Why CBT Didn't Work for Me — And What to Try Next
You learned the tools. You did the work.
You identified the distorted thoughts. You challenged them. You filled out the worksheets, tracked the patterns, practiced the techniques. And it helped — to a point. But something underneath didn't move. The same feelings keep returning. The same situations keep finding you.
That's not a failure of effort. It may be a ceiling of method.
What CBT Does Well
Cognitive Behavioral Therapy is a legitimate and well-researched treatment. For many people, it is genuinely transformative. It works by identifying maladaptive thought patterns and replacing them with more accurate, functional ones. It teaches skills for managing anxiety, regulating emotion, and interrupting destructive cycles.
In neurological terms, CBT is very good at creating new memories — new ways of thinking and responding that can override old patterns when actively applied. For symptom relief, for building coping capacity, for learning to function differently, it works.
Where the Ceiling Is
The limitation is that CBT builds on top of existing memory rather than changing it. The old patterns — the ones formed early, often before language, often in the context of important relationships — remain encoded underneath. New learning sits alongside them, and with effort and practice, the new can override the old. But the old is still there, still active, still capable of reasserting itself under stress, in close relationships, or when defenses are down.
This is why people can complete a successful course of CBT, feel better, and then find themselves back in the same place a year or two later. It is not that the treatment failed. It is that it addressed the surface without reaching the source.
What Psychoanalytic Treatment Does Differently
Psychoanalytic therapy doesn't primarily teach new ways of thinking. It goes back to the original encoding — the early experiences, relational patterns, and implicit memories that formed the foundation of how you experience yourself and others — and works to change those directly.
This happens through the therapeutic relationship itself. When old patterns are activated in the present — in the room, between patient and analyst — they become available for something more than observation. Research on memory reconsolidation suggests that when an old memory or pattern is reactivated in a genuinely new emotional context, it can be revised at the level of its original encoding. Not overwritten by something new sitting beside it, but actually changed.
This is slower work than CBT. It is less structured, less symptom-focused, and harder to measure in a twelve-session window. But it aims at a different depth — and for people who have hit the ceiling of skill-based approaches, that depth is often exactly what's needed.
Two Different Questions
CBT asks: how can you think and respond differently?
Psychoanalytic treatment asks: why does this pattern exist in the first place, and what would it mean to no longer need it?
Both are valid questions. They are just different questions, suited to different moments in a person's life and different kinds of suffering.
This Work Might Be Right for You If
You have completed CBT and found it helpful but insufficient. You notice the same patterns returning despite understanding them cognitively. You feel that something earlier — in your history, in your relationships — is driving what happens now. You are ready for a process that goes to the root rather than managing the symptoms.
A Note on My Approach
I am a certified psychoanalyst trained in modern psychoanalytic theory. My work draws on the clinical tradition of depth treatment alongside contemporary understanding of how lasting change actually happens in the mind. CBT and psychoanalysis are not enemies — many people benefit from both at different times. But if you have done the skill-based work and still feel stuck, there may be more available to you.
If that resonates, I would welcome a conversation.
Reach out to schedule a consultation.