# Personality Theory

Alfred Adler was an early member and president of the Vienna Psychoanalytic Society, but he never considered himself a follower of Sigmund Freud.  He strongly disagreed with Freud’s emphasis on sexual desire in the development of personality, focusing instead on children’s striving for superiority and the importance of social relationships.  He began to address the psychology of women as a cultural phenomenon, as opposed to Freud’s view that women are fundamentally incapable of developing a complete and healthy personality.  Adler also addressed issues of education, an individual’s unique perspective on the world, and family therapy.  Adler provided a perspective in which the striving of individuals to improve themselves is an essential characteristic of personality development.  Most importantly, he believed that personal improvement and success are best achieved in cooperation with others, and that culture is an important factor in determining how that can be accomplished.

It has been suggested that Adler may have had an even greater influence on the overall development of psychiatry and psychology than Freud himself, and that theorists such as Sullivan, as well as Karen Horney and Erich Fromm, should be recognized as neo-Adlerians, not neo-Freudians (Ellis, 1973; Kaufmann, 1992; Mosak, 1995; Watts, 1999).  Indeed, a reviewer of one of Karen Horney’s books once wrote that Horney had just written a new book by Adler (see Mosak, 1995).  Albert Ellis suggested that Adler set the stage for the cognitive/behavioral psychotherapies that are so popular today (Ellis, 1973).  Late in life, Adler encouraged the wife of a good friend to write his biography, and he gave Phyllis Bottome, who was herself a friend of Adler, a great deal of assistance (Bottome, 1957).  He wanted to be understood.  Perhaps, however, she came to understand him too well:

Adler was at once the easiest of men to know, and the most difficult; the frankest and the most subtle; the most conciliatory - and the most ruthless.  As a colleague he was a model of generosity, accuracy and wholehearted integrity, but woe betide that colleague who dared to presume upon his generosity; or who was himself guilty of inaccuracy; or who failed in common honesty!

Adler never again worked with a person whom he distrusted; except when that person was a patient. (pg. 13; Bottome, 1957)

Adler also had the ability to make an impression on people who did not know him.  When Raymond Corsini, a well-known psychologist in his own right, was 21 years old, he was invited by a friend to hear Adler speak at the City College of New York.  During the question period that followed the lecture, an angry woman called Adler stupid, and berated one of the observations he had discussed.  The young Corsini shared Adler’s perspective, and Corsini looked forward to hearing Adler’s “crushing reply.”  However, something quite different occurred:

He seemed interested in the question, waited a moment, then in the most natural and careful manner, completely unruffled by her evident antagonism, spoke to her very simply…

He seemed so calm, so reasonable, so precise, and so kind, I knew we were in the presence of a great man, a humble and kind person, one who repaid hostility with friendship. (pg. 86; Corsini cited in Manaster, et al., 1977)

Harry Stack Sullivan extended Adler’s focus on the individual and social interest, believing that each of us can be understood only within the context of our interpersonal relationships.  Like Freud, Sullivan focused intently on developmental stages, though he recognized seven of them, and believed that the primary purpose of development was to form better interpersonal relationships.  In regard to his interest in relationships he can be closely associated with Adler, who believed that social interest, and its resulting social interaction, was the best way for an individual to overcome either real inferiority (such as in the case of a helpless newborn) or feelings of inferiority that might develop as part of one’s personality.  Unlike Freud and Adler, however, Sullivan was born in America.  Thus, he should be considered one of the most important figures in American psychology, particularly within the field of psychodynamic theory.

## Brief Biography of Alfred Adler

Alfred Adler was born on February 7, 1870, on the outskirts of Vienna.  The second of six children, the family was fairly typical of the middle-class.  His father was a corn-merchant, and did well in his business.  While Adler while still quite young the family moved out into the country, where they kept cows, horses, chickens, goats, rabbits, and they had a very large garden.  Adler was particularly fond of flowers when he was a toddler, and the move out of Vienna had the consequence of protecting him from his bad habit of stealing flowers from the garden of the Palace of Schonbrunn, which belonged to the Kaiser!  Despite the seemingly idyllic setting, and the family’s financial comfort, Adler did not have a happy childhood.  The two main reasons for this were his sibling rivalry with his older brother and the unfortunate fact that he seemed to be surrounded by illness and death (Bottome, 1957; Manaster, et al., 1977; Sperber, 1974).

On the lighter side, most of the family was musically gifted.  One of his brothers played and taught the violin, and one of his sisters was an excellent pianist.  Despite the throat problems Adler had in early childhood, he developed a beautiful tenor voice.  He was often encouraged to set aside his interest in science and pursue a career as an opera singer.  Adler’s parents encouraged the musical interests of their children, and took advantage of the marvelous musical culture available in Vienna at the time.  Adler attended every opera and play that was running, and even by the age of 4 years old could sing entire operettas (Bottome, 1957; Manaster, et al., 1977; Sperber, 1974).

Although Adler spent a great deal of time reading, he was not a particularly good student.  His worst subject was math, until he finally had a breakthrough one day.  When the instructor and the best student in class failed to solve a problem, Adler raised his hand.  Everyone in the room, including the instructor, laughed out loud at him.  However, he was able to solve the problem.  After that, he did quite well in math, and overall he did well enough to enter the University of Vienna.  He studied medicine, as he had planned since being a young child, and graduated in 1895.  Almost nothing is known of his time spent at the University of Vienna.  Afterward, he briefly practiced ophthalmology, but then switched to general practice, a field in which he was very popular amongst his patients.  He also became active in socialist politics, where he met his future wife:  Raissa Timofeyewna Epstein (Bottome, 1957; Manaster, et al., 1977; Sperber, 1974).

Raissa and Alfred Adler had three daughters and one son between the years 1898 and 1909.  The family lived rather simply, but they always had enough to meet their needs.  Their daughter Alexandra and son Kurt both became psychiatrists.  Alexandra Adler described her relationship with her father as close and positive, and she considered it a privilege to follow in his footsteps, whereas Kurt Adler said that everyone in the family felt respected as an individual and that no one had to search for their identity (see Manaster, et al., 1977).

In his general practice, Adler began to see psychiatric patients.  The first was a distant cousin who complained of headaches.  Adler suggested that no one ever has only a headache, and asked if her marriage was happy.  She was deeply offended, and left in a huff, but 2 months later she filed for divorce.  As he saw more psychiatric patients, Adler treated each case as unique, and followed whatever therapy seemed most appropriate for the particular patient.  This was the beginning, of course, of Individual Psychology.  Adler was so popular in this regard that his biographer had the following experience herself when leaving a message for Adler:

‘Are you sure’, she asked the clerk at the desk, ‘that Professor Adler will get this message directly he comes in?’ [sic] ‘Adler?’ the clerk replied.  ‘If it’s for him you needn’t worry.  He always gets all his messages.  You can hardly keep the bell-boys or the porter out of his room.  They’ll take any excuse to talk to him, and as far as that goes, I’m not much better myself!’ (pg. 54; Bottome, 1957)

In 1926, Adler made his first visit to America.  Becoming a regular visitor, he lectured at Harvard and Brown Universities, in Chicago, Cincinnati, Milwaukee, and several schools in California.  In 1929, he was appointed a visiting professor at Columbia University, and in 1932 he was appointed as the first chair of Medical Psychology in the United States, at Long Island Medical College.  All of his child guidance clinics were closed when the fascists overthrew the Austrian Republic in 1934, and Alfred and Raissa Adler made New York their official home.  In the spring of 1937 he began a tour of Europe, giving lectures and holding meetings.  As he traveled to Aberdeen, Scotland on May 28th, he collapsed from a heart attack and died before he reached the hospital.

One of the enduring questions about Adler’s career was the nature of his relationship with Freud.  As mentioned above, it was the very popular Adler who defended Freud’s early theories, and helped Freud to gain recognition in psychiatry (remember that Freud was well known as an anatomist and neurophysiologist).  And yet, it is often suggested that Adler was a student or disciple of Freud.  According to Abraham Maslow, Adler was deeply offended by these suggestions:

Placing Adler in Context:  Perhaps the Most Influential Person
in the History of Psychology and Psychotherapy

To suggest that anyone may have been more influential than Freud, let alone a contemporary of Freud, is difficult to say.  And yet, if we look honestly at the accomplishments of Alfred Adler, and the breadth of his areas of interest, we will see that the case can be made.  When Freud first proposed his psychodynamic theory, with its emphasis on infantile sexuality, Freud was often mocked, or simply ignored.  It was the popular Dr. Adler’s defense of Freud, and Adler’s favorable review of the interesting nature of Freud’s theories, that helped Freud find an interested audience.  As supportive as Adler was, he had his own theories from the very beginning of their association, and Adler’s Individual Psychology has a certain logical appeal, without the corresponding controversy generated by Freud.

Infants are inferior, and we all try to gain control over our environments.  Thus, the basic inferiority/striving for superiority concept seems self-evident.  Likewise, the inferiority complex is one of the most widely recognized and intuitively understood concepts in the history of psychology.  Suggesting that each person adopts a style of life that helps them to pursue their goals also again makes perfect sense, and the suggestion that we have within us a creative power to form our style of life is a decidedly hopeful perspective on the human condition.

Adler’s influence within the psychodynamic field has been widely recognized, if not adequately advertised.  When he split with Freud, nearly half of the psychoanalytic society left with him.  His emphasis on social interactions and culture provided a framework within which theorists such as Karen Horney and Erich Fromm flourished.  Adler’s emphasis on child guidance, and including school teachers as being just as important as parents, must have had an important influence on Anna Freud (though she would never have admitted it).  Within the child guidance centers, Adler was one of the first (if not the first) to utilize family therapy and group psychotherapy, as well as school psychology.  It was within such an environment, influenced also by Maria Montessori, that Erik Erikson evolved into the analyst and theorist he became.

Adler’s influence also extended well beyond the psychodynamic realm.  His scheme of apperception set the stage for the cognitive psychology and therapies that are so popular (and effective) today.  He is recognized by many as the founder of humanistic psychology, though it was Rogers, Maslow, and the existentialists Viktor Frankl (Frankl worked closely with Adler for a time) and Rollo May who clearly split from psychodynamic theory into new schools of psychology.

Given this extraordinary influence, it is surprising that Adler is not widely recognized as belonging amongst the greatest theorists and clinical innovators in the history of psychology and psychiatry.  The honor is certainly well deserved.

Adler developed the concept of Individual Psychology out of his observation that psychologists were beginning to ignore what he called the unity of the individual:

A survey of the views and theories of most psychologists indicates a peculiar limitation both in the nature of their field of investigation and in their methods of inquiry.  They act as if experience and knowledge of mankind were, with conscious intent, to be excluded from our investigations and all value and importance denied to artistic and creative vision as well as to intuition itself. (pg. 1; Adler, 1914/1963)

To summarize Individual Psychology briefly, children begin life with feelings of inferiority toward their parents, as well as toward the whole world.  The child’s life becomes an ongoing effort to overcome this inferiority, and the child is continuously restless.  As the child seeks superiority it creatively forms goals, even if the ultimate goal is a fictional representation of achieving superiority.  Indeed, Adler believed that it is impossible to think, feel, will, or act without the perception of some goal, and that every psychological phenomenon can only be understood if it is regarded as preparation for some goal.  Thus, the person’s entire life becomes centered on a given plan for attaining the final goal (whatever that may be).  Such a perspective must be uniquely individual, since each person’s particular childhood feelings of inferiority, creative style of life, and ultimate goals would be unique to their own experiences (Adler, 1914/1963).

