Pathogenic Beliefs: The child’s observations and inferences are the basis of conscious and unconscious beliefs that he uses to guide him in daily activities. Some of these beliefs are maladaptive and significantly constrict his ability to develop and function successfully in the world.

These beliefs are referred to in Control Mastery terms as pathogenic beliefs and are the basis of the development of most psychopathology. They arise from traumatic interpersonal relationships. These experiences give rise to unconscious convictions about how one must behave in order to avoid the danger of re- traumatization. The pathogenic beliefs are irrational explanations about how one’s behavior caused the trauma to occur. The child’s irrational self-blame and unconscious guilt stem from the responsibility one assumes for anything bad that happens to oneself or loved ones. These beliefs are powerful. They compel one to behave in certain ways or prohibit certain kinds of behavior. These beliefs warn the child that if he attempts to exercise certain essential functions, or reach certain essential goals, he will put himself in some kind of danger and so risk feeling fear, shame, guilt, loss or remorse. As these beliefs are overgeneralized by the child, not only to the setting in which the trauma occurred but also to the world at large, they significantly influence all future personality development.

How Do These Pathogenic Beliefs Develop?

Children are highly motivated to be like, to obey, and to be accepted by their parents. Children will develop unconscious guilt about wanting to pursue any developmental goals that they perceive as weakening their ties to their parents – by for example harming them or provoking punishment from them. Children greatly exaggerate how their impulses, feelings, thoughts, and actions affect others or bring harm to themselves. Because they are egocentric, children have difficulty understanding that the people around them have feelings, attitudes and behavior patterns which have been caused for reasons independent of them.

Pathogenic beliefs stem from a number of sources including identifications with a parent’s pathogenic belief or in compliance with a parent’s interpretation of reality. The kind of beliefs a child develops depends on the nature of his specific motivations at the time the beliefs were created. It also depends on how the child believes his parents reacted to his motivations. For example, it depends on which of the child ‘straits or attitudes seemed to upset his parents, and how they displayed their displeasure. The child’s beliefs may be incorrect inferences about their parents’ motives, misunderstandings, or they may be accurate assessments and perceptions of the real situation. For example, an ill child who is kept in may incorrectly infer that his parents want him to remain dependent on them.

Examples of Pathogenic Beliefs

Several examples of pathogenic beliefs are presented below. Each example, however, reflects only one of the many, varied beliefs a child may develop. Guilt based on a person’s fear of harming others in the pursuit of his or her own goals may be divided into several distinct, although related, types of guilt. Of special importance are survivor guilt and separation guilt, both of which involve an exaggerated sense of responsibility for others (Modell, A. (1984a) (1984b)).

a) Separation guilt – Consider for example, a child who observes his parents becoming depressed or worried after he becomes more independent or displays more strength. That child may develop the pathogenic belief that his parent would be upset, hurt, or depressed if they were to become still more independent or feel even stronger. They might develop symptoms, such as a phobia, which would require them to stay close to home. In Control Mastery terms this person would be conceived of as suffering from Separation guilt. This stems from the belief that a parent would be hurt by the child’s attempts to separate and have an independent life. Separation guilt is another type of guilt arising from the fear of harming others as the result of pursuing one’s goals. Separation guilt was described by Modell (1965) as “the belief that one does not have a right to life . . . For the right to a life really means the right to a separate existence . . .” In some cases, according to Modell, “separation is unconsciously perceived as resulting in the death of the object” (p. 328). Weiss (1986) and Bush (1989) expanded this to include the guilt that people may feel, not only for separating, but also for being different from an important person in their lives. Separation guilt is characterized by the belief that one is harming one’s parents or other loved ones by separating from them or by differing from them and thereby being disloyal.

b) Survivor guilt- A child whose parents deprive themselves and appeared to become upset if the child achieves things for himself, might come to believe that his parents do not want him to have more in life than they did. He may deny himself good things in life so as to avoid getting more than his parents. In Control Mastery terms, this person would be conceived of as suffering from Survivor guilt. This is based on the belief that there is only a certain amount of the good things in life to go around. Therefore the child fears that his achievements are stolen from his family members.

