Affect integration and reflective function: Clarification of central conceptual issues

Abstract

The importance of affect regulation, modulation or integration for higher-order reflection and adequate functioning is increasingly emphasized across different therapeutic approaches and theories of change. These processes are probably central to any psychotherapeutic endeavor, whether explicitly conceptualized or not, and in recent years a number of therapeutic approaches have been developed that explicitly target them as a primary area of change. However, there still is important lack of clarity in the field regarding the understanding and operationalization of affect integration, particularly when it comes to specifying underlying mechanisms, the significance of different affect states, and the establishment of operational criteria for measurement. The conceptual relationship between affect integration and reflective function thus remains ambiguous. The present article addresses these topics, indicating ways in which a more complex and exhaustive understanding of integration of affect, cognition and behavior can be attained.

L'importanza della regolazione affettiva, della modulazione, o dell'integrazione per la riflessione higher-order e l'adeguato funzionamento sta venendo sempre più enfatizzata attraverso differenti approcci terapeutici e teorie del cambiamento. Questi processi sia che vengano esplicitamente concettualizzati o meno, risultano probabilmente centrali per ogni forma di psicoterapia. Negli ultimi anni, molte forme di approccio terapeutico hanno posto esplicitamente questi aspetti come area principale di cambiamento. Risulta ancora comunque una mancanza di chiarezza nel campo riguardo alla comprensione e all'operazionalizzazione dell'integrazione dell'affetto. In particolare quando si tenta di specificare e sottolinearne i meccanismi, il significato di diversi stati affettivi e lo stabilire criteri operazionalizzati di misurazione. Inoltre la relazione concettuale tra l'integrazione dell'affetto e la funzione riflessiva rimane ancora ambigua. Il presente articolo si focalizza su questi argomenti indicando dei modi in cui una più complessa ed esaustiva comprensione dell'integrazione degli aspetti affettivi, cognitivi e comportamentali possa essere raggiunta.

RÉSUMÉ

L'importance de la régulation affective, de la modulation ou de l'intégration pour une réflexion d'un ordre supérieur et le fonctionnement adéquat sont soulignés de plus en plus dans différentes approches thérapeutiques ainsi que dans théories du changement. Ces processus sont probablement centraux dans toute entreprise psychothérapeutique, qu'elle soit explicitement conceptualisée ou pas, et dans les années récentes un nombre d'approches thérapeutiques ont été développées qui les ciblent explicitement comme zone primaire du changement. Cependant, il y a encore un important manque de clarté dans ce domaine concernant la compréhension et l'opérationnalisation de l'intégration des affects, particulièrement quand il faut spécifier les mécanismes sous-jacents, la signification de différents états affectifs, et l’établissement de critères opérationnels pour la mesure. La relation conceptuelle entre l'intégration des affects et la fonction réflexive demeure ainsi ambiguë. L'article présent s'occupe de ce sujet, indiquant des voies dans lesquelles une compréhension plus complexe et exhaustive de l'intégration des affects, de la cognition et du comportement peut être atteinte.

A importância da regulação de afecto, modulação ou integração para reflexão de ordem elevada e adequado funcionamento, vem sendo cada vez mais enfatizado entre diferentes abordagens terapêuticas e teorias de mudança. Estes processos são provavelmente centrais em qualquer abordagem psicoterapêutica, quer sejam explicitamente conceptualizado ou não. Recentemente, um número de abordagens terapêuticas tem sido desenvolvido dirigindo-se a estes aspectos explicitamente como área primária de mudança. No entanto, existe ainda uma importante falta de clareza no campo no que diz respeito à compreensão e operacionalização da integração de afecto, particularmente, no que concerne ao especificar os mecanismos de base envolvidos, a significância de diferentes estados de afecto e o estabelecimento de critérios operacionais de medida. A relação conceptual entre a integração de afecto e a função reflexiva permanece ambígua. O presente artigo dirige-se a estes tópicos, indicando caminhos para que a compreensão mais complexa e exaustiva da integração de afecto possa ser obtida.Palavras -chave: Consciência de afecto, mentalização, integração de afecto, função reflexiva, desenvolvimento afectivo.

Keywords:

• affect consciousness
• mentalization
• affect integration
• reflective function
• affective development

Acknowledgements

The present article was funded by grants from the following.

(1) “The National Program for Integrated Clinical Specialist and PhD-training for Psychologists” in Norway. The program is a joint cooperation between Universities of Bergen, Oslo, Tromsø, The Norwegian University of Science and Technology (Trondheim), the Regional Health Authorities, and the Norwegian Psychological Association. The program is funded jointly by The Ministry of Education and Research and The Ministry of Health and Care Services.

(2) The Norwegian Multisite Study of Process and Outcome in Psychotherapy (NMSPOP) supported by grants from Medicine and Health, the Norwegian Research Council; Health and Rehabilitation through the Norwegian Council for Mental Health; the Department of Psychology, University of Oslo; the Department of Psychiatry, University of Oslo; and the Faculty of Psychology, University of Bergen.

(3) The Department of Psychology, University of Oslo.

Notes

1. The 11 discrete affects in the ACI are Interest-Excitement, Enjoyment-Joy, Fear-Panic, Anger-Rage, Shame-Humiliation, Contempt-Disdain, Disgust-Revulsion, Sadness-Despair, Envy-Jealousy, Guilt-Remorse and Tenderness-Care.

2. Even though the concepts of affect process and script are differentiated theoretically as the full description of the process on one hand and the organizing principles of that process on the other, we will for the sake of simplicity use the terms interchangeably below.

3. At low levels these scales indicate poor awareness and recognition of affects, a tendency for being overwhelmed by, unable to cope with and unable to decode meaningful information from affect activation, along with disavowal and shutdown of bodily expressive acts and inability to articulate and express semantic descriptions of affective experience. At intermediate levels affects are stably recognized and accepted, and both bodily expressive acts and semantic articulation of experience are generally acknowledged. Finally, high levels are characterized by capacity for focused and flexible awareness of nuances specific to different contexts and affect intensities, distinct openness to affective activation and its motivating and regulating functions, along with explicit reflection about the information inherent in the affect with its meanings and consequences for one's understanding of both self and others. At this level the nonverbal and conceptual expressions of affects are clear, nuanced, authentic and characterized by the experience of choice, responsibility and awareness of others’ reactions to one's communications (or lack thereof).