RO-DBT Skills Every Athlete in Eating Disorder Treatment Should Know: How to Stop Over-Control From Running Your Life
Radically Open Dialectical Behavior Therapy or RO-DBT is a technique of therapy for those that have an over-controlled temperament. It works to create openness, flexibility and social connections in order to treat eating disorders, anxiety, depression and perfectionism. Those with over-controlled temperaments tend to have characteristics around discipline, perfectionism, high standards and emotional inhibition. These very characteristics, although common and helpful as an athlete, are also common among those struggling with an eating disorder.
Understanding Over-Control in Athletes
In athletes, perfectionism shows up around training, nutrition, grades or appearance. You may notice high attention to details around tracking everything and maintaining a rigid schedule and routine. Suppressed emotions show up as a flat affect, difficulty asking for help or the common response of, “I’m fine”. High self-criticism and fear of judgement from others may stop them from doing things they used to enjoy and the athlete may withdraw from social activities or show discomfort with spontaneity.
Why Athletes Are Prone to Over-Control
Within sports culture there is a push for “no excuses” or “mental toughness” mentalities. Coaches and parents place high expectations on performance and there are often pressure on teams around body size and performance. You are rewarded for self-discipline, which reinforces inflexibility. This leaves athletes in a place of believing they will thrive through controlling as many factors as possible.
How Over-Control Fuels Eating Disorders
This same mentality of control fuels ideas around rigid food rules, compulsive exercise and over-training. With those struggling with an eating disorder, it creates heightened anxiety around deviation from the routine and difficulty trusting your own body’s signals, such as hunger and fullness. Shame fuels the fire through fear of underperforming.
What Makes RO-DBT Different
RO-DBT works for eating disorders in athletes because athletes often have a high threat sensitivity and low reward sensitivity. What this means is that they feel easily threatened, judged or looked down on and it takes a lot for them to feel they did something they can be proud of. This puts them in the perfect place to be over-controlled in order to try to not feel threatened. RO-DBT is different from other techniques because it does not just work through emotion regulation, rather it focuses on connection and openness.
Targeting Emotional Loneliness
RO-DBT goes by the understanding that we are all wired for connection and puts a focus on targeting emotional loneliness. Athletes may appear socially engaged but often feel alone or misunderstood.
Radical Openness vs. Traditional Mindfulness
RO-DBT also focuses on openness to feedback, criticism and new experiences. Self injury brings a willingness to be wrong instead of self-judgement.
Core RO-DBT Skills for Athletes
Self-Enquiry
This involves asking yourself questions with curiosity and openness. For example, “What am I avoiding by staying in control?” Avoiding vulnerability with teammates or fear of failure is something you can explore without judgement. According to the RO-DBT handout book, here are a few other example questions you can ask yourself:
Is it possible that my bodily tension means that I am not fully open to the feedback? If yes or possibly, then what am I avoiding? Is there something here to learn?
Is the resistance, dislike, and tension I am feeling helpful? What is it that I might need to learn from my closed-mindedness?
Do I find myself wanting to automatically explain, defend, or discount the other person’s feedback or what is happening? If yes or maybe, then is this a sign that I may not be truly open?
Am I finding it hard to question my point of view or even engage in self-enquiry? If yes or maybe, then what might this mean?
Flexible Mind DEFinitely
This exercise helps you become more radically open.
D Acknowledge Distress or unwanted emotion
E Use self-Enquiry to learn
F Flexibly respond with humility
Find a recent time where you noticed yourself becoming quickly irritated, annoyed or passing judgement. Use this skill to practice becoming more radically open.
Start with acknowledging the distress that is happening. This is the annoyance, anxiety or irritability. Describe to yourself what happened and what it felt like inside your body.
Use self-enquiry to learn from the distress in an open way, rather than trying to immediately regulate or fix the distress.
Flexibly respond with humility. This can look like reminding yourself it is okay to take time to reflect, communicating to others that you need some time to reflect, or reminding yourself that stalling does not mean walking away from the situation.
Activating Social Safety
Non-verbal social signals are a big piece of how others feel in social situations. Using warm facial expressions, gestures and tone can allow others to feel welcome and safe in our presence. Athletes often communicate confidence and stoicism but come off as distant. Practicing these skills can improve communication with coaches and team cohesion. An example of a skill that creates social safety is the Big 3 + 1. The Big 3 + 1 has the following three steps:
Lean back in your chair.
Take a slow deep breath.
Make a closed-mouth smile.
Use an eyebrow wag.
These steps allow you to have soft eye contact, a relaxed posture and warmth that helps strengthen team and coaching relationships. When working with an eating disorder therapist, these skills help in eating disorder treatment by helping you attune to when you need help and asking for it, as well as disclosing stress earlier instead of hiding it.
Opposite Action for Over-Control
Doing the opposite of what your rigid mind wants is not an easy task. However, it allows you to break free from compulsive patterns and puts your true self and values in the driver's seat.
If the urge is to overtrain..choose rest.
If the urge is to restrict..choose adequate fueling.
If the urge is to hide feelings..share something small with a teammate.
Tolerating the uncertainty allows you to let go of the illusion of control and is the key to eating disorder recovery. Do one imperfect thing on purpose. Share a “micro-vulnerability” with someone. Pause and ask, “What am I unwilling to feel right now?”
When to Seek Professional Support from an Eating Disorder Therapist
Signs that over-control is causing harm may be when there is anxiety, rigid food rules or isolation. RO-DBT may benefit you as an athlete in eating disorder treatment. Serendipity Counseling offers support for eating disorders in athletes. It traces athletes how to be flexible, open, and connected without losing their edge. To seek support, take the following steps.
Reach out for a free 15 minute consultation call.
Schedule your first RO-DBT appointment with an eating disorder therapist.
Get your journey eating disorder treatment journey started!
If you are not ready to start one-on-one eating disorder therapy, check out our other helpful resources. We have an eating disorder support group for “retired” athletes looking to redefine their relationship to movement, as well as many blogs on eating disorder recovery as an athlete.
About the Author: An Over-Controlled Eating Disorder Therapist
Kate Ringwood is a licensed professional counselor that resides in New Jersey. She identifies as having an over-controlled temperament and finds her passions in helping guide other over-controlled folks who are going through eating disorder treatment. Kate is here to support your journey towards letting go of rigidity and finding food freedom!
