Harry Stack Sullivan

Interpersonal Psychiatry

“Harry Stack Sullivan was one of the most important seminal thinkers in American psychiatry…He synthesized the contemporary ideas of psychiatry and social science together to form what has been called ‘social psychiatry.’ (Raghueer, 2011, p.87)”  Sullivan’s unique perspective blends insights from the fields of psychiatry with the social sciences.  He describes psychiatry as the “study of processes that involve or go on between people, (Morgan, 2014, p. 2).”

Sullivan on Personality

According to Sullivan: “‘personality’ is itself a hypothetical entity which cannot be isolated from interpersonal situations and, indeed, interpersonal behavior is all that is observable about personality, (Morgan, 2014, p. 2).”  Consequently, he believed it should be understood as a pattern of characteristics that define our relations with others.  Personality characteristics from this perspective are observable traits which define our interpersonal relationships, (Morgan, 2014).  What follows are a few key concepts that define our personalities according to Sullivan:

Tensions

“Sullivan conceptualized personality as an energy system…existing either as…potentiality for action…or…actions themselves” (Raghuveer, 2011, p. 67).”  Tension, is a term Sullivan uses to define as the “potentiality for action that may or may not be experienced in awareness, (Feist, n.d., p. 217).” In other words, it is a predisposition to act in a particular manner.  Once we act on this tension this energy has transformed into an overt behavior.  Sullivan describes two main types of tensions:

Needs

“Needs are tensions brought on by biological imbalance between a  person and the physiochemical environment both inside and outside the organism, (Feist, n.d., p. 217).”  These needs can pertain to physiological needs (i.e. food and oxygen) interpersonal needs, (i.e. tenderness or love), and finally zonal needs (pertaining to a body part).

Anxiety

Anxieties are much more vague, “calling forth a nonspecific action” (Feist, n.d., p. 218).”  Sullivan believed these anxieties are learned from our parents and empathetic connection we have with them during infancy.  While needs generally pertain to normal and healthy tensions, anxieties are disruptive forces in our lives (Raghuveer, 2011).  In addition to disrupting personal relationships, they produce behaviors that are aimed at anxiety relief over learning.  Consequently, people are less liable to learn from their experiences when aiming to relieve anxieties (Feist, n.d.).

Dynamisms

Dynamisms refer to behavioral traits or habits that characterize an individual’s approach to life and include two major categories: “first, those related to specific zones of the body…second….composed of three categories – the disjunctive, the isolating, and the conjunctive, (Fiest, et al, n.d. (219).”

Disjunctive Dynamisms (Malevolence)

“The disruptive dynamism of evil and hatred is called malevolence [is] defined by Sulllian as a feeling of living among one’s enemies.” (Raghuveer, 2011, p. 67).”  Sullivan felt this behavior results as a toddler when parents respond to a child’s needs by attempting to ignore or control their behavior (Feist, n.d.).  In time, children learn to protect themselves and limit expression of needs for tenderness and intimacy.

Isolating Dynamisms (Lust)

“Lust is an isolating tendency requiring no other person for its satisfaction…It manifests itself as autoerotic behavior even when another person is the object of one’s lust, (Feist, et al, n.d., p. 220).” It is based solely on sexual gratification.

Conjunctive Dynamisms (Intimacy & The Self System)

INTIMACY – “Grows out of the earlier ned for tenderness but is more specific and involves a close interpersonal relationship between two people who are more or less of equal status, (Feist, et al, n.d., p. 220).”  It facilitates interpersonal development while decreasing both anxiety and loneliness (Raghuveer, 2011, p. 67).”
THE SELF-SYSTEM   –  The self-system is crucial to personal development and consists of behaviors that maintain our sense of personal security by protecting us from feelings of anxiety (Feist, et al, n.d.; Raghuveer, 2011).  In this respect, these behaviors form in response to interpersonal experiences and they can be thought of as “security operations” (Feist, et al, n.d.; Raghueer, 2011)
  1. DISSOCIATION – one type of security operation involves blocking certain experiences out of our awareness (Raghuveer, 2011).
  2. SELECTIVE INATTENTION – “is a refusal to see those things that we do not wish to see, (Feist, et al, n.d.).”  

