What is ISTDP?
Intensive Short Term Dynamic Psychotherapy (ISTDP) is an evidence-based, unique form of experiential, emotion focused and brief psychodynamic psychotherapy. It was developed at McGill University in Montreal, Quebec, Canada by Dr. Habib Davanloo, a trained psychoanalyst, in the 1960’s and 1970’s. and has been refined over decades of research upto current day. ISTDP has continued to evolve and improve over time in the hands of more recent psychotherapist researchers like Dr. Allan Abbass, Jon Frederickson, and Dr. Patricia Coughlin, among others.
ISTDP is designed to quickly clarify their internal emotional conflicts causing their problems/symptoms while also intensifying the therapeutic process so that long-term structural changes can be accomplished in briefer periods than with traditional psychodynamic therapy
How does ISTDP work?
ISTDP theory suggests that psychological problems are caused by the unconscious avoidance of painful or conflicting feelings. When we experience present day triggers related to past emotional wounds, unconscious emotions related to these wounds rise, which in turn triggers anxiety. We avoid these anxiety-provoking emotions with unconscious patterns that were once useful but have become out-of-date and unhelpful. Because these emotions are being unconsciously avoided, they make it almost impossible for us to know that there might be an emotionally related underlying cause to our problems.
To overcome these difficulties, ISTDP therapists take an active and collaborative approach to help patients become aware of their unconscious, self-defeating avoidance patterns and understand how they contribute to their current life problems. Such awareness gives the client to an opportunity and choice to address the unresolved emotions to reduce anxiety and the need for the maladaptive avoidant patterns through experiencing and processing of those underlying emotions. Facing these avoided emotions often rapidly reduces anxiety, avoidance behaviours, and unnecessary psychological pain, thus offering them the symptomatic relief and long-term psychological well-being they are seeking.
What does ISTDP treat?
Research has shown ISTDP to be an effective therapy with many different types of psychological and emotional problems, including:
- anxiety disorders (GAD, panic, social anxiety, worry, OCD)
- depression (major depression, low mood, self-criticism)
- PTSD and other trauma-related symptoms
- relationship problems
Significantly, ISTDP has also demonstrated promising results in treating conditions typically termed as ‘hard-to-treat,’ such as personality disorders and certain resistant psychological disorders.
ISTDP has also been successful in relieving somatic symptoms and disorders that are linked to psychological distress, like chronic pain, fibromyalgia, chronic headaches, migraines, gastrointestinal problems and Functional Neurological Disorders.
Due to ISTDP’s intense and active approach, it is important for patients to work with a trained and experienced therapist who can evaluate their anxiety tolerance and the appropriateness of the approach.
How does ISTDP differ from other therapies?
There is a lot of overlap in different modalities of therapy. The uniqueness of ISTDP lies in its comprehensive metapsychology (understanding of human psychological functioning) that bases intervention on moment-by-moment assessment of the client’s internal responses. The ISTDP therapist constantly assesses the client’s anxiety levels, ability to tolerate emotions, learned ways of responding to anxiety provoking emotions, and emotional states while always keeping in mind the client’s treatment goals. ISTDP is a truly person-centred treatment that constantly tailors interventions to the needs of the individual.
The ISTDP metapsychology also offers a unique way to understand and resolve painful physical symptoms (e.g. chronic pain, gastrointestinal problems, headaches and migraines). ISTDP clarifies how anxiety manifests in the body and how avoidance of the anxiety-provoking emotions can generate different kinds of painful, somatic symptoms. Through careful investigation of client responses to anxiety and emotions, treatment can be tailored to improve emotional tolerance and reduce anxiety to improve somatic symptoms. By focusing on the underlying emotional contributors, ISTDP can help reduce or treat physical symptoms that have an emotional cause, thus offering an alternative to treatment approaches that focus only on symptom management and acceptance.
While ISTDP is highly effective, it is a lot more complex and requires more years of intensive training to master than some other modalities. It is advisable for individuals who are interested in seeking this form of treatment to inquire the clinician about their training and whether they have on-going consultation.
