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Controversy and Critique Sellam’s ideas invite critique on multiple fronts. Empirically, the transgenerational transmission of specific illnesses or behaviors remains a complex, contested field. Genetics, epigenetics, socio-economic conditions, and direct family learning all play roles; isolating symbolic transference as causal risks oversimplification. Clinically, interpreting disease as meaningful can overstretch responsibility onto patients, risking guilt or self-blame if framed improperly.