Dialectical Behavior Therapy
DBT Skills in Santa Monica and Across California
Most people meet DBT as a binder. A worksheet with a mnemonic on it, a module schedule, a homework sheet you fill in on the drive over because you forgot until Tuesday. That version helps some people and bores most of the rest, and the boredom is usually the point at which they conclude the skills do not work for them.
I teach DBT skills inside individual therapy, in the situations you are actually facing, rather than running you through a manual page by page. Distress tolerance, emotion regulation, and interpersonal effectiveness are genuinely useful things. They are also learnable in ordinary English, applied to the specific argument you had on Sunday, without anybody being asked to memorize an acronym.
What It Looks Like
Skills, taught in the situation you are actually in
Here is the difference in practice. A standard skills group teaches distress tolerance as a category, with a list of techniques and a rating scale. What we do instead is start from the ninety seconds between the text message arriving and you replying to it. What happened in your body. What you concluded before you had any evidence. What you would have needed, right then, to wait four minutes instead of nothing.
Then we build the skill for that ninety seconds. Sometimes it is temperature and breath, because physiology outruns insight when you are that activated. Sometimes it is a single sentence you have practiced enough that it is available to you when nothing else is. Sometimes it is leaving the room, which is unglamorous and works.
Emotion regulation work tends to start earlier in the chain than people expect. By the time you are flooded, your options are narrow. Most of the useful movement happens in the hours before that, and a lot of the early work is simply learning to notice the slope you are on while you are still somewhere near the top of it.
Interpersonal effectiveness is the part I find people underestimate. Knowing what you want, asking for it plainly, and tolerating the possibility that the other person says no is a set of skills, not a personality trait. We rehearse actual sentences out loud. It feels strange for about two sessions and then it does not.
In the Room
The three skill areas, in plain terms
Distress tolerance
Getting through the worst forty minutes without doing the thing that costs you three days of repair. This is damage limitation, not happiness, and treating it as the whole of therapy is a common mistake.
Emotion regulation
Noticing the build earlier, understanding what feeds it, and changing the inputs you can change. Sleep and food are in scope here, which people find either obvious or insulting, and are usually right about both.
Interpersonal effectiveness
Saying the actual thing, holding a boundary past the first push back, and repairing afterward. Most of the practice happens on small stakes so the skill is there for the large ones.
Why Not Skills Alone
Skills without understanding leave you competent and stuck
I have met a great many people who can run a clean thought record and name every skill in the book, and who have repeated the same relational pattern for a decade. The skills were never the missing piece. Nobody had asked why the pattern was necessary in the first place, what it protected them from, or who taught it to them.
So DBT skills sit inside a longer conversation here. We use them because insight you cannot use on Thursday night is entertainment. We do not stop at them, because a skill that manages a feeling is not the same as understanding why the feeling keeps arriving.
Practically, that often means the first stretch of a session is about meaning and history, and the last fifteen minutes are about what you do on Thursday. The balance shifts as the work changes, and you get a say in it.
Honest Limits
Honest notes about DBT here
This is individual therapy that draws on DBT skills. It is not a full adherent DBT program with a weekly skills group, phone coaching, and a consultation team. If that structure is what you need, I would rather say so early and point you toward a program that offers it than quietly substitute something smaller.
Skills also take repetition, which is the part nobody advertises. The first few weeks of practicing something new feel artificial and produce modest results. That is normal, it is not a sign the approach is wrong, and it is the reason consistency matters more here than intensity.
Where to Next
Related areas of the work
Free Consultation
Start with a conversation, not a commitment.
The first step is a free consultation call. We talk about what brings you here, what you have already tried, and whether working together makes sense. If I am not the right fit, I will say so and point you somewhere better.
- · You request a time on the form, and I confirm by email
- · Telehealth anywhere in California, or in person in Santa Monica
- · Private pay, with superbills for out-of-network reimbursement
- · 48 hours' notice for changes or cancellations
Or call the office at (213) 761-8555.