The Intimacy Need in Psychotherapy

IN The Continuous effort to conceptualize the psychotherapeutic process, a gradual but profound change of the theoretical framework has taken place. From the initial psychoanalytic point of view and its derivatives which considered the patient and the therapist as distinct, separate and almost unrelated entities, we have come to adopt a theoretical position that lays emphasis instead on the relationship and seeks to understand the happenings of psychotherapy in terms of the patient-therapist interaction.

The immediate result of this shift in theoretical position and orientation has been a greater awareness of the relevancy of interpersonal factors and the disclosure of the hitherto unrecognized importance of certain variables. It is the purpose of this paper to draw attention to one such variable, namely the fulfillment of an instinctual need for intimacy, and to inquire into the part that such need may play in interactions in general, and in the psychotherapeutic process in particular.

An early enunciation of the intimacy need is found in the works of Harry Stack Sullivan.1 Sullivan referred to the need for intimacy as a powerful motivational system, instinctual in nature. He pointed out its importance in human behavior and equated loneliness with its unfulfillment. Regrettably, in psychiatry the term “intimacy” never quite outlived its more prosaic connotations and, perhaps for this reason, Sullivan's conception of an instinctual intimacy need failed to arouse much theoretical interest and remained marginal to the main stream of psychiatric thought. Therefore, we may begin by saying, by way of a definition, that the term “intimacy need” refers here to the instinctual (i.e., born with) need that human beings have for contact with other human beings. In this sense the need for intimacy is to be understood at the same level with other needs, such as the need for anabolic materials or for fluids whose importance to the maintenance of the human organism is indisputable.

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