The Journal of Contemporary ISTDP (JCI) is an open access, peer-reviewed journal dedicated to Intensive Short-term Dynamic Psychotherapy, an emotion-focused psychoanalytic psychotherapy developed by Habib Davanloo. The journal is a hybrid-content journal mixing academic and non-academic content, spanning all the way from rigorous empirical studies to case studies to short personal reflections and arts. The foundation of the JCI was laid down by Thomas Hesslow, Kata Tamás, Johannes Kieding and Mikkel Reher-Langberg in 2023. The idea for the journal came up as an answer to the increasing need in the ISTDP community for a platform where ideas, theory, history, research and persons related to ISTDP can meet, communicate and grow together. The first issue was published in June of 2024.
Davanloo’s tapes led me to have a stereotypical idea of ISTDP: Nancy McWilliams interview
This interview with renowned psychoanalytic scholar and practitioner Nancy McWilliams explores her reflections following the Emotion Revolution conference in Bergen, Norway, in 2025. McWilliams discusses how observing Allan Abbass work with clinical video vignettes shifted her long-held, stereotypical impression of Intensive Short-Term Dynamic Psychotherapy (ISTDP)—originally formed after viewing Habib Davanloo’s tapes in the 1970s—toward a broader appreciation of contemporary ISTDP’s affective flexibility, range, and attachment-informed approach. The dialogue examines key points of convergence and divergence between classical psychoanalysis and ISTDP, including the diagnostic utility of character structure, the role of video supervision, and the tension between standardized short-term models and extended treatment for fragile patients. Finally, McWilliams and Hesslow discuss the future of psychotherapy integration, addressing both the persistent tribalism among competing clinical schools and the robust common-factors research demonstrating that the therapeutic alliance remains the primary driver of healing.
Intensive Short-Term Dynamic Psychotherapy (ISTDP)
Copyright (c) 2024 Journal of Contemporary ISTDP
Folk Concepts in Psychotherapy Supervision: A Learning Sciences Approach
When students learn psychotherapy, they bring implicit folk concepts—naïve theories of psychological functioning learned in their families and cultures—that conflict with clinical knowledge. If supervisors do not recognize these folk concepts, they continue to drive students' thinking even after scientific concepts have been taught. This paper integrates research from the learning sciences to help supervisors identify common folk concepts, such as the belief that defenses can be "taken away," that theories can be aggressive, or that passive listening allows unconscious material to naturally surface. We examine how lecturing, the most common supervisory approach, creates passive learning that students replicate with their patients. The solution is an experiential, dialogical supervision that uses systematic questioning to teach clinical thinking. We demonstrate how decision tree questions reveal the steps of assessment, metacognitive questions monitor learning, and experiential learning helps students discover the limitations of their folk concepts. By developing a theory of the student's mind and teaching through questions rather than lectures, supervisors can facilitate the conceptual change process, enabling students to shift from folk psychology to clinical thinking.
ISTDP World Map Project: A Global Community Effort
This article presents the ISTDP World Map Project, a community-driven initiative to document the global distribution of ISTDP therapists and organizations, highlighting the international growth of the model and the collaborative efforts involved in mapping its worldwide presence.
Intensive Short-Term Dynamic Psychotherapy
Copyright (c) 2026 Journal of Contemporary ISTDP
This editorial introduces the second issue of the Journal of Contemporary ISTDP, reflecting on the journal’s first year and framing the theme of endings—termination, loss, and mortality—as central to therapeutic change, learning, and growth within the ISTDP community.
On Becoming a Good Enough Therapist: My Journey in Learning ISTDP
This reflective essay traces the author’s long professional journey toward becoming a “good enough” therapist, highlighting how learning Intensive Short-Term Dynamic Psychotherapy (ISTDP) reshaped his understanding of therapeutic alliance, humility, emotional honesty, and personal growth in clinical practice.
Review of What I Couldn’t Tell My Therapist: The Truths We Told to Heal Our Lives
This book review explores What I Couldn’t Tell My Therapist by Michelle M. May, highlighting its vivid portrayal of Intensive Short-Term Dynamic Psychotherapy (ISTDP) through intertwined clinical narratives and personal reflection, and emphasizing its capacity to convey emotional depth, therapeutic process, and hope for psychological change to both therapists and general readers.