The suggestion that seeking to overcome one’s inferiorities is the driving force underlying personality development is, of course, a significant departure from Freud’s suggestion that development revolves around seeking psychosexual gratification.  Another important difference is that Adler did not distinguish between the conscious and unconscious minds as Freud had:

The use of the terms “consciousness” and “unconsciousness” to designate distinctive factors is incorrect in the practice of Individual Psychology.  Consciousness and unconsciousness move together in the same direction and are not contradictions, as is so often believed.  What is more, there is no definite line of demarcation between them.  It is merely a question of discovering the purpose of their joint movement. (pg. 56; Adler, 1929a)

### Inferiority and Compensation

In 1907, Adler published his classic Study of Organ Inferiority and Its Psychical Compensation, which was translated into English 10 years later (Adler, 1917).  This was primarily a medical article on the consequences of organ inferiority, in which Adler looked at how the nervous system helped the body to adapt to physical infirmities that resulted from, literally, inferior organ development.  For example, it is often suggested that people who are blind develop better hearing.  However, social psychologists have demonstrated that the social environment can profoundly affect our sensitivity to external stimuli.  The reason for this is probably just what Adler described as the primary means through which the brain can compensate for any deficiency:  by bringing attention to the processes necessary for compensation.  Thus, if a person has difficulty seeing, they pay more careful attention to hearing, as well as to the other senses.  However, this is not a perfect system, and it can also lead to over-compensation.  As a result, a wide variety of physical symptoms can result from the psyche’s efforts (including unconscious efforts) to compensate for some problem.  As noted by Freud, hysterical symptoms are typically manifested as physical problems.  According to Adler, underlying these physical symptoms, even when they are caused solely by the psyche, there must be some organ inferiority within the body (Adler, 1917).

Adler did not limit his theory of organ inferiority to medical problems or neurotic symptoms, but rather, he expanded the theory to incorporate all aspects of life.  Compensation refers to the typical manner in which a person seeks to overcome challenges.  For example, if one breaks their arm, they learn to function with a cast, or if one loses their eyesight, they learn to use a cane or work with a seeing-eye dog (Dreikurs, 1950; Mosak & Maniacci, 1999).  If we examine compensation in a more psychosocial realm, examples might include a college student who cannot find a suitable boyfriend or girlfriend so they focus on becoming a straight A student, a student who does not do well academically focuses their efforts on becoming a star athlete, or an only child who wished to have brothers and sisters has many children of their own (Lundin, 1989).  In such instances, compensation leads to balance in one’s life.  A weakness, or at least a perceived weakness, is compensated for in other ways (Manaster & Corsini, 1982).  Overcompensation involves taking compensation to extremes.  For example, a person born with a bad foot strives to become a professional dancer, or a person born in poverty strives to become a millionaire and then continues to work 80 hours a week or more striving to become a billionaire.  Generally speaking, the mechanisms of personality inferiority are more complex than those of organ inferiority.  Likewise, compensation and overcompensation are more complex when they pertain to one’s personality than when they involve physical challenges (Manaster & Corsini, 1982).

When a person finds it difficult to overcome their challenges in life, they can develop what Adler called an inferiority complex (Adler, 1928, 1929a, 1931a).  Although feelings of inferiority are universal, as is the striving for superiority, people are not created equal.  We all have different strengths and weaknesses.  However, when an individual cannot compensate for their weaknesses, and their feelings of inferiority overwhelm them, the inferiority complex arises.  According to Adler, the term complex is not really accurate, because the so-called inferiority complex is complicated, and it permeates the entire personality.  And yet, it may not always be obvious.  An individual with an inferiority complex may feel comfortable in situations in which they have enough experience to feel self-assured, although they may create those situations by avoiding competition that might expose their weaknesses (Adler, 1929a).  The inferiority complex will show itself, however, in tense or difficult situations, and often takes the form of excuses as to why the individual can’t pursue a certain course of action.  For psychologists, according to Adler, the presence of an inferiority complex can typically be recognized by contradictions, by certain emotions such as doubt, and by generally hesitant behavior.  The proper treatment, therefore, is to encourage people, never to discourage them, and to help them understand that they are capable of solving problems and facing the difficulties of life (Adler, 1929a).

When the intense feelings of inferiority associated with the inferiority complex become too much to bear, they can be transformed into a unique delusion that Adler described as the superiority complex (Adler, 1928, 1929a, 1931a).  The superiority complex should not be viewed as an extension of the normal process of striving for superiority.  The superiority complex arises out of the inferiority complex, and is actually an extension of the intense feelings of inferiority.  Interestingly, such people typically do not present themselves as superior individuals, instead they may be arrogant, snooty, domineering, or they may cling to prominent and important people.  In contrast, people who truly are superior often have a sense of modesty (Lundin, 1989; Mosak & Maniacci, 1999).  The complexity of the superiority complex, and its origin in feelings of inferiority and the continued striving for superiority that is universal can be seen not only in neurotic symptoms and other forms of mental illness, but also in criminal behavior:

We see children who start stealing suffering from the feeling of superiority.  They believe they are deceiving others; that others do not know they are stealing.  Thus they are richer with little effort.  This same feeling is very pronounced among criminals who have the idea that they are superior heroes…he wants to arrange matters so that he escapes the solution of the problems of life.  Criminality is thus, the result of a superiority complex and not the expression of fundamental and original viciousness. (pp. 80-81; Adler, 1929a)

Discussion Question:  Adler believed that we all begin life with feelings of inferiority and then strive for superiority.  What sort of things have you tried to be really good at in life?  Can you remember times when you felt inferior trying to accomplish those same goals?

### The Style of Life and the Life Plan

According to Adler, everyone faces difficulties in life, and they strive to overcome those difficulties.  As each individual faces their unique difficulties, and strives to compensate in their own characteristic ways, given the environment (or culture) in which they live, the individual develops a sense of meaning for their life and they set a goal for their strivings.  Initially Adler referred to the consistent movement toward this overriding goal as a life plan, but that term proved to be somewhat confusing.  So, Adler chose instead to refer to the pursuit of one’s goal as the style of life.  The style of life unifies the personality, as it is based on one’s early life experiences.  However, Individual Psychology looks not to the past, but rather to the future.  If we know a person’s style of life, we can predict their future actions (Adler, 1929a, 1931a).

It is not always easy to recognize the style of life, however, particularly in a psychologically healthy person or during times of relative calm.  It is when a person faces a new situation, or a new difficulty, that the style of life becomes clear to others.  For the normal person, the style of life is a framework within which the person is adapted to their society in such a way that the society benefits from the work of the person and the person themselves has the energy and courage to face any problems and difficulties that arise (Adler, 1929a).  The style of life encompasses our individual creativity, the ways in which we solve problems and compensate for inferiorities, our attitudes, opinions, and goals.  It unifies and expresses our personality, provides consistency for how we live our life, and helps us to find our place in the world (Adler, 1931a; Dreikurs, 1950; Lundin, 1989; Mosak & Maniacci, 1999).

The style of life is established fairly early in childhood, which can be a serious problem when it proves to be a dysfunctional style of life.  The inferiority complex is, of course, one faulty style of life.  When an inferiority complex arises out of an actual organ inferiority it can be particularly troublesome.  Robert Lundin (1989) described the case of a senior student he knew in college who was only 5’ 3” tall (very short for a man, though this would really only be a perceived inferiority).  He was extremely arrogant and hostile toward younger students, claiming to be intellectually superior in every regard.  He even offered to be Lundin’s roommate, since Lundin obviously needed his help to improve Lundin’s deficient personality!  Lundin declined the offer.  Adler noted that organ inferiority is not always a negative situation, and given the advances in prosthetic devices that exist today, it is even truer now that organ inferiority does not necessarily diminish one’s quality of life.  However, Adler emphasized that what matters most is how the individual experiences the weakness of their organ inferiority.  Some try to avoid or deny the problem, others constantly “wrestle and struggle” with their difficulties.  In the end, it comes down to the creative power of the individual to adapt (see below; Adler, 1932a/1964).

In addition to the style of life of that can result from organ inferiority (or perceived organ inferiority), Adler discussed two other factors that commonly lead to dysfunctional styles of life, and which can be attributed primarily to parental influence:  pampering and neglect.  The pampered style of life was of particular concern to Adler.  He was not referring to children who are loved and cared for intimately, but to children whose parents constantly hover over them, solve every problem, and relieve the child of any duties or responsibilities.  As a result, the child never learns to take care of itself or to interact with others in a cooperative manner.

The more deeply I have delved into the problem of neurosis and searched the cases presented, the more clearly have I come to see that in every individual with a neurosis some degree of pampering can be traced...Under such circumstances the child develops like a parasite… (pp. 88-89; Adler, 1932a/1964)

Extending this idea, Adler wrote that whether one is dealing with “difficult children, nervous or insane persons, suicides, delinquents, drug-addicts, or perverts, etc.” there is a lack of social feeling (Adler, 1964).  In other words, they simply do not function well in relationship to others because they have never had to.  As for the neglected child, one who is unwanted, they have had no opportunity for social interaction whatsoever, since their own family fails to interact with them.  In cases of suicide, Adler believed that even death can be desired as a means of revenge against those who have hurt or neglected a child by showing others what they have lost in the one they failed to love (Adler, 1967).  Since feelings of neglect are relative, pampered children often find themselves in situations, later in life, where they feel neglected, since they may no longer receive the pampering to which they have become accustomed (Adler, 1932a/1964).

Discussion Question:  How would you describe your style of life?  Adler believed that dysfunctional styles of life often result from either pampering or neglect.  Do you know anyone whose style of life clearly reflects how they were raised?  Are they someone you like to spend time with, or someone you would rather avoid?

### Social Interest and Cooperation

Adler believed that the right way to achieve superiority was through social interest and the cooperation that naturally follows.  This is not some high-minded philosophy, however, but simple reality.  According to Adler, “we are in the midst of the stream of evolution.”  As such, the human species as a whole has sought superiority, just as each individual seeks their own personal superiority (Adler, 1964).  The individual’s weakness causes them to seek support from others, by living within a society:

All persons feel inadequate in certain situations.  They feel overwhelmed by the difficulties of life and are incapable of meeting them single-handed.  Hence one of the strongest tendencies in man has been to form groups in order that he may live as a member of a society and not as an isolated individual.  This social life has without doubt been a great help to him in overcoming his feeling of inadequacy and inferiority.  We know that this is the case with animals, where the weaker species always live in groups…On the other hand, gorillas, lions, and tigers can live isolated because nature has given them the means of self-protection.  A human being has not their great strength, their claws, nor their teeth, and so cannot live apart.  Thus we find that the beginning of social life lies in the weakness of the individual. (pp. 60-61; Adler, 1929a)

In more practical terms, social interest is evident in cooperation.  In order for an individual to overcome their own feelings of inferiority they must know that they are valuable, which comes only from contributing to the common welfare.  Adler felt that those who seek personal power are pursuing a false goal, and they will eventually disappear from life altogether.  However, by contributing to family and society, either through raising children or contributing to the success of one’s culture or society, one can claim a sense of immortality.  Individual psychology is based on the premise that when a person realizes that the common good is essential to the development of humanity, then they will pursue personal development that is in accord with the greater good.  They will recognize both the good and challenges that come their way as belonging to all, and they will cooperate in seeking to solve the challenges.  They will not ask for anything in return, since they recognize that whatever they do to benefit others is ultimately to their own benefit as well (Adler, 1933/1964).  This perspective is surprisingly close to Eastern philosophies and the concepts of interbeing and karma, though Adler’s religious references are primarily Christian (though born Jewish, Adler later became a Christian).

