Harry Stack Sullivan

Harry Stack Sullivan (born February 21, 1892, Norwich, New York, U.S.—died January 14, 1949, Paris) was an American psychiatrist who developed a theory of psychiatry based on interpersonal relationships. He believed that anxiety and other psychiatric symptoms arise in fundamental conflicts between individuals and their human environments and that personality development also takes place by a series of interactions with other people. He made substantial contributions to clinical psychiatry, especially the psychotherapy of schizophrenia, and suggested that the mental functions of schizophrenics, though impaired, are not damaged past repair and can be recovered through therapy. Possessing an extraordinary ability to communicate with schizophrenic patients, he described their behaviour with clarity and insight unrivalled at that time.

Sullivan received an M.D. from the Chicago College of Medicine and Surgery in 1917. At St. Elizabeth’s Hospital in Washington, D.C., he came under the influence of the psychiatrist William Alanson White, who extended the principles of Sigmund Freud’s psychoanalysis to the severely ill, hospitalized psychotic, rather than restricting them to the more functional neurotics treated by most Freudian analysts of the time. In his interviews with schizophrenic patients, Sullivan’s uncommon ability in psychoanalysis first became evident.

While engaged in clinical research at the Sheppard and Enoch Pratt Hospital in Maryland (1923–30), Sullivan became acquainted with the psychiatrist Adolf Meyer, whose practical psychotherapy emphasized psychological and social factors, rather than neuropathology, as the basis for psychiatric disorders. As research director at Pratt from 1925 to 1930, Sullivan showed that it is possible to understand schizophrenics, no matter how bizarre their behaviour, with sufficient contact. He interpreted schizophrenia as the result of disturbed interpersonal relationships in early childhood; by appropriate psychotherapy, Sullivan believed, those sources of behavioral disturbance could be identified and eliminated. Developing his ideas further, he applied them to the organization of a special ward for the group treatment of male schizophrenics (1929). During the same period, he first introduced his concepts into graduate psychiatric training through lectures at Yale University and elsewhere.

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After 1930 Sullivan devoted himself chiefly to teaching and elaborating his ideas, working with social scientists such as the anthropologist Edward Sapir. He extended his early concept of schizophrenia to a theory of personality, arguing that both normal and abnormal personalities represent enduring patterns of interpersonal relationships, thus giving the environment, in particular the human social environment, the major role in personality development. Sullivan argued that individuals’ self-identity is built up over the years through their perceptions of how they are regarded by significant people in their environments. Different stages in the course of behavioral development correspond to different ways of interacting with others. To the infant, the most significant person is its mother, and anxiety results from disturbances in the maternal relationship. The child then develops a mode of behaviour that tends to lessen that anxiety, establishing the personality characteristics that will prevail in adulthood.

Sullivan helped to found the William Alanson White Psychiatric Foundation in 1933 and the Washington (D.C.) School of Psychiatry in 1936, and after World War II he helped establish the World Federation for Mental Health. He also founded (1938) and served as editor of the journal Psychiatry. During the later years of his life he more fully articulated his ideas in The Interpersonal Theory of Psychiatry and The Fusion of Psychiatry and Social Science (published posthumously in 1953 and 1964, respectively), among other works. After his death Sullivan’s theory of personality and his psychotherapeutic techniques had a continually growing influence, particularly in American psychoanalytic circles.