I first came across Hilary Jacobs Hendel’s work when I read a New York Times article in which Hendel, a practicing psychotherapist and writer, described the “Change Triangle,” an upside down triangle that explains how emotions work. The Change Triangle is also a roadmap that teaches us how we can use emotions as guides to both heal trauma and attain a more vital and calm state of being. As a follower of Hendel’s blog—and an avid user of the Change Triangle to understand my own inner emotional landscape—I was eager to read 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 and excited to ask her some questions:

Jill Karson: What are the elements of the Change Triangle?

Hilary Jacobs Hendel: The Change Triangle is a simple diagram that helps us understand our internal world and how we move from core authentic states of being to defended and disconnected states of being. More specifically the Change Triangle illustrates the relationship between our core inborn survival emotions (fear, anger, sadness, disgust, joy, excitement, sexual excitement), our inhibitory emotions (anxiety, shame and guilt), and the protective defenses we erect to avoid feeling emotional discomfort and pain. This information empowers us to work with our feelings instead of letting them run the show.

Jill Karson: In your book, you recall that when you first encountered the Change Triangle in 2004, “The elements of psychological experience, which had seemed random and chaotic, fell into place, like the final turn of a Rubik’s Cube.” I experienced this same kind of Aha! moment. In my case, I went through a personal crisis in 2016 that triggered some pretty serious childhood trauma. It was like the perfect storm—past and present trauma unleashed and entwined, and exponentially more potent. The resulting anxiety and dread were pretty agonizing, and I sought relief in the usual treatments: exploring the early trauma that contributed to my inability to cope, finding ways to calm my anxiety, and reading every book I could find. But many of the prescriptions felt vague and nebulous, and I was completely overwhelmed. It was when I read one of your articles about the Change Triangle that it “clicked into place.” Whereas before I thought shame and anxiety were just two more emotions in a long list of painful emotions I needed to tame, I was able to clearly see the interplay of the corners of the triangle—that is, that underneath my anxiety was great sadness and fear, to which I needed to tend. Is this the power of the Change Triangle?

Hilary Jacobs Hendel: Yes! You got it! For me, I felt so much relief knowing there was a cause for my anxiety. And, that I could help myself, as opposed to simply being stuck. Before I learned about the triangle, I thought that I was supposed to control whether I had emotions or not. It was a relief to learn that emotions happen without conscious control. Knowing there was nothing wrong with me for having emotions reduced so much shame I had about myself. I was happy to learn I could change my brain by working the Change Triangle and working on my triggers and how I expressed my emotions.

Jill Karson: You write that the seven core emotions (fear, anger, sadness, disgust, joy, excitement, sexual excitement) are biologically based experiences that allow us to respond to the environment in adaptive ways. These core emotions must be felt in the body. Why is this?

Hilary Jacobs Hendel: Because emotions are body-based experiences. They call them feelings because we feel them. Core emotions evolved to help us react quickly to the environment. They do this by getting our body ready for adaptive actions to help us survive and thrive. For example, if you see an animal charging at you, the sight of the charging animal will trigger fear in the limbic system of your brain. This process happens reflexively, it is not under conscious control. The limbic system communicates first with your lower brain that affects your body so you can run to safety. If you had to think first, you would be dead. Your body needs to run, not to think. So, your body reacts to get you ready to run to safety by affecting your heart rate, breathing, GI tract, muscles and more. It’s only after your body reacts that higher conscious brain levels read those body changes and recognize them as fear. To process core emotions then we must let them flow in the body as physical sensations. We do this by attending to them, by noticing the physical sensations a particular emotion evokes. When emotions flow, they release, and we feel calm again.

Jill Karson: You explain that when core emotions are too painful or otherwise unacceptable, “the inhibitory emotions [anxiety, shame, guilt] act like a red light that sends the signal: “STOP. Don’t feel that!” How do ACEs and early trauma lead to the development of these inhibitory emotions?

Hilary Jacobs Hendel: Overwhelming core emotions such as anger, sadness and fear, plus not enough connection and support, lead the mind, brain and body to use anxiety, guilt and shame to halt the overwhelming core emotional experience. Using muscular constriction, holding the breath, withdrawing inward and self-blame, and other ways, the experience shifts from core to inhibitory. To survive a child needs first and foremost to stay connected to their caregiver, even if that caregiver is mean or scary—which creates a terrible dilemma for the child. The child tries to be pleasing which may involve curtailing anger and other emotions that cause a caregiver to abandon or retaliate. Once the brain learns that certain core emotions are “dangerous” to express because they lead a caregiver to abandon or retaliate, those inhibitory patterns stick around. But just because you try to inhibit the expression of core emotions doesn’t mean those emotions go away. They get stuck in the body. And the mix of blocked core emotions and inhibitory emotions feels awful so the brain defends against the feelings and we become more and more disconnected from our true self and our true feelings and needs. This process is trauma in action. Traumatized parts remain cordoned off so the person can go on with daily living. But the person is compromised. Energy that could be used for living and thriving is diverted to maintaining defenses. It is a constant push pull with core emotions wanting to come up for release and our defenses and inhibitory emotions pushing them away.

