Intensive Short-Term Dynamic Psychotherapy (ISTDP) is an accelerated, emotion-focused form of psychotherapy designed to help patients rapidly overcome a wide range of psychological and interpersonal problems.

It operates on the principle that many psychological symptoms (like anxiety, depression, and chronic pain) are caused by unconscious, buried, or conflicting feelings that the mind defends against. When these feelings rise, the anxiety generated by the internal conflict is often misdirected into physical symptoms or maladaptive coping patterns.

Why ISTDP Is Effective

1. Intensity and speed. The ISTDP therapist uses specific techniques to quickly identify and challenge defense mechanisms (like denial or avoidance) and to facilitate the safe experience and expression of core, often painful, emotions (grief, rage, love). This focused work allows for faster symptom resolution.

2. Focus on emotion. The central engine of change is the ability to tolerate and process core complex emotions. By helping the patient face these emotions directly, ISTDP removes the underlying pressure that causes symptoms and defenses.

3. Measurable change. ISTDP seeks to restructure the personality and improve emotional capacity, not just provide temporary coping skills. Patients often report significant, lasting reductions in anxiety, increased relational capacity (learn more about couples therapy in Lisbon), and improvements in physical health issues linked to emotional stress.

4. Challenging avoidance. The therapist actively addresses and clarifies the patient’s resistance and avoidance patterns, preventing stagnation. It may feel difficult at times, however the therapist is always on your side — each intervention aims only at helping you break through dysfunctional patterns and access healing emotions.

ISTDP Format of Therapy

ISTDP sessions are typically longer than a standard therapy hour because the client and therapist require more time to safely and effectively work on an issue in the intensive manner characteristic of this kind of therapy.

An ISTDP session is 90 minutes long and usually occurs on a weekly or bimonthly basis.

About Our ISTDP Therapist — Piotr Szmyt

Piotr Szmyt was initially trained in Psychodynamic Psychotherapy at APPSI in Lisbon (Associação Portuguesa Psicoterapia Psicanalítica). While he found that psychodynamic theory was extraordinarily helpful in deeply understanding clients’ problems, he felt that it lacked more active techniques that would effectively guide clients toward change.

While he was still in training as a Psychodynamic Therapist in 2020, he began exploring ISTDP. He first participated in intensive workshops with master teachers such as Patricia Coughlin, Allan Abbass, and Jon Frederickson.

From 2022–2025, Piotr extensively studied ISTDP in a three-year Core Training program with Josette ten Have-de Labije, Ph.D, in Berlin.

If you would like to explore the clinical literature and theory behind this approach in more depth, see our recommended ISTDP reading list.