Pathogenic beliefs form the core of all psychopathology. They are formed in childhood and take the form of rules about reality and morality, about what “is” and what’s supposed to be.  Pathogenic beliefs predict that if the child pursues normal developmental aims, he or she might threaten relationships with caretakers. Health aims are thus given up or compromised.

Some people grow up in families in which they are recruited to parent their parents. This reversal of the normal order of things is invariably damaging to such children because they grow up not only feeling neglected but, more damaging still, feeling as if they are not supposed to be cared for. The “parentified child” feels loveable only for what he or she provides for others.

Too often, people – especially men – respond to someone suffering with efforts to fix or practically solve that person’s “problem.” Invariably, this tendency to attempt to fix the problem worsens it because the person with the problem experiences the “fixer” as non-empathic, burdened, or dismissive. On the other hand, simply listening to and attempting to understand someone who is suffering almost always helps that person feel better.

Sexual fantasies can be understood as attempts by our unconscious minds to establish conditions of safety in which sexual excitement and arousal can be experienced. Guilt and shame are two important feelings that make sexual arousal impossible. Sexual fantasies, especially ones involving dominance and submission, can be understood as solutions to the problems that guilt and shame pose to sexual excitement.