitude. Parents and peers then find it more and more difficult to react with tenderness, which in turn solidifies the child’s nega- tive attitude toward the world. Malevolent actions often take the form of timidity,
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mischievousness, cruelty, or other kinds of asocial or antisocial behavior. Sullivan expressed the malevolent attitude with this colorful statement: “Once upon a time everything was lovely, but that was before I had to deal with people” (p. 216).
Intimacy Intimacy grows out of the earlier need for tenderness but is more specific and in- volves a close interpersonal relationship between two people who are more or less of equal status. Intimacy must not be confused with sexual interest. In fact, it devel- ops prior to puberty, ideally during preadolescence when it usually exists between two children, each of whom sees the other as a person of equal value. Because inti- macy is a dynamism that requires an equal partnership, it does not usually exist in parent-child relationships unless both are adults and see one another as equals.
Intimacy is an integrating dynamism that tends to draw out loving reactions from the other person, thereby decreasing anxiety and loneliness, two extremely painful experiences. Because intimacy helps us avoid anxiety and loneliness, it is a rewarding experience that most healthy people desire (Sullivan, 1953b).
Lust On the other hand, lust is an isolating tendency, requiring no other person for its sat- isfaction. It manifests itself as autoerotic behavior even when another person is the object of one’s lust. Lust is an especially powerful dynamism during adolescence, at
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Significant intimate relationships prior to puberty are usually boy-boy or girl-girl friendships, according to Sullivan.
which time it often leads to a reduction of self-esteem. Attempts at lustful activity are often rebuffed by others, which increases anxiety and decreases feelings of self- worth. In addition, lust often hinders an intimate relationship, especially during early adolescence when it is easily confused with sexual attraction.
Self-System The most complex and inclusive of all the dynamisms is the self-system, a consis- tent pattern of behaviors that maintains people’s interpersonal security by protecting them from anxiety. Like intimacy, the self-system is a conjunctive dynamism that arises out of the interpersonal situation. However, it develops earlier than intimacy, at about age 12 to 18 months. As children develop intelligence and foresight, they become able to learn which behaviors are related to an increase or decrease in anxi- ety. This ability to detect slight increases or decreases in anxiety provides the self- system with a built-in warning device.
The warning, however, is a mixed blessing. On one hand, it serves as a signal, alerting people to increasing anxiety and giving them an opportunity to protect themselves. On the other, this desire for protection against anxiety makes the self- system resistant to change and prevents people from profiting from anxiety-filled ex- periences. Because the primary task of the self-system is to protect people against anxiety, it is “the principal stumbling block to favorable changes in personality” (Sullivan, 1953b, p. 169). Sullivan (1964), however, believed that personality is not static and is especially open to change at the beginning of the various stages of de- velopment.
As the self-system develops, people begin to form a consistent image of them- selves. Thereafter, any interpersonal experiences that they perceive as contrary to their self-regard threatens their security. As a consequence, people attempt to defend themselves against interpersonal tensions by means of security operations, the pur- pose of which is to reduce feelings of insecurity or anxiety that result from endan- gered self-esteem. People tend to deny or distort interpersonal experiences that con- flict with their self-regard. For example, when people who think highly of themselves are called incompetent, they may choose to believe that the name-caller is stupid or, perhaps, merely joking. Sullivan (1953b) called security operations “a powerful brake on personal and human progress” (p. 374).
Two important security operations are dissociation and selective inattention. Dissociation includes those impulses, desires, and needs that a person refuses to allow into awareness. Some infantile experiences become dissociated when a baby’s behavior is neither rewarded nor punished, so those experiences simply do not be- come part of the self-system. Adult experiences that are too foreign to one’s stan- dards of conduct can also become dissociated. These experiences do not cease to exist but continue to influence personality on an unconscious level. Dissociated im- ages manifest themselves in dreams, daydreams, and other unintentional activities outside of awareness and are directed toward maintaining interpersonal security (Sullivan, 1953b).
The control of focal awareness, called selective inattention, is a refusal to see those things that we do not wish to see. It differs from dissociation in both degree and origin. Selectively inattended experiences are more accessible to awareness and
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more limited in scope. They originate after we establish a self-system and are trig- gered by our attempts to block out experiences that are not consistent with our ex- isting self-system. For example, people who regard themselves as scrupulously law- abiding drivers may “forget” about the many occasions when they exceeded the speed limit or the times when they failed to stop completely at a stop sign. Like dis- sociated experiences, selectively inattended perceptions remain active even though they are not fully conscious. They are crucial in determining which elements of an experience will be attended and which will be ignored or denied (Sullivan, 1953b).
