How Emotional Avoidance Can Lead to Depression
- Camille Larsen
- Jun 3
- 4 min read
Many people think depression is only a chemical imbalance or a cognitive problem. However, many therapists, including therapist Hilary Jacobs Hendel, argue that what looks like depression is often rooted in emotional avoidance. In Hendel’s book It's Not Always Depression, she explains that when people disconnect from their authentic emotions, they can become stuck in patterns of numbness, hopelessness, anxiety, and emotional shutdown resulting in depression.
Drawing from Accelerated Experiential Dynamic Psychotherapy (AEDP) and concepts closely related to Intensive Short-Term Dynamic Psychotherapy (ISTDP), Hendel describes how humans naturally experience core emotions such as sadness, anger, fear, joy, disgust, and excitement. These emotions are biologically designed to move through the body like waves. When emotions are blocked or avoided, psychological distress often follows.
Emotional avoidance develops for understandable reasons. Many people grow up in environments where emotions were dismissed, punished, or overwhelming. Over time, the nervous system learns to suppress feelings to stay emotionally safe. While this strategy may help temporarily, chronic suppression can disconnect people from themselves and contribute to depression.
What Is the “Change Triangle” and How Does It Explain Depression?
AEDP’s and ISTDP’s “Change Triangle” is a practical framework for understanding emotional health. The triangle includes three key areas: defenses, inhibitory emotions, and core emotions.
At the top corners of the triangle are defenses and inhibitory emotions like anxiety, shame, and guilt. Defenses include behaviors such as (but not limited to):
· overworking
· procrastination
· substance use disorder
· compulsions like workaholism or excessive video game playing
· emotional numbness
· perfectionism
· excessive screen time
· intellectualizing feelings.
Depression itself can function as a defense because it disconnects people from deeper emotional experiences. It signals a lack of trust in self and others, and can leave us feeling overwhelmed.
At the bottom of the triangle are core emotions. These are the authentic feelings the body is trying to process. When individuals learn to safely experience these emotions rather than avoid them, they often feel calmer, clearer, and more connected.
ISTDP and AEDP approaches help clients recognize how avoidance patterns maintain depression. Instead of only managing symptoms, therapy focuses on identifying the underlying emotions that have been buried beneath anxiety, shame, or emotional shutdown.
How Does Emotional Suppression Affect the Body and Mind?
Emotions are not just thoughts; they are physical experiences. Fear may feel like tightness in the chest, sadness may create heaviness, and anger may bring heat or tension. Emotions are processed through the body, not just the intellect.
When emotions are repeatedly suppressed, the nervous system remains activated. Instead of resolving emotional experiences, the body stores stress and tension. Over time, this can contribute to fatigue, emotional numbness, irritability, anxiety, and depression.
Research on ISTDP also highlights that emotional avoidance is strongly connected to psychological symptoms. Individuals with more severe mental health struggles often rely on powerful defenses that block emotional awareness. Therapy works by helping clients gradually tolerate and process emotions safely instead of avoiding them.
This perspective helps explain why some people feel depressed even when they “should” feel fine. The issue may not simply be negative thinking. It may be that unresolved emotions have never been fully acknowledged, experienced, or processed.
How Can Therapy Help Someone Move Through Emotional Avoidance?
Therapies informed by ISTDP and AEDP help clients slow down and notice what is happening internally. Rather than bypassing emotions, therapists help individuals safely identify bodily sensations, recognize defenses, and connect with underlying feelings.
For example, someone who constantly feels anxious may discover sadness underneath the anxiety. Another person who feels emotionally numb may uncover long-suppressed anger or grief. Once these emotions are experienced in a safe therapeutic relationship, symptoms of depression often begin to ease.
This process is not about becoming overwhelmed by emotions. Instead, therapy teaches emotional regulation and emotional tolerance. Clients learn that emotions are temporary, informative, and survivable.
Hendel describes emotional health as becoming more “calm, curious, connected, compassionate, and confident.” When people stop fighting their emotions, they often regain energy, clarity, and a stronger sense of self.
Key Points About Emotional Avoidance and Depression
Depression can sometimes function as a defense against painful or overwhelming emotions.
Emotional avoidance often develops early in life as a protective survival strategy.
Suppressed emotions do not disappear; they frequently contribute to anxiety, numbness, and depression.
ISTDP and AEDP-based therapies help people reconnect with authentic emotions in safe and healing ways.
If you are struggling with depression, emotional numbness, anxiety, or feeling disconnected from yourself, therapy can help you understand the root causes beneath the symptoms. Aureum Counseling & Consulting offers compassionate therapy for depression and emotional healing. Request a therapy consultation today to begin reconnecting with your authentic self.
References
Hendel, H. J. (2018). It’s not always depression: Working the Change Triangle to listen to the body, discover core emotions, and connect to your authentic self. Random House.
Town, J. M., et al. (2022). Intensive short-term dynamic psychotherapy (ISTDP) offers unique procedures for acceptance of emotion and may contribute to the process-based therapy movement. Journal of Contextual Behavioral Science, 25, 106–114.
The Center for Emotional Health. (n.d.). ISTDP. Retrieved from The Center for Emotional Health
