Scientific Forum on the Psychoanalytic Approach to the Nature and Location of Pathogenesis

Two papers dealing with the subject of the forum were pre-circulated to all participants. One is Dr Jacob Arlow's paper entitled ‘Theories of pathogenesis’ the other—in part written in response to Dr Arlow's paper—is by Miss Anna Freud and is entitled ‘Problems of pathogenesis’. Brief summaries of these two papers now follow. Dr Arlow's summary of his paper was based on a precis provided by one of our students, Hiss Claudia Lament.

In this paper Dr Arlow presents his view as to the origin of various theories of pathogenesis. Theories of pathogenesis can very often be influenced by shared unconscious fantasies. This factor may determine the speedy enthusiasm with which some theories are accepted, even before there is adequate observational and clinical data to justify their acceptance. Arlow underlines the importance of adequate scientific observations as the groundwork for theory-building.

In keeping with primitive, pleasure-seeking trends, it is appealing to blame mental 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 theories which amount to a search for a villain in the development of illness. The most ‘popular’ villain in current theories of pathogenesis is the inadequate, unempathic mother. Arlow feels that the difficulty with such simplistic theories of pathogenesis is that they fail to take into account the complexities of the biological and developmental aspects of the psyche. Freud's original view of pathogenesis was a great deal broader than the current object relations theory.

Theories of pathogenesis influence psychoanalytic technique. If the analyst posits as the villain the unempathic mother, analysis becomes a form of replacement therapy, in which the analyst facilitates normal development by serving as an appropriate object. This approach may actually gratify unconscious needs in both the analyst and the analysand.

Putting ‘blame’ on the mother has a long history,