Intense emotions can make it difficult to think clearly, communicate effectively, or respond in ways that reflect your long-term goals. You may understand afterward that a particular reaction created additional problems, yet still feel unable to respond differently when emotions become overwhelming.
Dialectical Behavior Therapy, commonly called DBT, teaches practical skills for managing emotional distress, changing unhelpful behaviors, and improving relationships. DBT therapy in San Diego can help individuals understand the patterns contributing to their difficulties and develop more effective ways of responding.
Dr. Irwin Rosenfarb provides individual therapy informed by cognitive behavioral approaches, acceptance-based strategies, and DBT skills. Treatment is adapted to each person’s needs, symptoms, and goals.
What is Dialectical Behavior Therapy?
DBT is a form of cognitive behavioral therapy developed to help people who experience intense emotions and recurring behavioral or relationship difficulties. It was originally created for individuals with borderline personality disorder and has since informed treatment for other concerns involving emotional dysregulation.
The word “dialectical” refers to bringing together two ideas that may initially seem opposed. In DBT, one of the central dialectics is acceptance and change. Therapy can help you acknowledge your current experience while also working to change behaviors that are interfering with your life.
Acceptance does not mean approving of everything that has happened or giving up on improvement. It means recognizing what is occurring clearly enough to choose a more effective response.
Who May Benefit From DBT?
People seeking Dialectical Behavior Therapy in San Diego and California may be experiencing difficulties involving:
- Intense or rapidly changing emotions
- Borderline personality disorder
- Impulsive or self-defeating behavior
- Recurring relationship conflict
- Fear of rejection or abandonment
- Difficulty managing anger
- Persistent feelings of emptiness
- Black-and-white thinking
- Difficulty tolerating emotional distress
- Self-criticism or shame
- Anxiety or depression
- Trouble communicating needs or setting boundaries
Having one of these experiences does not necessarily mean that someone has borderline personality disorder. A careful assessment can help clarify the concerns that should be addressed and whether DBT-informed treatment is appropriate.
The Four Main Areas of DBT Skills
DBT organizes many of its strategies into four skill areas. The skills emphasized in treatment depend on the individual’s circumstances and goals.
Mindfulness
Mindfulness involves paying attention to present experiences without immediately judging them or reacting to them. This can help you notice thoughts, emotions, physical sensations, and urges before responding automatically.
The objective is not to stop having difficult thoughts. It is to become more aware of what is happening so that you have a greater opportunity to choose how you respond.
Distress Tolerance
Some situations cannot be resolved immediately. Distress-tolerance skills are intended to help people manage periods of intense emotion without making the situation worse through impulsive or harmful actions.
These skills do not solve the underlying problem. Instead, they can help you get through a difficult moment safely enough to consider what response may be most constructive.
Emotion Regulation
Emotions provide important information, but they can become difficult to manage when they are unusually intense, change rapidly, or seem unrelated to the current situation.
Emotion-regulation work can help you identify emotions, understand what influences them, and reduce patterns that increase emotional vulnerability. It may also involve improving sleep, building consistent routines, and increasing activities that support emotional well-being.
Interpersonal Effectiveness
Relationship difficulties often involve competing priorities. You may want to communicate your needs, maintain the relationship, and preserve your self-respect at the same time.
Interpersonal-effectiveness skills can help you ask for what you need, establish appropriate boundaries, manage conflict, and communicate more clearly without becoming unnecessarily aggressive or withdrawing completely.
DBT and Borderline Personality Disorder
DBT is closely associated with the treatment of borderline personality disorder. People with BPD may experience intense emotions, unstable relationships, impulsive behavior, rapidly changing perceptions of others, or a powerful fear of abandonment.
DBT skills can help individuals slow down emotional reactions, recognize recurring patterns, tolerate distress, and respond more effectively in relationships. Treatment may also address the beliefs and interpretations that contribute to conflict, shame, anger, or feelings of rejection.
Individuals interested in this area may also benefit from learning about Dr. Rosenfarb’s approach to therapy for borderline personality disorder in San Diego and California.
How Are DBT and CBT Different?
DBT developed from Cognitive Behavioral Therapy, and the two approaches share an interest in the relationship among thoughts, emotions, and behavior.
CBT often emphasizes identifying and evaluating patterns of thinking that contribute to emotional or behavioral difficulties. DBT places additional emphasis on acceptance, mindfulness, emotion regulation, distress tolerance, and interpersonal skills.
These approaches do not have to be mutually exclusive. Depending on your needs, therapy may incorporate cognitive strategies alongside acceptance-based and behavioral skills.
What to Expect From Individual DBT-Informed Therapy
Individual treatment begins by identifying the problems that are causing the greatest interference in your life. You and Dr. Rosenfarb can examine what happens before, during, and after difficult emotional or interpersonal situations.
Treatment may involve learning skills, practicing them between appointments, and reviewing how effectively they worked. Therapy can also help identify obstacles that make it difficult to use a skill when emotions are intense.
The goal is not simply to discuss problems. It is to develop practical responses that can be applied outside the therapy office.
Individual Therapy and Comprehensive DBT Programs
Comprehensive DBT programs commonly combine individual psychotherapy, structured skills groups, between-session coaching, and a consultation team for clinicians. Individual DBT-informed therapy does not necessarily include all of these components.
When contacting a DBT therapist in San Diego or California, ask what services are offered and whether the treatment is comprehensive DBT or individual therapy incorporating DBT principles and skills. Individuals needing a higher level of support may benefit from a coordinated program or additional psychiatric services.
Therapy is also not a substitute for emergency assistance. Anyone in immediate danger or experiencing an urgent mental health crisis should call 911, call or text 988, or visit the nearest emergency department.
Finding a DBT Therapist in San Diego and California
The relationship between therapist and client is an important part of effective treatment. You should feel that your concerns are taken seriously and that treatment goals are developed collaboratively.
Dr. Rosenfarb is a licensed psychologist with extensive experience providing evidence-based psychotherapy. His approach focuses on understanding the individual patterns contributing to a person’s difficulties and developing practical strategies for meaningful change.
If you are looking for DBT therapy in San Diego or California, contact Dr. Rosenfarb to discuss your concerns and determine whether individual DBT-informed treatment may be appropriate. Appointments are available at his Scripps Ranch and University City offices or online.
Contact Dr. Rosenfarb to schedule an introductory phone conversation about Dialectical Behavior Therapy in San Diego or California.