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Intensive Short-Term Dynamic Psychotherapy

ISTDP (Intensive Short-Term Dynamic Psychotherapy) is a method developed by the Iranian-Canadian psychiatrist Habib Davanloo (b. 1927) from the 1960s. During this time, traditional psychoanalytic therapy dominanted in mental healthcare, and this approach could take a very long time. As a result, there were long waiting lists with patients not receiving help, and many therapists were interested in finding approaches that could shorten these waiting lists. Like many other therapists, Davanloo essentially attempted to create an accelerated version of psychoanalysis, which is based on Freud's theories of mental disorders. What particularly characterized Davanloo was his detailed video analysis of therapy. By analyzing video recordings of therapy over many years, he and other colleagues began to identify what seemed to help patients the most. Therapists with a foundation in ISTDP still tend to record sessions on video, among other reasons, to better understand what impedes progress.

Central to ISTDP is the assumption that repressed emotions give rise to anxiety and psychological defenses that lead to symptoms. In practice, there are many nuances to this theory, but the point is that for patients to get better, they need help in facing and tolerating their own emotions and processing any emotional conflicts. Patients may need assistance with both "opening up" and "tolerating" the experience of emotions without being overwhelmed by anxiety. In ISTDP, the psychologist actively assists the patient with this. Patients vary in both emotional capacity and the degree of defensiveness, and no two patients are alike. Therefore, therapy is tailored to each patient based on the specific help they need at the moment. For those struggling the most with emotional capacity, the focus is on gradually expanding their capacity so they can process their emotions. This is known as the graded format of ISTDP. For those struggling the most to engage in therapy, the issue is often that they have unconscious defenses preventing them from being close in relationships. They need a strong and clear hand reaching through the resistance to be able to open up and become available for therapy, addressing the issues that trouble them internally.

Intensive

The intensity lies in the therapist taking an active role and attempting to help the patient work with their emotions and defenses at their highest capacity. In some cases, the therapist may act very challenging to assist the patient in utilizing all their resources.

Dynamic

Psychodynamic refers to the theory that mental disorders are caused by unconscious emotions and the defenses used to manage these emotions, typically originating from early life experiences and relationships. The psychodynamic understanding of the mind has its roots in Sigmund Freud's theories and has been further developed and modernized with newer sciences such as attachment theory and neuroscience.

Short-term

This method originates from psychoanalytic therapy, but while traditional psychoanalysis is usually a lengthy process, with, for example, three sessions per week for many years, ISTDP aims to make the process as fast as possible. This doesn't mean that all therapies are necessarily very short, and some may still require several years of weekly therapy to achieve lasting results.

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