Some basic ingredients to psychological wellbeing...

I was recently reading a piece by practitioner Dr. Tom Lynch, who spent over 20 years developing Radically Open DBT (RO DBT), an evidenced-based treatment for individuals with "overcontrolled" personality styles. RO DBT therapists work to reduce suffering by developing skills needed to move toward psychological health. Instead of looking for what’s wrong, the RO DBT therapist considers what’s healthy for all of us. In RO DBT, psychological wellbeing is a guide for treatment interventions.

Dr Lynch developed a treatment approach designed to engage with individuals who could be understood as experiencing psychological difficulties caused by "over control". Individuals with overcontrol often exhibit high personal standards and work hard at not appearing deviant. They are pro-social and often contribute to the good of society. Lynch notes that an overcontrolled coping style would include being detail-focused, restrained, perfectionistic, cautious, disciplined, structured, conscientious, reserved, planful, and dutiful.

These characteristics are helpful in many ways, and may even lead to rewards in our jobs and other areas of our lives; but their behavior may contribute to, and mask significant emotional pain. Overcontrolled clients do not need to better regulate their emotions, be more organised or try harder to achieve goals. Overcontrolled clients may benefit from interventions that teach how to actively seek wellbeing over control. Put another way: letting go of over control can open an individual to categories of experience that were simply off the menu.

For wellbeing to be the guide for treatment, it’s important to define the concept. Psychological health is theorized in RO DBT to have three core transacting features:

* Receptivity and openness to new experience and disconfirming feedback, in order to learn~

Difficulties of over control reflect the old behavioural saying: "If you always do what you always did, you'll always get what you always got". Funnily enough, I suspect Freud may have agreed through his lens of 'repetition compulsion'.

When we encounter the world and relationships through a rigid set of assumptions, we can become blind to outliers and disconfirming evidence. We can also anticipate 'more of the same'. By developing a receptiveness and openness to new experiences - we bring our brain from a world shaped by the 'there and then', into a world in which 'here and now' experience has a chance to be privileged and reflected upon.

* Flexible-control in order to adapt to changing environmental conditions~

The word here is flexible - or the capacity to shape ones decision making responsively, depending on the needs of the situation. The answer to difficulties of over-control is not to adopt its dialectic opposite across the board, but to seek a balance. This approach aims at interacting with rigidity, through a process of active reflection with the demands of the actual moment. To sort of develop one's 'emotional tastebuds' to gain a fuller picture of the moment a hand - not the one our mind has rapidly generated to protect us from further anxieties.

* Intimacy and connectedness with at least one other person.

The work of RO DBT starts with the assumption that personal connectedness emerges out of a connection with another. And, for those struggling with over-control, it is this aspect of human life than presents a quite challenging proposition. What if letting go of control in a relationships leads to something terrible? It's common for individuals to not be able to say what 'that terrible thing is' - but its presence in the background shapes a suite of decisions and behaviours associated with close relationships.

By seeking opportunities for small interpersonal rewards inside the treatment relationship, RO DBT provides a context for individuals to repeat a new behaviour beyond the therapy room.

Now, much of what has been described is not a new phenomenon - but I really like the distillation of these aspects as presented in RO DBT. I think for clients and clinicians alike, they represent capacities that can open and close depending on the contexts in which we live. I'll be reading and exploring further this interesting perspective of contemporary psychology.