RO DBT – Treating Loneliness

Radically open dialectical behavior therapy (RO DBT) is an evidence-based treatment targeting disorders of excessive self-control, or overcontrol (OC). It is intended for treatment of chronic problems such as treatment-resistant depression, anorexia nervosa, and obsessive-compulsive personality disorder. Radical openness (RO) is the core philosophical principle and the core skill of RO DBT, and loneliness is viewed as the core problem for people suffering from emotional overcontrol.

What is emotional overcontrol?

Self-control (the ability to inhibit urges, impulses, behaviors, or desires, and delay gratification in order to pursue long-term goals) is often equated with life success and happiness. However, too much self-control can be problematic. Overcontrol has been linked to social isolation, poor interpersonal functioning, perfectionism, rigidity, risk aversion, lack of emotional expression, and the development of severe and difficult-to-treat mental health problems.

Priorities in treating overcontrol:

Overcontrolled individuals are more likely to benefit from treatment approaches that prioritize the value of seeking pleasure, relaxing control, and joining with others over approaches that prioritize emotion regulation, problem solving, and tolerating distress. In RO DBT, clients are encouraged to directly and openly express themselves in a context-appropriate manner and join in more often with others. The heart of the matter for overcontrolled individuals is that they end up feeling extremely lonely and isolated, and they need skills to help them rejoin the human tribe. In RO DBT, open expression and engagement lead to trust, which then leads to greater social connectedness and psychological well-being.

-Noah Lankford, Psy.D.