Radically Open Dialectical Behavior Therapy: A New Treatment Approach
Many people are familiar with Dialectical Behavior Therapy, which began as a treatment modality focused on clients who have received a diagnosis of Borderline Personality Disorder, then expanded to the treatment of other personality disorders, and in general to those experiencing trouble in the arena of impulse control.
Radically Open Dialectical Behavior Therapy addresses the needs of a slightly different population: people whose impulses are overcontrolled, and whose approaches to stress include rigidity, perfectionism, and overinvestment in self-regulation.
One clinician’s overview of the approach, shared on the website of a center treating people experiencing eating disorders, highlights the challenges of emotional overcontrol. She writes, “Individuals who live a life of ‘overcontrol’ are prone to certain mental health issues, including depression, anxiety, dissociation, self-harm and eating disorders.”
The doctor goes on to discuss how emotional overcontrol can, paradoxically, lead to periodical “explosions” of anger or other strong feelings. “Many people who live a life of overcontrol, as outlined above, also exhibit an emotional state coined ‘emotional leakage.’ They tend to hold their emotions in so tightly, and for so long, that eventually the dam must burst. Yelling, insults and other intense displays of emotions can occur.”
This can lead to a backlash, in which the overcontrolled person feels shame and guilt for their emotional outburst and vows to control themselves more rigidly in future. Counterproductive spirals can follow.
A central goal of Radically Open Dialectical Behavior Therapy (RO DBT) is supporting clients in finding more flexible approaches to self-control, and in creating more authentic relationships with others.
A detailed look at the philosophy and practice of RO DBT is available as a fact sheet on the site of the Association for Cognitive and Behavioral Therapies.