Change Theory

Kurt Zadek Lewin (1890 – 1947)

CREDENTIAL AND BACKGROUND
• Father of Modern Social Psychology
• Born – September 09, 1890 into a Jewish family in Mogilno, Poland
• Died – February 12, 1947 at the age of 56 due to heart attack
• 1905 - Lewin and his family moved to Berlin
• 1909 – Friedrich Wilhelm’s University of Berlin
• 1914 – he served in the German Army when World War 1 began
– completed his requirements in Ph. D. in University of Berlin
• 1916 - received his Doctorate degree in Psychology in the same University
• 1926 – 1932 – served as a professor at the University of Berlin
• 1935 – Published “ A Dynamic Theory of Personality”
• 1936 – Published “ Principles of Topological Psychology”
• 1942 – President of the Society for the Psychological Study of Social Issues
• 1944 – Organized Research Center for Group Dynamics M.I.T.
• 1946 - Published Psychological Problems in Jewish Education
- Director of the Center for the Group Dynamics at M.I.T.
• Published 9 books
Major Concepts and Definition
Driving Forces
• - are forces that push in a direction that cause change to occur.
• - facilitate change because they push the person in the opposite direction.
• - They cause a shift in the equilibrium towards change.
Restraining Forces
• - are forces that counter driving forces.
• - hinder changes because they push the person in the opposite direction.
• - cause a shift in the equilibrium which opposes change.
Equilibrium
• - is a state that counter driving forces
 • - hinder changes because they push the person in the opposite direction.
• - can be raised or lowered by changes that occur between the driving and restraining
forces.
STAGES
• Consist of three distinct and vital stages:
• Unfreeze-change-refreeze
1. “Unfreezing”
• Is the process which involves finding a method of making its possible for people to
let go of an old pattern that was counterproductive in some way.
• Is necessary to overcome the strains of individual resistance and group conformity.
• Unfreezing can be achieved by the use of three methods.
First, increase the driving forces that direct behavior away from the existing situation
or status quo.
Second, decrease the restraining forces that negatively affect the movement from the
existing equilibrium.
Third, find a combination of the two methods listed above.
2. Change
• This stage involves a process of change in thoughts, feeling, behavior, or all three,
that is in some way more liberating or more productive.
3. Refreezing
• Refreezing is establishing the change as a new habit, so that it now becomes the
“standard operating procedure”
• Without this stage of refreezing it is easy to go back to old ways.
Application
It is pertinent that the driving and restraining forces must be analyzed before
implementing a planned change.
Lewin’s definition of behavior in this model is “a dynamic balance of forces
working in opposing directions.”

Major Assumption in Metaparadigm

Person – Lewin viewed the person as a system containing subsystem that are
more or less separate and more or less able to interact and
combine with each other. It “might be friendship for a certain person”
 “might be love for a certain sport”.
Environment – Lewin viewed the environment as a subject to cognitive
restructuring, it becomes better understood and he does a
better job of distinguishing between the real world and the “irreal”
world of wishes and fears.
Nursing - is an organized framework of concepts and purposes designed to guide the practice.
Behavior – a dynamic balance of forces working in opposing directions.

“If you want to truly understand something, try to change it”

