What is Psychodynamic Therapy? And How is it Different from CBT?

For anyone who has tried therapy before and wondered whether there is something more.

Many people come to me having already done therapy. Often it was CBT, offered through a workplace Employee Assistance Programme or via a GP referral, and often it was genuinely useful. They learned to notice unhelpful thought patterns. They developed coping strategies. They felt more equipped to manage difficult moments. And yet, somewhere underneath, something still does not quite feel resolved.

If that resonates, you are not alone. And it does not mean CBT failed you. It means you may be ready for a different kind of work.

What CBT does well and where it has limits

CBT is a structured, skills-based approach. It works with the relationship between thoughts, feelings, and behaviour, and it is particularly effective at helping people manage symptoms in the short term. For many people, that is exactly what they need. But it tends to work at the surface of things. It asks: what are you thinking, and how can we change it? It does not always ask: where did this come from, and what does it mean?

Psychodynamic therapy starts from a different place. Rather than focusing on managing thoughts or behaviours, it is interested in understanding. It works on the premise that many of the difficulties we experience in adult life, including anxiety, low self-worth, relationship patterns that keep repeating, or a persistent sense that something is not right, have roots in earlier experiences and relationships. Not necessarily dramatic ones. Sometimes simply the ordinary ways we were loved, misunderstood, encouraged, or let down.

Why the relationship at the heart of therapy matters

What this means in practice is that sessions feel different. There is no worksheet, no homework, no structured exercise. There is conversation, reflection, and over time, a relationship between therapist and client that itself becomes part of the therapeutic process. The way you relate to me in the room, the patterns that emerge, the things that feel difficult to say, all of this carries meaning and becomes material we can work with together.

This is why the relational element matters so much. In psychodynamic therapy, the connection between therapist and client is not incidental. It is central. Feeling genuinely heard, met without judgement, and held in mind consistently week after week creates conditions that many people have not experienced before, and that in itself can be quietly transformative.

I work with adults in Worthing and online across the UK, and this question, whether to try something different after CBT, comes up more than almost any other in initial consultations. There is no single right answer, but for people who sense that their difficulties have deeper roots, psychodynamic therapy is often worth exploring.

I am aware that private therapy represents a real financial commitment, and I do not take that lightly. What I would say is that the kind of change psychodynamic work can bring about tends to be more lasting precisely because it goes deeper. Rather than learning to manage a feeling, you come to understand it. Rather than interrupting a pattern, you begin to see where it came from and why it made sense at the time. That understanding does not disappear when therapy ends.

Ready to find out more?

If you have been through a structured therapeutic process before and found it helpful but incomplete, it may be worth exploring whether a more open-ended, relational approach might offer something different. I offer a free 15-minute phone consultation for anyone who wants to ask questions and get a sense of whether this kind of therapy might be right for them.

There is no obligation. It is simply a conversation.