The Island of Dr. Sullivan.

ALLEN, MICHAEL STUART

This is the only way he [Sullivan] satisfied himself, knowing that they were all homosexual, knowing that he was homosexual. I think toward the end he let the hairpins all come down.

William Elliot

The patients could hug, embrace and kiss the attendants without feeling rejected, odd, embarrassed or humiliated.

Arthur Linton

Similia similibus curantur. ("Like cures like.")

Harry Stack Sullivan

IN 1924 a young doctor, Harry Stack Sullivan, was put in charge of a ward for schizophrenics at Baltimore's Sheppard-Pratt Hospital. Though he had little formal training in psychiatry and an unpromising record of short-lived jobs dating back ten years, Sullivan was given free reign to experiment, and he hit the ground running with new and very well-developed ideas. Over the next five years he would become the first person to explore systematically the therapeutic milieu and use para-professionals to treat hospitalized schizophrenics--a revolutionary approach in the 1920's. What's more, as I discovered while doing research into Sullivan's life, this five-year experiment with schizophrenics was even more radical than history has recorded: Virtually all the ward attendants (who were selected and trained by Sullivan himself) and all the patients were homosexual men.

Although Harry Stack Sullivan (1892-1949) was a leading figure in American psychiatry for more than two decades, his personal life remains obscure--despite a putatively exhaustive 1982 biography by Helen Swick Perry, Psychiatrist of America: The life of Harry Stack Sullivan. Perry, Sullivan's secretary during the last three years of the psychiatrist's life, hints at--but ultimately denies--her employer's homosexuality. However, rumors flourished long before Sullivan died and continue to this day, fueled by his extreme secrecy regarding his early life and the fact that he shared his home for 22 years with another man, Jimmie Inscoe. A. H. Chapman, in his 1976 book Harry Stack Sullivan: His Life and His Work, charged that these rumors have served both to cloud and to diminish Sullivan's reputation. I can still recall a professor in the 1970's, when I was a graduate student, who, with a begrudging nod to Sullivan's contributions, dismissed him as "an alcoholic, a schizophrenic, and a homosexual." Even as far ba ck as 1923, William Alanson White, Sullivan's boss at St. Elizabeth's Hospital in Washington, D.C., wrote in a letter of recommendation that Sullivan was "a witty Irishman, who has a facade of facetiousness which it is a bit difficult to penetrate." Behind that facade, he added, "was a considerable discontent that might perhaps express itself in alliances with other discontented spirits."

Sullivan called his groundbreaking approach the "interpersonal theory of psychiatry." He argued for the power of interpersonal relationships to shape character past early childhood and beyond the drama of the nuclear family. The warmth and approval of aunts, uncles, grandparents, teachers, and especially friends could be forces for growth at any age. Disapproval could create anxiety so destructive that neurosis and even schizophrenia might result. While his friends anointed him as the "American Freud," he might better be seen as the man who Americanized Freud. He believed deeply in the value of psychotherapy, but also that therapy must at some point come to an end--and why should a therapist be needed to achieve healing effects? He added an American-style optimism to Freud, in his belief that at any time, just around the corner, you might encounter someone who could change your life--such was the transformative and healing power of friendship.

In beginning my research into Sullivan's homosexual inclinations and their effect on his research, I was at first encouraged by a conversation with Dr. Bert Schaffner, a psychiatrist with the William Alanson White Institute in New York, a training institute founded in part by Sullivan. In the 1950's, Schaffner's training analyst had been Clara Thompson, Sullivan's closest friend. She had told Schaffner that Sullivan was gay and that Jimmie Inscoe, the man he lived with, was indeed his lover.

I went on to interview Helen Perry and many of Sullivan's colleagues, friends, and students. A common theme emerged: Perry and the others described Sullivan as a passionate, committed intellectual whose personal life was barren, frustrated, and, to their knowledge, largely asexual. Even Sullivan contributed to this vague asexual image by describing himself, according to Perry, as merely "a slight, bespectacled mild-looking bachelor with thinning hair and a mustache."

