Monica Urru
The Neurobiology of Guilt
and its psychotherapeutic aspects
About this training
Guilt is not only a cognitive construct or the voice of the superego, but also a biophysiological reaction, rooted in evolution and in the fundamental need to maintain the bond.
As humans we are the only mammals that, for years after birth, need secure attachment in order to survive. In order to protect the relationship with the caregiver, even under conditions of trauma, the child’s psyche may repress murderous rage, rebellion or the impulse to separate. In their place, guilt appears.
As Monica Urru emphasizes: “Guilt does not appear because we are bad. It appears because at some point we had to repress a part of ourselves in order to save the bond.”
Patients rarely come in saying “I have a problem with guilt”. They come with depression, somatization, chronic tension, addiction to anger, devaluation of themselves or of the psychotherapist. Often they unconsciously punish themselves for an impulse they were once unable to experience.
If the patient does not go through the experience of true guilt, they may:
- remain fixated on anger,
- become stuck in a depressive identification with the object of the rage,
- perpetuate superego pathology,
- repeat trauma in relationships.
When guilt is fully experienced, on the other hand, a calm appears that is a sign of integration. The energy sustaining the defences becomes available to the ego.
“Before we begin to explore feelings, we have to make space by restructuring the superego.”
What sets this material apart
Monica Urru, who leads the training, combines the ISTDP model with a careful neurobiological process. She does not stop at the level of narrative; she leads to the experience of the impulse in the body.
Instead of avoiding dissociated feelings:
- she helps the patient to name them,
- to experience them,
- to bear them within the window of anxiety tolerance,
- to integrate them into a coherent life story.
In work with patients with a fragile personality structure, she takes into account the risk of losing the sense of “I” and the need for particular caution in breaking through defences.
The therapeutic effect
When the patient goes through the experience of guilt:
- the compulsion to self-punish subsides,
- the persecutory superego weakens,
- it becomes possible to experience both rage and love towards the same object,
- a more integrated ego emerges.
The patient may say: “I feel relief. I am more myself.”
Guilt can be a source of self-punishment. But it can also become a gateway to integration.
What will you learn?
- What is guilt? To discuss it as a biophysical reaction, immediate denial, and the evolutionary role of guilt.
- How can I access my unconscious feelings? - Theory, technique and identification with the superego
- How do you evaluate defense patterns that prevent you from experiencing complex and mixed feelings?
- How to create a more integrated ego and superego in the patient?
- How to recognize and assess the manifestations of unconscious guilt and self-punishment
What will you receive?
- 01A full-length training film - all fragments combined into an uninterrupted whole
- 02The presentation used in the training video with the possibility of downloading and viewing
A fragment of this training
A short excerpt from the recording itself. It is here so you can see how the material is taught, and what to expect, before you decide.
Your teacher
Monica Urru
MD, ISTDP supervisor and teacher
Dr. Monica Urru, MD, is based in Rome and has been active in the ISTDP community for over twenty years. She trained in Intensive Short-Term Dynamic Psychotherapy with Patricia Coughlin (Philadelphia, 2002-2006) and completed a further core training with Jon Frederickson and Josette ten Have de Labije (2008-2011), followed by a training of trainers for teachers and supervisors, led by Jon Frederickson, in Norway (2010). Today she works as a supervisor and runs ISTDP core groups in Rome, teaching how to work with the neurobiological underpinnings of trauma treatment. She has led an advanced ISTDP group in Italy for the past twelve years and a further advanced group in Poland since 2019. Alongside ISTDP, she has practised REAC neurobiological modulation continuously since 2008, in collaboration with Dr. Salvatore Rinaldi at the Rinaldi-Fontani Institute in Florence, integrating the two approaches across a wide range of diagnoses. Since 2026 she has been part of Inside BlueZone, the REAC® longevity programme developed by the Rinaldi Fontani Institute, which recreates Blue Zone conditions in the body to counteract inflammaging and cellular senescence. She also contributes to the epistemological framework of the Ordinative Sciences Foundation, translating clinical processes into structured models of coherence and regulation. She has presented at psychotherapy conferences in Italy, Poland, Denmark, Sweden, the United Arab Emirates, Egypt and Lebanon, and has co-taught with Jon Frederickson across Europe from 2008 to the present, including summer schools in Italy (2012, 2014) and France (2024). She is the author of Star Seeker, based on specific studies on autism, and of We Were Born Searching (2026), and co-author with Jon Frederickson of Clinical Thinking in Medicine (Elsevier, forthcoming) and Psychoneurophysiopathology of Adaptation: A New Paradigm (forthcoming in 2027).
Why train with us?
- Experienced ISTDP teachersOur teachers are practitioners with many years of experience.
- Practical methods for immediate useAfter reviewing the material, you will return to your practice with ready-to-use ways of carrying out more effective interventions with patients.
- Knowledge that stays with youYou can replay our online courses whenever you want and as many times as you need. After purchase, you receive unlimited access, which allows you to consolidate the knowledge you have acquired effectively.
Ready to start
The Neurobiology of Guilt
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