[Intensive short-term dynamic psychotherapy for chronic pain]

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.