Mini Workshop 16 - It’s Not What You Said, but How You Said It: Social Signaling as a Novel Treatment Target and Mechanism of Change, from a Radically Open Dialectical Behavior Therapy Perspective

Many psychotherapeutic interventions focus on changing internal experiences as a mechanism to decrease psychiatric symptoms. For instance, some psychotherapies focus on changing one’s emotions via emotion regulation or changing attention via mindfulness. A completely novel treatment focus and mechanism of change is changing how one socially signals to improve social functioning and decrease psychiatric symptoms (Lynch, 2018). A social signal is defined as any behavior (verbal or non-verbal) done in front of another person, regardless of intent or conscious awareness (Lynch, 2018; Gilbert & Codd, 2022). Examples include a yawn, eyeroll, tone of voice, and facial expressions.
A newer psychosocial treatment, Radically Open Dialectical Behavior Therapy (RO DBT) distinguishes itself from other therapies by its focus on social signaling as a main treatment target and mechanism of change. RO DBT is a transdiagnostic treatment that is designed for disorders of ‘overcontrol,’ and overcontrol is a phenotype, rooted in personality, and characterized by rigid behavioral repertoires, inhibited emotional expression, and perfectionism. Overcontol is evident across multiple psychiatric disorders, including treatment resistant depression and anxiety, anorexia nervosa, and obsessive-compulsive personality disorder, and these disorders often exhibit indirect or masked social signals that lead to poor social functioning and loneliness. As such, RO DBT targets maladaptive social signaling habits and teaches novel social signaling skills to enhance connection.
In this workshop attendees will be introduced to the transdiagnostic phenotype of overcontrol and common maladaptive social signals that impede close social connection. Attendees will also learn the theoretical foundation underlying the key mechanism of change in RO DBT (i.e., social signaling), how to identify and target maladaptive social signaling habits for change, and hands-on instruction and practice in prosocial signaling skills to enhance client openness and social connectedness—via didactic content, videos, immersive exercises, examples, and role-plays.

Outline:
1.Define overcontrol and social signals
Examples of disorders of overcontrol
Examples of maladaptive social signals
2. Introduce Radically Open Dialectical Behavior Therapy (RO DBT)
Very brief overview of treatment for disorders of overcontrol
Introduce the hypothesized mechanism of change in RO DBT: how targeting social signaling decreases emotional loneliness and psychiatric symptoms
3. Identify maladaptive social signals and maladaptive social signaling styles in overcontrol
Still-face experiment video and discussion
Presenter role-play illustrating maladaptive overcontrolled social signaling styles How to identify clients’ maladaptive social signals that could be targeted in therapy Example video and audio clips of problematic social signaling styles
4. Teach adaptive social signals as skills to improve social connectedness and decrease psychiatric symptoms
Eyebrow wags, Closed mouth cooperative smiles, and the Big 3 + 1
Apollo Eyebrow video; Airport exercise
Appeasement gestures and “the oh my gosh” to signal friendly intentions, openness and non-dominance
Practice with partners
Tips on changing voice tone
5. Factors that influence when and how to socially signal
The relationship, the context, and one’s values