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Heat on/Heat off

Most people can recall a childhood memory that stands out as significant in terms of pleasure or pain.  For those of us who lean to overcontrolled, we might have superior capacity to remember times that were especially embarrassing or in RO DBT terms, “heat on.”  For me, what stands out is being a grade one student going to music class.  To be fair, we must have done a lot through our grade one year in regard to music, I think as my adult self.  Having worked with small children myself, I am imagining a plethora of options to explore music.  But my memory is focused on singing.  Specifically, having to sing solo.

I was known by my legal name at this time, Jenni.  I recall my teacher was tall and blond and very beautiful and I wanted nothing more than to please her.  But music class was a dreaded event, especially the call and response singing exercise.  Specifically, it was a dreaded event because I was the only red-head.   And my tall, blond and beautiful teacher separated the singing by hair colour.  Imagine this:

Music teacher (sings out in her angelic voice): “Who has brown hair?”

Brown hair students (singing their response): “We have brown hair.”

Music teacher: “Who has blond hair?”

Blond hair students: “We have blond hair.”

Music teacher: “Who has black hair?”

Black hair students: “We have black hair.”

And then the dreaded musical call out:

“Who has red hair?”

Silence.

Music teacher: “Jenni, who has red hair?”

Silence.  Red face in addition to red hair.  Near tears.  In grade one you are not allowed to pee you pants but I think I am pretty close.

Music teacher (with extra enthusiasm): “Jenni, it’s your turn!”

Jenni: “I have red hair.”

In my memory everyone snickered because I was told by my parents our family could not carry a tune in a bucket. I also remember being aghast that everyone who had brown, blonde and black hair had a tribe to sing with.  I did not have any red heads to join my warbling chorus. In my early rebellion I started to sing with the blond haired kids (my best friend was blonde) but this did not stop the teacher from insisting there was a red haired response.

What does music have to do with RO DBT you may ask?  Well, it hasn’t improved my singing (tee-hee) but it has increased my awareness of a key RO DBT principle, which is “heat on/ heat off.” When we consider the biosocial model for RO DBT, we can see how people who lean to overcontrol learn coping habits that inhibit emotional expression and generally avoid situations where they are the centre of attention.  Too much “heat on” activates their threat system and good natured gestures of inclusion from others often result in an OC person ruminating about what they said and how they were perceived.  Too much “heat on” is often interpreted as criticism and/or fake appreciation (oh boy, the concept of fake will be its own blog soon, stay tuned!).  This can result in OC clients shutting down completely.  As such, RO DBT therapists are very astute at balancing direct attention (such as compassionate gravity or playful irreverence) with “heat off” techniques that can be roughly divided into three areas – physical space, body language, and linguistic/attitudinal orientation.

To be fair, most of us have been trained inadvertently as “heat on” therapists. I recall my early training emphasizing leaning into the client (to show you are interested), holding eye contact (to show you are paying attention) and having chairs positioned directly across from one another (so that the client could not disavow your complete and utter devotion!)  My early training videos show me earnestly doing the “right” moves as a therapist and thinking back on these, I might as well have been sitting in my clients’ laps.

So what does “heat off” look like in RO DBT counselling?

Physical space

Sometimes, heat off is literally heat off.  RO therapists keep their offices and skills classrooms cooler with the use of fans.  Because OC individuals are often in a state of threat, they are keenly attuned to temperature.  If there is more physical heat, their defensive arousal increases which makes it difficult to hear feedback, remember content or be fully engaged.  Likewise, counsellor and client chairs are set at a 45 degree angle so eye contact can be naturally broken and a table can be utilized for water and paperwork (allowing natural, regulatory breaks).

Body Language

To keep heat off in counselling sessions, the RO DBT therapist assumes a relaxed posture – one you might expect an old friend to demonstrate.  This open posture emulates universal signals of non-dominance and keeps one from being perceived as arrogant.  RO DBT therapist often model the Big Three +1 to activate our own social safety in order to be fully present for the client.  The Big Three + 1 involves the therapist leaning back, taking a deep breath, having a cooperative closed mouth smile and raising their eyebrows. This in turn elicits social safety in the client.

Linguistic and Attitudinal Orientation

Heat off is more than mere body language.  How therapists talk is equally important.  Therapeutic language is sometimes presented with qualifiers; “is it possible?” or “could it be?” to frame ideas and therapeutic issues in a way that does not provoke blame.  Attention to voice tone is important as heat on may illicit a “serious” tone whereas heat off elicits more musical voice range. Likewise, there is an attitudinal orientation of curiosity that is essential for engaging OC clients – when truly curious it is difficult to be in a position of “fixing.”

Of course, we need to put the heat back on at some point, but in RO DBT this is done with kindness. Since personal responsibility is a cornerstone of RO DBT, it would not make sense to have the heat off indefinitely as this smuggles forth that clients cannot handle the task at hand.  I see Thomas Lynch demonstrate this in his supervision and training of trainers – so this is not a mere therapy technique but an embodied RO DBT orientation.

I am still not a fan of being the centre of attention, even though many of my jobs demand I stand a little in the limelight – whether being an educator, an author, community organizer or my distant past of being a karaoke waitress.  My sense of duty will often override my sense of discomfort in these contexts.  But if you single me out to sing me happy birthday, give me a personal compliment or give me feedback, I will likely feel the heat.  I am learning how to control my temperamental temperature and this gives me loads of empathy for other OC people I work with.  Just don’t ask “who has red hair.”


About the author: J. Nicole Little, Ph.D., R.C.C.

Nicole is a therapist specializing in eating disorders and other conditions of overcontrol in Victoria, B.C., Canada.  She has also taught for 13 years at Universities and colleges.  Her passions are RO DBT and animal assisted therapy.