4. Sullivan - interpersonal Relationship Milieu Therapy PDF

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HARRY STACK SULLIVAN: INTERPERSONAL RELATIONSHIP AND MILIEU THERAPY Sullivan believed that one’s personality involves more than individual characteristics, particularly how one interacts with others. He thought that inadequate or non satisfying relationships produce anxiety, which he saw as the basis for all emotional problems (Videbeck 47) Five Life Stages. Sullivan established five life stages of development—infancy, childhood, juvenile, preadolescence, and adolescence, each focusing on various interpersonal relationships

He also described three developmental cognitive modes of experience and believed that mental disorders are related to the persistence of one of the early modes. (Videbeck 48) Therapeutic Community or Milieu. Sullivan envisioned the goal of treatment as the establishment of satisfying interpersonal relationships. The therapist provides a corrective interpersonal relationship for the client.

Sullivan’s Life Stages ❖ Infancy: Birth to onset of language Primary need exists for bodily contact and tenderness. Prototaxic mode dominates (no relation between experiences). Primary zones are oral and anal. If needs are met, infant has sense of well-being; unmet needs lead to dread and anxiety. ❖ Childhood: Language to 5 years Parents are viewed as source of praise and acceptance. Shift to parataxic mode: experiences are connected in sequence to each other. Primary zone is anal. Gratification leads to positive self-esteem. Moderate anxiety leads to uncertainty and insecurity; severe anxiety results in self-defeating patterns of behavior. ❖ Juvenile: 5–8 years Shift to the syntaxic mode begins (thinking about self and others based on analysis of experiences in a variety of situations). Opportunities for approval and acceptance of others. Learn to negotiate own needs. Severe anxiety may result in a need to control or in restrictive, prejudicial attitudes.

Milieu Therapy ❖

The concept of milieu therapy, originally developed by Sullivan, involved clients’ interactions with one another, including practicing interpersonal relationship skills, giving one another feedback about behavior, and working cooperatively as a group to solve day-to-day problems. (Videbeck 49)

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In the concept of therapeutic community or milieu, the interaction among clients is seen as beneficial, and treatment emphasizes the role of this client-to-client interaction. (Videbeck 49)

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Sullivan and later Jones observed that interactions among clients in a safe, therapeutic setting provided great benefits to clients. (Videbeck 49)

❖ Preadolescence: 8–12 years Move to genuine intimacy with friend of the same sex. Move away from family as source of satisfaction in relationships. Major shift to syntaxic mode occurs. Capacity for attachment, love, and collaboration emerges or fails to develop. ❖ Adolescence: Puberty to adulthood Lust is added to interpersonal equation. Need for special sharing relationship shifts to the opposite sex. New opportunities for social experimentation lead to the consolidation of self-esteem or self-ridicule. If the self-system is intact, areas of concern expand to include values, ideals, career decisions, and social concerns. (Videbeck 48)

Sullivan’s developmental cognitive modes ❖

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Protaxic: occurs in infancy and childhood. Involves short, unconnected experiences that have no relation. Schizophrenics can exhibit this. Parataxic: Onsets in early childhood, the child begins to make connections between experience and sequence. The child may not understand logic but may see coincidence in events. Paranoid ideas or slips of the tongue are associated with this mode. Syntaxic: Occurs in school aged children. The person begins to perceive themselves within the world and their environment and can analyze experiences....