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What is RO DBT and Why is it so Exciting

By September 20, 2018November 16th, 2018Adult Counseling, Dr. Beatriz Mann, Teen Counseling

RO DBT is an evidence-based therapy that actually transcends diagnoses, that is to say, it tackles a set of characteristics rather than a label or code.

Some might read this and think, “Well, aren’t the diagnoses/codes/labels there for a reason?” Of course, they are.  However, RO has researched a set of characteristics or traits that underlie some people’s behaviors that can lend themselves to the development of more severe and hard-to-treat disorders, like chronic depression, anorexia nervosa, and obsessive-compulsive personality disorder.  People who struggle with these disorders may have tried other treatments and found little success. Perhaps because, at the heart, these “traits” have not been fully understood or processed!  RO has created a treatment that gets to the core of these traits that can maintain or reinforce certain mental health issues.

What is RO DBT and Why is it so Exciting

Tell me about these “traits”?

RO targets a set of characteristics defined as overcontrol (OC).  OC goes beyond what we commonly think of when we talk about self-control.  We all generally benefit from a bit of self-control in our lives: to avoid impulses or delay gratification for a larger goal.  It is a quality that is often linked with success. This quality is frequently valued in most workplaces, even in greater society. At this point, you might be thinking, “So what’s the problem? Aren’t those all good things?”  Yes, there are aspects of self-control and even overcontrol that are very helpful and are, inherently prosocial. People with these traits tend to be the movers and shakers of the world. The people that – for lack of a better term – give a damn.  

And at the same time, being OC can become problematic when it starts to impact your life, more specifically your ability to connect with those around you. Essentially, maladaptive OC behaviors are not sustainable. RO proposes that when self-control goes too far and breaches into the world of maladaptive overcontrol (OC) it can lead to feeling alone and isolated, having difficulty interacting with others, ultra-perfectionism, rigidity, avoid risks, being emotionally shut off from others, which can lead to more severe mental health issues.   

RO states there are 4 things people with maladaptive OC struggle with:

A high sense of threat, which leads to a low level of openness.

People with OC look around and see “threat threat threat”. This makes them more likely to avoid anything that might bring uncertainty. They are very unlikely to engage in new behaviors, and very wary of feedback from others.

Being perfectionist to a T.

This goes beyond wanting to make sure you get good grades or put your best foot forward at work. OC perfectionism embodies almost a rigid need for structure, rules, and order.  These are people that hold themselves to an incredibly high standard. Both in terms of their work, their sense of social duties, behavior, and moral code.  It is essentially the thinking that there is only one right way for things to be done.   

Low emotional awareness and expression.

People with OC may learn over time to disconnect or hide what they are feeling.  They struggle to express themselves emotionally and they struggle to read the emotions of others. This can be very problematic!  For example, if you are really feeling sad, but end up talking about a sad thing with a bright and cheery disposition, you may not get the support you really need either from yourself or others!

Feeling different from or not connected to others.

Usually, as a result of the first three things on this list, OC people then feel very disconnected from others. Either because they do not feel it is okay to be vulnerable, or they are not able to express their needs. Or because their expectations don’t match the reality of what other people are able to do or give.

So what does RO do that is so different?

Instead of focusing on what is wrong, RO focuses on what is good and healthy in all of us. It focuses on finding the value in seeking out enjoyment, relaxing your ever-firm grip of control, and connected with others to get closer to your longer-term goals. It does this by focusing on 3 things.

  1. Openness: Being open to new experiences AND potentially uncomfortable feedback, so that we may learn. At the heart, it means that as humans, we are fallible AND that is okay.
  2. Flexibility: Finding a way to be flexible in our control, so that we can be flexible within our own environment.
  3. Finding our tribe: Working to connect with other people, to find our tribe because we were not built to stand alone.

If you read through this list and found yourself cringing or feeling uncomfortable by these goals, then chances are they may be the very things that might be helpful!  If you feel as though you are struggling with aspects of overcontrol, please give us a call so that we can connect and see how our clinicians at Integrated Care Clinic can help you start your journey towards openness and connectedness!

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Dr. Mann is a licensed psychologist that specializes in healthy coping, college adjustment, anxiety, personal identity, balance, and mindfulness.

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