Many of Freud’s early treatments were quite brief, but psychoanalysis soon became a very long form of treatment. Some of Freud’s colleagues, such as Ferenczi and Rank, were interested in shortening treatment. Ferenczi recognized that often a patient will not experience positive connection with the therapist until anger is first experienced. He also introduced more active techniques into the therapy. Rank said that the will must be mobilized and is the primary force which must do battle with unconscious destructive forces. He also believed that for therapeutic change to take place therapy must include aspects of emotional experience, rather than just theoretical construction. These ideas of Ferenczi and Rank are central to EDT.

Adler was indeed the first analyst who gave up the couch, choosing to sit face to face with his patients. He also accelerated treatment by discouraging patients from taking a dependent position in therapy. Reich’s work on analyzing character defenses foreshadowed aspects of Davanloo’s later work in IS-TDP.

Starting in the 1940's a series of psychoanalytically informed theorists began to develop models of short-term therapy. The first clinical experiences explicitly aiming to make psychoanalysis “briefer and more effective” are those written about by Alexander and French in 1946. They developed a model of short-term therapy which was based on work with high functioning neurotic patients and the principle technique was the interpretation of transference. They were able to demonstrate that:

The intense re-experiencing of the conflicting emotions in the transference, that is in the actual relation with an emotionally responsive therapist, brings about therapeutic change. This is what Alexander called corrective emotional experience and is pivotal to dynamic change. If such re-experiencing can be brought about rapidly, dynamic change can also be rapid, i.e., the phase of consolidation of change or “working through” is not a matter of time, but of adequate emotional experience. When an effective approach is employed, even relatively early traumas can be re-activated and solved independent of the length, frequency and total number of sessions. No doubt, the research by Alexander, French and colleagues represents, for these reasons, the dawning of Experiential Dynamic Therapy and of process acceleration.

Michael Balint founded the Brief Psychotherapy Workshop at the Tavistock Clinic, which consisted of a group of selected and gifted clinicians, one of whom was David Malan. Their original idea was to shorten therapy by selecting a specific and appropriate focus for therapeutic attention. In the mid 1960s Malan took over the Brief Psychotherapy Workshop at the Tavistock Clinic. Thanks to his extensive clinical research, Malan was actually able to disprove the “hypothesis of superficiality” according to which Brief Psychotherapy is a superficial treatment, applicable to superficially ill patients, and bringing about superficial results. As clearly spelt out by him: “The aim of every moment of every session is to put the patient in touch with as much of his true feelings as he can bear.” Malan oriented his work around that simplified psychodynamic models of the triangle of conflict and the triangle of persons, and this also became central to Davanloo’s work and to all of the EDTs. The triangle of conflict illustrates the relationship between anxiety, defenses, and the underlying impulses and feelings. The triangle of persons shows the connections between relationships with the therapist, other current people, and the people of the formative past.

Malan is a unique example of eagerness to lend his extraordinary understanding of psychodynamics to all those he believed to be valid contributors to the development of Brief Psychotherapy, like Davanloo, McCullough, and Couglin Della Selva. In London, David Malan conducted research into short-term therapy which established that the results were as good or better than those found through psychoanalysis. In addition, he found that short-term therapy could work with a broad range of patients. Initially, his approach was interpretive. However, upon encountering the work of Habib Davanloo, his work shifted in emphasis toward a much more affective, experiential approach.

During the last 25 years, short-term psychotherapy has made remarkable progress, especially thanks to the technical improvements introduced by Habib Davanloo. Davanloo, psychoanalytically trained at Harvard, also tried to apply psychoanalytic theory to short-term therapy. Disappointed with the results of an approach relying on interpretation only he began a systematic study of filmed and then videotaped therapies. He came to believe that it is the experience of one’s true feelings that holds the key to rapid therapeutic change. When Malan encountered Davanloo’s work he devoted himself to its theoretical explanation and clinical investigation. In the early 1980s Davanloo was in fact the first to demonstrate, with his video recorded clinical cases, that his dynamic and highly incisive approach was capable of dealing even with severe character problems in less than forty sessions. His strategies for breaking through the defensive barrier of even the most resistant patients, are really remarkable, and the effectiveness of Davanloo’s Intensive Short-Term Dynamic Psychotherapy, or IS-TDP is clear to anyone who has seen presentations of his videotaped cases.

Davanloo has taught many therapists over the years, several of whom have gone on to create variants of his basic technique. Michael Alpert developed an approach called Accelerated Empathic Therapy (AET). Alpert, using the work of Heinz Kohut, focused on the development of emotional closeness through the therapist’s emotional and empathic sharing.

Diana Fosha developed an approach called Accelerated Experiential Dynamic Psychotherapy (AEDP). Taking Davanloo’s emphasis on the physical experience of emotion, Fosha focused on several new aspects:

1) How the experience of warded off emotion transforms us;

2) How this takes place within a relationship of affect attunement;

3) How these processes could be understood from the perspectives of infant research and brain research.

