Intensive Short Term Dynamic Psychotherapy (ISTDP)
On this Page:
What is ISTDP?
How is it different to other approaches?
What does it mean by Short Term?
Who is ISTDP suited for?
Who may benefit from a different starting point?
Next Steps.
What is ISTDP?
Intensive short term dynamic psychotherapy (ISTDP) is an emotionally focused therapy that emphasizes the importance of facing feelings fully and with authenticity. ISTDP is derived from traditional analytic psychotherapy and holds the belief that most suffering we experience is a result of difficulty facing complex and painful feelings inside of us.
As we go through life, different experiences trigger emotional pain and often it appears to us that our current suffering is due to what has recently happened in our lives. However, upon closer examination in therapy, we often find that the current event creates so much pain because there are unresolved and often unacknowledged feelings resulting from past painful experiences and traumas. These feelings were too painful to face at the time, however continuing to avoid them now can be the basis for our present suffering. When these feelings are understood, faced fully, and embraced, there can be strong positive changes in our life. When we are more connected with our inner emotional lives, we can be more connected to ourselves and our values and aspirations; more connected to others; and capable of greater intimacy. Suffering can be replaced with hope and vitality.
An Example,
Imagine someone who starts to feel anxious when entering a relationship, or when a relationship becomes emotionally close. That anxiety is a signal. It indicates closeness is bringing up painful feelings related to past relationship traumas, often rooted in childhood experiences.
To manage this anxiety, they might pull away to create distance from their partner. While this reaction may have once been a useful way to cope, it is problematic in adult relationships. Over time, this distancing will lead to being lonely, disconnected, and/or confused about why relationships are unsuccessful or unfulfilling.
Because ISTDP encourages an honest, supportive, and emotionally open relationship between the client and therapist, the tendency to pull away may naturally arise in the room. The difference is that we get to notice it together, in the moment, with compassion and curiosity, and can address the emotional conflicts underlying the patterns collaboratively. Exploring these patterns as they happen, can be incredibly powerful. It helps you understand how old coping strategies (once protective) may now be getting in the way of the closeness, stability, and happiness you desire. Many people seek therapy when they realise that the cost of relying on these old patterns has simply become too high.
How is it different to other approaches?
Many psychological therapies aim at helping people build insight into how their past influences their current lives. They help people see their current difficulties in the context of significant earlier relationships such as with parents and caregivers. Whilst insight is very important, it is often insufficient on its own to bring about the changes people want from therapy. One way that ISTDP differs is in is its emphasis on building capacity to experience feelings fully in the therapy sessions. This experiential component is what often helps heal emotional and relational pain and traumas.
The ISTDP therapist takes a very active role in helping people identify what defences prevent them from being able to experience their feelings deeply and meaningfully. They help a client work on letting go of unhealthy defences that are creating problems in their lives. This requires motivation and a commitment to emotional health. The process can typically trigger anxiety as the avoided feelings get closer to the surface. So while the experience may feel uncomfortable and intense at times, the collaboration with the therapist in this endeavour can bring about significant change. Therefore, the therapist is active in helping the client both notice and regulate anxiety in the moment so that feelings can emerge in tolerable amounts.
As part of the process, clients are encouraged to notice the various ways defences work to avoid feelings in real time. A client may tell a story that diverts attention away from important feelings. Or a client may talk about their feelings from a rational or intellectual standpoint but avoid actually experiencing their feelings. This awareness allows a client to relinquish unhealthy defences that had previously been outside their awareness.
In essence, ISTDP is a very active and collaborative form of therapy. Instead of simply talking about whatever comes to mind, we work together with a clear focus on the issues that matter most to you. This helps us get to the root of what’s keeping you stuck, rather than staying on the surface. Because we explore your emotions and patterns in real time, the process can sometimes feel more intense or challenging than other therapies you may have tried. Many clients find this refreshing, and they appreciate having a therapist who is engaged, focused, and committed to helping them create meaningful, lasting change. Ultimately, the goal of ISTDP is to support you in building long-term emotional health and achieving the outcomes that brought you to therapy in the first place.
What does it mean by Short Term?
Whilst the therapy has “short-term” in the name, there is no prescribed number of sessions. Instead, the therapist is committed to helping the client take active and meaningful steps towards their goals in each session so that therapy can move at the best possible pace for the client.
Who is ISTDP suited for?
ISTDP therapy may be a good option if:
• You experience persistent emotional pain
The pain can manifest as anxiety, depression, stress, or physical symptoms that don’t have a clear medical cause. ISTDP therapy aims to help you understand and address what’s driving these patterns so you can find relief.
• You struggle with repetitive relationship or attachment problems
If you often feel distant, shut down, withdrawn, overwhelmed, have difficulty identifying your own emotions (and/or communicating them) in relationships, and/or have difficulty maintaining stable relationships, then ISTDP therapy can help you uncover and address the emotional conflicts behind these experiences.
• You want to understand yourself on a deeper level
Together, we explore your thoughts, feelings, and physical reactions in the moment, helping you to build deeper insight and emotional capacity.
• You’re open to a focused and experiential style of therapy
ISTDP is collaborative and active. We’ll work closely, in real time, to notice what happens for you emotionally in relationships.
• You often experience overwhelming emotions and anxiety
We’ll work to help you to understand and build capacity to tolerate these overwhelming feelings, so you can feel safer within yourself, less anxious when emotions are triggered, and more empowered to address and process those feelings.
• You’ve tried other therapies but still feel “blocked”
Some people notice that they understand their problems but can’t seem to resolve them. ISTDP focuses on the deeper emotional processes that often sit underneath these stuck points.
Who might need a different starting point?
ISTDP may not be the first step for people who are currently experiencing severe mental illness (Psychosis, Bipolar Disorder, Severe Depression), active substance dependence (alcohol or other drugs), or are acutely suicidal. In these cases, other supports may be more appropriate before considering ISTDP. If you or someone you know needs support now, you can call lifeline on 13 11 14.
Next Steps
To find out if you might benefit from this approach, it is most useful to have a 90–120-minute initial consultation. This gives you the opportunity to experience this approach and get a sense of how it feels and how it differs from previous other therapy. It is important we decide together if this therapy might be a good fit for you and that we can establish an effective, healing relationship. If you would like the longer initial session, please let the administration team know at the time of booking.