In American society, work is often done by teams.  The short definition of a team is two or more individuals, with different roles, who socially interact in order to pursue some common goal.  Teams can lead to successful outcomes in a wide variety of settings, such as in software development, Olympic hockey, disease outbreak responses, or the unexpected damage to a spacecraft like Apollo 13 (for two excellent and entertaining movies on teamwork, see Miracle [O’Connor & Guggenheim, 2004] and Apollo 13 [Howard, Broyles, Jr., & Reinert, 1995]).  However, teams can also lead to group failures, such as the international intelligence failures leading up to the 9/11 terrorist attack on the World Trade Center, the Space Shuttle Columbia accident, or the widely reported, storm-related deaths on Mt. Everest in 1997 (Kozlowski & Ilgen, 2006; Marks, 2006; for more on Mt. Everest see Boukreev & DeWalt, 1997; Krakauer, 1997).  Given the importance of teamwork, both in personal settings and within organizations, there has been a great deal of research on teams, addressing cognitive, motivational, and behavioral factors, as well as information on effective team design, team training, and team leadership.  Despite the wealth of information on both the positive and negative factors involved in teamwork, there is an interesting contradiction in the Western world:

…We school our children as individuals.  We hire, train, and reward employees as individuals.  And, yet, we have great faith that individuals thrown together into a team with little thought devoted to team composition, training and development, and leadership will be effective and successful. (pg. 115; Kozlowski & Ilgen, 2006)

Discussion Question:  Working in teams can turn out good or bad, depending on dynamics of the team and the individuals involved.  Are you actively involved in any teamwork?  Does your team work well together, or do the dynamics of the team cause problems and interfere with accomplishing your goals?

### The Life Tasks - Work, Communal Life, and Love

Based on the three ties described above, our ties to earth, humanity, and the opposite sex, Adler described three life taskswork, communal life, and love.  Work relates to the earth in an evolutionary sense, dating back to when our ancient ancestors were hunter/gatherers dependent on the environment for food and shelter.  According to Adler, all of the questions of life can be found within these three tasks, which challenge us continuously throughout our lives.  They tasks are not unrelated, since each one depends upon the successful pursuit of the other two.  Given this interrelationship, Adler believed that how a person approaches each of these tasks, through their style of life, reveals a great deal about what they view as the meaning of life.  It is necessary, of course, for there to be balance.  For example, a person in an unhappy marriage might spend a great deal of time at work.  This represents a mistaken style of life (Adler, 1931a, 1964).  Worse still, is someone who fails to pursue any of the life tasks:

Suppose, for example, we consider a man whose love-life is incomplete, who makes no efforts in his profession, who has few friends and who finds contact with his fellows painful.  From the limits and restrictions of his life we may conclude that he feels being alive as a difficult and dangerous thing, offering few opportunities and many defeats. (pg. 7; Adler, 1931a)

The importance of the work task is to be found in the fact that we must do something with our time.  As people began to cooperate, they were able to divide their labors.  Some would hunt, some would farm, some became craftsmen, some raised the young, and eventually others served in the armies that protected all the rest.  In this manner, each person served a valuable role within society (even if the role was not prestigious), and everyone benefited from the ability of each person to become more of an expert in their role.  Of course, this sort of social cooperation is the second task of life, the communal life or, as it is sometimes referred to, having friends.  Working with others for the common good can be quite difficult if people are doing so only for their own benefit, and it they distrust or fear those they seem to be cooperating with.  As societies became more advanced, and education became an important part of society, most societies encourage social interest as an aspect of education.  In America, for example, we talk about children learning to be good citizens, and schools include many civics lessons.  In addition, societies establish not only formal and informal guidelines and norms for acceptable behavior, but actual laws are written to punish those who act in defiance of the common good.  Not that this is easy!  The first amendment to the American constitution guarantees free speech, which includes the right to challenge the very existence of our form of government.  However, it is generally recognized that the greater good is served by protecting the people from possible abuses of power by the government.  Without getting into a discussion of politics, this balance, which seeks to serve the best interests of the community of citizens, has resulted in one of the longest lasting governments in the world today.

When Adler referred to the third task of life, love, he was primarily talking about choosing a partner to bear and raise children.  When a child is first born, the love of its mother is the basis for the child’s development of social feelings.  If a child is neglected, they do not learn how to relate to others, or if they are spoiled, they do not need to relate to others.  An early challenge for the child is found in the nature of the father, and then any siblings who may be a part of the family.  They typically do not approach the child with the same tender love as the mother.  If the mother protects the child from this, spoiling and coddling the infant, a disordered style of life develops, but if the mother leaves the child to face this new challenge on its own, they must rely on their creative powers to adapt to these different social relationships.  Children readily have this capacity, if they are allowed to utilize it.  Later in life, each person must choose a mate in order to have their own children, and their ability to adapt to relationships with love interests will, obviously, depend on their own development earlier in life.  Active, friendly members of a community will have more opportunities to meet someone they are truly attracted to.  Individuals who are successful and productive in their work will be better able to provide for a family.  And of course, the ultimate existence of each member of the community depends on continued procreation of the species.  Thus, work, communal life, and love come together within a healthy society for everyone’s benefit (Adler, 1931a, 1964; Lundin, 1989; Mosak & Maniacci, 1999).

Connections Across Cultures: Randy Kearse and
Using Prison as an Opportunity for Change

One of the challenges to social cooperation is the ability to communicate.  Communication takes place in at least two important ways:  language and shared experiences/goals.  If we cannot understand what a person is saying, then communication is obviously difficult.  But even if we speak the same language, if our entire perspective on life is different, particularly the direction in which we are headed (our style of life), it can be even more difficult to really communicate.  Randy Kearse is a man who has lived outside of what many of us consider mainstream America.  He grew up in a Brooklyn, NY ghetto, where he became well versed in street talk, or what he refers to as hip-hop and urban slanguage (Kearse, 2006a).  Despite coming from a relatively stable family (his mother was a teacher and all of his brothers and his sister graduated from high school), he descended into a life of drugs and crime, eventually spending over 13 years in a federal prison for dealing illegal drugs.  This introduced Kearse to a large, and growing, subculture in America:  the prison population.  Kearse learned one lesson very clearly in prison:  he hated it!  He hated people having such power over him, he hated the disrespect his mother had to endure when she visited him, he hated the food, he hated having the guards read his mail, etc., ad infinitum.

With so many reasons to hate prison, there was no way I was gonna put myself back in the same situation again.  Brothers complain about being locked up everyday all day while they’re there, but when they get a chance to run the streets again their hatred for prison life fades away.  That’s crazy! (pg. 132; Kearse, 2006b)

But how does one stay out of prison?  In Changin’ Your Game Plan! (Kearse, 2006b), Kearse offers some very practical steps.  But more importantly, he discusses why it matters, and how one needs to change their mindset in order to be successful.  His advice fits well with Adler’s emphasis on social interest and cooperation, as well as with Adler’s three life tasks.  As Kearse says, what good is street pride when you don’t have the respect of your mother, your children, and other people who know what you’re capable of accomplishing?

Kearse believes that everyone has a purpose in life.  Even prisoners serving life sentences can preach to others about straightening out their lives so the ones who do get out of prison can stay out.  For his own part, Kearse is trying to set a good example now that he is out.  He talks about the misguided sense of pride that keeps people from working minimum wage jobs when they come home.  Most people in prison do not want their children to live such a life, but can they really set the right example when they themselves get out of prison?  One of the most important things to realize is that their style of life has helped to create the problems that exist in their community:

We have a real obligation to make these changes while incarcerated because a lot of us are to blame for the condition our neighborhoods are in today.  We were major contributors to the chaos, mayhem and destruction that have plagued our communities…The saddest thing you can see while incarcerated, is a youngster young enough to be your son walk through the doors. (pg. 133; Kearse, 2006b)

In order to help their communities and their families, Kearse emphasizes that individuals returning home from prison need to get a job and work for an honest living.  Kearse tells New Yorkers exactly where to go and how to go about getting ID and a social security card.  He recommends getting a job as a messenger, especially if you have a driver’s license and can afford to buy a van (or if you save up the money to buy a van).  For most of us, having these things is simply taken for granted, but not so for many poor people growing up in the city where such things may not be necessary (especially if one works illegally).  One of the advantages of having a messenger/delivery job is that one gets to travel around, meet different people, and become aware of different opportunities.  This proved very helpful to Kearse as he pursued his dream of publishing Street Talk:  Da Official Guide to Hip-Hop & Urban Slanguage (Kearse, 2006a).  Curiously, the book is not complete.  In acceptance of his publisher’s concerns (representing the community), the commercially available version left out the most derogatory slang pertaining to women, race, sexual preference, ethnicity, and religion.  Kearse later published a supplemental version (“Da Grimy Version”) through a private site.  As Kearse became more experienced, he established his own publishing company for his second book, Changin’ Your Game Plan!, and he is now working on an autobiography.  Randy Kearse is working hard to make a better life for himself, set an example for his community, and to honor the mother who raised him to have ambition and dreams.  His mother still loved Kearse when he was sent to prison, but her patience was limited:

Once I received my sentence my mother told me straight up, “I’ll ride this time out with you, but if you get back out here and get caught up in them streets again don’t call me,” and I can’t blame her for that.  How much can a mother take seeing her child going back and forth to prison? (pg. 33; Kearse, 2006b)

It would be very difficult for most of us to imagine what prison life and culture is like, or even what it would be like to get caught up in the judicial system.  But for people who live in difficult circumstances, it can be just as difficult to avoid getting caught up in a style of life that promises instant gratification, but which costs a lot of money.  People who try to take shortcuts, such as stealing what they want, or selling drugs to make a lot of money, end up with little to show for their life except “a gang of years in prison.”  Escaping this style of life requires a plan, and even more so the motivation for making that plan work:

Coming out of prison you have to have a plan.  If you don’t, the chance of you returning to prison is great and you and I both know these people aren’t playing.  They’ll lock your ass up for a hun’ned years and not care…Shit is real. (pg. xxiii; Kearse, 2006b)

### The Creative Power of the Individual and Fictional Finalism

The science of Individual Psychology developed out of the effort to understand that mysterious creative power of life - that power which expresses itself in the desire to develop, to strive and to achieve - and even to compensate for defeats in one direction by striving for success in another. (pg. 32; Adler, 1929a)

Adler believed that we are all born with a creative force:  the creative power of the individual.  He did not reject the concepts of heredity, temperament, or disposition, but he emphasized that it not so important what we are born with, but rather what we do with it (Adler, 1932a/1964).  As noted above, infants are inferior, so everyone begins life with feelings of inferiority.  This leads to the striving for superiority, and the development of a style of life, which is aimed toward some goal.  The nature of that style of life is unique because it is created by the child, and it is done very early in life.  This is not a deterministic perspective, this creation of the style of life is just that, creative, and therefore it must be unique (hence, Individual Psychology).  Since Adler believed that all thought and behavior was oriented toward some goal, there must be some goal that underlies the manner in which the style of life is created.  Since a child cannot see into the future and create a specific goal in life, Adler proposed that we are guided by a fictional goal, the so-called fictional finalism (Adler, 1914/1963, 1928, 1929a, 1932a/1964; Lundin, 1989; Manaster & Corsini, 1982).

