Relationship OCD Obsessions & Compulsions
A common OCD theme is the obsession around relationships, which can take numerous forms, from fears of infidelity to worrying they are lying to themselves and do not love their partner or find them to be attractive, along with obsessive doubt and ruminating over whether they're in the right relationship, among other fears. Read more below about the characteristics of this presentation of OCD.
Relationship OCD Symptoms
Relationship OCD, or R-OCD, is a subtype of Obsessive-Compulsive Disorder (OCD) that specifically involves obsessions and compulsions related to intimate relationships. People with ROCD experience intrusive and distressing thoughts, doubts, and uncertainties about their romantic relationships. These thoughts can center around fears of not being in love, concerns about the partner's suitability, or worries about the relationship's future.
Common features of R-OCD:
Intrusive Thoughts: Individuals with R-OCD often experience persistent, unwanted thoughts that question the authenticity or quality of their romantic relationship, thoughts that they do not find their partner attractive, no longer love them, are not a good fit for each other, that they're lying to themselves, or that they have "morally cheated" in some way by finding someone else to be attractive or by e.g., having a sexual dream about someone else. These thoughts can be distressing and may lead to a false sense of doubt and credibility, prompting ongoing anxiety.
Compulsive Thoughts/Behaviours: To alleviate the anxiety caused by obsessive thoughts, individuals with ROCD may engage in various compulsive behaviours. These can include seeking reassurance from their partner or others, engaging in mental compulsions (read more here) by constantly analysing the relationship, engaging in internal mental debates with their mind, engaging in compulsive hypothesis testing (e.g., picturing their partner and seeing if they find them to be attractive), comparing their relationship to others, avoiding situations that trigger distress, or engaging in compulsive confession of any thought they have had about the relationship "I am worried I don't find you attractive", or "I saw an attractive woman when I walked down the street and I checked her out". The OCD taunts the individual "sure, your partner did not care about the fact you looked at that attractive woman, but did you tell her every detail of the memory, how can you be certain that they would be okay with it when they were not there to witness it - you need to confess every detail possible to ensure its okay".
Other compulsions common to this presentation of OCD might involve compulsive attention and somatic checking for signs of genital stimulation when they see someone that fear being attracted to, or the inverse: testing if they are aroused by their partner. However this compulsive testing of their reaction brings ambiguous results in both scenarios, where bringing attention to the genitals to scan for signs of arousal can inadvertently create arousal ("oh no its true, I am aroused by that person" or the inverse: trying to test if you are aroused by your partner with the pressure of the OCD will likely be an anxiety provoking situation where arousal is less likely to occur.
Fear of Making the Wrong Decision/Doubting Judgement: There is a heightened fear of making the wrong decision about the relationship, leading to uncertainty and distress. This fear can impact daily life and decision-making processes. When reassurance seeking becomes a dominant coping strategy, individuals may struggle with making decisions independently. The constant need for external validation hinders their ability to trust their judgment. Excessive reassurance seeking may also foster dependency on others for managing anxiety. This can strain relationships and create an unhealthy dynamic where the individual relies on external validation to cope with obsessive thoughts. Despite seeking reassurance repeatedly, individuals with OCD find that the doubts and anxieties persist. This realisation contributes to frustration and a sense of helplessness, perpetuating the cycle of compulsive reassurance seeking. Relying heavily on reassurance from others undermines an individual's sense of self-efficacy and confidence in handling life's uncertainties independently.
Impact on Relationships: R-OCD can significantly affect the quality of romantic relationships. The constant doubt and anxiety may strain the relationship, as the person with ROCD seeks reassurance or engages in behaviours that can be misconstrued as controlling. E.g., their partner might receive a text message, and then the sufferer of OCD experiences an intrusive thought "you have to know what that text message said, or you will be stuck on that thought forever" prompting them to compulsively request their partner reveals the content of the text, even if the OCD sufferer has no actual concern to know what the text said. As well, as result of compulsive confession, partners without an understanding of OCD might misconstrue the compulsive behaviour "maybe I'm not attractive to them anymore after all". Further, the significance placed on the intrusive thoughts by the OCD sufferer means they might e.g., sit their partner down to confess some "relationship sin" that is actually only an obsession (e.g., "I find my colleague to be attractive"), where the partner may experience this confession as more significant than it really is "the fact that they're sitting me down to confess this, must mean maybe it really is a significant issue and is not a harmless attraction to someone, they must not want to be with me anymore". This can create a vicious cycle where even the partner without OCD may come to care about things confessed to them that they previously would not have thought twice about, due to the false sense of credibility the act of confession gives to the "issue" confessed.
Insight: Some individuals with R-OCD are aware that their thoughts and fears are irrational, but they find it challenging to control them. Others may believe their concerns are valid, further complicating the situation.
Relationship OCD Treatment
It's important to note that like other forms of OCD, ROCD is a mental health condition that can be treated. If you or someone you know is experiencing symptoms of ROCD, it's advisable to seek help from a mental health professional who can provide a proper diagnosis and recommend an appropriate treatment plan.
Cognitive Behaviour Therapy:
ERP is a central component of cognitive behaviour therapy (CBT) and other treatment approaches for OCD. It involves exposing individuals to situations that trigger obsessions and preventing them from engaging in compulsive thoughts and behaviours to break free of the obsessive-compulsive cycle. For this particular presentation of OCD, treatment usually needs to address the covert mental compulsions being used which perpetuate the OCD, and to address compulsive reassurance seeking and confession. Partners often inadvertently (despite meaning well) fuel the OCD cycle in their attempts to offer this reassurance, where treatment may need to also shift how the sufferer's partner offers support, moving away from indulging the content of intrusive thoughts the sufferer is seeking reassurance for, and replacing this with a more general caring response, i.e., instead of "I can assure you that thought is not true, don't worry", support may look more like validating the difficulty of of their partner's anxiety without being pulled into or indulging the compulsive reassurance seeking.
Cognitive Restructuring & Building Metacognitive Awareness:
Addressing maladaptive thought patterns related to doubt and uncertainty. This includes challenging cognitive distortions and developing a more balanced and realistic perspective for what a healthy relationship might look like, helping to accept normal doubts, thoughts, and feelings without scrutinising them into uncertainty and perceived threat through the OCD cycle. Restructuring of the perceived utility of compulsions, and helping the individual let go of the misplaced sense of importance on using their compulsions, is also an important part of treatment.
Mindfulness techniques (when applied in an OCD congruent way) can help individuals observe their thoughts and anxiety without judgment and reduce the urge to engage in compulsive behaviours
Page Author: Caspar Wenn,
The OCS Clinic Director & Principal Psychologist