What is RO DBT (Radically Open Dialectical Behavior Therapy)?

Radically Open Dialectical Behavior Therapy (RO DBT) is an evidence-based treatment for those who tend to cope with their emotions with excessive self-control. While self-control can be a good thing, research indicates that too much control can impair functioning, especially in social relationships. Those who are overcontrolling have the tendency to struggle with flexibility and changes that are necessary in maintaining a healthy mindset and strong relationships.

RO DBT has helped those who struggle with any or all of the following:

• Delay of gratification
• Rigid behavior
• Generating extreme rules, such as restricting eating
• Difficulty adjusting to changing circumstances
• Avoiding the expression of emotions
• A hyper-focus on perfection and achievement
• Difficulties with intimacy and feeling connection
• Self-injury or suicidal ideation
• Isolation
• Excessive bitterness

RO DBT incorporates crossroads of the essentials for emotional well-being: being open, being flexible, and being socially connected. But RO DBT is more than mindful awareness. It means looking for areas of life that we may find uncomfortable or try to avoid, and treat them as a learning opportunity. It’s important for individuals using RO DBT to purposefully self-inquiry and be comfortable with being wrong, which provides the opportunity to establish stronger social bonds.

How does RO DBT work?

RO DBT is crafted based on strong research that studies the functional facilitation and communication of social connection and building close bonds. The concept is that “bio-temperamental” differences and experience combine to lead those who are overcontrolling to behave in a manner that interferes with the process of forming close bonds, which can result in isolation and distress. Bio-temperament is a genetic and biological precursor that moderates perception and regulation of emotion both pre-consciously and consciously.

The focus is changing social signals, which allows emotional expression to become more appropriate for social contexts. Better emotional expression results in more trust and the desire to interact with others, which increases social connection.

The Problem with Overcontrol (OC)

Individuals who are overcontrolling are usually quite serious about life, and they have high personal standards. They work hard, usually behave appropriately, and sacrifice personal needs to achieve goals or assist others. But people tend to feel like they're missing out on things, and might find it difficult to connect with other groups. Some evidence suggests those with overcontrolling tendencies can have chronic health issues, depression, anorexia nervosa, etc.

Overcontrol is not a single trait; it is a combination of traits that converge. Some will have more traits, or different traits, than others. But many overcontrolled people have a few things in common:

1. They feel lonely and don’t have a sense of belonging. The individual may have many friends, but there is a feeling that none of those friends really understand who they are. There is also the possibility that they feel different from others and tend to avoid any social situation.
2. There is a tendency to mask their emotions. There may sometimes be the tendency to express emotions that aren’t proper in the context of the situation. This may include a flat expression when another is expressing excitement or enthusiasm, not expressing sadness or distress when another is upset, or laughing at something that others may not consider funny.
3. Feedback is difficult, and they are frequently governed by rules. Overcontrolling individuals are hesitant to try new things and are usually closed off to experiences--especially if there is uncertainty and unplanned risks. They have the tendency to have a defensive knee-jerk reaction if they receive critical feedback, or they may avoid feedback altogether to avoid the pain of it.

If overcontrol is not addressed, it often leads to poor interpersonal relationships and difficulties coping with changes in environment and circumstances, which can lead to loneliness, depression, and other similar problems. There is also evidence that those with chronic mental health problems like depression and anorexia nervosa often have untreated overcontrol, which includes cognitive rigidity, a strong need for structure, strong self-criticism, rigid self-expectations, a strong fear of mistakes, excessive control of spontaneous feelings, and maladaptive perfectionism.