Harry Stack Sullivan

Herbert "Harry" Stack Sullivan (February 21, 1892, Norwich, New York – January 14, 1949, Paris, France) was a U.S. psychiatrist whose work in psychoanalysis was based on direct and verifiable observation (versus the more abstract conceptions of the unconscious mind favored by Sigmund Freud and his disciples).

Sullivan was a child of Irish immigrants and allegedly grew up in an anti-Catholic town. This resulted in social isolation which might have been the incentive for his later interest in psychiatry. He received his medical degree in Chicago College of Medicine and Surgery in 1917.

Along with Clara Thompson, Karen Horney, Erich Fromm, Erik H. Erikson, and Frieda Fromm-Reichmann, Sullivan laid the groundwork for understanding the individual based on the network of relationships in which he or she is enmeshed. He developed a theory of psychiatry based on interpersonal relationships where cultural forces are largely responsible for mental illnesses. In his words, one must pay attention to the "interactional", not the "intrapsychic". This search for satisfaction via personal involvement with others led Sullivan to characterize loneliness as the most painful of human experiences. He also extended the Freudian psychoanalysis to the treatment of patients with severe mental disorders, particularly schizophrenia.

Besides making the first mention of the significant other in psychological literature, Sullivan developed the Self System, a configuration of the personality traits developed in childhood and reinforced by positive affirmation and the security operations developed in childhood to avoid anxiety and threats to self-esteem. Sullivan further defined the Self System as a steering mechanism toward a series of I-You interlocking behaviors; that is, what an individual does is meant to elicit a particular reaction. Sullivan called these behaviors parataxic integrations, and he noted that such action-reaction combinations can become rigid and dominate an adult's thinking pattern, limiting his actions and reactions toward the world as the adult sees it and not as it really is. The resulting inaccuracies in judgement Sullivan termed parataxic distortion, when other persons are perceived or evaluated based on the patterns of previous experience, similar to Freud's notion of transference.

Sullivan's work on interpersonal relationships became the foundation of interpersonal psychoanalysis, a school of psychoanalytic theory and treatment that stresses the detailed exploration of the nuances of patients' patterns of interacting with others.

He was one of the founders of the William Alanson White Institute, considered by many to be the world's leading independent psychoanalytic institute, and of the journal Psychiatry in 1937. He headed the Washington School of Psychiatry (DC) from 1936 to 1947.

Although well recognized by many, Sullivan never acquired as much substantial reputation as many of his peers later did. It's conjecture whether or not this was due to his thinly concealed homosexuality. Starting in 1927, he lived with Jimmie Inscoe, then 15, who took on the name Jimmie Sullivan, for more than twenty years, until Sullivan's death in 1949. Controversy still surrounds the nature of their relationship, although reliable sources suggest they were what we'd now call, life partners. Jimmie Sullivan was known to friends as his foster son, although there was no formal, legal relationship. This was not an unusual status between homosexual partners from that era.

He made his reputation based on his experimental treatment ward for schizophrenics at the Shepard-Pratt Hospital, between 1925-29. He employed specially trained ward attendants to work with the patients to provide them with the peer relationships he believed they'd missed out on during the latency period of development. Doctors, nurses and other authority figures were banned from the ward. He believed there was a homosexual element to latency age peer relationships and that a failure to go through this stage led to self-loathing, a withdrawal from the world in fantasy and psychosis, and a failure to move on to heterosexual adjustment. Thus the patients, who were all young male homosexuals as well as schizophrenics, in their positive interactions with the attendants, also young male homosexuals, would heal the wounds from missing male intimacy as pre-adolescents.

Writings
Although Sullivan published little in his lifetime, he influenced generations of mental health professionals, especially through his lectures at Chestnut Lodge in Washington DC. Leston Havens called him the most important underground influence in American psychoanalysis. His ideas were collected and published posthumously, edited by Helen Swick Perry, who also published a detailed biography in 1982 (Perry, 1982, Psychiatrist of America).

Works
His writings include Conceptions of Modern Psychiatry (1947, repr. 1966); The Interpersonal Theory of Psychiatry (ed. by H. S. Perry and M. L. Gawel, 1953, repr. 1968); Schizophrenia as a Human Process (1962, repr. 1974).