Intensive Short-Term Dynamic Psychotherapy (ISTDP) has been developed over the last 45 years, initially by Dr Habib Davanloo in Montreal, Canada and more recently by a number of therapists who have trained with him. ISTDP is a brief, focused therapy that has been shown to be effective with a wide range of psychological/psychiatric problems. It works from the theory that most psychological problems arise from attachment problems that we experienced when we were growing up.

Difficulties in these early relationships create intense feelings, including rage, guilt about that rage and grief about the emotional distance that exists within those relationships. To cope with these feelings, people gradually develop what are known as ‘defences’. These are psychological, emotional and behavioural mechanisms that enable us to avoid the emotional pain we carry from these early relationships. However, these defences spread throughout most or all aspects of our lives, but are particularly intense in our interpersonal relationships, where we often experience a sense of distance or not feeling truly connected to the people we care about.

Defences can become the problems in our lives. They are experienced in a range of ways, including depression, anxiety, compulsive actions, physical complaints that have no medical explanation, avoidance behaviours, obsessive and ruminative thinking, self-sabotaging actions in relationships and/or careers, and problems with intimacy and closeness.

ISTDP is an interactive therapy where both the therapist and client work together to identify the way the client experiences their anxiety and the defences that arise to block the painful feelings from surfacing. Through working together, the therapist and client can overcome these defences, allow the previously avoided feelings to come to the surface and then work through these feelings and the thoughts and memories that are attached to them. This resolves these inner conflicts and restructures the defensive system into a healthy one that can allow close, intimate relationships and has no limiting or destructive aspects, including the resolution of your psychological problems.

We provide treatment for adults and adolescents using ISTDP-based treatment for:

Depression, Anxiety, Eating Disorders, Relationship Issues, Postraumatic Stress Disorders (PTSD), Personality Disorders, Marital Difficulties, Grief and Loss, Work Stress, Life Stresses, Self-Esteem, Assertiveness, Anger Management, Parenting Difficulties, Bipolar Disorder, Trauma and Impact of Abuse, Bullying, Sleep Problems, Behavioural Problems, Self-Harm Behaviour, Medically Unexplained Symptoms, Chronic Pain

At The ISTDP Clinic we conduct an initial 120 minute assessment interview (“Trial Therapy”) to complete a thorough assessment of your problems and to determine together whether ISTDP could be effective in helping you resolve your problems.

ISTDP is based upon psychodynamic principles: that symptoms arise as a result of the defensive ways in which we (ego) have learnt to manage the conflicting demands of our emotions (id), our sense of ‘right and wrong’ (super-ego) and the environment in which we live (external reality). The goal of any experiential dynamic psychotherapy is for the patient to become conscious of the unconscious ways that they ward off emotional conflicts. They are then encouraged to work through those emotional conflicts experientially in the present moment, at a pace that does not evoke excessive anxiety. Thus, the patterns that were formed in childhood which are being repeated in the current are undone in the here-and-now of the therapy room, in favour of healthy emotional connection and expression.

Fundamentally, Malan (2010) observed that an ISTDP approach to this therapeutic task differs from the traditional psychoanalytic one in this crucial respect: “Instead of allowing the client’s defences to operate and then offering interpretations at a time when the client is receptive, an ISTDP practitioner seeks to help the client confront and disown their defences as they are activated, facilitating the here-and-now experiencing of the emotions which they repress.”

Dr Habib Davanloo, the founder of ISTDP, found that when the therapist takes this active and involved stance two things become apparent: defences are not as impenetrable as first thought and the therapeutic alliance between therapist and patient is more powerful than first thought. In fact, the therapist can foster an ‘internal crisis’ whereby the patients healthy longings and desire for change eventually overpowers their defences, leading not only to symptom relief but enduring, robust character change within a much shorter timeframe.

What is the empirical evidence for ISTDP?

Beyond a 2006 Cochrane Review for Short-Term Dynamic Psychotherapy in general, evidence for ISTDP’s particular effectiveness has accumulated over the last three decades, and in the following areas:

  • Personality disorders
  • Treatment resistant depression
  • Anxiety disorders
  • Eating Disorders
  • Medically unexplained symptoms (Somatic disorders)
  • Chronic pain
  • Mixed samples
  • Clinical and cost effectiveness