ISTDP

Question 1

Who designed ISTDP?

Answer 1

Davanloo (2005)

Question 2

What does ISTDP stand for?

Answer 2

Intensive Short Term Dynamic Psychotherapy

Question 3

Describe why ISTDP is short-term, intensive and dynamic

Answer 3

Short-term: Brief therapy, aiming for rapid change by targeting warded off emotions
Intensive: aims to help patient experience warded-off emotions to maximum degree possible
Dynamic: Involves working with the unconscious and transference feelings

Question 4

What is the focus on in ISTDP?

Answer 4

Feelings, anxiety and defence mechanism

Question 5

According to ISTDP why are symptoms generated?

Answer 5

People use defence mechanisms to avoid anxiety that is generated by a negative feeling. An excessive use of defence mechanisms can generate symptoms.

Question 6

When do anxiety and defences emerge in therapy?

Answer 6

When patients recall episodes from the past that are unconscious, and the therapist helps the patient recognise them

Question 7

What is the aim of ISTDP?

Answer 7

To reduce defences and increase feeling expression

Question 8

What is ISTDP based?

Answer 8

Triangle of Conflict

Question 9

What are the 3 components of the triangle of conflict?

Answer 9

Feelings
Anxiety
Defences

Question 10

What is the feeling part of the triangle of conflict?

Answer 10

It is the awareness of the bodily activation following an activation

Question 11

What are the 3 elements we need to fully experience a feeling?

Answer 11

Cognitive Label
Physiological arousal
Motoric Impulse

Question 12

When do patients experience have full access to their feelings?

Answer 12

When the three elements are experienced: cognitive label, physiological arousal and motoric impulse

Question 13

What is the anxiety part of the triangle of conflict?

Answer 13

A bio-physical pattern of activation in the body

Question 14

What are the 3 unconscious pathways for anxiety discharge in the body?

Answer 14

Striated muscles–> more toleration
Smooth muscles (migraine, upset stomach)
Cognitive perceptual disruption (dizzy, blurry vision) –> less toleration

Question 15

How does the therapist assess anxiety?

Answer 15

By exploring feelings

Question 16

What is the defence part of the triangle of conflict?

Answer 16

Strategies patients use to keep thoughts, feelings and impulses that trigger anxiety out of awareness

Question 17

What are the 4 main types of defences?

Answer 17

Repressive- hiding feeling
Regressive- going back to early stage of development
Character defences- identification with punitive figures in the past
Tactical- tactics to keep the therapist at a distance

Question 18

What is the central dynamic sequence of ISTDP?

Answer 18

Inquiry, Invitation to feelings, defence work, break through to feelings, consolidation

Question 19

ISTDP evaluation

Answer 19

Transdiagnostic in principle but applied clinically specific outcome measures have been used- pre- & post- therapy

Question 20

ISTDP evidence base

Answer 20

Outcome data is growing showing efficacy of ISTDP for a wide range of mental health problems inc. major depression, anxiety disorders and personality disorder