What is Intensive Short-Term Dynamic Psychotherapy (ISTDP)?

ISTDP has been developed to make psychotherapy more effective and efficient.  As with Psychodynamic Psychotherapy, ISTDP aims to resolve current day problems by developing awareness of the thoughts and behaviours that are causing these problems, understanding the experiences and environment from where these thoughts and behaviours derive, and to process the emotions that cause them to occur, so that you can feel / think / behave differently.

ISTDP is an experiential therapy (which means working primarily in the here-and-now), utilising the immediacy of the therapeutic relationship to extrapolate from relational behaviours, and associated anxiety and feelings, as they occur in the moment, in order to understand how they link to present day symptoms and suffering.

Freedom from symptoms and emotional suffering is achieved by helping to build psychic capacities and overcome defences, in order to face and experience genuine emotions as deeply as possible.  It is understood that the unlocking of the unconscious and the experiencing of complex, mixed feelings is the most important factor in generating lasting change.  Here is a clinical study citing this:

https://pmc.ncbi.nlm.nih.gov/articles/PMC4157301/

What to expect

  • The ISTDP therapist is equipped with a sophisticated knowledge of the unconscious, core attachment needs and relational processes, along with a set of therapeutic and technical skills.

  • The ISTDP therapist acts as an active advocate for the innate, constructive, creative, healing forces of the unconscious, aiming to mobilise this positive force within you.

  • The ISTDP therapist welcomes and engages with all resistances, rather than find them problematic or a signal to back off.

  • The therapist is active in making observations and encouraging self-observation.  This empowers you to own what is yours, and to act on your own behalf; becoming your own therapist when life requires it, after the therapy ends.

  • The therapist constantly assesses the way anxiety is discharged in the body, and the ways in which you might unconsciously and automatically defend against this anxiety and subsequent feelings.  This means the work can progress more rapidly, as it moves in accordance with the capacity of your feelings/anxiety system in each moment.

  • ISTDP sessions are video recorded (with your permission), allowing review by therapist, and sometimes senior colleagues, to assess what is happening in a uniquely detailed, specific and objective way.   This enables the therapy to be attuned accordingly, reducing drawn-out suffering, stuckness and the chance of therapeutic misattunements.

  • The therapist encourages you to experience core feelings as fully and deeply as possible, as it is this that generates the most fundamental change.  Each time anxiety and defences are overcome and genuine feelings felt, often a sense of lightness, peace and connection is felt, and a shift is made.

As capacity builds for feeling emotions, you should find that maladaptive ways of managing dissipate, symptoms and suffering diminish, and ease and vitality increases.

Feelings are thereafter acted on in the way they are intended; i.e. anger leading to setting appropriate limits or making a change; guilt leading to making amends; love leading to reaching out to someone.  This takes the work from internal shifts to making changes in your life.

Evidence-based therapy

ISTDP has been the subject of a lot of experimentation, research and randomised, controlled trials which evidence its effectiveness as a therapy for any emotional, thought or behavioural neurosis; for depressive, anxiety, mood and personality disorders, and for enhancing one’s experience of life.  

Research indicates positive outcomes are long-lasting, with improvement continuing after termination. Please follow the below link to see a compilation of ISTDP studies showing various types of studies for a broad range of conditions:

http://reachingthroughresistance.com/wp-content/uploads/2024/07/ISTDP-OVERVIEW-JULY-24-2024-1.docx

The History of ISTDP

Intensive Short-Term Dynamic Psychotherapy (ISTDP) is an accelerated form of experiential psychodynamic therapy that was developed in the 1960s by Habib Davanloo, an Iranian-Canadian clinical researcher and psychoanalyst at McGill University and Montreal General Hospital.

Davanloo became frustrated that many of his patients made very little progress in classical psychoanalytic treatment, despite going on for many years.  In the quest to develop a therapy that would be more effective and efficient than traditional psychoanalysis, Davanloo recorded and analysed hundreds of hours of videotape of his own therapy sessions with patients, systematically experimenting with interventions and assessing responses, to find out what was effective.

The result of his pioneering research is a technique that aims to bring rapid relief and resolution to a wide range of psychological/psychiatric problems and self-defeating behavioural and relational patterns.  Davanloo went on to practise and teach his approach from the 1980s, and held annual metapsychology symposiums in Montreal.

There were other key psychiatrists/psychoanalysts of his generation also trying to work on shorter-term psychotherapy in the 1960s, such as Malan, Mann and Sifneos.  David Malan worked at the Tavistock Clinic 1956-1982, and led research into the effectiveness of short-term psychotherapy, developing therapeutic techniques and 'the science of psychodynamics’.

Malan also collaborated with Davanloo and played a major part in making Davanloo’s work accessible to a wider audience.  One of Malan’s ambitions was for ISTDP to be deployed in the NHS; the UK’s national health service, which it now is, in various settings, to treat patients with Functional Neurological Disorder (FND), medically unexplained symptoms, personality disorders, and severe depression.