What Is Radically Open DBT For Addiction and Mental Health?

Our personalities shape the way we experience and live in the world. Some of us are naturally more emotionally expressive, while other people may tend to hold back their emotions more. They’re important facets of our internal makeup, helping us connect and communicate with others, stay grounded, and navigate life’s challenges. Someone who has a healthy level of emotional regulation (called under control) is able to openly express their feelings, manage negative emotions, and enjoy attention from others. Others may need therapies such as dialectical behavior therapy and its variant, radically open DBT, to help control their emotions.  

When issues with mental health or substance abuse come into play, these emotional qualities have a tendency to become amplified. Emotional dysregulation can cause someone to have trouble regulating their emotions, resulting in unpredictable or erratic behavior. 

Others may lean heavily on what’s called emotional overcontrol, an excessive form of self-regulation marked by being overly cautious, reserved and suppressing their emotions, which can lead to problems forming and maintaining interpersonal relationships. 

Mental health therapies like dialectical behavioral therapy (DBT) have proven effective time and again for treating emotionally dysregulated conditions, but what about emotionally overcontrolled issues? Another version of DBT, radically open DBT, is designed to “open up” deeply ingrained habits of restraint and avoidance in people who struggle with emotional overcontrol. But how does it work? 

What Is Radically Open DBT? 

Radically open DBT is an evidence-based therapeutic approach designed to help people who struggle with the symptoms of emotional overcontrol.  

Why is radically open DBT necessary? Although the self-control and perfectionist qualities, risk avoidance, and emotional restraint inherent to an emotionally overcontrolled person may serve them well in certain contexts, they can also lead to being emotionally inflexible, detached, socially isolated, and having difficulty adapting to situations. 

Radically open DBT is a newer psychotherapy and was developed within the last decade by Dr. Thomas Lynch. It’s been used by therapists to treat a range of difficult-to-treat mental health problems and conditions where emotional overcontrol is dominant, such as anorexia nervosa, autism spectrum disorders, chronic depression, and obsessive-compulsive issues related to perfectionism, orderliness, and control, notes the Association for Behavioral and Cognitive Therapies (ABCT). 

What Is Dialectical Behavior Therapy? 

Cognitive behavioral therapy, or CBT, is a popular type of talk therapy that effectively treats substance use and mental health disorders for its ability to help people understand and reconcile how their thoughts may adversely affect their behaviors.  

DBT is an outgrowth of CBT and was adapted to help people who experience overly intense emotions or emotional dysregulation. “Dialectical” means to combine opposite ideas, mainly referring to the notion of embracing change and acceptance. While DBT utilizes the same principles of changing unhelpful thoughts, it focuses on teaching mindfulness to the present moment, awareness and acceptance of one’s emotions, and emotional distress tolerance, among other tools, to better manage one’s emotions during difficult moments. 

DBT is mainly used to therapeutically treat under-controlled disorders such as borderline personality disorder, bipolar disorder, post-traumatic stress disorder, anxiety and depression, and substance abuse and addiction issues.  

Radically Open DBT vs DBT: What’s the Difference? 

While radically open DBT and traditional DBT share some foundational elements, they do differ somewhat in their focus and approach, according to the ABCT: 

Who it’s for: 

• RO DBT: Designed for overcontrolled people suffering from conditions like chronic depression, OCPD, anorexia, and autism spectrum conditions. 

• Standard DBT: Designed for uncontrolled individuals struggling with BPD, substance use, bipolar disorder, and others. 

Core focus: 

• RO DBT: Social connectedness, improving emotional expression and flexibility. 

• Standard DBT: Emotion regulation, improving impulse control and distress tolerance. 

Therapeutic approach: 

• RO DBT: Encourages self-inquiry, playfulness, and radical openness to challenge rigid beliefs. 

• Standard DBT: Uses structured skills training to manage intense emotions and reduce self-destructive behaviors. 

Mindfulness style: 

• RO DBT: Informed by Malamati Sufism, it promotes radical openness, encouraging a flexible mind and relaxing mental rigidity. 

• Standard DBT: Influenced by Zen Buddhism, DBT emphasizes radical acceptance, encouraging the development of a wise mind and accepting reality to reduce suffering. 

What Is Emotional Overcontrol?  

Radically open DBT “emerged as a novel treatment approach for those presenting with excessive or maladaptive overcontrols,” notes a 2024 clinical study. But what is overcontrol, exactly? 

“Excessive self-control or overcontrol is a type of personality or coping style that can be identified in early childhood and can lead to social isolation, poor interpersonal functioning, and severe and difficult-to-treat mental health problems,” says the ABCT.  

