What is Radically Open DBT (RO-DBT)

RO-DBT is a new evidence-based treatment developed over the past 20 years by Dr. Thomas Lynch, that targets over-controlled behavior.  Excessive over-control is associated with social isolation and poor interpersonal relations and it contributes to conditions like Chronic Depression, Treatment-Resistant Anxiety, Avoidant, Paranoid and Obsessive Compulsive Personality Disorders, Anorexia Nervosa and Autistic Spectrum Disorders.  ‘Self-control’ is usually seen as a good thing, however too much self-control can cause difficulties.  Over-control is seen as a problem of emotional loneliness – not necessarily lacking contact with others …… but rather a lack of social connectedness with others.

What is Emotional Overcontrol?

Excessive self-control is associated with social isolation, interpersonal problems, and appears to be a major contributor to conditions like chronic depression and anorexia nervosa.  Unlike people whose lack of emotional control benefits from treatment to be less emotionally-driven and impulsive, people who are over-controlled need help learning how to relax overly rigid and inflexible control over their emotions and emotional expression.

What do you learn in RO-DBT?

RO-DBT offers a skills class and individual therapy.  RO-DBT focuses on learning three primary principles:

  1. Openness to feedback, even when this is challenging
  2. Flexibility in responding to challenges in our environment including other’s behavior
  3. Communication of our emotions, recognizing that emotional expression is vital to forming strong close interpersonal relationships

What does the treatment target?

RO-DBT poses that high temperamental threat sensitivity, high temperamental constraint, and low temperamental reward sensitivity transact with early family experiences emphasizing mistakes as intolerable and self-control as imperative.  This can manifest in an overcontrolled coping style that limits opportunities to learn new skills and exploit positive social reinforcers.

Novel strategies are introduced in the treatment, targeting social connectedness and the reduction of unhelpful envy, bitterness, and revenge – including skills designed to activate neural substrates associated with social-safety and desires for affiliation, non-verbal social signaling skills linked to the mirror neuron system and the establishment of trust, forgiveness of self and others, self-inquiry and openness, and breaking down over-learned inhibitory barriers.

Treatment strategies aim to build:

  • Flexible responding to the demands of the moment
  • Emphasis on the importance of authentic emotional expression to build positive interpersonal relationships
  • Self-inquiry into our usual responses
  • Ability to manage unexpected or challenging feedback

A Growing and Robust Evidence Base: RO-DBT is now practiced in the United Kingdom, Europe, and North America and is increasingly recognized as effective for patients who exhibit emotional overcontrol.  The efficacy of RO-DBT has been informed by experimental, longitudinal, and correlational research, including two randomized controlled trials (RCTs) of refractory depression with comorbid Obsessive Compulsive personality dysfunction that provided the foundation of the development of the RO-DBT treatment manual (Lynch et al., 2007; Lynch, Morse, Mendelson, & Robins, 2003), a case series open trial applying Radical Openness skills alone plus standard DBT with adult Anorexia Nervosa patients(Chen, et al., 2015) and one non-randomized trial targeting treatment resistant overcontrolled adults (Keogh et al, in press), while the mechanisms of change and efficacy for treatment of refractory depression and cormorbid OC personality disorders are being investigated via the large multi-site RCT ‘Reframed’ (

How are skills taught?

RO-DBT skills are taught in a traditional classroom format, where the facilitator’s goal is to create a warm, welcoming, and fun learning environment.  Each class begins with a brief exercise, followed by homework review, introduction of new material and homework assignments.

Are you the sort of person who struggles with some of the following: dutifulness, avoids risks and or new experiences, plans ahead, struggles to really connect with others, follows rules, feels unappreciated, struggles to relax and be playful?  If you would like to learn to be more receptive and open, flexible, and socially connected, our RO-DBT class is for you.  This is a 30 week curriculum that meets on Fridays from 12:30 – 3:00pm.  Classes start on Friday, June 29th, 2018 and offers open enrollment.  Cost is $100 per class.  An initial assessment is required.  To learn more about emotional overcontrol and whether RO-DBT may work for you or a loved one, please watch the video.