Overview
Affect Centered Therapy (ACT) is predicated on a developmental model for psychopathology (Sroufe, 1997) and upon a Dynamic Systems approach to personality self-organization (Lewis, 2000). The distressed, maladapted personality is believed to develop according to the same principles as the healthy personality. The personality organizes itself in the context of the early environment, consisting primarily of the infant-caregiver dyad. The quality of this dyad determines the quality of the attachment bond. Within this dyad, the infant acquires the skills of affect regulation (Schore, 1994). Deficits in the dyadic relationship result in failures of affect regulation. This is termed deficit experience. Deficit experience renders the child vulnerable to the effects of subsequent adversity. Overt trauma or adverse experience in childhood can compound already existing difficulties of affect regulation. Trauma and adversity place an emotional load on the vulnerable child that he or she lacks the internal resources to carry.

Across adolescence, the personality reorganizes in preparation for reproduction and adult socialization. The personality structure that emerges over adolescence is conditioned by the socializations occurring in childhood and latency. In the personality disorders, the self structure is often compromised both by severe deficits during the attachment phase and by adverse or traumatic experience. The emergent personality of adolescence integrates maladaptively into a unified structure formed by responses to life experiences over developmental time. In the clinical disorders, the emergent personality structure appears fragmented into ego states, at least one of which is more or less adaptively functional. Other ego states exist to regulate emotions that would otherwise overwhelm the system. In a subset of clinical disorders termed the ingestive disorders, the fragments of the personality system, I.E., the ego states, facilitate emotion regulation through the agency of an abused substance.

ACT is a general approach to treatment of both clinical and personality disorders that focuses on affects and the central place of affect regulation in the distressed personality system as well as on trauma-resolution.