“Overcontrol has been linked to social isolation, aloof and distant relationships, cognitive rigidity, high-detailed, focused processing, risk aversion, strong needs for structure, inhibited emotional expression and hyper-perfectionism,” notes Dr. Lynch in a 2015 study. 

Indeed, many people with an overcontrolled emotional style may tend to suppress emotional expression, avoid vulnerability and prioritize self-discipline or perfectionism. On the surface, these may sound like a useful set of positive qualities, but they can lead to misunderstandings with other people and prevent someone from connecting socially or adapting to change. 

This can result in people who overcontrol their emotions facing struggles with loneliness because they suppress feelings and avoid vulnerability, making it harder to form deep connections, notes the ABCT — and as social beings, we rely on emotional expression to build bonds that foster safety and belonging. Radically open DBT helps foster these outcomes by increasing one’s openness and social engagement. 

What Does Radically Open DBT Treat? 

Radically Open DBT for Addiction 

Recovery from drug and alcohol abuse isn’t just about quitting a substance and leaving it at that. Therapies like CBT and DBT aim to get to the heart of why you may drink or turn to drugs, perhaps to self-medicate other underlying mental health issues. If you’re prone to being emotionally overcontrolled, you may display rigidity and perfectionism that may feel like a protective barrier, but it can make it difficult to acknowledge the vulnerability you need to ask for help.  

Radically open DBT for substance abuse aims to break down these barriers and equip you with the tools to embrace the openness needed to confront and shed your addictions and embrace sobriety. 

Radically Open DBT for Mental Health 

In his 2015 research, Dr. Lynch described how radically open DBT can be effective for various mental health conditions where patterns of overcontrol, such as rigid thinking, emotional suppression, and avoidance of social risks, may dominate.

“Radically Open-Dialectical Behavior Therapy is a transdiagnostic treatment designed to address a spectrum of difficult-to-treat disorders sharing similar phenotypic and genotypic features associated with maladaptive over-control-such as anorexia nervosa, chronic depression, and obsessive-compulsive personality disorder,” he writes. It helps you cultivate flexibility, openness, and genuine connection with others. 

Radically Open DBT for Co-Occurring Disorders 

When mental health challenges and addiction occur together, it’s what’s called a co-occurring disorder. According to the Substance Abuse and Mental Health Services Administration’s 2022 National Survey on Drug Use and Health, nearly 21.5 million adults in the U.S. have a co-occurring disorder.  

Following a dual diagnosis and targeted treatment plan, radically open DBT addresses both issues (such as alcoholism and anxiety disorder) by focusing on the underlying behaviors and thought patterns that contribute to emotional overcontrol and its influence on your co-occurring disorder. 

What Are the Core Principles of Radical Open DBT?  

Radical Openness  

“The term ‘radical openness’ means there are three important aspects of emotional well-being: openness, flexibility, and social connectedness,” notes the ABCT.

As the core philosophical principle and core skill behind radically open DBT, radical openness involves approaching your emotions and experiences with curiosity rather than judgmentally — very similar to CBT and DBT. “RO DBT holds that ‘facts’ and ‘truth’ can often be misleading because we ‘don’t know what we don’t know,’ life is constantly in flux, and there is much that influences us that we aren’t aware of,” the ABCT says. 

Self-Enquiry  

“Radical openness involves a willingness to doubt or question ourselves and our convictions without falling apart,” continues the ABCT. “It helps relationships because it models humility and willingness to learn from what the world has to offer.”   

And with radically open DBT, this self-enquiry is made possible because it enables you to explore your thoughts, emotions and behaviors with compassion. By asking questions like “What am I avoiding?”, “Why do I feel the need to control this?”, or “Why do I choose to misuse substances?”, you can uncover the motivations behind overcontrol and begin to shift your perspective. 

Social Connectedness 

Radically open DBT focuses on improving social signaling — subtle behaviors like one’s body language, tone or even silence — that shape social connectedness, often without conscious awareness. The ABCT notes that cultivating these social signals is very important for connecting with others in a more authentic, meaningful way. 

“Overcontrolled individuals see new or unfamiliar (especially social) situations as dangerous, rather than rewarding, due to biological-temperamental differences and social/historical learning experiences,” the ABCT continues. “Their tendencies to hide expressions of emotion make it harder for others to know their true intentions, something that is needed to form close social bonds.” 

Mindfulness Skills  

Overcontrolled people often become overly preoccupied with internal goals or rigid routines. As a result, for example, missing social cues and failing to connect with others can create chronic social isolation that may lead to mental health or substance abuse issues. But through self-inquiry in radically open DBT comes mindfulness. Unlike traditional approaches that focus on inner awareness, it prioritizes awareness of social context. 

“RO DBT involves being able to listen openly to criticism or feedback, without immediate denial (or agreement), and a willingness to experience new things with an open heart, without losing track of one’s values,” notes the ABCT. 

