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Along with Clara Thompson, Karen Horney, Erich Fromm, and Frieda Fromm-Reichmann, Sullivan laid the groundwork for understanding the individual based on the network of relationships in which he or she is enmeshed. In his words, one must pay attention to the "interactional", not the "intrapsychic". This search for satisfaction via personal involvement with others led Sullivan to characterize loneliness as the most painful of human experiences.
Besides making the first mention of the significant other in psychological literature, Sullivan developed the Self System, a configuration of the personality traits developed in childhood and reinforced by positive affirmation and the security operations developed in childhood to avoid anxiety and threats to self-esteem. Sullivan further defined the Self System as a steering mechanism toward a series of I-You interlocking behaviors; that is, what an individual does is meant to elicit a particular reaction. Sullivan called these behaviors parataxic integrations, and he noted that such action-reaction combinations can become rigid and dominate an adult's thinking pattern, limiting his actions and reactions toward the world as the adult sees it and not as it really is.