Dissociation of Affect
Dissociation of affect describes a separation between an emotionally significant event or memory and the feeling that would normally accompany it, so that the person can discuss something distressing or traumatic in a curiously detached, matter-of-fact way, as though the emotional charge has become disconnected from the content. It is closely related to, and often discussed alongside, dissociative disturbances of a person's sense of self.
This has traditionally been discussed together with depersonalisation, since both involve a kind of separation or detachment within subjective experience, though dissociation of affect concerns the splitting-off of feeling from a specific event or memory, while depersonalisation concerns a more general detachment from one's own sense of self or reality.
Recognition features
- A noticeable gap between the emotional significance of what is being described and the feeling actually shown or reported
- The person may describe events that would ordinarily be highly distressing in a calm, detached, or almost clinical manner
- Often arises specifically in relation to traumatic or overwhelming material
- Distinct from the person simply choosing to appear composed; the detachment has a more automatic, involuntary quality
Eliciting it at interview
- Notice discrepancies between the emotional weight of the content being described and the affect displayed while describing it
- Ask the person directly what they are feeling as they recount a difficult event, rather than assuming their outward manner reflects their inner state
- Explore the history of the event in question, since dissociation of affect often relates to a specific traumatic or overwhelming experience
Distinguishing features
- Differs from denial, in which the person actively minimises or refuses to acknowledge the difficulty of a situation, rather than describing it accurately but without matching feeling
- Differs from affect blunting, a morbid expression of emotion in which the capacity for emotional response is generally reduced across the board, rather than selectively separated from particular content
- Closely related to depersonalisation, which involves detachment from one's own sense of self more broadly rather than from a specific emotionally charged memory or event
Common misconceptions
- That a calm account of a traumatic event means the event was not truly distressing; the detachment itself can be a sign of significant underlying difficulty processing what happened
- That this is the same as simply being stoic or private about one's feelings; the separation here has a more automatic, less chosen quality
Related phenomena
Abnormal Expression of Emotion · Denial · Depersonalisation
Practice this
A patient describes a serious road traffic accident she was involved in, in a calm, matter-of-fact tone with no visible distress, while her emotional responses to other, unrelated topics discussed in the same interview remain entirely normal and appropriately expressed. What is this? · Throughout a lengthy interview covering a wide range of topics, both neutral and emotionally significant, a patient's face, voice, and gestures remain flat and unchanging, showing no more feeling in response to distressing content than to mundane content. Before revealing the answer: is this dissociation of affect? · A patient discusses a distressing situation without the expected emotional reaction. Before revealing the answer, decide what distinguishes denial from dissociation of affect. · A patient shows a mismatch between emotionally significant content and the feeling displayed. Before revealing the answer, decide what distinguishes dissociation of affect from affect blunting. · You suspect dissociation of affect in a patient. Before revealing the answer, decide how you would assess for this. · Explain why dissociation of affect is described as having a more automatic, involuntary quality rather than the person simply choosing to appear composed.
Illustration
Recounting the sudden death of her husband the previous year, a 58-year-old woman describes the details of finding him and the funeral that followed in a flat, almost narrative tone, as though describing something that happened to someone else, and seems mildly puzzled herself when asked how it felt to live through it.
References
- Casey, P. & Kelly, B. (2019). Fish's Clinical Psychopathology, 4th ed. Ch. 6, 'Disorders of Emotion'.