Is RO DBT effective for this diagnosis?

Radically Open Dialectical Behavioral Therapy (RO DBT) has lately been shown to be effective for treating anorexia. Whereas standard DBT was developed to treat impulse control disorders, RO DBT applies the opposite principles to treating disorders of overcontrol and rigidity. Restrictive anorexia is characterized by these traits. RO DBT helps increase flexibility and connectedness as well as addressing the behaviors associated with overcontrol. We, at the DBT Center of Marin, offer Radically Open DBT to best address your anorexia. 

What is Anorexia?

Anorexia nervosa restrictive type is an eating disorder characterized by a persistent restriction in food intake. Symptoms include an obsession with thinness, distorted body image, and fear of gaining weight. Anorexia is a disorder of overcontrol meaning sufferers struggle with cognitive and behavioral rigidity. Anorexia negatively impacts your quality of life. Anorexia is an extremely dangerous disorder in terms of physical health but it is treatable. 

How does RO DBT support this diagnosis?

RO DBT can help replace restrictive behaviors with a biologically-based approach to therapeutic skills. The therapy focuses on three core components of mental health: openness, flexibility, and social connectedness. Support for these symptoms extends beyond the therapy session through phone coaching as a crisis intervention tool in addition to individual weekly psychotherapy and skills groups. RO DBT provides clients with guidance on how to apply therapeutic skills to the unique situations in their lives.

Which specific modules are most relevant?

Learn how to manage your anorexia through the 3 components of RO DBT: Openness, Flexibility, and Social Connectedness.

Openness: Learn to take new risks and accept critical feedback.

Overcontrolled behaviors can create an unfulfilling life. You may be naturally suspicious and miss the benefits of trying novel behaviors. Biologically-based skills help you stay calm when trying new things. Similarly, RO DBT skills can help you accept unexpected feedback that would usually upset you.

Flexibility: Learn to free yourself from perfectionism and rigidity. 

Staying rigid is impractical in a world that is ever-changing. RO DBT teaches skills that help you downregulate your hyperactive safety system, allowing you to adapt more readily to a changing environment. Mindfulness skills and cultivating healthy self-doubt help you stay in a flexible mindset.

Social Connectedness: Learn to successfully connect with others.

Overcontrolled individuals often feel uncomfortable and incapable of facilitating intimacy. RO DBT uses the science of social signalling to enhance your ability to connect with others. Additionally, skills help you cope with social shame, bitterness, and envy. By cultivating and skillfully applying vulnerability to your social interactions, you can improve your connections with others.

References to research that demonstrate the efficacy of the treatment for the diagnosis

1. This study found that RO DBT treatment of individuals with restrictive anorexia had significant improvements in eating disorder related psychopathology.

Lynch, T.R., Gray, K.L., et al. Radically open-dialectical behavior therapy for adult anorexia nervosa: feasibility and outcomes from an inpatient program. BMC Psychiatry 13: 293 (2013). https://doi.org/10.1186/1471-244X-13-293

2. This research study found that RO DBT participants reported better psychological flexibility.

Lynch, T.R., Hempel, R.J., et al. Refractory depression – mechanisms and efficacy of radically open dialectical behaviour therapy (RefraMED): findings of a randomised trial on benefits and harms. The British Journal of Psychiatry 216, 204–212(2020). https://doi.org/10.1192/bjp.2019.53

3. This study targeted overcontrol in the treatment of anorexia and found that a majority of participants achieved remission after RO DBT treatment. 

 Isaksson, M., Ghaderi, A., et al. Radically open dialectical behavior therapy for anorexia nervosa: A multiple baseline single-case experimental design study across 13 cases. Journal of Behaviour Therapy and Experimental Psychiatry 71, (2021). https://doi.org/10.1016/j.jbtep.2021.101637