ISTDP in Stockholm.

ISTDP stands for Intensive Short-Term Dynamic Psychotherapy. In the work, we explore what happens when feelings arise, how anxiety shows itself and which ways of handling the situation are activated. In ISTDP, these are called defences. Defences can be, or have been, helpful and protective, but they can also continue automatically and contribute to anxiety persisting, to you doing things that create problems or to the same difficulties recurring in relationships.

When ISTDP may help

ISTDP may be a relevant approach when feelings, anxiety and habitual defences interact with what you are seeking help with. Sometimes feelings are clear but difficult to handle. Sometimes it is harder to know what you feel, and you may instead notice, for example, emptiness, feeling shut down, bodily reactions or a sense of having lost your direction. These are just some of the possible experiences. We begin by exploring how it is for you. Physical symptoms also need to be assessed medically when relevant.

This might involve, for example:

• Recurring difficulties in relationships
• Emotional blocks or difficulties feeling, understanding or expressing feelings
• Anxiety or bodily reactions arising in emotional situations
• Low mood or depression where emotional conflicts and defences are part of the picture
• Trauma and reactions after difficult events
• When previous treatment has not led to the change you hoped for

What the research says

The research evidence for ISTDP has grown, particularly for depression that has not improved enough after previous treatment. Two randomised studies found greater average improvements with ISTDP than with treatment as usual in specialist psychiatric care and a waiting list, respectively. The studies were relatively small. The Halifax study was conducted at a single centre, and the other study did not include an active comparison treatment. The findings therefore do not tell us what an individual person can expect or how ISTDP compares with another active treatment.

A meta-analysis from 2025 included 57 randomised studies of a broader group of emotion-focused dynamic therapies, of which ISTDP is one. The therapies produced better average outcomes than inactive comparisons. Compared with active treatments, there was no statistically significant difference immediately after treatment, while results at follow-up suggested a possible advantage. The studies varied considerably, so the findings need to be interpreted cautiously.

For you, the crucial question is whether the work helps you in particular. We therefore follow what actually changes and adapt the plan together.

Working with me

Together, we formulate what you are seeking help with and what you want to change. That understanding guides how I use ISTDP and MCT, and we return to it when we need to.

I work actively, and the pace is adapted to what is possible and helpful for you. We explore feelings, anxiety and defences in the moment, including when a pattern becomes visible between us. There should be room to disagree, ask questions or pause. We follow what changes in your everyday life and adjust the work together.