Radically Open Dialectical Behavior Therapy (RO-DBT) in Chicago & Northbrook IL

What Is Radically Open DBT (RO-DBT)?

Radically Open Dialectical Behavior Therapy (RO-DBT) is an evidence-based treatment developed by Dr. Thomas Lynch specifically for people whose difficulties stem from overcontrol rather than emotional dysregulation. Where standard DBT targets impulsivity and emotional flooding, RO-DBT addresses the opposite end of the spectrum: excessive self-control, emotional inhibition, and the chronic loneliness and rigidity that can accompany a highly controlled coping style.

RO-DBT is grounded in a bio-social theory that some people are born with a temperament oriented toward high threat sensitivity, cautiousness, and detail-focused attention. Combined with certain environmental experiences, this can develop into a pattern of overcontrol that functions as a protective strategy but carries real costs in terms of connection, flexibility, and quality of life.

What Does Overcontrol Look Like?

Overcontrol is not the same as having your life together. It often looks like high functioning on the outside with significant internal suffering. Common signs include:

Perfectionism that is difficult to shut off
A tendency to mask or suppress emotional expression
Difficulty relaxing, playing, or being spontaneous
A strong need to plan, prepare, and avoid uncertainty
Holding back in relationships even when you want connection
Self-criticism that is relentless regardless of external achievement
Difficulty receiving feedback without feeling defensive or devastated
A sense of being fundamentally different from other people

“RODBT is an evidence-based treatment that we offer at Midwest Counseling & Diagnostics. Through individual and skills training classes, our RODBT-trained clinicians are passionate about working with individuals who benefit from this novel treatment. ”
– Danielle Doucette, PsyD, Midwest Counseling & Diagnostics

The Core Idea: Radical Openness

The treatment is organized around the concept of radical openness: a genuine willingness to be influenced by the world, by other people, and by experiences that do not fit your current framework. For people with an overcontrolled style, this is genuinely difficult because openness can feel like loss of control or vulnerability. RO-DBT approaches that difficulty with both compassion and directness.

A distinctive emphasis in RO-DBT is social signaling: how you communicate your internal experience to others, and how that communication, or lack of it, shapes your relationships. Many overcontrolled people are communicating far less warmth and openness than they feel inside, which contributes to the chronic disconnection they experience.

What Does RO-DBT Help With?

RO-DBT has a particular evidence base for presentations where overcontrol is central:

Treatment-resistant depression
Anorexia nervosa
Chronic loneliness and social isolation
Perfectionism that interferes with daily functioning and relationships
Obsessive-Compulsive Personality Disorder (OCPD)
Autistic adults wanting support in navigating rigidity or social connection challenges.
Chronic emotional inhibition and rigidity
Difficulty with closeness, vulnerability, or receiving care from others

How Is RO-DBT Different from Standard DBT?

They share a name and some philosophical DNA, but the targets, theory, and skills are distinct. Standard DBT is about slowing down impulsive or self-destructive responses to overwhelming emotion. RO-DBT is about learning to open up when the instinct is to close down, stay in control, or push through. The skills focus on flexibility, social connectedness, genuine emotional expression, and allowing yourself to be changed by experience.

Like standard DBT, RO-DBT typically involves both individual therapy and a skills class component. Your therapist at Midwest Counseling can help determine whether RO-DBT or another approach is the right fit for what you are dealing with.

RO-DBT in Chicago, Northbrook, and via Telehealth

RO-DBT is a specialized training with relatively few practitioners. Midwest Counseling includes RO-DBT trained clinicians working with adults in Chicago, Northbrook, and via telehealth across Illinois and many other states. Call (312) 291-9570 or book a consultation to learn more.

Frequently Asked Questions About RO-DBT

What is RO-DBT used for?
RO-DBT is designed for people whose difficulties involve excessive self-control, emotional inhibition, and rigidity rather than emotional dysregulation. It has the strongest evidence base for treatment-resistant depression, anorexia nervosa, and overcontrolled personality presentations including OCPD.

How is RO-DBT different from DBT?
Standard DBT targets emotional undercontrol: impulsivity, self-harm, emotional flooding, and intense relationship instability. RO-DBT targets the opposite profile: overcontrol, emotional suppression, perfectionism, and chronic disconnection in relationships. Both approaches are structured and skills-based, but the skills themselves and the underlying theory differ significantly.

What does radically open mean in RO-DBT?
Radical openness refers to a genuine willingness to be influenced by the world and by other people, including experiences, feedback, and perspectives that do not fit a person’s existing framework. For people with an overcontrolled style, cultivating this openness is the central therapeutic task.

Who developed RO-DBT?
RO-DBT was developed by Dr. Thomas Lynch, a clinical psychologist and researcher who recognized that standard DBT was not designed to address the specific challenges of overcontrolled presentations. He developed RO-DBT over several decades of clinical and research work.

Is RO-DBT available in Chicago?
Yes. Midwest Counseling & Diagnostics offers RO-DBT with trained clinicians at our Chicago and Northbrook locations, as well as via telehealth across Illinois and many other states. Because RO-DBT requires specialized training, availability may be more limited than standard DBT. Contact us to learn about current availability.

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