It's Not Always Depression by Hilary Jacobs Hendel

Depression and anxiety can be tough to handle and treat. Drugs may treat symptoms, but they do not cure depression and they typically do not work for long or require ever increasing doses. Talk based therapies can be helpful, but sometime it take a long time to get a helpful breakthrough.

Some forms of treatment aim to be more active. One such is accelerated experiential dynamic psychotherapy, or AEDP. This form of therapy is the basis of the methods described by therapist Hilary Jacobs Hendel in It’s Not Always Depression.

In a nutshell, AEDP sees maladaptive behaviors (defenses) and stressful emotions such as anxiety (inhibitory emotions) as ways to suppress potent core emotions. This can be useful to help us get along in social situations, maintain relationships and keep ourselves from being carried away by strong emotions. This is especially true when we are children and may not have the maturity or power to choose another path. However, we can become stuck in this behavior, never dealing properly with our core emotions, and our inhibitory emotions and defenses can become maladaptive, keeping us from the life and relationships we want and need.

Hendel organizes these items into an equilateral triangle setting on point. Defenses sit at the upper left corner, inhibitory emotions at the upper right, and core emotions at the bottom. Beneath the core emotions is your authentic self, which Hendel calls an openhearted state, in which one feels calm, confident and clear-headed.

Working the triangle is getting in touch with core emotions by finding how our defenses and inhibitory emotions are protecting us from them and the consequences of expressing them. Hendel draws examples from her therapy practice, but the fact that this is a book for a popular audience suggests that this is a technique that people could use on their own as well as in a more formal therapeutic setting. When we acknowledge our core emotions, name them, let ourselves feel them (they will pass) and express them in safe ways (sometimes through fantasy), they lose their potency and move on. By doing this repeatedly we learn that we can handle our emotions in ways that are safe and constructive; we have alternatives to our old defenses and inhibitory emotions and we can let them go. From here we can relax into an openhearted state.

“[W]e cannot  think our way through a core emotion; it must be experienced viscerally to be processed,” Hilary Jacobs Hendel, It’s Not Always Depression

Because defenses and inhibitory emotions protect us from core emotions, it can be difficult to know what we are feeling. Emotions are felt in the body, and Hendel describes was of slowing down to scan the body, assess our sensations and use this information to uncover our core emotions.

I’m not a therapist, but I can see the benefit of the framework. It gives someone a way to identify what they are doing and feeling. It can give one words to describe what one is experiencing and a process for exploring that experience. Its ultimate aim is to retrain the brain so one can let go of behaviors that are no longer helpful an embrace new ways of coping that allow for one to feel emotions and at the same time have the calm and clear mind to deal with situations constructively.

It is hard to do justice to these ideas in a few paragraphs. If you are looking for a way to deal with depression and anxiety, this book may be helpful. Even so, if your issues are severe, you should not abandon professional help from a physician or therapist. You may need a guide to help you through the process. There is no shame in that. We all need help when we are learning something new.

If you’re interested in this book, you may also be interested in

The Mindful Way through Depression by Mark Williams et al

The Road Less Traveled by M. Scott Peck

Hendel, Hilary Jacobs. It’s Not Always Depression: Working the Change Triangle to Listen to the Body, Discover Core Emotions, and Connect to Your Authentic Self. New York: Spiegel & Grau, 2018.