Personification

“Personification consist of an image that an individual has of himself or of some other person.  It is a complex of feelings, attitudes and conceptions that grows out of experience with need-satisfaction. (Morgan, 2014, p. 3).

Good Mother, Bad Mother

This concept, admittedly has a somewhat Freudian feel to it.   “The bad mother/good mother personification results from an infant’s breastfeeding experiences (Morgan, 2014; Raghuveer, 2011).  The bad mother personification is a byproduct of negative breast feeding experiences and the infant’s hunger needs are not met (Feist, n.d.).  As you might expect the good mother personification is a byproduct of positive breastfeeding experiences, (Feist, n.d.).  While the good mother is conceived of as caring and tender, the bad mother is anxious and malevolent.

Me Personifications

“During mid-infancy a child acquires three me personifications (bad-me, good-me, and not-me) that form the building blcks of self-personification (Fiest, n.d., p. 222).”

GOOD ME – is a byproduct of a young child’s experiences of parental approval (Raghuveer, 2011).  Here the child works hard to please and up hold parental standards as a “good me”, (Feist, n.d.).
BAD ME – is a byproduct of a child’s experiences with punishment and disapproval (Raghuveer, 2011).  In this personification, children learn they are “bad” through interactions with parents (Rosenthal, 2005).  
NOT ME – a “not me” personification exists as a byproduct of selective inattention in order to avoid feelings of anxiety or unresolved trauma (Feist, n.d.).  Here, the child choose to avoid experiencing aspects of oneself that are associated with unresolved trauma and anxiety (Feist, n.d.; Rosenthal, 2005).  

Eidetic Personifications

Eidetic personifications are “unrealistic traits or imaginary friends that many children invent in order to protect their self-esteem….[they] can create conflict in interpersonal relations when people project  onto others imaginary traits that are remnants of previous relationships. (Feist, et al, n.d., p. 223).”

Levels of Cognition

Sullivan also describes levels of cognition that function as modes of thinking or experiencing reality, (Feist, et al, n.d., p. 223).”  He has a threefold level of classification for how we experiencing reality (Morgan, 2014):

Prototaxic Level

“Experiences that are impossible to put into words are to communicate to others are called prototaxic. (Raghuveer, 2011, p. 88).”  This level of cognition represents our early modes of experiencing reality during infancy.  For example, “a neonate feels hunger and pain, and these prototaxic experiences result in observable action…[like] sucking or crying. Feist, et al, n.d.).”

Parataxic Level

“Experiences that are pre-logical and nearly impossible to accurately communicate to others are called parataxic (Raghuveer, 2011, p. 88).”  “Parataxic experiences are more clearly differentiated from protaxic experiences but their meaning remains private….[for example]…when a child is conditioned to say ‘please’ in order to receive candy…an illogical belief that a cause-and-effect relationship exists. (Feist, n.d, 224).”  This illogical conclusion is called a parataxic distortion.

Syntaxic Level

Experiences that can be accurately communicated to others are called syntaxic (Raghuveer, 2011, p. 88).”  “Experiences that are consensually validated and that can be symbolically communicated take place on a syntaxic level.  Consensually validated experiences are those on whose meaning two or more persons agree. (Feist, et al, n.d., p. 224).”

Stages of Development

“Interpersonal theory emphasizes the importance of various developmental stages – infancy, childhood, the juvenile era, preadolescence, early adolescence, late adolescence, and adulthood. (Feist, n.d., p. 213).”  According to Sullivan, healthy development is based on an individuals degree of success in maintaining intimacy in interpersonal relationships throughout life (Feist, n.d., & Morgan, 2014).

psychology-for-social-workers-human-service-professionals-nurses-51-638

References

Feist, J; Feist, G.J. & Feist, G.J. (n.d.) Theories of Personality. McGraw Hill.  Retrieved from: http://highered.mheducation.com/sites/dl/free/0073532193/993171/Feist7e_Ch8_Sullivan.pdf
Morgan JH (2014) The Interpersonal Psychotherapy of Harry Stack Sullivan: Remembering the Legacy. J Psychol Psychother 4: 162. doi:10.4172/2161-0487.1000162
Raghuveer Reddy G. (2011) The stalwarts: Harry Stack Sullivan. AP J Psychol Med; 12 (2): 87–9.
Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.

