Dialectical Behavior Therapy (DBT) in San Fernando Valley, CA

In this stage of treatment you will learn essential skills of building awareness and noticing things as they are and without judgment. With these new skills you can begin to develop the capacity of mindful eating rather than mindless eating that feels out of control. I will support you as you learn to observe your emotional state and to manage your urges and cravings with present awareness instead of running away through compulsive eating. Together we will process whatever you notice you are challenged by and I will teach you how to unhook from unhelpful narratives that involve black and white thinking and unrealistic perfectionism.

While all DBT skills are aimed at emotion regulation, in this stage the focus is on building insight and agency around your emotions. If helpful and appropriate, you will learn skills to make desired change to your emotions. Emotion regulation skills involve the development of self-awareness and an emotional vocabulary. This skill can be particularly helpful if you were raised in an invalidating environment and taught not to trust your own feelings and experiences (also called "gaslighting"). I will discuss the function of your emotions and how they influence your behavior by exploring relevant scenarios that led to binge eating. Part of our work in this stage of treatment will involve increasing your exposure to positive experiences and reducing your vulnerability to emotional intensity that results in problem eating. I will also help you build mindful self-compassion so you can stop judging yourself so harshly, which leads to a shame spiral and binge.

The purpose of distress tolerance skills is to be equipped with strategies to manage pain and distress when the option of immediate change is not present. This stage recognizes that we can't always avoid crises or extremely difficult circumstances, so it's wise to be prepared to manage the best we can. Distress tolerance skills are like the life vest that we hope not to need but it's responsible to be safe and have it anyway. With distress tolerance we develop radical acceptance of reality while understanding acceptance does not mean approval. We learn to focus on somatic or body-based experiences, such as breathing exercises and facial expressions known to increase a sense of calm. We also create a crisis survival toolkit to be used instead of turning to food when things just feel like too much.

In the final stage of treatment we focus on maintaining and solidifying your gains. We will review your treatment progress and discuss your experiences. By the end of a successful course treatment you should have developed a different relationship with your anxiety and other intense feelings. You should have an entirely new skillset so you are no longer using binge or compulsive eating to escape. Together, we will plan for your future success and prepare you to handle stressors with healthy coping skills instead of stress eating.