Intersubjective systems theory

Domain I · Psychodynamic & depth psychology · Stolorow, Atwood, Brandchaft · 1987

What it is

ISST is a psychoanalytic theory and sensibility, not a manualised therapy. Stolorow has declined to write a manual of clinical recommendations. He treats frequency, use of the couch and similar matters as decisions for each analytic pair, and he locates the core of the analytic attitude in inquiry…

Format

• No official phases. None of the primary sources defines treatment stages, session counts or criteria for moving between phases. ISST is practised as open-ended psychoanalysis or psychoanalytic psychotherapy, and the dyad sets the frequency. Stolorow & Atwood make analysability a property of the…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• The therapist enjoying the accommodation.
• Disclosure that shifts the emotional focus onto you.
• Decoding by formula. Read the image from the patient's associations.
• Confirming facts you cannot know. Validate the experience, not every causal claim.
• Unexamined conjunctions, which feel like perfect empathy and are the hardest to spot.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.