Psychodynamic Therapy vs Cognitive Behavioral Therapy
Psychodynamic Therapy vs CBT Therapy: What’s the Difference?
When looking into what type of therapy you want, you will likely feel overwhelmed, and confused, by the various names out there. That’s completely normal! Although many psychotherapies exist, I’ll talk about two of the most common forms of therapy, Psychodynamic Therapy and Cognitive-Behavioral Therapy (CBT). Let’s take a look at a brief description of the two.
Psychodynamic therapy focuses on how our unconscious mind influences how we think, feel, and behave. This type of therapy emphasizes uncovering the root of your problems, which usually stems from childhood. By gaining insight into the cause of your difficulties, you gain self-awareness and can live a freer life. For example, you might find yourself entering the same dissatisfying relationship patterns. Psychodynamic therapy can help you discover why you keep doing this, and stop repeating patterns that are not helpful, so that you can have more fulfilling relationships in the future.
You may be thinking, “I don’t want to talk about my childhood, that’s in the past!” The good news is that some forms of psychodynamic therapy focus on the here-and-now rather than diving into your past. Uncovering your unconscious can be done by exploring how you are behaving in the present. As the therapeutic relationship is an important piece of psychodynamic therapy, you and your therapist can examine your behaviors within your relationship together.
Another important piece to psychodynamic therapy sessions is expressing emotions. Your therapist will help you “feel your feelings”, especially those that have been tucked away to avoid pain. By putting your words into feelings, you will find long-term relief from your anxiety, depression, and other mental health conditions.
Cognitive-Behavioral Therapy (CBT) is another common type of talk therapy. CBT primarily involves examining and connecting your current thoughts, feelings, and behaviors. Instead of focusing on the root cause of your problems, you and your therapist will work to change negative thought patterns and behaviors in the present.
Building skills is often a significant part of CBT, such as learning breathing exercises to reduce anxiety or changing negative thoughts. Depending on what your therapist thinks and your own preferences, homework may be a part of CBT treatment. In this case, “homework” is just a way for you to practice the skills you have learned outside of your therapy sessions.
Choosing the Right Fit: Psychodynamic Therapy or CBT?
While Psychodynamic Therapy and CBT can be integrated, there are key differences that may be helpful when choosing the type of therapy that would best fit your needs.
The duration of treatment approaches is a significant difference when comparing Psychodynamic Therapy and CBT. Psychodynamic therapy generally tends to be longer-term than CBT and usually lasts from a few months to several years. That being said, there are short-term psychodynamic treatments that exist, such as Short-Term Dynamic Psychotherapy.
CBT is typically a shorter-term treatment and lasts around two to three months. However, you and your therapist may decide to continue with CBT treatment for longer if needed. The length of any treatment should be individualized and flexible to meet your needs.
How do you want to spend your time in therapy? If you are looking for a deeper understanding of who you are, and where your difficulties are coming from, psychodynamic therapy may be a better fit. Are you curious about yourself? Those of you who want to know why you think and behave a certain way may like this approach better.
You and your therapist will work on uncovering and resolving your inner conflicts. The more you know about yourself, the better you will be able to interact with yourself and others, ultimately reducing emotional distress.
You will spend your time differently in CBT sessions. Are you looking for tangible skills and more structured sessions? If so, you may want to consider CBT. You and your therapist work on identifying negative thoughts and ultimately changing them so that you can feel better. Your therapist will also teach you problem solving approaches for your current issues and provide skills, so that you can change your behavior, leading to less distress.
Exploring Techniques: Psychodynamic Therapy vs CBT
Psychodynamic therapy and CBT have different techniques for treatment.
Psychodynamic therapists utilize many different approaches to help their patients. One common technique is increasing awareness into patterns that we do not even realize we are doing.
Let’s say you frequently get into an argument with your partner when you come home from work. Your therapist points out that you may actually be upset with your boss at work rather than your partner. With this new insight into your behavior, you can then break the pattern of continually getting into a fight with your partner and address the underlying issue of being upset with your boss. Additionally, the therapeutic relationship (you and your therapist’s relationship) may be used to explore and shift patterns of interaction.
Another psychodynamic technique is helping you experience a full range of emotions. Sometimes, we do not realize that we are avoiding certain uncomfortable emotions, such as anger or sadness – especially if we have been told being angry or crying is “bad” our whole life. Your therapist may point out that while talking about something sad, you are laughing. Connecting with the sadness, and ultimately, tolerating a wider range of emotions, will often relieve your distress and increase your resilience.
