the William Alanson White Institute : In Memory

Contemporary Psychoanalysis, Vol. 22, No. 3 (1986)

Roots and Status

Stephen A. Mitchell, Ph.D.

AMONG THE MANY IMPORTANT and fruitful ideas which Sullivan developed, the concept I have found most important in broadening my own perspective and stimulating my own thinking has been the notion of the interpersonal field. The way an observer approaches and defines the object of study, Sullivan argued, goes a long way in determining what sort of data he will come up with and how he will account for them.

For Freud, the object of study in psychopathology is the individual mind. His "intrapsychic" model traces neurotic symptoms back to processes and structures arising within the mind of the patient. Sullivan felt that Freud had incorrectly framed the phenomena in question. Psychopathology is best approached, Sullivan believed, not in terms of one person, but in the context of actual interactions among persons, in terms of what he called the "interpersonal field." Personality and psychopathology do not exist in germinal form within the child, simply unfolding as a bud into a blossom; personality and psychopathology derive from, are composed of, interactions between the child and significant others. To understand the person in a meaningful way, you have to view the person in the context of the field from which he or she emerged and operates.

In my view, this illuminating approach to persons is also usefully applied to the history of ideas. Tonight's topic asks us to consider

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the roots and the status of Interpersonal Psychoanalysis. To address this question meaningfully, we have to consider the field in which Interpersonal Psychoanalysis arose and still operates, the larger field of psychoanalysis in general, the broader history of psychoanalytic ideas and contemporary schools of thought. Interpersonal Psychoanalysis was born in the clash between classical European psychoanalysis and the distinctively American sensibility generated in the early decades of this century by philosophical Pragmatism. I will begin then by considering psychoanalytic theory in its broadest historical perspective.

The theory of instinctual drive, which is the conceptual framework housing all of Freud's ideas, theoretical postulates, clinical insights, and technical recommendations, has been, like all human intellectual creations, essentially superceded. Classical drive theory was perfectly consistent with 19th century philosophy of science and neurophysiology. Now nearly a century in age, it is not at all surprising that it is dramatically inconsistent with current philosophy of science and neurophysiology. Thus, the past 50 years in the history of psychoanalytic ideas has witnessed a broad and pervasive revolution. Recent psychoanalytic contributions have been informed and pervaded by a different vision; we have been living in an essentially post-Freudian era.

Yet, because of the enormous shadow cast by Freud's genius and authority, and because theory has been developed by so many different authors (generally not acknowledging the contributions of each other), it is often not appreciated how different so much of psychoanalysis has become from Freud's initial vision. The "big ideas", the most important influences on theory-building and clinical practice, have come not from within the drive model, which Freud himself elaborated to a considerable complexity and refinement. The most creative and influential contributions have come from what Greenberg and I have termed the "relational/structure" model, an alternative perspective which considers relations with others, not drives, as the basic stuff of mental life. Some of these contributions have come from authors who have explicitly broken with drive theory (e.g. H. S. Sullivan, W. R. D. Fairbairn). Some have come from authors who write in drive model language but redefine all the key terms and rederive all the basic structural components, resulting in a vision which is relational in all major respects (e.g. D. Winnicott, H. Loewald). Other important contributions

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have come from authors who maintain a general allegiance to the drive model, but have developed perspectives which are incompatible with and largely supplant it (e.g. M. Mahler, H. Kohut).

The relational model theories which have dominated psychoanalytic thinking of the past several decades are varied and heterogeneous—they differ from each other in many important respects. Yet, they also draw on a common vision, quite different from Freud's. We are portrayed not as a conglomeration of physically-based urges, but as emerging from and embedded within a matrix of relationships with other people, struggling both to maintain our ties to others and yet to differentiate ourselves from them. In this vision, the basic unit of study is not the individual as a separate entity, clashing with an external reality, but the relational field within which the individual arises and struggles to articulate himself. The person is graspable only within this tapestry of relationships, past and present. In this perspective, the figure is always in the tapestry, and the threads of the tapestry (via identifications and introjections) are always in the figure. I regard Sullivan's Interpersonal theory as the first and in many ways the most important version of this relational model. Why Sullivan was so sensitive to basic deficiencies of the drive model and why he moved in the direction he did has much to do with the intellectual climate in which he lived.

