Pathological Psychoanalysis

International Journal of Cultic Studies, Vol. 5, 2014, 45-51.

Pathological Psychoanalysis: An Insider’s View of the Sullivanian/Fourth Wall Psychotherapy Community

Amy B. Siskind


This account focuses on the four therapists I had during the 21 years that I was involved with the Sullivan Institute/Fourth Wall community. I have been out of the community for 28 years. My experiences with each therapist were very different and occurred at different stages of my life within the group. I recount in this paper both how I experienced and was influenced by these therapists while I was in the group and my later reflections after I had left the group. My narrative focuses on both the therapists’ positive and negative influences in my own life and in the lives of others.[1]

Brief Description of the Sullivan Institute/

Fourth Wall Community

The Sullivan Institute/Fourth Wall community (referred to by members as “the group”) slowly evolved around the analysts and patients of the Sullivan Institute, a psychoanalytic institute founded in New York City in 1957. The founders viewed this enterprise as an attempt to build upon the theories and clinical work of Harry Stack Sullivan. Sullivan was a well-known American psychiatrist and psychoanalytic theorist who lived from 1892 to 1949; he was one of the founders of the William Alanson White Institute in New York City and the Washington School of Psychiatry in Washington, DC. Jane Pearce, MD, who, along with her husband, Saul Newton, founded the Sullivan Institute, was a former student of Sullivan.

Newton was not a psychotherapist by training; he had been an active member of the Communist Party of the United States, and he claimed to have fought in the Spanish Civil War with the Abraham Lincoln Brigade. He held an administrative position at the William Alanson White Institute. Pearce and Newton attempted to integrate Marxist and psychoanalytic theories with regard to developmental psychology and psychoanalytic theory. Their book, Conditions of Human Growth, published in 1963 (Citadel Press), was an explication of their theory.

Pearce and Newton believed that the nuclear family was the cornerstone of an unhealthy and selfish society. Specifically, they viewed the relationship of mothers to their children as the cause of almost all psychopathology, and also as the basis of all individual limitations. They believed the mother to be the first agent of repression in the individual’s life. Only those needs of the infant that she responded to would be met and become conscious—the child would repress all others. Therefore, in order to enable children to become healthy adults, Pearce and Newton deemed it necessary to make radical changes in the structure of the family and in child-rearing practices. The Sullivan Institute/Fourth Wall therapeutic community was an outgrowth of this ideology. In the formative years of the community (1957 to 1970), the leadership undertook the creation of “hitherto unconceived social forms”[2] by advising patients to formally break off contact with their families of origin, by advising childless patients not to have children, and by requiring members who were already parents either to send their children to boarding schools or to hire full-time caregivers and housekeepers. In the later years (1971 to 1992), most children lived in communal households with one parent and a group of same-sex roommates. Young children spent most of their days and nights in the company of paid caregivers and other community children.

Ralph Klein

My mother became a patient of a Sullivan Institute psychotherapist when I was 5 years old. She divorced my father and was awarded custody of my brother and me; my father had visitation with us twice a week. When I was 10 years old, my mother moved in with a roommate who also was seeing a Sullivan Institute therapist and studying to be a clinical psychologist. I began psychotherapy with a Sullivan Institute psychotherapist in 1966, at age 13, the year my mother left the country to pursue her dissertation research in anthropology. I was living with my father and was feeling disoriented by my mother’s absence and also a bit uncomfortable at home with my father and new stepmother. I visited my mother’s ex-roommate, whom I had become close with during the time she lived with us. She was a clinical psychologist and urged me to see a therapist. I told her that, if I was going to see a therapist, I wanted to see her; but she said this wasn’t a good idea. She suggested that I call Ralph Klein, one of the training analysts of the Sullivan Institute and also a friend/boyfriend of my mother.

I started seeing Ralph (as I have always called him) once a week, unbeknownst to my father. I was a quiet, shy kid, and I had not done well at Hunter College High School in the 7th and 8th grades. I began the 9th grade at Hunter after I had moved in with my father. I was interested in boys, but very shy. Ralph was apparently trying to help me improve my self-esteem. He complimented me, told me how pretty I was, and asked me if I masturbated. I told him not really. He said I should go home and try it out. Then he followed up on this advice by asking me how it went. I didn’t really want to talk to him about it, and I somehow succeeded in avoiding the question.

