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Vintage SullivanBenjamin Wolstein Ph.D.Published online: 24 Oct 2013.
To cite this article: Benjamin Wolstein Ph.D. (1977) Vintage Sullivan, ContemporaryPsychoanalysis, 13:3, 407-411, DOI: 10.1080/00107530.1977.10745502
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BENJAMIN WOLSTEIN, Ph.D.
Vintage Sullivan Comments on the 1946-1947 Seminar
Kvarnes, M.D., Robert G. and Gloria H. Parloff (eds.), et al., A Harry Stack Sullivan Case Seminar: Treatment of a Young Male Schizophrenic. New York, Norton, 1976.
T H I S BOOK, THE PRESENTATION of a case seminar, is genuine, vin- tage Sullivan, recorded live and offered in transcript form with later reflective commentary. It joins the growing body of posthum- ous work that his colleagues, students, and various coworkers are wisely deciding to organize, edit, and commit to print for enduring reference. These posthumous publications consist largely of tran- scripts of his discussions of theoretical concepts and therapeutic procedures, and of collections of his papers on a wide variety of topics in psychiatry, social policy and cultural values, and interna- tional relations. And now, in this volume under comment, the theme is his conduct of a seminar on the ongoing treatment of a young male schizophrenic.
The editors, Robert G. Kvarnes, M.D., and Gloria Parloff, and the commentators, John C. Dillingham, Stanley Jacobson, Ed.D., Robert G. Kvarnes, M.D., and Irving M. Rykoff, M.D., are to be congratulated for holding fast to their labor of love over the years until it could appear in hard cover, not only for their dedicated editing of the original 1946-1947 seminar led by Sullivan, and at- tended by a number of serious and penetrating participants, but also for their thoughtful 1971-1972 commentary on each of the five meetings. They seek to place the Sullivan legacy into historical focus from the perspective of the postSullivanian and even neo- Sullivanian present.
407 Copyright @ 1977 W. A. W. Institute. New York All rights of reprodudon in any form reserved. Contemporary Psychoanalysis, Vol. IS. No. 3 (1977)
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BENJAMIN WOLSTEIN, Ph.D.
rent efforts at psychoanalytic reconstruction, it aIso underscores an aspect of his work that was scarcely acknowledged from the 1930s through the middle 1950s, a period in which the divisive, polemical smoke tended to becloud the outcomes of actual inquiry, an aspect that is now becoming far clearer and more widely accepted. The editors and commentators observe, for example, at different points in their discussion, that Sullivans contributions can be seen as being principally in the realm of ego psychology.
In the rather special, social and cultural vocabulary of interper- sonal relations defined in operational terms, his major contribu- tions parallel and even extend the ego-psychological model of therapy to the point of making it the ego-interpersonal model, in that way reflecting a convergent emphasis of both ego psychology and interpersonal relations on the patients adaptive, consensual achievement within his social and cultural surround.
Formally the ego-interpersonal psychoanalyst, no less than the ego-interpersonal patient, appears in the experience of his recip- rocal other, essentially in the reactive, in preference to the active, mode. Worth special attention, in this effort, is Sullivans strong reiteration of the point, in various contexts of seminar discussion, that Dr. Kvarnes, the presenting psychiatrist, adopt an obviously professional-technical approach (even, in fact, as rehearsed be- havior) apart from a directly human-natural approach (as far, even, as vibrant immediacy) to the development of Kvarnes formu- lations, and to his use of them in therapeutic procedure.
Thus, during the December, 1946 seminar, in a not infrequent resort to aphorism-the wit, irony, humor, and imaginative excur- sus are, alone, well worth the price of admission-he remarks that everything is spontaneous except that nothing is spontaneous. And by the last seminar in May, 1947, as though to clarify the meaning of the earlier, apparent exception, he states, I have always insisted that a great deal of psychiatry has to seem spon- taneous, and to be carefully thought out-plainly indicating again, if there were still any doubt about it, how the exception that nothing is spontaneous had actually set forth the rule. But spon- taneity is not, of course, a wild animal that needs to be trapped, tranquilized, caged, nor, indeed, a mad dog that should be wasted.
It arises, rather, as a generic trait of the human psyche, it is directly acquired through natural endowment. It characterizes the immediate subject. of original, psychic processunique, individual,
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VINTAGE SULLIVAN
active (and, so to speak, sponsive). That is, it is compresent in the experiential field of therapy with the mediated objects of distribu- tive, ego-interpersonal patterning-shared, consensual, reactive (and, therefore, responsive)-during which process and pattern- ing, emerging in tandem, both psychoanalyst and patient move and shape the direction of their actual coparticipant inquiry. And so, spontaneity does not appear in the psychoanalyst or in his patient as a matter of caprice, whim, fashion, indulgence. It represents a genuine aspect of the human psyche, to be deflected and deformed only at the risk of either or both coparticipants crippling their serious efforts at psychoanalytic inquiry.
