Exploring Radically Open Dialectical Behavior Therapy
What Is Radically Open Dialectical Behavior Therapy (RO DBT)?
Dialectical Behavior Therapy (DBT) is a well-known, evidence-based treatment for individuals struggling with emotional under-control—a category that includes conditions like borderline personality disorder and self-harm.
In contrast, Radically Open Dialectical Behavior Therapy (RO DBT) is an innovative, newer therapy developed to address the opposite problem: emotional over-control. This profile often manifests as chronic social isolation, rigidity, or treatment-resistant conditions.
This post will explore the key features of RO DBT, how it differs from traditional DBT, and who it is designed to help.
Understanding Traditional DBT
Traditional DBT was developed by Dr. Marsha Linehan in the late 1980s. It is a cognitive-behavioral therapy that focuses on teaching patients skills in four primary areas:
Mindfulness: Cultivating non-judgmental, present-moment awareness.
Distress Tolerance: Developing healthy ways to cope with emotional distress.
Emotional Regulation: Learning to identify, understand, and manage emotions.
Interpersonal Effectiveness: Building effective communication and relationship skills.
The Emergence of RO DBT
RO DBT, developed by Dr. Thomas R. Lynch, is a transdiagnostic therapy (meaning it applies across multiple diagnoses) designed for issues related to emotional over-control. This includes chronic social isolation, anhedonia (a persistent inability to feel pleasure), and treatment-resistant conditions like obsessive-compulsive personality disorder and chronic depression.
RO DBT emphasizes the importance of:
Psychological flexibility: Encouraging openness to change and new experiences.
Social signaling: Enhancing non-verbal communication to foster social connectedness.
Radical openness: Promoting a curious and non-judgmental stance toward oneself and the world.
Key Differences: RO DBT vs. Traditional DBT
While both share a "dialectical" (acceptance and change) framework, there are crucial differences:
Target Population:
DBT: Designed for emotional under-control (e.g., high emotional volatility, impulsivity).
RO DBT: Designed for emotional over-control (e.g., high inhibition, rigidity, risk-avoidance).
Core Principles:
DBT: Focuses on balancing acceptance and change to build skills.
RO DBT: Emphasizes psychological flexibility, social signaling, and radical openness to increase connection.
Therapeutic Techniques:
RO DBT employs unique strategies, such as self-inquiry, skills for "joining in," and specific social-signaling exercises that are not part of traditional DBT.
View of Social Connection:
RO DBT places a central emphasis on social connectedness as a primary mechanism for well-being.
Who Can Benefit from RO DBT?
RO DBT is suitable for individuals who struggle with emotional over-control, often characterized by excessive self-control, rigidity, and difficulty expressing emotions.
Conditions that may benefit from RO DBT include:
Obsessive-Compulsive Personality Disorder (OCPD)
Treatment-resistant depression or anxiety
Autism spectrum disorder
Anorexia nervosa
Final Thoughts
RO DBT is an innovative therapeutic approach that addresses the unique needs of individuals with emotional over-control. By emphasizing psychological flexibility, social signaling, and radical openness, it offers a distinct and complementary alternative to traditional DBT, expanding the range of treatment options for both mental health professionals and their clients.