What is ISTDP?
Intensive Short‑Term Dynamic Psychotherapy (ISTDP) is a modern form of psychodynamic therapy developed by Dr Habib Davanloo and refined through decades of clinical research and practice. It is now taught and researched internationally.
At its core, ISTDP is based on a simple but powerful idea:
When emotions are blocked or avoided, the nervous system produces anxiety and symptoms instead.
Rather than working around this, ISTDP helps you understand and directly experience the emotions your system learned to avoid, in a way that is safe, contained, and tailored to you.
How emotional problems develop
Human beings are wired for attachment and emotional connection. From early life onward, emotions guide us toward what we need, what hurts, and what matters.
When strong emotions threaten important relationships, the nervous system adapts. Feelings become linked with danger. Anxiety rises. Defences develop automatically to keep those feelings out of awareness.
Over time, these patterns can lead to:
Chronic anxiety or panic
Depression or emotional numbness
Physical symptoms with no clear medical cause
A sense of being stuck despite insight
ISTDP works directly with this emotional–anxiety–defence pattern as it unfolds in real time.
How ISTDP is different from standard therapies
Many therapies focus on coping strategies, insight, or changing thoughts and behaviours. These approaches can be helpful, but they often leave the underlying emotional drivers untouched.
ISTDP is different in three key ways:
1. It works beneath the surface
Rather than managing symptoms, we focus on the emotional conflicts generating them.
2. The therapist is active and engaged
I will help you notice when anxiety rises or when you move away from emotions, and gently bring the focus back.
3. The work is often more efficient
Because we address the root process directly, many clients experience meaningful change in fewer sessions.
This does not mean rushing. It means staying focused.
ISTDP is guided by a clear clinical map.
Feelings are natural bodily signals like anger, sadness, joy, fear, or closeness.
Anxiety is not a thought. It is a physical response in the nervous system when emotions feel unsafe.
Defences are automatic habits that distract you away from emotions. These might include overthinking, self‑criticism, detachment, people‑pleasing, minimising, or saying “I don’t know.”
Symptoms emerge when anxiety and defences repeatedly replace feeling.
In ISTDP, we slow this process down so you can see it happening and respond differently.
For more information, please see my blog post The Therapy FAD: Rethinking our Feelings, Anxiety and Defences Across Modalities
Working with the body, not just the mind
ISTDP pays close attention to how anxiety shows up in your body.
Some people feel tension in muscles, jaw clenching, or restlessness. Others experience stomach problems, headaches, breathlessness, dizziness, or dissociation.
These patterns tell us how much emotional intensity your nervous system can tolerate at this stage.
Therapy is then carefully adjusted. For some clients, we first build emotional capacity and regulation. For others, we can move more directly toward deeper emotional work.
This tailoring is central to safe and effective change.
What actually happens in sessions
Sessions are collaborative and grounded. We focus on real situations from your life and what you feel toward the people involved.
As emotions come closer, anxiety and defences naturally appear. I will help you:
Notice these patterns as they happen
Understand how they affect your symptoms and relationships
Gradually turn away from defences that keep you stuck
Experience emotions in your body without being overwhelmed
When avoided feelings are felt fully, anxiety and symptoms often reduce sharply.
Over time, this leads to deeper self‑understanding, emotional freedom, and more authentic relationships are free to develop without the now old historical blockages.
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.
Primary focus: emotions, anxiety in the body, defences
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 is particularly helpful if you:
Feel stuck despite insight or past therapy
Struggle with anxiety, panic, or chronic stress
Experience physical symptoms linked to emotions
Feel cut off from emotions or overwhelmed by them
It is also effective for many people with long‑standing or complex difficulties, provided the work is paced correctly.
Is ISTDP right for everyone?
No therapy suits everyone.
ISTDP requires willingness to look inward and to stay engaged when emotions arise. Some people prefer a more skills‑based or supportive approach, especially at certain stages of life.
Part of my role is to help you decide whether this way of working fits you, now.
Why work with me
I am a UK‑based psychodynamic psychotherapist with experience integrating ISTDP principles into my clinical work. I work carefully, ethically, and at a pace that respects your nervous system rather than pushing past it.
My aim is not to force emotional breakthroughs, but to help you build the capacity to face what has been avoided so real change becomes possible.
Next steps
If you are curious about ISTDP or wondering whether this approach could help you, the next step is a consultation.
We will look at what you are struggling with, how your system responds under pressure, and whether this way of working feels right for you.
FAQ: ISTDP Therapy
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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.
Fees £65 per 50-minute online session
Flexible AM/PM appointments
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