I moved back in with my mother and my younger brother when they returned in June from their year away. My mother had not made plans for me for the summer, so Ralph offered to have me stay with him in his summer home in Amagansett, Long Island. My best friend, also the child of a community member, was invited to stay there, as well. We both spent the summer with Ralph, his two children, and their babysitter in Amagansett. I got a job as a counselor-in-training at a local day camp and went to work most days. While I was staying with Ralph, he made a lot of comments about my body. Some of them were explicit, others were not; but he encouraged me to engage in sexual activity. I began to have sexual encounters with boys whom I met over that summer. Ralph wanted to hear about them, and sometimes I told him. By the time I got to 10th grade, I had had a bit of experience, but not a lot.

Because I wasn’t doing well at Hunter High School, my parents had me apply to some private schools in Manhattan, and I switched schools for 10th grade. I started at Walden in the fall of 1968, and I was desperate to fit in with my new classmates. I used my new repository of sexual experience to act cool in school and to attract boys. In the meantime, I was still painfully shy and had difficulty entering the lunchroom at school because I became very anxious in the crowd of people and would not know where to sit.

In 11th grade, I dated two boys at the same time and enjoyed the notoriety. Ralph, I assume, was supporting these behaviors, and possibly even instigating them. The principal of our school didn’t seem happy about this situation. By 12th grade, one boyfriend had left for college and the other broke up with me. So I was boyfriendless in 12th grade and miserable. Ralph and my mother encouraged me to go to Cuba with the Venceremos Brigade.[3] I had a fantastic experience in Cuba; when I returned, it was the end of April 1970. I was about to graduate from high school, and I decided that I didn’t want to go to college right away.

In Between Therapists

I lived outside New York for the next year and a half. Then I returned to apply for college and to ask my father if he would pay for it. He agreed to do that, and I applied to the University of Arizona and left for Tucson in January of 1972. I encountered both academic and interpersonal problems in Tucson, partially related to a visit from my brother, who was 16 at the time and hitchhiking across the United States to Mexico. I felt responsible for my brother but couldn’t help him because I wasn’t mature enough. I became depressed and dropped out of school before the end of my first semester.

When I returned to New York City in the summer of 1973 I reentered psychotherapy with a Sullivan Institute therapist. Ralph Klein had referred me to Tina, a young woman in the new Sullivan Institute training program. Tina had a college degree, but not in psychology, and no advanced training in psychotherapy other than what she was receiving from the Sullivan Institute training program.

Tina—Psychotherapy With a “Trainee”

I saw Tina for approximately seven years. She was not a “warm and fuzzy” person. In fact, I never knew whether she liked me or not. While it is difficult for me to remember exactly how I felt more than twenty-five years ago, I do remember that I was intimidated by Tina—I think it is safe to say that I was scared of her. This fear resulted in my attempts to be a “good patient” while I was in her practice. My desire for Tina to think positively of me wasn’t only a case of concern about my own issues coming to the surface. It was also based on the fact that the Sullivan Institute had certain expectations of its patients and members.

With Tina, the first and main project in psychotherapy was for me to “do my history.” Doing this entailed me recounting my childhood memories, bringing in family photos and other memorabilia from my past, and then Tina interpreting them. Much of this interpretation involved casting both of my parents in a very destructive light and suggesting that I break off contact with them, which I did. My mother was still a member of the Sullivan Institute community.

When I first moved back to New York in the summer of 1973, I had moved in with a friend from the Cuba trip. We shared an apartment in Park Slope, and I was beginning to make friends in the neighborhood. Tina encouraged me to move into a group apartment with other patients of Sullivan Institute therapists. She believed that this move would accelerate my interpersonal development by allowing me to work on my peer relationships, which for some reason did not include the friends I had made in Park Slope. Group apartments within the Sullivan Institute community were almost all same-sex arrangements. Based on Tina’s recommendations, I moved into an apartment on the upper west side of Manhattan with four other women.

One important difference between my therapy with Tina and my therapy with Ralph Klein was that Tina was not a founder of, or in a position of leadership in the community. She was a member of the training program and, as such, did not have complete autonomy in her relationship with me. She took notes in the sessions and presumably shared them with her supervisors. Later in the course of my therapy, Tina would call me with some orders that I assume came from one of these supervisors.

