Intensive Short-Term Dynamic Psychotherapy (ISTDP) is one of my foundational therapy modalities I draw upon with clients. The reason for this is ISTDP offers a very effective map into the human psyche.
The map is surprisingly simple, yet deeply robust. Picture an upside down triangle. The bottom of the triangle is our feelings, our values, our wants, our needs, our impulses, our desire for emotional closeness with others. But somewhere along the line, usually in childhood, we learn that there are at least some things at the bottom of the triangle that are not ok to have, express, or even feel.
So we cover it up. It’s too dangerous, threatening even in some way. And now we are up to another corner of the triangle- anxiety. Anxiety is our nervous system, conditioned by the nonconsensual virus of how we had to adapt to our traumas and challenges in life, saying nope! Don’t go there! Tense up, go blank, get shaky, get nauseous, or any of a host of anxiety symptoms those who have experienced anxiety and panic attacks are familiar with.
And then we get to the third corner of the triangle- our coping strategies, or defenses. These are what we do to keep the stuff of the bottom of the triangle (feelings, desires, wants, values) at bay. We ignore, we suppress, we rationalize, we loop in anxious thoughts, we get super busy, we attack and beat up on ourselves, we put a heavy blanket over who we are, we go numb, and hundreds of other strategies. And I’ll say up front here- coping strategies aren’t inherently bad. We need them! In our society, at least, we need to be able to present ourselves a certain way, or table a feeling for later, or do what is necessary to keep our jobs.
But what I think ISTDP sells is intentionality. Let’s be intentional about when we cover up our feelings, values, wants, desire for emotional closeness so that when we want to be in contact with the core of who we are, we can.
Another way of thinking about ISTDP is this: we have the built up pressure of all the traumas and feelings we never got to fully process (through no fault of our own). And that stuff creates a pressure to unconsciously default to anxiety and defenses. So as we work to deeply face that stuff together (where it directly ties to your goals) , we can release that pressure. The space created by that work is where you get to be intentional. Rather than automatically going to anxiety unintentionally, or automatically start beating up on ourselves, we can choose.
We can choose to tense up when we need to get something done, and we can choose self reflection and self assessment rather than trying to unintentionally win some contest for how critical we can be of ourselves. And if you think about it, that’s depression right there- beating ourselves up, feeling tense, feeling heavy to cover up our feelings.
What about couples therapy? Well, how often do we have a reaction maybe without even realizing it, and then start acting out in ways that pushes our partner(s) away? We might not like what they said, but then instead of learning to say that directly with effective communication, we go straight to shutting down, or blaming, or attacking, or criticizing them or ourselves or everything everywhere somehow, or we start to spiral down into shame.
So couples therapy is another place where what we unintentionally do with our feelings and the rest of the stuff at the bottom of the triangle becomes the negative cycle between you and your partner(s). And the offramp to that awful cycle starts with recognizing what you are doing, and that you are doing it because you had a reaction to what the other person said. And often our reactions is based on how we unknowingly interpreted what they said, which is a topic for another day…