Learning About Friendship: Lessons from Radically Open Dialectical Behavior Therapy

 Recently, my 14-year-old niece was visiting and overheard me talking about Radically Open-Dialectical Behavior Therapy (RO DBT) with my partner:

My niece: “What’s RO DBT?”

Me: “It’s a therapy I use to help people who suffer from conditions of overcontrol.”

My partner, being undercontrolled, pipes up and says:

“Your Auntie helps people who don’t know how to make friends.”

Of course, RO DBT is a bit more complicated than that, but we do know that emotional loneliness is at the root of “overcontrolled” conditions such as depression, anxiety, and anorexia nervosa.

Thomas Lynch, Ph.D, the developer of RO DBT, writes in his upcoming book about how humans are a fundamentally tribal species and why our ancestors who were unable to have a strong tribal bond died. We need our tribe not just to survive, but to thrive.

We need our tribe not just to survive, but to thrive.  

Our tribal nature can be seen when kids march up to other kids and ask, “Do you want to be my friend?”  The view from my kitchen window looks out onto a park for toddlers, so I get a lot of opportunities for informal observation.

What I’ve noticed is that while some kids dive right into the games already underway or plop down in the sandbox to join in on the fun, other children hang back, looking less certain about how to proceed. Regardless of whether they charge forward or hang back, these children are demonstrating the power of our temperamental wiring.

When this temperament mixes with an environment that encourages self-control and a “stiff upper lip,” children begin to develop coping skills that masks their inner feelings, including frozen facial expressions or the “I’m fine” phenomenon.  What my patients are often not aware of is that this style of coping is read as a disingenuous or untrusting social signal—and it alienates people.

When you’re not genuine with people and they can tell, it is very difficult to make friends.

As someone who leans toward overcontrol, I know this firsthand. When I teach the RO DBT skills class on what makes a genuine friendship, I tell the story of my best friend Sam. In university, I was quite in awe of one of my classmates because she was so smart, skilled, confident,and a lot of fun.

Of course, I never revealed this to her; for people who lean toward overcontrol, vulnerable expression that could potentially lead to rejection or disconfirming feedback is habitually avoided. So I silently held warm thoughts about her and if people asked if I had friends at university, I would reply, “Of course, my best friend Sam!”

As we approached graduation, I learned that she would be moving to another country, so in typical overcontrolled style, I worked hard to find her a perfect going-away gift. The book was inscribed “to my best friend Sam” and then waxed poetically about how much she meant to me.

This revelation was not easy for me to do. She did not tell me until 20 years later that when she received that book she thought, “Oh my goodness, I had no idea Nicole even liked me!” While she and I can laugh about this now, it reminds me that part of being a genuine friend is being vulnerable and putting down my classic overcontrolled shield that proved to be a barrier between myself and those I wished to be my friends.

Building Friendships

For some of my patients, RO DBT is their first exposure to skills for building friendships. Many people who are overcontrolled are very accomplished people and may have an extensive network of colleagues, acquaintances or followers on their social media. Some patients will try to convince you they do not even want friends because of high levels of distrust or prior experiences of hurt and betrayal. But the good news is that research posits that you only need one close relationship to gain the psychological benefits of mutual caring. Close relationships are often characterized by friendship.  But who of us have had training in friendship skills?

As RO DBT therapists, it is our job to explore the 36+ characteristics of genuine friends (Lynch, forthcoming from New Harbinger Publications). When we review these characteristics with patients, it is often an eye-opening experience for them. For some, there can be the painful awakening that they have not been a genuine friend to others despite intending to be so. For others, learning that genuine friendships include tough stuff like honesty, letting go of grudges,and openness to feedback—all concepts that challenges their habits of perpetual politeness and superficial conversation.

It’s beautiful to see how patients begin to incorporate the characteristics of genuine friendship into the class setting, teasing a little, practicing giving and receiving feedback and dare we say, enjoying their time with their classmates. Because we’re a tribal species, friendships are more than niceties, they are necessities.

P.S. A note from “my best friend Sam”

(Yes, I really asked her to write this.)

I will attest to the truth in this story. I too have insecurities around fitting in with the cool kids and I lean toward overcontrolled (although some of us overcontrolled folks are overly agreeable and become completely overly accommodating. That’s a topic for a completely different blog entry).

And Nicole, although seemingly unaware of this face, was most definitely one of the cool kids in university. My reaction to her calling me her friend in that book was not as benign as she suggested—it was more like SHE LIKES ME!! SHE LIKES ME!! (channeling Sally Field at the Oscars). And although I still wonder whether I am more of a nuisance than a friend, we are still inconspicuous besties 20 years later.

Nicole Little, Ph.D, RCC, is a therapist specializing in eating disorders and other conditions of overcontrol in Victoria, B.C., Canada. She has also taught for 13 years at universities and colleges. She is passionate about RO DBT and animal-assisted therapy.

Learning About Friendship: Lessons from Radically Open Dialectical Behavior Therapy


APA Reference
Nicole, J. (2019). Learning About Friendship: Lessons from Radically Open Dialectical Behavior Therapy. Psych Central. Retrieved on May 28, 2020, from


Scientifically Reviewed
Last updated: 21 Sep 2019
Last reviewed: By John M. Grohol, Psy.D. on 21 Sep 2019
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