Michal Matthias, Emmenegger Pierre-Alain, Brehm Michelle
Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Deutschland.
Schweizerische Gesellschaft für ISTDP, Sulgeneckstrasse 38, 3007, Bern, Schweiz.
Schmerz. 2025 May 30. doi: 10.1007/s00482-025-00884-8.
Intensive short-term dynamic psychotherapy (ISTDP) is a psychodynamic treatment model that can achieve medium to strong effects in patients with functional (primary) pain.
We aim to summarize the theoretical background, therapeutic techniques, and evidence of ISTDP.
Narrative literature review.
Unlike usual psychodynamic psychotherapy, ISTDP is a highly focused approach. In the treatment of primary pain patients, the aim is to help patients experience their unconscious conflictual feelings that cause various anxiety symptoms (e.g., muscular tension, nausea, gastrointestinal cramps) and are maintained by defense mechanisms. By improving affect tolerance, overcoming maladaptive defense mechanisms, and processing the repressed complex feelings, there is a reduction or even remission from primary pain. ISTDP achieves medium to strong effects in terms of pain reduction and, thus, appears to be superior to cognitive behavioral therapy in the treatment of primary pain. However, further research is needed.
强化短期动力心理治疗（ISTDP）是一种心理动力治疗模式，对功能性（原发性）疼痛患者可产生中等至强效的治疗效果。
我们旨在总结ISTDP的理论背景、治疗技术及证据。
叙述性文献综述。
与通常的心理动力心理治疗不同，ISTDP是一种高度聚焦的方法。在治疗原发性疼痛患者时，其目的是帮助患者体验导致各种焦虑症状（如肌肉紧张、恶心、胃肠痉挛）并由防御机制维持的无意识冲突情感。通过提高情感耐受性、克服适应不良的防御机制以及处理被压抑的复杂情感，原发性疼痛可减轻甚至缓解。ISTDP在减轻疼痛方面取得中等至强效的治疗效果，因此在治疗原发性疼痛方面似乎优于认知行为疗法。然而，仍需进一步研究。