When Alexis de Tocqueville, the 19th century French historian, visited the United States in the 1830's, he was struck by the antiphilosophical quality of American culture. "In no country in the civilized world, " he noted, "is less attention paid to philosophy than in the United States." Several decades later, when a distinctly American philosophical point of view did emerge in the writings of Charles Pierce and William James, it was something of an anti-philosophy philosophy, or at least a philosophy that cast a suspicious eye on the value of philosophizing in the abstract.

American Pragmatism was a reaction to the broadly speculative expanses of ninteenth century European metaphysics, the grand, elegant, formal systems and armchair visions of Kant, Hegel and Schopenhauer. The Pragmatists were wary of what they regarded as the presumptuousness and arbitrariness of philosophical systems, and more concerned with the question of what one could

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do with any particular philosophical notion, what difference it makes in everyday living.

Interpersonal psychoanalysis was heir to this pragmatic tradition. Sullivan studied medicine in Chicago, the hub of the tremendous fervor which Pragmatism had begun to generate in American intellectual life and particularly in the social sciences, which were characterized by an orientation toward the practical, social reality, what can be seen and measured rather than intangible abstractions. Sullivan's relationship to Freudian psychoanalysis, complex and ambivalent, was very much influenced by this sensibility.

Although a psychology of unseen, intangible forces like drives was just the sort of theory likely to make any good Pragmatist cringe, Freud's ideas were by no means unwelcome among Sullivan and his contemporaries, who were involved in the treatment of schizophrenia. This field at that time was dominated by the ideas of Kraepelin, who viewed schizophrenia as an irreversible deterioration; schizophrenic phenomenology and symptomatology were meaningless murmerings of a nervous system undergoing a relentless, inexorable disintegration.

For Sullivan, Freud's theories had been a breath of fresh air. Freud had demonstrated that seemingly bizarre neurotic symptoms like hysterical conversions and obsessions were not the result of random and meaningless neurological discharge, but expressed the patient's wishes, intentions and conflicts. Similarly, Sullivan had come to regard schizophrenic phenomenology and symptomatology not as a sign of meaningless degeneration, but as expressive of important aspects of the patient's emotional life. Freud's psychodynamic theory provided Sullivan with a powerful tool for understanding his patients, and Sullivan's early papers were written largely in a Freudian mode.

Yet, Freud often attempted to account for that which was tangible and visible in terms of unseen forces. The schizophrenic break with reality, for example, was understood as a product of withdrawal of libidinal cathexis from the external world, rather than as reflecting, as Sullivan came to view it, the intense and distorted realities of the patient's interpersonal, familial context. Freud's explanation in terms of drives seemed to miss too much of importance, and, particularly with respect to schizophrenia, led to

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a therapeutic pessimism. What Freud saw as derivatives of instinctual forces, Sullivan came to see as residues (misunderstood and distorted) of real, interpersonal events.

In addition to the concept of the interpersonal field, the subtle workings of anxiety and the pursuit of security came to form the basis for Sullivan's system. Anxiety about anxiety is at the core of all psychopathology and constitutes the earliest organizational principle of the self, which takes shape in complementarity to the character of significant others. In classical drive theory, intrapsychic conflict is predetermined and universal, a product of the inevitable clash between psychosexual and aggressive drives and social reality. For Sullivan, both the qualitative and quantitative factors in personality organization derive exclusively from the particulars of the interpersonal matrix within which early development takes place, from the character of the parental figures and their relationships with the child. The contours of the child's personality tend to perpetuate themselves throughout life; the patient extrapolates from his early experience, assuming that the avenues of contact and avoidance in his family are representative of the species in general. Repetitive patterns of living keep the patient within the realm of the familiar, attached to early personifications of self and others, protecting him from the anxiety associated with personal growth and enrichment. What is most fundamental motivationally is the preservation of the shape of the self, the characteristic patterns of integrating relationships and the recurrent stance toward life. What is most fundamental therapeutically is the inquiry into these repetitive patterns of experiencing and living, particularly as they manifest themselves in the analytic relationship. Thus, Interpersonal Psychoanalysis arose as a corrective for a major weakness of traditional drive theory, its underemphasis on what actually went on between the patient and others in the past, and what actually goes on between the patient and others, including the analyst, in the present.

