Max Bird-Ridnell
on self-sabotage.

That’s the most common thing people say to me: "I know why I do it, and I still do it." Understanding a pattern doesn’t stop it, because the feeling underneath is still being avoided, and the pattern is how you avoid it.

In ISTDP, Intensive Short-Term Dynamic Psychotherapy, we don’t only talk about the pattern. We catch it while it’s happening in the session. That’s where recurring emotional patterns can start to shift. I can’t guarantee an outcome or how fast. But insight on its own often isn’t enough, and the part that’s missing is the feeling. That’s what we work on.

It’s doing something that works against what you say you want, and doing it again even though you know better. You procrastinate on the thing that matters. You walk away from a good relationship, or you push people away. You promise yourself and don’t follow through.

It looks like laziness or a lack of willpower, but it usually isn’t. It’s a way of avoiding a feeling, such as fear, anger, or guilt. It’s a recurring emotional pattern with a function. When we understand the function, the pattern has less to hold onto.

Because knowing isn’t the same as feeling. You can understand exactly why you do something, and still do it, because the behavior is protecting you from a feeling you’d rather not have. That’s why willpower so often fails.

The habit is doing a job. If we only try to stop the habit, the feeling just finds another way out. So in therapy we go to the feeling underneath, and let it be felt in the room. I can’t guarantee what changes or how fast, but it’s a different approach from trying harder.

You may notice the same difficulties returning: in relationships, in the way you respond to stress, or in habits you find hard to change.

Therapy offers a place to look closely at these experiences, and to begin understanding what lies beneath them.

Someone might say, “I want to work with you, but I just want to change my behaviors. I don’t want to look at my emotional life.” I would say, unfortunately, the success of my therapy is based on being able to look at your emotional life. So if you’re looking for a more cognitive behavioral therapy, I wouldn’t be able to help you, but I can refer you to someone that would.

The same way it does in your life. You might arrive late, cancel, go vague, change the subject when we get close to something, or agree with me without meaning it. Someone might say, "I don’t know," every time a hard question comes.

I notice it, and I name it directly but respectfully. That’s useful, because I don’t have to rely on a description of the pattern: I can see it happen. Then we can look at what you’re avoiding right then. It can be uncomfortable, and that’s where the work is.

Part of it is designed specifically for people who have been stuck in long-term therapies that haven’t worked. So it’s a very direct and active form of therapy, where both the therapist and the client are working hard.

It will sometimes, and I’d rather you tell me than push through silently. Direct doesn’t mean harsh. I go at a pace you can manage, and I check in with you.

The discomfort is often a feeling you’ve been avoiding, and being uncomfortable doesn’t mean something is wrong. But I won’t push you past what you can handle. And if it’s not for you, you’ll know by the end of the first session, and we can part ways. You don’t owe me anything past that.

You catch the pattern sooner. You notice the urge to avoid, and you feel what’s underneath instead of acting on it. Things you’ve put off start to move, and you can be more honest with people.

I can’t guarantee that, and every person is different. But there’s a rhythm to it: up to 26 weekly sessions, about six months, with an end in sight. Early on, we’ll both know whether it’s working. If it isn’t, I’ll tell you plainly, so you don’t spend money on something that isn’t helping.