What Is Radically Open DBT Like?   

A radically open DBT program generally includes three main components: 

Individual Therapy  

In a one-on-one session in a private, safe space, you’ll work with a radically open DBT therapist to identify patterns of emotional overcontrol and brainstorm strategies to foster openness with others — ways to be more open and receptive as you go out into the world. To cultivate more social openness and curiosity, therapy encourages taking small social risks for people who are emotionally overcontrolled, like sharing a personal story with someone or using a warmer facial expression instead of a fake smile. 

Skills Classes 

Outpatient, radically open DBT skills classes in a group setting provide a more structured place to learn and practice social techniques in the presence of others looking to develop the same social openness. Increasing self-awareness, improving social signaling,g and becoming more flexible in interactions are some of the key radically open DBT activities taught in group therapy. Unlike traditional DBT, which might emphasize emotion regulation, group therapy helps you loosen rigid control. Practicing in a group setting also allows for real-time feedback mirroring an actual social setting. 

Homework  

Putting radically open DBT skills to the test outside of therapy is your chance to be in charge of making a change in your life. This is the opportunity to apply what you’ve learned in the real world with homework from your therapist encouraging you to try new behaviors, whether it’s making eye contact, expressing appreciation, or engaging in small talk — small steps and radically open DBT activities that can lead to tangible results. Document your progress in a radically open DBT workbook. What you learn in therapy doesn’t stay in the therapist’s office, rather to bridge that gap between learning and applying it in your day-to-day, making social openness feel more natural over time. 

Radically Open DBT Techniques  

“Radical openness is more than mindful awareness,” notes Radically Open Blended Learning, led by Dr. Lynch. “It means actively seeking those areas of our lives that we want to avoid or may find uncomfortable in order to learn. It involves purposeful self-inquiry and a willingness to be wrong, with an intention to change if needed.” 

Having this flexibility and an internal pulse on oneself are just a few of the radically open DBT techniques that therapy teaches: 

Loving-Kindness Meditation 

To be good to others, you must be good to yourself. But sometimes, anger or fear are some of the underlying reasons why someone’s emotional overcontrol remains firmly fixed. Through cultivating loving-kindness — a tenet of Buddhist practice that DBT emphasizes — you can begin to foster warmth and compassion and, through that, direct kind thoughts to yourself and others and let go of the tightly wound emotional restraints characteristic of overcontrol. A daily loving-kindness meditation serves as a reminder that you are worthy of love and giving love to others.  

Self-Enquiry Practice 

Questioning yourself and looking deep within without judgment is one of the most important things you can do for yourself when pursuing radically open DBT. Self-inquiry involves taking an interest in your internal dialogue and reflecting on your thoughts and subsequent behaviors. Are your beliefs self-limiting and preventing you from connecting with others in a meaningful way? By asking important questions and broaching them in therapy, you can uncover new insights about your emotion regulation and motivations. 

Social Signaling Exercises 

Subtle cues like facial expressions, posture, and tone of voice can make a big difference in social interactions — often the very thing that can draw others in or shut them out. An emotionally overcontrolled person may unintentionally appear distant, aloof,f, or unapproachable. Radically open DBT exercises focused on developing friendlier social signals make you actively aware of these habits and adjust your behaviors, like fostering a sense of better self-esteem, giving you a reason to smile and make eye contact with a genuine love for yourself and others, infectious behaviors that give people a reason to want to know you. 

Flexible Thought Patterns   

Rigid thinking and rule-governed behavior are common in emotionally overcontrolled people — hard habits to break when someone has become accustomed to a lifetime of being inhibited or wary around others; too much self-control can sadly lead to social isolation and loneliness in people unable to form social connections even when they desire to. Radically open DBT ultimately teaches you to challenge your rigid, habitual thinking and explore alternative perspectives, even if it means saying hello to one new person every day. 

What Are the Benefits of Radically Open DBT?   

Emotional overcontrol may serve us well in certain situations — it’s a sign of admirable self-control. However, socially and interpersonally, it can leave one closed off from others. When that’s not your intention, mental health can suffer, and the risk of self-medicating with substances increases. Everyone deserves love and connection, and radically open DBT takes the principles of change and acceptance and helps you learn greater emotional flexibility and self-awareness, as well as the tools to become more open, trusting, and embracing of opportunities to express yourself and connect with others.  

It’s a transformative approach that can lessen the rigidity of emotional overcontrol and create a life filled with connection, flexibility and growth. But the change begins with you. Make contacting our mental health professionals a small first step, like a pre-therapy effort in becoming more connected. If you have questions about radically open dialectical behavior therapy near me and if it’s right for you, don’t hesitate to contact us today.