What is RO DBT?
RO DBT, or Radically Open Dialectical Behavioral Therapy, is a type of cognitive-behavioral therapy that is often used in the treatment of eating disorders. RO DBT 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 designed to help perfectionists, high achievers, and people who are negatively impacted by extreme control, otherwise identified as overcontrol, which is a common characteristic of eating disorders.
By: Anna Capetola
DBT vs. RO DBT
Dialectical Behavioral Therapy (DBT) is a type of cognitive-behavioral therapy that was first developed in the 1970s by Dr. Marsha Linehan. DBT provides individuals with a set of skills to help reduce conflict in relationships and regulate painful emotions. DBT is used to treat substance use disorders, depression, anxiety, post-traumatic stress disorder (PTSD), borderline personality disorder (BPD), and eating disorders. More recently, there has been a new evidence-based treatment approach that expands on DBT called RO DBT.
RO DBT stands for Radically Open Dialectical Behavior Therapy and it was developed by Dr. Thomas R. Lynch in the early 2000s. This treatment approach was specifically designed to treat individuals with excessive self-control characteristics, also referred to as “overcontrol” (OC) disorders. This includes anorexia nervosa, chronic depression, and obsessive-compulsive disorder (OCD). Given the name, the core principle is radical openness. Radical openness is a behavior and mindset that involves “openness, flexibility, and social connectedness.” This framework models “humility and the willingness to learn from what the world has to offer.” It aims to enhance social-signaling skills and alter neurophysiological arousal.
Self-control vs. Excessive self-control
Generally speaking, we are taught from a young age how to control our urges and emotions in school, at home, and in other environments. Therefore, it is only natural to have some level of self-control. However, having too much control over impulses and emotions all the time can make it difficult for someone to give up control when necessary. As a result of this, individuals who are over-controlled may experience trouble expressing their true emotions, which could potentially increase conflicts in relationships and feelings of loneliness.
How does RO DBT work?
RO DBT includes individual treatment sessions and skills training classes that focus on improving “inhibited and disingenuous emotional expression; hyper-detailed focused and overly cautious behavior; rigid and rule-governed behavior; aloof and distant style of relating; and high social comparison and envy/bitterness.” This is accomplished by concentrating on receptivity and openness, flexibility, and intimacy and social-connectedness.
Receptivity and Openness: For someone who is overcontrolled and ruled by perfectionism, it can be exceptionally challenging to accept feedback and constructive criticism from others. RO DBT highlights the importance of accepting feedback to promote positive change and growth and provides individuals with useful tools to become more receptive and open.
Flexibility: RO DBT aims to increase flexibility as it is essential to adapt from one situation to the next. For instance, we cannot always control the outcome of a situation and RO DBT helps individuals understand and cope with the feelings that arise from experiencing a lack of control, in an attempt to become more flexible and improve quality of life.
Intimacy and Social-Connectedness: RO DBT teaches individuals how to recognize, understand, and express their emotions effectively. The improvement in communication can serve to positively impact connections and relationships with others.
This post was written by BALANCE Social Work Intern, Anna Capetola.
Anna is a second-year graduate student at New York University pursuing her Master’s in Social Work. She completed her undergraduate education at Quinnipiac University, majoring in psychology and minoring in sociology. She previously worked for Vibrant Emotional Health, formerly known as The Mental Health Association of NYC, where she conducted assessments, provided short-term counseling, and offered crisis intervention services to individuals who were struggling with an array of mental health and substance use concerns. Anna also has experience working with the Traumatic Brain Injury population, as well as individuals diagnosed with Alzheimer’s disease and Autism Spectrum Disorder. She is devoted to learning about the mind-body connection, health, and overall wellness. She is deeply passionate about eating disorder awareness and recovery. Anna believes everyone has the right to feel supported, accepted, understood, valued, and cared for.
Resources
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.
Dialectical Behavior Therapy. (n.d.). Retrieved from https://www.psychologytoday.com/us/therapy-types/dialectical-behavior-therapy
History of Dialectical Behavior Therapy: A Very Brief Introduction. (n.d.). Retrieved from https://psychotherapyacademy.org/dbt/history-of-dialectical-behavioral-therapy-a-very-brief-introduction/
Home. (n.d.). Retrieved from https://www.radicallyopen.net/about-ro-dbt/