ISTDP is a structured, emotion-focused therapy. It is based on the understanding that emotional health is dependent on positive and nurturing experiences with our parent(s), siblings, friends, teachers and other caregivers. Our healthy, core emotions, such as happiness, anger and sadness, become unconsciously linked with fear when they threaten to break these connections. For example, if your caregiver(s) did not support you to cry when you were saddened by loss, to feel angry and set healthy boundaries when you experienced others as judgemental, or to feel happy when you were successful, then you may experience excessive anxiety and automatically use defences to hide these feelings in your interactions with others.

Therefore, ISTDP places a strong emphasis on defences you may use to avoid emotional intimacy when you make yourself vulnerable and talk about your feelings, views, wishes and problems. For example, avoiding eye contact, speaking quickly and laughing/smiling when you say something that is painful to you. Psychological defences are at the heart of human suffering as they ensure that you remain disconnected from the full extent of your feelings and, therefore, limit the emotional connection you experience with yourself and in your relationships. Further examples of defences are compliance and putting others first, self-devaluation/attack, self-harm, self-doubt, self-blame, uncertainty, rumination, worry, perfectionism, procrastination, passivity and helplessness, and devaluing and blaming others.

ISTDP is also unique in its focus on the moment-to-moment monitoring of your physiological anxiety symptoms, for example muscular tension, dry mouth, sweaty palms, nausea, dizziness/faintness, foggy thinking, racing mind, ringing ears and dissociation. This can help you learn to regulate your anxiety in a healthy way, and to assure that your therapy proceeds at the right pace for you.

Taken together these focuses can help you to fully re-connect with and respect your inner experiences. In an environment of safety I can help you to make contact with the feelings, thoughts and wishes that were once a threat to your most important relationships and now cause you anxiety. You can then stop using destructive defences and be free to make the positive changes that you want in your life. Through this process you can really understand the development of your emotional problems and become your own therapist.