What is affect?


What is affect?

Adapted by Ellaine B. Miller, Ph.D.

From presentation by

Margaret Keiley, Ed.D, LMFT

Auburn University, AL


Challenging Provider Issues

Make me Feel Like


Attachment Theory

Affect Theory

Change Theory


Attachment Theory

What is Attachment

Why does attachment exist

• Survival mechanism

• To maintain the proximity with a caregiver,

especially in a stressful situation

• Goal is to reduce arousal and reinstate a sense of

felt security

• To provide a “secure base” from which to explore

What about attachment and caregivers


Attachment Styles

• Secure Warm, available, and responsive caregiver

• Ambivalent-insecure Inconsistent caregiver

• Avoidant-insecure Emotionally unavailable or

rejecting caregiver

• Disorganized Intrusive, abusive caregiver

Insecure attachment styles interfere with a

person’s ability to regulate affect and to

explore his/her world


Internal Working Models

• Working models of the world

Who attachment figures are and how one might expect them to


• Working models of the self

How acceptable or unacceptable one is in the eyes of attachment


These internal working models of how attachment

relationships operate predispose individuals to

habitual forms of engagement with others, including

the regulation of affect


Internal Working Models (Cont.)

• Secure: Self is worthy and competent; world and others seen

as safe and trustworthy

• Anxious: Self is unworthy; world and others seen as

undependable and rejecting

• Avoidant: Self is unlovable, incompetent, never good

enough; the world and others are seen as untrustworthy and

never satisfied

• Disorganized: No organized internal working models

Last three attachment IWMs are driven by FEAR of:

Rejection, Incompetence, Caregiver


Affect Theory

What is affect

Information about our experience and desire

• How is affect regulated

• Affect regulation involves tolerance, awareness,

expression, and control of the physiological,

behavioral, and experiential aspects of affect

• Affect regulation is first co-constructed as part of

the attachment process in infancy

We need access to the information that is contained in affect in order to make decisions

about what we want & how we want get what we want. So it must be regulated.


Link between Affect & Attachment

• Secure individuals are able to flexibly manage their emotions

and their distance from others in conflictual interactions

• Ambivalently (Anxiously) attached individuals tend to

heighten distress and anger as well as pursue in conflictural


•Avoidantly attached individuals tend to restrict the

communication of anger and distress and withdraw from

conflictual interactions

• Disorganized individuals have no organized attachment

strategies or affect regulation strategies: Sometimes pursue and

heighten distress, sometimes withdraw and restrict expression


Examples of the Links between Affect &


• Secure

Overtly/Hidden: express vulnerable feelings

• Ambivalent

Overtly: nagging, angry criticism, and pursuit

Hidden: fear of rejection or sadness about disconnection

• Avoidant

Overtly: stonewalling, withdrawing, or flat affect

Hidden: anger, hurt, sadness, and fear of incompetence

• Disorganized

Overtly: stonewalling, withdrawing, flat affect, pursuit, anger

Hidden: terror, terror, terror


Summary MAP:

Attachment Positions and Affects

• Secure: Flexibility in movement toward and away

from the other and tolerance of own and others’ affect

(not afraid of feelings)

• Ambivalent: Pursue, show distress, hide sadness and


• Avoidant: Withdraw, show little distress, hide anger,

fear, and sadness

• Disorganized: No organized position, vulnerability

always hidden, terrified


Physiology of Affect

• The regulation of emotional arousal is the key factor in

determining the nature and form of close relationships.

(Porges’ Polyvagal Theory and Gray’s Motivational


• Emotional arousal gets our attention. THEN

• We are able to calm ourselves, attend to what is in front

of us and respond appropriately. We can regulate the

arousal in order to keep it in the tolerable zone


• Or we move into a highly aroused panic mode that is not

cognitively controlled. The result is we revert to a

habitual mode of interaction, either fighting (rage,



High Arousal (Red Zone)

• When you are highly aroused and in a panic

mode, you CANNOT engage your brain to make


• You go directly into a habitual mode of response

without thinking:

Flight, Fight, or Freeze


Central Nervous System

Autonomic Nervous System

Sympathetic Nervous System

Motivational Functioning

Parasympathetic Nervous System

Regulatory Functioning

Reward System:















Vagal Complex:

Vagus Nerve, Dorsal Motor

Nucleus, Nucleus Ambiguous

Vagal Tone:

