This article will provide a comprehensive comparison of psychodynamic therapy and CBT, exploring their techniques, effectiveness, and key differences.

The right therapy can help with a range of mental health disorders. However, knowing which type or modality is right for your needs can be tricky. The two most widely used are psychodynamic therapy vs CBT, but what’s the difference between these therapeutic approaches?

Understanding Psychodynamic Therapy

Psychodynamic therapy is talk therapy where you focus on your feelings, memories, and unconscious thoughts, particularly in relation to your previous experiences and how those impact your current emotions and behaviors.

Understanding Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy is talk therapy where you focus on recognizing your negative automatic thoughts and transforming them with positive automatic thoughts, all based on the fact that what you think has a direct impact on how you feel and how you behave and is something within your control.

CBT vs Psychodynamic Therapy: Key Differences

When looking at CBT vs psychodynamic therapy, the key differences apply to the treatment approach, duration of therapy, role of the therapist, and your involvement.

Approach to Treatment

CBT focuses on problems in the present, identifying negative thoughts and helping you learn to challenge those automatic negative thoughts, turning something like “I can never do anything right” into “Sometimes I make mistakes, but sometimes I also succeed.”

CBT is a practical, straightforward way of directly changing your emotions, your mood, and your behavior.
Psychodynamic therapy focuses on your past, identifying emotional patterns and themes from your childhood experiences that shape how you feel or behave today. The purpose here is to have a better idea of where psychological issues might come from and work to resolve them.

Duration of Therapy

A key difference between CBT vs. psychodynamic therapy is the duration of treatment.

CBT sessions can run anywhere between 5 weeks and 20 weeks and are typically broken down into the same structure where you have three critical phases of progression associated with a lot of homework in between.

Psychodynamic therapy can take several months or years and typically involves a much more long-term commitment compared to CBT because the idea is to uncover emotional patterns or themes from childhood that shape who you are now whereas CBT is there to address specific behaviors or issues in the present.

Role of the Therapist

With CBT, your therapist is there to help provide you with tools to more effectively manage your symptoms, editing away negative thought patterns in exchange for positive ones that give you a fast, recognizable change in your mood and actions.

With psychodynamic therapy, your therapist is there to use a lot of techniques like dream analysis or free association to help you explore your childhood and early experiences. This is a process where you are encouraged by the therapist to verbalize your thoughts without trying to censor them or cover them up or change them in real-time. This type of free association helps you uncover emotional patterns that might be hidden away with censorship or regular judgment.

Another process, like transference, helps you project your feelings about other people from your past onto the therapist, in which case the therapist is a stand-in, there to help you explore unresolved issues you might have with people from your past.

Patient Involvement

With psychodynamic therapy vs. CBT, your involvement is going to look different.

CBT involves a lot of homework with behavioral experiments and new skills that you get to practice in real time. Psychodynamic therapy doesn’t have this.

CBT and Psychodynamic Therapy: Which One Is More Effective?

When comparing CBT therapy vs. psychodynamic, the question “Which is more effective” is based on the condition.

Effectiveness Based on Mental Health Conditions

When looking at CBT therapy vs. psychodynamic therapy, the type of mental health condition you are seeking to treat and what you are trying to treat will determine which method is most effective for you.

Cognitive behavioral therapy is the most common treatment for conditions such as:

• Anxiety
• Depression
• OCD
• Eating Disorders

This is not to say that psychodynamic therapy wouldn’t work; however, with anxiety and depression, CBT is there to focus on identifying the thought patterns that lead to detrimental emotions or actions. This also gives you the practical solutions you need to challenge these feelings, which can make it easier to live with anxiety disorders, eating disorders, OCD, or depression.

Psychodynamic therapy is most common for conditions like:

• Relationship Issues
• Personality Disorders
• Eating Disorders

This is not to say that it cannot be used on depression or anxiety disorders; however, there are many personality disorders that are directly caused by childhood experiences and upbringing, so taking the time to explore these facets through psychodynamic therapy can help you better understand and control symptoms of your personality disorder.

Choosing the Right Therapy for You

When choosing between CBT and psychodynamic therapy, you will need to consider several factors.

• Availability: Availability in your area is often the biggest siding factor, as you may not have qualified specialists for one or the other.
• Severity of Condition: The severity of your condition will be a big determining factor in the most appropriate therapy, as psychodynamic therapy is reserved for more severe cases where CBT can help with moderate management.
• Preferences: Also consider your personal preferences and whether you are more comfortable with dream analysis transference therapies or the practical aspect of CBT.
• Goals: Consider your goals and whether you want a deep dive exploration into childhood experiences or a short-term understanding of how you can control symptoms.
• Accessibility: The accessibility of therapists may be a deciding factor in CBT vs. psychodynamic therapy if one is within a short drive and another is several hours away.

That said, there are times when you can consider combining both therapies. Cognitive behavioral therapy can provide actionable strategies for managing emotions and mood in the present, the efficacy of which can be heightened by a deeper understanding of childhood experiences contributing to your emotional thought patterns and behaviors.

Summing Up

When comparing psychodynamic therapy vs CBT, the biggest differences have to do with the length of your treatment, treatment goals, and the role of the therapist in your goal achievement. One is not better than the other but could be more suited to your needs, the severity of your mental health disorder, and your overall goals. Take time to explore different therapeutic approaches based on individual needs.