If a child’s parents have experienced very little career success, the child may develop the symptom of a work inhibition. He fears that his family would be hurt if he were more successful in work than they. Freud referred to survivor guilt in the wake of his father’s death, in a letter to Wilhelm Fliess, in which he noted “. . . that tendency toward self-reproach which death invariably leaves among the survivors . . .” (Freud, 1896; cited from Ernst Freud, 1960, p. 111). Survivor guilt was described by Neiderland (1961, 1981) as a psychological state common to people who survived the concentration camps of World War II. These survivors suffered from feelings of guilt for surviving loved ones who were killed in the camps. Years later, the survivors were noted to be experiencing depression, anxiety, and somatic symptoms. Neiderland described survivors as behaving as if they themselves were dead. Modell (1971) extended the discussion of survivor guilt to include more subtle forms. He described patients who inhibit themselves from success, or who engage in self-destructive behaviors, in response to unconscious survivor guilt for a parent or sibling whom they believe to be worse off than themselves. He suggested that people have “. . . an unconscious bookkeeping system, i.e., a system that takes account of the distribution of the available ‘good’ within a given nuclear family so that the current fate of other family members will determine how much ‘good’ one possesses. If fate has dealt harshly with other members of the family, the survivor may experience guilt as he has obtained more than his share of the ‘good’.” (p. 340). Weiss has suggested that survivor guilt occurs when people believe that they are—simply by furthering their own cause—experiencing good things at the expense of others, and that their success will make others feel bad by comparison. They assume irrationally that the attainment of good things is unfair to those who have not attained them, or is at the expense of those who have not attained them (Weiss, 1986).

c) Depletion Guilt- If a child’s parents seemed drained, burdened or overwhelmed, following the child’s attempts to be close, or get help, the child may develop the belief that there was something wrong with him that caused his parents to be drained, burdened or overwhelmed by him. He might develop the symptom of a reluctance to complain or express his needs for fear of draining his parents.

d) Omnipotent responsibility guilt – Omnipotent responsibility guilt also arises out of altruism. This guilt involves an exaggerated sense of responsibility and concern for the happiness and well being of others.  This person might worry a great deal about the other person or his impact on the other person without having any power to do anything about it. This kind of guilt intensifies when a parent acts weak and vulnerable or behaves in a way that leads the child to feel overly powerful or responsible

People who feel survivor guilt and/or separation guilt invariably feel omnipotent responsibility guilt. However, there are instances in which a person may feel omnipotently responsible for others without specifically feeling survivor guilt or separation guilt. Omnipotent responsibility guilt may be seen as an exaggeration of adaptive guilt, which concerns feeling anxious and disturbed about real and specific wrongful behaviors and the desire to make reparation.

e) Adaptive guilt is associated with good social adjustment and healthy personality development (Tangney 1991; Zahn-Waxler & Kochanska, 1990). In contrast, survivor guilt, separation guilt, depletion, and omnipotent responsibility guilt are often highly irrational and potentially pathogenic.

Retrospective Development of Pathogenic Beliefs

Children may also come to retrospectively blame themselves for causing a traumatic event and will inhibit whatever major goal they were attempting to pursue at the time. For instance a child, who had enthusiastically begun to explore the world, when a parent took ill, might inhibit his future exploration for fear of further hurting the parent. A child does this because he attributes a causal relation between his attempts to gratify an impulse and the traumatic event. He will repress the impulse or goal to prevent further trauma.

Children tend to endow their parents with supreme authority. They have no prior experience by which to judge their parents’ behavior. Since parents are such an important part of their lives, children want to consider their parents trustworthy, powerful, and wise. They want to be proud of them, emulate them, comply with them and be loyal to them. Their intense need for their parent’s causes them to suppress any belief that the parent is malicious or purposefully harmful. Children instead develop the belief that they deserve any bad treatment they receive from their parents. For example, they may assume that they deserved to be punished because they were pursuing a particular developmental goal. They hope by abandoning the goal they will avoid the bad treatment and get along with their parents.

Overcoming Pathogenic Beliefs: How do Patients Work in Treatment to Overcome these Crippling Beliefs?

Testing, Identification and Insight

Control Mastery believes that patients regulate their own treatment. They work in therapy to disconfirm their crippling pathogenic beliefs. Patients are made miserable by these beliefs and are highly motivated to disconfirm them. Patients think unconsciously about their problems, and make and figure out plans for disconfirming these beliefs. Symptoms such as compulsions or inhibitions can now be understood as efforts to avoid dangers foretold by the pathogenic beliefs. One way that patients work to disconfirm their pathogenic beliefs is by testing them in relation to the therapist. This is a way for patient’s to reevaluate the reality basis for the dangers predicted by the pathogenic beliefs. In testing, a patient acts in accordance with his pathogenic belief. Patients test in order to ascertain if the conditions of safety exist for making their beliefs conscious. For example, if a child believes that his parents were overly worried, he assumes that he must have done something wrong that caused them to worry. To test his belief, he will act worrisome with the therapist. He hopes that the therapist will not be worried. This would help him to disconfirm his pathogenic belief that he caused his parents to worry.

If the patient succeeds by testing the therapist, to disconfirm his

Pathogenic beliefs, he may then feel safer to lift his repressions and denials. This would allow the patient to become much more aware of his pathogenic beliefs and whatever impulses, attitudes, goals, or affective states he has repressed in obedience to these beliefs. Typically patients do not want to face core issues until they are reassured that it will be safe to do so. For example, a patient who was impaired by the belief he deserved to be blamed by his parents may not remember being blamed until he assures himself that the therapist will not blame him in the same manner that his parents did.

