Intensive Short-Term Dynamic Psychotherapy: Theory and Technique

by Patricia Coughlin

Traditional psychoanalytic thinking dictates that the only way to help most patients achieve significant insight resulting in lasting change is through a rigorous course of lengthy treatment involving anywhere from two to five sessions a week. Needless to say, the prospect of such a monumental therapeutic undertaking is repugnant to health insurers and clearly beyond the means of the majority of patients. As a consequence, the past two decades have witnessed a rise in popularity of several short-term psychotherapeutic approaches. Most well known among these is the intensive short-term dynamic approach first developed by Habib Davanloo in the late 1960s. A proven technique for accelerating and condensing the analytic process while remaining true to basic psychoanalytic principles, Davanloo's method has met with nothing less than miraculous results in case after reported case. Yet, until now, there has not been a clearly written, accessible guide devoted to schooling practitioners in the theory and practice of this revolutionary psychotherapeutic method.Patricia Coughlin Della Selva's Intensive Short-Term Dynamic Psychotherapy shows therapists how to achieve even the most ambitious therapeutic goals, including character change, in as few as 40 sessions. Not a cookbook, but a systematic guide to intervention, it outlines proven techniques for accessing a patient's ego-functioning, dismantling defenses, intensifying a patient's affective involvement in the treatment, identifying the transference patterns as they arise, and "unlocking the unconscious" with a speed and degree of accuracy previously considered impossible.

The book opens with a chapter in which the author lays down the theoretical foundations of the method. She supplies a detailed review of the psychoanalytic theory of neurosis, provides operational definitions of dynamic concepts, and defines strategies for observing unconscious processes. The remainder of the book is devoted to clinical practice. Following a format roughly paralleling the psychotherapeutic process, it details the requirements of initial evaluation; describes techniques for working with defenses; explains the role of affect in creating and remediating psychopathology; describes techniques for intensifying affective experience and facilitating its expression; details methods of enhancing and completing the working-through process; and outlines procedures for the successful termination of and follow-up to the course of treatment.

A book whose time has come, Intensive Short-Term Dynamic Psychotherapy makes accessible to the psychotherapeutic community at large a treatment model that has been described as "the most important development in psychotherapy since the discovery of the unconscious."

Of related interest . . .

UNLOCKING THE UNCONSCIOUS

selected papers of Habib Davanloo

These selected papers represent a valuable account of the development over several years of a powerful and innovative technique for overcoming resistance and confronting problems of the unconscious. Davanloo's Intensive Short-Term Dynamic Psychotherapy offers a body of theoretical, metapsychological, and technical knowledge which can be used with extraordinary precision to mobilize unconscious mental processes in order to achieve therapeutic results. The clinical material presented demonstrates how a single interview can provide an opportunity for both the therapist and the patient to view the multifoci core of the patient's neurotic structure, which is responsible for the patient's symptoms and character disturbances. 1995 (0-471-95611-2) 344 pp.

UNBEARABLE AFFECT

a guide to the psychotherapy of psychosis

David A. S. Garfield

Unbearable affect is seen as the focal point around which psychosis turns. When emotion becomes unbearable, some psychotic patients suffer from delusions, hallucinations, incoherence, negativism, autism, or emotional paralysis. In this remarkable book, Dr. David Garfield establishes paradigms for the diagnosis and psychotherapeutic treatment of psychotic disorders based on the location, understanding, and reordering of unbearable affect. He provides concrete clinical advice, vivid examples, and crisp, jargon-free descriptions of theoretical concepts and clinical techniques. 1995 (0-471-02536-4) 177 pp.

Genres: Psychology, Psychoanalysis

Hardcover

First published March 13, 1996

Reviews

[Dia · Rating 4 out of 5]

It's very exciting to think that relief from deeply rooted, self-defeating habitual patterns is possible at all, let alone after just 10-40 weeks of therapy. After reading this book, I'm convinced that, for those who are up to the challenge of ISTDP and lucky enough to have a trained therapist in their vicinity, such change is possible. I am amazed by the brilliance of Ms. Della Selva, both as a practitioner and as one with a firm grasp of theory. It would seem to be a rare therapist who can do ISTDP as she does (there are none in my area; I searched, longingly).

Ms. Della Selva shares powerful excerpts from her sessions, showing that, early in the course of therapy, defenses can be addressed persistently and transference can be used fruitfully. She is clear about the need for the patient's full affective involvement; this is emotionally demanding work. The author also provides concise expositions of theory, always starting with Freud and then showing how Davanloo, Malan, and the author herself have retained/condensed classic psychoanalytic theory (or taken a side when the classic theory resulted in some controversy) and developed techniques that facilitate and accelerate the classic process. This is a great book for just reminding oneself of what the essence of psychoanalysis is (I somehow forget easily!), and, because of the depth and clarity of Ms. Della Selva's thinking, personal insights become available even as one reads.

My one grouch about this book is that the publisher did not do it justice. The first half of the chapter on grief isn't about grief and belongs elsewhere; there is no conclusion to the book; and there are diction errors (confusing "affect" and "effect," writing "Drs." for "doctors") that are just inexcusable in a book of such valuable content!

[Nazish Salahuddin]

anotehr one that I've been reading for a long time and really need to finish --hopefully before internship starts! so far, it's reallly good! but, novels are so much more fun...

[Monica Phelps]

WOW! This book makes a lot of sense! Slow going though because it is so intense.