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I know for the most part the gist of what it looks like, I giggle at uncomfortable news, I get energetic and excitable when I'm scared or depressed, or I express no emotion at all.

What I dont get is why?

Is affect psychotic or trauma induced? I have heard its a coping mechanism and done when people automatically repress emotions or cover it up in an incongruent way. That makes sense from a trauma standpoint. Is the same thing happening in a psychotic person with affect problems? Are they also covering emotions?

I mean, if you have flat or incongruent affect, do you feel it? Do you feel normal and just happen to not act it? Or do you consciously cover up the feeling?

Is there a difference between ptsd and psychotic affect?

My tdoc wants me to work through my affect and express emotions. I dont really know how though, I can't express emotion when I dont think I'm actually covering one up but maybe I just dont know it. I dont understand why people have flat or incongruent affect so I dont understand how to get a normal affect

Edited by cosmeticplague
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Medication does help, I agree with that. Do you feel normal emotions but just dont express it or do you not feel those emotions at all and thus dont have anything to express?

thats where my confusion is, tdoc keeps telling me I need to express my emotions and that emotion must be so uncomfortable for me that I automatically cover it up and that is why my affect is not normal. I feel really cornered because I really dont think I'm covering anything up. I didnt even know my affect was different until people pointed it out and I eventually got self conscious. my next appointment is supposed to be about expressing my emotion and feeling "safe" but I dont feel unsafe with emotions, I like emotions, I just dont have intense emotion usually and when I do I act really giggly and happy. It just happens but I'm told I'm doing it? That I learned my affect because emotional expression was frowned upon when I grew up?

If affect can't be helped I dont know why people keep bugging me about it. it has me confused about what affect even is, is flat affect being numb? But I dont feel anything exists to be numbed in the first place. sometimes I talk about sad things or scary things and I laugh, I usually dont know I'm laughing, but people tell me laughing is ac coping mechanism because inside I'm uncomfortable. I dont usually feel uncomfortable but maybe I'm just not insightful. Are peoplr wrong or am I wrong? My dad has a flat affect because of aspergers but I dont think he is doing it on purpose? but I'm having trouble getting this question out right now, my head its a little unorganized right now

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Psychosis may affect you when you are are actually psychotic, but the term affect, as you are using it here, doesn't really refer to psychosis. A lot of people who have depression have a blunted, or flattened affect, which means their expression isn't very mobile, an tends to look neutral or depressed.

 

Laughing when things are stressful and serious is extremely common. It is as genuine an emotion as being visibly upset. It doesn't mean you think something serious is funny, it is just how you process difficult and awkward emotions.

 

I am leery of saying this, because I don't want to gainsay your therapist, but how does she know that emotions are so uncomfortable for you? Have you discussed this, or as she asserted it? What exercises is she going to give you to develop what s/he considers an appropriate affect? I agree mental illnesses can alter your natural affect, but not everyone is wired the same way, mentally ill or not.

 

How does your pdoc feel about all of this? Did s/he refer you to this psychologist, or vice-versa? Or did you pick them up independently of each other? I am just interested in your pdoc's opinion as to how to treat an "inappropriate" affect. I've always felt that the more appropriately medicated I am, the more stable I am, the more normal my affect is.

 

Also, if you are on medications, some can REALLY affect affect (I am really tired of writing affect two times in a row, but you know what I mean).

 

You should know that as a rule, I am leery of tdocs who think you can be trained into emoting properly. I *do* agree that proper treatment, supported by a therapist, can help. But from what you say, it sounds like this is her project, not a joint one with your pdoc. I hope I am misunderstanding.

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Do you feel normal emotions but just dont express it or do you not feel those emotions at all and thus dont have anything to express?

 

I don't feel the emotions at all and have nothing to express.  I *know* what the emotions are supposed to be based on how I've seen others react, but even knowing that I can't even fake them.

 

 

 it has me confused about what affect even is, is flat affect being numb?

 

Flat affect is like when you show no emotion and have no emotion.  When something (ie tragic) happens, you just have no and show no emotion.  That is how I understand it.  I don't think it is always being numb, because when I am depressed, I might cry but I feel numb at the same time.  Does that make sense?  I am not sure how else to describe it.

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Thanks ill try to print it out

I was psychotic but I'm on antipsychotics now, I know my affect was very flat psychotic but it still is. I dont feel any emotion inside so I dont express it and I'm not depressed, unless having an flat affect makes you not feel depression.

I found the tdoc online. They are really just assuming I have emotion I am uncomfortable with, they think I learned to have a flat affect because my childhood was not nurturing of emotional expression. I expressed lots of emotion though until my first psychotic episode, then I just started feeling cut off. Tdoc says thats because I consciously repressed my feelings then and now its automatic....but I genuinely dont feel anything to repress, you know? Even major life events dont really emotionally bother me, tdoc seems to find that impossible though.

Tdoc thinks I can be trained to express my emotion because he thinks its there, but I dont know. I keep trying to identify emotions but I just feel neutral and content. When I'm sad I get sad and I can cry too, but for the most part ifeel neutral so I express neutral. I admit I do manipulate my reactions, but its because I'm self conscious of acting abnormal....like I try to compose myself or when im neutral I try to act more empathetic, I dont feel anything but I try so when I talk about someone dying they dont call out the fact I'm not reacting and harangue me about what I'm feeling because they wont believe I dont feel much! I most not do agood enough job because they still say I'm flat. my intonation doesnt change or my body language or something like that. I used to be told I dissociated and that was why, but they dont think I dissociate anymore, I just look like it or something, I dont know. I'm very preoccupied by how I must look to people now.

Maybe they just want me to keep composing myself? change my affect expression? I dont know, I try to but still get complaints.

