Co-Creating Change: Effective Dynamic Therapy Techniques, by Jon Frederickson. Kansas City: Seven Leaves Press, 2013.
Reviewed by Tony Rousmaniere, PsyD
(Originally posted 19 November 2013)
The theory and practice of Intensive Short-Term Dynamic Psychotherapy (ISTDP) has been described well in multiple publications. Through these books, practitioners can gain an accurate and impressive picture of what ISTDP looks like in actual practice. What has been lacking, however, is a textbook on ISTDP that provides guidance on specific techniques to match the theory; in other words, a “how-to” book. Co-Creating Change: Effective Dynamic Therapy Techniques, by Jon Frederickson, aims to be the first textbook that comprehensively covers the full breadth of ISTDP theory: working with low-resistance to fragile cases; anxiety regulation; superego pathology; and the subtle nuances of addressing character and transference resistance. Given the complexity of ISTDP, this is an ambitious undertaking. However, Co-Creating Change succeeds admirably.
The book is organized in a series of logical steps that guide the reader progressively from more basic ISTDP concepts (e.g., the working alliance) up to the most advanced topics (e.g., transference resistance). Each step is illustrated with simple diagrams, akin to flow-charts, helping the reader conceptualize the progress of therapy. As is customary in ISTDP publications, every topic and point is illustrated via transcripts of real ISTDP cases. Although the book was clearly written as a practical guide to ISTDP, it also includes a host of academic references to notable and timely topics, including neuroscience, attachment theory, and psychoanalytic theory.
Crucially, the writing style throughout Co-Creating Change is very clear, consistent, and coherent, which is crucial for the learning of ISTDP. Along with the transcripts, learning points are repeated from multiple perspectives, so readers can better learn both the underlying theories and techniques for practical applications. The book frames each ISTDP topic in terms of the underlying theory (e.g., how defenses operate, from a neuroscience perspective, and the attachment theory underlying why people develop character resistance.)
Co-Creating Change does have some omissions, such as a discussion of various methods for ISTDP learning and training. As founder and faculty of the ISTDP Institute, Jon Frederickson has developed an innovative toolbox of ISTDP training materials, such as webinars, technique “drills,” and audio skill-building exercises. A description (with examples) of these methods would have been a valuable addition to this book, and hopefully will be included in follow-up volumes.
One last feature of Co-Creating Change worth noting is its attempt to reach out to the much larger community of psychodynamic psychotherapists. The theory and techniques described in the book are presented as “Dynamic Therapy” techniques—not just ISTDP techniques. By doing this, Frederickson breaks down the false wall separating ISTDP from the larger psychodynamic community, and helps frame ISTDP in more accessible terms. It is hoped that future publications will follow this path.