"Treatment should go beyond reducing negative emotions and focus on restoring meaningful activities, joy, and connection."

A New Path to Joy: Therapy Targeting Positive Emotions Outperforms Conventional Care

A groundbreaking study published in JAMA Network Open suggests that retraining the brain to feel pleasure may be more effective than traditional treatments for depression and anxiety.

Researchers from SMU and UCLA report that Positive Affect Treatment (PAT) —a therapy designed to rebuild the brain's capacity for positive emotions—led to greater improvements in overall clinical status than a conventional therapy in a randomized trial of 98 adults suffering from severe anhedonia, depression, and anxiety.

The Key Insight: Treating What’s Missing

Anhedonia—the inability to feel positive emotions—affects 90% of depressed patients and is a strong predictor of suicide and chronic illness. While most therapies focus on reducing negative emotions like sadness or fear, PAT takes a different approach: it targets the brain's reward system directly, never addressing negative feelings at all.

"Anhedonia reflects hopelessness—the belief that nothing can change."
— Lead researcher Alicia E. Meuret

Meuret distinguished between helplessness (which includes a drive to change) and hopelessness (a belief that change is impossible). PAT is designed to break this cycle of hopelessness by restoring the brain's ability to experience joy.

How PAT Works

PAT consists of 15 structured sessions designed to retrain the brain's reward system through specific exercises:

• Savoring — actively focusing on and extending positive moments
• Gratitude — consciously recognizing and appreciating what is good
• Loving-kindness — cultivating warmth and connection toward oneself and others

These exercises aim to rebuild neural pathways for reward processing, reversing the damage caused by chronic depression.

Surprising Results

Despite the fact that PAT never directly addresses negative emotions, patients showed significant reductions in both depression and anxiety symptoms.

The study identified modulation of reward and threat processes as the central mechanism driving this improvement. By enhancing the brain's ability to process positive experiences, PAT also seemed to dampen overactive threat responses.

Crucially, the advantage of PAT over conventional therapy was maintained at the one-month follow-up, suggesting durable benefits.

What This Means for Treatment

For millions who suffer from anhedonia—a condition often resistant to standard treatments—this research offers a new pathway. Instead of focusing on fighting negative emotions, therapy may need to restore the capacity for joy itself.

"Treatment should go beyond reducing negative emotions and focus on restoring meaningful activities, joy, and connection."
— Alicia E. Meuret