People may occasionally doubt certain aspects of even the strongest relationships, from their feelings for one another to whether they should be together at all. These doubts are normal, unavoidable, and are often not a cause for concern or a sign of any greater issue
For some individuals, however, this doubt can become all-consuming and interfere with their ability to enjoy their relationships or function in other aspects of their life. In particular, it can become the focus of obsessive-compulsive disorder (OCD), a condition characterized by persistent, recurring intrusive thoughts that cause distress and anxiety, as well as compulsive behaviors done in an attempt to neutralize anxiety, eliminate uncertainty, and prevent unwanted outcomes.
To shed light on this condition, we will dive into the following questions:
- What is Relationship OCD (ROCD)?
- What are ROCD’s main symptoms and triggers?
- How to tell if it’s “normal” anxiety or ROCD
- Treatment for ROCD, with a focus on exposure and response-prevention (ERP) therapy
What is ROCD?
ROCD is an OCD subtype that is characterized by ongoing intrusive thoughts and compulsive behaviors related to doubts or uncertainty regarding various aspects of one’s relationship, including:
- How one feels about their partner
- Whether their partner has the “right” traits for them
- How their partner feels about them
- Whether they are meant to be together
- Whether to stay in the relationship
Most people with ROCD find that their doubts feel impossible to accept or move on from. These unrelenting obsessions and compulsions can often interfere severely in one’s life or even damage their relationship.
ROCD can be incredibly time-consuming, draining, and limit one’s ability to feel connected to others. People with ROCD may worry that these thoughts will persist forever, or won’t relent until they’ve found enough reassurance or certainty to dismiss them.
As with all forms of OCD, the primary symptoms include obsessions—unwanted intrusive thoughts, images, and urges that cause anxiety or distress—as well as compulsions, done in an attempt to alleviate obsession-induced anxiety or prevent a negative outcome.
People with ROCD experience frequent obsessions that often take the form of doubting thoughts about one or more relationships, despite little evidence for them. Some example doubts include:
- Is my partner good enough for me?
- Am I good enough for my partner?
- Am I in love with my partner?
- Am I at risk for cheating?
- Is it okay that I found someone else attractive? Does it mean that this relationship isn’t meant to be?
- Do I need to leave or divorce my partner?
- What if I’m with the wrong partner?
- What if I made the wrong choice and am stuck with this person forever?
These doubting thoughts are often viewed as an indication that the relationship may be “flawed” in some way, fueling anxiety and driving sufferers to engage in various compulsions to gain certainty about their relationship status. Here are some common examples of ROCD compulsions:
To alleviate their anxiety, people with OCD often seek reassurance from others that what they fear isn’t true. In the case of ROCD, individuals may ask friends, family, or significant others questions like:
- Do you think my relationship is working?
- How did you know you met the right person?”
- Are you still in love with me?
- How did you feel about your previous partner?
Mental tracking/Mental review
Another common type of compulsion in ROCD is making lists in one’s head to prove or disprove their doubts. For example, someone consumed with the obsession “What if I’m not meant to be with my parter?” may come up with a list of reasons they are meant to be together, repeating it every time they have an intrusive thought to ease their anxiety. They may mentally review everything they’ve done together, list everything they don’t like about their partner, and “check” their feelings for signs of affection.
This can be understood as a form of self-reassurance, in which a person tries to gather as much evidence as possible to disprove their doubts and assure themselves, rather than asking for it from other people.
This could involve spending hours on social media, examining other people’s relationships, and asking oneself questions like Are they happier than we are? If someone experiences obsessive thoughts about whether they should get married, they might think about every married couple they know and investigate how long it took each couple to get married in an attempt to quell their doubts or uncertainties.
Though someone with ROCD may experience obsessions about their relationship without any clear cause, there are a variety of triggers that are likely to trigger them and the ensuing compulsions. Some examples include:
- Reading or hearing about other relationships
- Talking with other people about their relationships
- Finding someone else attractive
- Weddings or other romantic engagements
- Thinking about previous relationships
- Forming an emotional connection with someone else
How can I tell if it’s ROCD, anxiety, or relationship issues?
Everyone experiences doubt and relationship issues from time to time, and may even engage in reassurance-seeking, social comparisons, or other similar behaviors to alleviate anxiety. So, how can you tell whether the concerns you’re experiencing are “normal” levels of anxiety, reflect genuine relationship issues, or may signify ROCD?
