Sunday, 24th May
Last week I wrote about why insight is rarely the lever. A few people wrote back, and the replies that landed most were variations on a particular theme: "I'm not actually struggling to regulate. I'm over-regulating, and most of what I read about anxiety or burnout assumes the opposite."
That distinction isn't made nearly often enough.
There's a framework I want to think through with you, because it's one of the few in the literature that takes this distinction seriously. Thomas Lynch spent the better part of twenty-five years developing it. The evidence behind it is stronger than its reputation in popular psychology would suggest. It's called Radically Open Dialectical Behaviour Therapy (RO-DBT).
Most of the language around emotional difficulty (in pop psychology, coaching, and the general therapy literature) assumes the problem is some version of dysregulation. Too much activation. Insufficient capacity to contain it. The need for grounding, tolerance, self-compassion. DBT (developed by Dr Marsha Linehan) is the framework most people associate with this work.
Lynch built RO-DBT for the opposite case. The overcontrolled phenotype: cognitive and behavioural inflexibility, high inhibitory control, detail-focused processing, perfectionism, and a form of social disconnection that tends to look, from the outside, like composure.
The clinical observation I keep returning to is this: the profile that has presented most often in the work I do is more often the over-controller. High inhibition of emotional expression, extraordinary precision in naming and managing internal states, and recovery strategies that involve tightening the structure instead of loosening it.
The other thing worth noting is that the regulation rarely contains everything. The pressure tends to express itself less directly. It shows up as impatience with the people closest to you; a child who's being slow, a partner who does something in a less efficient way, a colleague missing the obvious. A quietly punitive response to someone else's inefficiency.
But it also shows up in ways that don't look interpersonal at all: more frequent complaints of jaw tension and head-ache, disrupted sleep, and a GI system that seems to have its own agenda. Perhaps even disproportionate fatigue after anything that requires emotional presence. A private internal accounting - a ledger of your own failures that no one else knows exists. And from the outside, it looks like conscientiousness.
And often, it is rarely about the other person, or the body, or the standard you didn't meet. It's what happens when a system that's holding too much, carefully, releases somewhere it can.
Underneath the precision is often a working assumption: that emotions fully felt, wouldn't resolve well. That it would unravel something. That it would prove inefficient at best, and unmanageable at worst. The control isn't only regulation. It's often a hedge against an outcome the person has agreed not to test.
What Lynch identified, and what tends to show up in formulation work with high-achieving professionals, is that the tools designed to help dysregulation tend to make overcontrol worse. While grounding strategies have their place, recommending them to someone already running a very efficient self-management system can land as adding another layer to their system rather than interrupt it.
What tends to move things for the those in over-control mode is closer to the opposite. Building tolerance for mess. Loosening the precision of the management. Practising what Lynch calls radical openness - genuine receptivity to feedback and experience that the management system is filtering out.
This is one of the reasons formulation matters before intervention. The same presenting symptoms in two different people can sit in opposite clinical architectures and respond to opposite approaches.
The main RO-DBT trial followed 250 people who had already tried medication and standard therapy for depression without improvement (a genuinely hard presentation to treat). However, the study found large reductions in depressive symptoms by the end of treatment compared to those receiving treatment as usual.
What held strongest over time wasn't symptom scores but psychological flexibility: the capacity to loosen rather than tighten, which is exactly what the theory predicted would move. RO-DBT itself is an intensive clinical programme that most people reading this won't need. The overcontrolled system doesn't require dismantling, just small repeated encounters with what it's been avoiding.
Here's one worth trying this week. Say something true before you've edited it. This might be to someone you trust. Not a disclosure or significant revelation, just something you'd normally have run through a second internal pass before it was made public. A small thing, like an honest reaction or a preference you'd usually smooth over.
Then watch what the system does.
This isn't a vulnerability practice by design, it's a small behavioural experiment to notice what gives when you stop withholding.
As always though, this isn't another technique to perfect. It's a small experiment to hold lightly.
Shoni
Dr Shoni Marshall-Edwards
Clinical Psychologist · AHPRA PSY0004030165
Alba Psychology · Online · Australia and New Zealand
P.S. If you know someone who'd recognise the over-control mode, this is a good letter to forward. Subscribe at alba.com.