A Compilation of Pathogenic Beliefs – In English and  Spanish

1.)  Beliefs in the form of causal statements to the effect that if one pursues a certain normal developmental goal one endangers one’s self or others. Alternately, if one renounces a certain normal developmental goal one increases one’s security or the security of others.
A.)  If I am successful (in work or love) I make others painfully envious and they want to hurt me.
Si tengo exito (en trabajo o amor) Yo hare envida a otros  y quisieron danarme.
B.)  If I am confident, unworried, I humiliate others, make them feel terrible.
Si tengo confianza, y no tengo preocupaciones, yo humillo a otros, y les hago sentir horrible.
C.)  If I am weak and irresponsible with money, I will reassure my inadequate and insecure father.
Si soy debil y iresponsable con dinero, yo calmo a mi papa quien se siente enadequado y enseguro.

D.)  If I do not confide everything in my parents I will hurt them terribly.
Si no confio todo a mis papas, les dano horriblemente.
E.)  If I show love to my parents, I will make them less sad and keep them alive (love cures).
Si muestro amor a mis padres, Yo les haria menos triste y mantenerles viva (el amor cura).
F.)   To feel happy, relaxed, successful or confident is to invite an ill fate.
Para sentir feliz, relajado, o con confianza es invitar los malestares del destino .
G.)  If you simply express your wishes, or ask directly for what you want, you will have your needs frustrated. There is no point to reasoned negotiations.
Si te espreses tus deseos o pides algo directamente, tus necesitades seran frustradas. No vale la pena negociar racionalmente.
H.)  I would destroy my mother if I rejected her.
Destruyo a mi madre se le rechaza.
I.)    If you are friendly and talk about yourself, you will be rejected.
Si tu eres amigable y hables sobre ti misma con la gente, tu seras rechazado.
J.)    There is little asking for help because if you ask for it you won’t get it.
No vale la pena pedir ayuda, por que si lo pides no lo vas a recibir.
K.)  If I am strong, healthy, independent of my mother she would fall apart get sick, be unhappy.
Si soy fuerte, saludable, y independente de mi madre, ella se deshace y estaria enferma, y infeliz
L.)   If I have a successful career, I would make my father look inferior and weak.
Si tengo exito en mi carrera, hago ver a mi papa como enferior y debil.
M.) If I pursued my sexual interests my father would be threated and my mother would feel left out.
Si busco a mis entereses sexuales, desafio a mi padre y mi mama estare abandonada.
N.)  If I am strong in a relationship I will harm the other person.  I will make the other person look bad.
Si soy fuerte en la relacion, hago dano a otra persona.  Hago ver mal a la otra person.
O.)  If I control my overeating and my diabetes I will make my father and brother look bad.
Si controlo mi sobre-comer y el diabetes yo hago ver mal a mi papa y mi hermano.
P.)  If I break up with lover I will be responsible for lover’s unhappiness/pain/ possible suicide.
So yo rompo con un amante, yo estare responsible por el dolor, infelicidad y possible suicide de ello/ella.
Q.)  If I live and act as I truly wish mother would die.
Si yo vivo y comparto como yo realmente quisiera, my madre moreria.
R.)  If I had a respectable and successful career I would make mother look inferior.
Si yo tendra una carrera respetado y exitoso, yo haria ver a mi madre como enferior.
S.)   If I speak up I will destroy the other person.
Si yo hablo mi verdad, destruyo a otros.

2.)  Prescriptions which can easily be reworded as examples of category 1.
A.)  Don’t do better than older brother, especially in athletics. (Brother was two years older. Patient was taller and stronger by age four. Parents worried about brother. They would not praise patient in front of brother.)
No hagas las cosas mejor que tu hermano, especialmente en areas de atletica.
B.)   Don’t do better than father. (Father told patient he had been shy as a child and at college and did not make friends.)
No hagas las cosas mejor que tu padre.
C.)  Don’t expect individual attention. (During childhood patient and brother were treated as a unit, “the boys”.)
No esperes atencion individuo. (eres unido con tu hermano, “los muchachos”)
D.)  Don’t see faults in parents. If you do they’ll be hurt.
No debes mirar las fallas y faltas de tus padres. Si haces eso, ellos estaran dolidos.

