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RO DBT: An Innovative Approach to Overcoming Perfectionism

Order vs chaos

If you’ve been to therapy before, you may have heard of DBT (Dialectical Behavior Therapy). It’s been around since the 1970’s and is a great therapy for helping individuals who have problems of impulse control. It teaches skills related to mindfulness and emotion regulation. However, this leaves a gap in treatment for those individuals who are TOO emotionally regulated. A great solution to this problem is RO DBT (Radically Open Dialectical Behavior Therapy). It is a therapy backed by 30 years of empirical research and has been shown to be effective in treating those individuals who struggle with overcontrol and too much self regulation. RO DBT is essentially a treatment for individuals with the opposite personality style as DBT. 

Diagram of Overcontrol

The theory behind RO DBT posits that OC (overcontrolled) individuals have a biological predisposition to hyperfocus on threatening details of a situation. If this person is raised in an environment that inadvertently encourages high levels of self-control  (i.e; a person always completing homework without prompting), high achievement, and discourages making mistakes, they can end up avoiding situations that involve uncertainty. These individuals may become emotionally guarded due to fears of being seen as vulnerable or out of control. Their lack of vulnerability and difficulty expressing what they are truly feeling can cause problems with loneliness. Their tendency for overcontrol can also cause rigid behaviors and difficulty relaxing. RO DBT encourages increased connectedness to others, and learning new ways to respond more flexibly in order to enhance relationships and intimacy. 

If you’re the type of person who would describe themselves as unable overcome perfectionism, stressed, rigid, and detail-oriented, then RO DBT could be helpful for you. There are definitely upsides to perfectionism, but when excessive, it can lead to burnout and emotional disconnection. In RO DBT, skills are taught to address emotional overcontrol, increase flexibility, and better manage unhealthy rigidity. Skills are often structured via acronyms and pneumonic devices to help make them easier to remember and implement.

The skills in RO DBT address deficits in the following problem areas for clients:

  1. Overly cautious and excessively detail-focused behavior

  2. Rigid and rule-governed behavior

  3. Difficulty authentically and vulnerably expressing emotions

  4. Socially distant style of relating to others

  5. High social comparison which can lead to envy/bitterness.


If you’re curious as to which coping style you lean towards, completing the word pair checklist below can help give you an idea as to whether you’re more overcontrolled or undercontrolled.

Word Pair Checklist
Download • 54KB

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