Bion and Sullivan: An enlightening comparison

Abstract

The author compares the life and work of two pioneers and major sources of inspiration to the contemporary psychoanalytic debate: W.R. Bion (1897–1979) and H.S. Sullivan (1892–1949). Both their life and their work show similarities that allow the author to illuminate and constructively compare the one with the other. The author proposes his work as a useful exercise in the field of “comparative psychoanalysis,” an important key for the reconstruction of the history of our field and for a more scientifically coherent articulation of its theories.

Keywords:

• W.R. Bion
• H.S. Sullivan
• comparative psychoanalysis

Acknowledgements

I thank Franco Borgogno for his help in the revision of the paper.

Notes

¹Of the seven volumes comprising Sullivan's work, only one, Conceptions of modern psychiatry, was published during his lifetime, in 1940, whereas the remaining six came out upon the initiative of the editorial committee that came into existence after his death (in 1949, aged 57), at a time at which he enjoyed a high reputation and was chaired by his future biographer, Helen Perry. Of the six posthumously published books, two are anthologies of papers published by him in journals, that is Schizophrenia as a human process (1962) and The fusion of psychiatry and social science (1964) and three volumes based on the selection of material coming from the series of courses and seminars he held at Chestnut Lodge in the 1940s, that is, Interpersonal theory of psychiatry (1953), The psychiatric interview (1954), and Clinical studies in psychiatry (1956). The last one to come out (1972) was Personal psychopathology, the only book he had personally written for publication at the beginning of the 1930s and whose publication he had renounced because of the originality of the ideas he had developed and the consequent need and desire to keep reflecting upon them, given also the fact of his being then still one of the most prominent members of the American Psychoanalytic Association. As a matter of fact, the book contains the very first articulation of what would later become Sullivan's interpersonal theory of psychiatry. But here are the central words of my preface to the Italian edition of Schizophrenia as a human process (Conci, 1993, p. VIII): “These papers on schizophrenia, which come eventually out in Italian in the hundredth anniversary of Sullivan's death, represent not only the context of origin and of original elaboration of all his later work, but also – in my opinion – the most faithful mirror of the multiple valences which characterise his line of thought. In other words, I see this anthology as the first book by Sullivan which anyone should read.”

²As good examples of such a peculiar orientation, the reader can look at the following quotations taken from Sullivan's published work. Here is, in the first place, the clinical context in which Sullivan for the first time makes use of the term “interpersonal”: “We have not seen maladjustment which was without a foundation of erroneous attitudes which parents or their equivalents had thrust upon the child. We have found all sorts of maladjustments in the history of patients who suffered the grave psychosis, but regardless of vicious influences subsequently encountered, the sufferer had acquired the tendency to such an illness while in the home situation. Interpersonal factors seem to be the effective elements in the psychiatry of schizophrenia” (cf. the paper “The onset of schizophrenia”, written in 1927 and published in Schizophrenia as a human process, 1962, p. 104). And here is how Sullivan took up again this very same point four years later, in the paper “The modified psychoanalytic treatment of schizophrenia”: “In brief, schizophrenia is meaningful only in an interpersonal context” (1962, p. 276). It is in this paper that we can also find the following conclusion, which he reached through the pioneering work he conducted between December 1922 and June 1930 at the Sheppard and Enoch Pratt Hospital, near Washington, DC: “The only tools that have shown results that justify any enthusiasm in regard to the treatment of schizophrenia are the psychoanalytic procedures and the socio-psychiatric program which the writer has evolved from them” (1962, p. 283).

³This last aspect can be further underscored by saying that the huge intellectual stature of both Sullivan and Bion brought them (as it had been the case, for example, with Ludwig Binswanger, 1881–1966) to experience schizophrenia as the “epistemologic challenge” that it actually represents – such a big challenge as to give a new direction to the work of anyone seriously dealing with it. Should we consequently consider them, also from this point of view, “imaginary twins?” As far as Binswanger was concerned, dealing with schizophrenia brought him to start cultivating and applying to psychiatry the existential point of view (with particular regard for Heidegger's work).

⁴Of course, as far as Italian psychoanalysis is concerned, a fundamental pioneering role in these developments was played by Luciana Nissim Momigliano (1919–1998), who was not only the editor, together with Andreina Robutti, of the anthology Shared experience. The psychoanalytic dialogue (1992), but also the author of the book Continuity and change in psychoanalysis. Letters from Milan (1992), which contributed to circulating her name outside of Italy, and which I myself reviewed in Joseph Reppen's journal Psychoanalytic Books (Conci, 1995).

⁵One of the most recent and interesting products of this new climate of opinion is represented by the papers given by Leo Rangell, “Reconciliation: the continuing role of theory”, and Arnold Cooper, “American psychoanalysis today: plurality of orthodoxies,” at the annual meeting of the American Academy of Psychoanalysis and Dynamic Psychiatry, held in San Diego, California, in May 2007, which appeared in print in Issue 2/2008 of the Journal of the Academy (Cooper, 2008; Rangell, 2008), with an introduction by Marianne Horney Eckardt (2008). I can highly recommend this to readers – to whom I can here offer only a small selection of some of the most significant statements made by the speakers. For example, Marianne Horney Eckardt's statement that “the theme of rapprochement has been with us since our very beginning” (since the Academy's foundation in 1956), as a “thought collective”, “in our commitment to the importance of fostering communication with each other” (2008, p. 215). Or the following statement by Leo Rangell: “There is no justification in eliminating the interpersonal from Freudian mainstream theory. Interpersonal relations live and constitute its very essence. And the cultural dimension, embraced by Karen Horney, is similarly intrinsic to the total, traditional Freudian ideational tree; the external world is in fact the fourth structural system” (Rangell, 2008, pp. 224–5). And, last but not least, the following considerations made by Arnold Cooper: “Harry Stack Sullivan, today acknowledged as a founder not only of the interpersonal point of view, but as a precursor of the relational and intersubjective viewpoints that are prominent in contemporary psychoanalysis was, at best, quietly ignored and effectively ousted from the mainstream of American psychoanalysis” (2008, p. 238).

⁶Since I believe that a major contribution to the new, dialogical dimension of contemporary psychoanalysis came from Stephen Mitchell (1946–2000), let me quote the words with which he introduced his “Editorial philosophy” in the first issue of Psychoanalytic Dialogues: “There is a great irony at the heart of contemporary psychoanalysis. The skilled psychoanalyst as a clinician is, perhaps, the most careful and systematic listener, the most precise and respectful speaker, the most highly trained and refined communicator, that Western culture has produced … . Yet, psychoanalysts have enormous difficulty listening and speaking meaningfully to each other” (Mitchell, 1991, p. 1).