There is an established relationship between having experienced trauma as a child and suffering from anhedonia (the inability to experience feelings of pleasure) as an adult.
Anhedonia drains the color from life, rather like seeing a film in high-resolution color suddenly fade into a grainy, blurred, black and white. One feels just intense emptiness and a complete blunting of positive emotional response. As we shall see, it can affect all areas of one’s life.
Many who suffer from anhedonia will have every aspect of their lives affected, whereas others may be affected in some areas but not in others.
In connection with research into the link between childhood trauma and anhedonia, Frewen et al have introduced the concept of ‘negative affective interference’. Essentially, this refers to the idea that, in response to positive events, those suffering anhedonia are not only unable to feel any pleasure but the positive event may actually lead to them feeling worse.
For example, when witnessing a beautiful sunset from the balcony of a luxury hotel in an idyllic setting, not only will those with anhedonia experience no joy, but experience an increase in negative affect (mood) such as intensified feelings of anxiety, guilt or shame. It is this increase in negative feelings in response to positive events which is referred to as ‘negative affect interference’.
In connection with this, the famously pessimistic poet, Philip Larkin, once wrote in a letter to his great friend, Kingsley Amis, the British writer that sunny days actually made him feel worse, precisely because of the societal expectation that such meteorological conditions should ‘lead to people ‘cheering up.’
Frewen et al’s study also showed that different types of childhood trauma led to different kinds of negative affective interference in response to positive events. For example, those who suffered emotional abuse as a child were more likely to experience increases in anxiety, whereas those who had suffered childhood sexual abuse were more likely to experience feelings of shame.
IMPLICATIONS OF ABOVE FOR THERAPEUTIC INTERVENTIONS RELATING TO ANHEDONIA :
The above findings suggest that therapeutic interventions for those suffering from anhedonia should not only focus on increasing positive affect but also on strategies for regulating negative affect in response to positive events.
4 TYPES OF ANHEDONIA (PHYSICAL, SOCIAL, ANTICIPATORY, AND CONSUMMATORY) AND HOW EACH TYPE MAY RELATE TO CHILDHOOD TRAUMA:
Anhedonia can be divided into 4 categories:
- PHYSICAL ANHEDONIA: This refers to the inability to derive pleasure from physical/sensory experiences such as eating, sexual activity, touching, temperature, movement, sound, and smell (Chapman et al., 1976)
- SOCIAL ANHEDONIA: This refers to a lack of pleasure derived from mixing with others (that cannot be explained by other factors such as social anxiety) and a preference to be alone.
- ANTICIPATORY ANHEDONIA: This refers to the inability to derive pleasure from the prospect of future rewards or, to put it more plainly, a loss of the capacity to look forward to things.
- CONSUMMATORY ANHEDONIA: This refers to the inability to feel pleasure in the ‘here and now” i.e. in-the-moment pleasure when the reward is actually encountered and experienced.
Research conducted by Fan et al., (2019) found that those who had experienced moderate to severe childhood trauma were significantly more likely to suffer from physical, social, and anticipatory anhedonia than controls but NOT from consummatory anhedonia. Indeed, this was found to be the case whether or not these individuals were suffering from a major depressive disorder.
HOW IS ANHEDONIA MEASURED? The Snaith-Hamilton Pleasure Scale (SHAPS):
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Chapman LJ, Chapman JP, Raulin ML. Scales for physical and social anhedonia. J Abnorm Psychol. 1976 Aug;85(4):374-82. doi: 10.1037//0021-843x.85.4.374. PMID: 956504.
Fan, J et al., Childhood trauma is associated with elevated anhedonia and altered core reward circuitry in major depression patients and controls. Wiley 2019.
David Hosier BSc Hons; MSc; PGDE(FAHE).
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