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  • Radically Open Dialectical Behavior
    Therapy (RO DBT)

    What Is RO DBT?

    Radically Open Dialectical Behavior Therapy (RO DBT) is an evidence based treatment developed specifically for problems of overcontrol. Radical openness is the core philosophical principle and core skill in RO DBT. The term “radical openness” means there are three important aspects of emotional well-being: openness, flexibility, and social connectedness. 

    Radically Open Dialectical Behavior Therapy (RO DBT) is a type of cognitive behavioral therapy developed by Dr. Thomas R. Lynch for disorders of overcontrol. Excessive self-control or overcontrol is a type of personality or coping style that can be identified in early childhood and can result in poor interpersonal functioning, social isolation and severe mental health problems, such as chronic depression, anorexia nervosa, autism spectrum disorders,, and obsessive-compulsive personality disorder (not OCD, related to control and perfectionism).

    Individuals who utilize overcontrolled coping are generally serious about life, set high personal standards, work hard, behave appropriately, and frequently will sacrifice personal needs in order to achieve desired goals or help others; yet inside they often feel “lost or clueless” about how to establish intimate bonds and join in with others.

    Overcontrol works well in situations such as sitting quietly at a desk and writing computer code; but it creates problems when it comes to social connections.

    RO DBT believes that “facts” and “truth” can often be misleading because we “don’t know what we don’t know,” life is constantly changing, and there is so much that influences us that we are unaware of. Radical openness involves a willingness to  create a healthy self-doubt or question ourselves and our convictions without falling apart. It helps to build relationships because it models the willingness to learn from what the world has to offer and to learn that we do not have all of the answers.

    How is RO DBT Different?

    RO DBT differs from other treatments by focusing on helping with deficits in social-signaling that reduce social connectedness. Social signals are any behaviors a person exhibits in the presence of another person; whether intentional or unintentional (sometimes a yawn is just a yawn) or conscious awareness (for example, an involuntary sigh). We are always socially signaling when around others (for example, via body movements, and tone of voice), even when we are deliberately trying not to (silence can be just as telling as nonstop talking).

    Overcontrolled individuals see new or unfamiliar situations as anxiety provoking, rather than rewarding, due to biological-temperamental differences and social/historical learning experiences. Their tendencies to hide expressions of emotion make it harder for others to know their true intentions, something that is needed to form close social bonds. Therefore, RO DBT focuses on indirect, hidden, and constrained social signaling as the main source of emotional loneliness, isolation, and misery over problematic internal experiences (e.g., negative emotions, harsh self-judgment, distorted thinking) and treatment strategies are designed to enhance social connectedness; including new skills to activate areas of the brain associated with the social-safety system and signal cooperation by deliberately changing body postures and facial expressions (e.g. raising eyebrows when stressed), encourage genuine self-disclosure, and break down overlearned expressive inhibitory barriers (via skills designed to encourage playful behavior and candid expression).

    According to RO DBT, when it comes to long-term health, how a person communicates or socially signals their private experience to others and its impact on social connectedness is held in higher regards than what a person feels or thinks inside. When you are lonely it’s hard to feel happy, no matter how much you try to accept or change your circumstances. Revealing intentions and emotions to other people is essential to creating the types of strong social bonds that are the cornerstone of connectedness and belonging. In the long run, we want to share our lives with other people. Essentially, when we feel part of a group, we naturally feel safe and worry less. RO DBT is designed to help emotionally lonely, overcontrolled clients learn how to make this a reality.

    What Are the Components of Outpatient RO DBT?

    Outpatient RO DBT has four components delivered over an average of 30 weeks. The first three components are specific to patients and the final component is specific to the RO DBT therapist. Specifically, the components are:

    1. Weekly individual therapy (one hour)
    2. Weekly skills-training class (2 hours)
    3. Telephone consultation
    4. Therapist participation in RO DBT consultation meetings