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Intensive short-term dynamic psychotherapy (ISTDP) is a form of short-term psychotherapy developed through empirical, video-recorded research by Habib Davanloo, MD.〔Davanloo, H. "Intensive Short-Term Dynamic Psychotherapy." In Kaplan, H. and Sadock, B. (eds), ''Comprehensive Textbook of Psychiatry'', 8th ed, Vol 2, Chapter 30.9, 2628–2652. Philadelphia: Lippincot Williams & Wilkins, 2005.〕 The therapy's primary goal is to help the patient overcome internal resistance to experiencing true feelings about the present and past which have been warded off because they are either too frightening or too painful. The technique is ''intensive'' in that it aims to help the patient experience these warded-off feelings to the maximum degree possible; it is ''short-term'' in that it tries to achieve this experience as quickly as possible; it is ''dynamic'' because it involves working with unconscious forces and transference feelings.〔Davanloo, H. (1995). Intensive short-term psychotherapy with highly resistant patients. I. Handling resistance. In H. Davanloo, ''Unlocking the unconscious: Selected papers of Habib Davanloo, MD''. New York: Wiley. (pp. 1-27).〕〔Malan, D. & Coughlin Della Selva, P. (2006). ''Lives transformed: A revolutionary method of dynamic psychotherapy'' (Rev. ed.). London: Karnac Books.〕 Patients come to therapy because of either symptoms or interpersonal difficulties. Symptoms include traditional psychological problems like anxiety and depression, but they also include physical symptoms without medically identifiable cause, such as headache, shortness of breath, diarrhea, or sudden weakness. The ISTDP model attributes these to the occurrence of distressing situations where painful or forbidden emotions are triggered outside of awareness.〔Davanloo, H. (1995). The technique of unlocking the unconscious in patients suffering from functional disorders. Part 1. Restructuring Ego's defenses. In H. Davanloo, ''Unlocking the unconscious: Selected papers of Habib Davanloo, MD''. New York: Wiley. (pp. 283-306).〕〔Malan, D. & Coughlin Della Selva, P. (2006). ''Lives transformed: A revolutionary method of dynamic psychotherapy'' (Rev. ed.). London: Karnac Books. Page 255.〕 Within psychiatry, these phenomena are classified as "Somatoform Disorders" in DSM-IV-TR.〔American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC American Psychiatric Association, 2000.〕 The therapy itself was developed during the 1960s to 1990s by Habib Davanloo, a psychiatrist and psychoanalyst from Montreal. He video recorded patient sessions and watched the recordings in minute detail to determine as precisely as possible what sorts of interventions were most effective in overcoming resistance, which he believed was acting to keep painful or frightening feelings out of awareness and prevent interpersonal closeness.〔Davanloo, H. (2000). Intensive short-term dynamic psychotherapy: Spectrum of psychoneurotic disorders. In H. Davanloo: ''Intensive short-term dynamic psychotherapy: Selected papers of Habib Davanloo, MD''. (pp. 1-35)〕 ISTDP is taught by Habib Davanaloo at McGill University, as well as in other University and post-graduate settings around the world. The ISTDP Institute offers on-line ISTDP training materials, including introductory videos and skill-building exercises. ==Origins and theoretical foundation of ISTDP== In 1895, Josef Breuer and Sigmund Freud published their ''Studies on Hysteria'', which looked at a series of case studies where patients presented with dramatic neurological symptoms, such as "Anna O" who suffered headaches, partial paralysis, loss of sensation, and visual disturbances.〔Freud, S. & Breuer, J. (1957). Studies on Hysteria. In J. Strachey & A. Strachey (Eds. & Trans). New York: Basic Books, Inc. (Original work published 1895)〕 These symptoms did not conform to known patterns of neurological disease, and neurologists were thus unable to account for symptoms in purely anatomical or physiological terms. Breuer's breakthrough was the discovery that symptomatic relief could be brought about by encouraging patients to speak freely about emotionally difficult aspects of their lives. Experiencing these emotions which had been previously outside of awareness seemed to be the curative factor. This cure became known as ''catharsis'', and the experiencing of the previously forbidden or painful emotion was ''abreaction''. Freud tried various techniques to deal with the fact that patients generally seemed resistant to experiencing painful feelings. He moved from hypnosis to free association, interpretation of resistance, and dream interpretation.〔Gay, P. (2006). ''Freud: A life for our time''. USA: W. W. Norton & Company, Ltd. Pages 49-50, 71-73, 107.〕 With each step, therapy became longer. Freud himself was quite open about the possibility that there were many patients for whom analysis could bring little or no relief, and he discusses the factors in his 1937 paper "Analysis Terminable and Interminable."〔Freud, S. (1937c). Die endliche und die unendliche Analyse. GW, 16; Analysis terminable and interminable. SE, 23: 209-253.〕 From the 1930s through the 1950s, a number of analysts were researching methods of shortening the course of therapy without sacrificing therapeutic effectiveness. These included Sándor Ferenczi, Franz Alexander, Peter Sifneos, David Malan, and Habib Davanloo. One of the first discoveries was that the patients who appeared to benefit most from therapy were those who could rapidly engage, could describe a specific therapeutic focus, and could quickly move to experience their previously warded-off feelings. These also happened to represent those patients who were the healthiest to begin with and therefore had the least need for the therapy being offered. Clinical research revealed that these "rapid responders" were able to recover quickly with therapy because they were the least traumatised and therefore had the smallest burden of repressed emotion, and so were least resistant to experiencing the emotions related to trauma. However, these patients represented only a small minority of those arriving at psychiatric clinics; the vast majority remained unreachable with the newly developing techniques.〔Della Selva P. Intensive Short-Term Dynamic Psychotherapy: Theory and Technique. 1996. Wiley and Sons. Cf.: Foreword by David Malan.〕 A number of psychiatrists began directing their psychotherapeutic research into methods of overcoming resistance. Dr. David Malan popularized a model of resistance, known as the ''Triangle of Conflict'', which had first been proposed by H. Ezriel.〔Ezriel,H. (1952). Notes on psychoanalytic Group therapy: II .Interpretation. Research Psychiatry,15,119.〕 At the bottom of the triangle are the patient's true, impulse-laden feelings, outside of conscious awareness. When those emotions rise to a certain degree and threaten to break into conscious awareness, they trigger anxiety. The patient manages this anxiety by deploying defences, which lessen anxiety by pushing emotions back into the unconscious. The emotions at the bottom of Malan's Triangle of Conflict originate in the patient's past, and Malan's second triangle, the ''Triangle of Persons'', originally proposed by Menninger, explains that old emotions generated from the past are triggered in current relationships and also get triggered in the relationship with the therapist.〔Menninger, K. (1958). Theory of psychoanalytic technique. New York, Basic Books.〕 The question of how maladaptive patterns of interpersonal behaviour could arise from early childhood experiences in the family of origin was postulated within psychoanalytic theory. Independent empirical support came from Bowlby's newly arising field of Attachment Theory. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Intensive short-term dynamic psychotherapy」の詳細全文を読む スポンサード リンク
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