Interpersonal Theory
Harry Stack Sullivan
◦ Born: February 21, 1892. Norwich, New York, U.S.
◦ Died: January 14, 1949. he died alone in Paris
France, at the age of 56
◦ Graduatedd High School as a valedictorian
◦ 1915 – He finished his studies.
◦ 1917 – Received his degree from Chicago.
◦ Enrolled for Medicine received degree, 2 Years After graduation.
◦ Poor relationship with father.
◦ Had one close friend named; Clarence Bellinger
◦ Smart but socially lacking
◦ 1921 Worked with Alanson White at St. Elizabeth General Hospital
◦ Private practice in New York
◦ Formed group called “Zodiac Club”
◦ His work is neither Psychoanalytic nor Neofreudian
◦ Was born in a small farming community in upper New York State in 1892.
◦ He was an only child of his parents so that’s why he was a socially
◦ immature and isolated child.
◦ Academically Gifted.
◦ Died of Cerebral Hemorrhage on January 14, 1949
Major Concepts and Definitions
◦ American psychiatrist who developed a theory of psychiatry based on interpersonal
relationship.
◦ He believed that anxiety and other psychiatric symptoms arise in fundamental
conflicts between individuals and their human environments.
◦ Personality development also takes place by a series of interactions with other people.
◦ The first American to develop comprehensive personality theory.
◦ Interpersonal Theory focuses on relationships between people and Thus focuses on
the social context.
◦ States that without people humans would not be able to develop personality.
 ◦ However, anxiety can interface with his development at any stage.
◦ Healthy development is marked by persons having experiences of intimacy and lust
towards the other person.
Concept of Personality
◦ Interpersonal Theory views personality as an energy system.

★Tension ( Potentiality for Action)

★ Energy Transformation ( Actions Themselves )

What is TENSION ?
◦ Anxiety, premonitions, drowsiness, hunger, sexual excitement.
◦ Partial distortions of reality.
◦ Not always on a conscious level.
TWO TYPES OF NEEDS:

★ NEEDS
*Episodic
*Once satisfied they lose their power
*Results in productive behavior

★ ANXIETY
*Non-productive
*Disintegrative Behavior
What are NEEDS ?
~Brought on by the Biological Imbalance between a Person and their physiochemical
environment.
Types of NEEDS:

★ Zonal Needs- arises from a body part.

★ General Needs- Overall well-being.

★ Tenderness is an example of a basic general Interpersonal Need.

ANXIETY
~ Is disjunctive and calls for no consistent actions for its relief.
Sullivan cited anxiety as the chief disruptive force in healthy
Interpersonal relations.
~ Transferred through empathy.
ENERGY TRANSFORMATIONS
~ Basically Tensions that are transformed into actions.

★Can be overt

★Can be covert
◦ Might as well be called patterns of behavior.
◦ Split into 2 Major Classes
1. Those related to specific parts of the body
2. Second class is composed of three categories.

★ The Disjunctive – Destructive

• Such as Malevolence

★ The Isolating- Unrealted to interpersonal relations

• Such as Lust

★ The Conjunctive- Beneficial

• Such as Intimacy and Self-system
MALEVOLENCE
• Evil and Hatred
• Is usually adopted as a form of protection.
• Is developed around 2-3 years old, Whenever parents
Punish or rebuff their children.
EXAMPLES OF THESE PATTERNS OF BEHAVIOR ARE;
• Timidity
• Mischievousness
• Anti – Social behavior
LUST
• Assumes an isolating Tendency.
• Auto- Erotic behavior
• Increases anxiety and decreases self worth.
INTIMACY
Equal partnership integrating dynamisms that Draws out loving reactions from people.
 • Decreases loneliness and anxiety
• Rewarding experiences most healthy people Desire.
Levels of Cognition
• Refers to ways of perceiving, imagining, and conceiving.

★ Prototaxic- Undifferentiated experiences which are Highly personal.

★ Parataxic- Communicated to others in a distorted Fashion.

★ Syntaxic- Consensually validated and symbolically Communicated.

Stages of Development
 THEORY HIERARCHY NEEDS
ABRAHAM MASLOW
 Abraham Maslow was born on April 01, 1908 and died on June 8, 1970.
 Full name: Abraham Harold Maslow
 Maslow first studied law at the City College of New York
 He received his BA in 1930, his MA in 1931, and his PhD in 1934, all in psychology,
all from the University of Wisconsin.
 He began teaching full time at Brooklyn College. During this period of his life, he
came into contact with the many European intellectuals that were immigrating to the
US, and Brooklyn in particular, at that time -- people like Adler, Fromm, Horney, as
well as several Gestalt and Freudian psychologists.