Personifications Beginning in infancy and continuing throughout the various developmental stages, people acquire certain images of themselves and others. These images, called per- sonifications, may be relatively accurate, or because they are colored by people’s needs and anxieties, they may be grossly distorted. Sullivan (1953b) described three basic personifications that develop during infancy—the bad-mother, the good- mother, and the me. In addition, some children acquire an eidetic personification (imaginary playmate) during childhood.
Bad-Mother, Good-Mother Sullivan’s notion of the bad-mother and good-mother is similar to Klein’s concept of the bad breast and good breast. The bad-mother personification, in fact, grows out of the infant’s experiences with the bad-nipple: that is, the nipple that does not sat- isfy hunger needs. Whether the nipple belongs to the mother or to a bottle held by the mother, the father, a nurse, or anyone else is not important. The bad-mother per- sonification is almost completely undifferentiated, inasmuch as it includes everyone involved in the nursing situation. It is not an accurate image of the “real” mother but merely the infant’s vague representation of not being properly fed.
After the bad-mother personification is formed, an infant will acquire a good- mother personification based on the tender and cooperative behaviors of the moth- ering one. These two personifications, one based on the infant’s perception of an anx- ious, malevolent mother and the other based on a calm, tender mother, combine to form a complex personification composed of contrasting qualities projected onto the same person. Until the infant develops language, however, these two opposing im- ages of mother can easily coexist (Sullivan, 1953b).
Me Personifications During midinfancy a child acquires three me personifications (bad-me, good-me, and not-me) that form the building blocks of the self personification. Each is related to the evolving conception of me or my body. The bad-me personification is fash- ioned from experiences of punishment and disapproval that infants receive from their mothering one. The resulting anxiety is strong enough to teach infants that they are bad, but it is not so severe as to cause the experience to be dissociated or selectively inattended. Like all personifications, the bad-me is shaped out of the interpersonal
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situation; that is, infants can learn that they are bad only from someone else, ordi- narily the bad-mother.
The good-me personification results from infants’ experiences with reward and approval. Infants feel good about themselves when they perceive their mother’s ex- pressions of tenderness. Such experiences diminish anxiety and foster the good-me personification. Sudden severe anxiety, however, may cause an infant to form the not-me personification and to either dissociate or selectively inattend experiences re- lated to that anxiety. An infant denies these experiences to the me image so that they become part of the not-me personification. These shadowy not-me personifications are also encountered by adults and are expressed in dreams, schizophrenic episodes, and other dissociated reactions. Sullivan believed that these nightmarish experiences are always preceded by a warning. When adults are struck by sudden severe anxiety, they are overcome by uncanny emotion. Although this experience incapacitates peo- ple in their interpersonal relationships, it serves as a valuable signal for approaching schizophrenic reactions. Uncanny emotion may be experienced in dreams or may take the form of awe, horror, loathing, or a “chilly crawling” sensation (Sullivan, 1953b).
Eidetic Personifications Not all interpersonal relations are with real people; some are eidetic personifica- tions: that is, unrealistic traits or imaginary friends that many children invent in order to protect their self-esteem. Sullivan (1964) believed that these imaginary friends may be as significant to a child’s development as real playmates.
Eidetic personifications, however, are not limited to children; most adults see fictitious traits in other people. Eidetic personifications can create conflict in inter- personal relations when people project onto others imaginary traits that are remnants from previous relationships. They also hinder communication and prevent people from functioning on the same level of cognition.
Levels of Cognition Sullivan divided cognition into three levels or modes of experience: prototaxic, parataxic, and syntaxic. Levels of cognition refer to ways of perceiving, imagining, and conceiving. Experiences on the prototaxic level are impossible to communicate; parataxic experiences are personal, prelogical, and communicated only in distorted form; and syntaxic cognition is meaningful interpersonal communication.
Prototaxic Level The earliest and most primitive experiences of an infant take place on a prototaxic level. Because these experiences cannot be communicated to others, they are diffi- cult to describe or define. One way to understand the term is to imagine the earliest subjective experiences of a newborn baby. These experiences must, in some way, re- late to different zones of the body. A neonate feels hunger and pain, and these pro- totaxic experiences result in observable action, for example, sucking or crying. The infant does not know the reason for the actions and sees no relationship between
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these actions and being fed. As undifferentiated experiences, prototaxic events are beyond conscious recall.
