ISTDP Practice

Practise Intensive Short-Term Dynamic Psychotherapy with patients whose authored presentations differ in resistance and fragility. Learn to read anxiety-discharge pathways, adjust pressure, work with defences and recognise marked emotional deepening.

What you practise

• Read authored striated-muscle, smooth-muscle and cognitive-perceptual signs to decide whether to continue, regulate or stop
• Use the Central Dynamic Sequence as a response-guided map rather than a checklist
• Identify and name specific defence mechanisms operating in the moment
• Apply Frederickson's five-step defence-restructuring sequence
• Adjust pressure in response to the anxiety pathway while checking that thinking and contact remain intact
• Track the Triangle of Conflict and Triangle of Person together

Who you can meet

• Henrik, 48 — A 48-year-old consultant engineer who talks about feelings with impressive fluency but never actually feels them. His intellectualisation is so polished it can pass for insight. His wife Sara has threatened to leave unless he "deals with his stuff." Anxiety discharges through striated muscle (jaw clenching, controlled breathing, tight fists), which signals that pressure is safe. The corrective experience: a therapist who refuses to accept understanding as a substitute for feeling.
• Lena, 34 — A 34-year-old primary school teacher who came for help with unexplained stomach pain and panic attacks that started after her mother's death six months ago. She is warm, eager to please, and terrified of her own anger. Anxiety discharges through smooth muscle (nausea, stomach cramps, dizziness) and occasionally cognitive-perceptual disruption (losing her thread, sudden confusion). The corrective experience: a therapist who reads her fragility and SLOWS DOWN instead of pressing through.
• Björn, 59 — Licensed psychologist and psychotherapist, twenty-two years in ISTDP, and a supervisor who still watches video of his own sessions. He asks what you feel rather than what you think, and he notices the moment you slide into explaining. He eases off when your body tells him to. Useful focus: notice where the anxiety goes in your body when he asks again, and what it is like to be stopped mid-explanation.

What the feedback looks at

• Inquiry and feeling invitation
• Pressure calibration
• Defense identification
• Defense restructuring
• Anxiety pathway reading
• Sequencing discipline
• Transference tracking
• Unlocking recognition

Rated against: Dimensions derive from Davanloo's Central Dynamic Sequence as presented in Abbass (2015), Reaching Through Resistance: Advanced Psychotherapy Techniques, and Frederickson (2013), Co-Creating Change: Effective Dynamic Therapy Techniques. No published, psychometrically validated ISTDP fidelity or adherence instrument exists as of 2026 — the California Evidence-Based Clearinghouse records no fidelity measure for ISTDP, Abbass (2015) serves as the field's de facto adherence manual, and trials such as Town et al. (2017) used study-specific adherence ratings rather than a standard scale — so this rubric is PsychBase's own wording, adapted with citation and transcribed from no source. Scores are generated by an AI supervisor from the session transcript: they are a practice aid, not a validated assessment, and are not equivalent to ratings by a trained human rater. No author, publisher, or training body endorses or certifies this tool.

This lab is for clinical training. The patient is generated by an AI language model from a written case; no real patient and no patient data are involved. Browsing is open; starting a session needs a free account.