Patterns, Not Flaws
Specialized care for long-standing patterns in emotions, relationships, and sense of self — fostering self-awareness, emotional regulation, and a steadier, more fulfilling life.
When the Same Patterns Keep Repeating
Some struggles aren't tied to a single event or season of life. They show up as patterns that feel woven into who you are: emotions that swing hard and fast, relationships that start intensely and end painfully, a sense of self that shifts depending on who you're with, or ways of coping that bring relief in the moment and regret afterward. When these patterns are persistent and cause real distress, they may reflect a personality disorder — a diagnosis that describes how someone has learned to cope, not who they are or what they're worth.
How Therapy Helps
Therapy here is collaborative, direct, and paced to you. The work combines practical skills for the moments that feel overwhelming with deeper exploration of where these patterns came from and what they've been protecting. Sessions may draw on:
- Dialectical Behavior Therapy (DBT) skills — mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness, for riding out intense emotions without acting against your own interests.
- Psychodynamic exploration — understanding how early relationships and experiences shaped the patterns you live with today.
- Cognitive-behavioral techniques — noticing and reworking the beliefs about yourself and others that keep old cycles going.
- Mindfulness practice — building the pause between feeling and reacting, so you have more choice in how you respond.
What the Research Says
Personality disorders are more common than most people realize, and structured therapy can make a meaningful difference:
- An estimated 9.1% of U.S. adults meet criteria for a personality disorder, according to the National Comorbidity Survey Replication.National Institute of Mental Health →
- A Cochrane review of 75 randomized controlled trials (4,507 participants) found that therapy tailored to borderline personality disorder reduced symptom severity by a clinically meaningful amount compared with usual care, with dialectical behavior therapy (DBT) among the most-studied approaches.Storebø et al., Cochrane Database of Systematic Reviews →
This is Tier One clinical therapy, which may be covered by insurance. All sessions are provided by Dr. Karina Rieke, PhD, LMHC-D, licensed in New York, Florida, and Nevada. All sessions are held online through secure video.