Intensive Short-term Dynamic Psychotherapy (ISTDP) for panic attacks and anxiety:
Which types of anxiety disorders can be helped by Intensive Short-term Dynamic Psychotherapy?
Intensive short-term dynamic psychotherapy is a form of psychotherapy that is effective as anxiety disorder treatment (for social anxiety, phobias, panic attacks, generalized anxiety, obsessive compulsive disorder, and post-traumatic stress disorder); it is intensive, emotionally alive, and relatively short-term.
I have heard that cognitive behavioral therapy is the best treatment for anxiety. Why should I try dynamic therapy?
Although CBT (cognitive behavioral therapy) is often very effective for anxiety disorders and panic attacks (and I incorporate such treatment techniques into my practice as well), sometimes there are unconscious factors that are keeping a person’s anxiety alive; in such cases, CBT may not be effective. Psychodynamic treatment also addresses resistances to change and to letting go of longstanding anxieties, reducing vulnerability to relapse as well as helping a person get past barriers to implementing cognitive or behavioral tools that can help with anxiety.
Dynamic therapy may be a good choice for you if you typically have good insight into yourself and are willing to try to understand yourself more deeply, as well as if you have previously tried other treatments (such as cognitive behavioral therapy) for anxiety that were not effective for you or did not have lasting effects. Many people who have panic attacks feel like they are dying or having a heart attack, leading to debilitating consequences such as fears of leaving the house as well as trips to medical doctors and emergency rooms- yet little relief comes their way despite the intensity of their distress or attempts to get help. The same is often true for other anxiety disorders as well.
How long does treatment take?
In my practice, patients who want to engage in short-term psychodynamic therapy typically attend sessions twice a week for a period of approximately 3-4 months in Clifton, NJ. This therapy will be intensive because it will focus on transference- the way in which you experience the therapist and the therapy setting- and how this connects to your earlier life experiences, past relationships, and current panic attack or anxiety symptoms.
What benefits will I experience and how does this therapy work?
As we talk directly about how you are experiencing the therapy process and relationship, as well as about feelings, images, and fantasies about it that come up in your mind, many of the underlying issues that are causing you anxiety will be able to come alive and unfold inside the therapy situation itself.
For example, if you felt humiliated in the past by authority figures, you may imagine that your therapist is going to humiliate you as well by judging or criticizing you if you share your feelings openly. Being able to talk freely about this expectation as it is happening, as well as uncovering fears and conflicts that you were previously unaware of, will most likely result in an initial resolution of the specific anxiety symptoms that you are experiencing. Here is another example: If you grew up in a home where healthy anger was not allowed to be expressed, you may believe that any expression of anger will lead to a loss of support by needed attachment figures; you may then worry that expressing anger towards your therapist will lead to a withdrawal of support and help by your therapist. Exploring such fears, and having them disconfirmed when the therapist acts differently from the ways in which past authority figures acted in relation to you, will help you feel freer to express yourself without undue anxiety.
As treatment progresses, you will also come to recognize certain themes and patterns that repeat themselves over and over in your life, and as this is pointed out in the therapy time and time again, you will become more conscious of these patterns, able to disrupt negative patterns, more in control of your choices, and less prone to having bursts of anxiety stemming from unconscious sources. Because this anxiety treatment is short-term, feelings of loss and fear about ending the relationship and separation also get to be explored, which is often a very transformative experience.
The effects of treatment and becoming more aware of one’s unconscious fears and conflicts often persist even once treatment is completed; in addition to decreased anxiety or panic attacks, you may notice that you are more reflective in general in your life and relationships, empowering you to be more in control and to make better decisions for yourself.
Common concerns and fears about starting short-term dynamic anxiety treatment:
You may be wondering if this treatment would be helpful to you. Some people feel scared about starting intensive short-term dynamic treatment because they worry that they won’t know what to talk about, or fear losing control if they think about talking too freely to a therapist they barely know yet. I usually tell people that if they can tolerate a little discomfort initially in order to get long-term help with their anxiety, this treatment is often a good idea. However, it is also fine to share your fears and to see if you are comfortable with how the therapist addresses them. After one or two consultation sessions, it may become clear whether you would like to give this type of anxiety treatment a try or not.
Although it may feel “weird” at first to share anything that’s in your mind with your therapist, and to become aware of feelings towards your therapist that feel personal or awkward, being able to speak freely in this way often starts to feel like a big relief for many patients, once they get used to it. You may also share your dreams in therapy as well as notice if you have feelings such as anger or love that are hard to express; such feelings often connect to earlier relationships with parents or authority figures, and being able to express these feelings in the therapy can open the door to understanding many of your fears.
Common unconscious sources of anxiety are: fears of one’s feelings getting out of control; fears that one can damage oneself or others by acknowledging very strong feelings (such as rage, for example); fears of acknowledging one’s need or love for other people due to past rejections or disappointments; fear of losing someone’s help or support if you openly express anger towards them; guilt about forbidden wishes or desires; and fear of re-experiencing feelings associated with past traumas by thinking and talking about such feelings.
Please contact me!
I invite you to contact me if you would like to discuss whether intensive short-term dynamic anxiety treatment can be helpful to you. Anxiety doesn’t have to hold you back any longer!