I think that what I needed at this point in my development was structure, in the sense that I needed to go to college and to learn how to hold a job, to make friends, and to create a support system. I found all these things in the group. My roommates were generally older than I was and taught me a lot of the basic things that we all need to learn to be independent adults. We all supported each other emotionally, with some exceptions. I was able to find work and to support myself while I attended and did well in college. I wasn’t ready for a long-term, committed, romantic relationship.

Tina was very directive as a therapist, not so different perhaps from many of the other therapists in the Sullivan Institute; but after having heard from other patients of hers, I believe that she was more heavy-handed than many. Two specific instances of this directiveness stand out. The first took place when I was in college. I was studying the writings of Karl Marx, and I had organized a group of people who wanted to learn more about Marx’s theories. I found a teacher for our group through the Union of Radical Political Economists, a relatively well-known group among leftist scholars. Right before the first class was to meet at one of our group apartments, I received a call from Tina telling me that the class could not take place, and that I couldn’t allow the teacher into the apartment. She told me to wait for him in the lobby of the building, pay him his fee, and dismiss him. I was given very little information about the reasoning behind this sudden decision on Tina’s part. It was obvious that this directive had not come from her. I didn’t ask her why I had to do this; I just knew somehow that I had better do what she said.

The second instance had to do with an arrangement that the residents in my group apartment had made with those in another group apartment in our building. We had decided to hire someone to cook three to four meals a week for all of us. We all chipped in for the cook’s salary and for the food, and we ate together at one of the two apartments. I remember that there was some problem with the residents in the other apartment in regard to their relationship with the leadership of the community. Tina told me that my apartment members had to end the relationship with those in this other apartment because of their bad behavior. This was the first time I realized that I was a puppet to some extent. I was angry, and I walked out of the session. Tina actually apologized for this incident—the first and only time she ever admitted any kind of mistake or fallibility as a therapist.

In addition to my own description of my experiences with Tina, which you have just read, Anna, another patient of hers, wrote a letter to Tina many years later. I would like to quote from that letter:

During the approximately 5 years (1976–81) you posed as my psychotherapist when I paid you thousands of dollars, you never helped me. Instead you made my life worse. A therapist is legally and ethically barred from telling a patient that she is worthless, and that everyone she knows hates her because she is so unlikeable. Yet, you said those things to me many times.

As I told you early on in “therapy,” I had been sexually abused by my stepfather from the age of 12 until I left home at 18. You took the information I gave you in confidence and trust about how I had been physically and verbally abused by my mother and stepfather long before the sexual abuse which began at adolescence, and you used that very information against me, to illustrate to me what a worthless person I was in your eyes. (AG, 1999)

Alice sent the letter to Tina with a request for a refund of $20,000. Unfortunately, Tina was not licensed at the time and therefore could not be sanctioned by the Office of Professional Discipline of New York State.

Three Mile Island Accident

In 1979, the Three Mile Island (TMI) nuclear accident took place in Pennsylvania. The leaders of the Sullivan Institute community were concerned that radioactive plumes with airborne contaminants would reach New York City. Approximately one hundred fifty people in the community left the city at this time and traveled to Florida to avoid these contaminants. This was a pivotal moment in my life; I realized that I wanted children, and that I didn’t want them to be affected by any mutations that the radioactivity might cause in my body.

Unfortunately for me, the TMI accident, our weeklong exodus, and the hysteria that ensued made it impossible for me to focus on my graduate work. In addition, the demands on my time increased: All community members were expected to work to educate others about the dangers of nuclear power.

Sandra—A Different Kind of Trainee

After 7 years with Tina, I decided that I needed a different type of experience with a therapist. I don’t remember how I came to this conclusion, but it may have been spurred by Tina’s orders (delivered to me) that my roommates and I disassociate ourselves from those in the other group apartment. I had a consultation with Saul Newton, which was the usual procedure when group members wanted to change therapists. I told Saul that after 7 years I was ready for a change. He called me a week or so later and referred me to Sandra, who was his daughter.

