Introducing Radically Open DBT:
Why is it helpful to know about emotional under and overcontrol
Most of mental health clinicians, workers, and clients may be familiar with Dialectical Behaivour Therapy (DBT) or have encountered it in some way. Initially developed by Marsha Linehan in the late 1980’s for treating Borderline Personality Disorder. It’s now recognised and validated as a great evidence-based therapy for a number of mental health concerns like depression, anxiety, eating disorders, ADHD, PTSD etc., the list is extensive.
DBT in its original and ongoing form targets thinking patterns, emotions and behaviours associated with emotional dysregulation and overwhelming distress – or broadly speaking concerns with Emotional Undercontrol. But what about the people on the other end of the spectrum? Those of us who rather than finding it difficult at times to cope with emotion, are more likely to over-cope or have excessive self-control? This is referred to as Emotional Overcontrol.
Self-control isn’t necessarily automatically an issue. We all know and admire people who are great at achieving long-term goals, delaying gratification, and acting dutifully or in the service of others. All pretty desirable traits for growing and thriving that are rewarded in our society.
This trait seems to develop early and has been observed in the Marshmallow Study, where children are given a Marshmallow and told that if they wait, and do not eat it, they will receive a second one (personally I don’t think I would have lasted):
Self-control can in the words of Thomas Lynch (developer of RO DBT) can become “too much of a good thing” when it comes with a strong fear of threat. This is when self-control grows into overcontrol and usually results in a subsequent loss of openness to the self, others, and experiences lest they make us feel wrong or faulty.
RO DBT (Lynch, 2018) labels the consequences of emotional overcontrol as:
- Low receptivity and openness – usually to anticipate and reduce the threat of uncertainty or critical feedback
- Low flexible control – a strong need for needs for structure and order or perfectionism
- Inhibited emotional expression and low emotional awareness – an absence or inconsistent emotions with the situation, stillness in face or expression
- Low social connectedness and intimacy with others – seen in aloof or lower connectedness, greater social comparison and in extreme envy, bitterness, competitiveness, or schadenfreude
Why is this important to know the difference?
For therapist and clients alike the concept of over and under control can be helpful in clarifying why someone comes along to therapy, and how best to address the targets. It is also very helpful in understanding and having a language you can both use and refer to when talking about your concerns whether you are utilising either of the therapies or not.
Broadly speaking Standard DBT and RO DBT both target distress. However, in the case of RO-DBT distress is often inside, not expressed to others directly or supressed entirely. Compared to standard DBT where emotion is experienced as out of control and frequently experienced as disinhibited.
RO DBT – How Overcontrol is treated
Often those of us who are more emotionally inhibited or controlled find it more difficult to express genuinely how we feel. This makes it more difficult to get our needs met or connect authentically and therefore although can be socially present can feel emotionally lonely.
In RO DBT treatment emphasises gradually opening oneself up to experiencing emotion, and expressing with others, using control when desirable and being able to be playful or spontaneous (even silly!), and connecting with others to be part of the tribe.
RO DBT proposes three core components (Lynch, 2018) to psychological wellness:
- Receptivity and Openness to new experience and disconfirming feedback in order to learn
- Flexible-control in order to adapt to changing environmental conditions
- Intimacy and social-connectedness (with at least one other person) based on premises that species survival required capacities to form long-lasting bonds and work in groups
Borrowing from standard DBT and informed by Polyvagal Theory (Stephen Porges) RO DBT emphasises the connection between social safety and emotional regulation but suggests we all have a need for both familiarity and new experiences.
RO DBT (Lynch, 2018) has three core ways of doing this:
- Dialectics – playfulness and connection vs. compassionate gravity (or seriousness)
- Radical openness – curiosity about my internal state and others, no one right way and connection to our tribe
- Self-enquiry – healthy self-doubt in order to learn
RO DBT takes the approach that to reduce the urge for control we need to feel safe, but for us to feel safe we also need to take a risk (e.g., trying something, sharing true feelings) to learn that we can be okay even in the face of imperfection.
If you want to know more…
- You can check out the RO DBT skills training manual which has all the information on overcontrol in greater detail and some of the skills: Lynch, T. R. (2018). The Skills Training Manual for Radically Open Dialectical Behavior Therapy: A Clinician's Guide for Treating Disorders of Overcontrol. New Harbinger Publications.
- The Hummingbird Centre is also hosting an Introductory Workshop Webinar with Hope Arnold, LCSW, MA on 27th April 2022 8am - 11am (AEST) which will give an overview of RO DBT, assistance to identify suitability for clients, and if it’s a therapy that might be worth learning to implement in your practice with further learning.
Author: Gabriel Heaton
Clinical Psychology Registrar
Available Workshop:
