The shape of the programme
The programme accompanies already-trained clinicians through the move from method to voice: from knowing how to apply ISTDP to knowing how to inhabit it. The structure follows the Core-Training model: three years, four meetings a year, with each meeting divided into a seminar half and a supervision half on real video material.
The three-year arc is progressive. The first year builds the bodily, perceptual and cognitive foundations: the threshold, anxiety, the somatic signal, general semantics and clinical thinking - and it is here that the therapist's voice begins to form. The second year enters the most delicate work - fragile structures, borderline personality, dissociation, trauma - where the calibration of pressure is everything. The third integrates: the now-mature voice, the adaptive field, complex PTSD, the narcissistic structure, and transmission.
A note on method. Each meeting carries a thread drawn from the narrative-clinical themes of Dr Urru's books - the gaze that "sees elsewhere", the body that knows before the mind, the search as movement toward a point of coherence, the stillness within noise. These are not decorations: they are the bridge between the technical rigour of ISTDP and the living experience of the patient.
Format of each meeting
Morning (9:30-13:00) - a theoretical-experiential seminar on the meeting's theme, including paired exercises.
Afternoon (14:00-17:00) - supervision on participants' clinical video material, connected to the morning's theme.
Year 1
The body, the threshold and the gaze
Foundations: general semantics, the somatic signal, and the voice beginning to form
The first year brings everything back to the body and to perception. Before any technique comes the reading of the somatic signal of anxiety, the distinction between its discharge pathways, and the capacity to stay on the threshold without either rushing in or withdrawing. But from the very start we also work on two tools that will accompany the whole three years: general semantics - distinguishing observation from inference, the map from the territory, and clearing the semantic noise to reach the datum - and clinical thinking, that is, the therapist's capacity to observe their own mind as it reasons. It is here that the therapist's personal voice begins to form.
Meeting 1 · The threshold, the body's signal and the map
Reading anxiety in the body, and telling observation from inference.
Seminar. The three discharge pathways of anxiety (striated muscle, smooth muscle, cognitive-perceptual disruption); the window of tolerance; the threshold as a place of work. Elements of general semantics (Korzybski): the map is not the territory, the ladder of abstraction, inference disguised as observation - and semantic noise as what interposes itself between therapist and datum, applied to clinical reading.
Supervision. Participants' initial videos: identifying each patient's anxiety channel and separating what is observed from what is inferred.
Thread from the books. The gaze that pauses before intervening - "not to find the right words, but to truly look". Semantic hygiene and clearing the noise to reach the datum: the centre of silence within semantic noise as the precondition of clinical observation. The therapist's body as the first diagnostic instrument, before abstraction.
From her trainings. "When patients sit down in the therapy room, they show us how their body adapted to relationship in order to survive it." - from the Fluctuation Asymmetry training
Meeting 2 · Pressure, challenge and the system of defence
Raising pressure without rupturing the alliance.
Seminar. The pressure-challenge-head-on sequence; tactical vs. regressive defences; when pressure mobilises and when it saturates.
Supervision. Moments of stalemate in the videos: where pressure was lacking, where it overshot, and how to recover the right measure in real time.
Thread from the books. Dis-adaptation as a loss of direction - the lines that "curve and forget where they were heading". Pressure as a way of renaming the direction.
From her trainings. "A child whose emotions were not accepted in childhood will, in adulthood, deny, repress and ignore feelings such as their own anxiety." - from the Character Defences training
Meeting 3 · Transference, clinical thinking and the nascent voice
Working in the here-and-now of the relationship, while observing one's own reasoning mind.
Seminar. Relational resistance and transference as living material; linking the impasse in session to the patient's pattern outside the room. Clinical thinking: the therapist's metacognition, observing one's own reasoning process while in the room; the first traits of a personal voice distinct from the manual.
Supervision. Clips where transference activation is evident: naming the movement as it happens and, at the same time, recognising how each therapist is already thinking in their own way.
Thread from the books. The body that responds before the mind - "the legs that knew before you did". The somatic recognition of the bond as clinical data, and the beginning of the voice.
From her trainings. "Without attending to the physical experience of emotion, we cannot become aware of our feelings." - from the Somatization training
Meeting 4 · Complex emotion and breakthrough
The passage from defence to direct emotional experience.
Seminar. The structure of complex emotional experience; rage, guilt, grief; the difference between feeling and discharging.
Supervision. Breakthroughs in the group's videos: what makes an activation a genuine turning point rather than a sterile catharsis.
Thread from the books. The search as movement - "we were born searching". Complex emotion as the moment when the parallel lines converge toward the point of coherence.
From her trainings. "To be able to bear the complexity of life, a patient has to develop the capacity to bear every feeling without stepping outside the window of tolerance for anxiety." - from the Neurobiology of Guilt training
Year 2
Fragile structures and dissociation
The most delicate work: regression, fragmentation, dissociation, trauma
The second year enters where a calibration error costs the most. With fragile structures, standard pressure does not merely fail to work: it harms. Here we work on the early recognition of the regressive threshold, on restructuring, and - at last - on the seminar devoted to dissociation that we lost years ago, in a format analogous to that one.
Meeting 1 · Recognising fragility
Distinguishing resistant structure from fragile structure before intervening.
Seminar. Signs of fragility; the regressive threshold; anxiety shifting into smooth muscle or into cognition; why standard pressure is contraindicated.
Supervision. Videos of fragile patients: locating the exact point where capacity runs out and must be built rather than challenged.
Thread from the books. The child who "does not respond to their name because they are inside something larger" - fragility as presence elsewhere, not as deficit.
From her trainings. "The identity of a person with fibromyalgia is the identity of someone who feels trapped, who cannot find a way out, who sees no possibility of escape." - from the Neuroadaptation training
Meeting 2 · Restructuring and borderline disorder
Building capacity in fragile personality structures.
Seminar. Cognitive and anxiety restructuring; borderline functioning as a fragile structure; managing affective dysregulation, splitting and the discontinuity of the self; isolating the defence without crushing the patient; the gradual widening of the window.
Supervision. Clips with borderline patients: recognising micro-progress, avoiding the rush to breakthrough, holding regulation.
Thread from the books. Sensory integration becoming "structurally more stable" - capacity as a field that gradually comes into tune, even in the fragmented self.
Meeting 3 · Dissociation - the rediscovered seminar
The dissociation seminar-workshop, in extended format.
Seminar. Dissociation as an extreme defence against emotion; the spectrum from derealisation to fragmentation; signs in session; how to bring the patient back into the window without retraumatising. Experiential workshop with role-play.
Supervision. Videos where dissociative material appears: reading the moment of the switch, calibrating regulation, rebuilding continuity.
Thread from the books. The centre of silence within semantic noise - stillness not as absence but as a coherent field to be recovered after fragmentation.
From her trainings. "Our patients are exiles from their own lives. Fear leaves them trapped in stillness, frozen in place." - from the Neurobiology of Fear and Anxiety training
Meeting 4 · Trauma, attachment and the body's night
Working with embodied traumatic memory.
Seminar. Attachment trauma; procedural and somatic memory; the nervous system that "keeps the night shift"; safety and timing.
Supervision. The group's long-term cases: trauma work as a process, not a single session.
Thread from the books. Vera waking in the night and feeling "the future as a place safe enough to return to" - healing as the rebuilding of the horizon.
From her trainings. "In response to life's stresses, the body becomes asymmetrical. That asymmetry is the measure of the trauma, suffering and pain a person has had to survive in their life." - from the Fluctuation Asymmetry training
Year 3
The therapist's voice and integration
Voice and adaptive field, PTSD, narcissistic structure, closure and transmission
The third year closes the arc. Once the method is in their hands, what clinicians need is permission and a path to make it their own. It is the year of the personal voice and of the adaptive field, but also of the presentations that demand the therapist's greatest maturity: complex PTSD and the narcissistic structure. It ends on transmission - how a journey is concluded and how one becomes, in turn, someone who passes it on.
Meeting 1 · The clinical voice, stillness and the field
From method applied to method inhabited; stillness as a therapeutic state.
Seminar. The therapist's personal style and the move from orthodoxy to a personal articulation of the work; flow as the moment when expression coincides with origin; coherence of the field, contact, resonance and dis-adaptation as clinical signals.
Supervision. Participants' mature videos: recognising each one's voice and reading resonance as data, not impression.
Thread from the books. "Finding one's own voice - the way you have found yours, the way I am still finding mine." The centre of silence within noise; resonance as the signal that one is moving toward one's own point at infinity.
From her trainings. "How we live shows up in the body." - from the Neuroadaptation training
Meeting 2 · PTSD and complex trauma
Working with embodied traumatic memory and post-traumatic disorder.
Seminar. PTSD and complex PTSD (C-PTSD); attachment trauma; procedural and somatic memory; hyperarousal and the nervous system that "keeps the night shift"; window of tolerance, safety, timing; avoiding retraumatisation.
Supervision. The group's long-term cases: trauma as a process, not a single session; recognising when to slow down and when to open.
Thread from the books. Vera waking in the night and feeling "the future as a place safe enough to return to" - healing as the rebuilding of the horizon.
From her trainings. "At the root of psychosomatic symptoms lie unacknowledged feelings tied to old, unprocessed trauma." - from the Somatization training
Meeting 3 · The narcissistic structure and complex presentations
Narcissistic functioning and comorbidity, where the therapist's mature voice is decisive.
Seminar. The narcissistic structure: grandiosity and vulnerability, sexualisation and other defences, the narcissistic transference; comorbidity and psychosomatic presentations; integrating the ISTDP reading with the bodily/biological dimension.
Supervision. The most difficult cases of the three years: integrated formulation and a multi-level treatment plan.
Thread from the books. Holding together the body and identity, the past and the present, loss and meaning - the parallel lines that converge.
From her trainings. "Most psychosomatic symptoms are driven by unregulated anxiety and an imbalance between the sympathetic and parasympathetic nervous systems." - from the Fluctuation Asymmetry training
Meeting 4 · Closure, identity and transmission
Concluding the journey and becoming, in turn, the one who passes it on.
Seminar. Closure as a clinical phase; the identity of the mature therapist; the ethics of transmission; how one becomes a supervisor and trainer. Review of the three years.
Supervision. A final round of videos: what each person takes away, what they can now give to others.
Thread from the books. "I do less ISTDP, but I am not less inhabited by it." The method that remains in how one reads and sits with patients, even when it moves into the background.
This is a framework, not a cage. The themes of individual meetings can rotate according to what the group brings, while keeping the three-year arc: body and threshold, fragility and dissociation, voice and integration.