I started seeing Sandra soon after, without any formal termination with Tina that I can remember. I felt liberated. Sandra was a different type of therapist than Tina; she listened to me and did not classify me in any particular way. She helped me to form views of people and situations in my life that enabled me to become more proactive. I felt that she respected me and was interested in what I had to say. During this period of time (1980 to 1982), I was a full-time graduate student at Columbia University in the geography department. I finished my MA certification in 1982, but I was told that I would not be admitted to the doctoral program in geography at Columbia. This news was a gigantic blow for me; I became very depressed. After several months of licking my wounds, I applied to Rutgers University’s Department of Geography as a doctoral student and was accepted.

I began a relationship with the person who later became my husband, in 1980. Romantic relationships were frowned upon in the Sullivan Institute community because they were seen as a way of removing oneself from the group as a whole. They were also considered to be emotionally constraining for the individuals involved and potentially destructive. In spite of this, Sandra did not comment about my relationship with Matt. She was supportive and again listened to what I said about the relationship and how I felt within it.

Alexis—The Henchwoman

In 1982 or 1983, I came to a session with Sandra, and she told me she was leaving New York to go to England. She could no longer be my therapist. I was sad about this, but I also started to think that, if she could leave the group, perhaps I could too. My relationship with Matt had become stronger, and we were discussing some of the problems we had with the Sullivan Institute community. In the meantime, I was referred to Alexis, who at that time was living with the four leaders of the Sullivan Institute in a building on the upper west side of the city. Alexis had recently given birth to twins, and she seemed a lot more interested in the twins than in her patients. The twins frequently came into her office (with a babysitter) during sessions, and I assume that Alexis considered this practice part of the therapeutic experience because she certainly didn’t stop the session or arrange to make up the time.

By the time I became a patient of Alexis, I was already disaffected with the community. Matt had ended our relationship, telling me that I was too focused on him. This was a common reason members gave for ending relationships in the community. I was devastated, was taking a few too many tranquilizers, and spoke with my therapist about the situation. Her suggestion was that I try to establish other relationships. I had told Alexis that I was interested in having children. I had been doing some babysitting within the group for a while at this point. Alexis somehow communicated to me that she did not consider Matt an acceptable father for my children (or, more likely, she didn’t consider me to be an acceptable mother for his children). Nor was she certain that I was mature enough to have children. I was devastated.

I continued to have contact with Matt because I worked in his apartment as part of my community work assignment. Eventually we started the relationship again; he told me that he had been ordered by his therapist to stop seeing me. Matt was a trainee and was higher up in the hierarchy of the group than I was. He was in direct contact with the leadership and therefore knew more about their interference with the private lives of their patients. He told me a lot of things about the leadership that were horrifying to him and to me, and at this point we started to discuss leaving the group together.

I began to lie in my sessions; I told Alexis that I wanted to redo my history in therapy. This meant that I wanted to revisit my infancy and childhood to determine their continuing impact on me as an adult. I did this so that I wouldn’t have to discuss the present with Alexis. At this point, Matt and I had concrete plans to leave the community, which we executed in March of 1985. I’m not sure how I terminated with Alexis—I think I did it via her answering machine.

With one of my closest friends, I moved out of my group apartment; we announced one day that we were leaving, and we brought packing boxes home and started to pack our belongings. Our roommates immediately reported this to the leadership, who told them to have us leave the apartment immediately. We refused to do this because we wanted to pack our things first, and we had a mover coming the next morning. Our roommates hid from us in their rooms while we packed; when it was time for us to leave, some of them were honestly sorry to see us go, while others accused us of being “whores for Matt”. The departure was violent and abrupt; my entire lifestyle changed that morning, and I couldn’t speak with my former roommates because I was considered persona non grata.

Impact of the Therapy

Clearly, the development of my personality and the course of my life were significantly impacted by these experiences, which took place over approximately fifteen years of my early adolescence and young adulthood. I was 31 when I finally left the community. A few years later I married MC, and 5 years after that we adopted a baby. In discussing the impact of the therapy on me, it is helpful to break it down into the positive and negative impacts. I am using these words in two senses: positive to mean what the therapy focused on specifically in my life, and also to mean how it actively influenced me. I am using the word negative to mean both the harm that was done to me, and also the needs and problems I had that were not addressed.

