This approach believes that persistent unmet needs and hurts experienced in our life cause wounds within us. These wounds result in us having painful hidden thoughts and feelings. Because we are generally programmed to avoid painful thoughts and feelings, our system develops all sorts of ways to try to avoid experiencing that pain and anxiety. ISTDP believes that the ways we try to avoid our painful thoughts and feelings cause the problems that we generally seek therapy for. 

The goal of ISTDP is to help us begin to notice our anxiety and pain and to help us identify what kinds of things we do to try and get away from it. It also helps us explore whether we can find another way to deal with that pain which is healthier than looking away from it.