The fictional final goal involves the sentiment of superiority, or at least the elevation of the personality to an extent that makes life seem worth living (Adler, 1928).  Thus, it does not need to be precisely defined, which is important for our consideration that it is created by a young child.  And yet it exists within the child’s mind, it provides the framework within which the style of life is creatively formed, and it serves as the child’s goal in life (though it remains primarily unconscious).  It is also important to recognize that although this goal is fictional, it is entirely positive, it is a healthy and natural motivational force (Lundin, 1989).  The fictional finalism should definitely not be mistaken for fictive superiority.  Fictive superiority is the imagination, or false belief, that one is actually superior.  It is a typical neurotic symptom that stems, primarily, from having been pampered.  A pampered child is superior, at least in the sense that everything is done for them.  However, adult life no longer sustains that delusion, yet the child has never learned how to adapt to life’s challenges, their style of life is set in the expectation of challenges being solved for them.  A healthy child, on the other hand, has learned to face challenges, and to strive toward overcoming them.  Thus, the healthy child develops a style of life that incorporates the process of facing and overcoming life’s obstacles, and this carries over into a healthy adulthood (Adler, 1932b/1964).

Within his discussion of the creative power of the individual and the fictional finalism, Adler began to address what can be viewed as the foundation for cognitive psychology and cognitive therapy (see Chapter 12):

In a word, I am convinced that a person’s behaviour springs from his idea.  We should not be surprised at this, because our senses do not receive actual facts, but merely a subjective image of them - a reflection of the external world. (pg. 19; Adler, 1964)

According to Adler, the prototype of the style of life, as it points toward the fictional finalism, is set in a particular orientation.  Throughout the individual’s life, their perceptions of the world are then constrained to “fall into a groove established by the line of direction” (Adler, 1929a).  He referred to this phenomenon as the scheme of apperception.  As a result of this scheme, the individual interprets experiences before they are accepted, and the interpretation always agrees with the original meaning that the individual has given to their life.  When the individual has developed a mistaken meaning to life, or when experience cannot be reconciled with the meaning they hold, they may be forced to change their scheme of apperception.  This is not easy, however, and only occurs when there is sufficient social pressure to do so (Adler, 1931a).

Discussion Question:  Adler described fictive superiority as the mistaken belief that one is superior to others.  What do you think about people who think they are great, who think they know everything about everything, and can do anything at all, but who really are no different than anyone else?

### Child Development and Education

Adler agreed with Freud that personality is basically set in the early childhood years.  Thus, Adler was particularly interested in child development, and also in the training of those responsible for raising children (typically, the parents, the rest of the family, and school teachers).  The emphasis in much of his work was on ensuring that children are brought up in the best way possible from the very beginning of life.  We have already examined the importance of the mother’s role, and that she needs to be supportive but must not spoil her child.  A child who is unable to resolve life’s problem without the assistance of others will grow up into a neurotic person demonstrating a dysfunctional style of life (Adler, 1913a/1963).  Since this is something that happens within the family, the parents obviously cannot serve as part of the solution for this problem.  Thus, Adler turned his attention to school teachers.

Adler believed that a person is educated when it becomes clear that they have become more relevant to more people (Adler, 1958).  In other words, they become a more active and involved member of their community, society, and perhaps even the whole world.  School represents a new situation for a child.  If they have been raised well, they pass this test rather easily.  If not, the defects in their style of life become evident.  School work requires cooperation with both the teacher and the other students, and the ability to cooperate is probably more important than the child’s innate intellectual abilities.  Adler did not dismiss the importance of I.Q. (though he did suggest that the child and the parents should never be told what it is), but he pointed out that a child’s ability to concentrate on school subjects is primarily dependent on the child’s interest in the teacher (Adler, 1930b).  So once again, we see the three life tasks coming into play.  School work is the child’s work, and it must take place within a communal setting (the classroom).  But what about love?  Whether you want to call it support, encouragement, caring, motivation, or love, Adler was clear in terms of what he thought about the “peculiar position” held by teachers:

The teacher, professional or amateur, must teach the simple thing:  love, and call it by its simple name:  love.  Almost since the beginnings of recorded history, however, the teacher has been in a peculiar position:  he is facing pupils, children or adults, who do not expect that the thing they ought to learn is so simple. (pg. 115; Adler, 1958)

According to Adler, it is the role of teachers to recognize the difficulties that children cannot overcome, and to “correct the mistakes of the parents.”  An essential aspect of this “correction,” however, is that it must never be punitive.  Adler believed that if teachers scold or criticize students who cannot connect with their teacher or their classmates, then the child will realize they were right to dislike school.  Rather, teachers must help children to connect with themselves, and then reach out to connect with others (Adler, 1931a).  But what about children who cannot redirect their style of life or face up to the challenges they encounter?

Discussion Question:  Teachers play an important role in each person’s development, according to Adler.  Who were the teachers who really influenced you, and were they good teachers who helped you, or bad teachers who inspired you to be a better person than you saw in them?

In those cases where the challenges of adolescence become too much for a child, they begin to creatively protect themselves by doing things such as forging report cards, skipping school, etc.  As they meet others doing the same things, they join with them, form gangs, and may well start out on a road that leads to a life of crime.  Demonstrating his great concern for the individual, however, Adler wrote:

All this can be avoided if we accept the point of view of Individual Psychology that no child should be thought hopeless.  We must feel that a method can always be found to help a child.  Even in the worst of circumstances there is always a particular way of approach - but this of course needs to be found. (pg. 179; Adler, 1930b)

If researchers can foster increased use of scientific practices in these ways, it is possible to achieve a society in which the largest possible proportion of children experience healthy, happy, and successful development and arrive at adulthood with the social, emotional, and cognitive skills they need to lead healthy and successful lives. (pg. 438; Biglan et al., 2003)

### The Psychology of Women

Adler’s views on the psychology of women could not have been more different than those of Freud.  As someone who questioned cultural discrimination long before most, Adler considered women to be equal to men, and he described the belief that they were inferior as a myth.  A division of labor has always been an important part of the communal life of the human species.  When neighboring groups came into conflict, it was the larger, stronger men who did most of the fighting to protect the group.  According to Adler, men extended this conflict and feeling of power to the subjugation of women.  Ever since, men have enjoyed privileges that were denied to women, and this has been maintained primarily through force, or the threat of force, but also through indoctrination and education (Adler, 1910/ 1978, 1927/1978, 1928).  Adler himself avoided the use of the term “opposite sex,” a term that implies an adversarial relationship, preferring instead to use the term “other sex” when referring to women (Manaster & Corsini, 1982).

Adler recognized that what women really desire is the privilege that men enjoy, but this is not unique to women.  There are also men, or boys, who are not dominant, and they also strive for superiority and privilege.  At birth, of course, both male and female infants are helpless and inferior, and must begin to strive for superiority.  The form that this striving takes is something Adler called the masculine protest.  It was not his intention to suggest that masculine traits of dominance and aggression make men better than women, but this was the nature of the times in which he lived.  It is purely cultural that the male gender role includes strength, knowledge, physical activity, etc., whereas the female gender role includes submissiveness, weakness, the desire for physical and emotional closeness, etc.  All children display some degree of these traits, but society directs boys toward the male role, and girls toward the female role (Adler, 1910/1978, 1912a/1963, 1928, 1929/1964).  We can now recognize what many consider Freud’s great mistake regarding the psychology of women.  Women who display masculine traits were seen as neurotic by Freud, but Adler viewed them as protesting the cultural denigration of women.  Still, it is not easy to challenge the nature of society, so Adler still acknowledged that women were more likely to be neurotic than men.  However, Adler attributes the neurosis of most women to masculine protest, not to the inability to resolve a woman’s penis envy!  In 1910, just as Adler was about to break away from Freud’s Psychoanalytic Society, Adler proposed that the great Oedipus complex is only a small part, just a stage, of the masculine protest, for both men and women (Adler, 1910/1978).

Discussion Question:  Adler described masculine protest as a cultural phenomenon in which women, and even some men, strive to act masculine in order to ensure the privilege reserved only for men.  Can you think of any strong women whose career or style of life fits into this theory?  What about any men you know (or know of)?

Adler’s approach to psychotherapy has been the topic of numerous books and chapters (e.g., Dinkmeyer, Dinkmeyer, Jr., & Sperry, 1979; Mosak, 1995; Nikelly, 1971a; Watts & Carlson, 1999), including specific books on family therapy and lifestyle counseling for people with disabilities (Rule, 1984; Sherman & Dinkmeyer, 1987).  It is generally accepted that Adlerian psychotherapists have no specific technique, but rather are eclectic in their approach.  There are, however, a few key elements to Individual Psychology.  First is the goal of understanding the style of life.  Once the therapist understands the style of life, they can understand most everything the patient does.  The therapist then helps the patient to strengthen their social interest.  This involves a practical application of social interest:  reorienting and readjusting the patient’s style of life.  Underlying the success of therapy in Individual Psychology is a supportive therapeutic relationship.  Adler believed in facing his clients, on an equal basis.  The therapist helps to educate the patient on the nature of therapy and the goals that might be pursued, which involves helping the client to recognize the mistaken style of life and goals they have been pursuing in the past.  In this way, the therapist helps the client in their own creative process of personality change (Dinkmeyer, Dinkmeyer, Jr., & Sperry, 1979; Mosak, 1995).  This approach shares many similarities with both the client-centered approach popularized by Carl Rogers and the behavioral-cognitive approaches developed by Albert Ellis and Aaron Beck.

### Understanding the Style of Life

Psychotherapy is about helping people to change their lives for the better.  Thus, it involves looking forward, despite whether or not we need to know what has happened in the past (and different theories consider the importance of the past in radically different ways).  According to Adler, “in order to understand a person’s future we must understand his style of life” (pg. 99; Adler, 1929a).  The style of life, and the associated scheme of apperception, brings all experience into line with the person’s fictional final goal.  So, if we can understand how a person is living their life, if we understand their style of life, we can help them to understand it as well, and then perhaps make changes for the better.  So, how might we go about understanding the style of life?

