Research Study

Exploring the Role of Emotion in Psychotherapeutic Change

An Interpretative Phenomenological Study of ISTDP with Adults Experiencing Treatment-Resistant Anxiety

  • This study aims to explore how adults with treatment-resistant anxiety experience the role of emotion in Intensive Short-Term Dynamic Psychotherapy (ISTDP) using a qualitative interpretative phenomenological approach.

  • The study uses semi-structured interviews and Interpretative Phenomenological Analysis (IPA) to explore participant experiences of emotion during ISTDP. This approach allows for an in-depth understanding of how individuals make meaning of emotional processes in the context of psychotherapy and therapeutic change.

  • Participants will adults aged 18–65, who (1) have experienced treatment-resistant anxiety, (2) completed at least 5 sessions of prior therapy, (3) completed at least 5 sessions of ISTDP, and (4) are no longer in active ISTDP therapy. Recruitment will occur via therapist referrals and online posts. Exclusion: current ISTDP clients, those in crisis, or unable to consent.

  • April–June 2025: Recruitment & interviews

    July–August 2025: Transcription & analysis

    September 2025: Final write-up and publish.

  • Many individuals with treatment-resistant anxiety report limited success with traditional therapies such as Cognitive Behavioral Therapy (CBT) or medication. This study investigates how such individuals experience and describe the role of emotion in Intensive Short-Term Dynamic Psychotherapy (ISTDP). Using Interpretative Phenomenological Analysis (IPA), the study seeks to uncover how emotional breakthroughs and emotional processing are linked to perceived reductions in anxiety and psychological change. It is expected that participants will describe emotion as a central mechanism in their therapeutic transformation.

  • Anxiety disorders are among the most common psychological concerns, yet many individuals do not experience sustained relief through traditional therapies such as Cognitive Behavioral Therapy (CBT) or pharmacological treatment. Intensive Short-Term Dynamic Psychotherapy (ISTDP) is a depth-oriented, evidence-based approach that focuses on emotional processing as a path to psychological change. Despite promising outcomes, the client’s experience of ISTDP—particularly how they engage with emotion—remains under-researched.

    This study aims to explore how adults with treatment-resistant anxiety experience the role of emotion in ISTDP. Using Interpretative Phenomenological Analysis (IPA), this study will examine how participants make meaning of emotional breakthroughs, affective expression, and emotional regulation during therapy, and how these processes may relate to reductions in anxiety and psychological distress.

    This research is important because it centers the client perspective in a modality that is gaining traction yet lacks widespread integration in clinical training. It also addresses a clinical gap by exploring emotion-based therapeutic change for clients who did not improve through other modalities.

    Research Question:
    How do adults with treatment-resistant anxiety describe the role of emotion in their experience of ISTDP therapy?

  • Abbass et al. (2012) found that ISTDP significantly reduces symptoms of anxiety and depression by targeting unconscious emotional processes, highlighting its promise for individuals unresponsive to traditional therapies. Town et al. (2019) used Interpretative Phenomenological Analysis (IPA) to explore the role of emotion in ISTDP for patients with medically unexplained symptoms, identifying emotion as a central mechanism of psychotherapeutic change. While their focus differed, their study supports the value of client-centered qualitative approaches. This proposed study extends these findings by examining how individuals with treatment-resistant anxiety experience and make meaning of emotion within the ISTDP framework.

  • This study will utilize Interpretative Phenomenological Analysis (IPA) to explore how adults with treatment-resistant anxiety describe the role of emotion in their experience of Intensive Short-Term Dynamic Psychotherapy (ISTDP). IPA is grounded in phenomenology, hermeneutics, and idiography, and is well-suited to this research as it emphasizes in-depth exploration of personal meaning and subjective lived experience. This design allows the researcher to interpret how participants make sense of emotionally significant events within a depth-oriented therapeutic process.

    The study is an in-depth qualitative exploration based on one-on-one, semi-structured interviews. It does not use surveys or pre-existing data. Interviews will be guided by open-ended questions designed to evoke detailed narratives about emotional experiences during ISTDP and their perceived impact on anxiety.

