Аутизм и нарушение развития (Jan 2019)
On Affective States and the Use of Affect in DIR Floortime Clinical Practice
Abstract
The leading role of affect became the premise of DIRFloortime. Ideas of S. Greenspan are confirmed by S. Porges who sees affective experience as driving force of the evolutionary process. Incidentally, children on the autistic spectrum operate within a limited repertoire of explicit emotions; it is the lack of affective expression that usually gets in a way of building meaningful connections. However, therapeutically sound range of affective initiations and responses has been studied very little. This paper examines the definition of affect within DIRFloortime framework, as compared to more conventional, albeit controversial, use of this term in the psychiatric practice. It is expected of a seasoned DIR provider to be able to identify his or her own affective state and corresponding mood fluctuations, to make use of interoceptive messages, and eventually, in the course of the therapeutic intervention, adjust it as s/he goes. In order to achieve these goals, one needs to develop working knowledge of the recent theories of neuroception, namely, polyvagal response and its link to affective experiences. Affective states, their types and intensity, need to be tailored down to meet and modulate the child’s affect; this paves the road to designing effective intervention plans. The path to effective affect modulation starts with the provider’s self-awareness. Practical considerations and strategies are discussed.