Dr. Coughlin spoke in Albuquerque, at the University of New Mexico IDEAS in Psychiatry Program, on Nov. 11, 2011.

Most brief psychotherapies aim to reduce symptoms such as anxiety or depression.  ISTDP, however, delivers the deep insights and healing traditionally sought via years of daily psychoanalysis on the couch.   Like psychoanalysis, ISTDP derives from the work of Sigmund Freud and attachment theorists.  Yet ISTDP delivers results in just a few sessions.  According to research, even one session can bring lasting results, such as getting off medications, or a reduction of panic attacks.

Dr. Coughlin explains, “The patient is in need of an experience, not an explanation.”  To enable this, the ISTDP therapist assumes a trance-like voice, helps the patient get in touch with childhood emotions and rage, and then adopt new ways of coping with these feelings.  “We go to hell, and then come back with the patient,” she said.

As an example, she showed a video of a star athlete who lost his drive to apply to college.  He was a muscular, blond man who reportedly never shed a tear, even after his mother died.  Under Dr. Coughlin’s guidance, the man spoke about how angry he was throughout his childhood, at his mother’s uncaring attitude toward him.
He beat his dog regularly, simply because the pet’s self-absorption reminded him of his mother.  To Dr.
Coughlin, he revealed that as a child, he wanted to choke his mother, to behead her, and to watch her blood spatter.  After extensive descriptions of his violence-laden fantasies, he revealed that his rage was because he always needed her love.  He envisioned her coffin floating on a river, and he as a small boy clinging atop it, not wanting to leave her.  In touch with his anger, the patient resolved his grief, became engaged with the world, and applied to college—within eight sessions.

“My own feeling is that the DSM is not helpful,” Dr. Coughlin said of the Diagnostic and Statistical Manual of Psychiatric Disorders.  She explained, “It is descriptive, but tells us nothing about the cause.”

Regarding anger management, she said, “Rage is reactive.  We weren’t born that way.”  The key is to get to the root of the conflict, and to resolve it, she said.  By resolving anger and guilt, a patient can let go of destructive and sabotaging behaviors.  The patient can stop acting out.

Even insurance companies have taken interest in the cost-savings ISTDP can bring.  In study of emergency room patients with severe but unexplained symptoms, an average of 3.8 ISTDP sessions were given to 77 patients.  Psychotherapy focused on the link between suppressed emotion and the physical symptoms.  The patients had an 80 percent reduction in panic attacks and a 69 percent reduction in repeat visits to the hospital.  In another study by Allan Abbass, ISTDP was administered to 89 patients who were considered highly impaired.  One-third had been hospitalized or suicidal, one-fourth were unemployed and disabled, 46 percent took multiple medications, and 83 percent were considered treatment resistant, having failed three or more therapies.  After an average of fifteen sessions, 71 percent had stopped all their medications.
Eighteen of 22 returned to work.   A savings of $402,523 yearly for three years resulted, in terms of
prescriptions, disability payments, and physician and hospital costs.

A single ISTDP session was given to 30 patients in another study.  Of the ten patients who took psychiatric
medications, seven stopped the drugs.  Two returned to work.  One-third of the patients required no further treatment.

Intensive Short Term Dynamic Psychotherapy works by opening a channel into the unconscious, Dr
Coughlin said.  The results are not only powerful, but lasting.

Whatever the source of stress, fortunately, holidays are
temporary. Easter-or the family reunion that descends with it-won’t last all
year, or even all week. So enjoy your aunt who won’t stop talking, the noise of
egg hunts, or the solitude of being alone while others celebrate.

Whatever the stress-it will pass, along with the holiday.

In my Weekly Wellness Tips, I’ll be posting advice I commonly give my patients. This advice is based on studies, as well as my 20 years of experience as a psychiatrist. Many of these tips are simple, even obvious. They can make a big difference.

Something is missing in health care reform, even if the one year old Affordable Care Act is landmark progress. According to a recent Kaiser Health Tracking Poll, 53 percent of Americans remain confused about the ACA, and 46 percent view the act unfavorably. Health insurance premiums continue to rise, while health care isn’t obviously better. True, the ACA isn’t fully implemented. But with Republicans intent on repealing the act, and judges ruling against its constitutionality, the ACA’s future hangs.

Could it be that health care reform needs moms?

Read the full article at Huffington Post

As a psychiatrist, I remember when I once did everything in my power to keep a disturbed patient stable, and society safe. I’d see the patient every day, or hospitalize the patient for months, if necessary. Needless to say, this degree of attention is impossible today, given limited resources, and the fights my staff and I regularly undertake with insurance companies to get even routine care approved.

For decades, the American health care system has prioritized profits, often by excluding the sick. This travesty is now coming to roost, in the form of mass violence, such as the recent shootings in Tucson, at Virgina Tech, and in communities across the country, including my own. Medical care for our most disenfranchised citizens will never turn good profits — yet basic health care for everyone, is necessary for the stability of society.

What does it mean that for kids today, the greatest threat of mass violence comes not from enemy powers, but from fellow disenfranchised citizens?

Read the full story at Huffington Post

If so, is Wall Street deciding your medical care?

It’s hard to recall that for-profit corporations were once kept out of health care — in fact, for most of the 20th century. During this time, the nation’s medical system was built largely by non-profit and charitable organizations, which is why so many hospitals are named for saints. Courts across the country ruled that for corporations to profit from medical care was simply “against sound public policy.” In the early 1980′s, however, when the financial and airline industries were deregulated, a similar process occurred for American medicine. For-profit corporations became newly encouraged to take leadership of health care. Deregulating health care into the free market was intended to drive down costs and to improve care. After all, medical care in 1980 consumed a whopping 9.1 percent of the nation’s GDP.

Never mind that after 30 years in the free market, health care costs have doubled to consume 18 percent of the GDP (with a third of these precious dollars wasted on bureaucracy). Never mind that health care has gotten increasingly inaccessible to the uninsured and even the insured, or that American health care has become an international poster child for reform.

The real issue is that modern medical care has simply, finally, gotten so effective. Today, even cancer and AIDs are no longer death sentences, and if organs fail, you try to get a new one.

Read the full story at Huffington Post