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Relationship OCD

ROCD: The OCD Subtype With Uniquely Challenging Social Ramifications

5 min read
Stephen Smith
By Stephen Smith
All types of OCD include obsessions and compulsions. Obsessions are unwanted and intrusive thoughts, feelings, urges and doubts, while compulsions are repetitive physical or mental actions performed in an attempt to relieve distress and anxiety.

I wouldn’t wish OCD on my worst enemy. Here is how I’d describe it to someone who isn’t as familiar with the condition:

Imagine you are driving on the highway in the far left lane on a clear, spring morning. You are driving at about 75 miles per hour without a care in the world, thinking about all of the work ahead of you that day. Suddenly, you hit a deep pothole head-on. Because you’re driving at full speed and the pothole is massive, your car’s suspension gets thrown into misalignment and your car begins to veer to the right, even when you purposefully steer it to the left. You become immediately nervous since no matter how hard you try, you can’t control your car’s direction and traffic is zooming past you. Your heart begins to race uncontrollably, and you aren’t quite sure how to cut across the other three lanes and pull over to safety. Finally, a window opens, you cut across the highway, and your broken-down vehicle comes to a screeching halt. Within seconds, you call AAA, and a truck is sent your way to start to tow your car to the shop. Within days, you’re back on the road driving to work. 

Now imagine if you weren’t able to pull over to the side of the road, no matter how hard you tried, and the only way to prevent getting into a massive accident on the highway was to keep up with traffic until an opening emerged. You would begin feeling frustrated and hopeless.

That’s what OCD feels like, except the window to pull over never actually emerges, no matter how hard you try. For most people, OCD onsets as unexplainably and quickly as hitting a massive pothole on the highway, and the fears caused by the condition attack what we love most, a feeling as if our personal suspension is in complete misalignment. The only way to manage the condition is to accept the uncertainty that “our car might always veer to the right, but we will try to get to work regardless.” Most people can learn how to do this with the help of a licensed therapist that is specifically trained to deal with the exact circumstances people with OCD face, no matter the subtype they have or the car they’re driving. 

Although OCD subtypes feel debilitating, they’re all treated the same: with Exposure and Response Prevention (ERP) therapy, and sometimes with the aid of medication. However, some subtypes create more challenging social ramifications than others, from my observation after personally suffering from OCD and seeing the ways millions of others navigate the condition over the years. 

Relationship OCD (ROCD) is a prime example. ROCD is a subtype that causes people to doubt their relationship’s state or stability. Some people with ROCD might fear that their partner doesn’t love them, or they may fear that they don’t love their partner. Others might fear that their partner will cheat on them, or they might cheat on their partner. It’s grueling, like most subtypes of OCD, but since ROCD fears directly involve significant others, the significant others are also usually at the center of the person’s safety-seeking behaviors, called compulsions

Let’s take an example: someone with ROCD may be out on a walk with their partner when they pass another couple holding hands. Immediately, they are struck with intrusive thoughts: “We aren’t holding hands. Do we not love each other as much as they do? Why not? Is our relationship doomed? Is it my fault?” They feel as if they can’t let go of these worries, and they start asking their partner questions throughout the day to feel more assured about their relationship: “You love me, right? Do you ever not want to hold hands with me? Did I do something to annoy you earlier? Is our relationship okay?” Their partner starts feeling overwhelmed, and tension grows when they spend time together—no matter what answer they give, the questions keep coming. 

Without treatment and education, compulsions like reassurance-seeking can lead to tension, arguments, and even avoidance, since the person with ROCD can’t just “snap out of it” and the significant other can’t understand why their loved one is acting so irrational and stubborn. 

Eventually, as the ROCD cycle continues and neither person has a deep understanding of OCD, you can imagine the toll this could have on the relationship. What if children were in the picture? It could be devastating, acutely affecting not just the couple, but also the rest of the family. Few OCD subtypes take such a personal toll on someone’s family as ROCD, and it can be detrimental to a relationship without proper diagnosis, treatment, and education. 

This is why it’s imperative to take a holistic treatment approach for people dealing with ROCD—one that helps people navigate their specific subtype and their families. Personally, I was lucky enough to have an amazing significant other who supported me through treatment; without her, I don’t think I would have managed OCD effectively. 

That’s why at NOCD we’re offering our members treatment that’s proven to significantly reduce ROCD’s severity, and educate significant others about how they can best help their loved ones, through NOCD 411 sessions. During a 411 session, NOCD Therapists will teach significant others what they can say and do to help their loved ones resist compulsions and accept uncertainty, while at the same time the person suffering from ROCD can receive ERP with NOCD Therapy. This approach aims to improve ROCD symptoms while also potentially benefiting the quality of life of both the therapy member and their significant other.

If you have ROCD or are a loved one of someone with the condition, please know we are here to help. You can work with a NOCD Therapist by booking a free call with our team, or find a clinician outside of the NOCD Therapy network in the IOCDF provider directory. Be sure to interview interview any prospective therapist before working them, though. The wrong therapist can provide care that isn’t just ineffective, but actually harmful

Stephen Smith

Stephen founded NOCD after feeling frustrated with a lack of treatment resources and support during his own OCD recovery. He enjoys running hill sprints, listening to audiobooks, and eating breakfast no matter the time of day.

Patrick McGrath, PhD

Dr. McGrath is a Licensed Clinical Psychologist and the Chief Clinical Officer at NOCD. He is a member of the Scientific and Clinical Advisory Boards of the International OCD Foundation, a Fellow of the Association for Cognitive and Behavioral Therapies, and the author of "The OCD Answer Book" and "Don't Try Harder, Try Different."

NOCD Therapists specialize in treating Relationship OCD

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Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

Andrew Moeller

Andrew Moeller

Licensed Therapy, LMHC

I've been a licensed counselor since 2013, having run my private practice with a steady influx of OCD cases for several years. Out of all the approaches to OCD treatment that I've used, I find Exposure and Response Prevention (ERP) therapy to be the most effective. ERP goes beyond other methods and tackles the problem head-on. By using ERP in our sessions, you can look forward to better days ahead.

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