Experience of Self › Disturbance of Awareness of Self-Activity

Loss of Emotional Resonance

Loss of emotional resonance is a subjectively felt inability to feel the ordinary run of small positive and negative feelings that everyday encounters with people, objects, and events would normally produce. It is most often described in depression, where the person feels that this natural emotional responsiveness has simply gone, and is often felt most acutely and painfully in relation to people the person loves.

This has traditionally been distinguished from a general lowering of mood: it is not simply that the person feels sad, but that the ordinary background hum of emotional reaction to the world has itself gone quiet, which can be a particularly distressing feature in its own right, especially when it makes a person feel unable to love or care about their own family.

Recognition features

• A subjectively felt loss of the ordinary small emotional reactions, positive and negative, that everyday life would normally produce
• Most often and most distressingly noticed in relation to loved ones, where the person expects to feel warmth or connection but instead feels nothing
• Purely subjective: to an outside observer, the person may still appear to respond appropriately, since this is a felt inner absence rather than a visible change
• Can compound feelings of guilt in a person with depressive illness, who may interpret their own lack of feeling as evidence of being a bad or unworthy person

Eliciting it at interview

• Ask directly: "Do you still feel things the way you used to, good or bad, when things happen around you?"
• Ask specifically about feelings toward close family or loved ones, since loss of emotional resonance is often most keenly noticed and most distressing in this context
• Where guilt is prominent, explore whether the person has interpreted their own loss of feeling as evidence of some personal moral failing, since this connection is a recognised and important one to address

Distinguishing features

• Differs from affect blunting, a morbid expression of emotion, which is an outward, observable reduction in emotional display, whereas loss of emotional resonance is a subjective inner experience that may not be visible to an observer at all
• Differs from apathy, which concerns reduced interest and motivation broadly, whereas this concerns specifically the felt absence of ordinary emotional reactivity
• Most classically associated with depressive illness, but also recognised in depersonalisation states more generally

Common misconceptions

• That a person reporting this must also look emotionally flat to others; the change is often entirely subjective and may not be apparent on observation
• That this feeling of not being able to feel reflects a genuine lack of care; it is a distressing symptom the person is suffering from, not a true reflection of their underlying feelings toward others

Related phenomena

Disturbance of Awareness of Self-Activity · Depersonalisation · Depressive Illness

Practice this

A depressed man describes, with visible distress, that when his children greet him he feels absolutely nothing — no warmth, no connection — despite still outwardly smiling and responding to them appropriately. To an observer he seems to react normally, but subjectively he feels a troubling inner absence. What is this? · A man with severe depression says he feels nothing when he sees his newborn grandchild, and concludes from this that he must be a fundamentally bad, unloving person. Before revealing the answer: how should this feeling and his interpretation of it be understood? · A patient describes a reduced emotional response. Before revealing the answer, decide what distinguishes loss of emotional resonance from affect blunting. · You are assessing a depressed patient and want to establish whether loss of emotional resonance is present. Before revealing the answer, decide what you would ask. · Explain why loss of emotional resonance can compound guilt in a person with depressive illness, in a way that affect blunting, being unrecognised by the patient, typically does not.

Illustration

A 43-year-old mother in the midst of a depressive episode describes picking up her toddler as she always has, but says with visible distress that she felt absolutely nothing while doing it, none of the warmth she knows she should feel, and worries this must mean she has become a terrible mother, even though she continues to care for her children attentively in every practical way.

References

• Casey, P. & Kelly, B. (2019). Fish's Clinical Psychopathology, 4th ed. Ch. 7, 'Disorders of the Experience of Self'.