Philosophy of ISTDP


ISTDP focuses on unconscious mental processes (perceptions, past events, feelings about events, and distorted beliefs) as the cause of emotional disturbance. What distinguishes practitioners of ISTDP is that we believe that psychological treatment should be both comprehensive and efficient (usually under 40 hours) and should:

  1. remove symptoms, and

  2. change character traits when necessary.

Findings of clinical improvement must be confirmed by scientifically designed studies that demonstrate that the above changes occur and that they are long lasting, and finally, that treated patients continue to improve even after termination.

To accomplish the above goals, the ISTDP therapist is an active advocate of change rather than a neutral observer. The attitude of the ISTDP therapist is that the patient's time is irreplaceable and comprehensive change is possible in a reasonable, cost-effective time frame.

In ISTDP, experience of core emotion from the past is seen as the transformative vehicle and the therapist relies on non-interpretive techniques: encouragement to feel; challenge to take responsibility to change; and confrontation of resistance to change.

ISTDP therapists ask patients to address the historical roots of their difficulty through highly focused attention on transference phenomenon or life events that activate defences.

ISTDP therapists strive to uncover repressed emotions or “complex feelings” about the past attachment failures. Many patients develop punitive self-structures to cope with these unresolved emotions during their development. ISTDP actively addresses the existence of these punitive structures beginning with the first interview.

ISTDP treatment is usually video recorded to facilitate supervision, consultation, and research into the process of dynamic psychotherapy.

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