Even if he was homosexual (or bisexual), had Sullivan successfully sublimated his passions into his career and his professional friendships? This was Perry's thesis, and almost everyone I interviewed assured me that she was the foremost authority--at least among those who would speak on the subject. Several angrily refused: one slammed the phone down in mid-conversation, while another accused me of trying to destroy Sullivan's reputation. Dr. David Scharf, then director of the Washington School of Psychiatry (also founded by Sullivan), terminated our interview when he learned of my interests. Dr. Margaret Rioch said she would not repeat "gossip and innuendo," suggesting I give up and write a novel instead. Gradually, the image of Sullivan as simply a fussy, asexual "bachelor" began to take root in me, too.

Rioch did, however, send me to a Dr. Benjamin Weininger, one of Sullivan's more obscure colleagues. "Benny's heterosexual," Rioch had said, "but he was a wild guy for our crowd. He had a baby out of wedlock, several divorces, many affairs, and he moved to Los Angeles," as if no more need be said. Traveling to California, I found Weininger in a house overlooking Santa Barbara. "He was one, you know," Benny said when asked about Sullivan's rumored homosexuality. "Everyone who knew him, knew he was a homosexual." Stunned by his candor, I asked tentatively how exactly he knew. Weininger stated flatly that he and Sullivan had had sex--twice, in 1937 or maybe in '39. Both encounters were after a few drinks at Sullivan's New York home on East 64th Street, when Weininger was a psychiatrist-in-training and Sullivan was his supervisor. I asked whether Weininger himself was bisexual, to which he replied with a laugh, "Not at all." But he and another heterosexual male colleague had "tried it out" a few times as a form o f research into the causes of paranoid schizophrenia. "We assumed in those days," he said, "that paranoid schizophrenia and homosexuality were causally linked."

Weininger assured me that he had not felt coerced into having sex with Sullivan, but instead was curious--and he admired his teacher. Beyond his undoubted homosexuality, my informant knew little more about Sullivan's personal life, but did recall that Sullivan had "premature ejaculations" both times they had sex.

RUMORS flourish best in the absence of facts, and Sullivan left very few facts about his life before his arrival in Washington, D.C., at the age of 29. What's known is that Sullivan grew up in the upstate New York farming community of Smyma; his grandparents were poor Irish immigrants; he was an only child with few friends, raised Catholic in a largely Protestant community in an age when religious differences mattered. Both parents were remote and unhappy, but he was close to his Irish-born grandmother and to his aunt, his mother's sister, Margaret Stack, a school teacher in New York City. He often visited her, and she encouraged him, financially and otherwise, to pursue a professional career. Margaret Stack may have influenced him in another way: She was, I learned from Perry, a lesbian, and lived for many years with her lover at the St. George Hotel in Brooklyn Heights.

In 1908 Sullivan left home to attend Cornell. He had been the valedictorian of his high school class, but at Cornell (where he planned to study physics) his grades were poor; he was suspended and refused readmission. Something appears to have happened--Perry speculates that it involved a petty crime, leading to a psychiatric hospitalization. Deepening the mystery, Sullivan then disappeared for two years. He would never speak publicly about what went wrong at Cornell or where he spent those missing years.

In 1911 he surfaced in Chicago, where he enrolled in the Chicago College of Medicine and Surgery--although he'd never before shown an interest in medicine. Again, he was plagued by poor grades, but this time he completed his studies. Over the next few years, Sullivan struggled to establish a medical career, drifting from one job to another until 1916, when he enrolled in the National Guard. He was soon discharged under ambiguous circumstances, echoing the mysterious expulsion from Cornell. Nothing is known about his personal life during these years, although Sullivan did tell friends that he saw a psychotherapist in 1915, an unexpected decision for a young man of limited means. Years later, Jimmie Inscoe would tell Perry that Sullivan had been upset over the death of a medical school classmate, a man with a "French name."