Review of Innføring i intensiv psykodynamisk korttidsterapi by Jon Anders Lied
This book review reflects on Innføring i intensiv psykodynamisk korttidsterapi by Jon Anders Lied, highlighting its accessible introduction to ISTDP and its emphasis on foundational principles, therapeutic alliance, and pacing in clinical work, particularly for trainees and early-career therapists.
On closing the frame: An existential argument for setting a time-limit in intensive short-term dynamic psychotherapy.
This paper provides a theoretical argument for setting a time-limit in Intensive Short-Term Dynamic Psychotherapy (ISTDP) as one way to circumvent protracted treatments with diminishing clinical benefits. The author draws from prior literature in the psychoanalytic and short-term dynamic psychotherapy movements, as well as existential-phenomenological theory, to suggest that the open-endedness of most psychodynamic psychotherapies provides fertile ground for defenses against termination to take root and that such defenses are often due to both the therapist’s and patient’s unconscious anxiety about their mortality. The author suggests that implicit assumptions in ISTDP about the achievable outcomes of psychotherapy, specifically the possibility that therapists can completely resolve neurotic derivatives of source trauma, do not account for the impact of our universal terror and defenses against death, which are future-oriented and therefore always at least somewhat unresolvable. The author suggests that setting a time limit at the outset of therapy, or 'closing the frame,' facilitates early recognition of unconscious defenses against death and separation. This approach helps bring underlying mixed emotions about separation, loss, and the limitations of psychotherapy to the surface before these defenses become more entrenched. Phenomenological research data and brief vignettes of time-limited ISTDP treatment from the author’s clinical practice are provided to support these ideas with examples. The author also discusses challenges and limitations of a time-limited approach to short-term psychodynamic psychotherapy.
Is it me or the model or the patient? Learning ISTDP with East Asian patients
This reflective clinical article examines the challenges and learnings involved in practising Intensive Short-Term Dynamic Psychotherapy (ISTDP) with East Asian patients. Drawing on the author’s experience as both therapist and patient, peer consultation, supervision, and a detailed clinical vignette, the paper explores how cultural factors intersect with resistance, alliance, transference, and superego pathology. It argues that while the core principles of ISTDP remain essential, cultural sensitivity, precision, and therapist self-reflection are crucial for effective application with East Asian patients.
Intensive Short-Term Dynamic Psychotherapy with a Person-Centered Emphasis: Habib Davanloo Meets Carl Rogers
This paper explores the potential integration of the person-centered approach (PCA), developed by Carl Rogers, with Intensive Short-Term Dynamic Psychotherapy (ISTDP), developed by Habib Davanloo. Despite the differences between the PCA’s non-directive stance and ISTDP’s directive and often confrontational techniques, ISTDP is arguably most effective when it incorporates the relational components central to the PCA as well as the common factors. These factors—including empathy, congruence, and curiosity—are vital for fostering a conscious therapeutic alliance which, in turn, is essential for deep emotional closeness between therapist and patient. The authors argue that ISTDP can be practiced in a manner congruent with the core principles of the PCA, such as respect for patient autonomy and authentic connection, and which ultimately may enhance the efficacy of ISTDP interventions. However, achieving this integration presents challenges, as the emotional intensity and complexity of ISTDP may provoke anxiety in therapists, potentially leading them to employ techniques defensively, thereby compromising the person-centered qualities of the therapeutic relationship and undermining the emotional closeness that is central to ISTDP. Ways that these challenges may be mitigated are discussed, including the balance between specific and common factors, a focus on the real relationship, and reflections on Davanloo’s admiration for his patients and the role of intuition in his work.
Inside Davanloo's late mobilization workshops: Jody Clarke interview.
In this in-depth interview, Jody Clarke reflects on his long participation in Habib Davanloo’s Closed-Circuit Training Workshops, offering a rare, first-hand account of their structure, pedagogical rationale, and clinical impact. The discussion explores how these workshops addressed therapists’ unconscious resistances, shaped the later development of ISTDP, and influenced Clarke’s personal life, professional practice, and understanding of honesty, intimacy, and responsibility in psychotherapy training.
A Brief History Of Active And Short-Term Psychoanalytic Techniques, part 2: Freud’s Mature Technique
In this article, the author presents an overview of key aspects of Sigmund Freud’s mature psychoanalytic technique: Its extent and physical setup, the use of free association, evenly suspended attention and therapeutic neutrality, the use of interpretation to bring about insight, and its approach to the transference. Lastly, the author draws parallels between Freud’s technique and Davanloo’s technique of ISTDP. This forms the basis for the next installment in this series of articles, in which the author will survey the history of the psychoanalytic movement during the 1920s, 30s, and 40s and the short-term and active modifications of Freud’s psychoanalytic technique that were developed during this period.
