If you’ve started exploring therapy options, you’ve probably come across a range of approaches, like cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and therapy from a Psychodynamic orientation, to name a few. While all of these involve talking with a therapist, they differ in their methodology, their approach and their goals. Understanding those differences can help you find the right approach for your needs.

What Is “Psychodynamic” Therapy?

Psychodynamically-oriented therapy is grounded in the idea that our past experiences, unconscious patterns, and early relationships shape our thoughts, emotions, and behaviors in the present. Rather than focusing only on current symptoms, it looks deeper by working to uncover the underlying emotional factors contributing to ongoing struggles. It also uses the relationship between the Therapist and Client to work out these struggles. As I like to say, “If it shows up in the in the therapy room, it likely shows up in your other relationships.”

Using a Psychodynamic approach, your therapist encourages you to speak openly about your feelings, memories, and relationships. Your therapist helps you identify recurring themes that may be operating beneath the surface. The goal isn’t just symptom relief; it’s a deeper understanding of yourself and the patterns that shape how you move through the world. From that place of understanding, change can occur.

Psychodynamic Therapy vs. CBT

Cognitive behavioral therapy is one of the most widely researched and commonly used forms of therapy, effective across a broad range of mental health concerns. CBT focuses on the connection between thoughts, feelings, and behaviors. Specifically, it help’s people identify and change unhelpful thinking patterns by focusing on our interpretations of experiences and our core beliefs, which influence our emotions and behaviors. An example would be having a core belief of “I’m worthless”, which gets reinforced when we make a mistake, and results in depression.

Therapy from a psychodynamic perspective, by contrast, places greater emphasis on understanding of how certain thoughts, feelings, and behaviors developed in the first place. It explores the emotional roots beneath the patterns, and the coping mechanisms used to navigate situations.

For example, if someone struggles with self-criticism, CBT might focus on identifying and reframing those negative thoughts. A psychodynamic approach would explore how those self-critical beliefs took shape through earlier relationships and experiences, and what they might still be protecting you from today, then address how to adapt them. Sometimes worksheets and handouts are involved in the process of identifying, tracking, and reshaping unhelpful thinking patterns.

Psychodynamic Therapy vs. DBT

Dialectical behavior therapy is another highly structured approach, originally developed to help people with borderline personality disorder and those experiencing suicidal thoughts. DBT builds skills in four core areas: mindfulness, emotional regulation, distress tolerance, and interpersonal effectiveness. Sessions often include worksheets, practical exercises, and strategies clients can use in everyday situations.

A Psychodynamic approach takes a different path. Rather than utilizing structured coping techniques, it focuses on looking at the unconscious dynamics that drive distress. DBT works best for people who need immediate, concrete tools to manage intense emotions and behaviors. Psychodynamic therapy may appeal more to those want to understand the “why” and the “how” behind what they’re experiencing through deeper self-exploration.

There Isn’t One Best Approach

Each of these therapies has genuine strengths, and no single approach works best for everyone. The right fit depends on what you’re dealing with, what you’re hoping to get out of therapy, and how you naturally tend to process things.

You might benefit most from psychodynamic therapy if you:

Want to understand recurring emotional patterns in your life
Sense that your current struggles are connected to earlier experiences
Want to engage in deeper self-exploration and insight

A more structured approach like CBT or DBT might work better if you:

Want practical tools and strategies for managing specific symptoms
Are looking to build emotional regulation skills you can use right away

My preferred approach to therapy is to use a combination of these techniques in order to customize the treatment to the client’s needs.

The most important thing is finding a therapist and approach that feels right for where you are now. If you’re curious about whether psychodynamic therapy, CBT, DBT, or other approaches might be a good fit for you, I’d be glad to talk it through.

Ready to get started? Reach out today to schedule a consultation. You don’t need to figure this out on your own. We can find the best path forward together.

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