Is RO DBT effective for this diagnosis?

Radically Open Dialectical Behavioral Therapy (RO DBT) is beginning to show promise in treating maladaptive perfectionism. Whereas standard DBT was developed to treat impulse control disorders, RO DBT applies the opposite principles to treating disorders of overcontrol and rigidity. Maladaptive perfectionism 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 perfectionism. 

What is Maladaptive Perfectionism?

Perfectionism can be a helpful or harmful trait. It can drive you to achieve your goals and work hard, or it can paralyze you, like in the case of maladaptive perfectionism. Symptoms of depression include excessive self-criticism, fear of failure, shame, and perceived social isolation. Maladaptive perfectionism is considered an issue of overcontrol because sufferers struggle with cognitive rigidity and social withdrawal. Maladaptive perfectionism can be mild or debilitating and can negatively impact your quality of life. 

How does RO DBT support this diagnosis?

RO DBT can help decrease maladaptive perfectionism 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 maladaptive perfectionism 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 case study shows a successful treatment of a perfectionistic individual with RO DBT.

 Little, J.N., Codd, R.T. Radically Open Dialectical Behavior Therapy (RO DBT) in the treatment of perfectionism: A case study. Journal of Clinical Psychology 76: 2097-2108 (2020). https://doi.org/10.1002/jclp.23062

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 Psychiatry216, 204–212(2020). https://doi.org/10.1192/bjp.2019.53