As with all methods of psychotherapy I will first enquire as to what has brought you to therapy, and what you want my help with. I will also ask you about the history of your problems, as well as your family, social, educational and employment history.
ISTDP is an emotion focused therapy. Therefore, your current problems are viewed as a result of some form of emotional avoidance.
To have access to your feelings we will look together at concrete examples of situations where you experience your problems, whether in relationships with your partner, relatives, friends, children or work colleagues, or whilst engaging in an activity that is important to you.
The goal of ISTDP is to help you fully re-connect with your core feelings, such as happiness, sadness, anger and guilt as quickly as possible but, most importantly, at the right pace for you without excessive anxiety and without reverting to the use of destructive psychological defences.
This is where the moment to moment focus on your physiological symptoms of anxiety, a central feature of ISTDP, is very helpful. Your anxiety will serve as a guiding light as to when you are able to deepen your experience of your feelings. For example, if your bodily tension becomes too high, or if you feel nauseous, your vision becomes blurred or your thinking is no longer clear, then we have a red light so to speak, and we will first stop to reduce your anxiety. This is a process of dipping your toe in and out of feelings that cause you anxiety. Thereby, you can gradually build your capacity to experience and manage your feelings in a healthy, constructive way.
When you make yourself vulnerable in your sessions, by talking about your feelings, views, wishes and problems, you may use defences to avoid your emotional connection with me. Examples are avoiding eye contact, speaking quickly, speaking in a general way, and laughing/smiling when sharing a painful experience. From the beginning of your therapy we will pay close attention to these processes, so you can make the positive changes you want in your life as quickly as possible.
Throughout your therapy we will remember that your emotional defences were once healthy, as they helped you to hide feelings that were not welcome. Even loving parents are often not able to help their children develop in the way they would have wanted, because of their own emotional restrictions. I always say it will hurt the same if someone stands on your toe purposefully or by mistake. Without seeking to blame we will identify the unhelpful developmental experiences that play a role in your current emotional avoidance and resulting problems.
We all have a healthy, constructive part of our mind and an unhealthy, destructive part. It is on the basis of your healthy part and your longing to understand yourself with love, care, precision and honesty, that you have decided to have therapy. If we work together I will do my best to align myself with your healthy part at all times. Through our concentrated work on and attention to your experience of your feelings, and subsequent anxiety and defences, you can become your own therapist and make the positive changes you want in your life.