Affect logic or affect-logic is a biopsychosocial notion, introduced in 1988 by Swiss psychiatrist Luc Ciompi, relating to Soteria psychiatric treatment, which sheds light on the interaction between thinking and feeling. It holds that affect and cognition, or feeling and thinking, are continually interacting with each other in the cortical network. Ciompi developed this theoretical account for the purpose of understanding the psychological disorder known as schizophrenia.
Although Ciompi's approach to the treatment of schizophrenia has been applied in several treatment facilities globally, his notion of affect-logic has been criticised in some subsequent reviews for being not testable and, as a result, atheoretical.
The application of affect logic has expanded beyond the scope of psychiatry into a number of fields, including sociology, where the concept has been used in analysing extremist mentalities and critiquing existing theories.
The Affect Logic Model
Ciompi's affect logic model departs from traditional diagnostic approaches that focus primarily on symptoms and behaviour, instead placing strong emphasis on the affective and cognitive processes that underlie psychiatric disorders. His work combines relevant clinical information across many disciplines including psychology, psychiatry, neurobiology, sociology, psychoanalysis and evolutionary sciences in order to illustrate the omnipresence of affective-cognitive interactions. The term 'affect logic' stems from the German 'Affektlogik', which implies "constant circular interaction between emotion and cognition in all mental functions".
Affects can be understood as feelings or emotions that vary in quality, duration and degree of consciousness, while cognitive functions can be understood as mental capacities such as attention, memory and perception. According to affect logic theory, specific cognitions trigger specific emotions in a circular causality loop. These simultaneously experienced affects, cognitions and behaviours are then stored in the mind as 'feeling-thinking-behaviour patterns' and form a dynamic complex system of essential building blocks of the psyche that organise thought and behaviour. The result can be mentalities dominated by specific logics such as 'logic of love', all the way to more nuanced ideologies on topics such as religion or politics.
Affect logic and schizophrenia
According to Ciompi's theory, schizophrenia arises when affective regulation (the congruence between one's emotions, thoughts and actions) is disrupted. Ciompi hypothesises, on the basis of the affect logic reasoning, that schizophrenia can be understood as primarily an affective disorder, with secondary effects on cognition. Although schizophrenia has typically been characterised as an illness wherein individuals experience emotional flatness and indifference, Ciompi argues that this can be, at least in part, understood as a defence mechanism against acute relapses in emotional instability - this defence mechanism may then become hardwired by neuroplasticity.
The classification of cognitive-emotional interaction as a complex dynamic system allows for a chaos theory interpretation of the development of schizophrenia. Chaos theory suggests that big effects triggered by minimal causes (the 'butterfly effect') can destabilise the system and bring it away from equilibrium. Consequentially, emotional tensions are capable of shifting individuals from normal to psychotic mental functioning. The psychotic state is the brain's way of establishing a new, less emotionally tense, equilibrium entailing a reorganisation of an individuals' patterns of feeling, thinking and behaving.
Ciompi conceptualises the evolutionary model of schizophrenia into three phases. He posits that emotional dynamics are more important than traditional literature suggests, not only in the first, premorbid period, of schizophrenia, where schizophrenogenic vulnerability occurs as a result of emotional forces responding to unfavourable genetic and environmental factors, but also in the second, acute, phase and the third, long-term evolution of the illness, where these factors are compounded.
As a result, Ciompi suggests an emotions-based understanding of schizophrenia.
Therapeutic implications
Ciompi criticises aspects of contemporary treatment including short bouts of hospitalisation with high neuroleptic medication intake, as well as trauma-inducing therapeutic settings characterised by discontinuity and violence. As a result of the Affect Logic Model's emotions-centred approach, Ciompi proposes treatment focussed on the reduction of emotional tensions for all stages of schizophrenia.
Inspired by the Soteria model first implemented by American psychiatrist Loren Mosher in San Francisco, Ciompi and his colleagues set up an adapted version in Switzerland, known as Soteria Bern. Soterias offer an alternative low-drug milieu therapeutic approach for acute psychosis in the framework of a sociotherapeutic community.
Soteria Bern was founded in 1984 on the principles of affect-logic. It differentiates itself from other treatment methods through its special therapeutic environment (wherein patients live together in a house with helpers, as a community), its interpersonal approach, and its ongoing cooperation with those close to the patient. Unlike the original Soteria model, Soteria Bern does not aim to eliminate medication entirely but to work alongside it when necessary; the treatment also integrates educational techniques and different compositions of the Soteria teams, with a balanced mix of helpers, some with psychiatric training and some with no medical background.
According to empirical research, two-year outcomes following admission to Soteria Bern are on par, and partly better, than those of traditional treatment facilities, with lower doses of antipsychotics administered and lower daily costs.
Around 15 of these facilities currently exist across Europe.
Criticisms and limitations
Critics point to the limited empirical data and argue that results from the Soteria projects rely heavily on clinical observation and are not necessarily testable through scientific means, particularly because they were not subject to stringently performed randomised controlled trials. Further influencing this scepticism regarding the data is the fact that not all types of schizophrenia patients were admitted to the Soteria Bern project, around 10-15% of cases were too severe or maladapted to the treatment facility. This raises questions regarding the general applicability of the affect logic treatment method, which some critics claim is limited.
Furthermore, the Soteria Bern model is heavily dependent on the context of Swiss culture and not necessarily adaptive elsewhere. This reflects a general underestimation of the role of culture and social context in the Affect Logic Model.
Additionally, the concept of affect is difficult to define and measure, making it challenging to apply consistently in research. Some critics argue that affect logic places too much emphasis on emotions as the primary drivers of behaviour and overlooks the role of cognitive processes in decision-making, as well as of environmental stressors and genetic predispositions.
Overall, as a result of the rarity of Soteria-like projects, the quantity and quality of empirical support for the beneficial effects of therapeutic strategies based on affect logic principles is still limited and requires further research.
Applications to other fields
In the field of sociology, the concept has been used for understanding extremist mentalities, particularly those on the far right. It has also been used to critique Niklas Luhmann's work on systems theory, positing that social dynamics can only be adequately understood through the application of affect-logic and the ensuing "filtering and switching effects of collective emotions on collective thought and behaviour".
Affect logic has further applications in the fields of philosophy, pedagogy, language, consciousness and, most recently, robotics.
Further reading
Bola JR, Mosher LR. (April 2003). "Treatment of acute psychosis without neuroleptics: two-year outcomes from the Soteria project." J Nerv Ment Dis. 191(4):219-29. doi: 10.1097/01.NMD.0000061148.84257.F9. PMID 12695732.