If you have relationship OCD, you may struggle with unwanted thoughts and feelings about the nature of your bond with your partner.
These may happen at any time. Perhaps you’re on a romantic date with your partner and someone you find attractive walks past. Suddenly, you find yourself questioning whether you find your partner appealing and whether you’re both wasting your time.
Individuals with the relationship subtype of obsessive-compulsive disorder (ROCD) are constantly plagued with doubts, insecurities, and questions about their relationship. However, ROCD is treatable and learning more about ROCD may inspire struggling individuals to reach out for support to start managing those unwanted thoughts.
What is relationship OCD?
Relationship OCD is a form of obsessive-compulsive disorder characterized by intrusive thoughts and urges related to your romantic relationship.
Sufferers combat these unsolicited intrusive thoughts with compulsive behaviors that are repeatedly performed to lessen anxiety. However, compulsions and repetitive behaviors may prove time-consuming, stressful, and end up causing further anxiety.
For example, a person in an otherwise healthy relationship, might obsess over whether their partner is being faithful. To alleviate doubts about their partners loyalty, they may check their partner’s social media profile, text messages or emails. This only provides temporary relief of their anxiety about their relationship as the obsessive thoughts continue to plague them, perpetuating the cycle between obsessions and compulsions to the detriment of both their relationship and everyday life.
Types of relationship OCD
Research shows relationship OCD presents itself in different ways:
Relationship-centered – sufferers demonstrate misgivings centered on the suitability of the relationship, such as the legitimacy of their own feelings, their partner’s feelings, or whether the relationship has a future. 
Partner-focused – sufferers within this category focus on an array of their partner’s perceived shortcomings, such as a lack of intelligence, beauty, morality, and social capability. 
While many people experience relationship anxiety from time to time, this has been theoretically and empirically distinguished from ROCD-related obsessions.  Compared with typical ‘worries’ about relationships, ROCD obsessions are less rational, more intense, time consuming, and likely to be accompanied by compulsions. 
Common ROCD compulsions
Common compulsions, used to reduce feelings of anxiety and distress, include but are not limited to:
- Comparing their intimate relationships with other people such as friends, family, or characters on film and TV.
- Seeking reassurance from friends, families, therapists, psychics, or fortune-tellers.
- Testing their partner to see if they are intelligent, moral, or sociable enough.
- Trying to ‘fix’ their partner to satisfy the obsessional requirement.
People with relationship OCD may put pressure on their romantic partner to engage in compulsive behaviors, which can be a source of tension and damage the quality of the relationship. 
What causes relationship OCD?
The exact cause of relationship OCD, like other obsessive-compulsive disorders, is unknown, although several genetic, environmental, and neurological factors may contribute to its development. These are highlighted below:
Genetic predisposition: There is evidence to suggest that OCD and related mental health conditions have a genetic component. People with a family history of OCD or anxiety disorders may be more susceptible to developing the relationship subtype of OCD.
Environmental factors: Stressful life events, traumatic experiences, or relationship problems may trigger or exacerbate symptoms of relationship OCD. These factors can contribute to increased anxiety, uncertainty, and obsessions about the nature of relationships.
Neurochemical imbalances – Research indicates that OCD is related to problems between the frontal cortex and other areas of the brain. Different structures in the brain use a neurotransmitter called serotonin, which plays a role in regulating mood and anxiety, to communicate.  Imbalances in these neurotransmitters may contribute to the development of ROCD.
Triggers for OCD
If you have ROCD, there are a range of everyday scenarios that may trigger obsessions about your relationship. These include but are not limited to:
- Sexual intimacy
- Being apart from your partner for any period of time
- Being around other people whom you find attractive
- Being around friends who they consider to have a ‘perfect’ relationship 
- Seeing romantic movies 
People with ROCD often try to avoid situations that trigger their unwanted thoughts or relationship doubts. This behavior can put strain on a relationship.
How to manage relationship OCD
As there is no permanent cure for OCD, the focus ought to be on managing your symptoms. Fortunately, there are many treatment options which may help to reduce the impact of ROCD symptoms and give you the best chance of maintaining a romantic relationship.
The treatment for ROCD typically involves a combination of psychotherapy and medication.
Cognitive behavioral therapy (CBT) – considered the gold standard therapy for treating obsessive-compulsive disorders, including ROCD, CBT helps patients identify and challenge negative thought patterns. The most effective form of CBT for treating ROCD involves exposure and response prevention (ERP). 
During ERP, patients are gradually exposed to thoughts or triggers that typically cause anxiety and obsessions related to their relationships. They are encouraged not to perform the compulsive behaviors they would typically to alleviate anxiety. Over time, patients learn to tolerate their obsessions and manage their symptoms. 
Couples Therapy – In some cases, involving the partner in therapy may be beneficial. Couples therapy can help improve communication, address relationship difficulties, and provide support and understanding to both partners. It can also help the partner comprehend and participate in the management of ROCD symptoms.
Medication – Your doctor may prescribe a course of selective serotonin reuptake inhibitors (SSRIs) to reduce the symptoms of ROCD. Studies show SSRIs to be the most effective pharmacological treatment for symptoms of obsessive-compulsive disorders. 
It’s important to work with a doctor and qualified mental health professional experienced in treating OCD and ROCD to receive an accurate diagnosis and appropriate therapy. Take medication exactly as prescribed by your doctor.
How to cope if your partner has relationship OCD
If your partner has ROCD, it can be challenging for both of you. Supporting your partner while taking care of your own well-being is crucial. Here are some strategies to cope with your partner’s ROCD:
Learn about ROCD and its symptoms to gain a better understanding of what your partner is experiencing. This knowledge can help you develop empathy and provide appropriate support.
Open and honest communication
Fostering an open and honest dynamic between you and your partner is essential if they are battling with ROCD. Create a safe space for them to express their thoughts, fears, and doubts related to the relationship. Show empathy and make them feel understood.
Encourage them to explore treatment options.
Suggest that your partner seeks therapy with a mental health professional experienced in treating ROCD. Without treatment, it is likely symptoms will not go away, so it is in their best interests to explore options. Offer to accompany them to therapy sessions if they feel comfortable with it.
It’s essential to prioritize your own well-being. ROCD can be emotionally draining for both partners. Engage in self-care activities, seek support from friends or a support group, and consider individual therapy if needed. Taking care of yourself enables you to provide better support to your partner. Encourage your partner to develop their own-self care routine. It could energize them and give them the boost they need to get on top of their symptoms.
- Doron, G., Derby, D., Szepsenwol, O., Nahaloni, E., & Moulding, R. (2016). Relationship Obsessive-Compulsive Disorder: Interference, Symptoms, and Maladaptive Beliefs. Frontiers in psychiatry, 7, 58. https://doi.org/10.3389/fpsyt.2016.00058
- International OCD Foundation. (2023d, April 20). International OCD Foundation | Relationship OCD. https://iocdf.org/expert-opinions/relationship-ocd/
- International OCD Foundation. (2023f, June 28). International OCD Foundation | What causes OCD?https://iocdf.org/about-ocd/what-causes-ocd/
- Doron, G., Derby, D. S., & Szepsenwol, O. (2014). Relationship obsessive compulsive disorder (ROCD): A conceptual framework. Journal of Obsessive-Compulsive and Related Disorders, 3(2), 169–180. https://doi.org/10.1016/j.jocrd.2013.12.005
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