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In the earliest writings by Freud (1901/1960) on “war neurosis,” as it was then called, his first observations were those of a surviving soldier mourning the death of a brother-in-arms. Freud does not initially speak of Oedipal conflict, libido, or an interaction among id, ego, or superego in these seminal writings. He speaks instead of how one friend misses another. At its heart, this is an interpersonal perspective. I also am interested in the interpersonal aspect of working with veterans and the symptoms of war neurosis, known now as posttraumatic stress disorder (PTSD), and more often associated with fear or with biological dysfunction.
I draw my theory from my training at the White Institute, and specifically from Harry Stack Sullivan (who was a veteran himself), one of the Institute's eminent founders, and his landmark work, The Interpersonal Theory of Psychiatry (1953). For Sullivan, pathology exists because of pathology in the patient's relationships. No psyche exists in a vacuum. Even when alone, the totality of a patient's existence comes from relationships with those living and dead.
From the interpersonal perspective, the symptoms of PTSD, while certainly glaring and present, are not quite as monolithic as in other paradigms, and certainly not as reductive as a mere collection of symptoms to be medicated and nothing more. If we focus solely on symptomatic relief of PTSD symptoms, we are at risk for missing entirely the deeper psychological meaning of PTSD. This meaning can be found in relationships with others, and the deeper levels of healing cannot be attained without exploring these relationships.
I would also submit that the interpersonal approach focuses on early relationships affecting current relationships; what's past is prologue. This is of significance analytically, because a child's first relationships with caregivers are their first relationships with people in positions of supreme authority, and relationships with authority figures are the bedr