I believe that Sullivan's version of the relational model is perfectly consistent and indeed complementary with many other relational model theories which address and attempt to correct for various other deficiencies of drive theory metapsychology including: the internal organization of early interpersonal relationships in the British School of object relations; the emergence of the individual from early fantasies of fusion with others as developed

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by Mahler and her co-workers; the organization of the self as developed within self psychology; and the reintroduction of the realm of personal responsibility and the will in Schafer's action language. Although precise influences are hard to substantiate, Interpersonal Psychoanalysis seems to have had a considerable impact on many of these developments, even including recent revisions by some of the most zealous supporters of the drive concept like Kernberg and Rothstein.

Mainstream psychoanalytic thinking has moved precisely in the direction of all of Sullivan's major emphases: the central importance of the actual interactions with caretakers, parental character pathology, the organizational structure of the self, language which reflects action and process rather than reified structures, and so on. In fact, in many respects, contemporary psychoanalysis is closer to Sullivan's thinking in the 1930's and 1940's than it is to classical psychoanalysis of the 1930's and 1940's.

If so many of the most influential thinkers within contemporary psychoanalysis draw on and develop a similar, essentially compatible vision, why is there so little apparent consensus? Why has psychoanalysis in recent years seemed to spawn one after another different theoretical systems, each with its own language, devotional following and deep conviction of proceeding on the only true path?

Because of its enormous range and depth, the abandonment of classical drive theory creates an immense conceptual vacuum. Unfortunately, most of the various would-be-successors to the architect of drive theory has attempted to fill this conceptual chasm by substituting a new system of his own design. None of these models, by itself, has been up to the task—each has been stretched too thin. There is not enough substance, not enough ideas to fill the same space, the depth and scope of the issues Freud reached through drive theory. The result has been a series of partial solutions, each important in its own right and perhaps closer to the clinical data than classical drive theory, but not as rich and comprehensive, not as compelling to large numbers of practicing analysts. Each of the rival would-be-successors to Freud tends to portray himself in terms of a singular line of descent, and if closely-related contemporary authors are noted, it is only minimally. Each major theorist establishes a new perspective around a particular issue, which is seen as the crucial failure of classical theory. The

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treatment of this new issue then becomes the rallying point for a new meta-theory, and all other critiques of classical theory are seen as incomplete, not quite radical enough, ventures in the same direction. In the 1930's and 1940's, H. S. Sullivan, M. Klein, E. Fromm, W. R. D. Fairbairn and K. Horney took scant notice of the striking overlap in their efforts. More recently, D. Winnciott, M. Mahler, H. Kohut, J. Gedo and R. Schafer, when they do remark on the closely related work of the others, do so by regarding it as an incomplete way-station to the final destination—their own system.

Thus, much of the apparent fragmentation of psychoanalysis as a discipline is an artifact of its history. Psychoanalysis was created by an individual intellect of towering genius. Freud's system, like all intellectual constructions, has been inevitably outgrown, but the singularity of his achievement became the model followed by his successors, who tend to present their contributions not as partial replacements, solutions to particular features, selected areas which Freud addressed, but as alternative, comprehensive systems. Consequently, they overlook the similarity and compatibilities of their efforts, and call for exclusive loyalty, which is neither compelling nor necessary.

