Many clinicians and clients alike have heard of the treatment Dialectical Behavior Therapy (DBT), developed by Marsha Linehan, PhD to help those who struggle with impulsive behavior, emotion dysregulation, and unstable/chaotic interpersonal relationships.
This treatment has been considered highly effective for many conditions and personality styles. It has been integral in the work I have done professionally with clients dealing with eating and mood concerns. However, throughout the years, I have encountered a number of clients that reported that DBT did not apply to them because emotion regulation and distress tolerance were not skills they struggled to employ. Both were skills they actually over-implemented.
Fortunately, Tom Lynch, PhD., and his colleagues realized that there is a population out there that actually has “too much of a good thing”, too much self-control and too much self-regulation. A treatment was needed to help these individuals regulate less and engage in open expression more. Whereas DBT helps individuals manage impulsivity and externalizing behavioral or emotional undercontrol (UC), Radically Open Dialectical Behavior Therapy (RO-DBT) was developed to treat disorders of emotional overcontrol (OC).
RO-DBT is transdiagnostic, which means its emphasis is less about diagnosis and more about temperament. RO-DBT considers temperament to be on a bell curve. In the middle of the bell curve, we have what we consider flexible control or an optimal ability to adapt to ever changing conditions. Each person’s temperament is different based on their genetics, upbringing, and how they have learned to cope through the years. Some people experience higher degrees of overcontrol than others.
While excessive self-control is highly reinforced and desired in our society, it usually comes at a cost. Overcontrol can impact a person’s ability to express their emotions to others. They are often rule bound and rigid, and live by a set (or sets) of rules to maintain order and predictability. They often seem “together” and are often labeled as “perfectionists” and “over achievers”. Yet, despite these highly sought after qualities, these individuals struggle on the inside.
Those who fall into this category may engage in surface level relationships or avoid meaningful connection altogether. People with emotional overcontrol might experience feelings of loneliness and isolation, often leading to serious mental health issues including clinical depression, anxiety, and eating disorders such as anorexia nervosa.
RO-DBT includes both individual and skills class treatment aimed at helping the OC individual to:
- Be more receptive to novel or new life experiences, as well as increase one’s ability to take in difficult feedback from others and the environment in order to grow
- Increase one’s ability to respond to ever changing circumstances with flexibility
- Enhance intimacy and social connection with at least one other person
Dr. Lynch considers these three core features to represent psychological health. These features inform what Dr. Lynch refers to as Radical Openness – which encourages us to actively explore “our personal unknown in order to learn from an ever-changing environment”. Radical openness improves relationships because it shows other people that we are willing to take a look at our personal blind spots.
According to Dr. Lynch, “Radical Openness enhances relationships because it models humility and the willingness to learn from what the world has to offer.” RO-DBT teaches a number of skills to bring congruence between affect (emotional expression) with that of internal emotional experience. Doing this increases the likelihood that others will perceive them as trustworthy and will be more likely to welcome them into their tribe. The ultimate aim of RO-DBT is to increase social connectedness thereby reducing social isolation, loneliness, and a number of associated psychological factors.
Lynch, R.T. (2018). Radically Open Dialectical Behavior Therapy: Theory and Practice for
Treating Disorders of Overcontrol. Reno, NV: Context Press, an imprint of New Harbinger Publications.
Lynch, R.T. (2018). The Skills Training Manual for Radically Open Dialectical Behavior
Therapy: A Clinician’s Guide for Treating Disorders of Overcontrol. Revo, NV: Context Press, an imprint of New Harbinger Publications.
(Boone & Buck, 2003; English & John, 2013; Kernis & Goldman, 2006)