Intensive Short‑Term Dynamic Psychotherapy (ISTDP)
A Focused Psychodynamic Approach to Emotional Difficulties
Intensive Short-Term Dynamic Psychotherapy (ISTDP) is a structured, research-informed form of psychodynamic therapy.
It works with the relationship between emotion, anxiety, and defence. Rather than managing symptoms alone, it addresses the emotional conflicts that generate them.
What is ISTDP?
ISTDP was developed by Dr Habib Davanloo and refined through decades of clinical research and international training.
Its central premise is straightforward:
When emotions are repeatedly avoided, anxiety and symptoms increase.
ISTDP works directly with this process. The aim is to help you experience previously avoided emotions in a way that is regulated, structured, and tailored to your capacity.
How Emotional Difficulties Develop
Human beings are organised around attachment and emotional signalling.
When strong emotions threaten important relationships or self-image, the nervous system adapts:
Feelings become associated with danger
Anxiety increases
Defences develop automatically
Over time, this pattern may present as:
Persistent anxiety or panic
Depression or emotional numbness
Medically unexplained physical symptoms
Repetitive relationship difficulties
A sense of being stuck despite insight
ISTDP works with this emotional–anxiety–defence sequence as it unfolds in session.
How ISTDP Differs From Other Therapies
Many therapies focus on coping strategies, insight, or cognitive change. These approaches can be useful.
ISTDP differs in emphasis.
1. It Works With Emotional Conflict Directly
Rather than working around symptoms, we examine the emotional processes maintaining them.
2. The Therapist Is Active
I help you notice when anxiety rises or when defences shift the focus away from emotion. This is done collaboratively and at a pace you can tolerate.
3. It Is Process-Focused
Sessions remain focused on the underlying emotional pattern rather than broad discussion.
This does not mean intensity for its own sake. It means clarity of focus.
Feelings, Anxiety, and Defences
ISTDP is guided by a simple clinical map.
Feelings
Natural bodily responses such as anger, sadness, fear, joy, or closeness.
Anxiety
A physiological nervous system response when emotion is perceived as unsafe.
Defences
Automatic habits that reduce emotional contact. These may include overthinking, detachment, people-pleasing, self-criticism, minimising, or saying “I don’t know.”
Symptoms often develop when anxiety and defences repeatedly replace emotional processing.
In therapy, we slow this pattern down so it becomes observable and modifiable.
The Triangle of Conflict
When emotion is linked to danger:
Feelings trigger anxiety
Anxiety triggers defence
Defence blocks feeling
ISTDP works moment-to-moment to:
Regulate anxiety
Identify defence
Restore access to feeling
This sequence is known as the “Triangle of Conflict.”
Working with the body, not just the mind
ISTDP pays close attention to how anxiety presents physically.
Some people experience:
Muscle tension
Jaw clenching
Restlessness
Others notice:
Stomach disturbance
Breathlessness
Dizziness
Dissociation
These responses indicate how much emotional intensity your nervous system can tolerate.
Therapy is adjusted accordingly. For some, initial work focuses on regulation and capacity. For others, deeper emotional work can proceed more directly.
Pacing is central to safety.
What Happens in Sessions
Sessions focus on real experiences from your life and your emotional responses within them.
As feelings approach awareness, anxiety and defences often become visible.
My role includes helping you:
Notice these processes in real time
Understand how they relate to symptoms
Gradually reduce reliance on defences
Experience emotion without becoming overwhelmed
When emotional processing increases, anxiety often decreases and symptoms may reduce.
Over time, this can lead to more flexible relationships and clearer self-experience.
How they differ in practice
ISTDP
ISTDP focuses on the emotions that the nervous system learned to avoid, and how anxiety and defences formed around them.
Main aim: lasting change by resolving emotional conflicts
Style: experiential, relational, emotionally focused
Therapist role: active, engaged, moment-to-moment
Best for: feeling stuck, recurring anxiety or depression, long-standing patterns, physical symptoms linked to stress
ISTDP does not teach you to think differently about feelings. It helps you experience them safely, so anxiety and symptoms no longer have to take their place.
CBT
CBT focuses on identifying unhelpful thoughts and behaviours and learning tools to manage them differently.
