Intensive Short-Term Dynamic Therapy (ISTDP) is an evidence-based psychotherapy approach founded on psychodynamic and attachment theory principles. ISTDP operates under the assumption that Human beings are fundamentally social creatures and thrive when having meaningful and emotionally close relationships with others. Current literature indicates that ISTDP may effectively treat a wide range of psychological disorders, including depression, anxiety, psychosomatic, eating, and personality disorders.
ISTDP theory, developed by Habib Davanloo, is strongly influenced by Freud’s second theory of anxiety, and Bowlby’s evolutionary theory of attachment. Attachment theory suggests that children come into the world biologically pre-programmed to form attachments with others because this will help them survive. Bowlby proposed that attachment can be understood within an evolutionary context in that the caregiver provides safety and security for the infant.
When caregivers cannot meet the emotional needs of infants or react to such emotional needs in rejecting ways, children learn to push such emotions out of conscious awareness to maintain attachment with their caregivers. The repression of emotions is costly; depressiveness, anxiety, low self-confidence, drug and alcohol problems, eating disorders and personality disorders are associated with repression of adaptive emotions. In adulthood, patients experience anxiety when previously repressed unconscious emotion is triggered. Patients engage in defensive processes to avoid experiencing unwanted feelings. ISTDP helps the patient overcome their internal resistance, experience their emotions, develop greater self-insight and form closer relationships with others.
How does ISTDP work?
ISTDP is an interactive therapy where both the therapist and client work together to understand the underlying dynamics that drive the patient’s difficulties. In ISTDP, the patient is considered the expert in their inner life, and the therapist the expert in their role as a therapist. The success of treatment depends on how well the patient and the therapist can work collaboratively.
The challenge is that patients often unconsciously use defensive strategies to ward off painful emotions out of conscious awareness. The therapist’s role is to help the patient become aware of their defensive strategies and let them go. When successful, this process is highly rewarding for the patient as they will no longer need to be a prisoner to their past.