Intensive Short Term Dynamic Psychotherapy
What is it and could it be helpful for you?
What Is Intensive Short-Term Dynamic Psychotherapy (ISTDP)?
Intensive Short-Term Dynamic Psychotherapy (ISTDP) is a focused, evidence-based therapy that helps people resolve emotional difficulties at their source — not just manage the symptoms they create.
Many people come to therapy having already done a lot of thinking. They understand why they feel the way they do, can explain their patterns clearly, and may even have had therapy before — yet nothing really shifts. ISTDP is designed specifically for this problem.
Rather than staying at the level of explanation, ISTDP works directly with the emotional and nervous-system processes that keep symptoms in place.
It is intensive because it works deeply.
It is short-term because it aims for real change, not endless exploration.
And it is dynamic because it focuses on emotions, attachment, and internal conflict — the forces that shape how we relate to ourselves and others.
What Is ISTDP Useful for Treating?
ISTDP is particularly effective when symptoms are emotionally driven, even if they show up physically or cognitively.
It is commonly used to work with:
Anxiety, panic, and chronic stress
Depression
Trauma and complex trauma
Psychosomatic symptoms (including migraines, IBS, chronic pain, fatigue)
Burnout, perfectionism, and self-criticism
Relationship and attachment difficulties
Emotional overwhelm or emotional numbness
Feeling “high-functioning but internally exhausted”
Many people who benefit from ISTDP are capable, responsible, and outwardly coping, yet privately struggling. The cost of holding everything together eventually shows up somewhere: the body, mood, relationships, or sense of self.
How ISTDP Understands Emotional Symptoms
ISTDP is based on a straightforward but often overlooked reality:
When emotions are blocked or avoided, they don’t disappear. They turn into anxiety or symptoms instead.
Early experiences teach us which emotions feel unsafe: anger, grief, need, vulnerability, closeness. Those emotions are then automatically suppressed, often without conscious awareness.
Over time, this creates internal pressure. The body carries it as anxiety. The mind carries it as rumination or self-criticism. The nervous system carries it as tension, pain, or shutdown.
ISTDP helps uncover:
Which emotions are being avoided
How anxiety is expressed in your body
What unconscious defences are operating automatically
How these patterns developed — and how they can change
This isn’t about blaming the past. It’s about understanding what your system learned to do to survive, and whether those strategies are still serving you.
How ISTDP Works
ISTDP sessions are active, engaged, and emotionally focused.
Rather than talking about feelings, the work happens in the moment — noticing what is happening in your body, emotions, thoughts, and relational responses as they arise.
Key elements include working with Anxiety (not against it)
Anxiety isn’t treated as the enemy. It’s treated as information.
We look at how your nervous system signals emotional pressure and help regulate it so emotions can be experienced safely rather than avoided.
Identifying Defences
Defences are the automatic ways we stay protected — intellectualising, pleasing, joking, minimising, withdrawing, staying “strong.”
In ISTDP, these aren’t criticised or taken away. They’re made visible, so you gain choice rather than running on autopilot.
Experiencing Emotion, Not Just Understanding It
Insight alone rarely changes anything. Change happens when emotions are felt, processed, and integrated at a pace your system can tolerate.
This is done carefully, collaboratively, and with close attention to safety and regulation.
Resolving Internal Conflict
As emotions are processed, the internal tug-of-war softens. Anxiety reduces because it no longer needs to contain what’s underneath. Symptoms ease because the pressure driving them is relieved.
How ISTDP Is Different from Other Approaches
Compared to CBT
CBT focuses on thoughts and behaviours. ISTDP focuses on what drives them emotionally.
For many people, cognitive strategies help — until they don’t. ISTDP is especially useful when insight hasn’t translated into change.
Compared to supportive or open-ended therapy
ISTDP is intentional and directional. The therapist is actively helping you stay with what matters, rather than circling familiar ground.
Compared to long-term psychotherapy
ISTDP does not aim to go on indefinitely. It works toward resolution, not endless exploration.
Compared to purely somatic approaches
ISTDP includes the body, but also works with emotional meaning, attachment patterns, and relational dynamics — integrating mind, body, and emotion.
Is ISTDP Right for You?
ISTDP may be a good fit if you:
Feel stuck despite insight or previous therapy
Want change, not just coping strategies
Are willing to be emotionally honest (even when uncomfortable)
Notice that anxiety or physical symptoms rise when emotions get close
Are curious about what’s driving your patterns, not just how to manage them
It may not be the right approach if you are looking for:
Advice, reassurance, or symptom-management only
A purely skills-based or educational approach
Therapy that avoids emotional engagement
A slow, unstructured process without clear direction
ISTDP asks something of you — presence, honesty, and willingness to look beneath the surface. In return, it offers the possibility of deep and lasting change.