What are we to make of Sullivan's secretiveness about the events at Cornell and his two-year "disappearance"? Why the scant details about his life in Chicago? His lifelong silence suggests, of course, that there was something to hide. Perry wrote that Sullivan told her he suffered from schizophrenia. She spent twenty years looking for evidence that he'd been hospitalized between 1909 and 1911 but found none. Certainly his highly productive career is not consistent with chronic schizophrenia. But if the secret involved his homosexual activities during this period, a different picture of his early adult life emerges: A shy young man suffers a nervous breakdown at college, disappears for two years, engages in activities about which he dare say nothing in later life. He certainly appears to have had himself in mind when he wrote:

many people whose self-esteem has been somewhat uncertain, depending on scholarship only, find their standing as students rapidly declining as they become completely preoccupied with the pursuit of lust objects. Thus they become the prey of severe anxiety, since their only distinction is now being knocked in half.

The ten years after 1911 are almost as mysterious. The few details we have are sketchy at best: below-par performance in medical school; professional drift; an unexplained dismissal from the National Guard; followed by meteoric (however belated) professional success. Is it too great a leap to argue that this is the story of a young gay man whose career played second-fiddle for many years to the all-consuming drama of coming out?

Furthermore, one might well ask how it transpired that such a confused young man would emerge from two years of obscurity determined to become a doctor and a psychiatrist--and a rather ambitious one at that. Irving Alexander, in his book Personology (1990), presents the fascinating thesis that during those two "missing" years after Cornell, Sullivan may have been involved with a man, possibly a doctor, who became his sexual and professional mentor following a period of profound confusion.

On first reading, Sullivan's life after 1921 appears to be thoroughly documented by Perry: Sullivan embraces the profession of psychiatry; there are no more disappearances; friendships with colleagues fill his life. He becomes a leader among the so-called "neo-Freudians," which also included Karen Horney, Erich Fromm, Frieda Fromm-Reichman, and Clara Thompson--all of whom rebelled against psychoanalytic orthodoxy by looking at human character in the larger context of human society and social interaction. He played a key role in establishing the William Alanson White Institute in New York and the Washington School of Psychiatry in D.C., where he spent the latter part of his life until his untimely death (in Paris) in 1949 at the age of 57. There followed some unsubstantiated rumors of suicide.

Perry argues that Sullivan subordinated his sexual and emotional needs to his driving passion, which was psychiatry, and grieved over his failure to marry, haunted as he was by a pervasive loneliness. But a closer reading reveals an evasiveness in Perry's account, an unwillingness to record all she knew: "Friends and colleagues of Sullivan's," she writes, "by their 'direct knowledge,' report that he had some sexual experiences with women as well as with men. ... But there is no ready label for how he lived and thought and yearned." On the puzzling subject of how 16-year-old Jimmie Inscoe came to share a home for 22 years with that "mild looking bachelor," Harry Stack Sullivan, she writes innocently that no one would tell her the answer. She does reveal that among close friends Jimmie was known as "the man who came to stay." That she did know more became clear on a quiet fall afternoon in her Cambridge, Massachusetts home, when she confided to me, with obvious discomfort, that this man had been a male hustler on the streets of Washington, D.C.

AN important contribution to our knowledge about Sullivan is Kenneth Chatelaine's Harry Stack Sullivan: The Formative Years, a raw, apparently unedited publication of a doctoral dissertation--an "intellectual biography"--long out of print and difficult to locate. While dismissing the notion that Sullivan was homosexual (based on an interview with the Smyrna town librarian), Chatelaine includes an astonishing chapter on Sullivan's work at Sheppard-Pratt that explodes both the image of Sullivan as a lonely bachelor and as a repressed homosexual. It appears that in the 1920's, on the eve of professional success and financial security, Sullivan was engaged with his sexuality.

It was in 1927 that he met Jimmie Inscoe, which marked a profound change in Sullivan's life. The circumstances of their meeting are unclear, but Inscoe soon moved in, and they shared a home until Sullivan's death 22 years later. Jimmie became Sullivan's secretary, housekeeper, office manager, and longtime companion. His place in Sullivan's life was complex and ambiguous, even to friends; he was known to the public as "Harry Stack's foster son" and took to calling himself Jimmie Sullivan, although they had no official relationship and Jimmie never legally changed his name. Several of Sullivan's colleagues told me they assumed Jimmie had been Sullivan's patient.