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Margaret Mahler (NeoFreudian)

Introduction

a psychoanalytic theory of development

The purpose of this post is to review key human growth & development theorists in Rosenthal’s (2005) review for the NCE exam.  In this review, he mentions the work of Margaret Mahler, who I am honestly not familiar with.  She is a contemporary psychoanalyst.   Corey (2015), notes that while this counseling theory has understanding gone significant changes since Freud’s day.  However, all psychoanalysis believe that “we are profoundly affected by experiences with others…over the course of our development…psychological symptoms often have a great deal to do with these experiences, (Corey, 2015, p. 81).”

What is object relations theory?

Object relations theory asserts we can learn about personality development by examining our mental representations of interactions with significant others in early life (Sharf, 2015).  According to this theory, these early mental representations serve as a template for relationships later in life and influence the process of individuate of in adulthood. The word “object” refers to a term used by Freud as anyone or anything that serves a critical need (Corey, 2015).  The relationships we develop with these objects early in life, influence our development into adulthood.  In her theory of development, Mahler rejected Freud’s sexualized perspective.  Instead, she focused “on the child’s progression from a symbiotic relation- ship with a maternal figure toward separation and individuation, (Corey, 2015, p. 81).”  Focusing on the first three years if a child’s life she describes this gradual process of separation in a series of stages…

Mahler’s Stages of Development

Normal Autism

“In the first few weeks of life, babies are driven by primitive needs like eating and sleeping. This is called NORMAL AUTISM, (Rosenthal, 2005).”   During this state we respond only to states physiological states. “Mahler believes the infant is unable to differentiate itself from its mother in many respects at this age. (Corey, 2015, p. 83).”  In other words no mental construct exists in the middle me of either the self or objects (i.e. – anything/anyone that fills a need).

Symbiosis

At two months we enter a stage called SYMBIOSIS.  During this stage, the infant is highly dependent on the mother.  “The child feels like he/she is part of the mother – a fusion, This fusion later results in symbiosis implying the two individual’s cannot exist without each other. (Rosenthal, 2005).” Corey (2015 states this stage lasts from approximately 3-8 months.  During this phase infants display a high degree of dependency upon their primary caregiver.  “The infant seems to expect a very high degree of emotional attunement with its mother, (Corey, 2015, p. 83).”

separation & individuation

“From five months – age three the child is in the SEPARATION / INDIVIDUATION PERIOD. The child develops own “self” separate from the caretaker.  The (NCE) could identify this as the DIFFERENTIATION PROCESS. (Rosenthal, 2005).”  During this stage we vacillate ambivalently between dependence and independence.  For example, at the doctor’s office, a toddler can be seen exploring the toys in a waiting room while checking periodically to make sure mom is nearby. “Others are looked to as approving mirrors for the child’s devel- oping sense of self; optimally, these relationships can provide a healthy self- esteem. (Corey, 2015, p. 83).” According to Mahler, BPD and Narcissistic Personality Disorder have developmental roots in this stage.

Rapprochement

Rosenthal, (2005) Mahler’s final phase “Rapprochement” & describes it as an alternation between feelings of closeness with a need for distance.   “The ideal mother will provide comfort and reassurance and allow some independence. (Rosenthal, 2005).” Corey, (2015), instead describes this as a final sub phase of separation & individuation.  During this phase toddlers (2-3) display a more fixed mental representation of self and objects.  “Ideally, children can begin to relate without being overwhelmed with fears of losing their sense of individuality, and they may enter into the later psychosexual and psychosocial stages with a firm foundations of selfhood (Corey, 2015, p84).”

References

Corey, G. (2015). Theory and practice of counseling and psychotherapy. Retrieved from: http://bk.unesa.ac.id/wp-content/uploads/2015/09/Theory_and_Practice_of_Counseling.pdf
Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.
Sharf, R. S. (2015). Theories of psychotherapy & counseling: Concepts and cases. Cengage Learning.

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Freud’s Psychosexual Stages

Whether you like him or not he is the number one figure in the history of psychology.   His contribution to developmental psychology is his Psychosexual Stages….(Rosenthal, 2005).”  “Freud believed that the development of personality and the formation of the id, ego, and superego, as well as ego defense mechanisms, depend on the course of psychosexual development in the first 5 years of life. The psychosexual oral, anal, and phallic stages occur before the age of 5 or 6; then there is a relatively calm period for 6 years (the latency period), followed by the genital stage in adoles- cence, which starts at the beginning of puberty. Freud’s theory is based on bio- logical drives and the importance of the pleasure principle; thus, certain parts of the body are thought to be a significant focus of pleasure during different periods of development (Sharf, 2015, p. 37.”

