The Role of Affect Integration and Regulation in Disorders of the Self

ANSWERING THE TITLE QUESTION of this issue of Psychoanalytic Inquiry (Is shame the central affect of disorders of the self?) seems intuitively straightforward: Yes, shame is the central affect for disorders of the self. Elizabeth Carr's case provides us with a wealth of clinical material with which to examine the question, although I am unable to examine the separate topics of shame, affect, and disorders of the self as fully as they deserve. I hope the reader will accept the speculative spirit in which I offer my ideas about the title question and the case material.

But perhaps the question itself deserves closer examination before we answer it so easily. To begin, I find it useful to understand shame, not as an affect, but as an emotion. Most writers who consider shame an innate affect cite Tomkins (1962, 1963), who defined shame-humiliation as an affect auxiliary, meaning that it functioned as a “specific inhibitor of continuing interest and enjoyment” (1963, p. 123).1 Shame-humiliation consists of an innate reaction that functions primarily to reduce facial communication, and includes lowered eyes, dropped head, and blushing. Yet reading Tomkins reveals that he employs the term shame to describe several additional and incomparable concepts. Tomkins (1963) writes: