Blunted Affect: Definition, Symptoms, & Examples
What is blunted affect, and what does it mean if somebody is experiencing it? This article describes the symptoms, causes, common contexts, and treatments of blunted affect.
As a clinician, blunted affect is one of the first things I might notice in a new client, and it makes me wonder why that person isn’t experiencing or expressing emotions as most people do. Read on to learn what blunted affect looks like, what science tells us about the causes of blunted affect, and how it can be treated.
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What Is Blunted Affect? (A Definition)
Blunted affect is when a person shows almost no emotion. Affect is a word psychologists use for the expression of emotions, and blunted in this case means dulled, weakened, or slowed down. Typically, this means minimal demonstration of emotion through facial expressions, making less eye contact in conversation, using fewer gestures and other forms of body language to express emotion, and having a flat tone of voice (Padmanabhan & Keshavan, 2016). It may also be thought of as a reduced affect display.
To see blunted affect in action, you can watch this video, in which a person with schizophrenia describes her experience of having blunted affect. (Many people refer to blunted affect as “flat affect” and many people with schizophrenia experience blunted affect – more on both topics in a moment.) You might notice that this person engages in very few gestures and that her facial expression remains consistently neutral throughout the video, even as she discusses experiences that might be upsetting for her.
Video: Blunted Affect (Flat Affect)
The Opposite of Blunted Affect
The opposite of blunted affect is expressing emotions in the ways we usually expect to see it. People using the full range of ways to express emotion have regular changes in their facial expressions and tone of voice as they transition between different emotions. They may also become more animated in their body language when expressing stronger emotions.
To fully understand the difference, you might compare the behavior of the woman in that video to your memory of the last time you met up with a good friend you hadn’t seen in a while. You were likely both very emotionally expressive: exchanging smiles, sustaining eye contact, leaning in toward each other during conversation, and showing enthusiasm or caring in your tone of voice.
What Is Blunted Affect in Psychology?
Psychologists and psychiatrists came up with the definition of blunted affect that I shared with you through careful observation of people experiencing mental health challenges. Specifically, we know from research that blunted affect is common in several groups of psychiatric disorders, including schizophrenia and its related disorders, bipolar disorder, depressive and anxiety disorders, post-traumatic stress disorder, and autism spectrum disorder (Strauss & Cohen, 2017).
Although blunted affect may look much the same on the outside, the experience of blunted affect on the inside looks different across these disorders. For some people, blunted affect reflects the fact that they are not experiencing much emotion—they feel numb or empty inside. Other people with blunted affect are experiencing a typical range of emotions, but for reasons we will explore below, they are unable to physically demonstrate those emotions in the ways we usually expect.
Blunted Affect Symptoms
Let’s look at the symptoms of blunted affect in more detail. On the outside, blunted affect may involve speech that is monotone or robotic, where the words you would expect to hear emphasized are not. A person with blunted affect will also respond without emotion to events that would evoke emotions in most people, such as learning that one received a promotion or that a loved one was in a car accident. People experiencing blunted affect say that it is even hard for them to force their faces into emotional expressions (Ekman, 2003; Gabay et al., 2015).
As you might imagine, being on either side of the equation in a conversation where somebody has blunted affect can be difficult. Human connection relies on the ability to empathize, to feel not only our own emotions, but also intuit and feel what others are feeling (Fredrickson, 2013). People with blunted affect have more difficulty doing this (Lee et al., 2014), making it harder for them to build and maintain relationships.
Blunted Affect Examples
By way of example, let’s imagine you are on a first date—dinner and a movie. During dinner, you notice that your date is not really responding to you. When you share something exciting that recently happened in your life, they nod and seem to be listening, but don’t react to your show of emotion. When you ask them about their week, they describe what sounds like a highly stressful interaction with their boss, but nothing changes in their facial expression—no creased forehead, no rise in the volume of their voice, no sigh of frustration. Even when describing their own mistakes in the matter, they don’t lower their voice the way you might expect when somebody feels ashamed or embarrassed.
When you’re at the movie theater later that night, you sneak a peek at your date to see whether they’re enjoying the film. It’s a dramatic moment—the hero has just been confronted with a devastating setback—but nothing registers on your date’s face. As you are parting ways for the night, you are surprised when your date asks to see you again, saying they enjoyed the movie and had a good time with you. You couldn’t tell that any of that was the case; in fact, it felt for most of the night like they weren’t interested in you.
