What Makes ISTDP So Effective?

Posted on: February 5, 2016

News & Insights From Santa Monica Psychiatrist Katherine Watkins, M.D.

One of the things that makes ISTDP so effective is its concentrated attention to the unconscious barriers that work against successful treatment. In ISTDP, these barriers are referred to as “defense mechanisms” or “defenses.” ISTDP posits that defenses prevent us from experiencing our authentic feelings, and that it is only with active and persistent attention by the therapist to exposing and confronting these defenses will patients be able to experience the full range of their emotions. In childhood, defenses can be a useful tool in emotionally overwhelming or traumatic situations. Defenses such as dissociation and repression can shield us from intense feelings that we are developmentally unprepared to experience and process. However as we grow up, this shielding cuts us off from our full range of feelings, even when we are now emotionally able to handle the feelings. When this happens, it may lead to depression, anxiety, relationship problems and self-defeating behavior, or as one of my patients said, “I’m living a two dimensional life.”

A Sense Of Freedom

In the therapy, I will work with you to help you identify the defenses that are preventing you from having direct access to the full range of your feelings and to having emotionally satisfying relationships. In this way you can make the choice to give up your defenses and to allow yourself to experience your emotions honestly and fully. As you become able to calmly face your whole range of emotions, such as anger, sadness, remorse/guilt, forgiveness, and love, you will become able to use these feelings in a productive manner to enhance closeness with people in your life. A sense of freedom and well-being comes with the capacity to face your feelings rather than the all too common situation of ignoring and avoiding feelings.

Sometimes when painful feelings emerge, anxiety can come up. The source of the anxiety is the painful feelings that are generating the internal conflict. Together, in session, we will monitor your physiological responses to the material that come up, so that you won’t be overwhelmed. You become well acquainted to listening to your body. Thus a sense of balance is felt; for example you can use both your emotions and thoughts as guides in your life.

Posted in: Fundamentals, ISTDP