Obsessive compulsive disorder - OCD treatment and therapy from NOCD

What is Relationship OCD?

Ever worry whether your partner feels the same way about you—or if they're truly the one for you? Are you overly focused on who else might be out there, for either one of you? Maybe you're riddled with thoughts about finding someone better, or questioning everything about your partnership. What you're experiencing is Relationship OCD (ROCD), a subtype of obsessive-compulsive disorder characterized by ongoing intrusive thoughts and compulsive behaviors related to close personal relationships.

Experiencing doubts and insecurity from time to time is normal in a relationship. But when these thoughts are recurring, deeply troubling, and intrusive, they could be a sign of relationship obsessive-compulsive disorder (ROCD).

“People with ROCD often find themselves questioning everything about their relationship, feeling that they need to be perfectly certain and secure. One may be especially invested in starting a relationship, maintaining a relationship, being a good partner, or being with the right partner, so the slightest doubts can feel impossible to accept,” explains Ryan Ventillo, LMHC, an OCD specialist at NOCD, a leading telehealth provider of OCD treatment.

As a subtype of OCD, ROCD doesn't just stop with the intrusive thoughts. It also entails behaviors (aka compulsions) that people engage in, all in an attempt to quell the distress brought on by the obsessions. This means you might seek reassurance from others, check up on your partner or snoop through their phone, compare your relationship to others', or force a certain way of being in an attempt to be pleasing to your partner.

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Relationship OCD (ROCD): Your guide to symptoms and treatment

Unfortunately, these compulsions don't bring the relief—at least not long term—that you intended. That shouldn't be cause for despair, though. Like all forms of OCD, there is hope for you if you're struggling with ROCD, or think you might be. Keep reading for answers to all your questions—including top signs of ROCD and the best way to recover and keep your relationships strong (and your sanity intact).

Symptoms of ROCD: Obsessions and Compulsions

What are the signs and symptoms of ROCD? As mentioned above, the key components required for an ROCD diagnosis—just as with any type of OCD—are two types of symptoms called obsessions and compulsions.

Obsessions are intrusive thoughts, images, or urges. Experiencing these obsessions on a loop can lead to intense, all-consuming distress. That's what leads someone with ROCD to engage in compulsions—physical or mental attempts to neutralize the thoughts or ease their discomfort. Here are some examples of compulsions involved in ROCD.

Obsession

Compulsion

  • Repetitively taking relationship quizzes online
  • Spending hours on relationship forums to feel better
  • Checking for “signs” that you're attracted to your partner, or vise versa
  • Repeatedly asking your partner for reassurance about their love for you
  • Avoiding certain relationship milestones to protect yourself from getting hurt
  • “Testing” your partner by openly flirting with others

What causes ROCD?

It's only natural to wonder why you're experiencing such distressing thoughts, intense doubts, or why you're so driven to resort to compulsions. Sometimes, ROCD can feel as if it simply popped up overnight. So what's really to blame?

Believe it or not, your intrusive thoughts, doubts, feelings, urges, and other triggers aren't actually the cause of ROCD. In fact, everyone has intrusive thoughts, and anyone in a relationship is likely to experience similar thoughts from time to time! What distinguishes ROCD is your response to them: while others might dismiss these thoughts as random or unhelpful, ROCD makes them feel like real threats and demands that you respond with compulsions.

The underlying causes of OCD aren't known for certain, but research has shown that genetics, brain chemistry, and life events may all play an important role in how and why people develop the condition. For ROCD in particular, your relationship history might also come into play.

Many people develop OCD in the wake of especially stressful or traumatic events, so it stands to reason that severely negative experiences involving relationships could lead OCD to latch onto similar themes.

Melanie Dideriksen, LPC, CAADC

Melanie Dideriksen

“Certain aspects of one's relationship history may sometimes have an influence on why a person's OCD fixates on this theme. Many people develop OCD in the wake of especially stressful or traumatic events, so it stands to reason that severely negative experiences involving relationships could lead OCD to latch onto similar themes,” explains Melanie Dideriksen, LPC, CAADC, a therapist who specializes in OCD treatment.

In a cruel twist of fate, another reason that OCD might latch onto your relationship in particular is simply because it's so important to you. Research has actually shown that one's personal values impact the content of their obsessions, so your ROCD symptoms may reflect just how important your relationship is to you.

The Relationship OCD Cycle

As long as compulsions help you feel better in your relationship, there's no problem with engaging with them, right? Unfortunately, compulsions only provide, at best, fleeting relief. When the relief fades, the obsession returns, and you're right back in what's called the OCD cycle.

distress leads to compulsions, which leads to temporary relief, and the cycle repets.

Do I actually have ROCD, or is it just “normal” relationship anxiety?

