What is Relationship OCD?
Relationship OCD (ROCD) is among the many subtypes of Obsessive-Compulsive Disorder (OCD). Before looking more closely at this particular subtype, let’s do a quick review of OCD.
Obsessive Compulsive Disorder (OCD) is characterized by the presence of disturbing thoughts or images (obsessions) that are intrusive and unwanted. The nature of these obsessions are distressing and experiencing them on a daily can cause individuals to question whether they are inherently immoral or are likely to end up committing an immoral act. As a result, people with OCD will engage in repetitive mental or behavioral rituals (compulsions) that help them to feel that they are safeguarding themselves from such possibilities.
Compulsions may be outwardly visible behaviors (including commonly known ones such as checking and cleaning), but they can also involve mental rituals that are more “hidden”. Examples of this include counting, replacing a “bad” thought with a “good” thought, praying in a certain manner, or mentally reviewing their recent actions to make sure they have not done anything “wrong.”
These compulsions are effective in the short-term because they can immediately extinguish intense guilt, shame and anxiety. However, the relationship between obsessions and compulsions is cyclical, with one only serving to reinforce and perpetuate the other.
What is Relationship OCD?
Relationship OCD (ROCD) is characterized by ongoing, extreme doubts about the relationship one is in. Sometimes it is easy to notice, for example, someone with OCD has been in a long-lasting, committed intimate relationship when all of a sudden he or she is overwhelmed by an onset of intrusive thoughts such as “What if I do something to ruin this relationship?” or “Maybe I don’t love my partner enough”.
Other times, ROCD can be sneakier, and what tends to be natural or “normal” concerns in many relationships gradually develop into full-blown obsessions that the person with OCD can’t stop thinking about:
- “What if there’s someone better out there for them?”
- “What if there’s someone better out there for me?”
- “Did I accidently cheat on my partner?”
People with ROCD may then compulsively seek reassurance from their partner that “everything is okay.” Other compulsions include:
- constantly looking for evidence and/or “signs” that the relationship is good or bad
- mentally reviewing essentially anything and everything related to the relationship
- avoiding the partner due to the high levels of distress the person with ROCD starts to experience when his or her partner is around
- confessing innocuous interactions with the opposite sex to their partner out of fear it may have been “cheating” (“this girl came up to me and asked for directions. I gave them to her and then she walked away. I’m worried because I smiled when I answered her and she may have thought I was flirting. I don’t remember what was going through my head at the time, but it’s possible I was smiling because I was intentionally trying to flirt. I’m really sorry, I have been wracking my brain for days trying to determine what my intentions were when I smiled during that 20 second conversation”).
It can be difficult to distinguish ROCD from other types of relationship issues. One of the keys to look out for is that the person with ROCD is truly struggling with anxiety related to uncertainty, and their OCD-driven doubts about the relationship usually become all-consuming. This is different from someone who knows they are not in love with their partner or knows the relationship is not going well and they need to end it.
Treatment
There are highly effective treatment methods for OCD, including Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP).
The use of medication for the treatment of OCD is also commonly used to reduce the sensitivity to anxiety and allow a sense of letting go, rather than clinging on to obsessions. Currently, Selective Serotonin Reuptake Inhibitors (SSRI’s) are commonly used for treatment of OCD. Some of the most commonly administered SSRI’s include Zoloft, Prozac, Luvox, Paxil, Celexa, and Lexapro.
Antidepressants are also used in the medication management of OCD, such as Effexor and Cymbalta. The right prescription, dosage, and frequency rely heavily on a consultation with a primary care physician who can assess the appropriateness of use.
Seeking Mental Health Support
ROCD is a lesser-known and frequently unidentified form of obsessive-compulsive disorder. If you suspect this applies to you, it is best to consult with a a mental health professional who specializes in OCD, like the therapists at Chicago Counseling Center. Schedule an appointment with Chicago Counseling Center and meet our team to learn more!
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