Rescuing the Heart from the Therapy Room Floor
This learner journey reflects on the author’s personal and professional encounter with Intensive Short-Term Dynamic Psychotherapy (ISTDP), describing how experiential engagement with the method reshaped her understanding of emotion, resistance, therapeutic honesty, and the central role of relationship in psychological change.
This performance piece offers a personal, poetic reflection on Intensive Short-Term Dynamic Psychotherapy (ISTDP), tracing the author’s encounter with the method through humor, vulnerability, and lived experience. Through storytelling, the piece explores anger, loss, and transformation, illustrating how being deeply seen can catalyze emotional change.
ISTDP goes multimodal: Using ISTDP as a theoretical foundation for change in an intensive, multimodal, medication-free treatment approach in Ålesund, Norway
This interview explores an eight-week intensive, multimodal, medication-free treatment program at Vegsund DPS in Ålesund, Norway, where Intensive Short-Term Dynamic Psychotherapy (ISTDP) serves as the unifying theoretical foundation across treatment modalities. The program integrates individual ISTDP, psychoeducation, group and body-based interventions, and family involvement for treatment-resistant patients. The article highlights the rationale, structure, clinical experiences, and organizational factors supporting the implementation of ISTDP within a public healthcare setting.
This research recap highlights recent studies on ISTDP and related affect-focused treatments, including RCTs showing strong effects in chronic pain, functional somatic symptoms, anxiety disorders, and medical settings. The findings underscore the effectiveness of brief, intensive psychodynamic interventions and their growing empirical support.
De-Idealizing the Unlocking of the Unconscious: Comment on Johansson et al., 2024
This commentary critically examines the role of the unlocking of the unconscious as a mechanism of change in Intensive Short-Term Dynamic Psychotherapy (ISTDP), in response to Johansson et al. (2024). While unlockings are associated with superior outcomes, substantial improvements also occur without them. Drawing on common factors research, the paper proposes complementary mechanisms – including increased awareness, patient agency, honesty, and relational factors – and argues for a more integrative understanding of change in ISTDP.
ISTDP is a Functional Analytic Psychotherapy
In this paper, I describe and analyze Intensive Short-Term Dynamic Psychotherapy (ISTDP) from the perspective of Functional Analytic Psychotherapy (FAP), a behavioral psychotherapy explicitly emphasizing the therapeutic relationship as the primary context for clinical intervention. I propose that FAP can be understood as a generalized system of behavioral psychotherapy, characterized by procedural guidelines (“FAP’s Five Rules”) derived from operant conditioning principles. Further, I demonstrate that ISTDP, despite its psychoanalytic origins, procedurally fulfills the criteria of this generalized behavioral system, particularly through its structured use of contingent responding (Pressure, Challenge, Head-On Collision) within therapeutic interactions. ISTDP’s implicit universal conceptualization of emotional health — emphasizing adaptive emotional experiencing, expression, and interpersonal closeness — is explicitly articulated within the behavioral framework. Highlighting complex clinical phenomena of ISTDP, such as emotional breakthroughs (“unlockings”) and the expressions of the Unconscious Therapeutic Alliance (UTA), I argue that these phenomena challenge purely operant behavioral explanations and thus suggest the potential benefit of integrating advanced behavioral theoretical frameworks like Relational Frame Theory. The paper discusses implications for theoretical advancement, clinical practice refinement, and improved empirical research in ISTDP.
Anxiety pathways in ISTDP: self-reported symptom clusters in patients with persistent physical symptoms
Although case studies support the notion of three anxiety pathways in Intensive Short-Term Dynamic Psychotherapy (ISTDP), empirical research remains scarce, highlighting the need to investigate how somatic symptoms cluster in line with ISTDP’s anxiety pathway theory using validated measures. This study therefore explored the clustering of self-reported somatic symptoms in 550 patients with persistent physical symptoms (PPS) from three previous randomized controlled trials, examining their potential alignment with the theory of unconscious anxiety and its discharge pathways, as proposed in ISTDP. Using the Patient Health Questionnaire-15 (PHQ-15), an exploratory factor analysis identified three symptom clusters—musculoskeletal, gastrointestinal, and cardiopulmonary—that together explained 40.1% of the variance. This three-factor structure, validated through confirmatory factor analysis, partially aligned with ISTDP’s conceptual anxiety pathways, though limitations were noted in capturing cognitive-perceptual disturbances. These findings suggest that self-reported symptom assessment can complement clinician-led methods in identifying anxiety-related symptom clusters, warranting further development of self-report tools within psychodynamic assessment frameworks.