Were they, in fact, lovers? Harry Biele, a gay man and a patient of Sullivan's friend Clara Thompson, remembered meeting them at a party at her Greenwich Village home in the 1930's. They certainly looked like a couple, he recalled; they weren't making out in the corner--neither were the straights--but what else would this 40-year-old doctor be doing at a party with a 20-year-old at his side. Philip Sapir, whose famous father, anthropologist Edward Sapir, had been a close friend of Sullivan, remembered as a teenager visiting Harry and Jimmie at their summer home in Maine. He knew them well and was only mildly surprised, he told me, to find that they shared a bed. In 1927, Sullivan also wrote a largely sympathetic review of a book entitled The Invert and His Social Adjustment. The author called himself "Anomaly." This book, an extraordinary document for its time, made a case for compassion, tolerance, and understanding for homosexuals. (Still, the author concluded on a sorrowful note: "In the whole series of p arallels between the invert and normal man there is none more striking nor more pitiful than the invert's attempt to find peace and satisfaction in the achievement of a permanent union with some similarly conditioned man.")

Meanwhile, Sullivan's work with schizophrenics at Sheppard-Pratt had brought him international recognition. Despite his lack of formal training as a psychiatrist, he had developed a very specific theory on the cause of schizophrenia and its treatment. Sullivan believed that there is a critical period before adolescence when acceptance by one's peers is crucial for the development of a strong, intact personality. A person who misses such acceptance never feels quite at home in the world or with himself, a feeling that's at the root of schizophrenia. For such a person, the damage can be undone through the introduction of warm, empathic relationships with peers in a carefully controlled setting.

To test this theory, Sullivan endeavored in his experiment (among other elements) to recreate for his patients a kind of preadolescent world. Doctors and nurses were banished from the ward and replaced by ward attendants selected and trained by Sullivan himself--young men who were shy and sensitive, men who had perhaps struggled in their own lives and would feel a natural empathy toward the patients. What's more (according to his friend Clifton Read), all of Sullivan's patients and attendants were young homosexual men, and physical affection was encouraged as part of the treatment. From Kenneth Chatelaine's interview with William Elliot, an attendant on the ward, we learn that:

Sullivan was attempting to take his patients through a stage of development that they had missed. His theory was that homosexual intimacy was a stage to be lived and worked through, and that when arrested at the homosexual stage could lead to schizophrenic thinking. Sullivan's theory of therapy was to show these patients that they were not inhuman for such feelings and activities by having homosexual attendants interact with them.

Elliot also notes that Sullivan was known as "Miss Sullivan" among the staff, and argues that he "was getting vicarious experience in working with these young homosexuals. This is the only way he satisfied himself, knowing that they were all homosexual, knowing that he was homosexual. It was just like a ringmaster. You jump but I am not going to jump. And I think toward the end he let the hairpins all come down." Arthur Linton, a nurse who came to work at Sheppard-Pratt in 1929, confirmed to Chatelaine that Sullivan was gay, adding that "all of his patients were young male homosexuals. The attendants were of the same background, homosexuals who were potentially schizophrenic. The reason was therapeutic. The patients could hug, embrace, and kiss the attendants without feeling rejected, odd, embarrassed or humiliated." The experiment ended in 1929 when Sullivan resigned in a dispute ostensibly about funding.

Just what was Sullivan up to at Sheppard-Pratt? In a 1929 article he spelled out the theory behind his unorthodox approach, arguing that a homosexual phase in the pre-adolescent stage of development is necessary to achieve heterosexual intimacy and that the failure to explore one's sexuality during those years can result in schizophrenia.

If this theory seems strange, its origins obscure, recall that in the age of Freud psychologists were at liberty to draw from their own emotional experience as a source of evidence for their theories. Sullivan had told Helen Perry that he suffered from schizophrenia after Cornell, the very illness that he later associates with adult homosexuality. Whether it really was schizophrenia is beside the point. If Sullivan believed it was, then he may well have leapt from this personal experience to a view of schizophrenics as people who had failed to come to terms (as Sullivan had) with their adolescent sexual terror. And if there's any doubt of Sullivan's radicalism on the subject of sex, consider his recommendation in 1929 to the World League for Sexual Reform: "that sexual experience be provided for all youths in the homosexual phase of personality genesis in order that they might not become hopelessly lost in the welter of dream-thinking and cosmic fantasy making up mental illness." He was, after all, talking a bout twelve-year-olds.