In adults, prototaxic experiences take the form of momentary sensations, im- ages, feelings, moods, and impressions. These primitive images of dream and wak- ing life are dimly perceived or completely unconscious. Although people are inca- pable of communicating these images to others, they can sometimes tell another person that they have just had a strange sensation, one that they cannot put into words.
Parataxic Level Parataxic experiences are prelogical and usually result when a person assumes a cause-and-effect relationship between two events that occur coincidentally. Parataxic cognitions are more clearly differentiated than prototaxic experiences, but their meaning remains private. Therefore, they can be communicated to others only in a distorted fashion.
An example of parataxic thinking takes place when a child is conditioned to say “please” in order to receive candy. If “candy and “please” occur together a num- ber of times, the child may eventually reach the illogical conclusion that her suppli- cations caused the candy’s appearance. This conclusion is a parataxic distortion, or an illogical belief that a cause-and-effect relationship exists between two events in close temporal proximity. However, uttering the word “please” does not, by itself, cause the candy to appear. A dispensing person must be present who hears the word and is able and willing to honor the request. When no such person is present, a child may ask God or imaginary people to grant favors. A good bit of adult behavior comes from similar parataxic thinking.
Syntaxic Level Experiences that are consensually validated and that can be symbolically communi- cated take place on a syntaxic level. Consensually validated experiences are those on whose meaning two or more persons agree. Words, for example, are consensually validated because different people more or less agree on their meaning. The most common symbols used by one person to communicate with another are those of lan- guage, including words and gestures.
Sullivan hypothesized that the first instance of syntaxic cognition appears whenever a sound or gesture begins to have the same meaning for parents as it does for a child. The syntaxic level of cognition becomes more prevalent as the child be- gins to develop formal language, but it never completely supplants prototaxic and parataxic cognition. Adult experience takes place on all three levels.
In summary, Sullivan identified two kinds of experience—tensions and energy transformations. Tensions, or potentiality for action, include needs and anxiety. Whereas needs are helpful or conjunctive when satisfied, anxiety is always disjunc- tive, interfering with the satisfaction of needs and disrupting interpersonal relations. Energy transformations literally involve the transformation of potential energy into actual energy (behavior) for the purpose of satisfying needs or reducing anxiety. Some of these behaviors form consistent patterns of behavior called dynamisms. Sul- livan also recognized three levels of cognition—prototaxic, parataxic, and syntaxic. Table 8.1 summarizes Sullivan’s concept of personality.
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Stages of Development Sullivan (1953b) postulated seven epochs or stages of development, each crucial to the formation of human personality. The thread of interpersonal relations runs throughout the stages; other people are indispensable to a person’s development from infancy to mature adulthood.
Personality change can take place at any time, but it is most likely to occur dur- ing the transition from one stage to the next. In fact, these threshold periods are more crucial than the stages themselves. Experiences previously dissociated or selectively inattended may enter into the self-system during one of the transitional periods. Sullivan hypothesized that, “as one passes over one of these more-or-less deter- minable thresholds of a developmental era, everything that has gone before becomes
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T A B L E 8 . 1
Summary of Sullivan’s Theory of Personality
I. Tensions (potential for action) A. Needs (conjunctive; they help integrate personality)
1. General needs (facilitate the overall well-being of a person) a. Interpersonal (tenderness, intimacy, and love) b. Physiological (food, oxygen, water, and so forth)
2. Zonal needs (may also satisfy general needs) a. Oral b. Genital c. Manual
B. Anxiety (disjunctive; it interferes with the satisfaction of needs)
II. Energy Transformations (overt or covert actions designed to satisfy needs or to reduce anxiety. Some energy transformations become relatively consistent patterns of behavior called dynamisms)
III. Dynamisms (traits or behavioral patterns)
A. Malevolence (a feeling of living in enemy country)
B. Intimacy (an integrating experience marked by a close personal relationship with another person who is more or less of equal status)
C. Lust (an isolating dynamism characterized by an impersonal sexual interest in another person)
IV. Levels of Cognitions (ways of perceiving, imagining, and conceiving)
A. Prototaxic (undifferentiated experiences that are completely personal)
B. Parataxic (prelogical experiences that are communicated to others only in a distorted fashion)
C. Syntaxic (consensually validated experiences that can be accurately communicated to others)
reasonably open to influence” (p. 227). His seven stages are infancy, childhood, the juvenile era, preadolescence, early adolescence, late adolescence, and adulthood.
Infancy Infancy begins at birth and continues until a child develops articulate or syntaxic speech, usually at about age 18 to 24 months. Sullivan believed that an infant be- comes human through tenderness received from the mothering one. The satisfaction of nearly every human need demands the cooperation of another person. Infants can- not survive without a mothering one to provide food, shelter, moderate temperature, physical contact, and the cleansing of waste materials.