A second and closely related historical cause of the apparent fragmentation within psychoanalytic theories has been the heavily political nature of the psychoanalytic movement from the very beginning of Freud's relationships with his early followers. Freud saw psychoanalysis not just as an intellectual discipline and method of treatment, but as a highly provocative and personally disturbing set of truths about human nature. With considerable justification, he rated himself third behind Copernicus and Darwin as the bearer of humbling tidings to mankind. Based on his experience with patients' resistances to interpretations, he anticipated massive general resistance to psychoanalytic ideas and methods. Thus, from early on, Freud regarded psychoanalysis as a "movement;" its successes and failures, its adherents and detractors, were thought about in a quasi-religious, quasi-political frame of reference. It was not without some justification that psychoanalysts began to feel that psychoanalytic concepts could only be meaningfully evaluated by the initiated—those having undergone a personal analysis. A change of conviction in those who had already

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been analyzed became prima facie evidence of "unanalyzable" psychopathology.

Thus, intellectual beliefs tended to become blurred with accusations and counteraccusations hurled in both directions between loyalists and dissidents. A key factor in these controversies was the designation "psychoanalytic." Although Freud designated different features of his theory at different times as being the essence of "psychoanalysis, " those who broke from current orthodoxy, even if they retained a belief in many of Freud's ideas, were accused of no longer representing "psychoanalysis." The claim to direct conceptual lineage to Freud became the psychoanalytic equivalent of possessing the royal sceptor, and many psychoanalytic papers begin by claiming that some obscure passage from Freud's opus reveals a hidden meaning suggesting Freud's belief in whatever argument the author then proceeds to make. Thus, political loyalties and fears have had a major impact on the way in which innovative psychoanalytic concepts are presented and positioned, often obscuring both their distance from classical psychoanalytic thought and their similarities with each other.

Where does this leave Interpersonal Psychoanalysis today? It seems to me that there are three different ways to view it. We could consider Interpersonal Psychoanalysis an historically important corrective to mainstream psychoanalysis, having served a crucial function in the development of psychoanalytic ideas. In this view, what was important and unique within the Interpersonal tradition has already been absorbed into the mainstream, and therefore an independent Interpersonal school is now redundant and unnecessary. A second approach would be to claim that Interpersonal Psychoanalysis represents a fundamentally different, fully developed and comprehensive paradigm, incompatible with traditional Freudian psychoanalysis as well as with contemporary offshoots of classical analysis like ego psychology, self psychology and object relations theories. In this view, Interpersonal Psychoanalysis should be preserved as a separate and integral tradition, with any efforts at synthesis with other schools raising the risk of diluting and contaminating what is best and clinically most powerful within the Interpersonal tradition. I don't agree with either of these views. On the one hand, there is no question that the potential contributions from the Interpersonal tradition have not run dry,

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that the emphasis on actual transactions between self and other, past and present, provides a vantage point on clinical work which is extremely important and not as developed in any other contemporary psychoanalytic school. The contributions of Levenson, Wolstein, Chrzanowski, Witenberg & Cooper and many others, including, most recently and most surprisingly, Merton Gill, are testimony to the continuing fertile ground of interpersonal concepts.

On the other hand, as I have indicated, I think that some of the theoretical and clinical avenues developed by other traditions are complementary with and add greatly to, the interpersonal focus on transactions. In my view the interpersonal position is strong enough to participate in a rapproachment and synthesis, without running the risk of losing its identity or integrity.

The future of Interpersonal Psychoanalysis is not written in the stars, predetermined, but rather is what we, those who have been trained in its traditions, make of it. I think this is an enormously exciting time within psychoanalysis. There is widespread dissatisfaction with the drive/structure model, even among the most zealous Freudians, and there are wide-reaching efforts in many new directions for a framework to replace it. Many of these efforts, in my view, are very much complementary with each other, and their interfaces generate very fruitful syntheses. I think that Interpersonal Psychoanalysis can play a central role in the crystalization of a new framework out of the many avenues currently being pursued. To play that role requires us to leave behind the political battles and divisions of the 1930's and 1940's, to remain open to new avenues for growth. In the future of Interpersonal Psycho-analysis, I believe the danger of isolation is much greater than the danger of contamination. In general, the richness and maturity of post-Freudian psychoanalysis depends on our recognition of how far we have come and the exciting interplay among the routes we have taken.

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