Blunted Affect vs Flat Affect
Remember that “blunted affect” means emotions that are dulled or greatly reduced in intensity. Somebody showing “flat affect”, by contrast, is completely lacking in displays of emotion: their face is completely impassive, their voice unchanging. Think of somebody wearing a Halloween mask, or the automated voicemail message saying the person you called isn’t available right now.
Blunted Affect vs Constricted Affect
Constricted affect is a less severe version of blunted affect. In other words, the person is not showing as much emotion as usual, but they are still demonstrating emotion in noticeable ways (Kaufman et al., 2020). While the presence of blunted affect usually reflects significant mental health struggles, people may have constricted affect for a variety of reasons. For example, constricted affect is often observed in people taking strong psychiatric medications, such as antipsychotic medication (Haverkampf, 2013). A parent trying very hard to remain calm when dealing with their defiant child might intentionally use constricted affect (for example, but not reacting with strong emotions) to help their child self-regulate.
Blunted Affect Causes
Since expressing emotions is so fundamental to our daily lives (Fredrickson, 2013), most people experiencing blunted affect will likely have a psychiatric diagnosis and be experiencing significant challenges in their lives. And since it is so impairing, blunted affect has been the subject of lots of research.
Blunted affect in the brain
Brain imaging studies have shown that the parts of the brain responsible for paying attention to emotions, recognizing facial expressions, and helping us empathize and imagine what other people are thinking, are functioning worse in people with blunted affect (Chuang et al., 2014; Stoodley & Schmahmann, 2010). These findings have led some scientists to believe that impairments in thinking (for example, not recognizing one’s own emotions) are one of the causes of blunted affect (Boden et al., 2021; Strauss & Cohen, 2017).
Similarly, other research suggests that blunted affect may also be caused by people’s brains not recognizing cues of emotions, perhaps because their mirror neurons—the parts of our brain that make us feel what another person is feeling—are less active when they are interacting with other people (Lee et al., 2014). However, some research suggests that people with blunted affect only have trouble expressing emotion, not feeling it, which means they may recognize other people’s feelings but not be able to respond to them effectively (Aghevli et al., 2003).
In summary, blunted affect is probably caused by a breakdown in the links between the parts of the brain involved in emotions and other parts of the brain, such as the prefrontal cortex (where thinking and decision-making primarily happen) and the motor cortex (which controls physical action).
Blunted affect in depression
Many people with depression experience blunted affect. In fact, blunted affect overlaps somewhat with a symptom of depression called “psychomotor retardation” (Sobin & Sackeim, 1997). People experiencing this symptom of depression are slower in their thoughts, movements, and emotional reactions. However, people with depression are typically still able to express negative emotions, which makes their version of blunted affect different (Tremeau et al., 2005).
Blunted affect in schizophrenia
In addition to experiencing hallucinations or delusions, most people with schizophrenia have “diminished emotional expression”, also known as blunted affect (American Psychiatric Association, 2013). As you might imagine, having difficulty expressing emotion makes it even harder for people with schizophrenia—who are already experiencing thoughts and sensory experiences that other people don’t—to connect with the people around them.
Blunted affect in autism spectrum disorder
People with autism spectrum disorder (ASD) are typically less aware of and attuned to other people’s emotions; they may also have trouble talking about their own feelings and demonstrate less emotion in their facial expressions and gestures (American Psychiatric Association, 2013). In other words, people with ASD typically have difficulty in recognizing and expressing emotions that, if the impairment is severe enough, can be described as blunted affect. Just like for people with schizophrenia, struggling to express emotions makes it harder for people with ASD to connect with others (Foss-Feig et al., 2016).
Blunted Affect Treatment
Treatment for blunted affect usually consists of trying to reduce the main symptoms of whatever psychiatric disorder the person is experiencing. There is some evidence that drugs designed specifically to treat psychosis may reduce blunted affect (Gabay et al., 2015), but in general, psychologists and psychiatrists have not had success in treating blunted affect directly. (Winograd-Gurvich et al., 2006). Similarly, when people with depression receive treatments that help the parts of their brain that are struggling perform better, their blunt affect can be reduced (Boden et al., 2021).
Since treatment for blunted affect is based on other psychiatric diagnoses, trying to address it on your own would be very difficult. If you or someone you love is experiencing blunted affect, getting professional help is probably your best bet.
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Final Thoughts on Blunted Affect
To review, blunted affect is the consistent, ongoing inability to express one’s emotions, whether through tone of voice, facial expressions, or other body language. Blunted affect can make connecting socially very difficult and is common in certain psychiatric disorders. After reading this article, I hope you feel empowered to support yourself or someone else in finding help when experiencing blunted affect.