E.)  Don’t show your true feelings (sadness). You will just offend others if you do. Try to look animated and happy.
No muestras tu verdaderos sentimientos ( como tristeza). Si lo haces, ofenderias a otros.
3.)  Beliefs in the form of self-attributions, descriptions of one’s character or sense of self, which are limiting, discouraging and self-destructive.
Creancias en la forma de atribuciones de ser, descripciones del character o de la esencia del ser, que pueden ser limitando, llena de disilusion, y auto- destructivo.
A.     I am a bad, harmful person.
Soy una persona peligrosa, quien hace dano a otros.
B.     I am a stupid person.
Soy una person estupida.
C.     I am a disgusting, slimey person.
Soy una person horrible, con disgust.
D.    I am disabled.
Estoy con disabilidades.
E.     I want too much.
Yo deseo demasiado.
F.     I am spoiled, selfish.
Soy consentida y llena de avaricio.
4.)  Beliefs about how one deserves to be treated or how one ought to be treated by fate and/or other people, or what one should or ought to do. These are beliefs using ethical or moral words and therefore, least at first glance, ethical or moral beliefs.
A.)  I deserve to be rejected.
Yo merezco ser rechazo.
B.)  I should never be relaxed.
You nunca debe ser relajado
C.)  I should always be straining to accomplish as much as possible.
Siempre debes estar intentando que cumplir lo mas que puedes.
D.)  I should work exceedingly hard and receive little from others.
Debo trabajar lo mas fuerte que puedo y recibir lo minimo de otros.
E.)  I should not be better off than my parents or siblings.
No debo cumplir mas y estar major economicamente que mis padres o mis hermanos.

F.)   I should not be recognized by others (parent figures) as more capable than my siblings.
No debo ser reconocido por mis papas or otros como mas capaz que mis hermanos.
G.)  I should not charge ahead happily.
No debo avanzar tan felizmente.
H.)  I don’t deserve to have a good relationship with my children.
No debo tener una relacion positiva con mis hijos.
I.)    I should be the last to be considered.
Yo debo ser la ultima quien sea considerada.
J.)    I don’t deserve to receive anything from my husband.
Yo no merezco recibir nada de mi esposo.
K.)  I do not deserve to have a good healthy life of my own because my parents were so burdened by me when I was growing up.
Yo no merezco un vida saludable y de mi propia porque mis padres estaban tan encargados de mi cuando yo era chiquillo.
L.)   I do not deserve to take care of my health since mother never seemed to care.
Yo no merezco cuidar de mi salud porque mi madre nunca cuido lo suya.
M.) I shouldn’t expect any more for myself than my mother expected for me.
Yo no debo esperar mas para mi que mi mama esperaba para mi.
N.)  I should not get more out of life than my siblings do.
Yo no debo recibir mas de la vida que mis hermanos han recibido.
O.)  I ought not to try to have a better life than my parents were able to have.
Yo no debo tartar de tener una major vida que mis padres pudieron tener.
5.)  Beliefs in the form of misleading, fatuous, self-destructive, etc. principles on which to base one’s thought’s and actions.
A.)  Unless you can be outstandingly successful, star in your field, there is no point to developing competence in that area. If you had the talent to be a star, then your success would come naturally, and not require much effort.
Solo si tu puedes ser sumamente exitoso, un estrella en tu carrera, si no, no vale la pena en desarollar tu competencia en este area. Si tu tuvieras el talent para ser una estrella, tu exito vendra naturalmente, y no require tanto esfuerzo.
B.)  If someone humiliates you, you will inevitably feel humiliated. If someone accuses you, you will inevitably feel guilty. There is no way to defend yourself in the circumstances.
Si alguien te humilla, vas a senitir humillada inevitablemente. Si alguien te acosa, te vas a senitr culpable. No hay manera de defenderte bajo estas circumstancias.
C.)  It is better not to try than to risk making a mistake. If something goes wrong, somebody inevitably made a mistake, and that blameworthy party must be identified.
Es major no intentar que arriesgar un error. Si algo mal pasa, eventualemente alguien va ser un error, y la gente quien hizo el error se tiene que identificar.
D.)  There is no such thing as bad luck. People are responsible for the bad events in their lives.
No existe mala suerte. Toda persona son responsible para los eventos que pasan en su vida.
E.)  The only way to get what you want in this life is to manipulate or cheat the people with whom you deal.
La unica manera to consiguir lo que tu deseas es manipular o enganar a la gente.
F.)   To be alone is to feel miserable.
Ser solo es ser miserable.
G.)  You can’t get better until you admit you are disabled.
No puedes mejorar hasta que admitias que eres deshabilitada
Beliefs combining 2 or more of the above categories.
a.)   I am an unimportant nerd who deserves to be ignored and rejected.
Soy un bobo quien merece ser ignorado y rechazado.
b.)  I am too much for others: i.e. upset them, offend them, use them up, etc.
Yo soy demasiado para otros: les afecto negativamente, les ofendo, les uso, etc.
c.)   I am a bad person who does not deserve to be given to, loved. My motives are bad, harmful.
Soy una persona mala, quien no merece nada, ni amor. Mis motivos son malas, danosos.
d.)  I am bad if I am disloyal to the negative attributes my father gave me: I will be lonely, unliked and have no friends.
Soy mala/malo si no

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