Where psychoanalysis sifts the inner self to shift the outer, CBT adjusts external behaviour to ameliorate the internal state. Psychoanalysis gets to the root cause, often lying in one’s early years, where CBT focuses on the presenting issue. CBT is much more short-term, usually limited to about 30 sessions.
Two additional bonuses, Smiths says, include the fact that CBT doesn't bother with rooting through years of sexual frustration or trauma to unwind underlying causes, and it's a science that plays nice with others in the field: "it enjoys an affinity with pharmacologically oriented psychiatry in which symptoms, should they fail to be dissolved by therapy, can be handily lined up with drugs. Needless to say, this is a system that plays well with the pharmaceutical giants."
And yet, despite the CBT's streamlined, quantifiable benefits, Smith posits that psychology, even stripped of its scientific bona-fides, deserves to remain in the therapy canon because it does what CBT does not: it focuses on relationships, first by enabling the patient to forge one with a psychiatrist or psychologist, with the long-term goal of enabling patients to understand and improve their other relationships. Smith concludes:
Relationships are fundamental to happiness. And so a science that has the courage to include the doctor's relationship with the patient within the treatment itself, and to work with it, is a science already modelling the solution it prescribes. What psychoanalysis loses in scientific stature, it gains in humanity.