What is RO DBT?
RO DBT stands for Radically Open Dialectical Behavioral Therapy. RO DBT is a new evidence-based treatment approach that has been proven to help those with chronic depression, treatment-resistant anxiety, anorexia nervosa, and a spectrum of disorders characterized by excessive self-control. It is taught through a series of classes and is designed to help perfectionists, high achievers, and people who are negatively impacted by extreme control, otherwise identified as overcontrol (OC).
by: Megan Madsen
How Does RO DBT Work?
Radically Open Dialectical Behavior Therapy (RO DBT) was created by Dr. Thomas R. Lynch and is intended to help clients with especially difficult-to-treat overcontrol disorders. This approach builds on the principles of traditional Dialectical Behavior Therapy (DBT). Developed by Marsha Linehan, Ph.D., DBT is a psychotherapy treatment that was developed to treat chronically suicidal individuals diagnosed with borderline personality disorder (BPD).
The primary attributes of overcontrol (OC) personality disorders are:
strong desire to have total control over one’s environment and circumstances
repressed emotional expression
limited social interaction and problems with intimate relationships due to avoidant attachment tendencies
skepticism and fear of rejection or criticism
cognitive and behavioral rigidity
RO DBT differs from other treatment methods in that the focus is on correcting the underlying overcontrol behaviors through a set of specialized classes, as opposed to concentrating on diagnosis alone. Dr. Lynch gives the following example of overcontrol in eating disorders: “By conceptualizing restrictive and ritualized eating as symptoms or consequences stemming from rigid maladaptive overcontrolled coping based on research showing that overcontrol coping preceded the development of the eating disorder.”
How is Overcontrol Characterized?
In our society, individuals are praised for their capacity to maintain a high level of self-control. From a young age, we are exposed to the concept of “perfectionism,” which is utterly unattainable. Some may appear to thrive on their pursuit to perfection, however, internally, it is an incredibly difficult, lonely endeavor.
Some characteristics of overcontrol are; being extremely detail-oriented, having trouble moving on from mistakes, avoiding risks and spontaneity, not liking new things or experiences, having a high sensitivity to feeling threatened, not easily impressed by rewards or compliments, and excessive planning. These behaviors resonate most notably in people with eating disorders, namely anorexia nervosa. Overcontrol of appearance, isolation from others, and fixation on restricting foods serve as numbing agents from stressors or troubles and are easily concealed behaviors.
People with overcontrol personality disorders do not exhibit obvious symptoms of overcontrol superficially. In fact, they constantly hold in their emotions until a particular occurrence triggers them to spill out. RO DBT can help individuals address and manage these behaviors with the skills taught in the class.
What Does Treatment for Overcontrol Consist of?
Radically Open Dialectical Behavior Therapy concentrates on three specific areas to help improve the quality of life for overcontrolled individuals. Dr. Ellen Astrachan-Fletcher describes these treatment interventions below:
Receptivity and Openness — RO DBT helps individuals become more receptive to feedback; feedback and constructive criticism can be difficult for perfectionists to acknowledge; those with a high sense of control find feedback to be quite threatening. Yet, we cannot learn and grow unless we are open to feedback. Also, most people do not like those they perceive as close-minded or as “know it all’s.”
Flexibility — RO DBT helps those with overcontrol develop a sense of flexibility — a key to living a full life: life itself requires adaptability because our behavior in one situation might not be appropriate in another situation; we certainly can’t control everything — and trying to do so will inevitably lead to internal strife.
Intimacy and Connectedness — RO DBT teaches emotional recognition and emotional expression — these are important skills often lacking in people who are overcontrolled; these skills help us facilitate healthy and rewarding relationships.
References:
1. Astrachan-Fletcher, E. (2018, February 8). Radically Open DBT: A Therapy to Ease a Life of Control – Dr. Ellen Astrachan-Fletcher. Retrieved 2019, from https://www.eatingrecoverycenter.com/blog/february-2018/radically-open-dbt.
2. Lynch, T. R. (2018, August 24). The Skills Training Manual for Radically Open Dialectical Behavior Therapy: A Clinician's Guide for Treating Disorders of Overcontrol Interview. Retrieved 2019, from https://www.edcatalogue.com/skills-training-manual-radically-open-dialectical-behavior-therapy-clinicians-guide-treating-disorders-overcontrol-interview/.
3. Tsangarides, L. (2018, July 8). Dialectical Behavior Therapy: For More Than Borderline Personality Disorder. Retrieved from https://psychcentral.com/blog/dialectical-behavior-therapy-for-more-than-borderline-personality-disorder/.
This post was written by Megan Madsen.
Megan is currently working toward receiving her B.S. in Psychology. She is a Certified Nursing Assistant with a passion for eating disorder research and education. Megan has worked as a CNA on several units in a hospital setting and as a Psych Tech at an eating disorder treatment center. It was there that she discovered her passion for helping those afflicted with eating disorders and where her desire for educating patients and the community on eating disorders and mental illnesses began. In the future, she hopes to work as a Clinical Psychologist with a focus on eating disorder treatment.