The Affect That Never Arrives; Living With The Volume Turned Down

We have a rich vocabulary for too much feeling. Emotional dysregulation, affect intensity, rejection sensitivity, flooded nervous systems that cannot find their way back to baseline. It fills our training, our formulations and our caseloads, and it should, because distress is what brings people through the door.

But, there is an opposite presentation, and it's one that is much harder to find words for, precisely because it's about what doesn't show up. The person who's experience is contained, and seemingly untroubled by the things that trouble other people. The reason we say so little about it is, I think, structural rather than accidental. The over-regulated presentation is invisible in almost exact proportion to how well it works.

So what does it look like in the people we see?

My experience is that it is rare for it be raised as a presenting problem in its own right, which is the first difficulty. The referral, if there is one, is usually for something else. Such as sleep, a performance issue at work, or relationship that is not working, often framed as the other person's deficiency. Frequently the person has come because someone else sent them, like a partner who says they are closed off. The complaint arrives by proxy, because the person is not in any obvious pain.

In sessions, I notice I may ask how something felt and get a thought back. Not because of evasion. They are trying to answer. But the reply tends to be an evaluation, or an account of what they did, or what the situation meant, rather than a felt quality. The felt sense I was reaching for is either not there to be reported, or not consciously reachable from where they are sitting.

These clients can often narrate the worst things that have happened to them in an even, organised, almost reportorial register. They might describe a bereavement handled well. A childhood described without weather. A divorce they moved on from briskly, with perhaps a mild puzzlement at why others expected more of them. Often I find, sitting opposite, that I'm feeling more about their life than they appear to be. Other times, I experience the lack of affect in the room as a slight disconnect that is tricky to put my finger on at the time. But actually, that the gap between their affect and mine can be the most informative thing in the room.

Many of these clients are highly capable and visibly self-sufficient. Competence is often central for the whole identity, and receiving anything, including the help of a therapist, sits slightly wrong - another reason, perhaps, why they often aren't in the room in the first place. They are usually the ones other people lean on, not the ones who are comfortable needing from others.

Some can name the experience. A sense of watching their own life from a step behind glass. A flatness that doesn't appear to be depression, because the machinery seems to be working and their days function objectively well, but the colour to their lives is dimmed. More of an absence rather than an acutely felt pain.

It also isn't a total global flatness, which is part of what makes it hard to spot, in clients and in ourselves. The capacity to feel is usually intact, and at times it can be strong. It tends to come online where feeling is safe: when it is about witnessing rather than exposing, vicarious rather than personal, aesthetic, or carried on behalf of someone else. For e.g., many of us were moved to tears by the end of Adolescence, the father tucking his son's teddy into the bed and saying, too late, that he should have been better. The feeling is real and it is large. It is also perfectly safe, both on screen for the father - because the child is not there and cannot respond, and for the viewer - because it is happening to someone else on a screen, and they are the witness, not the one asking for anything. Safe depth, with zero risk.

That is only half of the pattern, and the revealing half is the other one. What tends to stay offline is the needful, reaching register towards a present other. Longing. The wish to be reassured. Minding whether someone stays or goes. The affect of depending on a person who might not meet them. The same person who weeps at a father on a screen may feel very little when an actual person, in the room, needs them, or might not meet their needs. That band can be gated while everything else flows freely, and the person carrying it will tell you, accurately, that they can feel. They do. Just not those things, and not in that direction. The contrast is the sign, not the flatness: full feeling where nothing is at stake, and silence exactly where something is.

What the evidence says

It would be easy to treat all this as a clinical impression, the kind of pattern an experienced therapist recognises but cannot quite evidence. It is more than that. Several literatures that do not usually talk to one another describe this presentation, and they converge on the same account of it.

Starting with our own in the contextual behavioural science community. In ACT terms this is experiential avoidance - the rigid dominance of attempts to escape or avoid private experience over chosen, valued action (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996; Bond et al., 2011). But the version in front of us has a feature worth dwelling on. Most experiential avoidance is effortful and self-announcing, and the felt struggle is what brings people in. Here the avoidance has been so thoroughly over-learned that it runs automatically, before there is anything to struggle with. Gross's (1998) process model is useful for seeing why. Emotion can either be regulated late, by modulating a response that has already formed, which is effortful and tends to leak, or early, by selecting situations, steering attention and reappraising meaning before the emotion is fully online. The deactivated presentation is predominantly the early, automatic kind, which is exactly why the usual signs of effortful suppression are missing. There is little response to suppress when the regulation has already happened upstream.

The obvious objection is that low self-reported feeling might simply mean low feeling. This is where the attachment literature is interesting because it measured the body rather than the report. Dozier and Kobak (1992) recorded skin conductance during the Adult Attachment Interview and found that people using deactivating strategies, who described their early relationships in positive terms and played down the significance of attachment, showed marked physiological arousal precisely when asked to recall separation, rejection and threat. The composed account and the aroused body came apart. Fraley and Shaver (1997) then showed that dismissing-avoidant adults are able to suppress attachment-related thoughts, and even to reduce their physiological arousal while doing so, which means the calm is not just impression management. The strategy works. But it is not free, and it is not total. Mikulincer, Dolev and Shaver (2004) found that under low cognitive load avoidant individuals suppressed separation-related thoughts effortlessly and held positive views of themselves, while under high cognitive load the suppression failed and more vulnerable, negative self-representations surfaced. The feeling, and the need, were there the whole time, held offline by something that worked until the system was taxed.

