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Book Review: It's Not Always Depression

Depression is thought to be one of the most common psychological ailments.

When clinical social worker Hilary Jacobs Hendel wrote an op-ed in the New York Times titled, “It’s Not Always Depression,” it was the most emailed article for 48 hours, and stayed in the top ten shared articles for more than a week.

Clearly, Hendel had struck a chord.

In her new book, It’s Not Always Depression: Working the Change Triangle to Listen to the Body, Discover Core Emotions, and Connect to Your Authentic Self, Hendel presents what we commonly label depression as a loss of the authentic self; a loss that not only keeps us from knowing what we really want out of life, but from knowing how to get it.

Healing is not something that happens only when we seek treatment, writes Hendel. Rather, it is an innate human drive to fully actualize, experience, and develop our potential. In short, we are wired to heal.

This drive, called transformance, is described by creator of Accelerated Experiential Dynamic Psychotherapy (AEDP) Diana Fosha as “a fundamental need for transformation.”

“We are wired for growth and healing. And we are wired for self-righting, and resuming impeded growth. We have a need for expansion and liberation of the self, the letting down of defensive barriers, and the dismantling of the false self. We are shaped by a deep desire to be known, seen, recognized, as we strive to come into contact with parts of ourselves that are frozen,” Fosha says.

A pivotal piece of undoing emotional suffering, however, is undoing aloneness.

“How loved and accepted we were by others directly correlates with how much we love and accept ourselves. If we received little or no compassion when we felt bad, we will give ourselves little or no compassion for our internal suffering,” writes Hendel.

Yet connection goes beyond simply alleviating painful emotions. It is the birthplace of positive emotions such as joy, delight, pleasure, and awe. In this way, the practice of AEDP transcends the exchange of empathy and validation, opening space to celebrate accomplishments, connect with strengths, and experience ourselves more fully.

One key component of AEDP is understanding the role of emotions.

“Emotions drive us to act in the moment. We feel these as impulses. Be it anger, sadness, fear, disgust, joy, excitement, or sexual excitement, core emotions prime us for action,” writes Hendel.

Emotions also have energy, creating physical sensations, acting as inhibitory controls, and collapsing on each other causing anxiety. One example is the feeling of shame.

“We naturally experience shame when we believe we do not measure up. Even people with loving supportive families can be ashamed for being poor, or nonwhite, or non-Christian, for identifying as transgender or gay; or for being sick or disabled, just to mention some of the groups that will suffer stigma or injustice,” writes Hendel.

The question Hendel encourages us to ask ourselves is: should we accept that part of growing up is to become ashamed of our authentic selves?

The process of AEDP would say no. Our struggles and frustrations act as signals to access ourselves more fully, uncover our deepest gifts, hidden strengths, and most positive emotions, eventually finding what Hendel calls the openhearted state.

“In an openhearted state we are calm; curious about our mind, the minds of others, and the world at large; connected to our body and to the hearts and minds of others; compassionate to ourselves and to others; confident in who we are; courageous in our action; and clear in our thought,” writes Hendel.

Through the practice of using our authentic self to notice our defenses, thoughts, feelings, impulses, and bodily sensations, we can use the information to further inspire our transformational process, as opposed to being overtaken by emotions and acting on impulses. This process acts as a non-finite transformational spiral, in which upward spirals give rise to more energy and vitality that inspire increased growth.

“As you move toward vitality and authenticity your ability to tolerate challenges will grow. Pain, anxiety, and fear will still arise, but emotions won’t be as debilitating or scary as they were before. We are not powerless to change or at the mercy of our minds,” writes Hendel.

Through powerful examples of her work with patients, highly relatable language, and erudite clinical wisdom, Hendel encourages readers to look beyond what we think is depression to uncover our true, openhearted and authentic selves.

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

Hilary Jacobs Hendel, LCSW

Speigel & Grau

February 2018

Softcover, 269 Pages

Book Review: It's Not Always Depression

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Claire Nana

Claire Nana is a regular contributor and book reviewer for Psych Central.

APA Reference
Nana, C. (2018). Book Review: It's Not Always Depression. Psych Central. Retrieved on September 30, 2020, from
Scientifically Reviewed
Last updated: 25 Jan 2018
Last reviewed: By a member of our scientific advisory board on 25 Jan 2018
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