Affect dysregulation as a way of life.
Storms of affect, states of panic, and other apparently dysregulated affect states may not be as dysregulated as they seem. While initial states of panic during a rape, etc. may have the quality of chaos and be associated with dissociative experience, rekindled affect may actually burst forth in an unconsciously scripted manner, telling a story for which words have not yet been found. The story of abusive experience may only appear to be dysregulated. The patient with an apparent dysregulation of affect may be suffering from complex affect scripts to which she is subject via unconscious attempts to tell a story based on experience that has been nonverbally encoded. The interaction of neurobiological systems of affect and memory to produce decontextualized experience, which leaves a person bereft of understanding but reeling from storms of affect, is described. While more work remains to be done to delineate the kind of model described here, the efficacy of such an approach and the blamelessness of the neurobiological givens may be a useful construct. Rather than thinking of people who demonstrate affective dysregulation as being subject to psychic disorganization, attention to the sequences and repetition of affect states may lead to analysis of previously unknowable model scenes and their resolution. This framework brings some hope to an area of inquiry that is strewn with despair for both patient and clinician. The treatment of dissociative disorders teaches us much about how we all are much more alike than we are different. If only we are willing to immerse ourselves in the milieu of the affective chaos our patients bring to treatment, then we can begin to study the repetitive scripts of experience that act like the strange attractors of chaos theory.
Chefetz
R A
RA
Advanced Psychotherapy Training Program, Washington School of Psychiatry, USA. chefetz@erols.com
D000342:Affective Symptoms / Q000523:psychology*; D003379:Countertransference; D004213:Dissociative Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D011575:Psychoanalytic Therapy; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*