Much of RO DBT therapy includes an emphasis on practicing skills that will help people who lean toward overcontrol (OC) get back into the tribe, and as a result, back to optimal mental health. According to Lynch, psychological health or well-being in RO DBT is hypothesized to involve three core transacting features:
- Receptivity and Openness to new experience and disconfirming feedback in order to learn.
- Flexible-control in order to adapt to changing environmental conditions.
- Intimacy and social-connectedness (with at least one other person) based on premises that species survival required capacities to form long-lasting bonds and work in groups or tribes”
If I had five dollars for every time I heard an OC client say “well I would be willing to do that except it’s fake” I might be retired. Indeed, as an RO DBT therapist, getting curious about the concept of ‘fake’ has been one of my steepest learning curves. Before we dive into how to work around this therapeutic pickle, it might be helpful to consider what leads OC folks to perceive the practice of the above three – and general politeness – as being fake.
Consider this conversation with ‘Amy’, who is a 35-year old single mother of a 6-year old and presented with chronic depression:
Nicole: So how did it go on the diary card?
Amy: Ok, but I wanted to inform you that the behaviour of chatting to other moms didn’t go very well.
Nicole: Oh? What happened?
Amy: Well, I did just like we practiced. Big three plus 1 and all that jazz.
Nicole: Well done! We’ve been practicing that for a while. So, did the other moms talk to you? Cause normally you say you try to avoid contact all together.
Amy: Yes, a couple of people talked to me. But what I wanted to tell you is that I just did it for the homework. It felt completely fake and I don’t think RO DBT would endorse people running around talking about the weather or other things that have no substance.
Nicole: Hmm, ok, that kinda makes me wonder how people get to know one another?
Amy: What do you mean?
Nicole: I dunno, I am thinking that when I meet somebody for the first time I normally don’t use opening lines like “nice to meet you, my grandmother has cancer” or “nice to meet you, I have a long history of shoplifting.” I mean, those might be things of substance but they are not my opening lines. So what exactly did you say? Can you show me?
Amy: [groan – she is used to having to “show me” social signals. She raises her eyebrows and smiles] I hope the weather holds for the kids to go on their fieldtrip tomorrow.
Nicole: Wonderful! If I were one of the moms I might answer with: Me too, what should we plan if the event is cancelled?
Amy: Right, SO fake.
Nicole: Ok, Amy, here’s the deal. I didn’t feel like you were being fake with me there. Let me ask you this: would you tell your son to avoid small talk with his classmates because it means he is a big fake-flake? How might you coach him to make friends?
Amy: Argh, I see what you are saying. He is not going to make friends unless he exchanges a few pleasantries. But I don’t want friends, I am fine just the way I am.
Nicole: Sure, you don’t want friends and no one said that was a requirement of RO DBT. But what we do know is that avoiding interactions that have some of the social glue needed for cooperation leaves you out of the mom tribe – and probably stuck in depression.
Amy: So you’re saying that being polite is social glue?
Nicole: yep, pretty much. We actually practice this prior to a session and on break at skills class, so I know it is not an inherent deficiency 🙂
Amy: Ok, I will keep at it.
In a perfect world, the conversation about ‘fakeness’ would end here (unless we are talking about fake news!). But consider for a moment that for many of our patients, they live in a heightened state of threat, and as a result, are physiologically responding to the world as though it is threatening. It is difficult to make small talk with a frozen smile, flat face or clipped tone; others avoid you and this perpetuates the cycle of isolation. I often tell my patients that learning to do the ‘small talk’ or social politeness rituals is akin to moving your limbs after they have been frozen. That is, it is going to be stiff and awkward at first, but that doesn’t mean you don’t have limbs.
Given there is such energy around feeling fake, I did a little research into the term: “One theory claims that fake could be related to the German fegen or Dutch vegen, both meaning ‘to polish’ or ‘to wipe clean’—the implication being that something might once have been said to have been ‘faked’ when it had been cleaned up to appear more valuable than it actually was.” http://mentalfloss.com/article/92556/fake-etymology-story-behind-one-dictionarys-most-intriguing-words
Indeed, when we first meet people or engage in small talk, we are likely ‘polishing’ some of our contributions. As stated above in the clinical vignette, I don’t normally offer extra-vulnerable aspects of myself upon first meeting people. At the same time, every piece of shining silver eventually begins to tarnish and through this tarnishing comes love and attention to re-polishing. This is akin to how relationships work: we are polished, we show our tarnish, and we are cared for, and eventually tarnish shows up again. From an RO DBT perspective, this is healthy progress. How ‘bout that?
About the author: J. Nicole Little, Ph.D., R.C.C.
Nicole is a therapist specialising 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.