There is also a measurable trait that sits close to all this. Alexithymia, assessed by the Toronto Alexithymia Scale (Bagby, Parker, & Taylor, 1994), comprises difficulty identifying feelings, difficulty describing them, and an externally oriented style of thinking that attends significantly less to inner emotional life. That third component is close to a direct description of processing one's experience cognitively rather than affectively, and alexithymia is reliably associated with insecure attachment, including the avoidant, deactivating pattern that appears relevant here (Zhang, Zhang, Mao, & Wang, 2024). It gives the presentation a name, a measure, and a bridge between the attachment and the ACT framings.

Put together, the convergence says something more useful than "some people do not feel much." It says the feeling is usually present, that it is being regulated early and automatically rather than suppressed late and effortfully, that the regulation carries a physiological cost the person does not report and may not register, and that the whole arrangement is most stable when nothing is taxing it. This has a clinical consequence. The absence of distress is not evidence of health, and in this presentation more than most, the patient's ability to self-report is degraded by the very thing we would be trying to assess. The instrument is compromised, and the person holding it is likely to be the last to know.

The part that does not stay on the other side of the room

Interestingly, this adaptation can be just as present in clinicians, as clients. Indeed, it can be rewarded as it can look, for years, exactly like competence. The capacity to sit with another person's most intense affect while remaining the steady, regulated one is a real clinical skill. It is also, structurally, the safe form of feeling described above. Maximum contact with emotion, all of it someone else's, with the clinician reliably contained and never exposed. The calm, low-reactive, endlessly containing therapist that others lean on may be doing excellent work and running an old strategy at the same time. The two are not mutually exclusive.

Even more interestingly for me, is that the adaptation might not merely survive our therapies, if we aren't understanding it fully. It can embrace our tools. Several of the instruments we reach for most readily are, at root, distancing operations as well as therapeutic ones, and a person organised around distance, client or clinician, will gravitate towards them and quietly bend them to the old purpose.

Defusion is the clearest case. The aim is to loosen the grip of literal, evaluative thought, and it is a real and valuable skill. But the core move, stepping back from a thought and observing it as a thought, is also a move away. In relational frame terms the conceptualised self is self-as-content, a rigid verbal account of who one is, and defusion works by shifting one's relation to private experience from a here-and-now frame to a more distant there-and-then one (Hayes, Barnes-Holmes, & Roche, 2001). For someone whose baseline strategy already is distance, that is a more sophisticated and more sanctioned version of what they have always done. They tend to be unusually good at it, because it is congruent with the pattern rather than a challenge to it. It presents as flexibility but may well be functioning as armour. The tell is in the function, not the form. Defusion that reliably takes distress to zero, deployed pre-emptively, never letting the painful thought land even briefly, is not changing a relationship to experience. It is preventing the experience.

The observing self is more seductive, because it offers somewhere to live. Self-as-context, the standpoint from which experience is noticed, is a real source of flexibility, but flexibility is the capacity to move into the observer and back into the experience. The defended version takes up permanent residence in the observer and never comes down. "I notice I am having the feeling" can be a moment of presence. It can also be the most elegant way yet devised of not being in the feeling at all. The skill and the defence are the same operation, distinguished only by whether the person can also do the opposite

And then there is formulation, which is our craft, and the place the disguise runs deepest.

Formulation is a real good. It orients the work and makes suffering intelligible, and it earns its place many times over. But put a certain kind of client with a certain kind of clinician and the shared activity of formulating can become something else, a meeting of two intellects that protects both of them from the material it is supposedly about. The client intellectualises their experience. The clinician meets it with conceptualisation. Together they produce an account of the suffering that is elegant, mutually satisfying and entirely cognitive, and that everyone can admire while no one has to feel anything.

This is parallel process in a form that is easy to miss. We usually reserve that term for moments when the dynamic between client and clinician reproduces a dynamic from the client's life. It operates just as powerfully at the level of defence. The client's strategy, think about it rather than feel it, is met and matched by the clinician's, formulate it rather than contact it, and the two defences interlock. The work feels collaborative and intelligent because it is. The hours are interesting. And the affect never enters the room.

For me, our corner of the field is especially exposed to this, because contextual behavioural science gives us a rich and powerful conceptual apparatus and trains us to think functionally about everything, including, in principle, this. The better the model, the more places there are to hide inside it. If it isn't clear already, the reason the processes I am describing are so interesting to me is exactly because this is a trap I know I, as a clinician, am well placed to fall into. Few things interest me more than a beautiful, technically impeccable formulation. I could spend many fascinating hours working out the mechanics of my clients' difficulties. And that is often incredibly helpful but it can also be the most sophisticated piece of avoidance ever created. Worse, it will not feel like avoidance to either of us, because both are working hard and both are getting something they value.