The development of my sexuality and my sense of myself as a sexual being was deeply affected by my experiences with Ralph Klein. His voyeuristic comments and attitude impacted me in the sense that I believe I acted in ways that I wouldn’t have otherwise. My early experimentation with sexual activity may or may not have taken place without his input, but I don’t think that my objectification of myself would have been the same. I was taught to distance my sexual feelings from my other emotions. Thankfully, I wasn’t always able to achieve this separation; but at certain points in my life I did have sexual encounters that were fairly impersonal. In the Sullivan Institute community, for anyone to become deeply emotionally involved with one person was considered dangerous.

My sense of myself as a competent, intelligent person was both enhanced and assaulted at various points by my therapists and by the leadership of the community. I was supported in my academic aspirations, but at a certain point the demands of the group made it impossible for me to achieve my goals. Additionally, one of the most basic things about my sense of self-worth as a woman—my ability to raise a child—was questioned.

Simply having a great many social experiences in the context of the community helped my shyness and social anxiety. However, the deeper issues of my difficulties with friendship and commitment were never addressed. While I was a member of the group, I was able to develop close relationships with women and a few men. I don’t remember being helped to deepen these relationships.

Because my relationships with my father and mother were stopped during the period that I was in the group, I didn’t have the opportunity to develop adult relationships with them. I didn’t learn that I could separate from them, hold different opinions from them, and still love them. I was lucky to be able to resume these relationships after I left the group, but not without a lot of pain and loss. I reconnected with my father several months after I left the community, just before my brother died violently in Israel in what was called a suicide.

My mother remained in the group until its dissolution in 1992, and even at that time we did not reconnect or try to have a relationship. Prior to the breakup of the community, she had been actively involved in supporting the group’s position in the Pappo-Hoy case in 1986.[4] I was involved in litigation against the group then.[5] The actions that my mother took made me suspicious and angry, and I was not inclined to reach out to her. Years later, she contacted me, and we are now in the process of constructing a relationship that was interrupted more than forty years ago.

As I have tried to make clear by including the excerpts of Alice Graves’s writing about her experiences with Tina, I was not the only one to have been affected by Tina’s misuse of psychotherapeutic techniques and the role she played as an authority figure in my life. Nor was Tina by any means the only trainee or nontrainee therapist who behaved in the ways that Alice Graves and I have described.

Over the past years, I have had many discussions with former patients/members of the Sullivan Institute/Fourth Wall community. Many of them had similar experiences with their therapists, and some were told that they were not fit to be parents and were instructed to give their children up for adoption. I believe this is a violation of a parent’s (or a potential parent’s) human rights. In my opinion, of the many choices in our lives that we may wish to make on our own, having a child is one of the most important. A mental-health practitioner would need overwhelming evidence of potential or actual harm to children to legitimately take the action of telling a patient that she is not fit to be a parent, she should not have children, or that she should give up her already-existing children.

Childbearing and childrearing were only two life decisions that the Sullivan Institute psychotherapists felt empowered to direct their patients to make. The therapists often told patients to quit school, or to go back to school in a different specialty because they felt that the patients would be “better” at another type of work. There were several doctors and medical students in the group, and they represented one of the segments the therapists advised. Only some patients got the go-ahead from their therapists to enter medical practice. Others were told to “stay in the lab” because they were not empathic enough to relate to patients.

The leaders of the group overstepped ethical boundaries in the sense that they believed that they knew better what was right for their patients (and their supervisees’ patients) than the patients themselves did. So while some patients benefited when their therapists agreed with them or supported them in life decisions, others were stymied and, worse, were prevented from exploring relationships and career paths that ultimately may have been fulfilling and productive.

About the Author

Amy B. Siskind, PhD, received her PhD in sociology from the New School for Social Research in 1995. She has written extensively about The Sullivan Institute/Fourth Wall community—a group she belonged to for 22 years. In June of 2003, her book The Sullivan Institute/Fourth Wall Community: From Radical Individualism to Authoritarianism was published by Praeger Publishers. She has also written about the effects of totalistic groups on children and the conditions within these groups that can result in child abuse and neglect. She is currently a Research Director at the Michael Cohen Group, LLC and lives in Brooklyn with her husband and daughter. amy.siskind@gmai

International Journal of Cultic Studies ■ Vol. 5, 2014