Faculty of Medicine, Centre for Emotions and Health, Dalhousie University, Halifax, Nova Scotia, Canada.
J Clin Psychol. 2021 Feb;77(2):398-413. doi: 10.1002/jclp.23115. Epub 2021 Jan 21.
Intensive short-term dynamic psychotherapy (ISTDP) was developed to manage treatment impasses preventing the experiencing of feelings related to childhood attachment interruptions, such as parental loss. According to ISTDP theory, certain categories of patients will exhibit habitual patterns of responding within the treatment relationship (called defenses) to certain anxiety-provoking thoughts and feelings. Such defensive behaviors interrupt awareness of one's own feelings, self-directed compassion and engagement in close human attachments, including the bond with the therapist. Rupture-repair sequences in ISTDP are primarily considered in the context of a patient's defenses and the responses a therapist has to these defenses. By understanding and clarifying these defenses, this risk of subsequent misalliance, that is negative shifts or ruptures in the alliance, are minimized. In this paper we summarize ISTDP theory and technique through the use of clinical vignettes to illustrate defense management as a rupture-repair equivalent in ISTDP.
强化短期动态心理疗法（ISTDP）旨在解决治疗僵局，这些僵局阻止了与儿童期依恋中断相关的感觉的体验，例如父母的丧失。根据 ISTDP 理论，某些类别的患者在治疗关系中会表现出习惯性的反应模式（称为防御），以应对某些引起焦虑的想法和感觉。这种防御行为会中断对自己感觉、自我同情和参与亲密人际关系（包括与治疗师的关系）的意识。在 ISTDP 中，破裂-修复序列主要在患者的防御和治疗师对这些防御的反应的背景下考虑。通过理解和阐明这些防御，随后的错误联盟的风险，即联盟中的负面转变或破裂，被最小化。在本文中，我们通过使用临床案例来说明防御管理作为 ISTDP 中的破裂-修复等效物，总结了 ISTDP 的理论和技术。
