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Merging TMS and Dynamic approach concepts

tomer

tomer

New Member
I am very interested in Merging TMS and Dynamic approach concepts especially differentiating the TMS experience of pain of a patient on the corners of 'the Triangle of conflict' (Malan's approach/ ISTDP)/
It is logical to attribute the pain to the corner of defence because the purpose of that mechanism is to divert the attention away from experiancing the rage underneath. But, the pain can be also attributed to the corner of anxiety because it is known that the pain is getting worse as the anxiety rising up.
I would appreciate any comment on the topic (theoretical and experiential).
 
There has always been a very close relationship between TMS and ISTDP. Arlene Feinblatt, who developed the psychological treatment approach for Dr. Sarno in the 70's, based her TMS treatment on ISTDP. She wrote the following for a wiki page of ours


ISTDP is a technique based on psychoanalytic theory. A major difference regarding this technique is the handling of resistance. With psychoanalytic work a passive neutrality and indirect focus including free association and dream interpretation are utilized. The hallmark of ISTDP is the unlocking of the unconscious and maintenance of the therapeutic alliance through focus on resistence and defenses as well as undoing of the idea of therapist as omnipotent.

Training in ISTDP involves videotaping of both therapist and patient during sessions. Evaluation of the patient is performed in an open-ended intake - that is, the patient is told to be prepared for a two hour, three hour or even longer session. This enables the therapist to examine how the patient tolerates the process.
The major efforts of the therapist are to help the patient clarify their triangle of feelings. This includes their impulses or feelings, their anxiety and their defenses. A second triangle with which ISTDP therapists work involves using the feelings generated in the session to connect to significant people in the patient's past, current conflicts with people, and their reaction to the therapist or transference. The ego adaptive capacity of the patient determines the rapidity with uncovering can be done.

Working with ISTDP takes a great deal of training. Uncovering of defenses is sensitive work. Once an unconscious therapeutic alliance is established, then, and only then, can interpretations be made. To make such interpretations earlier is to encourage intellectual rumination. I would encourage anyone interested in learning this technique to read the books published by Dr. Habib Davanloo.
Click to expand...

ISTDP has also gain traction more even recently. Howard Schubiner included it in the 2nd version of his book, Unlearn Your Pain, and Alan Gordon has a section on it in his TMS Recovery Program. It relates very well to TMS due to its focus on helping people come to accept and no longer fear intense emotions such as rage and anger. ISTDP researcher, Alan Abbass, wrote, "In essence, the rage or anger is turned inward into somatic symptoms both to protect the other person from the rage and to serve as a form of self punishment for having the rage to begin with." Since chronic pain is simply a form of a somatization, this is very much in line with the theories of Dr. Sarno.


I am not as familiar with the different Triangles of Conflict, but I think TMS can be attributed to both the corner of defense and the corner of anxiety. Sometimes the symptoms may be distracting us from our emotions, and other times it could be more about our anxiety about our symptoms. The key is to understand how both of these corners affect your symptoms. When does your anxiety begin to get ramped up? What emotions do you tend to avoid? We need to address both of these questions in order to recover. You can know exactly what emotions you are repressing but if your anxiety ramps up and you become hyperaroused, thinking psychological may not help. Likewise you can have a handle on your anxiety, but if you do not allow your emotions to be present your symptoms will continue to persist. Recovering involves addressing both of these issues and understanding what role they play in our own lives.

There are some terrific forum posts and wiki pages about this topic. Here are a few of them:
 
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