There are several important differences between relationship stress that’s caused by ROCD and regular or healthy relationship anxiety. One key factor is how easy it is for you to let go of these thoughts. Obsessions are “sticky,” meaning they feel impossible to move on from. Ordinary relationship doubts that occur outside the context of ROCD generally aren’t nearly as gripping or attention-grabbing, and tend to correspond more closely with actual events in a relationship.
Obsessions also lead to a significant amount of distress. When people without ROCD experience relationship doubt, it may cause brief anxiety, but it is generally weaker in intensity and shorter in duration. A powerful and enduring anxious response to doubts or intrusive thoughts regarding one’s relationship may be a sign that a mental health condition like OCD is playing a role in creating and sustaining those feelings.
Compulsions are a tell-tale indication that what you’re experiencing is the result of OCD and not normal anxiety or relationship issues. So, if, in response to intrusive thoughts about your relationship, you feel an overwhelming need to repeatedly engage in mental or physical behaviors to alleviate anxiety or uncertainty, OCD is likely the culprit.
Finally, if your relationship doubts repeatedly carry over from one relationship to the next, constantly overtaking your thoughts regardless of who you are with, that’s a strong signal that ROCD is the source.
Treatments for Relationship OCD
The best course of treatment for ROCD, like all types of OCD, is exposure and response-prevention (ERP) therapy. ERP is considered the gold standard for OCD treatment and has been found effective for 80 percent of people with OCD. The majority of patients experience results within 12–25 sessions.
As part of ERP therapy, you’d be tracking your obsessions and compulsions and making a list of how distressing each thought is. You’ll work with your therapist to slowly put yourself into situations that bring on your obsessions. This is carefully planned to ensure you’re gradually building toward your goal rather than moving too quickly and feeling overwhelmed.
The idea behind ERP therapy is that exposure to these thoughts and discomfort is the most effective way to treat OCD. When you continually submit to the urge to do the compulsions, it only strengthens your need to engage in them. On the other hand, when you prevent yourself from performing compulsions, you teach yourself a new way to respond. This will likely lead to a noticeable reduction in obsession-based stress and increase your ability to tolerate uncertainty.
Here’s an example of a potential exposure for ROCD: Let’s say you’ve identified with your therapist that every time your partner makes a joke you don’t find funny, you have intrusive doubts about whether you’re really meant to be together. In these moments of doubt, it feels like the only thing that helps is calling a friend for reassurance.
ERP therapy will help to identify this cycle, so you know how to handle the situation when it comes up. So the next time your partner makes a silly joke and your obsessive doubts kick in, instead of reaching for the phone to call your friend, you’ll try to sit with the anxiety that comes from worrying that you may be with the wrong partner. You might start by simply waiting for 15 minutes before reaching out for reassurance, and later work on accepting uncertainty by saying to yourself: “Maybe we’re not truly meant to be together. Who really knows?” Over time, you’ll start to feel less agonized when those thoughts come up, enjoying your relationship despite the uncertainty you feel.
ERP vs. “Traditional” talk therapy
While traditional talk therapy is effective for treating many issues, it can actually be counterproductive for ROCD. Here is a brief example.
Say you are worried about whether you’re with the right person. In talk therapy, you might focus on all the positives in your relationship so you feel more assured about your relationship status. The therapist might say something like, “I’ve known you for five years, and I think this is the happiest you’ve been with a person. Is there something specific that’s bothering you now?”
Although this comment may feel helpful for someone concerned about their relationship, for someone struggling with ROCD, it may fulfill the compulsive need for reassurance and rumination. It might feel good in the short term to have your anxieties relieved, but in the long run, this isn’t doing anything to help ROCD.
How to get help for ROCD
ROCD can be difficult to diagnose because many of the behaviors can sound like normal components of any relationship. However, a mental health professional who specializes in OCD will be able to make an accurate diagnosis.
When seeking help for OCD, it’s important to work with a licensed professional who has specialty training in ERP therapy. If you think you may be struggling with ROCD, schedule a free call with our care team to learn about working with a NOCD Therapist.
Learn More About Relationship OCD
If you’re interested in learning more about ROCD, here is some further reading: