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It has been More than Fifty Years since Harry Stack Sullivan suffered a fatal illness while on a mission for the World Health Organization. Members of the Washington School of Psychiatry, founded by Sullivan and a group of colleagues in 1936, initiated a commemorative conference under joint sponsorship with the William Alanson White Institute, which became the intellectual home of interpersonal psychoanalysis, based on his ideas. It is instructive to return to Sullivan's seminal writings with a view to considering how they have been expanded, revised, reinterpreted, and sometimes discarded in the exciting ferment of contemporary psychoanalytic theorizing. With this in mind, I offer this essay, which sketches the trajectory of Sullivan's central premises and suggests certain lines that might be pursued in the creation of a new, more comprehensive psychoanalytic paradigm. In the course of this discussion, certain distinctions are drawn between Sullivan's ideas and those of Freud and others who were writing at the same time. Interpersonal ideas are presented in opposition to orthodox theory, in order to highlight the historical perspective under consideration. There is the possibility that such a comparison might be read as maintaining the polarity between the interpersonal and Freudian schools. That is not my intention and certainly not my goal. In truth, such polarity hardly exists any longer. Contemporary theorists from all groups are considering common questions and finding common solutions. Indeed, I hope my essay will be read as searching for certain central positions that I believe are crucial for a new, integrative psychoanalytic paradigm.
Last year I participated in an ecumenical gathering, sponsored by the journals of the PEP-CD-ROM. My mother visited while I was writing my paper, and, as only a mother can, she asked how my business was doing, because she had read that managed care threatened to eliminate our fees. I tried to reassure her that this is really a