Because he believed that psychic disorders grow out of interpersonal difficulties, Sullivan based his therapeutic procedures on an effort to hnprove a patients relationship with others. To facilitate this process, the therapist serves as a participant observer, becoming part of an interpersonal, face-to-face relationship with the patient and providing the patient an opportunity to establish syntaxic communication with another human bemg.
While at St. Elizabeth Hospital, Sullivan devised a then radical means of treating seriously disturbed patients. His supervisors agreed to grant him a ward for his own patients and to allow him to select and train paraprofessional workers who could treat the patients as fellow human beings. At that time, most schizophrenic and other psychotic patients were warehoused and regarded as subhuman. But Sullivan's experiment worked. A high rate of his patients got better. Erich Fromm (1994a) regarded Sullivan's near miraculous results as evidence that a psychosis is not merely a physical disorder and that the personal relationship of one human bemg to another is the essence of psychological growth.
In general terms, Sullivanian therapy is aimed at uncovering patients' difficulties in relating to others. To accomplish this goal, the therapist helps patients to give up some security in dealing with other people and to realize that they can achieve mental health only through consensually validated personal relations. The therapeutic ingredient in this process is the face-to-face relationship between therapist and patients, which permits patients to reduce anxiety and to communicate with others on the syntaxic level.
Although they are participants hi the interview, Sullivanian therapists avoid getting personally involved. They do not place themselves on the same level with the patient; on the contrary, they try to convince the patient of their expert abilities. In other words, friendship is not a condition of psychotherapy—therapists must be trained as experts in the difficult business of making discerning observations of the patient's interpersonal relations (Sullivan, 1954).
Sullivan was primarily concerned with understanding patients and helping them improve foresight, discover difficulties hi interpersonal relations, and restore
Chapter 8 Sullivan: Interpersonal Theory 233
their ability to participate hi consensually validated experiences. To accomplish these goals, he concentrated Ins efforts on answering tlnee continuing questions: Precisely what is the patient sayhig to me? How can I best put into words what I wish to say to the patient? What is the general pattern of communication between us?
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