Clinical Psychologist & Chartered Psychologist

Copyright © 2014 Dr Alex Fowke. All Rights Reserved.

Dr Alex Fowke Clinical Psychologist CBT Cognitive

Radically Open DBT (RO DBT)

RO DBT is an exciting new evidence-based therapy developed by Professor Tom Lynch.  

The treatment incorporates the core principle of dialectics seen in the standard DBT 

model, but targets difficulties associated with excessive self-control which can

lead to many difficult-to-treat conditions including chronic depression and

anorexia nervosa.  RO DBT has been found to be particularly effective in treating

problems including (but not limited to!) rigid & obsessive behaviours, rumination,

perfectionism, and the interpersonal problems that these issues often result in.


Professor Lynch considers the fundamental problem experienced by clients who are

emotionally over-controlled to be that of 'emotional loneliness', as opposed to the

emotionally dysregulated/under-controlled population for which standard DBT is so effective.  

What is RO DBT?

How RO DBT could help you:

RO DBT teaches specific skills that can help you develop a greater awareness of yourself through self-inquiry, spotting

problematic social signalling and familiar patterns of emotional avoidance that seem to keep you feeling as though you're

in complete control, but which ultimately keep you stuck in your pain through 'emotional loneliness'.  It can be a particularly

helpful therapeutic approach if you tend to "bottle up" your emotions or keep the way you feel hidden from others.


RO DBT can also help you feel more socially connected, identifying and addressing some of the difficulties that stop you from having more meaningful

relationships, and why you might struggle to feel close to other people.  


I was trained in RO DBT by Professor Lynch and acted as an adherent RO DBT therapist in the REFRAMED research trial.  I am a Senior Clinician with

Radically Open and I incorporate RO DBT skills in my individual clinical work where appropriate when clients present with difficulties consistent with emotional over-control.  


Using the new RO DBT skills I can help you to notice when your behaviour is governed by a fixed set of rules that are preventing you from living the life that you want for yourself, or when your relationships are influenced by strong feelings of bitterness, resentment, anger, fear or envy.  


By addressing some of these difficulties, it is possible that you can free yourself from depression and other psychological difficulties associated with rigid behaviours, repair distant relationships, become less sensitive to threat and criticism, and become more emotionally expressive, as well as adjust any other problems associated with a powerful drive to be in control.  


Clients with difficulties associated with emotional over-control tend to have a limited behavioural repertoire and struggle to engage in new or unfamiliar experiences.  With this in mind, I can also teach you the skills to become more playful and sponteneous, and to cope with the anxiety that we can all feel when we find ourselves our of our 'comfort zone'.      


Freedom from these difficulties does not mean abandoning a previously relied-upon set of rules and ways of behaving.  Instead, I can encourage you to develop greater flexibility, so that you can notice when your rules are working to your advantage, and when they are causing more problems than they solve.  For example, a pefectionistic style can be extremely effective in terms of achieving academic excellence and progressing through your career, but might remove any spontaneity from your personal life, possibly for fear of getting things wrong or feeling embarrassed in front of other people.  RO DBT would aim to teach you to retain the fundamentals of the rule, but be more flexible with when the rule is applied and when not.  


I currently run a 30-week RO DBT Skills Class, co-facilitated with my colleague Helen Brice.  Skills classes are hosted

at The Boutique Workplace, 1 Neal Street in Covent Garden on Thursday evenings from 7pm until 9pm.  The fee is £80 per

2-hour weekly skills class and it's payable for five classes in advance.  


Clients can join the skills class at any point during the cycle and continue for 30 weeks from the time of joining.  Clients can commit to the full RO DBT programme (which would include additional weekly individual therapy sessions), or choose to attend just the skills class each week.