One of DBT's core assumptions is that people are doing the best they can with what they have, and that they are capable of learning new ways of responding. Psychotherapist Marisa De Sa treats that as the working answer to a question this audience asks constantly: whether a person with a personality disorder is capable of changing at all.
Marisa De Sa is a psychotherapist with over twelve years of experience across hospital settings, community mental health, and schools. She is now in private practice at the Cognitive and Behavioral Care Center in Greenwich, Connecticut, working with children, adolescents, adults, and families, and she sees clients virtually as well, so she is not limited to one area. She specializes in cognitive behavioral therapy and dialectical behavior therapy, has training in internal family systems, and runs what DBT calls middle path sessions for a parent and teenager who have dug in on opposite sides.
She starts by taking apart the assumption that a personality disorder is intractable, which she describes as an unfair narrative that adds stigma and hopelessness to people who already feel plenty of both. She explains what these disorders are, why they tend to surface in adolescence or early adulthood, and the environmental and attachment factors that appear to feed them. Then she gets to the harder question: how anyone gets into treatment when the defining feature is not wanting to be told what to do. DBT builds commitment strategies into its pre-treatment phase for exactly that reason, including acknowledging out loud that the patterns have been serving a purpose, which moves a resistant person further than pushing against the resistance.
The back half is about communication. Marisa walks through DEAR MAN, DBT's structure for making a request, using a co-parent who shows up ten minutes late for pickup: describe the facts with no judgment attached, express how it landed using I statements, ask for the specific change, and reinforce what is in it for the other person, all delivered mindfully and with some give and take. She covers David Burns's five secrets of effective communication, and why agreeing with someone you are in conflict with feels backwards and still works. Lisa maps it onto the strategic communication Been There Got Out teaches, and they compare their language for the same goal: lowering the temperature, disarming the other party, and negotiating from the thing you both want.
As always, this is strategic education, not legal or mental-health advice for your specific situation.
🎓 What you'll learn
- What a personality disorder is, and why clinicians don't treat it as a life sentence
- How DBT builds buy-in with someone who doesn't believe they need treatment
- The four DBT skill modules, and which one high-conflict co-parents use most
- DEAR MAN step by step, worked through with a real co-parenting example
- Why validating the other person lowers their defensiveness even when you resent them
- Universal agreement: finding the one thing you both want and negotiating from there
- How CBT differs from DBT, and what each one is good for
- Walking the middle path when a parent and a teenager have polarized against each other
⏱️ Chapters
0:00 Intro
1:00 Is a personality disorder a life sentence? What DBT was built for
4:00 Where these patterns come from, and how someone ends up in therapy
7:00 Building buy-in with a person who doesn't want to be controlled
8:00 What DBT actually is: individual therapy plus a skills group
11:00 The time commitment, and what progress looks like
13:00 How CBT differs, and what it's good for
15:00 Applying both to a high-conflict divorce
17:00 DEAR MAN: a script for asking without starting a fight
20:00 The five secrets, validation, and finding universal agreement
24:00 Middle path sessions, teaching kids to negotiate, and staying hopeful
Keep going 💜
Book a free 30-minute discovery call and we'll help you map your next steps: https://beentheregotout.com/call
📘 Been There Got Out: Toxic Relationships, High-Conflict Divorce, and How to Stay Sane Under Insane Circumstances — https://www.amazon.com/dp/194627495X
📘 Been There Got Out: When Your Ex Turns the Kids Against You (our parental-alienation book) — https://www.amazon.com/dp/1967674183
🔗 Marisa De Sa at the Cognitive and Behavioral Care Center: https://cbcarecenter.com/
About Been There Got Out
Chris Barry and Lisa Johnson are high-conflict divorce, custody, and co-parenting strategists, and the founders of Been There Got Out. They know these cases from the inside: both have successfully represented themselves in family court. Few attorneys have a playbook for a case like this — Chris and Lisa write yours with you, so you and your kids can get through it as unscathed as possible.