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Much has been written about affects and their significance for psychic functioning. This paper is primarily concerned with the earliest evidences of affective differentiation. Such a perspective has been of special interest in our attempt to understand the role affects may play in the psychosocial setting of psychiatric or somatic disease onset.
Our group at the University of Rochester Medical Center has been interested in the affective reactions which either accompany or precede the apparent onset of a wide variety of somatic or psychological dysfunctions (Greene, 1954), (1958); (Greene and Miller, 1958); (Engel, 1955), (1962a), (1962b); (Engel and Reichsman, 1956); (Schmale, 1958), (1962). The affective reactions of what are being called helplessness and hopelessness have been found to be the most frequently experienced and reported antecedents of disease onset. These affects are considered to represent two different types of ego "giving up," i.e., the ego's awareness of its inability to defend against a loss of autonomy. Helplessness reflects a loss of ego autonomy with a feeling of deprivation resulting from the loss of gratification which is desired from an other-than-self object. Hopelessness, on the other hand, is a loss of autonomy with a feeling of despair coming from the individual's awareness of his own inability to provide himself with