5 Signs You're Not Psychologically Flexible: Identifying Over-Control and Pathways to Adaptation

This podcast episode by Dr. Tracey Marks, a psychiatrist, delves into the concept of psychological flexibility, defining it as the ability to adapt to changing circumstances, cope with distress, and pursue goals despite adversity. It introduces various therapeutic models that address this, including Gestalt Therapy, Cognitive Behavior Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Radically Open Dialectical Behavior Therapy (RO-DBT), with a particular focus on the RO-DBT framework for identifying signs of inflexibility.

The episode outlines five key signs of cognitive inflexibility, rooted in pathological over-control. These include inhibited emotional expression, where individuals control their feelings and avoid vulnerability; hypervigilance and excessive caution, characterized by risk avoidance, seriousness, and a tendency to notice small errors; rigid and rule-governed behavior, driven by an excessive need for order and duty; aloofness and distance in relationships, marked by conflict avoidance and a dismissal of negative feedback; and finally, envy and bitterness, linked to compulsive striving, high social comparisons, and pessimism.

Dr. Marks explores the origins of this pathological over-control, attributing it to a combination of nature (temperament), coping tendencies, and family influences. Examples of detrimental family influences include parents who consider mistakes intolerable, punish errors instead of defiance, criticize emotional expression, invalidate worries, or insist on constant self-control (e.g., "boys don't cry"). The episode also categorizes various psychiatric disorders into "under-controlled" (e.g., conduct disorder, antisocial PD) and "over-controlled" (e.g., anorexia nervosa, autism spectrum, OCPD) to illustrate the spectrum of control issues.

Finally, the podcast touches upon therapeutic approaches to enhance flexibility. It differentiates Radically Open DBT from standard DBT, explaining that while standard DBT focuses on regulating out-of-control emotions, RO-DBT emphasizes improving social signals, openness, and connection with others. Acceptance and Commitment Therapy is presented as another mindful approach that promotes living in the moment and guiding thoughts and decisions by one's core values to foster greater psychological flexibility.

"Psychological flexibility refers to your ability to adapt to changing circumstances and be able to cope with any distress that those circumstances create."

"Another way of saying it is the ability to pursue your goals even in the face of adversity."

"You may refrain from talking about your feelings and exposing your vulnerability to people."

"You may be very risk avoidant, only experimenting with the unknown when you can be sure of all the possible outcomes."

"You're strongly guided by what's the right thing to do, and you expect others to do the same."

"You prefer to walk away from a conflict."

"You tend to dismiss negative feedback and rarely apologize."

"You tend to be pessimistic and believe that most things in life just don't work out."

"This kind of pathological over control is thought to be caused in part by your nature, which is your temperament that you're born with, your coping tendencies and your family influences, which would be how you were nurtured."

"Insisting that boys don't cry is an example of this."

"Standard DBT focuses on regulating out of control emotions, but Radically Open DBT works on social signals, being more open and forming better connections with others."

"Acceptance and Commitment Therapy... focuses on having your thoughts and decisions be guided by your values."