Oral Stage (1st year)

“Sucking at mother’s breasts satisfies need for food and pleasure. Infant needs to get basic nurturing, or later feelings of greediness and acquisitive- ness may develop. Oral fixations result from deprivation of oral gratification in infancy. Later personality problems can include mistrust of others, rejecting others; love, and fear of or inability to form intimate relationships, (Corey, 2015, p. 67).”

Dependent on Mom.
Occupied with sucking and the mouth (Rosenthal, 2005)
Mouth is the erogenous zone & primary source of pleasure
Oral fixations (smoking) have roots here caused by deprivation of oral gratification in infancy(Rosenthal, 2005).
“Oral personality is clinging and passive/dependent (Rosenthal, 2005).””

Anal Stage (1-3)

“Anal zone becomes of major sig- nificance in formation of personality. Main developmental tasks include learning independence, accepting personal power, and learning to express negative feelings such as rage and aggression. Parental discipline patterns and attitudes have signifi- cant consequences for child’s later personality development, (Corey, 2015, p. 67).”

Developmentally focused on toilet training & self-esteem.

“Anus is the erogenous zone, (Rosenthal, 2005).”
Parents should maintain balance between punishment & reward or conflicts can develop into an anal-retentitive or explosive temperament (Rosenthal, 2005).
Anal-retentive individuals are: “compulsive, unusually neat, frugal, obstinate, hoarder, very orderly, and condescending towards others, (Rosenthal, 2005).
 “Anal-explosive character has a messy desk at work, unclean house, and disorganized…(Rosenthal, 2005).”

Phallic Stage (3-6)

“Basic conflict centers on unconscious incestuous desires that child develops for parent of opposite sex and that, because of their threatening nature, are repressed. Male phallic stage, known as Oedipus complex, involves mother as love object for boy. Female phallic stage, known as Electra complex, involves girl’s striving for father’s love and approval. How parents respond, verbally and nonverbally, to child’s emerging sexual- ity has an impact on sexual attitudes and feelings that child develops, (Corey, 2015, p. 67).”

Child has interest in his/or own genitalia and genitalia of others.
Most controversial component of Freud’s theory = Oedipus / Electra Complex (r/t sexual feelings for opposite sex parent)
    1. Oedipus complex (boys) want all of mom’s attention and dad out of the picture.  Does what is necessary to get attention unconsciously.
    2. Electra complex (girls) Little girl wants to beat out mom for dad’s attention, but when she realizes she can’t, she identifies with aggressor – mom – to resolve this.
Castration complex – There is a fear of castration from dad….somehow causes them to repress Oedipus complex. 
Penis Envy –  “Girl develops negative feelings towards mother when she realizes she lacks a penis. This is parallel to castration anxiety in boys.” (Rosenthal, 2005).

Latency Stage (6-12)

“After the torment of sexual impulses of preceding years, this period is relatively quiescent. Sexual interests are replaced by interests in school, playmates, sports, and a range of new activities. This is a time of socializa- tion as child turns outward and forms relationships with others, (Corey, 2015, p. 67).”

Genital Stage (teens – death)

“Freud concerned himself with childhood development rather than adult development. In the genital stage, the focus of sexual energy is toward members of the other sex rather than toward, (Sharf, 2015, p. 376.”  “Old themes of phallic stage are re- vived…adolescents can deal with sexual energy by investing it in various socially acceptable activities such as forming friendships, engaging in art or in sports, and preparing for a career…. (Corey, 2015, p67).”

References

Corey, G. (2015). Theory and practice of counseling and psychotherapy. Retrieved from: http://bk.unesa.ac.id/wp-content/uploads/2015/09/Theory_and_Practice_of_Counseling.pdf
Rosenthal, H. (2005). Vital Information and Review Questions for the NCE and State Counseling Exams. Routledge.
Sharf, R. S. (2015). Theories of psychotherapy & counseling: Concepts and cases. Cengage Learning.

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