NEEDS
 Something that is necessary for a living organism to live a healthy life.
 Deficiency would cause a clear negative outcome – deficiency or death.
 Can be Objective/ Physical or Subjective.
 Objective / Physical needs – Food, shelter, sleep and etc.
 Subjective needs - Affection, Acceptance, self- esteem and etc.

PHYSIOLOGICAL NEEDS
Needs:
 Air
 Water
 Food
 Rest
 Exercise
 Mostly, literal requirement for human survival.
 If not met, the human body cannot function.
 Metabolic needs – Air, water, food and rest.
 Clothing, shelter – needed by people and even animals.
  Could be classified as basic animal needs.

SAFETY NEEDS
Needs:
 Safety
 Security
 Protection
 Freedom from Fear
 Once physical needs are met, safety needs take over.
 Health and well-being.
 Financial Job and security.
 Safety of property against natural disasters, calamities, wars and etc.
 Law and order.

LOVE AND BELONGING

Needs:
 Love
 Belongingness
 Affection
 Need to love and be loved.
 Need to feel a sense of belonging and acceptance.
 Small groups – Clubs, Office teams, School/ college houses.
 Large groups – Political Parties, Sports teams, Facebook.

ESTEEM
Needs:
 Strength
 Status
 Respect
 Need to be respected by others and in turn respect them.
 Sense of contribution, to feel self-valued, in profession or hobby.
 Lower- Respect of others, the need for status, recognition, fame, prestige, and
attention.
 Higher- Self-respect, the need for strength, competence, mastery, self-confidence,
independence and freedom

SELF-ACTUALIZATION
Needs:
 Personal Growth and Development
  Fulfillment
 What a man can be, he must be.
 Intrinsic growth of what is already in a person.
 Growth-motivated rather than deficiency-motivated.
 Cannot normally be reached until other lower order needs are met
 Acceptance of facts, spontaneous, focused on problems outside self, without
prejudice.

Characteristics Common in Self-Actualized Individuals

Acceptance and realism:
 Self-actualization reflects the individual's acceptance of who he/she is, what he/she is
capable of, and his/her realistic and accurate perception of the world around him or
her.

Problem-centering:
 Self-actualized individuals are not purely focused on internal gain; they appreciate the
benefits of solving problems that affect others so as to improve the external world.

Spontaneity:
 The self-actualized individual thinks and acts spontaneously, as a result of having an
accurate self- and world-view. In spite of this spontaneity, these individuals tend to
act and think within the accepted social norms and according to the expectations of
others.

Autonomy and Solitude:

 While the self-actualized among us conform to societal norms and are often people-
centered in their problem-solving, they often display the need for personal freedom
and privacy.

Continued Freshness of Appreciation:

 No matter how simple, straightforward or familiar an experience, the self-actualized
individual is capable of seeing things from new perspectives and appreciating the
breadth and wonder of things in his/her world.

Continued Freshness of Appreciation:

 No matter how simple, straightforward or familiar an experience, the self-actualized
individual is capable of seeing things from new perspectives and appreciating the
breadth and wonder of things in his/her world.

Peak Experiences:
 These peak experiences are thought to produce invigorating feelings such as
inspiration, physical and mental vitality, and a renewed sense of perspective.
 GENERAL SYSTEM THEORY
Karl Ludwig Von Bertalanffy 1901 – 1972
 Born on September 19, 1901, in Atzgensdorf (near Vienna), Austria –Hungary
 1918 - Bertalanffy started his studies at the university level in philosophy and art
history, first at the University of Innsbruck and then at the University of Vienna
 1926 - He finished his PhD thesis “Fechner and the Problem of Higher-Order
Integration” on the psychologist and philosopher Gustav Theodor Fechner
 1934 - He received his habilitation in "theoretical biolo
 Bertalanffy was appointed Privatdozent at the University of Vienna
 1940 - He joined the Nazi Party, which facilitated his promotion to professor at the
University of Vienna
 1948 – Bertalanffy left Vienna due to denazification
 June 12, 1972 – Died from heart attack at the age of 70, in Buffalo, New York, USA

MAJOR CONCEPTS AND DEFINITIONS

SYSTEM
 A set of related components that work together in a particular environment to perform
function are required to achieve the system's objective.

