Relationship OCD (ROCD) is a subtype of obsessive-compulsive disorder (OCD) where a person experiences intrusive doubts and fears about their romantic relationship—and sometimes platonic ones, too. These unwanted thoughts often focus on questions like, “Do I really love my partner?” or “Is this the right relationship for me?”
ROCD isn’t simply about being unsure. It’s a clinically recognized pattern of obsessive thoughts and compulsive behaviors that can cause intense distress. OCD affects about 1-3% of the population, and research shows that relationship OCD is common, with about 51.3% of people identifying with this subtype.
How is ROCD different from normal relationship doubts?
It’s normal to occasionally question your feelings or worry about compatibility. What sets ROCD apart is the intensity, frequency, and persistence of the doubts:
- Thoughts feel intrusive and uncontrollable
- Doubts cause significant anxiety
- You spend several hours analyzing your feelings or your partner’s actions
- The worries don’t resolve, even after reassurance
In short, healthy relationship questions come and go, while ROCD doubts feel overwhelming and lead to compulsions.
What are common symptoms of relationship OCD?
ROCD symptoms involve two primary symptoms: obsessions and compulsions.
Obsessions (intrusive thoughts, images, urges, feelings, and sensations)
Below are a few examples of common ROCD obsessions:
- What if we fall out of love?
- What if they cheat on me?
- Am I still attracted to my partner?
- That other couple seems so happy. Is something wrong with us?
Compulsions (repetitive physical or mental acts)
And here are some common compulsions in ROCD:
- Repetitively taking relationship quizzes online
- Checking for “signs” that you’re attracted to your partner, or vice versa
- Repeatedly asking your partner for reassurance that they love you
- Avoiding certain relationship milestones to protect yourself from getting hurt
Unfortunately, compulsions only provide, at best, fleeting relief. When the relief fades, the obsession returns, and you’re right back in what’s called the OCD cycle.
What causes relationship OCD?
While researchers are still investigating the underlying causes of OCD, the following factors may contribute to the development of ROCD:
- Genetics: OCD often runs in families
- Brain chemistry: Differences in serotonin and brain circuits
- Stress and life events: Big changes in relationships can trigger symptoms
It’s important to remember that ROCD isn’t a sign of a “bad” relationship. The doubts come from OCD, not your partner’s perceived flaws.
How is relationship OCD diagnosed?
ROCD isn’t a separate diagnosis, but a presentation of OCD. A licensed mental health professional—preferably someone with specialized training in OCD—can assess symptoms using clinical interviews and standardized tools.
Diagnosis focuses on:
- Intrusive obsessions
- Time-consuming compulsion (at least one hour a day)
- Significant distress or impairment
What treatments work best for relationship OCD?
The good news? Relationship OCD—and all OCD subtypes, for that matter—is treatable. Several evidence-based treatments exist that can help you break the cycle of intrusive doubts and compulsions and put focus on what matters most to you.
Exposure and response prevention (ERP) therapy
ERP therapy is a specialized form of cognitive behavioral therapy (CBT) proven to be effective for OCD. General CBT, if not tailored for OCD, can sometimes be unhelpful or even worsen symptoms.
This specialized therapy has two components:
- Exposure: Gradually facing the thoughts and situations you fear
- Response prevention: Learning to resist compulsions like reassurance-seeking
Studies show that ERP is highly effective, with 80% of people with OCD experiencing a significant reduction in their symptoms.
Medication
Selective serotonin reuptake inhibitors (SSRIs) are often prescribed alongside ERP therapy. These medications can reduce the intensity of intrusive thoughts and anxiety.
Other therapies and support
Below are some additional methods that can support ERP therapy as you learn how to manage relationship OCD.
- Acceptance and commitment therapy (ACT)
- Mindfulness-based strategies
- Support groups or OCD-specific communities
- Family or couples therapy to reduce accommodation behaviors
People with severe, treatment-resistant ROCD may benefit from more intensive treatments, such as:
- Transcranial magnetic stimulation (TMS)
- Deep brain stimulation (DBS)
- Gamma knife radiosurgery (GKRS)
- Intensive outpatient programs (IOPs)
- Partial hospital programs (PHPs)
- Residential treatment centers (RTCs)
Working with an OCD specialist can help you determine the best treatment plan to address your symptoms.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Can relationship OCD go away on its own?
ROCD rarely goes away without treatment. The cycle of obsessions and compulsions tends to reinforce itself over time. The good news: ERP therapy and medication can help you break this cycle and regain trust in your feelings.
FAQs about relationship OCD
Can you have ROCD in a happy relationship?
Yes. ROCD is about intrusive doubts, not the actual quality of the relationship. Many people with ROCD are in loving, healthy relationships.
Can ROCD cause breakups?
If left untreated, ROCD can put significant strain on a relationship. Treatment can help reduce compulsions that erode closeness and trust.
Is ROCD common?
Yes. Relationship-related obsessions are very common in people with OCD.
Bottom line
ROCD can make you question your feelings and your relationship in painful ways, but it’s treatable. If you’re struggling with constant doubts and compulsions, help is available. Exposure and response prevention (ERP) therapy, alongside supplement support, is the most effective treatment and can help you break free from the cycle of uncertainty.
Key takeaways
- Relationship OCD (ROCD) is a subtype of OCD marked by intrusive doubts and fears about your romantic relationship.
- ROCD symptoms include obsessive questioning (“Do I really love my partner?”) and compulsions like constant reassurance-seeking.
- The most effective treatment for ROCD is exposure and response prevention (ERP) therapy, often combined with SSRIs.
- ROCD rarely resolves on its own, but with treatment, most people experience significant relief and improved relationships.
