Intensive short-term dynamic psychotherapy

Domain I · Psychodynamic & depth psychology · Habib Davanloo · 1990 · Montreal

What it is

Intensive short-term dynamic psychotherapy (ISTDP) is an emotion-focused psychodynamic therapy developed by Habib Davanloo at McGill. He built it from video recordings of his own sessions. The model holds that interrupted attachments leave complex mixed feelings (love, rage, guilt about the rage,…

Format

• Two maps used in every session
• Patient spectrum (decides the format)

Who practises it, and how they are trained or regulated

• The method is manualised in books and training rather than as a single session-by-session protocol. Davanloo's original technique is taught today through Abbass, Frederickson, ten Have-de Labije & Neborsky, Della Selva and others. They differ mainly in pace, in how hard they confront, and in how they work with fragile patients.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• 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

• Old defenses coming back around the ending.
• You leading the material. It's working when memories come with feeling and fill out the formulation.
• A "yes" that is only compliance. It's working when the patient starts initiating and steering toward the feeling themselves.
• You recapping for the patient. Have them do it. It's working when recaps come faster, more accurately, and without being asked.
• Linking used as intellectualising before any feeling has been felt. It's working when links come spontaneously and with feeling.

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.