Radically Open Dialectical Behavior Therapy (RO-DBT) is a major adaptation of DBT with  a very unique theory. 

 

Just like DBT, the foundation of treatment in Radically-Open DBT (RO-DBT) is behavioral principles, a dialectical philosophy, and a focus on learning new skills in all contexts.

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Developed  by Dr. Thomas Lynch,  it has been shown by research to effectively treat emotional over-control.

 

Though self-control is a highly desirable trait, too much self-control is associated with social isolation, poor interpersonal relations & contributes to difficult-to-treat conditions including anorexia nervosa, chronic depression, unremitting anxiety,  and several personality disorders other than Borderline Personality Disorder.

The dialectical opposite of DBT,  RO-DBT focuses on treating an avoidant attachment style characterized by abandoning relationships that involve discomfort.  

Usually however,  typical DBT patients have an anxious attachment style characterized by frantic attempts to avoid abandonment.

 

Since all relationships with depth can involve tension at times, this habit of abandoning relationships means people with over-control issues can end up lonely and disconnected.

 

This habit can also mean that people with over-control issues do not stay in treatment when they experience tension with their therapist even though they may be very unhappy and sincerely desire help.

 

Many people with over-control issues may stop & start treatment repeatedly, leading to a cycle that ultimately leads to a feeling of hopelessness & rejection, even if they have been the one to initiate termination of treatment.

 RO-DBT treatment works to increase a client’s social connectedness through improving social signaling, increasing openness to new situations or experiences, decreasing tendencies to be rigid & rule-driven in behaviors &/or interacting in an aloof manner.

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A key element to treatment in RO-DBT is teaching clients how to relax prior to social interactions so they are better able to communicate and connect with others.  By contrast, DBT focuses on coping skills while in the moment. 

 

Patients are taught to turn off their tendency to highly monitor themselves and rehearse interactions prior to engaging with others, to allow for less inhibited or disingenuous emotional expression.  

 

Patients practice these steps repeatedly during individual sessions, skills classes, & outside of therapy.

Through modeling radical openness, therapists teach an approach to life in which we actively seek the things we want to avoid in order to learn and be able to respond flexibly.

 

There is an emphasis on:

• Self-discovery

• Cultivating healthy self-doubt

• Sharing internal experiences with others in order to increase connection (vulnerable expression of emotion)

• Participating without planning as a way to increase enjoyment

• Learning to engage with people when there are relationship problems to experience how the process of repair can be relationship-enhancing.