Intensive Short-Term Dynamic Psychotherapy (ISTDP)
What is ISTDP?
When we ask our clients why they think they might have the challenges they do, many tell us they’re sure it comes from something in their childhood, even though most can’t identify a single event or cause. Intensive Short-Term Dynamic Psychotherapy (ISTDP) is a type of therapy that harnesses a person’s feelings about present-day events to uncover those issues left over from the past. We all have the ability to change what isn’t working for us now, but only when we first become able to ‘see’ what we’ve been doing and how that’s kept us stuck.
Many types of emotional problems, like chronic anxiety, depression and anger, as well as relationship problems, like being too defensive, avoiding conflict, or being a people-pleaser can all stem from the relationships we had with important adults in childhood. Believe it or not, so can issues that show up physically, like unexplained medical symptoms and functional neurological disorders.
As infants, we can do almost nothing to keep ourselves alive, so nature gives us a critical tool for survival: We change ourselves to be what we think our adult caregivers want or need us to be! Of course, we benefit from that when our caregivers give us enough to survive and reach adulthood. But, we also pay a price when pleasing others requires us to close off important parts of ourselves. Similar to how we are taught to tie a shoelace one way, that way becomes automatic and we might never even consider learning another, those patterns of interacting with important others can also become automatic and continue to show up over the rest of our lives. What worked in childhood might not work as well in adulthood, especially when our situation has changed and we’re interacting with different types of people.
How Does ISTDP Work?
ISTDP therapists pay attention to the feelings, thoughts and behaviours that show up in the therapy room when you talk about yourself and the people in your life. They look for patterns of behaviour that might be very subtle, like looking away or changing the subject when emotions start creeping up, and they start to bring those to your attention so you can see them too. ISTDP therapists will ask about your goals for therapy and want the very best for you. They believe behaviours that keep you at an emotional distance from yourself (and others) do more harm than good and will invite you to make the choice to feel your feelings instead of continuing to avoid them. When we do that, blocked memory systems open up and can reveal the source of our childhood issues. Examining those through your ‘adult eyes’ gives you the chance to start changing both perceptions and problem behaviours. As the name indicates, ISTDP is intensive, in that it asks us whether we’re ready to be truly honest with ourselves and feel even complicated feelings, like when we feel both love and anger towards the same people.
What Should I Expect From ISTDP Treatment?
ISTDP will often begin with a two-hour session called a Trial Therapy. That gives you and your therapist lots of time to get right down to the business of examining your concerns and helping you start to make positive changes right away. Your therapist will be very curious about the kinds of experiences you’re having with them right there, in the moment, and they’ll ask about the kinds of emotions, thoughts and bodily sensations that are occurring as you talk together. People who have avoided or resisted against feelings for many years usually say they aren’t sure what they’re feeling, but that begins to come clear in time, gradually revealing both the source of the problems and the pathways through. On average, a course of ISTDP therapy might last anywhere between 10 and 40 sessions.
