What Does the ISTDP Experience Look and Feel Like?

Posted on: February 15, 2016

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

Intensive Short Term Dynamic Psychotherapy “ISTDP” is part of a group of therapies, known as the “emotionally focused therapies.” In it, the goal is for patients to actively experience various feelings during the session; it has been referred to as a neurobiological technique, as one of the goals is to become aware of the internal physical experience of all of your emotions. Treatment usually begins with me asking you about the precise nature of your problem. Based on what is uncovered, we will set your therapeutic goals. During each session we will collaborate to examine specific conflicts or problematic events in your life while observing your responses to them. I will draw attention to your internal experience throughout the session, including your automatic defenses, anxiety symptoms, and emotions (both physiological sensations and impulses).

Therapeutic interventions focus on what’s taking place moment to moment with the intention of replacing automatic defenses and anxiety with healthy emotional regulation. This is the heart of the work. When you are able to reduce your anxiety and change automatic defenses, unconscious longings, feelings and memories rapidly rise to the surface and are available for deep processing. Many patients describe this part of the therapy as extremely powerful and liberating and report feeling “relieved,””free”and “at peace” at the end of an ISTDP session.

One thing that sets ISTDP apart from other therapies is the use of videotape. The highly complex nature of the work means that a great deal of verbal and non-verbal material surfaces during the treatment. It is often difficult for me to see it all at once. With their client’s permission, most ISTDP clinicians use videotape to later review what has occurred. It is always left up to you to decide whether or not to allow videotaping of your sessions.

How is ISTDP Different from Other Therapies?

ISTDP is not your typical “talk therapy.” In this unique model, therapist and client establish a specific set of therapeutic goals at the onset of treatment and work together in a structured, purposeful way. Initially, this may seem strange or even challenging for people accustomed to using their therapy hour to discuss whatever they wish in an open-ended or free-flowing manner. In the beginning, the ISTDP therapist takes a more active and directive role, and sessions can feel quite intense. At the same time, therapist and client work cooperatively in an atmosphere of mutual respect, trust, and honesty to monitor for excess anxiety or discomfort with an eye toward keeping it at a tolerable level.

Posted in: ISTDP