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CONFUSION ABOUT THE MEANING OF CONCEPTS is one of the most common causes of disagreement in psychoanalytic debate and is especially striking when affects are the topic of discussion. In commenting on these discussions by seven experts on shame, then, clarification of the meaning of shame and related terms will be my first focus. After such clarification, I will try to synthesize a rather comprehensive model of that affect. I will then turn to the question that is the focus of this issue: “Is shame the central affect in disorders of the self?” Since all psychoanalytic theorists are clinicians first, much of the theoretical discussion herein is, as it should be, in terms of the clinical material that has been presented. I will conclude by trying to pull together some of these clinical ideas about Aaron specifically and, more generally, about some technical approaches to the sometimes difficult problem of treating patients with intense shame.
As if to highlight the semantic problem, Malin calls into question the meaning of the term affect itself. He advocates differentiating between affects, which he thinks of as the basic, innate response patterns with which we are endowed constitutionally, and emotions, which are the complex constellations that develop around those basic response