Intensive Short Term Dynamic Psychotherapy (ISTDP) is a modern approach in psychotherapy, which has been developing since the 1960’s in Canada, USA and Western European countries, and since 2008 also in Poland. This approach grew out of a lack of satisfaction with the effects and duration of psychoanalytic therapy and a need to explore and understand what interventions in the therapeutic relationship produce real, assessable change in the patient. The creator of this approach, Habib Davanloo, based on precise observation of recordings of therapy sessions, developed an innovative therapy method allowing to achieve deep and permanent intrapsychic changes in a relatively short period of time. The theoretical foundations of ISTDP are based on psychoanalytic assumptions and John Bowlby’s attachment theory, integrated with contemporary neuroscientific knowledge. ISTDP is a structured therapy. Each patient response is the basis for applying a specific type of intervention, the effects of which we can immediately verify.
- intensive – the patient’s attention is immediately focused on the problem,
- short-term – we take the shortest route to achieving change,
- dynamic – we focus on understanding and resolving the patient’s internal conflict
ISTDP assumes an active role for both therapist and patient. The first goal is to develop a conscious and unconscious working alignment. Using the techniques of confrontation, identification, clarification (KIK), the therapist works with so-called frontal defenses (passivity, submission, speaking in generalities, avoiding eye contact, etc.). The patient has a chance to see clearly the self-destructive effect of avoiding intimacy with the therapist, and this allows him to abandon the defenses, deciding consciously upon his own good. The therapist views the patient through the lens of what is known as the Triangle of People and the Triangle of Conflict (Malan 1979). The patient’s reactions (feeling/impulse, fear, defense) represent the vertices of the Triangle of Conflict. We always examine them on the basis of a specific situation concerning the relationship with the therapist during the session, a relationship from the patient’s current life, or a relationship with important people in the past (The triangle of People). This way, we help the patient understand their current reactions and connect them to the unique story of their childhood. The patient’s experience of blocked emotions and longings from early relationships opens them to consciously experience feelings and desires in current interpersonal situations. It is essential to the therapeutic process to accurately diagnose the patient’s characteristic pattern of spreading anxiety and to help the patient re-establish a healthy regulation of it. Continuous monitoring of anxiety levels helps avoid over-hasty interventions that could result in uncontrollable increases in anxiety and block the therapeutic process. Real, full access to feelings and healthy regulation of anxiety involve experiencing them on a physical level, so the therapist constantly directs his or her and the patient’s attention to reactions of the body. All sessions are recorded, which allows for precise supervision of the therapy, significantly increases the effectiveness of the therapeutic process of the patient and the training process of psychotherapists working in this approach. The results of successful therapy are: the patient’s understanding of the processes he or she sets in motion, the patient’s ability to view his or her reactions in terms of the Triangle of Conflict (feeling/anxiety/defenses) the patient’s ability to monitor his or her anxiety and regulate it in a healthy way, the patient’s conscious letting go of defenses, experiencing his or her desires and feelings as fully as possible, and the patient’s ability to express them (if he or she wants to) in a constructive way. The effectiveness of ISTDP is documented by numerous scientific studies. The method can be successfully applied to most problems where psychotherapy treatment is indicated.