For the careful student of intensive psychotherapeutic inquiry, this volume of and about Sullivan also serves as a concise statement of the main outlines of his conceptions of modern psychiatry. It points up the significantly ego-psychological slant of Sullivans con- ceptions, and reviews their intervening role as part of a larger, socializing, environmentalist movement in psychoanalytic thought. Psychoanalytic metapsychologies were then in transition from the 19 15- 19 17 id-libidinal perspective to the self-psychological perspectives of the 1960s and 1970s.
In addition, it provides further sources of illustration-mainly, I think, by a persistent emphasis on the empirics of observation as distinct from the myths and metaphors of symbolic representation-that point up how he helped to refocus the themes of the actual therapeutic inquiry away from the excesses of his precursorss interpretive metapsychologies.
And finally, it clearly depicts the reasons why Sullivan should be considered an early member of the emerging American School of psychoanalysis-this School, in the 1930s and 194Os, already draw- ing together varieties of therapeutic procedure based on a pluralism of backgrounds in beliefs, values, and ideals. Sullivan can be seen this way because of his consistently operational focus on clinical inquiry, and because of his commitment to the large practi- cal meaning of the fundamental distinction, in present-day terms, between psychology and metapsychology in the structure of
The only extensive work that Sullivan ever saw through publica- tion is, of course, the W.A. White Memorial Lectures, entitled Con-
For discussion of some major, distinguishing aspects of its perspective, see Wol- stein B. (1977), Psychology, metapsychology, and the evolving American school. This Journal, 13: 128-154.
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BENJAMIN WOLSTEIN, Ph.D.
ceptions of Modern Psychiatry. Even a cursory comparison of those carefully composed 1940 lectures with the lively exchange of this 1946- 1947 seminar would illustrate the remarkable difference be- tween his written and his spoken word. But the difference, it should be emphasized, derives from the spontaneous style of his presenta- tion, not from the substance of his theoretical concepts and therapeutic procedures. For while the mood of the seminar ap- pears to be impressionistic, the scope of its themes is, nonetheless, comprehensive.
The leading principles of Sullivans interpersonal approach to intensive psychotherapy are, in the main, present and accounted for, and their application to a particular patients life experience is indicated and directly illustrated. Such principles, for example, as the interpersonal career-line of personality through socially and cultural defined stages of development, the critical disclosure of anxiety during inquiry into the origin and function of the security operations, the mapping of therapeutic maneuvers to circumvent the rise of transference neurosis in the clinical field of interaction, the selective usage of collaterally acquired information about the patients history and about his reported difficulties in living, the operationist concern for the empirical as against both the systema- tic and the interpretive orders of therapeutic inquiry, but without, however, making a clear distinction between the order of explana- tory hypothesis or theory and that of beliefs, values, or ideals of metapsychology, are amply demonstrated, and more.
Even so, from the perspective of current psychoanalytic theory and clinical inquiry, the contribution of this Case Seminar to the Sullivan legacy is particularly interesting for still another reason. It helps to illumine the prevailing climate of opinion and context of doctrine in which he sought to articulate the effects of both the culture and the science of his time on the changed conditions of intensive psychotherapeutic practice. And in the retrospect of cur- psychoanalytic inquiry.
The scholarly student of the history of psychoanalysis may also discern in this Case Seminar how Sullivans psychiatric conceptions may be traced to the convergence of the three main sources of his thinking-Freuds psychoanalytic therapy, Meyers commonsense psychobiology, and Whites institutional psychiatry-as a result of which Sullivan could, for example, propose the intensive psychotherapeutic study of the category of parataxic distortions
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VINTAGE SULLIVAN
(or, as he termed them elsewhere, transference distortions) with- out appealing to the interpretive power of the libido metaphor, or to that of the other antecedent perspectives on metapsychology. And so, within the frame of the American School emerging then, the uniqueness of his own deeply individual stamp on those three sources is unmistakable. He brought a respect for the unique indi- viduality of the human psyche whose existence, most unfortunate- ly, he did not see fit to acknowledge in his interpersonal theory of a psychiatry for all who, as he put it, are more simply human than otherwise.
The grand direction of his approach, however, remains unmis- takably unique and individual both in the philosophy and in the treatment of the schizophrenias and psychoses. The id-instinctual perspective on metapsychology, then still well established, had long before placed these categories of patients beyond the pale of psychoanalytic therapy because they did not fit into the artificially distinct grouping of the transference neuroses in that perspec- tive. Sullivan, instead, undertook a therapeutic exploration of the narcissistic neuroses4espite their being, in his day, still consid- ered incapable of extending their manifestations in transference, and therefore treated as unpsychoanalyzable. For his progressive purpose, he adopted the contrary assumption that the narcissistic neuroses are, in observable fact, quite capable of manifesting a wide and indefinitely extended range of transferences, resistances, and anxieties, though in these patients far more distorted than real.
A Harry Stuck Sullivan Case Seminar bears witness to the enduring value of that courageous assumption.
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