An observation about emotion in the Obsessive-Compulsive style of life

A chance remark by one of my patients led me to start examining something I'd taken for granted since I entered this field eons ago. We all know that people with what DSM-IV calls Obsessive Compulsive Disorder or Obsessive Compulsive Personality Disorder tend to avoid emotion wherever possible and try to remain focused on more digital matters of content. I had gotten terminally disgusted with my patient's habit of polling as many as twenty friends and colleagues (telephone calls, e-mail) to get their input on anything "important" that either came up in our sessions or in her interpersonal (dating) life. Shorn of my "analytic neutrality," I invaded this territory to find why she couldn't simply sit with her feelings about whatever the subject, and realized suddenly that she couldn't live with the urgency normally associated with innate affect. If an affect is triggered, she must solve that problem immediately even if it is not capable of solution in any way other than experience of life (a much more time-consuming activity than traditional problem-solving activity).

Gulp. Innate affect, says Tomkins, involves a discrete number of properties. 1) It brings urgency---indeed, wherever in human life we find a sense of urgency it has been brought about by an affect. 2) The affects are abstract, not connected to any specific trigger (like a drive). 3)Innate affect is analogic; each affect resembles the triggering stimulus in some way (distress-anguish is a steady-state drone, surprise-startle has a sudden onset and sudden offset, etc.) 4) Affect match in profile their stimulus---this is like the previous item, but a bit different in that it is not just the quality of the stimulus but its contour in time that is amplified. 5) Because in the human, no stimulus garners a response unless and until it triggers an affect (which is why I describe what Tomkins called a "scene" as a SARS, short for stimulus-affect-response-sequence), affect may be said to correlate stimulus and response. 6) affects are general, not associated with any particular or specific region of the body as must the drive be localized to some organ of consummation.

We've all worked with obsessional patients who couldn't stand the cascade of associations that flood them when an affect is triggered---traditional cognitive-behavior therapy deals with that all the time, for this is what we mean by "dealing with the thoughts that hover at the edge of consciousness." But until this session with this particular patient, I had never considered the possibility that any individual patient is "allowed" to find unsavory any specific moiety or quality of innate affect! Learned protocols for the avoidance of urgency now began to spring to light everywhere I turned with all of the obsessional patients in my practice. Each of them responded in the most gratifying way---at first amazed by the observation, then constrained to study its implications for their own lives, and then emboldened to play with the affective experience as one that did not require an off switch, each of them began to deal with affect in a new way that allowed us to consider the triggering source differently.

Not to say that therapy is ever easy.

Yet this has made such a difference in my work with a number of patients that I thought some of you might find interesting the observation that the attitude toward emotion seen in the obsessional spectrum may be broken down into its relation to each of the six qualities of innate affect. I look forward to learning whether any of you has ever noticed anything like this, and also to your experiences trying this approach with those who visit you for therapeutic assistance.

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