What is ISTDP?
Intensive Short-Term Dynamic Psychotherapy, or ISTDP, is a revolutionary approach to psychotherapy that offers rapid relief from suffering, abatement of symptoms, and a comprehensive understanding of the self. Oftentimes we hear former patients talk about the deep sense of meaning, freedom, and purpose they now have in their lives after removing the chains of psychological suffering. Because ISTDP is a short-term therapy, often lasting months, these results can appear very quickly.
ISTDP was developed by Dr. Habib Davanloo, MD, emeritus Professor of Psychiatry at Montreal General Hospital and McGill University Faculty of Medicine, beginning in the 1970s and further refined into the 2000s. Early in his career, Dr. Davanloo, like other psychiatrists and mental health workers, was beset by the troubling tenacity of resistance. Patients would come genuinely seeking help but resist looking at their true feelings and the origin of their symptoms. This is, of course, understandable; the past and our feelings about it are often painful, troubling, and a part of us would prefer to let sleeping dogs lie. An approach by a seemingly caring other, while wanted, can also be anxiety provoking and generate defensiveness. Unfortunately, this means that the task of psychotherapy–to understand the origin of psychological problems, work through unresolved feelings, and heal–is impaired. But so much of resistance is out of our awareness and motivated by forces that often appear out of our control. How can a therapist help a person overcome it?
Dr. Davanloo, using research from extensive audio-visual recording of his sessions, developed a reliable method for compassionately handling resistance, strengthening the will and motivation of patients to face their past and liberate their true selves. What Dr. Davanloo saw, and what ISTDP clinicians continue to witness, is that humans have an innate strength, dignity, and will to heal that is more powerful than even the most incapacitating mental health problems. ISTDP, in essence, is a method designed to free the healing force that is nascent within each of us and bring its full capacities to bear on the treatment. What is so beautiful and inspiring about ISTDP is working with people who have often struggled for decades suddenly develop the strength and self-confidence to transform their lives.
What kinds of problems does ISTDP address? Research continues to emerge about an ever-expanding range of conditions for which ISTDP is effective. Currently, there is data demonstrating the effectiveness of ISTDP with anxiety and panic disorders (Lilliengren et al. 2017; Solbakken & Abbass, 2017), depression and treatment-resistant depression (Town et al., 2017), personality disorders (Town et al, 2011; Abbass et al., 2011; Abbass et al. 2008), medically unexplained symptoms (Town et al., 2017), chronic pain and headaches (Abbass, Lovas, & Purdy, 2008), addictions (Solbakken & Abbass, 2016), self-defeating behaviors and emotional blocks. What is more, because ISTDP is designed to be a short-term therapy, it has been shown to save thousands of dollars per patient per year in a number of these conditions (Abbass & Katzman, 2013). What this means is less money and less time devoted to therapy, with all the benefits of a comprehensive and effective treatment.
Given its proven efficacy and cost-effectiveness, why is ISTDP rarely practiced by mental health clinicians? There are a number of reasons for this, chief among them the time and dedication to training that ISTDP clinicians must devote in order to become proficient. In addition to foundational training in psychotherapy and the years spent getting their degrees, ISTDP clinicians never stop honing their craft, which often involves individual and group supervision, extensive reading, and hundreds of hours spent watching their own videotapes. Just as Dr. Davanloo developed the method by video-recording his experimental sessions and reviewing them carefully to determine what was effective and what wasn’t, so too do all ISTDP clinicians continue to video record their sessions and watch them for which interventions were most helpful, what they might have missed, and what they could do better in the next session. It is this relentless dedication to effectiveness that truly marks the ISTDP clinician and the unique experience of ISTDP therapy.