    To manage bias and ensure quality, the researcher will engage in reflexive journaling throughout the study and use bracketing to identify and temporarily set aside personal assumptions. An audit trail will be maintained to enhance credibility and transparency. Themes will be supported by verbatim quotes from participants to ensure that interpretation remains grounded in data.

    As a candidate in clinical psychology with training in psychodynamic approaches, the researcher acknowledges a professional affinity for emotion-focused therapies. This positionality will be reflexively examined throughout the research process. The goal is not to prove ISTDP’s effectiveness, but to understand participants’ lived experience and meaning-making around emotional processes in therapy. The researcher anticipates participants may describe both challenging and transformative emotional moments, which will be explored without imposing theoretical or biased assumptions.

  • This study will include a purposive sample of approximately 6-8 adult participants, in alignment with guidelines for Interpretative Phenomenological Analysis (IPA), which values depth over breadth. Participants will be between 18 and 65 years old and must self-identify as having experienced treatment-resistant anxiety—defined as having participated in at least five sessions of a prior therapy modality (e.g., CBT, talk therapy) without meaningful or sustained symptom relief. Participants must also have engaged in at least one trial therapy session or multiple sessions of Intensive Short-Term Dynamic Psychotherapy (ISTDP) with a licensed clinician. Recruitment will be conducted through referrals from ISTDP practitioners, online ISTDP communities, social media, and psychology-related forums. Inclusion criteria: Adults 18–65 years old; fluent in English; self-reported treatment-resistant anxiety; and at least one experience of ISTDP. Exclusion criteria: Individuals currently in acute psychological crisis or experiencing active suicidality, individuals with active psychosis, or those unable to provide informed consent. Participants who are current or former clients of the researcher will also be excluded. This focused population will allow for an in-depth exploration of how emotion is experienced in ISTDP and its perceived role in therapeutic change for anxiety.

  • This study will involve in-depth, semi-structured interviews with approximately 6 adult participants who have experienced Intensive Short-Term Dynamic Psychotherapy (ISTDP) for treatment-resistant anxiety. Participants will be recruited through referrals from ISTDP therapists, professional networks, online forums, and social media platforms. All participation will be voluntary and based on informed consent. Data will be collected through individual interviews conducted over a secure, HIPAA-compliant Zoom platform. Each interview will last approximately 60 minutes and will be audio-recorded with participant consent. A semi-structured interview guide will be used to elicit participants’ lived experience of emotion in the context of ISTDP. Topics will include emotional processing, breakthroughs, symptom relief, and comparisons to previous therapy. The interviews will be conversational and flexible, allowing participants to reflect deeply on their emotional experiences. Audio files will be transcribed verbatim by the researcher or a HIPAA-compliant transcription service. Transcripts will be de-identified using pseudonyms, and identifying details will be removed. Interview data will be stored securely on the researcher’s encrypted Pacifica OneDrive folder. The analysis will follow the six-step approach to Interpretative Phenomenological Analysis (IPA) outlined by Smith et al. (2009). The researcher will read and re-read transcripts, make exploratory notes, develop emergent themes, and look for patterns across cases. Themes will be grounded in participant quotes to ensure fidelity to the lived experience. The researcher will use reflexive journaling to maintain awareness of bias and enhance interpretive rigor. The interview guide was developed based on the study’s purpose and includes questions such as: “Can you describe what your emotional experience was like during ISTDP?” and “In what ways, if any, did your experience with emotion relate to changes in your anxiety?” Follow-up prompts will be used to deepen reflection and clarify meaning. No other instruments or surveys will be used. This study aims to produce nuanced, idiographic insight into how participants make sense of emotional experiences during ISTDP and how these may relate to perceived therapeutic change.

  • All participant data will be stored on a secure, password-protected OneDrive account provided by Pacifica Graduate Institute, in accordance with institutional storage guidelines. Audio recordings will be deleted after transcription is verified. Transcripts will be de-identified using pseudonyms and stripped of identifying information. The key linking participants to pseudonyms will be stored separately in a secure file. Only the researcher will have access to the data. Data will be retained for five years following study completion and then permanently destroyed. Participant anonymity and confidentiality will be protected throughout the study and in all written materials.

