Healing the Traumatized Self by Paul Frewen

Author:Paul Frewen
Language: eng
Format: epub
Publisher: W. W. Norton & Company

FIGURE 6.5. Affective Circumplex Indicating Hypothesized Location of Hedonic Deficit (Anhedonia) versus Hedonic Negative Affective Interference. Copyright © 2011 by the American Psychological Association. Adapted with permission. The official citation that should be used in referencing this material is Yik, M., Russell, J. A., Steiger, J. H. (2011). A 12-point circumplex structure of core affect. Emotion, 11(4), pages 705–31. The use of APA information does not imply endorsement by APA.

The theoretical importance of these findings is to highlight that deficits in reward circuitry may not fully account for the experience of anhedonia in all traumatized persons. Instead, experiences of negative affect, including anxiety and shame, accompanied by neural responses implicating higher-order emotional responding, rather than only lower-order reward circuitry, may interfere with individuals’ ability to experience joy, pleasure, and healthy self-esteem in the context of positive events, such as the acknowledgment of their achievements and others’ expression of relational affection toward them. If this is true, the clinical implications are important: namely, that standard psychological treatments for addressing anhedonia, such as behavioral activation (e.g., pleasant event scheduling), are unlikely to be productive in all cases. Such interventions can be expected either to have neutral or even counterproductive effects, exacerbating individuals’ tendency toward anxiety and shame in the face of positive events. Instead, approaches aimed at reducing negative affective interference, such as those encouraging resource building, self-compassion, and anxiety management, may be more beneficial in such cases (Frewen, Dean, et al., 2012, Frewen, Dozois, et al., 2012; Korn & Leeds, 2002). Low self-compassion has been reliably associated with psychological problems, including affective disorders (Macbeth & Gumley, 2012), and psychological interventions explicitly aimed at developing self-compassion are being developed and validated by clinical researchers (Hoffmann et al., 2011). The next two sections describe case studies of hedonic negative affective interference in trauma survivors.

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