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Arlow, J.A. (1981). Theories of Pathogenesis. Psychoanal Q., 50:488-514.

(1981). Psychoanalytic Quarterly, 50:488-514

Theories of Pathogenesis

Jacob A. Arlow, M.D.


Theories of pathogenesis can be influenced by shared unconscious fantasies. This may determine the speedy enthusiasm with which some theories are accepted. In keeping with primitive, pleasure-seeking trends, it is appealing to blame illness on others and to view pathogenesis in terms of the intrusion into the self of some alien, noxious agent. These ideas can be seen in certain current theories that ascribe pathogenesis to inadequate, unempathic mothering. Such theories influence psychoanalytic technique. Analysis becomes a form of replacement therapy, in which the analyst facilitates normal development by serving as an appropriate object. This approach may gratify unconscious needs in analyst and analysand alike. The attempt to isolate one specific pathogenic factor as crucial fails to do justice to the complexity of pathogenesis and may lead to the failure to recognize the role of unconscious conflict and to analyze resistances.

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