  • Findings from this study will be presented in the final dissertation submitted to Pacifica Graduate Institute and will also be submitted for presentation at professional conferences or publication in peer-reviewed journals focused on psychotherapy research or depth-oriented clinical practice. All findings will be reported in aggregate form, with identifying information removed to protect participant anonymity. Verbatim quotes will be used to illustrate emergent themes but will be de-identified and contextualized with care. The goal is to share meaningful insights from client experiences that may inform clinical practice and future research.

  • Abbass, A., Town, J. M., & Driessen, E. (2012). Intensive short-term dynamic psychotherapy: A systematic review and meta-analysis of outcome research. Harvard Review of Psychiatry, 20(2), 97–108. https://doi.org/10.3109/10673229.2012.677347                               

    Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative phenomenological analysis: Theory, method and research. SAGE Publications.                                                                          

    Town, J. M., Lomax, V., Abbass, A. A., & Hardy, G. (2019). The role of emotion in psychotherapeutic change for medically unexplained symptoms. Psychotherapy Research, 29(1), 86–98. https://doi.org/10.1080/10503307.2017.1300353                                      

    Pacifica Graduate Institute. (2023). Clinical psychology PhD dissertation handbook 2023–2024.

  • Appendices

Research Committee Team

  • Brenda Murrow, Ph.D. is a clinical psychologist and educator with a specialized focus on trauma, attachment, and animal-assisted therapies. She is a Clinical Fellow at the Reiss-Davis Child Study Center in Los Angeles, where she provides psychodynamic treatment to children and adolescents with histories of trauma, abuse, and early attachment disruptions.

    Dr. Murrow holds a Ph.D. in Clinical Psychology from Pacifica Graduate Institute, an M.B.A. from the University of Colorado at Denver, and a B.A. in Mathematics from the University of Northern Colorado. Her clinical expertise includes the assessment and treatment of families impacted by postpartum depression and domestic violence, with a particular emphasis on the early bonding process between infants and caregivers. She is trained in the observation and assessment of infant-parent dyads and integrates equine- and canine-assisted interventions into her work.

    Prior to entering the field of psychology, Dr. Murrow spent over a decade in the information technology industry, where she held senior management positions in statistical forecasting, systems engineering, and corporate communications. This interdisciplinary background informs her holistic and systems-based approach to psychological care.

    In addition to her clinical work, Dr. Murrow serves as Core Faculty and Research Coordinator in the Clinical Psychology Department at Pacifica Graduate Institute. She is committed to making psychological concepts accessible through research and public scholarship, and is the creator and host of Connection Therapy, a podcast exploring the relational dimensions of healing.

    Her published work includes contributions to both peer-reviewed journals and public media, including Spring: A Journal of Archetype and Culture, and community-based newspapers such as the Ojai Valley News and Santa Barbara News-Press. Her doctoral dissertation examined the therapeutic role of the human-animal bond.

  • Deborah Pollack, Ph.D. is a licensed clinical psychologist and professor with over twenty years of experience in psychotherapy, clinical supervision, and teaching. She received her Ph.D. in Clinical Psychology from Duquesne University and completed her internship at SUNY Upstate Medical University. Dr. Pollack has held leadership roles in numerous clinical settings, including directing the Bariatric Psychology Program and co-directing the Dialectical Behavior Therapy Program at SUNY Upstate Medical University. She currently serves as a consultant to the Transplant Service at SUNY Upstate and maintains a private practice offering psychotherapy, assessment, and supervision.

    Dr. Pollack is a certified Teacher and Supervisor of experiential-dynamic therapy and currently serves as President-Elect of the International Experiential Dynamic Therapy Association (IEDTA). Her integrative training includes ISTDP, AEDP, DBT, existential, and psychodynamic therapies. She has also worked extensively in health psychology, neuropsychology, and eating disorder treatment across hospital and academic settings.

