M. Christina Benson, M.D., D.L.F.A.P.A

Psychiatry-Psychotherapy-Psychoanalysis

Cognitive Behavioral Therapy vs. Psychodynamic Psychotherapy

A lively debate exists currently on the relative benefits of CBT vs PDT for a wide range of disorders and specific behaviors. It has been historically much easier to design research protocols to assess its efficacy when controlled against another form of treatment. The results are in general quite positive, and it has become beloved by residency directors (it is evidence-based), insurance companies (it can be done in a time limited number of sessions) and consumers (who both want something affordable and shown to be efficacious). It is only fairly recently that PDT/PSA have had effectively conceptualized research models and protocols that also show significant and positive results across very similar domains. Direct comparisons are difficult, though not impossible, because PDT/PSA can take years to complete, while CBT may be done in a matter of 3-6 months.

Putting it simply, CBT is a form of psychotherapy that focuses on cognitions (thoughts, images, beliefs) as a useful framework with which to understand and treat psychiatric disorders. More specifically, CBT involves helping individuals to recognize their existing cognitive patterns and belief structures in order to be able to modify them with alternative thoughts and beliefs. By considering alternative cognitions, individuals develop and experiment with new outlooks, which sets the stage for novel behavioral and emotional experiences. While originally designed as a treatment for depression, it has since been successfully applied to a number of different disorders, including anxiety and panic disorder, substance abuse and bipolar disorder.

Psychodynamic psychotherapy (PDT), also known as psychoanalytically psychotherapy (PSA), examines the complexities of individuals and of interpersonal issues. It stresses two important assumptions: each individual and their difficulties are unique, and factors outside of out awareness influence our thoughts and behaviors.

Psychodynamic therapy is the oldest of current therapies and while it evolved from Freudian psychoanalytic theory it is also quite contemporary. It is generally what is meant by traditional “talk” therapy. Considerable research research supports the efficacy of psychodynamic therapy (put articles to download here).

In this therapy, one size fits all prescriptives are not thought to be useful at producing lasting change (eg., 10 Steps to Manage Depression). If such directive techniques appeal to you, CBT may be a better fit for your personality

Psychodynamic therapy is the oldest of current therapies and while it evolved from Freudian psychoanalytic theory it is also quite contemporary. It is generally what is meant by traditional “talk” therapy. Considerable research research supports the efficacy of psychodynamic therapy.

Most people intuitively grasp that we all find ourselves behaving at times in ways we don’t fully understand. Psychodynamic therapy is in part based on the idea that we are not transparent to ourselves and that sometimes, what we do not know or understand about ourselves causes us problems. As your therapist, I will try to understand your difficulties in the context of who you are as an individual including your family history and upbringing and to help you to do the same.