Therapeutic Approaches

Intensive Short Term Dynamic Psychotherapy (ISTDP)


help to put aside harmful defences against pain and confront reality).
Intensive Short Term Dynamic Psychotherapy (ISTDP)’s central theory holds that we all have pain and mixed feelings that make us anxious, and for some people this anxiety is very high.

This will often be because these feelings were not welcome in an early attachment relationship (eg. having my own opinion made Mum distance herself, expressing sadness made Dad distance himself).

In these cases we will use defences against these feelings and the anxiety they trigger

(eg. I suppress my opinions, I cover my sadness with anger). While defences are usually useful in the environment and early relationships in which they are formed, it is our defences that can cause our suffering in later life, like a coping strategy that has outlived its usefulness.

Some defences will be more harmful than others in adult life.

For example, a defence of intellectualising about one’s feelings rather than deeply feeling them may be mostly safe, but occasionally become a problem for someone. A defence of coping with fear of getting hurt by viewing everyone as dangerous might cause more problems more often.

‘What is the problem you would like help with?’

ISTDP therapy will always begin with the client being asked ‘what is the problem you would like help with’ and the therapist then serving the client in trying to solve that problem together to reduce suffering. This will involve invitations to the client to notice how emotions, anxiety and defences interact to create the problem and helping them to regulate their anxiety. The client will then need to decide if they want to look under their defence to reconcile with their mixed feelings so they can find relief from the suffering caused by their defence.

ISTDP is a form of psychodynamic therapy, and is excellent for depression, relationship issues, and anxiety.

‘What is the problem you are seeking help with?’ Is the first question I will ask you. Good on you for seeking help.