@AuntGlow and others interested, here are the parts I most resonated with from the article https://yung-sidekick.com/blog/severe-anhedonia-a-somatic-and-behavioral-protocol-for-rebuilding-the...
Standard behavioral activation protocols consistently recommend "pleasant activities" for these clients. You've witnessed the resulting frustration and despair. These traditional approaches fail because they assume your clients retain basic pleasure capacity.
I also related a lot to being able to distinguish between the 2 types of anhedonia:
... BA targets motivational aspects through activity scheduling and barrier identification [3], yet leaves consummatory deficits completely unaddressed.
I wonder whether this specific quote might be relevant to many others experience too... @NightFury (My own bolding added)
The standard BA recommendation to engage in "pleasant activities" can intensify suffering for severely anhedonic clients... Severe anhedonia involves impaired reward system functioning beyond reduced motivation... Pleasant activity assignments create a cruel paradox for these clients. Activities prescribed as remedies become evidence of their broken reward system. Each failed pleasure attempt reinforces hopelessness and generates iatrogenic shame—treatment-induced shame that compounds existing suffering. This approach validates clients' fears that nothing will ever feel good again.
I found this part validating:
Rather than aiming directly for pleasure—which clients' nervous systems cannot currently access—initial goals must shift toward regulation.
... Recovery requires first establishing somatic regulation and safety—helping nervous systems achieve neutrality before attempting positive states. Subsequently, rebuilding the dopaminergic "wanting" system through micro-efforts prepares ground for eventual pleasure experiences.
...neutral precedes positive in recovery. Clients frequently feel frustrated when pleasant activities produce no pleasure. Reframing the initial target as achieving neutrality rather than pleasure establishes realistic expectations while explaining how calmer states enhance overall emotional regulation.
I think this part is relevant to explaining the reason that despite doing all the right things I have deteriorated and become burnt-out. I have been pushing myself to do big-effort things without reward; I think I need to step back from big-effort and aim for small-effort so that I am not exhausted from effort, which in itself creates a negative feedback loop for me.
1% effort tasks and movement experiments
I am interested to try the 'Map reward learning' tracking, but know I may find it hard to be motivated to make the effort to track things. This might be somewhere that people here can help me keep motivated/encouraged to do.
I don't think I have much experience (yet) with the application of the pavlovian cue pairing for reward prediction to myself (but to my dogs? Definitely!)
The protocol uses controlled stimulus-reward pairings to rebuild these connections. Identify neutral stimuli—visual cues, sounds, or objects—that can be consistently paired with mildly positive experiences.
I have noticed that when I see pictures of snow-scenes I get a very mild brief fleeting feeling which is neutral-positive. So I can try to leverage that maybe. Like when I saw @Bunniekins 's post today about the "cool bunnies" (bunnies in the snow lol). Thank you @Bunniekins 😍.
... to be continued!
