Support for intense emotions, relationships, and recurring patterns
Borderline personality disorder can affect how you experience emotions, relationships, and yourself. Feelings may become intense very quickly, making it difficult to pause, understand what is happening, or choose how you want to respond.
You may long for closeness while also worrying about rejection, abandonment, or being hurt. A disagreement, delayed response, or unexpected change in plans may activate powerful emotions and fears. These experiences can create distress, conflict, and behaviors you later regret.
Dr. Irwin Rosenfarb provides borderline personality disorder treatment in San Diego and online across California for adults and their families. He uses Cognitive Behavioral Therapy, Dialectical Behavior Therapy, and family-focused approaches to help clients understand recurring patterns, respond more effectively to emotions, and develop healthier ways of navigating relationships.
Understanding Borderline Personality Disorder
Borderline personality disorder, often called BPD, is associated with difficulties regulating emotions. It may also affect relationships, self-image, behavior, and impulse control.
Experiences vary from person to person but may include:
- Intense or rapidly changing emotions
- Fear of rejection or abandonment
- Unstable or conflict-filled relationships
- Difficulty maintaining a consistent sense of identity
- Impulsive behavior
- Intense anger or difficulty managing anger
- Feelings of emptiness, shame, or worthlessness
- Anxiety or periods of depression
- Self-harm or thoughts of suicide
These experiences are not simply a matter of being overly emotional or difficult. They may reflect deeply established ways of understanding yourself, interpreting relationships, and protecting against rejection or loss. Effective treatment can help you recognize these patterns and begin responding differently.
How BPD Can Affect Relationships and Self-Image
Relationships can feel especially complicated when you want connection but fear being abandoned or misunderstood. You may seek reassurance and then become distressed when it does not provide a lasting sense of security. Intense emotions may lead to arguments, withdrawal, impulsive decisions, or attempts to protect yourself from anticipated rejection.
Afterward, you may experience guilt, regret, or confusion about what happened. Repeated cycles can affect romantic relationships, friendships, and family connections.
BPD can also influence how you see yourself. Your sense of identity or self-worth may change depending on your circumstances or relationships. Therapy provides a place to explore these shifts with curiosity rather than judgment.
How Therapy Can Help
The goal of borderline personality disorder therapy is not to label emotions as right or wrong. Treatment can help you understand what activates emotional distress, how you interpret the situation, and what behaviors tend to follow.
Therapy may help you:
- Recognize emotional and relationship patterns
- Identify triggers and early signs of distress
- Consider different interpretations of interpersonal situations
- Pause before responding impulsively
- Develop practical coping and problem-solving skills
- Communicate needs more clearly
- Establish and respect healthier boundaries
- Strengthen your sense of identity and self-worth
- Respond more effectively to conflict
Learning to recognize these patterns can make experiences that once seemed unpredictable feel more understandable and manageable.
CBT for Borderline Personality Disorder
Dr. Rosenfarb uses Cognitive Behavioral Therapy to help clients examine connections among thoughts, emotions, and behaviors.
You may hold painful beliefs about yourself, expect rejection, or interpret uncertain situations through the lens of earlier experiences. CBT can help you notice these patterns, examine whether there may be other explanations, and develop responses that better reflect your goals.
This work is not about dismissing your feelings or forcing positive thinking. It involves understanding why a reaction makes sense within your experience while developing more constructive ways to respond.
Dialectical Behavior Therapy for Borderline Personality Disorder
DBT is very similar to CBT for Borderline Personality Disorder but, in addition, helps individuals manage intense emotions. Dr. Rosenfarb helps clients manage intense emotions by helping them develop distress tolerance skills as well as by learning to accept difficult thoughts and feelings.
DBT can also be used to enhance communication skills. Dr. Rosenfarb uses DBT to teach clients effective communication with others as well by helping clients maintain appropriate boundaries and live life according to their values. DBT can also be used to help clients stay in the moment and to be fully engaged in their lives. Finally, Dr. Rosenfarb uses dialectical strategies by validating and acknowledging both sides of a problematic issue.
How This Approach Differs From Comprehensive DBT programs
Comprehensive DBT programs may include individual therapy, structured skills groups, between-session coaching, and a clinician consultation team. Dr. Rosenfarb’s approach described on this page incorporates components of DBT into his work. If you are specifically seeking a comprehensive DBT program, ask about the services provided so you can determine whether the treatment structure matches your needs.
Family Support for Borderline Personality Disorder
BPD can also affect partners and family members. People close to you may want to help but feel unsure how to respond during periods of intense distress. Understandable attempts to reassure, protect, or set limits may sometimes contribute to recurring cycles of conflict.
Dr. Rosenfarb works with families to improve their understanding of BPD and develop more effective ways of communicating and offering support. Family work may focus on recognizing patterns, reducing blame, setting appropriate boundaries, and responding to difficult situations without taking away the individual’s independence.
An Experienced California Psychologist
Dr. Rosenfarb is a licensed psychologist with more than 40 years of experience. He is also the former Director of the Clinical Psychology PhD program at Alliant University, San Diego, and is currently Professor Emeritus in the Clinical Psychology Ph.D. program at CSPP/Alliant University. He has served as principal investigator on an NIMH research grant and has authored more than 100 publications and presentations.
Dr. Rosenfarb also worked with Dr. Marsha Linehan, the developer of Dialectical Behavior Therapy, when he was a psychology intern at the University of Washington. His dissertation was a test of Dialectical Behavior Therapy’s interpersonal effectiveness model and he published the results of this study along with Steven C. Hayes, the developer of Acceptance and Commitment Therapy (ACT), and Dr. Linehan in the journal *Psychotherapy. *
His approach combines empirically supported psychotherapy with compassion and collaboration. Treatment is shaped around your experiences, relationships, strengths, and goals rather than a one-size-fits-all plan.
BPD Therapy in Scripps Ranch, Sorrento Valley, and online across California
Dr. Rosenfarb provides BPD treatment in San Diego at offices in Scripps Ranch and University City. He works with adults experiencing BPD and with family members seeking more effective ways to provide support. He also provides BPD treatment online throughout California.
If you are experiencing thoughts of suicide, self-harm, or an immediate mental health crisis, call or text 988. In a life-threatening situation, call 911 or go to the nearest emergency room. This practice does not provide emergency or crisis services.
If you would like to learn more about treatment, contact Dr. Rosenfarb to schedule an introductory phone conversation.