As Freud and Breuer had before him, one area of interest for Adler was the analysis of dreams.  However, Adler did not distinguish between the conscious and unconscious, or between waking and sleep.  He considered dreams to be a reflection of the style of life, and the individual’s striving for superiority.  Thus, dreams do not hold any special meaning (Adler, 1912b/1963, 1928, 1929a, 1932b/1964).  As such, their interpretation can be relatively straight-forward:

Take, for instance, our knowledge that mankind as a whole is really cowardly.  From this general fact we can presuppose that the largest number of dreams will be dreams of fear, danger, or anxiety.  And so if we know a person and see that his goal is to escape the solution of life’s problems, we can guess that he often dreams that he falls down.  Such a dream is like a warning to him:  “Do not go on - you will be defeated.” (pg. 155; Adler, 1929a)

Of greater interest to Adler was the analysis of early memories.  He believed that the earliest childhood recollections provided valuable information, and he did not let a single patient go without having been asked about them:

The information regarding memory is significant.  Memory is an activity.  It is based on the life style, which here steps in by selecting from old impressions a single one.  This leads us to the question, why this single one?  In it the entire life style resonates. (pg. 197; Adler, 1932b/1964)

It is not even important if the memory is, in fact, true.  A “memory” may be created by a child based on their conscious experience in order to reflect an attitude, or an emotional tone, if that is necessary to pursue their unique, personal goal (Adler, 1928).  Accordingly, if we can obtain a person’s earliest memories, we make reasonable predictions regarding the future course of their life.  However, early memories are not reasons for behavior, but they are hints.  It is also true that some forgotten memories (or unconscious memories) may have played a role in the creation of the style of life, but they are obviously more difficult to obtain, so they defy analysis.  But, Adler did not consider them to be any different in content and tone from the conscious memories; the unconscious psyche enacts the same style of life toward the same final goal (as with dreams; Adler, 1929a, 1931a, 1964).  There may, however, be some interesting differences in early memories based on culture.  For example, Wang (2006b) examined the earliest memories of European American and Taiwanese college students in response to five cue words:  self, mother, family, friend, and surroundings.  In both groups, memories for ‘mother’ came from an earlier time than memories for ‘self,’ and memories for ‘mother,’ ‘family,’ and ‘friend’ were more socially oriented.  The European Americans typically had memories from earlier ages, and their memories tended to report more specific events and to focus on their personal roles and autonomy in those memories.  Thus, early memories not only reflect one’s style of life, but do so within a cultural context.

Discussion Question:  What are your earliest memories, especially of your mother, father, and sense of self?  Can you see a clear relationship between the content of those memories and your style of life?  How does your life plan fit with those memories?

### Strengthening Social Interest and Reorienting the Style of Life

Adler believed that everyone has some degree of social interest, but in neurotic and psychotic patients there is relatively less.  He described Freudian transference as an expression of the patient’s social interest, directed toward the therapist.  Resistance is simply the patient lacking the courage (i.e., feeling too inferior) to return to social usefulness and cooperation with others.  The therapist must, therefore, help the patient to strengthen their social interest and reorient their style of life.  Since the style of life is creatively formed, it becomes important to understand how and when the failed style of life began.  Just as the individual took time and was selective in the formation of their failed style of life, the therapist must take time to understand it and educate the patient about it (Adler, 1913b/1963, 1929/1964, 1930c, 1932b/1964, 1958).

Individual Psychology stresses enormously that the psychological development of a person can reach a normal condition only when he can achieve the necessary degree of ability to cooperate. (pg. 199; Adler, 1932b/1964)

It is almost impossible to exaggerate the value of an increase in social feeling…The feeling of worth and value is heightened, giving courage and an optimistic view…The individual feels at home in life and feels his existence to be worthwhile just so far as he is useful to others… (pg. 79; Adler, 1929/1964)

There are numerous ways in which a therapist can help a client to increase their social interest.  It begins with the therapist openly communicating with and accepting the patient, which is, of course, a social interaction.  This is especially effective if the therapist displays social feeling themselves, while also helping the patient to recognize the patient’s value as a human being (as well as the value of other people).  The therapist can point out that if other people, including the therapist, had the same values, goals, and cognitive orientation as the patient then others would also have the same problems as the patient.  The therapist can then nudge the patient toward their own niche, where they can feel comfortable with others without fearing being the loser in personal interactions.  And finally, the therapist can encourage the patient to get involved in concerns outside themselves (Nikelly, 1971b).  Each of these ways of encouraging social interest can be a part of the reorientation and readjustment process, the “working-through” phase of therapy, in which the patient gains insight into their style of life, confronts their goals, and realizes that they are capable of making choices and decisions (Nikelly & Bostrom, 1971).  The patient must be encouraged to understand and believe that they have the power to implement their insights and change their life.

The client must not be allowed to think of himself as the victim of past circumstances but must come to recognize that the problem is his alone and that he alone will solve it.  In contrast, emphasis on past history may lead to rationalization and intellectualization without appropriate action.  The client learns more and more about his problem and does less and less about it. (pg. 103; Nikelly & Bostrom, 1971)

### Group Psychotherapy and Family Therapy

Our discussion of Adlerian psychotherapy would not be complete without mentioning group psychotherapy, and in the same breath, family therapy.  Group psychotherapy probably has multiple origins, having been tried by a variety of independent therapists.  In 1921, Adler began interviewing and counseling parents in front of a group of professionals.  This fit well within his perspective on the three life tasks and social interest, since he felt that parents, family, and other important people, such as school teachers, needed to be involved in the development of children.  Adler soon discovered that these settings led to personal growth in everyone present, establishing a form of group therapy that may be the oldest still in use.  Strictly speaking, Individual Psychology does not prescribe any specific techniques for group psychotherapy, but rather, there is Individual Psychology for patients in a private setting as well as for patients receiving therapy in a group setting (Corsini, 1971).

Involving the parents in a child’s therapy is, quite obviously, the beginning of family therapy.  However, when Adler established his child guidance centers, they were open for parents, teachers, social workers, and other interested people to be able to observe the process of psychotherapy.  Adler felt it was important for everyone involved in the development of children to be educated in the important process of Individual Psychology, and the same was true of Rudolf Dreikurs, a student of Adler who opened family education centers in the United States (the first in Chicago in 1937; see Dreikurs, 1950; Sherman & Dinkmeyer, 1987).  This education may be particularly important for the parents, whose attitude can have a profound influence on whether psychotherapy for a child is successful or not.  As for teachers, understanding Individual Psychology can help them to put a child’s academic performance into a context that helps to explain it as a style of life aimed toward a particular goal, even if that goal is dysfunctional and interferes with schoolwork (Friedmann, 1930; Spiel & Birnbaum, 1930).  Overall, the goal of family therapy is to improve communication and cooperation amongst all members of the family, and to help parents avoid the most difficult problems (Alexandra Adler, 1930a; Adler, 1930d).

In our conversations with the parents we relentlessly try to make them realize that children must not be beaten.  Beating can only lead to a discouragement of the child, and we know well enough that this can make the child worse and not better…We always dissuade parents from engaging in warfare with the child, since the child inevitably remains in the end the stronger party. (pp. 110-111; Alexandra Adler, 1930a)

Discussion Question:  Have you ever experienced group psychotherapy, family therapy, or anything similar (or know anyone who has)?  What advantages did you experience, or what do you think you might experience if you were to work on your relationships with family members or other people?

## Brief Biography of Harry Stack Sullivan

Several aspects of Harry Stack Sullivan’s life history are quite strange, and so, according to some biographers, was Harry Stack Sullivan himself.  He was born on February 21st, 1892, though his medical records say he was born in 1886, in the rural community of Norwich, New York.  His father’s name was Timothy Sullivan and his mother’s name seems to have been Ella Stack, but it remains unclear whether her name was actually Ella.  That is the name that appears on Sullivan’s birth certificate and on her death certificate, but in the family records her name was listed as Ellen, and on Sullivan’s baptismal certificate it was listed as Ellina.  Timothy Sullivan was a hired-hand on the Stack farm (or another farm nearby), whose father had died when Timothy Sullivan was young, leaving the family quite poor.  There was a great deal of discrimination against Irish Catholics at the time, and Timothy and Ella struggled.  They lived in a poor part of town, where there was an improperly drained canal that was believed to be a breeding ground for “black diphtheria.”  The Sullivans had two children before Harry, both born in February, who died in terrible convulsions before reaching the fall of their first year.  When Harry was born in February, his mother was terrified that he would die as well (Alexander, 1990; Evans, 1996; Perry, 1982).

When Sullivan was 2 ½ he was sent to Smyrna, New York to live with his maternal grandmother.  Where his mother was for the next few years is unknown.  It was rumored that she had a nervous breakdown, and may have been kept hidden away in the attic of the barn until she recovered.  Although she eventually returned to public view, she was never really Sullivan’s caretaker again.  Neither was his father.  When Sullivan’s maternal grandfather died, there was no one to run the farm, which provided the support for him and his grandmother.  Being poor himself, Timothy Sullivan was granted control of the farm.  However, the Stack family had always considered Timothy Sullivan to be beneath them (the Stack family had a prestigious ancestry), so the legal documents were quite demeaning to Timothy Sullivan, and the farm’s name remained the Stack farm.  Timothy Sullivan worked hard, but withdrew into himself and had little contact with others (Alexander, 1990; Evans, 1996; Perry, 1982).

Sullivan did very well in school, but had few friends due to the common prejudice and discrimination.  At one point, the Ku Klux Klan burned a cross in front of the Stack farm.  His only friend was a boy who was 5 years older, Clarence Bellinger.  The two were very close throughout school, and both went on to become psychiatrists.  However, after high school, they never contacted one another again.  Bellinger always spoke poorly of Sullivan, and Sullivan simply never spoke of Bellinger.  The reasons why are unknown, but it may have something to do with the fact that neither one of them ever married, and Sullivan was widely regarded as a homosexual.  When Sullivan was 35, he took in a foster son, who may also have been a psychotic patient.  Late in life, Sullivan seems to have referred to the young man as a “lover” (Alexander, 1990).  If this was their relationship when his companion was only 15, and if his companion was a former patient, it was both unethical and criminal.  It is tempting to suggest that Sullivan’s sexual development and alleged later actions may have been influenced by an inappropriate relationship with Bellinger while Sullivan was still quite young.  However, the truth is not known, and there are other gaps in the history of Sullivan’s life (Alexander, 1990; Evans, 1996; Perry, 1982).

Two family members helped Sullivan with his education during his school years.  His mother’s sister Margaret, a schoolteacher, brought him many books and introduced him to a wide range of intellectual ideas.  His father’s brother, Will, was a respected lawyer and then a judge who was influential in applying psychological issues to the law.  He helped to foster Sullivan’s interest in human problems.  This aunt and uncle both later helped Sullivan with college finances, and they helped him to win a prestigious New York State Regents’ Scholarship to Cornell University.  However, Sullivan was not prepared for college.  After a fair start, his grades dropped drastically.  He became involved with a group of boys who were illegally obtaining and selling chemicals.  Only Sullivan was caught, and he was convicted of mail fraud.  His whereabouts for the next 2 years are unknown.  He may have been in jail, but there is evidence to suggest that he was hospitalized at Bellevue Hospital following a psychotic break.  Later in life he was friends with the renowned A. A. Brill (the psychiatrist who first translated many of Freud’s books into English), and Brill was working at Bellevue at the time.  Sullivan was also friends later in life with another employee who worked at Bellevue at that time, and no simple explanation can be given for his friendship with two men who worked at Bellevue Hospital during the time Sullivan’s whereabouts are unknown (Alexander, 1990; Evans, 1996; Perry, 1982).

In 1911, Sullivan reappeared and entered the Chicago College of Medicine and Surgery.  He finished his coursework in 1915, but did not receive a degree, possibly due to owing the school money.  He worked briefly as an industrial surgeon in a steel mill, and in 1916 joined the Illinois National Guard.  After only 5 months he was released on medical grounds, supposedly due to a broken jaw.  He then disappeared for a while, later claiming that he received 75 hours of psychoanalysis during the disappearance.  But where that occurred, or with whom, is again unknown.  In 1917, he was finally awarded his medical degree, and he joined the U. S. Army.  His application contained many inaccuracies and falsifications, including lying about his age.  Nonetheless, he was commissioned as a lieutenant, promoted to captain at the end of World War I, and spent 2 years moving between Chicago and Washington, DC.  In 1920, he left the Army, and again a year of his life seems to be missing.  In November, 1921, he joined St. Elizabeth’s Hospital in Washington, DC, and began his career in psychiatry (Alexander, 1990; Evans, 1996; Perry, 1982).