    She is a psychology professor at Utica University and holds teaching and supervisory appointments at SUNY Upstate Medical University and Syracuse University, where she mentors doctoral students in clinical psychology. Her research, grounded in a feminist-psychodynamic perspective, explores maternal attachment, emotional expression, and embodiment. Her current project, The Holding Space Group for Mothers, is supported by a grant from the American Psychological Association and focuses on postpartum depression and anxiety.

    Dr. Pollack is a long-standing leader in the Central New York psychology community, having served as President, Board Member, and Communications Officer for the Central New York Psychological Association (CNYPA), where she was honored as “Psychologist of the Year” in 2013. She is a frequent presenter at local and international conferences and has published on women's mental health in peer-reviewed journals and academic texts.

  • Juliet Rohde-Brown, Ph.D. is a licensed clinical psychologist, educator, and author with a focus on integrative and depth psychological approaches to healing. She serves as Chair of the Depth Psychology: Integrative Therapy and Healing Practices doctoral specialization program at Pacifica Graduate Institute, where she has taught psychology for over two decades.

    Dr. Rohde-Brown completed her clinical internship at the C.G. Jung Institute of Los Angeles and has worked in both private practice and hospital settings. Her training background includes integrative work in hypnotherapy, neuropsychological assessment, and in-patient care. She brings a unique blend of clinical and contemplative experience to her work, incorporating inter-spiritual dialogue, somatic awareness, and imaginal processes into both teaching and therapy.

    She is actively engaged in service-oriented leadership and mentorship, serving on the boards of Tierra Sagrada and Restorative Justice Resources, and as a mentor with the Spiritual Paths Foundation. Dr. Rohde-Brown has presented internationally on topics related to psychology, spirituality, and transformation, and has led or co-facilitated numerous retreats and workshops.

    Her book, Imagine Forgiveness, explores forgiveness through psychological, spiritual, and relational lenses. She has authored peer-reviewed articles in journals such as the Journal of Humanistic Psychology, Psychological Perspectives, and the Journal of Divorce and Remarriage. Her academic contributions also include book chapters in volumes focused on interdisciplinary studies in humanistic psychology, child development, and forgiveness.

  • Danté Spencer, M.A. is a Clinical Psychology doctoral candidate at Pacifica Graduate Institute, where he is completing his dissertation on Intensive Short-Term Dynamic Psychotherapy (ISTDP) and its impact on treatment-resistant anxiety. He currently serves as a doctoral intern at the Pepperdine University Counseling Center, working with undergraduate and graduate students in both individual and group therapy formats.

    Danté’s clinical training spans a variety of settings, including university counseling, dual diagnosis treatment centers, and integrative wellness programs. His therapeutic approach draws from depth psychology, ISTDP, and somatic awareness, with a special interest in emotional expression, cultural identity, and trauma integration.

    Danté holds an M.A. in Clinical Psychology from Pacifica Graduate Institute and an M.A. in Spiritual Psychology from the University of Santa Monica, reflecting his integrative approach to healing. He also earned a B.A. in Communication from the University of California, San Diego. His teaching experience includes guest lectures on the intersection of art and resilience at Pepperdine University and assistant roles in psychology and nutrition courses. He is also certified as a National Board-Certified Health & Wellness Coach and Holistic Nutritionist. He has presented at national conferences, including the APA Division 32 Society for Humanistic Psychology, and has conducted qualitative and quantitative research on topics such as mass incarceration, the impact of COVID on relationships, and the psychological effects of social media. His current research employs Interpretative Phenomenological Analysis to explore client experiences of ISTDP.

    Danté is an active member of APA Divisions 32 and 39 and serves as a Student Ambassador for the Society for Humanistic Psychology, where he advocates for integrative and culturally responsive approaches to clinical practice. Following graduation, he will begin a postdoctoral position specializing in the treatment of narcissistic personality disorder and pathological narcissism, further deepening his clinical focus on complex characterological presentations and depth-oriented interventions.