Maybe you keep ending up in the same kind of relationship. Maybe the same argument shows up at every job. You understand it in your head, yet it keeps happening. Psychodynamic therapy is built for this kind of question: why do I keep doing this, and how do I stop? This post explains what psychodynamic therapy is, what a session looks like, how it compares with cognitive behavioural therapy, and how to start psychodynamic counselling in Cambridge or online.
This post is general information, not a diagnosis or a treatment plan.
What is psychodynamic therapy, the core idea
Psychodynamic therapy is a form of talk therapy. Its main idea is simple: a lot of what drives our feelings and choices sits outside of our everyday awareness. Old experiences, especially early relationships, shape the way we see ourselves and others today. Those patterns can keep repeating long after they stop being useful.
In psychodynamic therapy, you and your therapist look at these patterns together. The goal is not just to feel better this week. It is to understand yourself more deeply, so you can make freer choices going forward.
A few ideas you will often hear:
Patterns. The same feelings, fears or relationship moves that keep showing up.
The past in the present. How early experiences can echo in current relationships.
Mixed feelings. Wanting two things at once, like closeness and distance.
The relationship in the room. How you relate to your therapist can show patterns that happen in other relationships too.
You can read more on our psychodynamic therapy page.
A repeating relationship pattern, and how this work sees it
Here is a made up example. Imagine someone in their thirties notices that their partners always seem to leave. Every relationship starts warm and close. Then, after a few months, the person starts to feel uneasy. They pull back, pick at small things, or test their partner to see if they will stay. Eventually the partner does leave, and the person thinks, "See, everyone leaves."
A psychodynamic therapist would be curious about this. What happens inside you as things get close? What do you expect from the people you love? When did you first learn that closeness might not last? Over time, the person might notice that they pull away first to protect themselves from being left. Seeing that clearly does not erase the fear. But it gives them a choice they did not have before.
This kind of understanding often grows slowly. It is less about a single big insight and more about noticing the pattern again and again, until it loosens its grip.
Inside a psychodynamic session
Psychodynamic sessions can feel more open than some other kinds of therapy. There is usually no worksheet or fixed agenda. You are invited to talk about what is on your mind, including things that seem small or random.
Your therapist listens closely and may:
Point out themes that come up across different stories.
Ask about feelings you mention in passing.
Notice what you avoid talking about, gently and without judgment.
Wonder with you about how past experiences connect to now.
Talk about what is happening between the two of you in the session.
Sessions are often weekly. Some people come for a few months to work on one issue. Others stay longer to make deeper changes. You and your therapist decide this together, and you can always talk about how it is going.
It is normal to feel unsure at first. Talking freely can feel strange when you are used to having a plan. Many people find it gets easier as trust builds.
What should you bring? Anything that is on your mind. A dream that stuck with you. A fight with your sister. A feeling you could not shake on the drive in. Nothing is too small. Often the moments that seem random turn out to connect to the bigger pattern.
The U.S. National Institute of Mental Health describes talk therapy as a way to help a person identify and change troubling emotions, thoughts and behaviours (see Sources). It lists goals like relief from symptoms, better daily functioning and a better quality of life. Psychodynamic therapy shares those goals. It simply gets there by looking closely at the roots of a pattern, not only its surface.
What the research says
Psychodynamic therapy has a growing research base. A 2023 umbrella review in World Psychiatry looked at recent meta analyses of randomized controlled trials in adults (Leichsenring and colleagues, see Sources). It found high quality evidence that psychodynamic therapy reduces symptoms of depression and somatic symptom disorders. It found moderate quality evidence for anxiety and personality disorders. It also found moderate quality evidence that psychodynamic therapy works about as well as other active therapies for these conditions.
If depression is part of what brings you in, our post on psychodynamic therapy for depression goes into more detail.
Psychodynamic therapy compared with cognitive behavioural therapy
People often ask about psychodynamic vs CBT. Both are well studied talk therapies. They simply take different routes.
Focus. Cognitive behavioural therapy (CBT) looks mainly at current thoughts and behaviours and how to change them. Psychodynamic therapy looks at deeper patterns and where they came from.
Structure. CBT sessions often follow a plan, with skills and home practice. Psychodynamic sessions are usually more open and follow what you bring.
Goals. CBT often aims at a clear symptom, like panic or worry. Psychodynamic therapy often aims at understanding yourself and changing long standing patterns, along with easing symptoms.
Feel. CBT can feel like learning a set of skills, step by step. Psychodynamic therapy can feel like exploring together.
Neither one is better for everyone. Some people want tools fast. Others feel stuck because they already know the tools but keep falling into the same pattern. Some people use both at different times. Our post on CBT therapy in Cambridge explains that approach if you want to compare.
A free consultation is a good place to talk about which style fits you. You can ask how a therapist works, how often sessions happen, and what a typical session looks like. Those answers can help you decide before you commit to anything.
Starting psychodynamic counselling, in person or online
Our Cambridge office is in Galt, at 188 Main Street, N1R 1W8, and at 73 Water St N, Suite 300, N1R 7L6. Online therapy is also available anywhere in Ontario, so you can meet from home if that is easier.
You might consider a psychodynamic therapist in Cambridge if:
You keep repeating patterns in relationships or at work.
You feel low, anxious or empty and do not know why.
You have tried skills based therapy and want to go deeper.
You want to understand how your past shapes your present.
You feel stuck in a way that is hard to put into words.
You do not need to know where to start. Many people begin with, "I keep doing the same thing, and I want to understand why." That is exactly the kind of question this work is for.
Cost, billing and your first step
Sessions with our therapists range from $130 to $200, depending on the clinician.
We accept Health Spending Accounts (HSAs).
We can direct bill many insurers. Coverage depends on your plan, so check with your insurer before you start.
Book a free 15-minute consultation with our admin team. We can help you find a therapist who offers psychodynamic therapy, in Cambridge or online.
If you're in crisis: if you or someone you love is in immediate danger, call 911. If you're thinking about suicide, call or text 9-8-8 any time, day or night.
Last reviewed: October 2026
Sources
Leichsenring, F., and colleagues. "The status of psychodynamic psychotherapy as an empirically supported treatment for common mental disorders: an umbrella review based on updated criteria." World Psychiatry. 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC10168167/
National Institute of Mental Health. "Psychotherapies." https://www.nimh.nih.gov/health/topics/psychotherapies