Intensive Short-Term Dynamic Psychotherapy as a method of treatment for patients with somatization

Abstract

Artykuł przedstawia założenia intensywnej krótkoterminowej psychoterapii dynamicznej. Wskazuje, jak podejście to może być pomocne w rozumieniu i leczeniu pacjentów z somatyzacją. Autorzy opisują specyfikę interwencji terapeutycznych stosowanych wobec tych pacjentów.The purpose of this article is to present intensive short-term dynamic psychotherapy (ISTDP) as a type of therapy considered particularly useful when treating patients with somatization. After a short presentation of the psychodynamic understanding of the phenomenon of somatization and the basic principles of ISTDP, the main diagnostic and therapeutic strategies and methods used when working with such patients are discussed. The patients are people who – similarly to patients suffering from depression – demonstrate high levels of unconscious anxiety and very high levels of resistance in transference at the same time, which require a specific way of conduct. During the first stage of psychotherapy, a restructuring of ego defense mechanisms is done using the so called graded format (which constitutes in continuous monitoring of the patient’s anxiety level and alternating pressure on the patient’s experiencing of emotions and the so called cognitive analysis of what is happening during the session). Only in the second phase of psychotherapy, other ISTDP techniques are used (such as challenge and head-on collision) as a part of the central dynamic sequence, leading to the unblocking and processing of the feeling causing the anxiety, the repression of which contributed to the development of the symptoms