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In some patients, among them the so-called psychosomatic patients, somatically experienced affects are not transformed into words and symbols. Due to deficient mentalization, affective arousal is not linked to a meaningful and emotionally experienced selfrepresentation. These patients do not experience affects as their own, and the analyst does not get through to their self-states by way of interpretation.
The aim of this paper is to elaborate on the concept of affirmation as previously discussed by the author,2 and to argue in favor of affirmative interventions to supplement classical interpretation in the treatment of patients with deficient affect mentalization. It is further argued that intonation and the sound quality of the analyst's voice play a decisive part in conveying affirmative messages to the emotionally isolated patient.