GOAL SEEKING
 It is important to be able to identify the objectives of any existing or new system to be
able to understand it and evaluate its effectiveness

HOLISM
 Systems should be viewed as a whole
 A system is greater than the sum of its parts

OPEN SYSTEM
 Organizations are open to environment
 Permeable boundaries – information
and resources flow in and out
 Exchange with environment
 FEEDBACK
 To be effective and efficient a system
needs a feedback mechanism, whether the outputs of the system are what they
should
 A system should have the ability to adjust its inputs or processes to improve
the outputs. An ideal system is self-regulating
ENTROPY
 a measure of the degree of disorder in a system The concept of entropy says that any
system will tend towards disorder.
 Balance: energy, resources, and information coming into the system to help it reach
hemostasis or equilibrium

INTERDEPENCE
 Organizations are in dynamic, interconnected relationship with their environment
 PSYCHOSOCIAL DEVELOPMENT
ERIK HOMBURGER ERIKSON
 Born: June 15, 1902, in Frankfurt, Hesse, Germany
 Died: May 12, 1994 (aged 91)
 Father of Psychosocial Development
 His theory, Post-Freudian Theory
 He was an ego psychologist who developed one of the most popular and influential
theories of development.
 A world fame Psychoanalyst, Anthropologist, Psychohistorian and a Medical School
Professor. Yet he had no college degree of any kind.
 He was an artist and a teacher in the late
 1920s
 With Anna’s (Sigmund Freud’s daughter) encouragement, he began to study child
psychoanalysis at the Vienna Psychoanalytic Institute.
 He immigrated to the US in 1933 and taught at Yale and Harvard University.
 His theory is a reflection of his own background, that consist of arts, extensive travels,
experiences w/ varied culture and a lifelong search of his own identity

PERSONALITY
 Personality consists of all the relatively stable and distinctive styles of thought,
behavior, and emotional responses that characterize a person’s adaptions to
surrounding situations

ERIK ERIKSON’S THEORY IN

UNDERSTANDING THE SELF
 Individuals go through 8 psychosocial stages of
development.
 Emphasize or the development of the ego.
 Each stage consists of developmental tasks that
one needs to accomplish to develop successfully.
 During each stage, an individual also experience
life crisis which could have negative
consequences if not properly resolved.

1. TRUST VS. MISTRUST

 First year of life
 This stage begins at birth continues to approximately 18 months of age.
 The infant is uncertain about the world in which they live, and looks towards their
primary caregiver for stability and consistency of care.
 The child will develop trust if he/she is properly cared of

2. AUTONOMY VS. SHAME AND DOUBT

 Early childhood (18 months to 3
  years)
 Autonomy: independence of
 thoughts and confidence to
 think and act for oneself
 Children begin to assert their
 independence during this stage

3. INITIATIVE VS. GUILT

 Preschool age (3 to 5 years)
 Developing a sense of responsibility among children lead to the development of
initiative
 Children assert themselves more frequently through directing play and other social
interaction

4. INDUSTRY VS. INFERIORITY

 School age (5 to 13 years)
 Children face the task of developing knowledge and skills usually taught in school

5. IDENTITY FORMATION VS. IDENTITY CONFUSION

 adolescent period (13 to 19 years)
 Adolescents face the task of finding out who they are, what they are and what they
want in life.

6. INTIMACY VS. ISOLATION

 early adulthood (20 to 40 years) when people explore personal relationships.
 People develop intimate, loving relationships with other people.

7. GENERATIVITY VS. STAGNATION

 middle adulthood (40 to 65 years)
 Generativity, involves a person’s desire to contribute to the world by teaching,
leading, and guiding the next generation and doing activities that will benefit the
community.