St. Elizabeth’s Hospital was one of best psychiatric hospitals of the time (and remains so today), under the leadership of the renowned William Alanson White, a pioneer in applying dynamic psychotherapy to psychotic patients.  After a year, however, there was no permanent position for Sullivan.  So, he applied for a position at the Sheppard and Enoch Pratt Hospital in Baltimore (as prestigious as St. Elizabeth’s both then and now).  White’s letter of recommendation for Sullivan was lukewarm and vague.  He described Sullivan as “better equipped than the average State Hospital assistant,” but he also acknowledged that he didn’t really know Sullivan because of Sullivan’s personal distance from other people (Alexander, 1990).  Nonetheless, Sullivan was hired for his first clinical psychiatric position at Sheppard Pratt (as it is more commonly known - Note:  The author’s wife had the privilege of working at Sheppard Pratt early in her career), and he began an exciting and innovative period of eight years, during which he did the most important clinical work of his career, including innovative techniques for the treatment of schizophrenia in young patients (Alexander, 1990; Evans, 1996; Perry, 1982).  Today, the Sheppard Pratt Health System includes the Harry Stack Sullivan Day Hospital, a partial hospitalization program assisting adults with severe mental illness, including psychotic disorders.

During his time at Sheppard Pratt, Sullivan became close friends with a young psychiatrist named Clara Thompson.  They shared an interest in questioning Freud’s concepts of the feminine psyche and other challenges to orthodox psychoanalysis.  As Sullivan became particularly interested in the work of Sandor Ferenczi (who accompanied Sigmund Freud and Carl Jung on Freud’s only trip to America, but later split with Freud), he encourage Thompson to go to Budapest and be psychoanalyzed by Ferenczi.  She did so, and upon her return she was Sullivan’s training analyst, and Sullivan was later admitted to the American Psychoanalytic Society.  The two remained close throughout their lives, and supposedly agreed to marry one another, but both quickly broke off the engagement the very next morning (Alexander, 1990; Evans, 1996; Perry, 1982).

In 1930, Sullivan moved to New York City to establish a private practice and conduct research.  However, he failed to make much money, incurred some family debts following his father’s death, and he filed for bankruptcy in 1932.  The next few years were interesting, but unstable.  He was the driving force behind the establishment of the William Alanson White Foundation in 1933, and he actively collaborated with two colleagues at Yale University (where they likely had an influence on Erik Erikson’s work).  However, one of those colleagues died in 1939, and Sullivan immersed himself in a project studying Black adolescents in Tennessee and Mississippi.  He then settled in Bethesda, Maryland, where he spent the rest of his career (Alexander, 1990; Evans, 1996; Perry, 1982).

The year 1939 marked the beginning of a highly productive period for Sullivan.  Dexter Bullard, the director of a psychiatric hospital named Chestnut Lodge, provided Sullivan with steady consulting opportunities.  This provided Sullivan financial security, and through Chestnut Lodge he met many influential psychiatrists in the Washington, DC area.  William Alanson White had died in 1937, and Sullivan delivered a series of public lectures, which became the First William Alanson White Memorial Lectures, and which were released as Sullivan’s only book published while he was still alive:  Conceptions of Modern Psychiatry (Sullivan, 1940).  The White Foundation established the journal Psychiatry, and the Washington School of Psychiatry.  Sullivan also encouraged the White Foundation to establish a second training program in New York City, and the core faculty included Clara Thompson and Erich Fromm.  The second program is known today as the William Alanson White Institute.  When, in 1941, Karen Horney was disqualified as a training analyst by the New York Psychoanalytic Society, Clara Thompson walked out of the meeting, and helped to establish a rival Association for the Advancement of Psychoanalysis, with Horney as its dean.  A series of political battles between opposing psychoanalytic societies followed, in many ways pitting followers of Freud against those whose interests and relationships were closer to Sullivan (Alexander, 1990; Evans, 1996; Perry, 1982).

In 1945, Sullivan became quite ill, and was urged to retire for his health.  Instead, Sullivan accepted a new challenge.  He was invited by Brock Chisholm, who was soon to become the first director of the World Health Organization, to serve as a consultant for the post-World War II International Congress on Mental Health.  Sullivan focused on applying psychiatric principles to problems of world peace, including educating children on values for peace.  He helped to establish the World Federation for Mental Health, and participated in the UNESCO Seminar on Childhood Education Toward World-Mindedness.  In January 1949, following a particularly frustrating meeting of the World Federation for Mental Health, Sullivan died in a hotel room in Paris, France.  He was cremated, as he had requested, and his ashes were buried at Arlington National Cemetery, honoring his service to the U. S. Army Medical Corps during World War I.  A committee was established by the White Foundation to publish his papers.  Between 1953 and 1972, the committee published seven books of Sullivan’s work, ensuring that his theories remained available to the fields of psychiatry and psychology (Alexander, 1990; Evans, 1996; Perry, 1982).

Placing Sullivan in Context:  America’s Psychodynamic Theorist

Harry Stack Sullivan was an enigmatic character.  His parents were poor and, apparently, both suffered from mental illness; his siblings died during their infancies.  The region where he was raised was extremely prejudiced against Irish Catholics, and the KKK burned a cross in front of their home.  As a student, Sullivan was very successful, but legal problems (due to his own bad choices) and presumed hospitalizations for his own mental illness delayed his success in college and medical school.  And yet, he went on to become the most influential psychodynamic theorist born in America, worked at two highly prestigious psychiatric hospitals, co-founded an influential foundation, and has a hospital named after him.  Like Adler, however, his contributions seldom receive proper recognition, and he remains somewhat obscure.

Sullivan’s most interesting and enduring contributions relate to his relationship with William Alanson White.  Although Sullivan only worked with White briefly, and White’s letter of recommendation for Sullivan’s next position admits that White considered Sullivan to be distant and hard to get to know, Sullivan vigorously pursued White’s interest in the treatment of schizophrenia.  Sullivan helped to found the William Alanson White Foundation, which established two psychiatric training institutes and the journal Psychiatry, and Sullivan delivered the First William Alanson White Memorial Lectures.  Today, the Sheppard Pratt Health System includes the Harry Stack Sullivan Day Hospital (for the treatment of psychotic disorders).

## Sullivan's Interpersonal Psychology

Sullivan shares two particular distinctions with Adler:  his influence is extraordinarily wide ranging, and he is not very well known.  It has been suggested that he was the most original and creative American-born psychiatrist (Chapman & Chapman, 1980).  In Corsini & Wedding’s Current Psychotherapies (1995), Sullivan is mentioned in ten of the fourteen chapters, including those written by Albert Ellis, Carl Rogers, Aaron Beck, and Rollo May, as well as the chapters written about Sigmund Freud, Alfred Adler, and Carl Jung.  Due largely to his emphasis on interpersonal relationships, he is acknowledged by Jean Baker Miller and other founding members of the Stone Center (see Chapter 9; Jordan, et al., 1991; Miller, 1976).  So how can he be relatively unknown?  According to Evans (1996), there are a number of reasons for Sullivan’s lack of popularity, but two seem to stand out.  First, Sullivan did not publish much during his lifetime, and what he did publish was somewhat poorly written and difficult to understand.  Second, Sullivan was apparently a very difficult and strange man, whose writings often included derogatory statements about psychiatry and psychiatrists (even though this was his own field).  Whatever the reasons are for his lack of renown, Sullivan has had a significant influence on psychiatry and psychology nonetheless.

Whereas Adler considered relationships to be an obvious consequence of social interest, the primary factor in Individual Psychology is the striving for superiority.  Social interest and interpersonal relationships, of course, make healthy superiority possible.  For Sullivan, however, it was the interpersonal relationships themselves that were paramount:

One achieves mental health to the extent that one becomes aware of one’s interpersonal relations…It is part of the framework that supports all explanations of what is going on, what might be going on, and what will presently be going on…It is the necessary formula to which everything must be assimilable, if it is therapy. (pg. 207; Sullivan, 1940)

### Euphoria, Tension, and Security

Sullivan believed that we exist somewhere between the states of absolute euphoria and absolute tension.  Absolute euphoria is a state of utter well-being, which, unfortunately, is not really possible.  The closest we can come to experiencing absolute euphoria is in the deep sleep of a newborn infant.  Tension is the alternative state to euphoria, and tension is very much a part of our lives.  It arises from two sources:  needs and anxiety.  There are two basic types of needs:  those that arise from actual biological needs (food, water, air, etc.), and those that are cultural or learned.  In real life, however, these types of needs cannot be separated.  An infant cannot satisfy its biological needs, it must be cared for.  Thus, Sullivan talked routinely about a mothering need, which is a need for an intimate, interpersonal relationship.  When the mother does indeed care for the infant, the infant experiences this as tenderness, and the infant develops an ongoing need for tenderness.  Thus, through the need for a mother and the need for tenderness, the infant finds itself in a world in which it needs interpersonal relationships for continued survival and psychological development (Chapman & Chapman, 1980; Lundin, 1979; Mullahy & Melinek, 1983; Sullivan, 1940, 1953).

Anxiety is the result of real or imagined threats, and can be experienced by the infant or caused by an anxious mother.  In either case, it can be particularly intense in an infant because they cannot specifically do anything about it.  Furthermore, unlike biological needs that can be met quite specifically (e.g., a hungry child can be fed), how can anxiety be satisfied?  The answer, according to Sullivan, is through the pursuit of interpersonal security.  In other words, a sense of security, the alternative to anxiety, can be obtained only through relationships that provide the child with tenderness and empathy.  Sullivan used the term empathy to describe “the peculiar emotional linkage that subtends the relationship of the infant with other significant people - the mother or the nurse” (pg. 17; Sullivan, 1940).  Long before infants show any sense of understanding emotional expressions, they seem to be able to share in emotional feelings, through what Sullivan considered an innate capacity for empathy.  Even an infant is not, however, merely a recipient of the relationships in which it is involved, it is an active and engaged person.  Likewise, children do not simply wait and hope for security, they actively engage in thoughts and behaviors that Sullivan called security operations.  Security operations serve to maintain our sense of self-esteem, or self-respect, and they often begin with an emphatic sense of “I.”  Unfortunately, this leads to an odd paradox:  the concept that we can have self-esteem without being in relationship with others:

It is one’s prestige, one’s status, the importance which people feel one is entitled to, the respect that one can expect from people…that dominate awareness.  These things are so focal in interpersonal relations of our day and age that the almost unassailable conviction develops…that each of us, as defined by the animal organism that we were at birth, are unique, isolated individuals in the human world… (pg. 219; Sullivan, 1964)

### Dynamisms and the Self-System

Underlying Sullivan’s emphasis on interpersonal relationships is the fundamental concept of dynamism.  Similar to the physical universe, our psychological environment involves ongoing transfers of energy (in the psychological sense) between ourselves and the people we interact with, and this is a dynamic back-and-forth system (i.e., a relationship).  A dynamism is a relatively enduring pattern of energy transformation that allows us to characterize a living organism.  Each organism, or each person, has many dynamisms, but the ones of particular interest to psychiatrists, according to Sullivan, are those related to how we interact with others (Sullivan, 1953).