Intensive-Short term Psychodynamic Therapy
“The Shaking Grandmother”: Assessing and Addressing Multiple Pathways to Somatic Symptom Formation in ISTDP
Intensive Short-Term Dynamic Psychotherapy (ISTDP) can be an effective treatment for complex cases presenting with fragility, repression, character problems and multiple medically unexplained somatic symptoms. However, in such cases, the treatment is not always “short-term,” and the therapist needs to engage in the complicated task of assessing and addressing the specific mechanism involved in the formation of diverse somatic symptoms as they emerge in sessions. This case report describes the application of graded ISTDP with a patient presenting with long-standing difficulties with depression, masochistic character traits, and multiple medically unexplained somatic symptoms. Session transcripts from early, mid and late treatment phases will illustrate the assessment and therapeutic work with anxiety thresholds, as well as detecting and restructuring somatization. Further, I will illustrate how the emergence of the unconscious therapeutic alliance (UTA) in later stages of treatment can elicit high levels of anxiety in the therapist and discuss the critical role of having supervision when working with primitive unconscious phenomena in fragile patients. Outcome at termination and one-year follow-up will be presented.
The Case of the Charmer: Shape-shifting Seduction, Lethal Splitting, and a Salvaged Treatment Using Conversational Intimacy
This paper explores the treatment arc of a case where higher order defenses and capacities consistent with psychoneurotic functioning occurred in close conjunction with regressive defenses indicative of more severe personality disturbances. Within a theoretically-grounded exploratory case study design, several notable features of the case will be highlighted, alongside illustrative transcript excerpts. First, the importance of therapist attention to capacity thresholds in the context of the patient’s unique configuration of psychodynamics will be outlined. Second, consistent with the principles of the graded format of ISTDP, we illustrate how over-threshold responses and periods of regression were addressed and ameliorated through a reduced focus on guilt-inducing torturous impulses. Third, the reader will be introduced to an adaptation of the graded approach we refer to as conversational intimacy, which we suggest facilitated progress through integrating feelings of love and hate at lower levels of intensity. Therapist self-disclosure and patient authenticity are foregrounded as primary vehicles for this integration, and generative of a titrated form of emotional intimacy. We also consider how the patient’s a priori knowledge of ISTDP may have impacted the treatment. Although the treatment approach in this case shifted focus away from major mobilization of the unconscious, it appeared to build capacity and facilitate corrective emotional experiences nonetheless. We argue that this was achieved partly through emotional intimacy developed at the conversational level, which in turn led to the course correction of a previously derailing treatment process.
The Therapist’s Experience of the Rising Unconscious Therapeutic Alliance in the Patient: The UTA Mental State
Traditionally, the rise of the patient’s unconscious therapeutic alliance (UTA) has been described in observable, objective terms in the Intensive Short-Term Dynamic Psychotherapy (ISTDP) literature. The therapist’s subjective experiences of when the UTA rises in the patient, on the other hand, has received little attention. In this paper, the author introduces a first-person account of a subjective phenomenon she experiences as a therapist when the UTA rises in the patient, which will be referred to as the UTA mental state. By defining and describing this phenomenon, the author aims to: a) invite further reflection and development of the concept in the wider clinician community, and b) suggest how the concept may provide an additional data point in the therapist’s clinical decision making. To this end, an historical consideration of the UTA in the ISTDP literature is first presented. Next, a phenomenological description of the proposed UTA mental state concept is provided. Three clinical vignettes are then presented to illustrate the phenomenon, with potential benefits to clinical decision-making discussed, and consideration given to resistance against the UTA in both the therapist and patient. The paper concludes with a discussion of conceptual and practical strengths and limitations of this concept.
Recent studies continue to support the efficacy and cost-effectiveness of short-term psychodynamic therapies, including ISTDP. A 2023 study replicated ISTDP’s effectiveness for treatment-resistant depression, while pilot trials explored its potential for histrionic and antisocial personality disorders. Research also links therapist oxytocin levels to treatment outcomes. Large-scale studies confirm the societal cost-effectiveness of short-term therapies, while evidence suggests longer treatments yield greater benefits. An umbrella review further establishes psychodynamic therapy as an empirically-supported treatment across mental health conditions.