Primary focus: thoughts, beliefs, behaviours
Main aim: symptom reduction and coping
Style: structured, skills-based
Therapist role: collaborative guide and teacher
Best for: clear, present-day problems where skills and strategies are enough
CBT can be very effective. For many people, it provides relief and practical tools. Some clients, however, notice symptoms return when emotional pressure builds again.
A simple way to think about it
CBT asks: “What are you thinking, and how can we change it?”
ISTDP asks: “What are you feeling, and what happens inside when that feeling comes close?”
Neither approach is “better” in general. They do different jobs.
Who ISTDP can help
ISTDP may be helpful if you:
Feel stuck despite insight or previous therapy
Experience persistent anxiety or panic
Notice stress-linked physical symptoms
Repeatedly encounter similar relational difficulties
Feel disconnected from emotion or overwhelmed by it
Suitability depends on individual circumstances and capacity.
Is ISTDP right for everyone?
No single therapy fits everyone.
ISTDP requires willingness to examine emotional processes and remain engaged when feelings arise. Some people prefer a more skills-based or supportive model at particular stages.
Part of my role is to assess whether this approach fits your current needs.
Working With Me
I am a UK-based psychodynamic psychotherapist integrating ISTDP principles into my work.
My focus is on regulation, clarity, and pacing. The aim is not to force emotional intensity, but to build the capacity required for sustainable change.
Fees and Practical Information
£65 per 50-minute online session
Flexible morning, afternoon and night time appointments
UK-based online therapy
Next Steps
If this reflects your experience, you can book an initial consultation.
The consultation allows us to assess fit, clarify goals, and determine whether this approach is appropriate for you.
Book a Consultation
Ready to have a different conversation?…
Taking the first step can feel impossible, but you don’t have to do it alone. If what you’ve read resonates with your life, reach out. Together, we can start to take a good honest look at what’s been holding you back and begin the process of change.
For media and press enquiries, please use the same form
FAQ: ISTDP
-
ISTDP can be emotionally powerful, but it is not about pushing or overwhelming you.
The intensity is adjusted to your nervous system. Some sessions feel calm and reflective; others may involve stronger emotions. If anxiety rises too much, we slow down and regulate it first. Safety comes before depth.
-
Yes, when practised properly.
ISTDP pays close attention to how anxiety shows up in the body. This allows us to work within your emotional capacity rather than exceed it. For clients with lower tolerance, therapy focuses first on building regulation and stability.
Good therapy is about capacity building and this is one of the core strengths of ISTDP.
-
No.
ISTDP focuses on what is happening inside you now, often using present-day situations or what emerges in the session. Past experiences are explored only when they become emotionally alive and relevant.
Nothing is forced, and nothing is explored without purpose.
-
No.
ISTDP does not aim to retraumatise or flood you with memories. The goal is to help you experience emotions in a contained, regulated way, so they can be processed rather than avoided.
For clients with trauma or fragility, the work is paced very carefully.
-
In many talking therapies, sessions can become descriptive or intellectual. ISTDP stays focused on what you feel, how anxiety shows up, and how you move away from emotions in real time.
I may gently interrupt patterns that keep you stuck, not to control you, but to help you reconnect with yourself.
-
There is no fixed number of sessions.
Some people notice meaningful change within a relatively small number of sessions. Others benefit from longer work, especially if difficulties are complex or long-standing.
The aim is not speed for its own sake, but efficiency with care.
-
ISTDP is commonly used for:
anxiety and panic
depression and emotional numbness
physical symptoms linked to stress
long-standing or recurring problems
feeling stuck despite insight or past therapy
It can be adapted for a wide range of presentations when paced correctly.
-
That’s very common, and it’s not a failure.
In ISTDP, “I don’t know” is often understood as a protective response, not a lack of intelligence or motivation. We become curious about what happens inside just before the uncertainty appears.
Nothing is criticised. Everything is explored.
-
No.
Many clients start therapy feeling disconnected, numb, or unsure what they feel. ISTDP is designed for this. Emotional capacity is something we build, not something you need to arrive with.
-
ISTDP may be a good fit if:
you want more than coping strategies
you are open to looking inward
you are willing to notice what happens in your body and emotions
you want lasting change, not just symptom control
A consultation helps us decide this together.
-
We focus on:
what you want help with
how your difficulties show up
how your anxiety operates
whether this way of working feels right for you
There is no pressure to commit beyond that.