One of the most important dynamisms is the self-system.  The self-system is somewhat unique, in that it integrates and provides meaning for all of the individual’s interactions and experiences; Sullivan referred to it as a secondary dynamism (secondary here refers to a higher level of processing, not secondary in importance; Sullivan, 1953).  The self-system also integrates the security operations, and serves to protect the individual from tension.  Chapman & Chapman (1980) offer a useful description of various ways in which the self-system utilizes security operations in the actions of a 3-year-old child:

1.  When faced with an emotionally threatening situation, the child may lapse into stubborn silence.
2.  When there is tension between the child and the demands of older children, the child will obstinately resist the efforts of the older children to get the child to conform to their desires.
3.  When stressful interpersonal situations arise, the child will withdraw into solitary play.
4.  In new, anxiety-provoking environments the child will physically cling to a familiar adult.
5.  When anxiety arises between the child and others, the child may engage in meticulous play with inanimate objects (toys, coloring books, etc.).
6.  When the child’s emotional needs are not met by others, they may regress into more immature behavior and speech.

By observing these behaviors, we can understand who this child is at this point in their life.  For a 3-year-old, such behaviors are quite normal.  However, such security operations would be considered less appropriate for an adult.  And yet, sometimes these behaviors become part of the self-system of an adolescent, or an adult, and Sullivan referred to such instances as dynamisms of difficulty (Sullivan, 1956, 1972).  When dynamisms of difficulty go into action, they fail to achieve a desired goal, or at best achieve only an unsatisfactory goal.  Since they are relatively enduring, as are all dynamisms, they tend to characterize states of psychological illness, and would indicate the need for psychotherapy.  As a curious side-note, while discussing the dynamism of the self-system, Sullivan appears to be the first person to have used the now well-known term significant other (Sullivan, 1953).

Another important type of dynamism is the personification.  A newborn infant cannot really understand who their mother is, or who they themselves are, so the infant develops an image of the mother, the father, themselves, etc.  These images, which can sometimes conflict with one another, are called personifications.  For instance, when the mother feeds and comforts the infant, she is the “good” mother.  But when she fails to display appropriate tenderness, or her own anxiety is expressed to and experienced by the infant, she is the “bad” mother.  Later, as the child develops greater intellectual capacity and experience, these personifications are fused into a single mother.  Similarly, the infant begins life with personifications of itself as sometimes “bad” and sometimes “good,” and later in life fuses these personifications as the adolescent begins to establish a clear identity (Chapman & Chapman, 1980; Mullahy & Melinek, 1983; Sullivan, 1953, 1964).  As with all of the concepts we have discussed here, the process of personification continues into adulthood.  A mother will develop her own personifications of the infant, which, as mentioned above, may be experienced by the infant.  For example, if a baby is colicky (cries constantly and cannot be soothed), it can be very frustrating for a mother, especially a new mother.  Her anxiety may lead to a personification of her baby as inconsolable and of herself as a “bad” mother.  Her discomfort, then, in caring for her baby can be experienced by the baby, leading to the baby’s personification of her as a “bad” mother.  The key here, according to Sullivan’s theory, is that neither the mother nor the baby is in any way bad or good, inconsolable or tender, except in relation to one another!

Sullivan described the personified self as those aspects of personality about which one is consciously aware.  This provides important information for a psychotherapist, and pursuing information about the personified self is an important part of the psychiatric interview (Sullivan, 1954).  During the interview, Sullivan recommended that the psychotherapist examine four aspects of personified self:  what does the patient esteem and/or disparage about themselves; to what experiences is the patient’s self-esteem particularly and unreasonably vulnerable; what are the characteristic security operations employed when the patient is made anxious; and how great are the patient’s reserves of security?  In addition to these important points, Sullivan also considered it essential for a psychotherapist to gain an impression of the whole interview situation, particularly with regard to the patient’s sense of proportion in terms of where they fit into life.  By understanding the personified self, the patient’s knowledge of themselves, and how they view themselves within the context of their life, the psychotherapist can gain an understanding of what is realistically possible for the patient during the course of therapy (Sullivan, 1954).

Discussion Question:  Sullivan described the personified self as knowing what you like or dislike about yourself, what experiences are particularly damaging to your self-esteem, your characteristic security operations, and how deep your reserves of security are.  Consider each of these points, and provide yourself with a self-evaluation.  Overall, do you see yourself as a relatively healthy, secure person, or someone whose life is plagued by tension and anxiety?

### Developmental Epochs

Sullivan considered an understanding of the course of human development to be essential to understanding individuals.  He described seven developmental epochsinfancy, childhood, the juvenile era, preadolescence, early adolescence, late adolescence, and adulthood (Sullivan, 1953, 1954, 1964).  These developmental stages represent a gradual unfolding of the individual’s capacity for effective interpersonal relationships or, in other words, the individual’s ability to fit into the social structure of their environment (Chrzanowski, 1977; Lundin, 1979).  As we all know, children maintain very different relationships than adults do, and we would not expect children to have adult-like relationships.  Thus, when attempting to evaluate a person’s state of mental health, which Sullivan equated with their ability to form healthy relationships, we clearly need to understand something about what constitutes the developmentally appropriate possibilities.

Infancy begins at birth, and lasts until the acquisition of speech.  It is the time of the most empathic connection between the infant and its caregivers, which can be characterized by tenderness and security, or by anxiety and tension.  Childhood lasts through the remainder of the preschool years, and involves extending one’s interpersonal relationships outside of the immediate family to peers (friends and playmates).  In addition, language is incorporated into one’s experiences of approval and disapproval.  The juvenile era begins as one enters grade school.  Once again, interpersonal relations are expanded to include a wider variety of people and situations, including competition with one’s peers and subordination to authority figures (such as teachers and the school’s principal).

Adolescence involves some very dramatic changes, particularly in the direction of the intensely intimate relationships of adulthood.  During preadolescence, there is a marked increase in the closeness of friendships (e.g., “best friends forever!”), which is characterized by an intimate dynamism.  Early adolescence is marked by an interest in the other sex, and an erotic dynamism is formed.  Late adolescence, which Sullivan placed between the middle high school years the early college years, were a time of developing full and mature interrelationships, as well as understanding of the need for responsible citizenship within one’s society.  When these dynamisms, including the self-system, become stabilized, and society has transformed the individual into a completely social being, the person has attained adulthood (Chrzanowski, 1977; Lundin, 1979; Sullivan, 1953, 1954, 1964).

Sullivan provided ages for the transition of these developmental epochs, but he also acknowledged that they are based on experience.  Thus, it is possible for the stages to occur at different times in unique individuals.  The course, however, remains the same, unless the course fails to progress.  If an individual is not provided with the opportunities to advance their interpersonal development, there can be an arrest of development (Sullivan, 1953, 1964).  An arrest of development does not mean that the personality becomes static, but rather, the freedom and velocity of constructive changes becomes markedly reduced.  Later, the arrested development becomes apparent through eccentricities in one’s interpersonal relations.  The individual does not simply continue to act like a normal child, there is an increased likelihood that this “warp” in personality development will also lead to malevolent dynamisms and the consequent social problems (such as delinquency and crime).

Discussion Question:  Do you know anyone who demonstrates arrested development (someone who seems immature, especially in relationships)?  Are you able to maintain a friendship with that person, or is the situation too stressful?

### Final Notes on Harry Stack Sullivan

From his early days working with William Alanson White, Sullivan was particularly interested in the treatment of schizophrenia.  One of the books published by the White Foundation was entitled Schizophrenia as a Human Process (Sullivan, 1962), in which his longtime friend Clara Thompson described him as having a “genuine liking and respect” for his patients.  Later the White Foundation published a series of seminars Sullivan offered to the psychiatric residents at Sheppard Pratt, as well as members of the Chestnut Lodge and the Washington School of Psychiatry, on the treatment of a young, male schizophrenic.  The text includes commentary by others some 25 years after the seminar (see Kvarnes & Parloff, 1976).

Like Alfred and Kurt Adler, Sullivan recognized the difficulty of treating psychotic patients.  The prognosis, in Sullivan’s opinion, depends to a large extent upon the patient’s history of successful interpersonal relationships:

…let us consider the empirical fact that the schizophrenia which appears in the form of a sudden dramatic onset is usually considered to have a more favorable prognosis than the schizophrenia with more gradual onset.  But in those cases of sudden onset in which satisfactory experience with significant persons in the past is totally lacking, the patient may be practically beyond redemption; he may manifest empirically trustworthy capacity for recovery to the extent of making excellent institutional recovery; but the psychiatrist is daft who expects that he can put the patient out into the world without prompt relapse. (pg. 197; Sullivan, 1956)

Returning to Sullivan’s basic concept of personality, he offered the following definition:

Personality is the relatively enduring configuration of life-processes characterizing all of the person’s total activity pertaining to such other persons, real or fantastic, as become from time to relevant factors in his total situations. (pg. 47; Sullivan, 1972)

While this definition is rather sweeping in its coverage, it remains focused on interpersonal relationships.  According to Thompson, Sullivan was very serious about his own relationships:

The quality of his friendship showed the same genuineness and tolerance so characteristic of his relation to patients.  He was slow in making friends.  He tested them for a long time…Once a person had passed the test he could count on Harry for absolute loyalty.  No matter what your mistakes - and he might point them out to you privately - before the world he was on your side…He had a characteristic phrase when parting from a friend - “God keep you.” (pg. xxxiv; Clara Thompson in Sullivan, 1962)

Personality Theory in Real Life:  Achieving Athletic Excellence
Despite Physical Challenges

Adler’s studies on inferiority began with physical problems, what he called organ inferiority (Adler, 1917).  Most students of Adler look past that medical beginning, and focus instead on the psychological inferiorities that children experience during their development.  However, there are many people with organ inferiority, or what we more commonly refer to as disabilities, handicaps, or “challenges.”  There may be some debate as to which term is preferred, but since the phrase “politically correct” is itself a contradiction in terms, I will use the terms disability and handicap as presented in Warren Rule’s book Lifestyle Counseling for Adjustment to Disability (Rule, 1984).  In his summary of previous research, Rule adopts the definition of a disability as a “relatively severe chronic impairment of function” that occurs as the result of a congenital defect, disease, or an accident.  Accordingly, disability refers to actual physical, mental, or emotional impairments that become a handicap only if they cause lowered self-assessment, reduced activity, or limited opportunities.  When disabilities become a handicap, they can affect the individual’s entire style of life.  Thus, Rule brought together a group of therapists trained in Individual Psychology, and published the aforementioned book on using lifestyle counseling for people with disabilities that have led to handicaps.

However, not everyone with a disability develops a handicap.  Instead, some individuals become truly inspirational by the way in which they live their lives in spite of their disability, or rather, as if they simply were not disabled.  Erik Weihenmayer (2001; see also Stoltz & Weihenmayer, 2006) was born with retinoscheses, a degenerative eye disease, which slowly destroyed his retinas, leaving him blind by the age of 13.  In high school, Erik spent a month one summer at the Carroll Center for the Blind in Massachusetts.  The summer camp included a weekend of rock climbing in N. Conway, New Hampshire (where the author has done a lot of rock-climbing).  Weihenmayer’s rock climbing experience altered his life.  He continued climbing rock, and then moved on to ice-climbing and mountaineering.  He didn’t just followed more experienced climbers up the cliffs, he also learned to lead-climb:  placing one’s own protection along the climb and then clipping in the rope, what climbers call “the sharp end” of the rope.  I had the pleasure of climbing with Erik in Michigan’s Upper Peninsula a few years ago, while his seeing-eye dog slept in a sort of ice cave formed by the overhanging ice.  It is truly extraordinary to watch him climb.  He moves so smoothly, as he feels the ice above with his ice axe, and then sets the ice axe so deliberately when he finds the right spot, that you would not know he was climbing blind if you only watched for a little while.  Eventually, Erik decided to pursue the Seven Summits, climbing the highest peak on each continent:  Mt. McKinley (N. America), Aconcagua (S. America), Mt. Everest (Asia), Mt. Elbrus (Europe), Vinson Massif (Antarctica), Mt. Kosciusko (Australia), Kilimanjaro (Africa).  He accomplished his goal in 2002.