In contrast to Davanloo, Fosha does not believe that the experience of unconscious murderous rage or unconscious guilt is necessary in order to undo psychopathology. Instead, she believes that healing takes place through the experience of transformative and healing affects within a relationship where the therapist is constantly attuned to current and emerging affective experience. Her work is notable for its emphasis on the development of emotional closeness in the therapy relationship.

Leigh McCullough carried out impressively profound, cross-theoretical research into change mechanisms, and their correlation to therapist/patient interaction. Her approach creates a strong connection between research data and clinical methodology and integrates the effective aspects of different theories, such as dynamic, behavioral, cognitive, and gestalt therapeutic approaches. McCullough shares Davanloo’s emphasis on understanding the triangle of conflict and the physical experience of affect as key factors. Whereas Davanloo’s emphasis on the unconscious is strongly related to Freud’s drive theory, McCullough updates the theoretical basis using Tomkin’s affect theory. Both of her books elaborate on all the steps involved in helping patients identify their defenses, see the difference between their impulse/feelings and defenses, and turn against their defenses. Because much of her work is with patients with low GAF scores, her work is very strong on the ways we can help patients with low ego adaptive capacity.

Patricia Coughlin (Della Selva) has written a book considered by many to be the clearest and best introduction to Davanloo’s technique of IS-TDP. Although her work uses all of Davanloo’s techniques and formulations, she has a broader emphasis in her work. She believes that the experience of unconscious murderous rage and guilt can be critical to undoing psychopathology, but she also believes many other factors can be equally if not more important. Hence, she also focuses on the experience of emotional closeness similar to Fosha, and she is extremely explicit in the ways we enhance ego adaptive capacity like McCullough. She is noted for her emphasis on the ways we develop a conscious therapeutic alliance and how to help patients turn against their defenses.

Ferruccio Osimo with Malan carried out a clinical study on the quality of results obtainable by STDP. Based on that study and the exposure to Davanloo and McCullough, Osimo developed a radically functional method of Experiential STDP, paying close attention to the interplay between theoretical model, metapsychology, and the actual personal characteristics of each and every therapist and therapist-patient matching. Central to this model are the three dynamic activities of Emotional Maieutics, Defense Restructuring, and Anxiety Regulation, theoretically and operationally described in a Manual of Experiential STDP (2003). In particular, Osimo introduces the concept of “maieutic” interventions bringing about the bodily experience and good-enough expression of deep feeling (the word is derived from the ancient Greek for “midwife”). According to this model, the therapist will engage in one or another dynamic activity depending on the moment-to-moment prevailing signals coming from the patient, as a consequence of the constantly varying levels of Anxiety, Defenses, and Deep Feeling. Ferruccio Osimo offers an integrative perspective, suggesting that different patients require different kinds of optimal responsiveness from the therapist: some require heavy confrontation of ego syntonic defenses, others require a warmly encouraging empathic approach.

Jeffrey Magnavita has worked on ways to make IS-TDP applicable to personality disordered and borderline patients. His work is notable for its attempt to link interventions to specific character types and DSM IV categories. Allan Abbass is noted for his research studies in the applicability of IS-TDP to a broad range of disorders, including schizophrenia and somatic disorders. Rob Neborsky has been publishing a series of papers which link Davanloo’s multidimensional concept of the unconscious with recent brain system research. And his papers show how he is reconceptualizing traditional concepts of transference and the transference pattern of behavior in terms of attachment disorders.

Josette ten Have-de Labije, another ISTDP practitioner, one of the founders of the VKDP (the Dutch Association for Short-Term Dynamic Psychotherapy), from 1994 onwards together with her group developed an education and training program for ISTDP. International co-operation was enhanced by her group e.g. in organizing in 2002, in Amsterdam, the Netherlands an International Conference on STDP and the 2 yearly International Summer Schools in which colleagues like Patricia DellaSelva, Jon Frederickson, Allen Kalpin, Ferruccio Osimo and Robert Neborsky were invited to teach. Colleagues such as Allan Abbass, Leigh McCullough were invited to present at workshops. In 2002 she was one of the founders of the Ad Hoc Bulletin of Short Term Dynamic Psychotherapy : Practice and Theory. Besides being the author of books and articles she is the editor of several books and the Ad Hoc Bulletin. She has developed a systematic approach to help ISTDP practitioners to select the particular interventions with the appropriate timing, duration and dosage in order to establish with the patient an unconscious and conscious working alliance on the road to unlock complex transference feelings in a safe way and to help the patient to experience them and to work them through. In her work we clearly see the subsequent steps for establishing an unconscious/conscious working alliance with a broad spectrum of patients., ranging from highly resistant to patients with fragile ego structure.

In very recent years these and other clinicians, most of whom have been trained and inspired by Habib Davanloo, have recognized that the work they do, although different one from another, still shares essential common elements that have their bases in the work of Davanloo. Some of the important common elements that the various forms of EDT (including Davanloo’s IS-TDP) share are:

1) Psychodynamic metapsychology oriented around the triangles of conflict and of persons;

2) Emphasis on the in-session experience of emotions;

3) Central use of the therapeutic relationship for both assessment and treatment;

4) Focus on emotional closeness and attachment.