In preparing for a workshop on working with emotion and psychotherapy,  I re-read an article on emotion by Stolorow and Socarides in Psychoanalytic Treatment:  An Intersubjective Approach by Stolorow, et. al. (1987)   This is an important article, which throws more light on the essential importance of emotion in the lives of all human beings.

Stolorow and Socarides  say that that the chief motivation in human beings is the maintenance of the self, which they define as the individual’s organization of experience.  They base their ideas on the work of Heinz Kohut, the founder of the psychoanalytic school of Self Psychology.  The self is considered, in Kohut’s theory, as our experience of ourselves as existing in space and time.  It relates to how we experience the world and ourself in relationship to it, how we create meaning.  Emotion, or the broader system of affects, is the main factor in the formation of a self structure that is cohesive and grounded and flexible.  The cohesion, flexibility and solidity of the self is also essential in providing for effective affect regulation.

As I indicated in the first article I posted on my blog on the subject of emotions, infants experience affects from birth, and expert raters can, with strong agreement, code their facial expressions into eight affect states:  interest,  social smiling, distress, disgust, anger, surprise, sadness, fear.  It isn’t accurate, of course,  to say infants experience these affect states as emotions.  That doesn’t occur until they develop explicit memory and verbal ability.

The very important job of the caregiver during infancy and continuing on throughout childhood is fourfold.  I shall discuss the results for the developing child when each of these tasks is both adequately and inadequately fulfilled by the caregiver.   It is, of course, a relative issue; the vast majority of parents are neither perfect or woefully imperfect in performing these tasks.

1.  Responding differently to different affect states.  If the caregiver responds in a different way to the infant’s showing, for example,  signs of sadness than when the child is showing anger, the child can gradually learn to experience these affects as different from each other and can learn to expect different, appropriate responses to them from the environment.  For example, sadness might elicit holding and comforting by the caregiver, anger may elicit verbal responses of understanding and, if the anger becomes overwhelming, containment.  If the caregiver responds as if they are the same affect, then the child doesn’t learn to experience them as different.  With a continued lack of attunement on the part of the caregiver, the child’s self structure will become rigidified and inflexible.  I have seen videotapes by Beatrice Beebe of mothers and babies in interaction and it was very painful to watch one mother treating her baby, who was showing social interest, as if she was sad and needed outside, cheerful stimulation.  The baby made a number of attempts to get the mother to respond appropriately, eventually just gave up and withdrew into what looked like a state of depression.  It was very painful to watch.

2.  Responding to the child as being the same person whatever is being expressed.  Frequently the child is experiencing contradictory affects such as fear and social interest.  For example, the child might be curious about the presence of a stranger in his or her environment, but also somewhat fearful about the newness of the situation.  Thus the child will be in conflict, wanting to approach the stranger, but fearful about doing so.  If the parent is accepting of the child no matter what affect is being expressed, the child can begin, over time, to experience himself or herself as a unitary being with an integrated sense of self.  “The caregiver must be able to reliably accept, tolerate, comprehend and eventually render intelligible the child’s intense, contradictory affect states as issuing from a unitary, continuous self.” (Stolorow, et. al. p. 71).  In the the situation of the stranger, the appropriate response might be for the caregiver to take the chid by the hand and lead him or her over to the stranger, thereby providing safety but implicitly encouraging exploration of the environment.  If the parent responds to the child as “good” when he or she responds in a way that meets the parent’s needs and “bad” when the child responds in a way to frustrate the parent’s needs, the development of the child’s affect synthesizing capacity will be obstructed.  For example, if the parent responds with contempt and teasing at the child’s showing fear of the stranger, but pride when the child responds with “bravery,” the child will eventually have to disavow fear.  Also, if the caregiver responds with anger and rejection when the child is angry and pushing the parent away,  but lovingly when the child is smiling and cheerful, the child will eventually come to see himself or herself as unlovable in the former case, as lovable and acceptable in the latter.  Eventually, the child’s ability to be an integrated self will be severely limited.  I have had a great many clients over the years who saw themselves as being two people:  a good one, who experienced happiness and caring of others; and a bad one, who was angry, jealous or vindictive.  Shame is the usual accompaniment to the view of a part of the self as bad.

3.  Being able to tolerate intense affect states instead of being overwhelmed by them.  This results in the ability to use affects as self-signals.  The caregiver’s tolerating and responding appropriately to the child’s shifting affective states “gradually makes possible the modulation, gradation, and containment of strong affect.” (Storolow et. al. p. 71).  This is similar to Winnicott’s notion of the “holding environment.”  “If the caregiver responds through countless experiences throughout early development by comprehending, interpreting, accepting, and responding empathically to the child’s unique and constantly shifting feeling states, he or she is enabling the child to internalize these functions and eventually provide them for himself or herself.”  (Stolorow et. al, p. 71.)    For example, a parent may be able to stay present and be able to comfort a child who is colicky and crying for a short period of time but then isolates the child when the crying and screaming continues and becomes emotionally destabilizing to the parent.  The child then must, eventually, dissociate from the intense affect.  The result is often  severe depression.

Any clinician who has been in practice for awhile has seen clients who are unable to experience intense affect and have to handle the affect  by  dissociation, repression or disallowing intense emotion.  Caregivers who can’t provide this function reliably cut off whole sectors of the child’s affective life.    The ability to experience intense affect without fragmenting in the face of trauma is probably why some people develop PTSD symptoms in a traumatic event, why others do not.

4.  Desomatization and cognitive articulation of affects. This is the process of transforming affects into emotions that can be verbally expressed.   Affects in infancy are almost completely experienced somatically.  If is only as the child develops verbal ability and concurrent explicit memory that it is possible for these affects to become emotions.  The caregiver must provide the words to the child’s expressed affect states and encourage the child to use them.  Without that education, the individual is likely to keep the affects on a somatic level and later on develop psychosomatic states and disorders in adulthood.    Keeping them on a somatic level often brings secondary gain.  The “ailments” are reinforced by visits to physicians, who must respond professionally to their patients even when they sense that the complaints are mostly psychosomatic.  Woody Allen, in his persona of the hypochondriac in some of his movies,  is an amusing example of this type of person.  The actual experience of such people is, however, anything but amusing.  They really do suffer, often from severe pain, extreme anxiety and are very limited in their ability to enjoy life.  I have had somatizing clients who had a while host of physicians whom they regularly saw with no alleviation of their physical symptoms until they began to access the affects and the traumatic experiences accompanying them.