The emphatic linkage between mother and infant leads inexorably to the de- velopment of anxiety for the baby. Being human, the mother enters the relationship with some degree of previously learned anxiety. Her anxiety may spring from any one of a variety of experiences, but the infant’s first anxiety is always associated with the nursing situation and the oral zone. Unlike that of the mother, the infant’s reper- toire of behaviors is not adequate to handle anxiety. So, whenever infants feel anx- ious (a condition originally transmitted to it by the mother), they try whatever means available to reduce anxiety. These attempts typically include rejecting the nipple, but this neither reduces anxiety nor satisfies the need for food. An infant’s rejection of the nipple, of course, is not responsible for the mother’s original anxiety but now adds to it. Eventually the infant discriminates between the good-nipple and the bad- nipple: the former being associated with relative euphoria in the feeding process; the latter, with enduring anxiety (Sullivan, 1953b).
An infant expresses both anxiety and hunger through crying. The mothering one may mistake anxiety for hunger and force the nipple onto an anxious (but not hungry) infant. The opposite situation may also take place when a mother, for what- ever reason, fails to satisfy the baby’s needs. The baby then will experience rage, which increases the mother’s anxiety and interferes with her ability to cooperate with her baby. With mounting tension, the infant loses the capacity to receive satisfaction, but the need for food, of course, continues to increase. Finally, as tension approaches terror, the infant experiences difficulty with breathing. The baby may even stop breathing and turn a bluish color, but the built-in protections of apathy and somno- lent detachment keep the infant from death. Apathy and somnolent detachment allow the infant to fall asleep despite the hunger (Sullivan, 1953b).
During the feeding process, the infant not only receives food but also satisfies some tenderness needs. The tenderness received by the infant at this time demands the cooperation of the mothering one and introduces the infant to the various strate- gies required by the interpersonal situation. The mother-infant relationship, however, is like a two-sided coin. The infant develops a dual personification of mother, seeing her as both good and bad; the mother is good when she satisfies the baby’s needs and bad when she stimulates anxiety.
Around midinfancy, infants begin to learn how to communicate through lan- guage. In the beginning, their language is not consensually validated but takes place on an individualized or parataxic level. This period of infancy is characterized by autistic language, that is, private language that makes little or no sense to other peo- ple. Early communication takes place in the form of facial expressions and the
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sounding of various phonemes. Both are learned through imitation, and eventually gestures and speech sounds have the same meaning for the infant as they do for other people. This communication marks the beginning of syntaxic language and the end of infancy.
Childhood The era of childhood begins with the advent of syntaxic language and continues until the appearance of the need for playmates of an equal status. The age of childhood varies from culture to culture and from individual to individual, but in Western society it covers the period from about age 18 to 24 months until about age 5 or 6 years.
During this stage, the mother remains the most significant other person, but her role is different from what it was in infancy. The dual personifications of mother are now fused into one, and the child’s perception of the mother is more congruent with the “real” mother. Nevertheless, the good-mother and bad-mother personifica- tions are usually retained on a parataxic level. In addition to combining the mother personifications, the child differentiates the various persons who previously formed the concept of the mothering one, separating mother and father and seeing each as having a distinct role.
At about the same time, children are fusing the me-personifications into a sin- gle self-dynamism. Once they establish syntaxic language, they can no longer con- sciously deal with the bad-me and good-me at the same time; now they label behav- iors as good or bad in imitation of their parents. However, these labels differ from the old personifications of infancy because they are symbolized on a syntaxic level and originate from children’s behavior rather than from decreases or increases in their anxiety. Also, good and bad now imply social or moral value and no longer refer to the absence or presence of that painful tension called anxiety.
During childhood, emotions become reciprocal; a child is able to give tender- ness as well as receive it. The relationship between mother and child becomes more personal and less one-sided. Rather than seeing the mother as good or bad based on how she satisfied hunger needs, the child evaluates the mother syntaxically accord- ing to whether she shows reciprocal tender feelings, develops a relationship based on the mutual satisfaction of needs, or exhibits a rejecting attitude.
Besides their parents, preschool-aged children often have one other significant relationship—an imaginary playmate. This eidetic friend enables children to have a safe, secure relationship that produces little anxiety. Parents sometimes observe their preschool-aged children talking to an imaginary friend, calling the friend by name, and possibly even insisting that an extra place be set at the table or space be made available in the car or the bed for this playmate. Also, many adults can recall their own childhood experiences with imaginary playmates. Sullivan insisted that having an imaginary playmate is not a sign of instability or pathology but a positive event that helps children become ready for intimacy with real friends during the preado- lescence stage. These playmates offer children an opportunity to interact with an- other “person” who is safe and who will not increase their level of anxiety. This com- fortable, nonthreatening relationship with an imaginary playmate permits children to be more independent of parents and to make friends in later years.