8. INTEGRITY VS. DESPAIR

 Old age
 Begins at approximately age 65 and ends to death
 Focused on self-reflection on one’s life
 Individuals reflect on the important events of their lives.
 Theory of Moral Development
Lawrence Kohlberg (1920- 1987) , (Philosopher And Educator)
 Born on October 15, 1927 in Bronxville, New York.
 Graduated from Phillips Academy in Andover, Massachusetts in 1945.
 In 1948, he returned to the U.S and enrolled at the University of Chicago and
completed his B.A. in Psychology in one year.
 In 1958, he completed his Ph.D. in Psychology at the same university.
 In 1959, became an assistant professor of Psychology at Yale University.
 As a result of his doctoral dissertation research of the moral development of children,
Kohlberg found professional fame.
 In 1962, he returned to the University of Chicago as an associate professor and
director of Child Psychology Training Program.
 Rest of his career was spent as a Professor of Education and Social Psychology at
Harvard University from 1968 to 1987.
 Authored 9 books.
 Died on January 17, 1987 at the age of 59.

Moral Development Theory

 Kohlberg extended Piaget’s theory and proposed that moral development is a
continual process that occurs throughout the lifespan.
 Based his theory upon research and interviews with groups of young children and
presented a series of dilemmas to determine their judgment of each scenario.
 The theory explained moral development in a philosophical and psychological
context.

Morality
 the system one uses to decide what is right and wrong, how once conscience affects
choice.

Moral Development
 it refers to the capacity of the
individual to act in accord with
conscience and moral
imperatives rather than
egocentric values.

Major Concept
1. Preconventional Morality
2. Conventional Morality
3. Post-conventional Morality

Level one Preconventional Morality

  Usually occurs in early childhood development.
 A person is motivated by obedience by authority.
 Kids learn a fear of punishment/obedience.
 Self-interest
 Moral code is shaped by the standards of adults and the consequences of following or
breaking their rules.

Stage 1 Obedience & Punishment

 Earliest stage of moral development.
 Children see rules as fixed and absolute.
 Obeying rules is important to avoid punishment.
 Morality is motivated by punishment.

Stage 2 Individualism and Exchange

 Children accounts for individual points of view and judge actions based on how they
serve individual needs.
 Reciprocity is possible in this point in moral development, but only if it serves one’s
own interests.

Level two Conventional Morality

 Usually occurs in middle school.
 People focus on following social norms and customs.
 Teens learn to conform to others.
 Rules or laws are upheld.
 Reasoning is based on the norms of the groups to which the person belongs.

Stage 3 Interpersonal Relationship

 Referred to as the “good boy- good girl” orientation.
 At this stage person who are by now entering their teens, see morality as more than
simple deals.
 Focused on living up social expectations and roles.
 There is an emphasis on conformity, being “nice” and behave in “good” ways.
 Emphasizes the maintenance of happy interpersonal relationships and pleasing others.

Stage 4 Maintaining Social Order

 Considers the society as a whole when making judgement.
 Focus on maintaining social order and obeying laws. Doing one’s duty and respecting
authority.

Level Three Post-Conventional Morality

 Occurs in adolescence-adulthood.
 Judgement is based on self-chosen principles.
 Moral reasoning is based on individual rights and justice.
Stage 5 Social Contract and Individual Rights
 People begin to account for the differing values, opinions and beliefs of other people.
 Rules of law are important for maintaining a society, but members of the society
should agree upon these standards.

Stage 6 Universal Principle

 Based on respect for universal principle and the demands of individual conscience.
 Follow internalized principle of justice, even though its against the law.
 Moral judgment is motivated by one’s own conscience.
 This stage is based upon universal ethical principles and abstract reasoning.

Relevance to Nursing Practice

 Moral Development is relevant to the nursing practice as it influenced the ethics of
nursing.
 It helps nurses understand and develop a strong system of morals in order to uphold
strict ethics required of them.
 It also helps understand of how patients view things from right versus wrong.
 This will help the nurses to treat their patients with more understanding, compassion
and effectiveness.

