Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Here’s How OCD Affects Your Relationships Before, During, and After Treatment

By Patrick McGrath, PhD

Nov 30, 20237 minute read

Reviewed byDr. Keara Valentine

treatment and relationships

Obsessive-compulsive disorder (OCD) affects every aspect of life, including — and sometimes especially — relationships.

Driven by concern and a deep need to help their loved one be OK, partners of people with OCD take on a lot of emotional responsibility. They feel like they have to safeguard their partner and protect them from unnecessary upset. At the same time, the partner with OCD notices their loved one doing extra emotional work and can easily start to feel guilty. 

Is my partner getting frustrated with me? 

Are they going to cheat on me?

It’s a stressful situation to be in, and the fear of losing your trusted partner can make OCD symptoms that much more difficult. 

The good news is that treatment can help, especially when it’s a proven, effective treatment program like exposure and response prevention (ERP). ERP teaches you how to manage your OCD more effectively, so you and your partner feel less stressed.

What kind of stress does OCD put on relationships?

There are many different subtypes of OCD, and each one affects a person’s relationships differently. Someone with contamination OCD might avoid sexual activities for fear of genital infections. Someone with “Just Right” OCD might feel the need to close the garage door multiple times before it feels right, so every attempt to leave the house takes longer.

But no matter what a person’s triggers and symptoms are, the impact is similar across OCD relationships. When life is exceedingly difficult to manage for one person, it’s difficult for both.

Before treatment: What OCD symptoms affect relationships the most?

Excessive reassurance seeking. Everyone needs reassurance from time to time, but with OCD, the need is persistent and compulsive. You might feel the need to ask again and again if your partner still loves you, if the bathroom is clean, if you turned the oven off, and so on. 

This can leave you feeling guilty and ashamed, and even then you might not believe your partner when they give you the reassurance you’re asking for! On top of that, your partner might express frustration, or it might cause conflict in your relationship if they no longer want to provide you with the reassurance you request. 

Avoidance of everyday situations. When you have OCD, it’s common to feel like you can’t handle situations that trigger your intrusive thoughts and compulsions. Some people feel like it’s too hard to walk into a grocery store because of germ fears. Others are uncomfortable around knives because of harm OCD and want someone else to chop all the vegetables.

It’s hard enough to feel like you’re not up to seemingly basic tasks. But when you see your partner taking on those avoided tasks, you can start to feel embarrassed or inadequate. You might wonder if you should apologize, or if that would just be more work for your partner. It feels like a no-win situation for you and possibly for your partner as well.

What about relationship OCD?

Relationship OCD gets its own section here because, with this subtype, the relationship itself is the trigger.

Every intimate relationship has some level of uncertainty — relationships involve complex human beings and their feelings about one another. If you have relationship OCD, you probably have trouble tolerating this uncertainty. You likely think obsessively about whether the relationship is “right” or if your partner is “the one.” Even if your partner reassures you that they care, you might have trouble believing them.

At the same time, your partner has to live with that daily questioning of the relationship. Maybe they have to watch you “check out” strangers, take relationship tests online, or express your doubt verbally to friends. 

Even if you both know that OCD is the cause of this insecurity, it can be demoralizing and scary for both of you.

What happens next?

Anticipatory avoidance AKA Accommodation. When a person with OCD has extreme fear reactions to a particular situation, the people who love them naturally try to offer protection. Your partner might try their best to keep your environment clear of triggers. If they can’t, both of you could end up feeling guilty.

Knee-jerk reactions. Some partners of people with OCD don’t know how to support someone with a mental health diagnosis. Others know to be compassionate and understanding, but they experience frustration and don’t know how to express it, so they take it out on their partners.

In moments of frustration, your partner might result to unhelpful reactions such as criticizing, snapping at, or belittling you. At times, they might even blame you for not being able to control your OCD symptoms, even if they know deep down you’re trying your hardest. Regardless of whether you’re struggling with your OCD or well on the road to recovery, these reactions are important to address. In the end, no one deserves to be mistreated by their partner. You may even benefit from involving your partner in your treatment to help them learn just how challenging living with OCD can be. 

DIY therapy. Many partners are happy to provide emotional support and guidance when OCD rears its ugly head. They ask you about your feelings and responses, encourage you to notice when your “OCD brain” is in charge, and express understanding about the intensity of your feelings.

Also remember that as reassuring as partner support can be, it’s no substitute for professional treatment. It’s important to seek the help of a trained therapist so your partner doesn’t have to do that work.

During treatment: How can ERP therapy transform your relationships? 

When one person in a relationship has OCD, both partners must rearrange their daily lives to make room for symptom management. When you go through ERP treatment, you learn how to manage your triggers and reduce your anxiety so you and your partner aren’t so strained. It’s one of the most important things you can do to make your relationship healthier. 

In ERP therapy, you work with a therapist to safely expose yourself to situations that ordinarily make you feel anxious. Your therapist works with you to create custom-designed exposure exercises, each related to a particular OCD trigger. Your job is to do those exercises without resorting to avoidance or ritual behaviors to make yourself feel better.

Ordinarily with OCD, an internal or external trigger causes intense anxiety that prompts compulsive behaviors. Your body and mind learn to believe you can’t handle those situations without avoiding them or doing rituals.

If OCD is interfering in your relationship, your therapist might encourage you to bring your partner in for a session or two to learn about your symptoms and how they can best be supportive. This might involve teaching your partner how to respond to requests for reassurance and decrease accommodations.

ERP breaks the cycle and empowers you to make healthier choices. Your anxiety becomes less overwhelming. You gain control over your OCD, and you and your partner are able to focus less on your OCD and more on your time together. 

After treatment: What’s the long-term prognosis for my relationship?

Studies have shown that ERP can be the catalyst that changes a person’s OCD outlook from “poor” to “very good.” That’s largely because ERP doesn’t just teach you coping skills. Through experience, it convinces your body and mind that you can handle triggering situations without avoiding, doing ritual behaviors, or asking for reassurance.

The longer you live with this kind of confidence and independence, the more your partner can relax and trust you to manage your OCD symptoms. Daily life gets easier, and most importantly, the relationship takes on the equality and balance that every healthy relationship should have. 

If you or someone you know is struggling with OCD, I encourage you to learn more about NOCD’s accessible approach to evidence-based treatment. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP. At NOCD, all therapists specialize in OCD and receive ERP-specific training.

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