CBT therapists tend to incorporate cognitive (how we think) and/or behavioral (how we behave) techniques in treatment – hence, the “C” and “B” in CBT. A widely used cognitive technique is teaching patients how to change their negative thought patterns and behaviors.
A common example is the “all-or-nothing” thinking trap: a negative thinking pattern that involves thinking in extremes of all good or all bad. For example, following a breakup, you think, “I’ll never find anyone again,” get depressed, and then give up on dating. Your CBT therapist will help you develop healthier and more balanced thoughts, such as, “Even though this breakup was really difficult, it doesn’t mean I won’t ever find someone again.” Changing this thought pattern will ultimately change how you feel, and how you behave (in this case, feeling more hopeful and going on a date).
Another frequently used behavioral technique is exposure, which gradually exposes you to situations or things you fear instead of avoiding them. The more you confront something that scares you, the less anxiety you will have overtime. Let’s say you get anxious when speaking in front of others at work: you will slowly expose yourself to similar anxiety-provoking situations, such as saying “hi” in a meeting as a first step, to ultimately being able to speak in front of the group meeting without anxiety. Along the way, your therapist will teach you how to cope with anxiety during exposures, such as deep breathing techniques.
Effectiveness and Applications: Psychodynamic Therapy vs CBT
So, would psychodynamic therapy or CBT be more effective for you?
Despite being harder to research, psychodynamic therapy has been shown to be effective for a wide range of mental health conditions. Moreover, research has demonstrated this type of therapy can provide long-lasting healing, rather than a “quick fix,” particularly because the therapist and client are getting at the root cause of the problem.
Psychodynamic therapy tends to work well when you are willing to do a deep-dive into your difficulties, including depression (especially when it’s chronic), anxiety, relationship issues, childhood trauma, and substance abuse. Psychodynamic therapy works well even if you do not have a specific diagnosis or issue, but rather, want to understand yourself better.
CBT has also been shown to be highly effective in many research studies. CBT tends to be easier to research and thus has been associated with the term, “evidenced-based.” CBT may be a better fit if you are looking for a shorter-term treatment that emphasizes teaching you skills.
Since “homework” is usually a component in CBT, you should think about if you are willing to practice the skills outside of your therapy sessions. If so, CBT works especially well with depression, anxiety and anxiety-related disorders (obsessive-compulsive disorder [OCD], panic attacks, post-traumatic stress disorder [PTSD], phobias), eating disorders, and medical issues, such as insomnia.
Tailoring Treatment: Psychodynamic Therapy and CBT Approaches
Psychodynamic therapy and CBT both have their strengths and weaknesses in providing relief. Your treatment should be tailored to best help you.
When looking for a therapist, you might consider someone who has training in more than one treatment approach. Even if your therapist has a treatment preference (for example, they primarily identify as a CBT therapist), there is still room for flexibility should your goals for therapy change. Additionally, many therapists consider themselves “integrative” where they combine different treatment techniques that would best suit their patients’ needs.
A good example of when integrating approaches can be beneficial is when a patient comes in looking for immediate relief. Incorporating CBT skills, such as relaxation techniques, in the beginning of treatment can be helpful in quickly reducing anxiety or other symptoms. Overtime, treatment may shift to a more psychodynamic approach, where you and your therapist explore where your anxiety is coming from so that it does not continually come back.
Regardless of which type of therapy you choose, your therapist should be flexible in tailoring their treatment approach to fit your needs. Many of the therapists here at Madison Park Psychological Services work integratively and use both psychodynamic and CBT approaches to best fit your needs.
Book an Appointment With One of Our Psychodynamic OR CBT Therapists
If you would like to seek psychodynamic and/or CBT therapy, click here to book an appointment with one of our therapists.
Author:
Jennifer Gittleman, Ph.D.
Life can be hard; you don’t have to navigate it alone. You should feel proud for making the leap to help yourself. My goal as your therapist is to reduce your distress and help you live the life you desire. I will provide you a safe space to heal. You deserve a life filled with meaning rather than suffering – I can help you get there.
Jennifer Gittleman, Ph.D.
Life can be hard; you don’t have to navigate it alone. You should feel proud for making the leap to help yourself. My goal as your therapist is to reduce your distress and help you live the life you desire. I will provide you a safe space to heal. You deserve a life filled with meaning rather than suffering – I can help you get there.
