Radically Open Dialectical Behavior Therapy: An Approach for "Too Much" Self-Control

Dr. Danyale McCurdy-McKinnon
Sep 2, 2025
3 min read

Updated: Nov 12, 2025

Most psychological treatments focus on helping people gain better self-control—managing impulses, regulating emotions, and making thoughtful decisions. But what happens when someone has too much self-control? Radically Open Dialectical Behavior Therapy (RO-DBT) addresses this often overlooked problem, offering a novel treatment for individuals whose excessive inhibition creates its own form of suffering. Those of us on the undercontrolled end of the spectrum (🙋🏼‍♀️) often get more attention due to the “louder” nature of these characteristics. However, those on the overcontrolled end of the spectrum can also suffer, much of the time, in silence.

Understanding Overcontrol

Developed by Thomas Lynch, RO-DBT targets disorders of "overcontrol" (OC)—conditions characterized by emotional rigidity, social isolation, and excessive self-restraint. This includes chronic depression, obsessive-compulsive personality disorder, avoidant personality disorder, and eating disorders (predominantly anorexia nervosa). While these individuals may appear highly functional on the surface, they often struggle with profound loneliness and an inability to form genuine connections with others.

The Biotemperamental Basis of Overcontrol

The theory of OC suggests that certain biotemperamental predispositions—high threat sensitivity, low reward sensitivity, and superior inhibitory control—can become maladaptive when rigidly applied. These traits might help someone excel academically or professionally, but they interfere with the spontaneity and emotional expressiveness needed for close relationships.

Social Signaling: The Core Mechanism

RO-DBT's distinctive focus lies in social signaling deficits rather than internal emotion regulation. Overcontrolled individuals often mask their inner experiences, send mixed social signals, and often appear emotionally flat. Despite worthy intentions, these behaviors can signal disinterest or inauthenticity to others, perpetuating a cycle of social rejection and loneliness.

Embracing Radical Openness

RO-DBT emphasizes "radical openness"—an active willingness to be vulnerable, curious about one's knowledge gaps, and genuinely receptive to feedback. This stance requires questioning one's assumptions and being open to learning from uncomfortable experiences. By fostering this openness, individuals can begin to break free from the constraints of overcontrol.

Treatment Components and Evidence

Unlike traditional DBT approaches that encourage emotion regulation or distress tolerance, RO-DBT teaches individuals to increase emotional expressiveness, engage in novel behaviors, and practice social connectedness skills. Research demonstrates promising outcomes, including significant weight restoration and reduced symptoms among those with anorexia nervosa.

The Role of Emotional Expressiveness

One of the key components of RO-DBT is enhancing emotional expressiveness. This involves not only recognizing one’s emotions but also sharing them with others. By doing so, individuals can foster deeper connections and reduce feelings of isolation.

Challenging Assumptions About Control in Disordered Eating

One of RO-DBT's insights concerns the relationship between self-control and disordered eating. Rather than viewing all binge-purge behaviors as impulsive, RO-DBT recognizes that some individuals plan these behaviors in advance and can also experience "subjective binges." These involve average amounts of food that feel out of control due to one's rigid dietary standards. Thus, research points to OC vs. undercontrol as constructs to acknowledge rather than whether someone restricts, binges, and/or purges.

Understanding Subjective Binges

Subjective binges highlight the complexity of eating disorders. They reveal how rigid standards can distort one’s perception of normal eating. This understanding is crucial for developing effective treatment strategies.

Implications for Mental Health Treatment

RO-DBT’s framework offers another perspective in understanding psychological dysfunction. It recognizes that different temperamental styles require different therapeutic approaches. The emphasis on social connection as fundamental to wellbeing also moves beyond purely intrapsychic models and towards understanding mental health in a relational context.

The Importance of Social Connection

In contemporary society, social isolation and perfectionism are increasingly common. For individuals whose suffering has been overlooked precisely because they appear so controlled and competent, RO-DBT offers both validation and a path toward genuine connection with others. Building these connections can be transformative.

Moving Forward with RO-DBT

While RO-DBT continues to evolve through ongoing research and clinical application, evidence suggests it addresses a significant gap in available treatments. It offers hope for those whose greatest struggle isn't gaining control, but learning when and how to let it go.

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