More than 20 years ago Habib Davanloo coined the term unlocking of the unconscious to describe ho... more More than 20 years ago Habib Davanloo coined the term unlocking of the unconscious to describe how the psychodynamic concept of the human unconscious can become accessible using the technique of Intensive Short-Term Dynamic Psychotherapy (ISTDP). According to Davanloo, the possibility that unconscious material will be revealed is greatly increased when therapeutic efforts promote dominance of the unconscious therapeutic alliance over unconscious resistance. When these ingredients are present there is a psychic shift that allows unacceptable painful feelings to come to the surface. Toward adding further empirical support for the concept, in this article we compare outcomes between patients who experienced one or more major unlocking of the unconscious (N = 57) to those who did not experience major unlocking (N = 32) during ISTDP treatment. Significant and widespread differences were seen between these two groups, those with major unlocking had greater symptom reduction, interpersonal...
The way that healthcare providers feel, both within themselves and towards their patients, may in... more The way that healthcare providers feel, both within themselves and towards their patients, may influence their clinical performance and impact patient safety, yet this aspect of provider behavior has received relatively little attention. How providers feel--their emotional state --may be influenced by a variety of factors including characteristics of the patient, ambient conditions in the healthcare setting, diurnal, circadian, infradian and seasonal variables, as well as endogenous disorders of the individual provider. Analogous to cognitive errors, the provider's emotional state may also contribute to errors, which can be referred to as 'emotional errors'. Clinical reasoning and judgment may be particularly susceptible to emotional influence, especially those processes that rely on intuitive judgments. However, emotional influences on decision making and patient safety have attracted little attention to date. To reduce emotional errors, the level of awareness of these factors should be raised. Emotional skills training should be incorporated into undergraduate and postgraduate education. Specifically, clinical teaching should promote more openness and discussion about provider's feelings towards patients. Strategies should be developed to help providers identify and de-bias themselves against untoward emotional influences that may impact care, particularly in the emotionally evocative patient. Psychiatric conditions within the provider that may compromise patient safety need to be promptly detected, diagnosed and managed.
Background. Intensive Short-Term Dynamic Psychotherapy (ISTDP), as developed by Habib Davanloo, i... more Background. Intensive Short-Term Dynamic Psychotherapy (ISTDP), as developed by Habib Davanloo, is an intensive emotion-focused psychodynamic therapy with an explicit focus on handling resistance in treatment. A core assumption in ISTDP is that psychotherapeutic effects are dependent on in-session emotional processing in the form of rise in complex transference feelings that occurs when treatment resistance is challenged. Recent research indicates that an unlocking of the unconscious, a powerful emotional breakthrough achieved at a high rise in complex transference feelings, can potentially enhance ISTDP's effectiveness. While ISTDP has a growing evidence base, most of the research conducted has used small samples and has tested therapy delivered by expert therapists. The aims of this study were to evaluate the overall effectiveness of ISTDP when delivered in a tertiary psychotherapy service, and to investigate if having an unlocking of the unconscious during therapy predicted e...
The advent of readily accessible, inexpensive Web-conferencing applications has opened the door f... more The advent of readily accessible, inexpensive Web-conferencing applications has opened the door for distance psychotherapy supervision, using video recordings of treated clients. Although relatively new, this method of supervision is advantageous given the ease of use and low cost of various Internet applications. This method allows periodic supervision from point to point around the world, with no travel costs and no long gaps between direct training contacts. Web-conferencing permits face-to-face training so that the learner and supervisor can read each other's emotional responses while reviewing case material. It allows group learning from direct supervision to complement local peer-to-peer learning methods. In this article, we describe the relevant literature on this type of learning method, the practical points in its utilization, its limitations, and its benefits.
This study evaluated the efficacy and long-term effectiveness of intensive short-term dynamic psy... more This study evaluated the efficacy and long-term effectiveness of intensive short-term dynamic psychotherapy (ISTDP) in the treatment of patients with DSM-IV personality disorders (PD). Twenty-seven patients with PD were randomized to treatment with ISTDP or a minimal-contact, delayed-treatment control condition. ISTDP-treated patients improved significantly more than controls on all primary outcome indices, reaching the normal ranges on both the brief symptom inventory (1.51-0.51, p Ͻ 0.001) and inventory of interpersonal problems (1.56 -0.67, p Ͻ 0.001). When control patients were treated, they experienced benefits similar to the initial treatment group. In long-term follow-up, the whole group maintained their gains and had an 83.3% reduction of personality disorder diagnoses. Treatment costs were thrice offset by reductions in medication and disability payments. This preliminary study of ISTDP suggests it is efficacious and cost-effective in the treatment of PD. Limitations of this study and suggestions for future research are discussed.
PSYCHIATRIC ANNALS 43:11 | NOVEMBER 2013 Healio.com/Psychiatry | 517 b Previous failure to respon... more PSYCHIATRIC ANNALS 43:11 | NOVEMBER 2013 Healio.com/Psychiatry | 517 b Previous failure to respond (in terms of significant symptomatic relief) to three or more prior treatment attempts for the ongoing psychiatric disorder. c Ability to regard problems as result of difficulties in dealing with feelings, thoughts, and reactions to self/others in response to dialogue about what problem the patient wants help for. d Except short, reactive psychotic episodes. e After which entering treatment is possible.
