It's Not Always Depression: Working the Change Triangle to Listen to the Body, Discover Core Emotions, and Connect to Your Authentic Self

For many years I'd been seeing doctors who had diagnosed me with major depression and social anxiety. I tried the "gold standard" approach of Cognitive Behavioral Therapy (CBT) and the newer mindfulness-based Acceptance and Commitment Therapy (ACT), as well as medication, meditation, exercise, and countless other things everyone always recommends. They all helped somewhat, but I couldn't help feel that they never touched the heart of my emotional pain. One day, I happened to read Hilary Jacobs Hendel's op-ed in The New York Times titled "It's Not Always Depression, Sometimes It's Shame." The story of "Brian", whose parents had provided for him materially but neglected him emotionally, spoke to me, and something crucial clicked when Hendel called his experience "a form of trauma." When I saw that Hendel was publishing a new book with the same title as her article, I jumped at the chance to buy it.Trauma was a word I had always associated with experiences like warfare, car accidents, rape, or natural disaster. But reading her article sent me on a path of searching, which eventually led me to the work of Bessel van der Kolk, Pete Walker, Beverly Engel, and others who recognized that things like abuse, neglect, bullying, or other more workaday adverse experiences can result in similar symptoms as those more obvious traumas. In this book, Hendel calls these "small t traumas" (as opposed to "Big T Traumas"), and makes the point that "we are all a little traumatized." Such "small t traumas" are often easy to overlook, but can deeply wound our ability to feel what we really feel and (by extension) be who we really are. In this book, Hendel teaches you how to reconnect with your emotions and with your true self, what she calls "the openhearted state", characterized by calm, compassion, clarity, connectedness, confidence, and courage.It's taken me several months to get through the book. Hendel really wanted to get as much of the healing potential of therapy (particularly the style of therapy she practices, Accelerated Experiential Dynamic Psychotherapy) into the book as possible and make it as accessible as possible, using plain language. The result is admittedly more pragmatic than immediately inspiring. It makes for a slow read, especially if (like me) you want to contemplate the information and apply it to your life. It's not easy work, and may require working through it with a therapist. But this is vital information in a world which seems to revolve around running from our emotions, and each page is brimming with empathy and compassion for her clients and for her readers. Hendel was doing a brave and risky thing in making this information, heretofore available only to mental health professionals, widely available in a book for the general public. Diana Fosha, the founder of AEDP, expresses in the Foreword to this book a veiled apprehension about having her life's work loosed upon the world, out of her careful guardianship, though I don't think she need worry. This book is thus a gift of deep compassion, and I'm extremely grateful she put in the work and dedication to get this information out to as many people as possible. I especially appreciated the inclusion of specific techniques for working with emotions like anger, anxiety, and shame; in addition, Hendel goes into considerable depth about the nature of trauma, the factors that can contribute to our anxiety or shame, and offers moving, relatable stories from her own therapy practice.It's not a perfect book. The Change Triangle she uses is a helpful shorthand for our uneasy relationship with our emotions, but I'm not convinced that this framework (developed for clinicians) will be successful as self-help tool for a general audience, due to the level of self-awareness required. (I note that, to date, many of the positive reviews are by therapists and not laypeople.) What's more, I don't feel Hendel emphasized the potential pitfalls of trying to do this work on your own. AEDP is a deeply interpersonal form of therapy, and this comes across in both Fosha's Foreword, and Hendel's moving clinical vignettes. Especially when we're dealing with trauma, the presence of a compassionate other is vital. I previously read Tina Gilbertson's delightful  Constructive Wallowing: How to Beat Bad Feelings by Letting Yourself Have Them , which covers much the same ground as Hendel, and I find myself using her T-R-U-T-H technique more than the Change Triangle, though they accomplish essentially the same thing. But Hendel's book adds a wealth of information from neuroscience, attachment theory, emotion research, and clinical practice that will be valuable to anyone interested in going deeper.

Very human should have this information! Seriously, get this book! You will understand yourself and others so much better!

Helpful advice. I appreciated the info and layman's terms of processing emotions.

As a psychiatrist and therapist for over 40 years I have always encouraged my patients to pay attention to how they are feeling and thinking. To deny or avoid one's true feelings and emotions leads to a multitude of problems and symptoms from states of depression to anxiety and everything in between.This practical and clearly written self-help book written by a gifted therapist helps the reader learn the incredible importance of understanding and accepting our core emotions and the variety of ways we use defenses and other emotions (anxiety, guilt, and shame) to protect us (even though they cause us pain as well).It is filled with examples from her personal life and her work with patients to help you understand the importance of discovering and accepting your emotional responses and how to use that knowledge to better navigate your life.She introduces you to The Change Triangle, a conceptual tool, a map, to understand our emotions and discover what we are doing with them that limit our awareness and growth.Without jargon or overly technical explanations, she presents the latest theories and discoveries in cognitive psychology, neuroscience and mindfulness meditation. She distills this knowledge into a multitude of useful tools and skills to better understand, acknowledge and use our emotions to enhance our lives.She describes clearly and compassionately the various ways we have of avoiding emotions with the layers of defenses, protective feelings, and automatic emotional reactions.Her approach reminds us and focuses on our innate health and teaches how to use that more effectively.The book is filled practical techniques of observation and mindful awareness skills to help one become more in touch and accepting of our core emotions. The book offers hope and direction.The author is a trained and obviously skilled therapist and writes openly about her own struggles and discoveries. She writes with openness, compassion and humor that offers the reader the opportunity to understand what she is feeling and how she thinks and how she guides her patients to help them discover their true power.This gives us a window into how our minds work and how important it is to pay attention to our bodies and our emotions whenever interacting with others (and ourselves).And most important this book offers hope for gaining understanding, acceptance and healthy ways to manage our deepest feelings.Larry Drell, MDAnxiety And Depression Therapy ServicesWashington, DC

This book has been instrumental in helping me change my codependent tendencies. I love books and my therapist recommended this one. I’m so glad she did! The change triangle is simple and easy to use when feeling great or feeling triggered. Highly recommend!!

This clearly demonstrates how we lie to ourselves and others about how we really feel and how much of a burden this places on our ability to be our true selves and how we so often modify our thoughts, feelings and behaviour in order to avoid confronting our fears shame and guilt. It shows how often we allow others to push us into uncomfortable places from which we feel we cannot escape. Everyone should read this. Learn to recognise how and when you are stifling your emotions and how to take responsibility for your life. This is powerful stuff and does not always make for easy reading.My only criticism is that it is somewhat repetitive in places.

As a social worker myself I like the way emotions and defense mechanisms are being looked at in this book. I definitely learned something new! The book is written in an easy to understand language, therefore it’s not only for professionals.However, the foreword doesn’t do the book any favours. It’s a lot of hot air from someone who wanted to be heard. Don’t put the book away after reading the foreword, I almost did and I would have regretted it.

An interesting model for how defenses against emotion can lead to depression. Useful if the cause of your negative emotions is in the past, or if you have any positive emotions available to feel now. If your life is unhappy and you have no cause or outlet for positive emotion, then it's not much use. Worth a look though.

Found this purely by accident and the title intrigued me. Read it over a weekend and plan to read it again. I thought the techniques wouldn't work but tried them with an open mind and they did work, and I'll be repeating these as required.

An excellent book, easily the best of several I’ve read on depression, anxiety and emotions.