Most talking therapies were originally designed with emotional dysregulation in mind — helping people who feel too much, too intensely, too unpredictably. Radically Open Dialectical Behaviour Therapy (RO-DBT) flips that around: it was built specifically for the opposite pattern, sometimes called ‘overcontrol’ — excessive self-control, rigid rule-following, and difficulty opening up to others, which sits right at the heart of Obsessive-Compulsive Personality Disorder (OCPD).
A 2025 study looked at data from a large randomised controlled trial (250 participants) originally testing RO-DBT for treatment-resistant depression, and specifically examined what happened for the subset of participants who also had OCPD. The findings were encouraging: RO-DBT was linked to meaningful improvements in emotional approach coping (actually engaging with, rather than avoiding, difficult emotions) and reduced psychological inflexibility, and — importantly — having OCPD didn't blunt these benefits. People with OCPD responded about as well as everyone else.
This is a genuinely useful finding, because OCPD has historically been seen as something that gets in the way of good therapy outcomes. RO-DBT was designed with exactly this kind of rigid, over-controlled pattern in mind, which is why it's increasingly considered one of the more promising therapy options specifically for OCPD. If this pattern sounds familiar, it's worth asking a psychologist whether RO-DBT-informed approaches might be a good fit.