What is relationship OCD (R Obsessive-Compulsive Disorder)? We can all experience thinking about whether our partner is the right one

Even the closest couples can experience moments of uncertainty about how they feel about each other.

It is a common experience to have doubts about compatibility with one’s partner or how appropriate our romantic relationship is.

In some cases, such as the example described above, these doubts and worries occupy so much of the person’s mental space that they come to limit their social and work functioning.

In these cases, we speak of Obsessive-Compulsive Disorder (OCD) from relationship

An obsessive-compulsive symptomatology that has its focus on intimate relationships and has only recently begun to receive attention from both clinical and research perspectives (Doron, Derby, Szepsenwol, 2014).

Onset of relationship OCD

‘Relationship’ obsessions can involve various types of relationships, such as a mother’s relationship with her child or even her relationship with God, although much of the research has been based on the relationship with one’s partner.

In some cases, symptom onset follows important relationship decisions, such as a marriage proposal or having children.

In other situations, obsessive-compulsive symptoms occur after the termination of a romantic relationship.

The person obsessively worries about how the previous partner was the right person, fearing that they will regret their choice forever.

And so he feels the need to reassure himself by, for example, remembering the reasons why the relationship was ended, or recalling the conflicts he experienced, as if to find justification for that choice.

The research shows that both the duration of the romantic relationship and gender are not variables related to this type of OCD.

Types of relationship OCD (R OCD)

There are two common manifestations of this symptomatology: relationship-centered obsessive-compulsive symptoms and partner-focused symptoms.

Relationship-centered

In the first case, people feel haunted by doubts and worries about how they feel about their partners, how their partners feel about them, and how ‘right’ the relationship is.

They may repeatedly have thoughts in their heads such as, “Is this the right relationship for me?” or “What I feel is not real love!” or “Am I okay with him/her?” or “Does my partner really love me?”

Partner-centered

In the case of a partner-focused symptomatology, on the other hand, the core of the obsessions are physical characteristics of the partner (such as a body part), social qualities (e.g., not possessing the prerequisites for success in life), or even aspects such as, for example, morality, intelligence, or emotional stability (“He is not smart enough for me,” “He is not a sufficiently stable person with whom I can carry on a family project”).

The relationship between the two types of symptoms

The two symptom manifestations are not mutually exclusive in the same person.

Clinical experience and scientific research have shown that relationship-centered and partner-focused OCD symptoms often occur together.

Many people describe first being concerned about a perceived flaw in their partner (e.g., regarding physical appearance) and then being plagued by thoughts about how ‘right’ the relationship might be, given that very physical limitation.

The reverse can also occur: one starts having doubts about the relationship and only later becomes concerned about some defect in the partner.

In this case, the intrusive thought regarding the partner’s defect could be considered precisely the sign of something wrong in the relationship.

Relationship OCD: behavioral strategies

Compulsions

As a prerogative of any form of obsessive-compulsive disorder, doubts and worries are associated with a variety of compulsions whose purpose is to try to suppress/reduce the frequency of these thoughts, as well as reduce uncertainty with respect to content.

The most common compulsions that people with relationship OCD tend to enact are as follows:

• paying attention to and controlling their own feelings (“Do I feel love toward my partner?”) and behaviors (“Am I looking at other women/men?”);
• comparing one’s relationship with that of other people, such as friends, colleagues or even the romantic relationships of TV personalities (“Am I as happy as they are?”);
• reassure themselves by recalling experiences with their current partner in which they felt certain about how they felt.

Avoidances

People suffering from relationship OCD often try to avoid situations that may act as triggers to their unwanted thoughts and doubts about the relationship.

For example, they may avoid social occasions with friends recognized as ‘the perfect couple.’

If those circumstances were not avoided they would occupy all their time comparing their own behavior with that of their friends, noting those differences that would then be read as confirming that their relationship is not ‘right’.

Similarly, pleasure activities, such as watching a romantic movie, may be avoided for fear of detecting a discrepancy between that what they feel about their partner and the passionate and overwhelming love that perhaps distinguishes the film’s protagonists.

Relationship OCD: the cognitive elements

It is widely recognized in obsessive-compulsive disorder that the different reaction toward one’s internal events plays a role in the development of the disorder.

In the specific case of relationship OCD, for example, individuals may attach great importance to the couple relationship as a foundational part of their being, of who they are.

Thus, if one’s self-esteem and self-worth is closely connected to the relational domain, one is inevitably hypervigilant to everything related to the relationship, to the point that a normal feeling of boredom within the relationship with one’s partner may have significantly negative implications on my idea of myself.

Similarly, these people will be more sensitive to thoughts about their partner’s qualities if some flaw in the partner is perceived as reflecting their own self-worth.

Here, how the partner compares with others and how he or she is regarded by the rest of the world can reverberate on the person by affecting Self-image, resulting in negative emotions (e.g., shame, guilt).

Dysfunctional beliefs

Specific beliefs about relationships, moreover, may be particularly relevant to the maintenance and development of relationship OCD.

For example, catastrophic thoughts related to the harm of being in a relationship in which one has doubts or about the negative consequences for the other of breaking off an existing relationship (e.g., “Ending a relationship with a partner is one of the worst things that can happen in a person’s life”) and for oneself (“The thought of living my life without him/her terrifies me”).

These people usually present rigid beliefs of what they should feel within a ‘right’ relationship, such as “If you don’t think about your partner every moment of the day, it means he/she is not the one” or “If you are not always happy when you are with him/her, it is not true love.”

Finally, perfectionism, intolerance of uncertainty, the importance of thoughts and their control, as well as hypertrophic responsibility, which represent some of the typical beliefs in obsessive symptomatology, are also present in relationship OCD.

Treatment of relationship OCD

As with other forms of obsessive-compulsive disorder, cognitive-behavioral treatment is effective in relationship OCD.

Cognitive-behavioral therapy enables the learning of functional strategies for managing and reducing obsessions and compulsions.

Specifically, the techniques used are exposure with response avoidance (exposure to feared situations without being able to resort to compulsions to manage doubts and negative emotions) and cognitive restructuring of dysfunctional thoughts and beliefs.

In some cases, the partner may also be involved in order to assess any reinforcement provided by the partner to the patient’s symptoms and interrupt dysfunctional interpersonal cycles.

A significant reduction in symptoms would allow for a greater awareness of what is happening within the relationship allowing the person to come to a decision (to leave or not to leave the partner) based on actual relationship experience rather than fears and concerns related to the disorder.

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Source

Doron, G., Derby, D., & Szepsenwol. O. (2014). Relationship obsessive-compulsive disorder (ROCD): A conceptual framework. Journal of Obsessive-Compulsive and Related Disorders, 3, 169-180.

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