How Much Change Can Happen in One Therapy Session?

In many models of therapy, change is seen as a gradual process.

But in ISTDP, meaningful shifts can sometimes happen much sooner, even in a single session.

This isn’t about rushing. It’s about working directly at the emotional core of the problem.

When unconscious emotional conflicts are brought into awareness and experienced fully, symptoms can shift, not over months, but in moments of deep emotional clarity.

Why Are Symptoms There in the First Place?

From an ISTDP perspective, symptoms like anxiety, depression, somatic complaints, or chronic self-doubt are often signals of internal emotional conflict.

At some point, the person experienced feelings; often anger, grief, guilt, or longing, that felt too threatening or painful to fully experience.

To manage this, the mind employed unconscious defences to keep those feelings out of awareness.

These defences, while protective in the past, create long-term problems:

• Anxiety builds as feelings are continually pushed down

• Emotions get distorted or redirected (e.g. turning anger inward as self-criticism)

• The nervous system remains stuck in high alert

• Relationships suffer because real needs and feelings can’t be expressed

In short: symptoms are the cost of avoiding the truth of one’s emotional life.

Why Unlocking the Unconscious Changes Things

Change happens when the unconscious becomes conscious, not just intellectually, but emotionally.

When therapy helps a person feel what they’ve been defending against, directly, in the room, in the body, the entire internal system begins to reorganise.

This is what ISTDP calls the unlocking of the unconscious.

It’s not about catharsis. It’s about integration.

The defences are no longer needed in the same way, because the feelings they protected against have now been faced, felt, and processed.

And with that, symptoms that were once maintained by emotional suppression often reduce sometimes dramatically.

People describe:

• Feeling clearer, lighter, or more connected to themselves

• Noticing reduced anxiety or physical tension

• Understanding long-standing patterns in a completely new way

• A sense that something real has shifted, not just been talked about

Change Can Begin with a Single Session

While ISTDP is a focused and active approach, it recognises that deep, transformational change doesn’t always have to take years.

When the right conditions are created; emotional safety, a clear therapeutic focus, and moment-to-moment attention to anxiety and defence, deep emotional contact can happen quickly.

That’s why one session can sometimes be enough to:

• Alleviate longstanding symptoms

• Unlock grief, anger, or tenderness that’s been buried

• Create a felt sense of emotional relief or self-connection

• Set a clear path for further healing and change

It’s Not a Quick Fix, It’s a Direct Approach

This isn’t about skipping steps.

It’s about starting in the right place: with the defences, anxiety, and unconscious emotional material that maintain a person’s suffering.

By helping clients reach the emotional truth behind their symptoms, even a single session can bring a shift that years of surface-level insight might not touch.

Curious About What One Focused Session Could Do?

If you’ve felt stuck in therapy that hasn’t gone deep enough, or you want to experience what this kind of focused emotional work feels like, I offer trial sessions and structured therapy blocks based on ISTDP.

Feel free to get in touch if you’d like to learn more.