More than 20 years ago Habib Davanloo coined the term unlocking of the unconscious to describe ho... more More than 20 years ago Habib Davanloo coined the term unlocking of the unconscious to describe how the psychodynamic concept of the human unconscious can become accessible using the technique of Intensive Short-Term Dynamic Psychotherapy (ISTDP). According to Davanloo, the possibility that unconscious material will be revealed is greatly increased when therapeutic efforts promote dominance of the unconscious therapeutic alliance over unconscious resistance. When these ingredients are present there is a psychic shift that allows unacceptable painful feelings to come to the surface. Toward adding further empirical support for the concept, in this article we compare outcomes between patients who experienced one or more major unlocking of the unconscious (N = 57) to those who did not experience major unlocking (N = 32) during ISTDP treatment. Significant and widespread differences were seen between these two groups, those with major unlocking had greater symptom reduction, interpersonal...
The way that healthcare providers feel, both within themselves and towards their patients, may in... more The way that healthcare providers feel, both within themselves and towards their patients, may influence their clinical performance and impact patient safety, yet this aspect of provider behavior has received relatively little attention. How providers feel--their emotional state --may be influenced by a variety of factors including characteristics of the patient, ambient conditions in the healthcare setting, diurnal, circadian, infradian and seasonal variables, as well as endogenous disorders of the individual provider. Analogous to cognitive errors, the provider's emotional state may also contribute to errors, which can be referred to as 'emotional errors'. Clinical reasoning and judgment may be particularly susceptible to emotional influence, especially those processes that rely on intuitive judgments. However, emotional influences on decision making and patient safety have attracted little attention to date. To reduce emotional errors, the level of awareness of these factors should be raised. Emotional skills training should be incorporated into undergraduate and postgraduate education. Specifically, clinical teaching should promote more openness and discussion about provider's feelings towards patients. Strategies should be developed to help providers identify and de-bias themselves against untoward emotional influences that may impact care, particularly in the emotionally evocative patient. Psychiatric conditions within the provider that may compromise patient safety need to be promptly detected, diagnosed and managed.
Background. Intensive Short-Term Dynamic Psychotherapy (ISTDP), as developed by Habib Davanloo, i... more Background. Intensive Short-Term Dynamic Psychotherapy (ISTDP), as developed by Habib Davanloo, is an intensive emotion-focused psychodynamic therapy with an explicit focus on handling resistance in treatment. A core assumption in ISTDP is that psychotherapeutic effects are dependent on in-session emotional processing in the form of rise in complex transference feelings that occurs when treatment resistance is challenged. Recent research indicates that an unlocking of the unconscious, a powerful emotional breakthrough achieved at a high rise in complex transference feelings, can potentially enhance ISTDP's effectiveness. While ISTDP has a growing evidence base, most of the research conducted has used small samples and has tested therapy delivered by expert therapists. The aims of this study were to evaluate the overall effectiveness of ISTDP when delivered in a tertiary psychotherapy service, and to investigate if having an unlocking of the unconscious during therapy predicted e...
The advent of readily accessible, inexpensive Web-conferencing applications has opened the door f... more The advent of readily accessible, inexpensive Web-conferencing applications has opened the door for distance psychotherapy supervision, using video recordings of treated clients. Although relatively new, this method of supervision is advantageous given the ease of use and low cost of various Internet applications. This method allows periodic supervision from point to point around the world, with no travel costs and no long gaps between direct training contacts. Web-conferencing permits face-to-face training so that the learner and supervisor can read each other's emotional responses while reviewing case material. It allows group learning from direct supervision to complement local peer-to-peer learning methods. In this article, we describe the relevant literature on this type of learning method, the practical points in its utilization, its limitations, and its benefits.
This study evaluated the efficacy and long-term effectiveness of intensive short-term dynamic psy... more This study evaluated the efficacy and long-term effectiveness of intensive short-term dynamic psychotherapy (ISTDP) in the treatment of patients with DSM-IV personality disorders (PD). Twenty-seven patients with PD were randomized to treatment with ISTDP or a minimal-contact, delayed-treatment control condition. ISTDP-treated patients improved significantly more than controls on all primary outcome indices, reaching the normal ranges on both the brief symptom inventory (1.51-0.51, p Ͻ 0.001) and inventory of interpersonal problems (1.56 -0.67, p Ͻ 0.001). When control patients were treated, they experienced benefits similar to the initial treatment group. In long-term follow-up, the whole group maintained their gains and had an 83.3% reduction of personality disorder diagnoses. Treatment costs were thrice offset by reductions in medication and disability payments. This preliminary study of ISTDP suggests it is efficacious and cost-effective in the treatment of PD. Limitations of this study and suggestions for future research are discussed.
PSYCHIATRIC ANNALS 43:11 | NOVEMBER 2013 Healio.com/Psychiatry | 517 b Previous failure to respon... more PSYCHIATRIC ANNALS 43:11 | NOVEMBER 2013 Healio.com/Psychiatry | 517 b Previous failure to respond (in terms of significant symptomatic relief) to three or more prior treatment attempts for the ongoing psychiatric disorder. c Ability to regard problems as result of difficulties in dealing with feelings, thoughts, and reactions to self/others in response to dialogue about what problem the patient wants help for. d Except short, reactive psychotic episodes. e After which entering treatment is possible.
Uploads
Papers by A. Abbass