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There are significant basic, explicit contributions to the themes in this paper, made in the 1940s by Harry Stack Sullivan and Frieda Fromm-Reichmann, that should not be overlooked. Also, in the 1950s Sandor Rado made significant clinical interpretations about rage and withdrawal in the depressions that are relevant to this theme.
In Conceptions of Modern Psychiatry (1940), Sullivan presents as one of his basic assumptions that “One assumes that everyone is much more simply human than unique, and that no matter what ails the patient, he is mostly a person like the psychiatrist”. His next basic assumption is that
one accommodates to the apparent prevailing tendencies. When … my patient will say nothing further about the cause of the staring and is obviously unfriendly, I accept the fact that this line of inquiry is for the present ended … [and] it is important that I avoid any irrational performance called out by the rebuff.… I do not fold my psychic hands in mute acceptance of a juvenile “the patient will not cooperate” … I take up another line of inquiry.
His last basic assumption is that
personality tends towards the state that we call mental health or interpersonal adjustive success, handicaps by way of acculturation notwithstanding. The basic direction of the organism is forward. Regardless of the warp incorporated in the self, the psychiatrist, given sufficient insight and skill, may expect favorable changes to ensue from his study of the patient's situation. (p. 96)
Sullivan reinforces his point:
as a person seeks … to correct deficiencies in diet, so also one seeks for experience which will correct his deficiences in acculturation. This is another way of saying that there is a tendency to achieve mental health. (p. 99)
Turning to , in Remarks on the Philosophy of Mental Disorder (1946), she states,
Every general practitioner knows that many physical symptoms are not only expression of the patient's disease but also an expression of the tendency in the