Radically Open DBT


Tom Lynch explains why RO DBT was developed.


Radically Open Dialectical Behaviour Therapy (RO DBT) is a new treatment for patients who suffer from emotional over-control.

RO DBT has been developed over the past 20 years for patients with chronic depression or anorexia nervosa. Research results suggest that it is effective in these, and other, hard-to-treat groups.

Listen to a PodCast from CBTRadio about RO-DBT here: Prof Lynch about RO-DBT - PodCast 5th of October 2015

Emotional over control

‘Self-control’ is thought desirable, and uncontrolled behaviour is often censured. However too-much self-control is a problem for many patients. Excessive self-control is associated with social isolation, poor interpersonal relations, and contributes to difficult-to-treat conditions including anorexia nervosa and chronic depression (see Lynch & Cheavens, 2008; Riso et al., 2003; Zucker et al., 2007).

A new treatment

RO DBT offers a fundamentally different way to treat patients with overcontrol. The treatment starts by observing three core components of emotional well-being:

  1. Openness to feedback, even when this is challenging.
  2. Flexibility in our responses to changing environmental demands, and
  3. Communication of our emotions, with a recognition that expressing emotion is crucial when forming close interpersonal bonds.

Some patients lack emotional control and need interventions designed to enhance constraint or inhibitory control; others require interventions designed to relax rigid or inflexible inhibitory control.

Treatment strategies aim to build:

  • Acknowledgment and awareness of feedback that is unexpected or challenging.
  • Self enquiry into habitual responses to challenging feedback and our urges to regulate emotional responses to feedback (for example to defend, capitualte, avoid, or accept).
  • Flexible responding to the demands of the moment, with great emphasis on the importance of emotional expression to facilitate positive interpersonal relationships.

A growing evidence base

RO DBT is now practised in the UK, Europe, and North America, and is increasingly recognised as effective for patients who exhibit emotional over-control.