The Missing Piece in Trauma Recovery: Why Learning to Tolerate Joy Matters More Than You Think

When we think about trauma recovery, we naturally focus on helping people manage difficult emotions—reducing anxiety, processing painful memories, and building resilience against triggers.

But there's a crucial piece of the healing puzzle that often gets overlooked: the ability to tolerate positive emotions.

Professor Andrew Leeds, a pioneering researcher in trauma therapy, introduced the concept of "positive affect tolerance"—our capacity to experience and sustain pleasant emotions without shutting down or feeling overwhelmed.

For many trauma survivors, this proves surprisingly challenging.

The Paradox of Positive Emotions

It might seem counterintuitive, but joy, excitement, and even calm contentment can feel threatening to someone whose nervous system has been shaped by trauma.

When your brain has learned that good moments are often followed by something terrible, positive emotions can trigger hypervigilance rather than relief.

I've witnessed this countless times in therapeutic settings.

A client makes a breakthrough, experiences a moment of genuine laughter during group work, or feels a rare sense of peace—only to immediately withdraw or find ways to sabotage their progress.

Their nervous system, wired for survival, interprets these positive states as dangerous anomalies.

Why Positive Affect Tolerance Gets Overlooked

Traditional therapy models often focus primarily on symptom reduction.

We measure success by decreased anxiety scores or fewer panic attacks.

But what about increased capacity for joy?

Enhanced ability to receive compliments? Greater tolerance for success and connection?

The research is clear: people who struggle with positive affect tolerance often experience:

• Difficulty maintaining therapeutic gains
• Tendency to sabotage relationships when they become fulfilling
• Challenges celebrating achievements or accepting recognition
• Chronic dysregulation that persists even after trauma processing

The Neuroscience Behind the Struggle

When we experience positive emotions, our parasympathetic nervous system should activate, creating a sense of safety and connection.

But for trauma survivors, this same activation can feel unfamiliar and threatening.

The brain, having learned that letting guard down leads to harm, maintains hypervigilance even during positive experiences.

This creates a cruel irony: the very states that promote healing—joy, connection, safety—become sources of anxiety themselves.

Building Positive Affect Tolerance in Practice

Developing this capacity requires intentional, gradual work. Some approaches that show promise include:

Micro-dosing positive experiences: Starting with brief moments of pleasant sensation and slowly building tolerance for longer durations of positive affect.

Somatic awareness: Helping clients notice how positive emotions feel in their bodies, learning to stay present with pleasant sensations rather than dissociating or numbing.

Experiential approaches: Creating safe contexts where positive emotions arise naturally—through flow activities, creative expression, or meaningful connection—while providing support to tolerate these states.

Integration work: Processing the beliefs and fears that make positive emotions feel dangerous, often rooted in early attachment experiences or trauma conditioning.

The Flow State Connection

This is where experiential approaches like those used in surf therapy become particularly valuable.

Flow states naturally generate positive affect—the neurochemical cocktail includes dopamine, endorphins, and other feel-good compounds.

But crucially, they do so in a context that feels earned and authentic rather than imposed.

When someone catches their first wave or experiences that moment of perfect balance on a board, the positive emotions arise organically from genuine accomplishment.

The therapeutic task then becomes helping them tolerate and integrate these naturally occurring positive states rather than immediately returning to familiar patterns of struggle or self-criticism.

Expanding Our Definition of Healing

Perhaps it's time to expand our understanding of what trauma recovery looks like.

Yes, we want to help people manage their symptoms and process their pain.

But equally important is helping them reclaim their birthright to experience joy, connection, and aliveness.

True healing isn't just the absence of symptoms—it's the presence of vitality.

It's the ability to receive love, celebrate successes, and tolerate the full spectrum of human experience, including the bright parts we may have learned to fear.

What's been your experience with positive emotions in therapeutic contexts?

Have you noticed clients struggling with good feelings as much as difficult ones?

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