I dont giggle because I'm awkward, I just smile a lot. its good to know thats not totally uncomfortable though. I know when I was psychotic I was scared all the time but people thought I was happy because I was very stimulated and i laughed and talked a lot. i think that was as you say a common reaction because I was processing my fear as excitement or something. Other times though, I dont know. I dont always know. I didnt know I did it until I was in the hospital and I punched myself in the face so nurses kept asking how I got a black eye and so I told them very matter of fact, and they just looked at me and asked why I was smiling. I didnt realize I was smiling, but it kept happening, some nurses thought it was offensive and annoying because they had serious conversations with me but I kept smiling and chuckling, I would chuckle if someone turned the lights off or changed the channel, so it was annoying. I was actually sad then, but I didnt feel depressed and I smiled a lot so they told me my depression has been in remission. I dont think I was processing an awkward situation with humor because I felt pretty comfortable and didnt realize I was smiling. Im self conscious of affect now, I try not to smile at the wrong time because I do it without meaning to, you know? Now that I think of it though when I punched myself I was crying and laughing, I do that a lot. Emotions happen all at once but ifeel none of them and in five minutes ill be back to baseline and completely over it. I dont know.

But now that im not sad my affect is supposedly flat (not as flat as when psychotic thiugh!) So I dont feel happy or sad too much but tdoc keeps insisting I do...its confusing! I feel burnt out. Sometimes I cry in the middle of talking but I actually feel fine, so that makes people really not believe me when I say I dont feel asd nything. So thats why I wondered if im just numb and feelings exist and I dont know they do. I think my tdoc thinks that, but my tdoc also insists I couldnt express emotion growing up but I dont think thats the problem. Tdoc makes lots of assumoptions.

I think my affect is just how I am, but im self conscious now because for years its scrutinized....people think I smile too much or they think I dont act emotional enough and dont believe that I have no note worthy emotion to express.

Haha affects affect is confusing...

I think medication gives me more of an affect. I would say I'm more blunted than flat now I guess. I'm very apathetic too, maybe apathy impacts the way I express myself or feel. I'm universally flat though. I'm not psychotic, or depressed today though. I dont know how tdoc expects to train me. I know he wants me to keep track of what I'm feeling and identify emotions and then when ifeel them to express them. Thats hard though because I dont feel anything really, how do you express neutral? Especially when someone else insists you arent actually neutral. this all came up when I was talking about someone dying. Maybe I didnt act the right way when I was talking about it.

You dont think affect is intentionally put on and thus capable of being taken off? Im kind like a sociopath, I study reaction and try to mimic it when I meet people, but I feel zilch inside so I can't possibly tell someone what I'm "really" feeling because I dont feel anything. Its all the same to me. When I do express emotion it lasts a matter of seconds and then im back to flat, but even while I express that emotion I dont feel much of it. I remember feeling a lot more things, now I dont, so I express less, hence the flat affect. No one believes me though. Its confusing for me. Thats why I wondered, maybe I'm numb.

Edited by cosmeticplague
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Maybe...i am always nervous in public so that could be it! its automatic laughter, maybe nervous laughter fits. I just smile a lot, can't shut it off, but I am always nervous talking so maybe thats it! When im left alone im flat again, I think youre right

do you think laughing when hurting myself could be nervous laughter as well? If I get very agitated or pushed to the edge I laugh when I'm by myself, maybe its nervous in nature too

Edited by cosmeticplague
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Inappropriate affect and laughter are associated with psychotic disorders, and I'm surprised that your tdoc doesn't know that. As I mentioned above, print out what you have written to help your therapist understand what's going on with you. Try not to put so much pressure on yourself to conform to what others expect of you. If I were you, I'd discuss this with my pdoc, not just my tdoc.

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Ill print it out and sure both of them, when isee them face to face its hard to get it out the same so if this makes sense to you guys ill just show them this!

Welll I think tdoc views everything differently, he is raeally set on seeing things from a ptsd standpoint. A lot of things cause affect problems so I dont know how one differentiates it from each other you know, neither do I, so I have no idea either, if I'm doing it to myself. If its because I'm nervous or because I'm covering up feelings then I could work through it, I'm guessing. If its from psychosis though, shouldn't I be better because I'm not actively psychotic? The nervous laughter or inappropriate affect, whichever it is, I know is mostly when I am actively in an episode, like fee lings and expression is all messed up, but when I'm stable again, I'm still really flat. Maybe my meds arent good enough? Pdoc doesn't want to put me on a second aap because of weight gain, but maybe I should anyway? My current aap has me like fifty percent better b ut I dont think I'm psychotic anymore so it is working Hmmm well I see tdoc and pdoc both next week so I will bring it up. I see tdoc so ill find outhow he expects to train me or whatever, but like I said....its so hard...not feeling much and being told I just dont know I have feelings??? Makes me feel stupid you know :P

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I couldn't begin to tell you what you need to do with your meds (that's up to pdoc), but I think that you need to communicate your concerns to both your pdoc and tdoc. I can imagine how I would feel if people were telling me what I'm feeling without even listening to me. That's horrible. Don't be hard on yourself.

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I wonder what would happen if you told tdoc that you feel like you would benefit from some psychoeducation on emotions, how to express them, and emotion face recognition.

 

Just a passing thought.

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I've never asked about education but I think thats helpful...i did a dbt course before and we did a lot on emotions, identifying them, and effectively communicating them, but maybe going over that again is helpful because that course was years ago. when I have emotion I do think I express it but I dont feel much worth exoressing anymore so I dont use what I learned. it would be nice to learn about why my own emotions are so shallow, because I dont feel closeness or attachment either anymore, the whole package is kaputt.

what is face recognition though? I did google but it didnt make much sense

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