Intensive Sort-Term Dynamic Therapy

How Does ISTDP Work?

ISTDP appears to work by getting the emotions out: mobilizing and experiencing unconscious emotions

palpate the emotions.

put the focus on the emotions and monitor the anxiety reponse. clarify defenses..

as awareness increases, the threshold for somatization increases. they learn how to talk about and experience

Emotions

somatization in any system
defensive, anxious, and avoidant patient
patients who know they turn rage into the body (neurotic patients)
patients who have self sabotage and defeat
patients who wish to explore emotional forces involved in their somatic problems

Reasons not to use ISTDP

Crohn's, ulcerative colitis, MS
actively suicidal
bipolar disorder (relative contraindication), psychotic disorder
patients with prominent projection, cognitive-perceptual projection, or highly resisitant patients need supervision

Average 1.5 hours

over 2/3 have partial or major breakthrough in unconscious feelings

no change in symptoms - look for medical factors
symptoms fluctuate in response to anxiety - possible role
symptoms removed by emotional experience - likely somatizaion
no unconscious anxiety mobilized - no anxiety is present, or therapy is not doing well

7 RCTs, 2Ct