Beliefs and pathogenic beliefs

In order to adapt to reality, since the very first moments of life (Stern, 1985) we start to develop and test reliable “maps” of our world.  We do it first unconsciously and then consciously, and in developing these maps we pay particular attention the kinds of situations, experiences, and people that make us feel safe or in danger. These “maps” organize our perceptions, cognition, emotions, behavior and they shape our temperament as well as the development of our personality (Silberschatz, Sampson, 1991). They are our guides into the world and describe how we are, how other people are, how the world is and how we must behave in order to reach our goals and to avoid dangers. These maps, which we will call “beliefs”, define our “reality” and “morality” (Weiss, 1993). Our “beliefs” or more precisely, our “system of beliefs”, are not originally expressed in words, so that we have sensorial, motorial, and procedural maps together with verbal maps which tend to be hierarchically structured. We can formulate most of these beliefs as “if…then” structures, and try to make them as coherent as possible.

The beliefs we develop are strongly influenced by the emotional/motivational systems which are active when we first develop them, and even as we modify and build new beliefs throughout life the beliefs we developed as children (and adolescents) tend to be particularly powerful.  Why are beliefs formed in childhood so compelling?  Children are totally dependent on their caregivers and consequently can easily feel endangered: our attachment (and care) needs are stronger than ever, we need to have a good enough relationship with caregivers and will do anything we can to preserve this vital relationship. We need to see our caregivers as strong, good, and wise, and if there is a disagreement we think that we are wrong and they are right.  In fact, children tend to think that the way their parents treat them is the way they deserve to be treated. Thus, the implicit and explicit demands, teachings, and the experiences we had with our caregivers are the foundation of our core beliefs. The beliefs that we develop when we are children are also influenced by our cognitive and emotional immaturity and by the paucity of our experiences.  As children, we tend to put our self at the center of any situation, often give  ourselves more power than we have,  blame ourselves more than we deserve, and  overgeneralize on the basis of very few cases (Weiss, Sampson, & the Mount Zion Psychotherapy Research Group, 1986).

Each of our beliefs is then connected to four possible strategies: compliance (with the parent and the belief), identification (with the parent who “taught” it to us), rebellion (against the parent and the belief) and counteridentification (with the parent who “taught” it to us). These strategies, together with the belief they are associated with and the affects that connotate it, give rise to our “schemas” (Silberschatz, 2005).  

We are very slow in changing our beliefs and schemas (which is basically adaptive) and tend to more heavily weight information or experiences that confirm them (confirmation bias) - particularly for the beliefs that warn us against danger. And there is a subset of beliefs and schemas that we call “pathogenic beliefs and schemas” because they make us suffer, inhibit us, fuel our symptoms, or push us to behave in ways that are dysfunctional. They are generally formulated during our developmental years and their defining feature is that they associate the pursuit of a healthy and pleasurable goal to an internal or external danger to ourselves or to loved ones. Pathogenic beliefs and schemas may be conscious but are generally unconscious either because they are repressed or because they are based on implicit/procedural knowledge.

Pathogenic beliefs and schemas derive from both “shock” and “stress” traumas, and they originated as efforts to adapt to these traumas: we developed them by processes of inference, trying to understand how the trauma happened, what we did to cause it and how we can prevent similar traumas in the future.  However, with the changing of our needs, relationships, and experiences these beliefs and schemas become maladaptive because the negative consequences they have on our lives are too burdensome and painful.  Consequently, even though it feels dangerous, we are deeply motivated to disconfirm them and this is the main reason a patient looks for a therapist.

Just one example: Seeing that my mother looked hurt any time I wanted to spend time with people other than her, I developed the pathogenic belief that the people I love are easily hurt if I do not remain close to them.  As a result of this belief, I may tend to: (1) always stay very close to people I love (compliance) and feel guilty if I do not do so; (2) avoid interpersonal closeness and feel a claustrophobic anxiety when another person wants to be very close to me (rebellion); (3) require people I love to be very close to me and become hurt or angry when they want to be with other people (identification), or (4) convey the message that I do not need loved ones to stay with me and then become anxious or guilty when I sense that they feel that I need them to stay close to me (counteridentification). These could be my pathogenic schemas.

 

References

 

Silberschatz, G. (2005). (ed.), Transformative relationships: The control-mastery theory of psychotherapy (pp. 219-235). New York: Routledge.

Silberschatz, G., & Sampson, H. (1991). Affects in psychopathology and psychotherapy. In Safran, J.D., Greenberg, L.S. (eds.) (1991), Emotion, psychotherapy, and change. New York: Guilford Press, pp. 113-129.

Stern, D. N. (1985). The interpersonal world of the infant: A view from psychoanalysis and developmental psychology. London: Karnac Books.

Weiss, J. (1993). How psychotherapy works: Process and technique. New York: Guilford Press.

Weiss, J., Sampson, H., & Mount Zion Psychotherapy Research Group. (1986). The psychoanalytic process: Theory, clinical observation, and empirical research. New York: Guilford Press.