Nursing Ethics
 Deals with the values pertaining to human conduct, considering the rightness and
wrongness of actions and the goodness or badness of the motives and end of such
actions.
 Nursing ethics is a system of principles governing the conduct of a nurse.
 It deals with the relationship of a nurse to the patient, the patients family, associates
and fellow nurses, and society at large.
 Interpersonal Theory of Nursing
Harry Stack Sullivan
 Harry Stack Sullivan, (born February 21, 1892, Norwich, New York, U.S.—died
January 14, 1949, Paris)
 Sullivan received an M.D. from the Chicago College of Medicine and Surgery in
1917. At St. Elizabeth’s Hospital in Washington, D.C.
 While engaged in clinical research at the Sheppard and Enoch Pratt Hospital in
Maryland (1923–30), Sullivan became acquainted with the psychiatrist Adolf Meyer
 Developing his ideas further, he applied them to the organization of a special ward for
the group treatment of male schizophrenics (1929).
 During the same period, he first introduced his concepts into graduate psychiatric
training through lectures at Yale University and elsewhere.
 Henry Stack Sullivan (September 18, 2013l psychiatry or Interpersonal
Psychoanalysis
 He proposed interpersonal theory of personality.
 He explained the role of interpersonal relationships and social experiences in shaping
personality.
 Sullivan graduated from high school as valedictorian at age 16. He entered Cornell
University intending to become a physicist , although he also had interest in
psychiatry .
 He also explained about the importance of current life events to psychopathology.
 The theory further states that the purpose of all behavior is to get needs met through
interpersonal interactions and decrease or avoid anxiety.
 He is also consider the father of interpersonal psychiatry, developed the Interpersonal
Theory of Nursing
 The Interpersonal Theory explains six developmental stages, which Stack Sullivan
calls “epochs” or heuristic stages
in development.

Major Concepts and Definitions

Stages of Development Sullivan
 explained six developmental
stages called "epochs" or heuristic
Stages in Development.
 Sullivan explained about three
types of self:
 The ‘good me’ versus the ‘bad me’ based on social appraisal and the anxiety
that results from negative feedback
 The ‘not me’ refers to the unknown, repressed component of the self.
 Sullivan's theory explains about anxiety, self system and self-esteem:
 Security operations –those measures that the individual employs to reduce
anxiety and enhance security.
  Self system – all of the security operations an individual uses to defend
against anxiety and ensure self esteem
 Sullivan's interpersonal theory provides the theoretical basis for interpersonal
psychotherapy (IPT) for depression and schizophrenia.
 Interpersonal theory proposes that depression develops most often in the context of
adverse events, particularly interpersonal loss. (Tasman 2008)
 He also wrote on techniques and approaches on psychiatric interview.
 The Interpersonal Theory explains three types of self: the good me, bad me, and not
me. The “good me” versus the “bad me” based on social appraisal and the anxiety that
results from negative feedback. The “not me” refers to the unknown, repressed
component of the self.

Anxiety: the “main disruptive force” in interpersonal relations.

Basic Anxiety: fear of rejection by significant persons.
Interpersonal Security: feelings associated with relief of anxiety, the point when all needs are
met or a sense of total well-being.
Parataxic Distortion: a person’s fantasy perception of another person’s attributes without
consideration important personality differences
Selective Inattention: how people cope with the anxiety caused by the undesired traits
Major Assumptions
Nursing-provides the basis for interpersonal psychotherapy to specifically address patients
with depression and schizophrenia.
Person- the purpose of behavior is for the patient to have his or her needs met through
interpersonal interactions, as well as decrease or avoid anxiety.
- people developed a personification of self and others through the integration of “good
me, bad me, and not me” perception (the self-system):

