Radically Open Dialectical Behavioral Therapy: A New Wave in Mental Health Treatment

Written by: Kelsey Esser, MSW, LCSW

Mental health treatments are continuously evolving, with new therapies emerging to address the diverse needs of individuals.

One such innovative approach is Radically Open Dialectical Behavioral Therapy (RO-DBT). This therapeutic modality, a derivative of traditional Dialectical Behavioral Therapy (DBT), has a unique approach to treating disorders characterized by excessive self-control. This blog post delves into the core principles, applications, and benefits of RO DBT, shedding light on why it represents a significant advancement in mental health care.

Radically Open Dialectical Behavioral Therapy was developed by Dr. Thomas Lynch and his team as an adaptation of DBT, originally designed by Dr. Marsha Linehan for individuals with borderline personality disorder (BPD). While traditional DBT focuses on managing intense emotions and impulsivity, RO DBT targets the opposite end of the spectrum—those struggling with overcontrol.

The Concept of Overcontrol

Over control is often explained as having “too much of a good thing”. While self control is often positively reinforced in our society, having too much self control can start to become a hindrance to psychological flexibility. Overcontrol is characterized by excessive self-discipline, perfectionism, and emotional inhibition. Individuals with overcontrolled tendencies often appear highly organized, conscientious, and detail-oriented but may suffer internally from chronic loneliness, rigidity, and a lack of spontaneity. Disorders commonly associated with overcontrol include anorexia nervosa, chronic depression, obsessive-compulsive personality disorder, and certain anxiety disorders.

Core Principles of RO DBT

RO DBT is grounded in three overarching principles:

  1. Radical Openness: RO DBT prioritizes openness and flexibility. Radical openness involves being receptive to new experiences and perspectives, even when they challenge deeply held beliefs or behaviors. This principle encourages individuals to embrace vulnerability and uncertainty as opportunities for growth.

  2. Self-Enquiry: This principle involves a deep, introspective examination of one's thoughts, emotions, and behaviors. Self-enquiry helps individuals understand the underlying motivations and fears driving their overcontrolled tendencies. Through guided reflection and mindfulness practices, clients learn to identify and challenge rigid patterns of thinking and behavior.

  3. Social Signaling: RO DBT places a strong emphasis on the role of social signals in emotional regulation and interpersonal relationships. Social signaling refers to the nonverbal cues we send and receive during interactions, such as facial expressions, body language, and tone of voice. By improving their ability to send and interpret these signals, individuals can enhance their social connectedness and reduce feelings of isolation. 

Key Components of RO DBT

Individual Therapy

RO DBT includes individual therapy sessions. These sessions provide a personalized space for clients to explore their unique challenges and progress. Therapists and clients utilize diary cards to track thoughts, emotions and behaviors that may not be aligning with the client’s valued goals. This allows the therapist and client to increase awareness and understanding of patterns that may be reinforcing overcontrolled ways of coping. Therapists use a combination of validation, guidance for self-enquiry and skills integration and to help clients apply RO DBT principles in their daily lives. Individual therapy also allows for a deeper exploration of personal histories and traumas that may contribute to overcontrol.

Skills Training Class

Weekly skills training class is another integral component of RO DBT. These classes provide a supportive environment where clients can learn and practice new skills. The group setting also facilitates social learning and helps reduce feelings of isolation. This is a structured class that includes a mindfulness practice, homework review and a new skill taught each week. All of the skills are designed to increase flexibility, oppress and connectedness.

Applications and Benefits of RO DBT

Treating Overcontrolled Disorders

RO DBT has shown promise in treating a range of disorders characterized by overcontrol. These include:

  • Anorexia Nervosa: RO DBT addresses the rigid control over food intake and the perfectionistic tendencies often seen in individuals with anorexia.

  • Chronic Depression: For individuals with chronic depression, RO DBT helps break the cycle of emotional inhibition and social withdrawal.

  • Obsessive-Compulsive Personality Disorder (OCPD): RO DBT targets the perfectionism and inflexibility that define OCPD, promoting more adaptive ways of thinking and behaving.

  • Anxiety Disorders: RO DBT can be effective for certain anxiety disorders where overcontrol and avoidance play a significant role.

Enhancing Emotional Well-being

Beyond its applications in treating specific disorders, RO DBT offers broader benefits for emotional well-being. By fostering radical openness and flexibility, individuals can experience: 

  • Increased Emotional Resilience: RO DBT helps individuals develop the skills to navigate life’s challenges with greater adaptability and resilience. 

  • Improved Relationships: Enhanced social signaling and connectedness lead to more fulfilling and supportive relationships. 

  • Greater Life Satisfaction: By embracing new experiences and perspectives, individuals can cultivate a richer and more satisfying life.

Conclusion

Radically Open Dialectical Behavioral Therapy represents a groundbreaking approach to mental health treatment. By addressing the unique challenges of overcontrol, RO DBT offers a pathway to greater emotional well-being, improved relationships, and a more fulfilling life. As mental health professionals continue to explore and refine this innovative therapy, it holds the potential to transform the lives of countless individuals struggling with overcontrol and its associated disorders.

 

Learn more about our Radically Open Dialectical Behavioral Therapy program!

All of our therapists have been extensively trained by Dr. Thomas Lynch, the developer of RO-DBT, and participate in an ongoing weekly Consultation Team to ensure quality treatment to our participants.

Contact us to get started.

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