ISTDP teamwork with Cluster C personality disorder: A group interview about an innovative approach in Gothenburg, Sweden
This article explores an innovative ISTDP-based treatment program for Cluster C personality disorders at Sahlgrenska University Hospital in Gothenburg, Sweden. The program integrates individual and group therapy in a structured, stepwise format, emphasizing teamwork among therapists. Preliminary outcomes suggest promising improvements for patients. The approach highlights the benefits of collaboration, professional development, and sustainable healthcare solutions.
Intensive Short-Term Dynamic Psychotherapy and the Cherry Blossoms of Yoshino
Fundamentally, this viewpoint article is about the mystery and wonder that lie within the hearts of clients, therapists, as well as at the heart of this transformative work. The article speaks of the ways that ISTDP’s insistence on direct experience helps to convert the forces of resistance into those of the therapeutic alliance. Further, the article touches on the ways intensive, non-dual forms of meditation help mobilize the depths of the unconscious, and awaken the profound healing and compassionate forces of the human psyche. This writing also speaks about Windhorse’s Zentensive Workshop and Retreats, APA accredited trainings which blend the technical with the spiritual, the psychodynamic with the transcendent. Personal experiences of the author, and others, are shared to give voice to the transformative nature of this approach to training. These narratives also help shift the nature of this work from the theoretical to the practical, and help dissolve the sometimes vague and arbitrary distinctions made between our personal and professional lives. Finally, this article warns of the potential dangers of assuming an overly-technical approach to our clinical work and training. It looks ahead to how a spiritual therapist might practice, and to the exploration of potentially new paradigms of psychotherapy arising out of a place of Wonder.
Chris D. Gioielli reflects on the challenges of ISTDP training, exploring how idealization of the model led to self-doubt and emotional strain. He examines the allure of omnipotence in therapy, the pain of disillusionment, and the ultimate freedom found in embracing personal authenticity. His journey offers insight into balancing skill development with self-acceptance.
Marianne Wiens recounts her transformative journey from a career in music to becoming an ISTDP-informed therapist. She shares the emotional and intellectual challenges of training, the impact of personal loss, and the ongoing commitment required for mastery. Reflecting on balance, motivation, and connection, she explores the deeper spiritual dimensions of therapeutic work.
Internalized Object Relationship as an Advanced Level of Psychodiagnosis
Internalized representations of past relationship experiences, referred to as internalized object relations (IOR), impact how patients perceive and experience their therapist and the therapist’s interventions. The ability to identify the internalized object relationship paradigm through which the patient experiences the therapist allows the therapist to formulate interventions that challenge rather than unconsciously enact pathogenic transference dynamics. In this paper, a case example is used to highlight methods for psychodiagnosing internalized object relational roles in the patient-therapist interaction. Further, the authors attempt to demonstrate the utility of incorporating internalized object relations-based formulations in the planning of interventions and assessment of patient responses, and identify areas for further development of internalized object relations concepts in ISTDP theory and technique.
Authenticity and Discipline in ISTDP Learning
In this article, Chenhong Xu reflects on her Intensive Short-Term Dynamic Psychotherapy (ISTDP) training journey, navigating the tension between methodological rigor and therapeutic authenticity. Initially drawn to ISTDP’s structured frameworks, she encountered challenges with rigidity, sparking internal conflicts between compliance and personal style. Through peer collaboration, diverse mentorship, and integrating complementary modalities, Xu reconciled these tensions, embracing the "wounded healer" archetype to deepen emotional attunement. Her evolution highlights balancing disciplined techniques with intuitive, client-centered care, underscoring critical reflection and adaptability. This narrative advocates for continuous learning, collegial support, and synthesizing diverse perspectives to cultivate an authentic therapeutic voice, bridging structured methods with individualized practice in psychotherapy.
A Brief History Of Active And Short-Term Psychoanalytic Techniques, part 1: Freud’s early discoveries
In this article, the author presents a brief history of the early development of Sigmund Freud’s psychotherapeutic technique, as well as some fundamentals of his early metapsychology. First, the influence of Joseph Breuer’s work with Anna O on Freud’s early research is considered. The author then reviews Freud’s disagreements with Breuer in light of the former’s exposure to French psychiatry. Following this, Freud’s early clinical findings are reviewed. This forms the basis for a brief overview of the history of the psychoanalytic movement during the first two decades of the 20th century, and forms the first part of a series of four articles that will be presented across four issues of the Journal.