Intensive Short-Term Dynamic Psychotherapy (ISTDP) is an evidence-based therapeutic approach that has been proven to effectively treat a wide range of mental health conditions. In this article, we'll explore what makes ISTDP so effective and how it can benefit those who are seeking help.
What is ISTDP?
ISTDP is an accelerated form of psychotherapy that focuses on helping individuals identify and process their blocked emotions and change maladaptive coping patterns, that are the root causes of many issues such as depression, anxiety, relational and emotional problems.
This approach was developed by Psychoanalyst Dr. Habib Davanloo in the 1960's, following a frustration from the lack of results he saw from traditional psychotherapy.
He wanted a more effective and efficient approach that would create change in a much shorter time frame. Through analysing hundreds of therapy session videos he was able to begin to make sense of what interventions and approaches within sessions would lead to change for his patients.
He used the theoretical understanding of Psychoanalysis, that the unconscious mind and maladaptive defence mechanisms drives much of our behaviour, but realised that real change happened within therapy when these were directly looked at and optimally challenged within sessions.
Since then, further researchers and therapists have helped to advance the technique, to where it is now, as an effective method of psychotherapy that has allowed the acceleration of change for individuals.
What happens in an ISTDP session?
During sessions, patient and therapist work together to understand and turn against the current maladaptive coping mechanisms and are encouraged to explore their emotions and experiences with the guidance of a skilled therapist.
Unlike other forms of therapy this is a moment by moment task within the therapy. By focusing in accurately on what is happening in the therapy, both the therapist and client can build up an accurate picture of the defences and unconscious strategies an individual uses to currently manage their emotions and difficulties. This can then be used to make significant changes to these current mechanisms.
An example of how such an intervention may work:
Patient: I think I feel some sadness for what happened to me (patient describes this without feeling their sadness.)
Therapist: Do you notice that when you describe your sadness you say 'I think' I feel sad, could this be a way of dismissing your own feelings?
Patient: Yes I have a tendency to do that, I'm expecting you to dismiss my feelings, so I'm stopping myself from feeling them. (client is projecting a belief that the therapist will treat the patient in a certain way, normally arising from clients past experiences with expressing feelings)
Therapist: Okay, that's really important information you have shared, I'm not here to dismiss your feelings (therapist blocks the potential projection, which would lead to client shutting down feelings further), do you know where that idea comes from? that feeling your sadness will be dismissed?
Patient: Oh that definitely comes from my dad, he always told me it was weak to show feelings.
Therapist: Okay so how would it feel right now to go against your dad's rules of dismissing your feelings and let yourself feel this sadness? (therapist challenges patient to stop using their defence of stopping the expression of their sadness).
Patient: Patient begins to let themselves feel the sadness that they had been resisting feeling previously. (Without tackling this projection, patient would have resisted expression of the sadness).
Research has shown that by using this approach, many emotional and psychological difficulties can be significantly improved in ways that other forms of therapy have been unable to do.
How does ISTDP work?
One of the key features of ISTDP is it's aim to fully resolve issues, through an experiential approach, rather than to just bring insight into the difficulties, or create coping strategies to manage it, like such approach's as CBT.
ISTDP also relies heavily on emotional regulation techniques, mentalisation, anxiety regulation and a focus on understanding a person's current coping patterns and working together to create healthier and more adaptive ones, these techniques allow the therapist to work both optimally and safely within the work.
Research has shown that without these processes, most individual's symptoms will return again in the future, as the underling feelings that the defence mechanisms are trying to manage, have never been fully experienced, nor the current defence mechanisms been sufficiently challenged to create change.
Who can benefit from ISTDP?
ISTDP can benefit individuals struggling with a range of mental health challenges. People who experience anxiety, depression, personality disorders, and trauma-related issues can all potentially benefit from ISTDP.
Individuals who struggle with managing their emotions in relationships or have difficulty expressing themselves may also find this therapy approach helpful.
Additionally, those who have experienced childhood trauma or other significant life events that impact their emotional well-being may see improvements through ISTDP.
ISTDP is particularly effective for people who are looking to make long lasting, improved changes to their mental and emotional wellbeing. It has been shown to be effective in treating a wide range of psychological problems and improving overall quality of life.
It's important to note that not everyone will respond the same way to ISTDP. Some people may need more support than others during the process, and it's essential to work closely with a qualified therapist to determine if this type of therapy is right for your individual needs.