Saturday, October 19, 2019

Radically Open DBT

"Radically Open Dialectical Behavior Therapy (RO DBT) is a new evidence based treatment targeting a spectrum of disorders characterized by excessive self control, often referred to as overcontrol (OC)It is supported by 20 years of clinical experience and translational research that parallels established guidelines for treatment development (e.g., UK Medical Council, 2008; Rounsville & Carroll, 2001; 2006). You can read more about RO-DBT on the ABCT website: RO DBT Fact Sheet."

"Maladaptive overcontrol is characterized by four core deficits:


  • Low receptivity and openness: manifested by low openness to novel, unexpected, or disconfirming feedback, avoidance of uncertainty or unplanned risks, suspiciousness, hyper-vigilance for potential threat, and marked tendencies to discount or dismiss critical feedback.
  • Low flexible-control: manifested by compulsive needs for structure and order, hyper-perfectionism, high social obligation and dutifulness, compulsive rehearsal, premeditation, and planning, compulsive fixing and approach coping, rigid rule-governed behavior, and high moral certitude (e.g., there is only one right way of doing something).
  • Pervasive inhibited emotional expression and low emotional awareness: manifested by context inappropriate inhibition of emotional expression (e.g., exhibiting a flat-face when complimented) and/or insincere or incongruent expressions of emotion (e.g., smiling when distressed, showing concern when not feeling it), consistent under-reporting of distress, and low awareness of body sensations.
  • Low social connectedness and intimacy with others: manifested by aloof and distant relationships, feeling different from other people, frequent social comparisons, high envy and bitterness, and reduced empathy."




Undercontrolled (UC)
Emotionally Dysregulated and Impulsive

  • Borderline PD Borderline Personality Disorder is characterized by emotional instability, intense interpersonal relationships, and impulsive behaviors.
  • Antisocial PD Antisocial Personality Disorder tends to show up in childhood, unlike most other personality disorders that don't appear until adolescence or young adulthood. Symptoms include a disregard for rules and social norms and a lack of empathy for other people.
  • Narcissistic PD Narcissistic Personality Disorder is associated with self-centeredness, exaggerated self-image, and lack of empathy for others.
  • Histrionic PD Histrionic Personality Disorder features a need to always be the center of attention that often leads to socially inappropriate behavior in order to get attention. People with this disorder may have frequent mood swings as well.
  • Binge-Purging Eating Disorders
  • Conduct Disorders
  • Bipolar Disorder
  • Externalizing Disorders


Overcontrolled (OC)
Emotionally Constricted and Risk-Averse

  • Obsessive Compulsive PD Obsessive-Compulsive Personality Disorder is characterized by a preoccupation with orderliness, perfection, and control of relationships. It's not the same as obsessive-compulsive disorder (OCD).
  • Paranoid PD Paranoid Personality Disorder affects between 1 percent and 2 percent of adults in the U.S. Symptoms include chronic, pervasive distrust of other people; suspicion of being deceived or exploited by others, including friends, family, and partners; angry outbursts in response to deception; and cold, secretive, or jealous behavior.
  • Avoidant PD Avoidant Personality Disorder can show up during childhood. It's characterized by a disregard for rules and lack of empathy and remorse.
  • Schizoid PD Schizoid Personality Disorder is characterized by social isolation and indifference toward other people. It affects more men than women. People with this relatively rare disorder often are described as cold or withdrawn, rarely have close relationships with other people and may be preoccupied with introspection and fantasy.
  • Anorexia Nervosa
  • Chronic Depression
  • Austism Spectrum Disorders
  • Treatment Resistant Anxiety-OCD
  • Internalizing Disorders