Erik Weihenmayer is by no means the only well-known, disabled climber.  In an amazing video, Beyond the Barriers (Perlman & Wellman, 1998), Erik goes climbing with Mark Wellman and Hugh Herr.  Wellman was paralyzed from the waist down in a climbing accident (Wellman & Flinn, 1992), and Herr lost both of his lower legs to frostbite after being caught in a vicious winter storm on Mt. Washington, NH (Osius, 1991; Note: The author has suffered a small patch of frostbite during a winter storm on Mt. Washington).  In Beyond the Barriers, Herr leads the hike toward the climb, while Erik carries Wellman.  Once on the climb, Herr leads the climb, Erik follows, and they set ropes for Wellman to do pull-ups up the cliff.  It simply has to be seen to be believed.  One of the surprising aspects is how they joke with each other about what they are doing.  As Erik is carrying Wellman, Wellman says:  “I don’t know man.  A blind man giving a para a piggyback ride?  It’s a pretty scary thing!”  When Herr starts climbing on a day when it was snowing, he says his hands are getting numb from the cold.  So, Erik asks him how his feet feel!  Humor was always an important part of Adlerian psychotherapy (Scott, 1984), so perhaps it should not be surprising that a sense of humor is an aspect of their personalities.  One of the funniest stories that Erik tells is about the time he accidentally drank out of his climbing partners piss bottle (a bottle used to urinate inside the tent during storms).  Erik became quite upset that the bottle wasn’t marked somehow, but his partner defended himself by saying he had clearly written on the bottle which one it was.  It slowly dawned on Erik’s partner that the writing was of no help to Erik.  As another example of Erik’s humor, consider the challenge he tried to avoid after having climbed the highest peaks in Africa and North and South America:

Emma Louise Weihenmayer was born on June 21, year 2000, at 3:57 A.M.  There is so much to learn about parenthood.  Sometimes being a father is about as intense as climbing Denali, Kilimanjaro, and Aconcagua, all in a day.  Because I’m blind, I tried to convince Ellie that I couldn’t change diapers, but for some reason, she didn’t buy it. (pg. 303; Weihenmayer, 2001)

In addition to his climbing, Erik Weihenmayer is a college graduate with a teaching certificate, and he spent some time as a middle school teacher.  He also tried the sport of wrestling, and was a wrestling coach.  Trevon Jenifer was also a wrestler.

Trevon Jenifer was born without legs.  Perhaps even more challenging, however, was the fact that he was the fourth child of a poor, single mother living in a ghetto outside of Washington, DC.  Obviously, Trey (the name he goes by) began life facing difficult obstacles, but little by little, things got better.  His mother, Connie, made a conscious decision to take care of him the best she could.  She soon met Eric Brown, who became Trey’s step-father, providing a stable home for their family.  He met a wonderful special education teacher named Bob Gray, who got Trey interested in sports, and who helped to make participating in sports a realistic possibility.  He eventually joined a wheelchair track and basketball team named Air Capital, and he was very successful on the track, setting national records in the 100-, 200-, and 400-meter races.  It was prior to his junior year in high school, however, that his step-father, who had been a wrestler, recommended that Trey try out for the wrestling team, the regular wrestling team.

What Trey wanted more than anything was to fit in, to have a normal social life at school.  Being in a wheelchair, that was not likely to happen.  However, he felt that sports might help him accomplish that goal, so he did try out for the wrestling team.  He worked hard, learned as much as he could, and he made the varsity team as the 103-pound competitor (actually, there was no one else that light on the team, but he didn’t know that).  His coach, Terry Green, did all he could to help Trey find a wrestling style that would take advantage of his relative arm strength (he made weight without legs, so his upper body was relatively large) while overcoming the disadvantage of not being able to balance or leverage his body weight by spreading out his legs.  Now it was up to Trey.  He was nervous in his first match, didn’t assert himself, and was easily pinned.  In his second match he became the aggressor and earned his first victory.  The rest of his junior year continued to be a series of wins and losses, and he ended the season 17-18.  Of course, it had only been his first season of wrestling.

In anticipation of his senior year in high school, Trey continued to train hard.  Outside of the ring he also received recognition, and became a part of the social network of the school.  He received a Medal of Courage from the National Wrestling Hall of Fame, he attended his school’s prom, and he was chosen as co-captain of the wrestling team.  Once again, humor played a role, as he compared his strength to a teammate from the previous year.  Trey had made significant strides in how much he could bench-press, so his former teammate asked him how much he could squat (a lift done entirely with the legs)!  Both wrestlers enjoyed a good laugh at that one.

Trey was doing quite well in league wrestling, and he also began to do well in tournaments.  Eventually, he won a tournament, ended his season at 26-6, and from there went on the state championship.  He won his first match, but then had to face an undefeated wrestler.  He lost, but in that loss there was a sense of accomplishment due to how far he had come:

I lost 5-2…I was hurt less by the fact that I lost, and more by the closeness of it.  This one hurt even more because of how close I was to beating the best wrestler in the state.  Sharbaugh went on to win the state championship.  In fact, he won his last two matches very convincingly, 6-0, and, 12-5.  He told reporters afterward that my match was his toughest of the tournament. (pp. 171-172; Trevon Jenifer in Jenifer & Goldenbach, 2006).

The next morning he had to return to the championships to wrestle for a chance at third place in the state.  He began with a vengeance, scoring victories of 9-1 and 9-2.  His next match, and a shot at third place, was not so easy, but he won 3-1, earning his 30th victory of the season.  He then won his final match, and earned third place in the state championship.  However, an even more important challenge now loomed ahead of him:  college.

Coming from a poor, Black family, there was no tradition of children going to college.  However, a group of concerned philanthropists became interested in supporting his dreams.  His old coach at Air Capital had talked to Jim Glatch, who coached wheelchair basketball at Edinboro College in Pennsylvania, a school with a large population (10 percent) of students with disabilities.  Trevon Jenifer currently attends Edinboro College and plays on the wheelchair basketball team.  He does not know if he will ever wrestle again, but it is interesting to note that Edinboro College has a famous wrestler as their athletic director:  two-time Olympic gold medalist Bruce Baumgartner!

Recently, Trey was kind enough to respond to an email I sent him, and he provided me with an update on how things have gone during his first year of college.  He misses wrestling very much, but he has really enjoyed his return to wheelchair basketball.  It probably didn’t hurt that the team is very good, and they came in second-place in the NCAA championship for wheelchair basketball.  Trey maintained good grades, his family strongly supports him in pursuing his education, and he has made many new friends.  But a few challenges remain.  It has been a little difficult for him to get used to the weather in northwestern Pennsylvania, and he has been too busy to attend as many book signings as his publisher would like (but he says they have been very understanding).  As for becoming the inspiration his mother thought he was born to be:

I think that I have inspired some people, and I think that is great, but I don’t think that it has reached all the people that I would like it too.  My family says that I have done a good job, but I [think that I could do a lot better], and I will try until I feel that I have reached that. (Trevon Jenifer; personal communication, 2007)

The range of sports in which disabled individuals compete is extraordinary today.  Beyond the Barriers also includes disabled individuals sailing, scuba diving, surfing, and hang gliding.  A few years ago, I began practicing Tae Kwon Do, and I soon discovered that I had degenerative joint disease in both hips.  I considered quitting Tae Kwon Do, but I was strongly encouraged to continue by my instructors, as well as by my orthopedic surgeon and physical therapist.  I have since learned that Dirk Robertson, a former social worker turned actor and writer, has worked hard promoting martial arts training for people with disabilities (Robertson, 1991; see also McNab, 2003).  Each person simply needs to be encouraged to do their best.  Adler suggested that the best way to strive for superiority was through social interest.  Whether it’s a climbing partner, a wrestling team, a wheelchair basketball team, a martial arts school, whatever, when people work together to help each individual achieve their potential, it can prove to be a highly rewarding experience.

Whilst it is important to be sensitive to their particular situation, their disability should not be the central focus all the time.  Their ability to learn, listen and adapt should be built on and encouraged.  Do not be over-protective or an instant expert on people with disabilities.  The experts are the people themselves, so listen to what they have to say. (pp. 101-102; Robertson, 1991)

## Review of Key Points

• Adler faced death numerous times as a child, including his brother’s actual death.  These events had a profound impact on the nature of his theories.
• Adler helped Freud gain recognition for Freud’s personality theory.  This lends credence to Adler’s claim that he was never a student or follower of Freud, but rather a colleague interested in similar psychiatric/psychological questions.
• The fundamental aspect of Individual Psychology is that we are born inferior and spend our lives striving for superiority.
• Striving for superiority takes the form of compensating for our weaknesses, which, unfortunately, can sometimes lead to overcompensation.
• When individuals can not compensate, they may develop an inferiority complex.  Extreme feelings of inferiority can lead to the paradoxical superiority complex.
• Adler believed that all thought and behavior was tied to some goal.  Our overriding goal is the life plan, and we pursue it by living a characteristic style of life.
• Dysfunctional styles of life can result from pampering and neglect, both of which reduce our social interest.
• According to Adler, social interest is the best way to achieve superiority, and it can most easily be seen in cooperation.
• Formal examples of cooperation include teamwork, which can lead to either positive or negative outcomes, depending on the circumstances.
• Important aspects of our ability to strive for superiority are the creative power of the individual and the goal we set as the fictional finalism.
• Each person exists within their own perception of the world, known as the scheme of apperception.  This scheme guides all experience to fit into our style of life and our goals.
• Since child development is so important, Adler created child guidance centers to train both parents and schoolteachers in the principles of Individual Psychology.
• Adler was very interested in the effects of birth order and the family constellation.  Being an only child is likely to result in pampering, whereas an oldest child must deal with being dethroned.
• In an attempt to understand the psychological motivation of women, and some men as well, Adler proposed the theory of masculine protest.
• The key to Adlerian psychotherapy is understanding the patient’s style of life.
• An important technique for revealing the style of life is the early memories test.
• Once the style of life is understood, Adlerian psychotherapists work to strengthen social interest and reorient the style of life.
• Adler was an early innovator in terms of both family therapy and group psychotherapy.
• Sullivan began his formal psychiatric career at two prestigious hospitals:  St. Elizabeth’s and Sheppard Pratt.
• According to Sullivan, we are a constant state of tension, due to our needs and anxieties.  We seek security, and we employ security operations to reduce our anxiety and tension.
• Sullivan referred to the energy transformation that underlies our personal interactions as dynamisms.  Perhaps the most important dynamism is the self-system.
• When an individual develops dysfunctional security operations, Sullivan referred to them as dynamisms of difficulty.
• Before we can truly understand relationships, we develop images in our mind known as personifications.  The personified self includes everything we can consciously describe about ourselves.
• Sullivan described seven developmental epochs, which provide a framework for our unfolding abilities to engage in healthy interpersonal relationships.