The referral pathways guide
Read with intention
Meet the cliniciansWhen feelings run hotter and longer, and it costs you the people you want.
Emotions at full volume, relationships swinging between too close and unbearable, being told you are “too much”. That pattern has a name, and therapy with real evidence behind it. No diagnosis needed to start.
Not a character flaw. A pattern with a history.
These are the experiences people describe when they come to us about emotional intensity and relationships. You do not need all of them, and you do not need a diagnosis, for this page to be about you.
- Feelings arrive at full volume, and take far longer to come back down than they seem to for other people.
- Relationships run hot and cold: intensely close, then suddenly unbearable, sometimes in the same week.
- A small sign that someone is pulling away can feel like the floor going out from under you.
- You have been called too much, too sensitive, or too intense, often by people you love.
- Who you are seems to change depending on who you are with, and you are not sure which one is real.
- When the pain peaks, you do things that help for an hour and cost you for a week.
- Emptiness that is not quite sadness sits underneath, even on days that go well.
- You have had therapy before for anxiety or depression, and it helped a little, and the pattern stayed.
Not sure where to start? The Mind Health Check takes about ten minutes and points you to the right next step. If things feel urgent right now, our urgent help page has the numbers you need.
Five dials, not ten boxes.
The current international classification stopped sorting people into types and now describes five traits that everybody has, to some degree. It fits how this actually presents. The useful question becomes not which one am I but how far up is this dial, and what is it costing me.
Emotional intensity
negative affectivityFeelings arrive fast and at full volume, and take longer to come down than they seem to for other people. Anxiety, anger, shame and low mood are all part of this one dial, which is why they so often travel together.
Distance
detachmentPulling back from people, and sometimes from your own feelings. It can look like being reserved or self-sufficient from outside, and feel like flatness or absence from inside.
Acting on the moment
disinhibitionDoing the thing that helps right now at the cost of the thing you wanted. Impulsivity, difficulty finishing what you start, and a plan that never survives contact with a bad day.
Control and perfectionism
anankastiaHolding yourself and everyone else to a standard that leaves no room to move. It usually feels like the responsible option, and costs flexibility, time and closeness.
Hardness
dissocialityFinding other people’s feelings hard to weigh against your own, and treating relationships as transactions. The least comfortable of the five to read about, and worth naming honestly.
Nobody is high on all five, and being high on one is not a disorder. It becomes one only when the pattern is long-standing, runs across your life rather than one relationship, and costs you things you want. For the diagnostic version, with every named condition, see personality disorders.
Two therapies with real evidence. And an assessment before either.
Personality patterns are not treated with generic counselling. There are specific, structured approaches for this, and which one suits you depends on what the pattern is doing and how long it has been there.
Assessment first, always
Two to three sessions to understand the pattern, its history and what it is costing you, before anyone recommends a therapy. You leave with a formulation you can read, not a label.
Dialectical Behaviour Therapy
Skills for the moment the feeling peaks: distress tolerance, emotion regulation, and how to stay in a conversation that is going badly. DBT has the strongest evidence base for borderline personality difficulties.
Schema Therapy
Works on the beliefs underneath (abandonment, defectiveness, mistrust) that formed early and still run the pattern. Slower than skills work, and it changes the thing that keeps regenerating the problem.
Safety, if safety is the issue
If self-harm or suicidal thinking is part of this, that is addressed first and directly, with a plan you help write. It is not a reason to be turned away. It is a reason to start.
Both approaches are also useful without a diagnosis. Read more about DBT and Schema Therapy. Or, if you want the diagnostic picture with every named condition, personality disorders.
The first three sessions, honestly.
Nobody decides what therapy you are having until we both understand the pattern.
- 1
You tell it your way
The first session is yours. No questionnaire battery and no rushing to a category. Just what has been happening and what you want to be different.
Session 1 - 2
We map the pattern together
Where it started, what sets it off, what it protects you from, and what it costs.
Sessions 2–3 - 3
You choose the approach
Your psychologist explains what DBT and Schema Therapy would each involve for your pattern, including how long. You decide. You can change your mind later.
From session 3
You will know the cost before you attend.
This kind of therapy usually runs longer than a short course of CBT, so the funding question matters more. We will be straight with you about it at the start, not at session ten.
See fees- Medicare rebates apply with a Mental Health Treatment Plan from your GP.
- NDIS and private health are both accepted where your plan or policy covers psychology.
- No referral needed to book. A plan only changes what you pay, not whether you can come.
More ways we can help.
Check in with yourself.
Free, private tools to try before or alongside sessions. They are not a diagnosis.
Free · 5 to 10 min
Take the Mind Health Check
Short questionnaires, scored privately in your browser. We have ticked the ones most related to this page, and you can change them.
Fact sheet: Emotional regulation
A plain-language guide with practical steps. Free to download.
Try this week
- Notice strong feelings and name them before acting on them.
- Use a pause: count to ten or step away when emotions surge.
- Keep a short list of people and things that help you feel steady.
Need help now? Our urgent help page has who to call, day and night.
Things people ask before they book
Do I need a diagnosis to come?
No. Most people who come to us for this have never been given a formal diagnosis, and many do not want one. DBT and Schema Therapy work on the patterns themselves, not on a label. If a diagnosis would be useful to you, for a workplace, a plan or your own understanding, we can talk about it. If it would not, we do not need one to start.
Is this the same as being told I'm difficult?
No. Patterns like intense emotion, fear of abandonment and unstable relationships almost always develop for good reasons. Often they began as ways of coping that made complete sense at the time and now cost more than they give. Therapy for this is not about character, and it is not about being fixed. It is about learning skills that were never taught, and unpicking beliefs formed a long time ago.
How long does this take?
Longer than therapy for a single problem like a phobia. Schema Therapy and DBT are usually measured in months rather than weeks, because they work on long-standing patterns rather than recent symptoms. At the end of the assessment your psychologist will give you a realistic picture, not a number pulled from the air, and you can stop at any point.
Is borderline personality disorder treatable?
Yes. BPD has one of the better evidence bases in psychology for structured therapy, and the long-term outcome research is more hopeful than its reputation suggests: most people improve substantially over time. It is not a life sentence, and it is not a description of who you are.
What if I've tried therapy before and it didn't work?
Common, and worth saying out loud in the first session. Therapy aimed at anxiety or depression often helps a little and leaves the underlying pattern untouched. That is exactly what you would expect if the pattern is what is driving the symptoms. Tell your psychologist what was tried and what happened; it is useful information, not a mark against you.
Can I use a Mental Health Treatment Plan?
Yes. A Mental Health Treatment Plan from your GP gives you a Medicare rebate on individual sessions. We will tell you the exact out-of-pocket cost before you attend (see fees and rebates).
Is telehealth suitable?
Can my family or partner get support?
There’s a name for it, and help for it.
Tell us what’s going on and we’ll match you with a psychologist who works with emotional intensity and relationships, usually after a free triage. No referral needed to begin.
