Therapeutic Approach
I practice Intensive Short-Term Dynamic Psychotherapy (ISTDP). It’s a very powerful form of therapy, and I believe in it’s ability to facilitate deep and permanent change for the large majority of clients. If you have been in therapy before, you may find ISTDP to be more focused, challenging, and intense, since we would be helping you face difficult feelings you tend to avoid. Many clients also find it to be more helpful than other therapies, and leave the first session with newfound hope.
Some of the theory
ISTDP grew out of psychoanalytic theory, and though the technique is quite different from psychoanalysis, it shares much of the foundational understanding of human nature and emotional illness. I’ll attempt to state the basics as clearly and simply as possible.
At the heart of everything is love. We are born with a deep need and powerful drive to attach within loving, attuned relationships. As infants, and throughout childhood, we are completely dependent on our caregivers to survive. Without them we die. When these original relationships go well, they are cemented in a poignant and unshakable love between parent and child.
When these relationships do not go well, however, and when the parent-child bond is chronically strained or broken, it marks the child’s heart and causes anguish. Since the wound occurs before the child is fully self-aware, she will unconsciously adapt and accommodate the parent in whatever way she needs to—anything to hold on to mom and dad. Unfortunately, this often means the child develops with a wound in her heart she is only peripherally aware of, and that she guards without knowing. A tree pressed against a fence post will contort itself and grow around the post, and can even swallow it completely.
When the child swallows her emotional pain and holds it inside, she does it to save her precious relationships with mom and dad. As the child grows into an adult, she still holds this unfelt pain, and acts out of it without realizing. She also suffers from it, and it will often manifest in a psychological disorder.
If the parent is able to consistently pay attention to the child, see him, and love him, things go differently. The child begins to know himself as the parent reflects back what she sees. He accepts himself because the parent accepts him, and he accepts all of his feelings, because his parent accepts those too. The child learns to come and go within an intimate love relationship, and to treat himself with the same love he is shown.
When the parent does not pay attention, or does not see the child, or does not love him, he will not learn to see and love himself. If the parent cannot tolerate the child’s feelings, the child won’t either. He perceives that mom or dad does not like his anger, or sadness, or love, and finds ways of burying them. If he doesn’t, he risks losing the relationship he cannot survive without. He has no choice.
As an adult, he finds himself unprepared for life in some way, or in many ways. Something isn’t working. He may be in some kind of emotional pain. He may be anxious, all the time, and not know why. He may be depressed, apathetic, purposeless. If it gets bad enough, he may feel like dying. Since his original love relationship was disturbed, he will expect disturbances within romantic relationships, and will unconsciously protect himself from intimacy and the anguish he believes is inevitable.
He does not know how he feels. He does not know what he feels. He believes that his feelings destroy him, and destroy the relationships he cherishes, so he feels anxious whenever feelings come close to the surface. He wards them off, hard and fast, in ways he does not even know.
Sadly, he avoids the feelings he needs to face. By avoiding his painful, buried feelings, he lives a life of anxiety and avoidance. He finds ways of pushing his feelings down, or of avoiding any relationship or situation that would bring up the feelings he fears. By avoiding his feelings, he maintains his suffering.
Some of the practice
In the first session, we would try to get a thorough understanding of the current emotional problem that’s bothering you. Maybe it’s mounting anxiety, or a depression that you don’t understand, or a problem in a relationship. We would try to establish when the problem began, and what triggered it. With your permission and will, we would then invite you to feel the underlying feelings to the deepest extent possible.
Sounds straightforward, but it’s rarely simple. Each client is complex, and thoroughly individual. We would pay careful attention to all of your thoughts and feelings, and would search out the ways you avoid the feelings that frighten you. Once you see your defenses against feeling, you have more choices. You can now choose to feel instead of avoid.
We would also pay careful attention to the anxiety that comes up in sessions and in day-to-day life. We would learn from the anxiety, see what feeling it’s simultaneously pointing to and covering over. If anxiety gets too high, we will help you learn to regulate it and reground yourself. If you aren’t feeling any anxiety at all, we may not be helping you face the feelings that scare you, and we would not be doing our best to ease your suffering.
Your emotional difficulties may play out within the therapeutic relationship as well. You may find yourself reluctant to open up, or sharing too much too fast. You might feel things towards the therapist that don’t fully make sense. Most likely, you will carry a whole set of assumptions about other people, and about how relationships with them go.
We would observe all of these dynamics as they play out, and help you get to know yourself within the safety and protections of the therapeutic relationship. I don’t mind your feelings, even the ones towards me, and I will do everything I can to help you feel and understand them.
Some of your feelings will scare you. None of them will harm you. The more deeply you can learn to feel your feelings as they rise in your body, to understand them, and accept them, the more you will heal and grow. You will rediscover your inner compass. You will learn that feelings give you a sense of who you are and what you want out of life. Decisions will become easier, and your relationship will be better. Intimacy may finally feel safe enough to explore and let yourself sink into. If therapy goes well, it can truly change your life.
If you’d like, send me a message.
We can set up a time to meet, and see how therapy can help you as quickly as possible