What is Interpersonal Psychoanalysis?

A Writer Trimming his Pen, Painting by Jan Ekels the Younger, 1784

Interpersonal psychoanalysis is a branch of psychodynamic therapy that focuses on the role of relationships in shaping personality and emotional well-being. This approach was developed by American psychiatrist Harry Stack Sullivan in the early 20th century and focuses less on intrapsychic drives like classic psychoanalysis, and more on the interpersonal environment. Sullivan believed that our sense of self is constructed through interactions with others, beginning in childhood, and that disturbances in these interactions are contributors to emotional suffering. Therefore, the therapeutic relationship itself becomes a space for understanding how early relational patterns continue to impact present-day behaviour.

The primary goal of interpersonal psychoanalysis is to help individuals gain insight into how their relational patterns, especially maladaptive ones, affect their current emotional and interpersonal difficulties. Therapists pay close attention to “selective inattention,” or the aspects of experience that clients avoid or overlook. In doing this, patients can begin to uncover how early attachments and interpersonal experiences shaped their sense of identity.

The Titan's Goblet, Painting by Thomas Cole, 1833

Interpersonal psychoanalysis is particularly effective when patients present with emotional struggles coming from relational conflicts or unresolved psychological trauma. Patients often come to therapy with difficulties in forming or maintaining meaningful relationships, making decisions, or processing unresolved grief, which is typically linked to past experiences where emotional needs were unmet, resulting in internalized shame, self-doubt, or emotional disconnection. Interpersonal psychoanalysis helps bring these underlying conflicts into awareness and allows patients to explore how they have constructed multiple versions of the self over time to cope with relational pain.

The therapeutic process involves identifying one or more of four primary problem areas: unresolved grief, role disputes, role transitions, and interpersonal deficits. Once the central issue is clarified, the therapist and patient can collaboratively explore how this issue has impacted the patient’s functioning and mental health. For example, unresolved grief may lead to emotional numbness or depressive symptoms, while role disputes can come from unmet relational expectations. Role transitions, such as becoming a parent, changing careers, or moving to another country, can unsettle one’s identity and lead to distress. Interpersonal deficits refer to long-standing difficulties in initiating or sustaining close relationships.

Interpersonal psychoanalysis remains a valuable method within the psychodynamic tradition, especially for individuals whose struggles come from their relational history and identity formation. It offers a human-centered path toward healing with the belief that change occurs through understanding our patterns of connection with others.