Henry Stein's post in response to Don's summary of the remainder of the Harold Payne case brings up a problem that I believe is inherent in the process of this (or any other) written clinical case presentation. There is no accurate method of imparting the true depth and breadth of the complex affects experienced by patient and therapist when one writes about a case. For an affect theorist, this is a serious drawback because of our belief that affect, as opposed to cognitive factors, is the primary motivating force in human psychology. I have the advantage of having known Don and his work for over twenty-five years. I know that he would only have attempted the maneuver he used with Harold if he experienced a positive interaffectivity in the transference that would allow him to feel that he could push Harold without danger of the relationship being damaged. Nor would he have pushed Harold the way he did unless he felt that Harold had already begun to shift the script that held him captive between conflicting affective states. I do not believe that Don nor anyone else can convey this kind of emotionally experienced information in a written case description.
The ultimate goal of therapy for an affect theorist is to relieve someone of scripts that detract from their quality of life. The greatest quality of life is available when we are able to experience affect immediately and alter our behavior (short-term or for the long run) or thinking such that we can maximize positive affect, minimize negative affect, and minimize the inhibition of affect. In this system, affect is seen as information in the moment that we must be free to use to ensure our physical and emotional survival. Scripts that develop during our lifetime may help or hinder our ability to respond to affect. Harold was prevented from acting because he had a script that left him stuck in guilt when trying to decide whether to leave his wife. This script that formed a core piece of his personality began in childhood as he experienced his mother's pain in her relationship to his father and himself. This script kept him stuck in a conflict between his interest-excitement in Meg and his shame-fear (guilt) of hurting anyone, especially a woman and especially a "wife." Paradoxically, his inaction was, of course, most likely hurting both women (although that must remain a speculation because we do not know what scripts were active that kept the women engaged in this triangle). Don's maneuver, I suspect, was based on a sense of Harold's readiness to be helped to the next level of freedom from this paralyzing script and a sense that no amount of additional cognitive insight was going to be of use. An affect theorist is willing to take such action because—to paraphrase America's great philosopher Yogi Berra—you ain't changed until you change. We see many useful insights occur only after change has taken place. It is our opinion that many insights are only possible after change because such insight is based on affectively-informed thinking and one cannot know what being different feels like until one has lived that difference.
One final thought: affect theorists do not use Socratic method or any other techniques where the affect of the therapist is withheld such as the "blank screen" of classical analytic method. The reason for this is a bit technical, but let me try to explain. Tomkins proposed that the innate affect shame-humiliation is triggered by any impediment to the continuation of the positive affects interest-excitement and enjoyment-joy (please see other areas at this Behavior Online site to learn more about shame and affect theory). All people in therapy have a great deal of interest-excitement in what the therapist thinks and feels. They are, after all, primarily motivated by their interest in feeling better and counting on our expertise to do so—not to mention paying for our help. When the therapist withholds (and I do not mean personal information about the therapist, I mean the therapist's emotional self), then shame is triggered in direct proportion to the amount of interest-excitement impeded. Not all shame is bad i.e., non-therapeutic. Chronic shaming, however, is counter therapeutic as it motivates the formation of scripts to prevent its presence. A common script developed by clients who are being regularly shamed is to withhold potentially shaming information from the therapist and present only that which the client believes the therapist wants to hear. Thus, the client can maintain the relationship with a minimal amount of shame--and usually a minimal amount of change. Affect theorists are ever vigilant to shaming clients in order to avoid such situations.
Congratulations to Don on the presentation of a great case. I look forward to the next presentation and will try my best to ascertain the affective components of the case. For me, that is where the action is.