Intensive Short-Term Dynamic Psychotherapy (ISTDP) Therapists’ Experiences of Staying with Clients’ Intense Emotional Experiencing: An Interpretative Phenomenological Analysis

Abstract

This study aimed to explore Intensive Short-Term Dynamic Psychotherapy (ISTDP) therapists’ experiences of staying with their clients’ intense emotional experiencing. Semi-structured interviews were conducted with five qualified ISTDP therapists. Participants’ accounts were analysed using Interpretative Phenomenological Analysis. The analysis generated three superordinate themes: (1) “Opening that door”: striving for emotional closeness, (2) Connection versus disconnection: what’s happening in the room, and (3) “There’s more of myself now”: building one’s own capacity. These themes were each supported by several subordinate themes that highlight the complexities and ambiguities inherent in intensive, experientially-focused therapeutic work from a psychodynamic perspective. The findings of the study reveal: (1) a paradox of the moment-by-moment precision aimed for by therapists, whereby effectiveness can be accompanied by a heightened focus on what gets missed; (2) how therapists make sense of the therapeutic relationship as a place of safety and risk; and (3) the importance of deliberate practice to help therapists build their capacity to work effectively with their clients’ deep emotions. Participants’ accounts also suggested that core features of the theory and practice of ISTDP, such as its analytic stance and active, collaborative style, aligns well with counselling psychology’s concern for integrative, evidenced based practice that prioritises the therapeutic relationship as the vehicle for change. Applicability to clinical practice in counselling psychology is highlighted. Future directions include research into the somatic experiences of therapists involved in helping facilitate a therapeutic experience of emotion with their clients.