Psychodynamic & CBT: What's the Difference?
As you begin to search for the right therapist and the right type of therapy, you will certainly have come across terms like Cognitive Behavioral Therapy (CBT) and psychodynamic therapy. While these–and other forms of therapy–may feel like word salad at a certain point, it’s useful to understand some of the basic underlying principles of each to best decide on an approach to start with.
Both forms of therapy are evidence-based and can be highly effective, so it’s less about choosing the “better” approach and more about finding an approach, and a therapist, who fit you and what you’re looking for.
What Is CBT?
Cognitive Behavioral Therapy (CBT) is a structured, goal-oriented approach that focuses on the relationship between your thoughts, emotions, and behaviors.
The basic premise is that the way that we interpret situations influences how we feel, what we think, and therefore how we respond. By identifying unhelpful thinking patterns and experimenting by responding with new behaviors that bring about more positive outcomes, people often experience changes in their thinking, leading to improvements in anxiety, depression, stress, and other concerns.
In CBT, sessions often involve:
Identifying automatic thoughts
Learning practical coping strategies
Challenging unhelpful beliefs
Practicing new skills between sessions
CBT is often a good fit for people who appreciate structure, want concrete tools, or are hoping to address a specific problem, such as panic attacks, obsessive thinking, or social anxiety.
What Is Psychodynamic Therapy?
Psychodynamic therapy takes a different approach. Rather than focusing primarily on changing thoughts in the present, psychodynamic therapy seeks to understand why certain patterns developed in the first place, to better understand why and how they show up now. It explores how past experiences, relationships, emotions, and unconscious processes continue to shape current life.
Many of the ways we relate to ourselves and others develop long before we're fully aware of them. We may find ourselves repeatedly ending up in similar relationships, struggling with perfectionism, avoiding conflict, or feeling responsible for everyone else's emotions, without understanding where those patterns originated or how to change them. Psychodynamic therapy creates space to explore these deeper themes.
Rather than simply asking, "How can we reduce this symptom?" psychodynamic therapy also asks:
What patterns continue to show up in your relationships?
What emotional experiences are being repeated?
How did these ways of coping once serve you?
Do these responses and coping mechanisms still make sense for you today?
The goal is to understand why and how we arrived at where we are today, to better understand what elements of these responses we want to change and keep moving forward. Psychodynamic therapy believes that greater self-understanding often creates lasting emotional flexibility that allows people to respond differently in their present lives.
Which One Is Right For Me?
Research has consistently shown that both CBT and psychodynamic therapy can be effective treatments for anxiety, depression, and many other mental health concerns, so the best approach often depends on your goals, and what kind of therapist you feel most comfortable with.
If you're looking for practical strategies to manage a specific problem in the short term, CBT may feel like a natural fit.
If you're interested in understanding longstanding emotional patterns, improving relationships, or making deep, lasting changes in how you experience yourself and others, psychodynamic therapy may resonate more.
It is also very likely at this point, that any practicing therapist will incorporate elements of multiple therapy modalities into their work–different issues and moments require different ways of working and approaches. For example, someone experiencing acute work anxiety might benefit from CBT techniques that help manage anxious thoughts and reduce avoidance. At the same time, exploring why achievement feels so tightly connected to self-worth—or why setting boundaries feels impossible—can lead to deeper, more enduring change.
Ultimately, the relationship you have with your therapist is often more important than the specific therapy model they use. You can read more about my approach here, and together, we can determine an approach that fits your goals.