Environment- all psychological disorders have an interpersonal origin and can be

understood only with reference to the patient
Dynamisms
 Energy transformations become organized as typical behavior patterns that
characterize a person throughout a lifetime. Sullivan (1953b) called these behavior
patterns dynamisms, a term that means about the same as traits or habit patterns.
Dynamisms are of two major classes: first, those related to specific zones of the body,
including the mouth, anus, and genitals; and second, those related to tensions. This
second class is composed of three categories—the disjunctive, the isolating, and the
conjunctive.
Intimacy
 Grows out of the earlier need for tenderness but is more specific and involves a close
interpersonal relationship between two people who are more or less of equal status.
Intimacy is an integrating dynamism that tends to draw out loving reactions from the
other person, thereby decreasing anxiety and loneliness, two extremely painful
experiences. Because intimacy helps us avoid anxiety and loneliness, it is a rewarding
experience that most healthy people desire (Sullivan, 1953b).

Levels of Cognition
PrototaxicLevel
The earliest and most primitive experiences of an infant take place on a prototaxic level.
Because these experiences cannot be communicated to others, they are difficult to describe or
define. One way to understand the term is to imagine the earliest subjective experiences of a
newborn baby. These experiences must, in some way, relate to different zones of the body.
ParataxicLevel
Parataxic experiences are prelogical and usually result when a person assumes a cause-and-
effect relationship between two events that occur coincidentally. Parataxic cognitions are
more clearly differentiated than prototaxic experiences, but their meaning remains private.
Therefore, they can be communicated to others only in a distorted fashion. parataxic
distortion, or an illogical belief that a cause-and-effect relationship exists between two events
in close temporal proximity.
SyntaxicLevel
Experiences that are consensually validated and that can be symbolically communicated take
place on a syntaxic level. Consensually validated experiences are those on whose meaning
two or more persons agree.
Self System: The collection of experiences or security measures to protect against anxiety
Good Me: represents what people like about themselves and is willing to share with others
Bad Me: what people don’t like about themselves and not willing to share. Develops in
response to negative feedback with feelings of discomfort, displeasure, and distress. The
“Bad Me” creates anxiety.
Not Me: the aspects of self that are so anxiety-provoking that the person does not consider
them apart of the person. It contains feelings of horror, dread, dread. This part of the self is
primarily unconscious (dissociative coping).
Infancy
Infancy begins at birth and continues until a child develops articulate or syntaxic speech,
usually at about age of 18 to 24 months. Sullivan believed that an infant becomes human
through tenderness received from the mothering one. The satisfaction of nearly every human
need demands the cooperation of another person. Infants cannot survive without a mothering
one to provide food, shelter, moderate temperature, physical contact, and the cleansing of
waste materials.
Childhood
The era of childhood begins with the advent of syntaxic language and continues until the
appearance of the need for playmates of an equal status. During childhood become reciprocal;
a child is able to give tenderness as well as receive it.
Juvenile
The juvenile era begins with the appearance of the need for peers or playmates of equal status
and ends when one finds a single chum to satisfy the need for intimacy. During the juvenile
stage, Sullivan believed, a child should learn to complete, compromise, and cooperate.
Preadolescence
It is the time for intimacy with one particular person, usually a person of the same gender.
Sullivan called this process of becoming a social being the “quite miracle of preadolescence”,
a likely reference to the personality transformation he experienced during his own
preadolescence.
Early Adolescence
Early adolescence begins with puberty and ends with the need for sexual love with one
person. It is marked by the eruption of genital interest and the advent of lustful relationships.
As with most other stages, however, Sullivan placed no great emphasis on chronological age.
Late Adolescence
Late adolescence begins when young people are able to feel both lust and intimacy toward
the same person, and it ends in adulthood when they establish a lasting love relationship. Late
adolescence embraces that period of self-discovery when adolescents are determining their
preferences in genital behaviour.
 Overall, Dr. Sullvian was a prominent theorists with regard to understanding the
magnitude of interpersonal relationships. Hildegard Peplau also credited her
theoretical approach of nursing interventions with psychiatric patients based on
Sullivan’s theory. It is unfortunate that he doesn’t get more recognition but that’s
why additional context was given to provide more consideration.