Here’s a simple example: Little John’s parents were active alcoholics. He needed care and attention as all children do. But when he tried to get their attention, they ignored or snapped at him. He would get angry and his parents would get angrier until they scared him. His brain figured out he had better stop his anger and his bids for attention. So whenever he sought love and connection, his brain “remembered” that he would only end up scared and alone. Anxiety then came up as soon as his core need for attention or anger came up to signal not to let it. Instead he felt anxiety or shame or both. He became more insecure believing something was wrong with him. He felt alone with these distressing feelings and his needs went unmet. This is a recipe for trauma caused by ACEs—in this case having an active alcoholic as a parent. The brain isolated threatening experiences so he could go on—but his nervous system was deeply affected—over-aroused—in flight, fright and freeze modes. He was dysregulated, which means he could not thrive. He developed low self-esteem, he did not feel like engaging with others, and he was not be able to explore the world positively. Any adverse events or early traumas cause many emotions to be triggered. That’s why adverse and traumatic events set the stage for later symptoms like chronic anxiety, depression, addiction, and more. Because to survive ACEs, a child must block core emotions which then leads to anxiety, depression and other symptoms of psychological trauma and distress.

Jill Karson: In your clinical practice, you use the Change Triangle to work through the emotional components of patients’ early traumatic experiences. Can you give us an example of how this works?

Hilary Jacobs Hendel: It is not so easy to give a quick answer to this which is why I added detailed stories in the book to illustrate this process. But basically, here’s how it goes. I work in the here and now of the moment with a patient. Let’s say Brook comes in feeling badly about herself because she was second guessing something she said to a friend. I will help her get to know that part of her that feels badly: I help her name the emotion, possibly shame. Then I ask her if this is the first time she ever felt this feeling or, if not, can she bridge back in time to the first memory that comes up when she felt this way. Then we work the Change Triangle with that memory. Let’s say a memory from age 9 comes up when she was bullied at school. I would help her get in touch with her anger at the person who bullied her and at the teachers and other grownups who didn’t do anything to help. I’d help her mourn for her younger self, feeling the sadness. If there was fear or disgust there, we would work with that too. The idea is that by the end, these stuck emotions would be freed and she would experience relief. Her brain would integrate these experiences and her nervous system would reset for the better. Brook’s self-esteem would grow as she felt more and more confident that she could experience her core emotions safely and that she was not to blame. It is very transformational to feel on a deep level that there was never anything wrong with you. It was the environment that let you down when you were a child.

Jill Karson: Can the Change Triangle be used to heal complex trauma?

Hilary Jacobs Hendel: Yes. The Change Triangle is the map that is a part of any emotional healing. In addition to the Change Triangle, to heal complex trauma, we need safety and connection to experience those painful feelings from the past. The trick is not to re-traumatize ourselves as we experience the feelings. It needs to happen in a new way that feels better at the end—relieving. That’s where having someone with us, undoing the original aloneness when those feelings were not safe to feel, is so important. And, another thing, when I help someone process complex trauma from the past, that person must be able to have one foot in the present with me and another in the past. If they go too much into the past, they will re-experience the trauma. That is not what we want. In essence, we are working with the Change Triangle from a part of them that lives on in the memory of the trauma. For example, if a woman was raped when she was 18 years old, I will be helping the person experience the core emotions from that 18 year old part of her at the time of the rape. I would help her get to her core anger with its fight impulse, so she felt empowered at the end. We’d likely also have to process fear, disgust, and then sadness on behalf of the self for what she went through. We can use fantasy scenarios to create healing of those parts that were perpetrated against or just focus on the physical sensations. There are many ways to process traumas.

Jill Karson: What is the one thing you would like readers to take away from your new book?

Hilary Jacobs Hendel: That we are not bad, sick, crazy, weak, etc., for having emotions. Emotions just are! We need emotions to tell us about the world and to inform us as to what is good for us and bad for us. Also, it is important to know that emotions are really physical sensations we come to recognize as an emotion. For example, I know when I feel that familiar heaviness in my chest and feeling in my eyes that I want to cry that I am sad. To work with our feelings, we have to become comfortable with how they feel in our bodies. We can all do this with practice and guidance. I have free resources on my website to help and the book shows and tells in detail how to do experience feelings physically but in a safe way.

Jill Karson: Is there anything else that I didn’t ask you that you’d like to share?

Hilary Jacobs Hendel: Yes. It is my pet peeve that our society provides us no formal education in emotions and how adversity and trauma affect us. Not only that, our society perpetuates the idea that we can be disconnected from others and ourselves, suffer the hardships of modern life, and still be ok. Well, humans don’t work like that. They need connection to their deepest truths. My mission with the book was to show what healing looks like and to give all people who want it a basic education in emotions. Just knowing that we cannot stop emotions from happening made a difference in my life. I stopped blaming myself for having feelings and instead started to deal with them. There are many levels and layers on how people can use this book: 1) just to get an education in emotions so they further their self-understanding and to understand other people better; 2) to start a practice of working the Change Triangle; 3) to read it with others, like in a peer support group; 4) to bring the book to a therapist to help work more deeply on childhood wounds and traumas.

It’s Not Always Depression: Working the Change Triangle to Listen to the Body, Discover Core Emotions, and Connect to Your Authentic Self is available at https://www.penguinrandomhouse...-lcsw/9780399588143/

I highly recommend this book, in which Hendel describes in much greater detail the nuts and bolts of how we can use our emotions to heal our wounds and blossom into our best selves. What I really love is that the methods Hendel proposes are simple to employ—and oh so fruitful! As we learn to identify what we are genuinely feeling, why we are suffering, and what we can do about it, the rewards are rich. In sum, I feel full of hope and optimism having read this book.

Please visit Hilary’s website to sign up for her blog and for free resources to help you connect to your authentic self: https://www.hilaryjacobshendel.com/