Relationship Obsessive-Compulsive Disorder ROCD

~ Understanding Relationship OCD

Relationship Obsessive-Compulsive Disorder (ROCD) is a type of OCD in which the person suffers from intrusive, unwelcome and distressing thoughts and obsessive doubts about their intimate relationships. The person may repeatedly question if they are happy with the relationship or if their partner is really the one for them. Such obsessions can make the person extremely frustrated, confused, and shameful of their thoughts, which causes negative implications on their relationships.

The age of onset for relationship OCD is still unknown. Some patients reported symptoms in early adulthood. There are others who can trace back their symptoms to the first time they had to decide on life-changing, commitment-related issues, such as moving in together or getting married. ROCD obsessions may also plague those outside a romantic relationship, but greater distress and disruptions are experienced by those who develop the condition while in a romantic relationship.

~ What Relationship OCD Looks Like

ROCD is different from typical relationship doubts. For a person with this type of OCD, their doubts contradict their true feelings. Someone who really loves their partner will find the thoughts distressing because they are inconsistent with what they truly feel. These intrusive thoughts are called ego-dystonic. On the other hand, typical relationship doubts are often ego-syntonic, which simply means that the thoughts are expressions of true feelings. While these thoughts may be saddening, they don't plague the person to the point of distress.

~ Effects on Relationships

Even though it's common for most people to have doubts about their intimate relationships, ROCD is characterized by symptoms that can be incapacitating and severe — it gets in the way of fully enjoying a relationship. A person's doubting obsession about their partner's perceived flaws can become time-consuming, impairing, and stressful. The relationship may turn chaotic if one person has ROCD. Even the most understanding partner will tire of hearing how the person they love doubts their feelings for them. Instability due to constant misunderstandings and conflicts can lead to separation, which may trigger even more obsessions and compulsions.

~ Types of ROCD

Relationship-Centered ROCD: People with this type have strong doubts and worries related to the true nature of their feelings toward their partner, or whether their partner truly loves them. They would often doubt if they are in the right relationship or if it is "meant to be." Thoughts about ending the relationship give them terrible anxiety, yet staying in the relationship leaves them vulnerable to nagging doubts about its validity.

Partner-Focused ROCD: This type involves repetitive, intrusive thoughts about the characteristics of one's partner — their physical attractiveness, social skills, career, and personality traits. The patient constantly compares their partner to others and is focused on their partner's shortcomings while failing to acknowledge their good qualities.

~ Treatment Outcome

Just like other types of OCD, the best treatment for Relationship OCD is Cognitive Behavioral Therapy (CBT), specifically Exposure and Response Prevention (ERP). Initially, the client must acknowledge that their obsessions and compulsions hinder them from enjoying their relationship. Upon experiencing significant symptom reduction through treatment, they come to understand the true nature of their relationship by fully experiencing it — rather than by listening to their relationship-related doubts and fears.

Dr. Henry Srednicki specializes in the treatment of ROCD and related anxiety disorders. With offices in Upper Montclair, NJ and New York City, and telehealth across 42+ states through PSYPACT, evidence-based care is within reach.