The extended diagnostic-treatment session in which the therapist tests the client's response to pressure, anxiety regulation, and defense work while also giving a real experience of ISTDP.
Step-by-step guide
- Clarify the presenting problem and treatment wish
- Explain the active emotional focus of the work
- Evoke a concrete relational episode
- Track feeling, anxiety channel, and defense
- Adjust pressure according to anxiety tolerance
- Summarize the dynamic pattern and treatment implications
When to use
- At the beginning of ISTDP treatment
- When suitability and anxiety tolerance must be assessed
- When the therapist needs to map resistance and fragility
Key phrases
What do you feel toward this person right now as you speak about them?
Follow-up questions
Where does the anxiety go in your body?
What do you do instead of feeling it?
Alternative phrasings
Let us see together whether this work is safe and useful for you.
We are not only gathering history; we are observing your process live.
Warnings
- ⚠️ Do not intensify pressure before assessing anxiety channel
- ⚠️ Do not treat trial therapy as a performance of toughness
- ⚠️ Stop and regulate if cognitive-perceptual disruption appears
Source: Davanloo, H. (1980, 1990); Abbass, A. Frederickson, J
Materials are informational and educational and summarize publicly available scientific sources. They are not medical or psychological advice, are not intended for self-diagnosis or self-treatment, and do not replace consultation with a qualified professional.