INTENSIVE SHORT-TERM DYNAMIC PSYCHOTHERAPY (ISTDP)
The main goal of ISTDP is to enable and empower the individual to overcome one´s inner struggle with his or her forces of emotions. Only when this inner conflict becomes conscious can we tolerate, accept and appreciate our inner conflict, and ultimately, relief and personal growth will occur
SHORT-TERM THERAPY FOR LONG-TERM CHANGE
The experience of being overwhelmed by symptoms such as anxiety and depression at times throughout our lives is not so unusual as we think. These are in fact feelings about past and present-as well as eventual future experiences- that overwhelms us. These feelings are often emotional consequences of broken attachment (for example between parents and / or one of the caregivers and child) and relational trauma. Serious disruption of attachment, or a marked lack of presence to atonement from caregivers, can lead to a stream of complex emotions (pain, grief, rage, guilt, etc.) that are attempted avoided due to the understandable fear / discomfort they activate. Activation of anxiety can be a result from these complex emotions often being aimed at primary attachment figures and, therefore perceived conflictual. Through learning, strategies of avoidance (defense / averts) of complex emotions can become automatic as such and thus be generalized to other people and situations. The avoidance creates both pathology and leads to its maintenance, and can therefore over time lead to become anchored in the personality of an individual. Because of the potential intimidating, threatening and painful nature of emotions, a conflict arises and as part of this, anxiety in the individual. Many also experience physical ailments as a result of this, which may be diffuse and make it difficult to understand how things are connected. It is in such situations that many seek a psychologist for an initial consultation.
As a psychotherapeutic approach, ISTDP suggests that these physical and mental problems are the result of trauma, memories and emotions that are too powerful as well as painful that they can come up from the unconscious and remain at a conscious level. Such blocking of emotions can further lead to adverse health effects in particular as physiological systems are affected by this, such as the gastrointestinal system, the cardiovascular system, respiratory system, immune system, muscles and skin. In addition, these problems are known causes of disability (of work) and secondary depression.
The concept of psychosomatic disorders is used to designate relatively extensive distressing physical symptoms that for no secure significant physical reasons can be found. Psychosomatic symptoms may manifest itself in somatic, bodily symptoms that are believed to stem from psychological factors and can be explained by psychological reasons.
HOW IS ISTDP DIFFERENT FROM OTHER THERAPY FORMS?
The goal of this therapy approach is to achieve character change in the individual by the use of intensive and focused techniques and methods.
The thinking is that permanent change can happen if the individual let go of all the obstacles or so called resistances that he / she has, both conscious and unconscious, in order to relate to his or hers emotional experience of reality. This therapy method has therefore the individual´s unconscious defense mechanisms, feelings and thoughts as an ally in therapy work.
Treatment in ISTDP, which was designed by Habib Davanloo and further developed by, among others, Allan Abbass, Patricia Coughlin, Jon Frederickson and Kees Cornelissen, is first to make individuals aware of these unconscious sequences consisting of ´emotions – anxiety – defense symptoms´, for then to help them to overcome emotional blockages. This will often mean a focus on the emotions the individual is experiencing ´here and now´ in the therapy setting with the therapist, as well as identification of the individual’s habitual uses of defense strategies or exhibit resistance ( as defense against emotional closeness) followed by systematically challenging these dysfunctional mechanisms.
With time, when these feelings and emotions are experienced fully, a fast and significant decrease in bodily tension, anxiety and other physical symptoms as well as defense, is likely to take place. At this point of time in the therapy process, the client and the therapist has developed and achieve together a clear understanding of the emotional forces that triggered the anxiety and toward which the defense was aimed at. The aim is for a significant healing process to take place, where previously avoided feelings are fully experienced in a bearable and non threatening way as well as worked through.
Often, a simple case of breakthrough of emotion can be enough to achieve great improvement in symptoms and symptom reduction as such, while in most cases, a series of these is necessary to achieve greater behavioral and character changes that will last over time.
FOR WHAT MENTAL PROBLEMS AND SYMPTOMS IS ISTDP THE OPTIMAL CHOICE OF THERAPY?
This treatment and variations of it have been extensively studied and shown effective in clients with depression, anxiety, somatization and / or psychosomatic symptoms (which may be diffuse pain, dizziness, abdominal pain or headache), substance abuse, eating disorders and a wide range of personality problems.