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Sullivan (1953b) referred to childhood as a period of rapid acculturation. Be- sides acquiring language, children learn cultural patterns of cleanliness, toilet train- ing, eating habits, and sex-role expectancies. They also learn two other important processes: dramatizations and preoccupations. Dramatizations are attempts to act like or sound like significant authority figures, especially mother and father. Preoc- cupations are strategies for avoiding anxiety and fear-provoking situations by re- maining occupied with an activity that has earlier proved useful or rewarding.
The malevolent attitude reaches a peak during the preschool years, giving some children an intense feeling of living in a hostile or enemy country. At the same time, children learn that society has placed certain restraints on their freedom. From these restrictions and from experiences with approval and disapprobation, children evolve their self-dynamism, which helps them handle anxiety and stabilize their per- sonality. In fact, the self-system introduces so much stability that it makes future changes exceedingly difficult.
Juvenile Era The juvenile era begins with the appearance of the need for peers or playmates of equal status and ends when one finds a single chum to satisfy the need for intimacy. In the United States, the juvenile stage is roughly parallel to the first 3 years of school, beginning around age 5 or 6 and ending at about age 81/2. (It is interesting that Sullivan was so specific with the age at which this period ends and the preado- lescent stage begins. Remember that Sullivan was 81/2 when he began an intimate re- lationship with a 13-year-old boy from a nearby farm.)
During the juvenile stage, Sullivan believed, a child should learn to compete, compromise, and cooperate. The degree of competition found among children of this
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During the juvenile stage, children need to learn competition, cooperation, and compromise.
age varies with the culture, but Sullivan believed that people in the United States have generally overemphasized competition. Many children believe that they must be competitive to be successful. Compromise, too, can be overdone. A 7-year-old child who learns to continually give in to others is handicapped in the socialization process, and this yielding trait may continue to characterize the person in later life. Cooperation includes all those processes necessary to get along with others. The juvenile-age child must learn to cooperate with others in the real world of interper- sonal relationships. Cooperation is a critical step in becoming socialized and is the most important task confronting children during this stage of development.
During the juvenile era, children associate with other children who are of equal standing. One-to-one relationships are rare, but if they exist, they are more likely to be based on convenience than on genuine intimacy. Boys and girls play with one an- other with little regard for the gender of the other person. Although permanent dyadic (two-person) relationships are still in the future, children of this age are be- ginning to make discriminations among themselves and to distinguish among adults. They see one teacher as kinder than another, one parent as more indulgent. The real world is coming more into focus, allowing them to operate increasingly on the syn- taxic level.
By the end of the juvenile stage, a child should have developed an orientation toward living that makes it easier to consistently handle anxiety, satisfy zonal and tenderness needs, and set goals based on memory and foresight. This orientation to- ward living readies a person for the deeper interpersonal relationships to follow (Sul- livan, 1953b).
Preadolescence Preadolescence, which begins at age 81/2 and ends with adolescence, is a time for in- timacy with one particular person, usually a person of the same gender. All preced- ing stages have been egocentric, with friendships being formed on the basis of self- interest. A preadolescent, for the first time, takes a genuine interest in the other person. Sullivan (1953a) called this process of becoming a social being the “quiet miracle of preadolescence” (p. 41), a likely reference to the personality transforma- tion he experienced during his own preadolescence.
The outstanding characteristic of preadolescence is the genesis of the capacity to love. Previously, all interpersonal relationships were based on personal need sat- isfaction, but during preadolescence, intimacy and love become the essence of friendships. Intimacy involves a relationship in which the two partners consensually validate one another’s personal worth. Love exists “when the satisfaction or the se- curity of another person becomes as significant to one as is one’s own satisfaction or security” (Sullivan, 1953a, pp. 42–43).
A preadolescent’s intimate relationship ordinarily involves another person of the same gender and of approximately the same age or social status. Infatuations with teachers or movie stars are not intimate relationships because they are not con- sensually validated. The significant relationships of this age are typically boy-boy or girl-girl chumships. To be liked by one’s peers is more important to the preadoles- cent than to be liked by teachers or parents. Chums are able to freely express opin- ions and emotions to one another without fear of humiliation or embarrassment. This