It's worth repeating that practically everyone feels anxiety and doubt about their relationships at some point. The difference between relationship anxiety and ROCD often comes down to the amount of time and energy that these obsessions and compulsions consume. An ROCD diagnosis requires obsessions and compulsions to:

  • take up to an hour or more per day
  • cause significant distress
  • interfere with your ability to show up for your life (work, social life, and yes, your relationship)

For instance, you might find that worrying thoughts are relentless, hanging on for hours or even days, and you simply cannot focus on anything else in between your worries and compulsions. You may even discover that the more energy you put into “making things okay,” the more disconnected you feel from your partner.

If you find that you need to ask your partner the same question over and over again because it's the only way you'll feel less anxious about your relationship—even though they've already given you the same answer 10 times—that's a telltale sign of ROCD.

Keara Valentine, PhD
Keara Valentine

Why is ROCD so misunderstood?

Unlike the symptoms that can be obvious with other kinds of illness or disorders, it's easy for ROCD symptoms to go undetected. After all, so much of ROCD happens below the surface, in the minds and hearts of sufferers. Not only that, but it's easy to rationalize obsessions as having a “healthy concern” for your relationship life.

The reasons why you might not notice ROCD symptoms—or even brush them off—can include factors like:

  • You think you're just insecure and feel that working on your self-esteem alone could improve how you feel about your relationship
  • Your brain tries to convince you that your worries aren't intrusive, and that you're effectively coping with relationship issues
  • OCD is only about obsessive hand-washing or cleaning, not about things like relationships (a common myth!)
*When people join the NOCD Community, they are able to select the theme(s) of OCD that they identify with. By collecting and anonymizing their responses, we can gain insight into the experiences of nearly 300,000 people struggling with OCD.

ROCD can keep you stuck in an endless cycle of doubt.

An experienced, specialty-trained therapist can help you find a path forward, with a virtual evaluation and personalized treatment plan.

How is Relationship OCD treated?

As mentioned above, until you learn how to break the cycle of ROCD (meaning, you stop responding to obsessions with compulsions), it will always feel like OCD is running the show. But “breaking the cycle” isn't about mustering up the willpower to stop. (So if you've ever felt bad about not being able to do that, here's the permission to let go of any guilt.)

The most successful treatment for ROCD, like all forms of OCD, is a form of behavioral therapy called exposure and response prevention (ERP). Unlike traditional talk therapy, which can backfire and make ROCD worse, ERP—which was developed specifically to treat OCD—is clinically proven to be highly effective in the majority of people.

It's customized for each person and their unique needs, but here's how ERP generally works: After asking you about your specific symptoms, a trained therapist who specializes in OCD creates your ERP therapy plan. Based on that, you'll work together to rank your fears or triggers based on how stressful they seem—this way, you can gain coping skills gradually without getting overwhelmed.

ERP can disrupt the cycle of triggers, obsessions, and compulsions.

To begin with, your therapist will typically prompt you to face a fear that's not too scary—maybe you start by simply saying the word “cheating” out loud. When you start feeling anxious or distressed, instead of responding with a compulsion, you gradually learn to tolerate the discomfort you feel. As you progress through these exercises with your therapist and between sessions, you'll gradually move on to more difficult ones—eventually, your goal may be to resist the urge to ask your partner if he loves you before going to sleep, learning to accept any uncertainty or anxiety you feel.

There's science at play here, because when you see that you handled the discomfort better than you thought you could, your brain learns that you can live with uncertainty and anxiety—they don't need to rule your life. And as a result, you feel less of an urge to engage in compulsions to feel better.

ROCD makes you believe that you need to feel 100% certain about the state of your relationship, but this is an emphatic lie. A key part of progress in ERP is learning to accept uncertainty, because it exists everywhere in our lives.

Patrick McGrath, PhD

Chief Clinical Officer at NOCD

Melanie Dideriksen

An ERP Therapy Success Story

I wanted to know with 100% accuracy whether or not I was with the right person. Questions bombarded my head, 'Should I experience more?' I wondered: 'Is it too soon to settle down?' Even if I was happy in my relationship, 'Could I be happier?'

I met a friend who happened to have OCD. One day I finally opened up to this person and poured out all that I had been experiencing, all that I held in for so long.

This process, painful as it was, opened up a whole new world. I resonated with their story so much. They showed me the NOCD app.

For me, medication paired with ERP has been beneficial. ERP has helped me learn so much. I have learned how important it is to let thoughts be there. Let them be there and I don't need to respond, I don't need to do anything with them.

A final word on how ERP therapy can transform your relationships

You and your partner(s) deserve to be in charge of your relationship, not OCD. Effective treatment exists, and ERP is—for the majority of people—the most promising option for them to regain their lives.

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 fact, while not the case for everyone (and certainly not a requirement), there are some instances where an OCD therapist might encourage you to ask your partner to join 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.

As you gain control over your OCD, you and your partner are able to focus less on your OCD and more on your time together. Daily life gets easier, and most importantly, the relationship takes on the equality and balance that every healthy relationship should have.

“You are not crazy and you are not broken. Doing ERP can change your life.”

- Anonymous, NOCD Therapy member

OCD recovery is more accessible than ever before. Every NOCD Therapist specializes in treating OCD with ERP therapy, and we accept most major insurance plans.