Emotional Trait

Vagal Reactivity or

Vagal “Brake”:

Emotional State


Vagal Tone (VT): Heart Rate Variability

• High VT: Heart rate variability high: Easier to regulate

reactivity appropriately; emotional & communication


Associated with better child, adult outcomes

• Low VT: Heart rate variability low: Harder to regulate

reactivity appropriately; emotional inflexibility and

communication difficulties

Associated with both externalizing and

internalizing problems

Aggression – anger, rage

Depression – sadness

Anxiety – fear, panic


Vagal Reactivity (VR): RSA Reactivity

This vagal “brake” regulates heart rate increases and

decreases to deal with environmental demands

VR facilitates effective coping with challenges by allocating

cognitive and motivational resources

VR reflects intra-individual shifts in levels of fear and anger

Moderate VR: Optimal engagement, prepare to respond

Excessive VR: Emotional lability

Vagal tone stabilizes by age 1, but vagal reactivity is

somewhat amenable to alteration and change


Porges’ Polyvagal Theory (PNS):

Regulatory Functioning

Influences on the Heart:

Vegetative Vagus – Deceleration of heart rate

associated with orienting (older, reptilian brain)

Smart Vagus – After orienting Decision

Point: One of two decisions (mammalian


1. Attend to and engage: Sustained attention

and further deceleration of heart rate

2. Fight-Flight: Rage-Panic: Excessive

acceleration of heart rate and enlist SNS


Change is Hard

• Why

What can we do about it


Stages of Change

• Precontemplation

• Contemplation

• Preparation/Determination

• Action/Willpower

• Maintenance

• Relapse


1 st order : De-escalation

2 nd order : Permanent Change


Mechanism of Change

• Low Arousal (First Order Change)

Cognitive change – Reframe allows for awareness of

initial internal working models (Emotional and

Cognitive changes)

Behavioral changes – De-escalation of cycles

• High Arousal (Second Order Change)

Repeated in-session Change of Cycles

Consolidation of change of relationship cycles (outof-session



Low Arousal: 1 st Order Change

De-Escalation of Cycles with Reframe

• The trainer reframes providers’ overt feelings and

behaviors to illuminate their vulnerable feelings,

attachment desires and positions, and the

consequences of their behaviors

• The results of reframing are:

Cognitive change

Internal working models change (Emotional and

Cognitive changes)

Behavioral changes – De-escalation of cycles


High Arousal: 2 nd Order Change

Training Visit Interventions and Directives

•The trainer directs the provider to respond in a different way.

To express his/her vulnerable feelings to the other, that is to ask

directly for what she or he wants

Or to help him/her to hear, understand, and respond to this

expression of vulnerable feelings and attachment needs

This directive RAISES the AROUSAL LEVEL of the


•Over time, the participants learn to take new positions with each

other and that helps to reorganize their interactional



Evoking High Arousal

• Only evoke the vulnerable feelings of the


• Fear

• Sadness

• Incompetence/Anger of the withdrawer

• Do not evoke the overt or defensive feelings

• Rage, Anger

• Shame

• Embarrassment



• Do we think we know what our own attachment style


• Do we have an idea of what our providers’ attachment

styles are

• Having and idea about our own and others’ styles can

help us engage with others in a more positive and

productive way.


Types of Providers

What are the characteristics of the providers you are

involved with

• Can we create profiles

Styles of Engagement

• How do we relate to or engage in meaningful

conversation with each type

• Is this a one-size fits all approach

• Do we need different approaches

1. Engagement

2. Assessment

3. 1 st Order Change: Reframe

4. 2 nd Order Change: Directives

5. Consolidation


Engagement Strategies

• Empathy

• Validation & Normalization

• Heightening Vulnerable Feelings

• The Use of Metaphors & Stories



What is assessed

• Attachment positions

• Overt and vulnerable feelings related to positions

• Interactional cycles and consequences

We assess these things by tracking and

reflecting the interactional cycles and the



1 st Order Change -- REFRAME

• Address negative feelings (yours and provider’s)

• Change the script

• Stop the cycle


2 nd order change -- DIRECTIVES

• Change the cycle

• Stop

• Think

• Respond differently

• Practice, practice, practice

• Needs to hold up under stress


Practicing Strategies

• Applying the theories

• Role play



• Attachment style

• Affect/vagal tone

• Change is hard

• Culture

• Family of origin

• Present situations

• History

• Trust


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