To be clear, the attention I'm drawing here isn't to suggest these tools cannot be helpful but rather to point to ways that they, like any tool, can easily be subsumed into a client's (and therapist's) control agenda. Given our training often focuses on the overtly distressed client, we might do well to notice how the same tools, in the context of a client with the opposite difficulty, might have functions we hadn't anticipated if we are not fully attending to the client's particular experience.

So, as with anything in ACT, the test is workability. Does the formulating session ever cost anyone anything? Does feeling ever break through the conceptual work and change its temperature? Or do we both leave each session clarified, but unmoved? For me, it's worth asking what the function of that clarity seeking is?

Therapy that is reliably comfortable and reliably interesting for both parties, with a deactivated client, ought to raise a question rather than a sense of a job well done. It's particularly a risk when clinician and client share the pattern (even if to different extents), because it may not be visible and because both find it satisfying. It usually takes a third position to see it, which is the strongest argument I know for supervision that attends to the temperature of the work and to its absence, rather than only to content and technique. A supervisor watching for that can sometimes notice in twenty minutes what a year of excellent thinking inside the room may have been organised not to notice.

Learning from other models

If all this suggests the presentation has been neglected, my sense is that it has, but not by everyone. From a different lineage to ACT, Lynch's Radically Open Dialectical Behaviour Therapy (Lynch, 2018; Lynch, Hempel, & Dunkley, 2015) was built precisely for what it calls maladaptive overcontrol: inhibited and disingenuous emotional expression, aloof and distant relating, rigid and rule-governed behaviour, and a hyper-vigilant, detail-focused, overly cautious style, seen across chronic depression, anorexia and obsessive-compulsive presentations. Its evidence base is still emerging, anchored by a single randomised trial in treatment-refractory depression and otherwise resting on smaller and uncontrolled studies (Hatoum & Burton, 2024).

Three features make it worth knowing. Its neurobiosocial model separates the outward signal from the inner experience, which explains how a person can feel something inside and show nothing outside (Lynch, Hempel, & Dunkley, 2015). It locates the core problem not in dysregulation but in the loneliness that follows from low openness and inhibited signalling, keeping the relational cost rather than any symptom at the centre. And, in a detail that ought to give the rest of this piece pause, it holds that radical openness cannot be reached by intellect alone, and so asks the therapist to practise it on themselves before asking it of a client. The treatment for over-control begins with the clinician's own.

The difficulty is that from the inside it is very hard to tell integration from distance. The discrimination you would use to settle it is itself a cognitive operation, and this is exactly the kind of pattern that recruits cognitive operations into its own service. You can think very clearly about whether you feel, and the thinking will tell you remarkably little. The evidence rather underlines this, because it is precisely where the report and the body came apart, and precisely under load that the hidden material surfaced. If there is an answer, it does not live in introspection. It lives in the channels that bypass it: the physiology, the relationship, and what shows up when the system is taxed and the usual management is too busy to run. In working to evoke more affect, not less, and stepping out of the cognitive defences enough to allow clients to feel their needs fully in the context of meaningful relationships.

Which is, perhaps, the most useful thing to say to a room full of people who are very good at thinking. Some questions do not yield to more of it. This may be one we have to feel our way into, rather than answer.

Christian Hughes is a BABCP-accredited cognitive behavioural psychotherapist and clinical supervisor based in Stourbridge, West Midlands. He works within a contextual behavioural science framework and supervises CBT and ACT therapists individually and in group format.

If you would like to have a chat about whether supervision with me might be a good fit, you can get in touch via the contact page or book a free 15 minute call here.

References

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Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., Waltz, T., & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42(4), 676–688. https://doi.org/10.1016/j.beth.2011.03.007

Dozier, M., & Kobak, R. R. (1992). Psychophysiology in attachment interviews: Converging evidence for deactivating strategies. Child Development, 63(6), 1473–1480.

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Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152–1168.

Hayes, S. C., Barnes-Holmes, D., & Roche, B. (Eds.). (2001). Relational frame theory: A post-Skinnerian account of human language and cognition. New York: Plenum Press.

Lynch, T. R. (2018). Radically open dialectical behavior therapy: Theory and practice for treating disorders of overcontrol. New Harbinger Publications.

Lynch, T. R., Hempel, R. J., & Dunkley, C. (2015). Radically open-dialectical behavior therapy for disorders of over-control: Signaling matters. American Journal of Psychotherapy, 69(2), 141–162. https://doi.org/10.1176/appi.psychotherapy.2015.69.2.141

Mikulincer, M., Dolev, T., & Shaver, P. R. (2004). Attachment-related strategies during thought suppression: Ironic rebounds and vulnerable self-representations. Journal of Personality and Social Psychology, 87(6), 940–956.

Zhang, J., Zhang, Y., Mao, Y., & Wang, Y. (2024). The relationship between insecure attachment and alexithymia: A meta-analysis. Current Psychology, 43(7), 5804–5825. https://doi.org/10.1007/s12144-023-04749-0