Got a problem in your life that is causing internal discomfort or distress? Or maybe you would just like to get to know yourself better? ISTDP can help you get to understand yourself better by delving into the unconscious issues and defences which prevent you from achieving your full potential!
What is ISTDP?
Intensive Short-Term Dynamic Psychotherapy (ISTDP) is a brief, focused therapy designed to work with a wide range of mental health concerns. This therapy operates from an understanding that most psychological concerns stem from attachment difficulties in childhood.
ISTDP has been in development for 45 years by Professor Habib Davenloo and several therapists since who trained with Davenloo. This therapy is based upon attachment theory, neuroscience and psychodynamic therapy, and seeks to address underlying defences and symptoms in an accelerated format.
This approach works with difficulties which arise from intense feelings created in early relationships such as rage and guilt. These emotions bring coping strategies called ‘defences’ which are emotional, psychological and behavioural mechanisms designed to enable us to avoid emotional pain. These defences play out throughout the lifespan, particularly in interpersonal relationships which stir up old emotions and may create a distance or feeling of disconnectedness with loved ones. The difficulties are experienced in a range of ways including anxiety and depression, as well as compulsiveness and physical issues without medical explanation, obsessions and avoidance, self-sabotage and intimacy issues.
ISTDP is an interactive therapy for the client and therapist to work together in identifying the way the client experiences their anxiety and defences which arise to block the painful feelings. As a team, the therapist and client work to overcome the defences, allow the suppressed feelings to surface, and work through the feelings, thoughts and memories attached to the feelings to facilitate resolution of inner conflict. In this manner, the defence system is restructured to work for the client, and allow for close, intimate relationships and resolution of mental health concerns.
What is it used for?
Many emotions over time may become “blocked,” rage, guilt and sadness may become uncomfortable and become expressed as intense anxiety, or maybe you find you can’t help crying whenever you’re frustrated or annoyed? Perhaps it is happiness that you can’t experience without a companion feeling of dread? If emotions have become confused or buried, ISTDP can help restructure your emotional self and unlock the hidden meanings to your thoughts and behaviours, allowing you conscious control over self-sabotaging behaviours, and increasing self-compassionate and goal-oriented behaviours.
The basis of ISTDP is to elicit complex feelings and defences in the therapy room which are activated in your outside life. In exploring these defences, links to emotions and pain from the past will be raised and dealt with, relieving present defences and symptoms such as depression, anxiety, headaches, bowel issues and nausea, medically unexplained symptoms and pains, obsessive and negative thoughts, relationship difficulties and emotional detachment.
How will it work in practice?
Anxiety at meeting a psychologist is common. Using ISTDP we will aim to use this anxiety to explore emotions driving present difficulties, and the ways you unconsciously "defend" which may be keeping you from attaining your therapeutic goals. In experiencing complex emotions beyond the defences, symptoms and anxiety may be lifted.
This internally focused therapy will allow you greater insight into yourself, your emotions, and relationships with others and the world around you. With insight and understanding comes greater control over defences and old behaviour patterns which may be affecting your life in a negative way. Defences often aim to reduce or block anxiety and emotions in the conscious experience, though may leave us with an emotional experience which is detached or unstable, making building and maintaining close relationships difficult.
How does ISTDP differ to CBT or ACT?
ISTDP operates from an attachment framework, and as such it utilises the most effective treatment element in psychology – the therapeutic alliance. What this means is in ISTDP you will not be given “skills” by the therapist, instead the therapist’s role is to help you better understand yourself, make your own decisions about your thoughts and behaviour, and facilitate you discovering the best methods to help yourself. In ISTDP it is assumed that as the client you know more about yourself than anyone else in the world (me included!), and as such you are in the best position to know your needs and make choices for yourself. My role is to notice and point out the ways you may be standing in your own way, and let you decided what to do about it. This can be frustrating for clients as I will not occupy the traditional role in therapy as an “expert” as will not presume to know what’s best for you. Instead I will help you to explore and discover your unconscious self, clarifying behaviour patterns and symptoms from complex emotional experience, and facilitating healing of emotional pain and unleashing you to become your best self.
If you think this approach may be for you or you are interesting in using the ISTDP approach for accelerated treatment of emotional and attachment difficulties, please consider making an appointment with me to explore your present problems and assess your emotional health.
- Abbass, A. (2002). Intensive short-term dynamic psychotherapy in a private psychiatric office: clinical and cost effectiveness. American journal of psychotherapy, 56(2), 225.
- Abbass, A. (2015). Reaching Through Resistance: Advanced Psychotherapy Techniques.