Intensive short‐term dynamic psychotherapy (ISTDP) was developed to manage treatment impasses preventing the experiencing of feelings related to childhood attachment interruptions, such as parental loss. According to ISTDP theory, certain categories of patients will exhibit habitual patterns of responding within the treatment relationship (called defenses) to certain anxiety‐provoking thoughts and feelings. Such defensive behaviors interrupt awareness of one's own feelings, self‐directed compassion and engagement in close human attachments, including the bond with the therapist. Rupture‐repair sequences in ISTDP are primarily considered in the context of a patient's defenses and the responses a therapist has to these defenses. By understanding and clarifying these defenses, this risk of subsequent misalliance, that is negative shifts or ruptures in the alliance, are minimized. In this paper we summarize ISTDP theory and technique through the use of clinical vignettes to illustrate defense management as a rupture‐repair equivalent in ISTDP.

中文翻译：

---

强化短期动态心理治疗中的联盟破裂修复过程：与抵抗合作

强化短期动态心理治疗 (ISTDP) 旨在管理治疗僵局，防止经历与童年依恋中断相关的感觉，例如失去父母。根据 ISTDP 理论，某些类别的患者会在治疗关系（称为防御）中表现出对某些引起焦虑的想法和感受的习惯性反应模式。这种防御性行为会打断自己的感受、自我导向的同情心和与人类亲密关系的参与，包括与治疗师的联系。ISTDP 中的断裂修复序列主要是在患者的防御和治疗师对这些防御的反应的背景下考虑的。通过理解和澄清这些防御措施，这种后续误会的风险，联盟中的负面转变或破裂被最小化。在本文中，我们通过使用临床小插曲来总结 ISTDP 理论和技术，以说明防御管理作为 ISTDP 中的破裂修复等价物。