SEVENTY years later, it is impossible not to ask if Sullivan's work at Sheppard-Pratt was motivated by other than purely scientific concerns. Elliot suggests that it was designed as a place where he could be a voyeur (at least at first), while Linton argues that it became for Sullivan a safe haven where gay men could find acceptance among their own kind. Both suggest that Sullivan was himself changed by the experiment. Another clue may lie in Sullivan's 1929 trip to Europe with his close friend, the political scientist Harold Lasswell. In Berlin they met Billy Silverberg, a young American psychiatrist (who later achieved notoriety as Montgomery Clift's analyst). Silverberg joined Sullivan and Lasswell, and the three spent their holiday exploring Berlin. According to Helen Perry, both Lasswell and Silverberg were quite open about their homosexuality. In 1929, Berlin was a relatively open city for homosexuals, as we know from Isherwood's memoirs, among them Christopher and His Kind, in which he recounts his day s exploring the Berlin scene with his pals W.H. Auden and Stephen Spender. Before leaving for Berlin, Sullivan concluded his talk to the World League for Sexual Reform with these words, suggesting that he may have emerged from the 20's as a man more at peace with himself: "... any sexual adjustment which has brought a large measure of satisfaction ... seems to guarantee an individual from grave mental disorder."

For all this, we still have only fragmentary evidence to reveal how Sullivan may have experienced himself as a homosexual. His friend Clifton Read told me Sullivan claimed he had lost his virginity to his (male) high school principal. Phil Sapir, lowering his voice to a whisper (as his wife made us sandwiches in the kitchen), recalled how Sullivan sweetly made a pass at him when he was a student at Yale. Among the memorabilia kept by Jimmie Inscoe I found a series of playful homoerotic photographs of himself and a series of index cards on which he kept track of holiday greetings sent by "Harry and Jimmie" to friends in the 1940's. Still, researchers, myself included, have found no diaries, and only a few letters remain--letters that reveal a witty and observant man with many friends. And yet, Sullivan was an active correspondent: where are the letters? Jimmie left behind a photo scrapbook, but why only one picture of Harry and Jimmie to-gether?

One of his students, the psychiatrist Ruth Moulton, inadvertently provided me with an insight into what it may have been like to be homosexual in the world of 1940's psychiatry. Had I ever worked with homosexuals, she asked, one therapist to another, as we sat in her dark, heavily draped Upper West Side apartment? I had told her I was gay, but it was as if she could not take in this detail about me. She then spoke tenderly and precisely about the sexual fixations of her first lesbian patient, which reminded me of how homosexual patients were talked about when I was in training in the 70's, as a distant specter that one never expected to encounter outside one's professional life. And I realized just how invisible Sullivan's gayness would have been to his colleagues back in the 30's and 40's, and how easy it would have been, having lived a life of ironic detachment, to keep them in the dark.

Michael Stuart Allen is a research associate at the Center for Research and Education in Sexuality at San Francisco State.

References

Alexander, I. Personology: Method and content in personality assessment and psychobiography. Duke University Press, 1990.

Anomaly. The Invert and His Social Adjustment. Bailliere, Tindall & Cox (London), 1927.

Chapman, A. H. Harry Stack Sullivan: His life and his work. G. P. Putnam's Sons, 1976.

Chatelaine, K. Harry Stack Sullivan: The formative years. University Press of America, 1981.

Isherwood, C. Christopher and His Kind. Farrar, Straus and Giroux, 1977.

Perry, H. S. Psychiatrist of America: The life of Harry Stack Sullivan. Belknap Press, 1982.

Sullivan, H. S. Review of The Invert and His Social Adjustment. In American Journal of Psychiatry, 7, 1927, pp. 532-537.

Sullivan, H. S. Schizophrenia as a Human Process. W. W. Norton & Company. 1962

Sullivan, H. S. The Interpersonal Theory of Psychiatry. W. W. Norton & Company, 1953.

Sullivan, H. S. Personal Psychopathology. W. W. Norton & Company, 1972.