Relationship obsessive compulsive disorder (ROCD) is a form of obsessive compulsive disorder (OCD) that causes repeated unwanted thoughts, images or urges related to relationships. People with ROCD experience intrusive, distressing thoughts about their partner or relationship, and engage in compulsive behaviors to try to relieve their anxiety. ROCD can negatively impact relationships and cause significant distress.
What are the symptoms of ROCD?
Common symptoms of ROCD include:
- Intrusive thoughts about your partner’s suitability as a partner
- Excessive doubts about whether you love your partner
- Obsessing about your partner’s flaws
- Compulsive checking of your feelings towards your partner
- Repeatedly seeking reassurance from your partner
- Mentally reviewing your relationship
- Comparing your relationship to others’
People with ROCD experience these intrusive thoughts and compulsive behaviors frequently, often for hours each day. The obsessive thoughts and compulsive behaviors become time-consuming and distressing.
What causes ROCD?
The exact causes of ROCD are unknown, but some potential factors include:
- Brain chemistry – ROCD may be related to low levels of serotonin, a neurotransmitter that helps regulate mood.
- Genetics – Having a family member with OCD increases your risk of developing ROCD.
- Stress – High levels of stress may trigger the onset of ROCD symptoms.
- Personality traits – Having perfectionist tendencies or being intolerant of uncertainty may contribute to ROCD.
- Negative relationship experiences – Trauma or difficult experiences in relationships may predispose some people to ROCD.
In some cases ROCD arises without an identifiable cause. The obsessions and compulsions become self-perpetuating. Rather than feeling comforted by performing compulsions, it provides only temporary relief from anxiety. This leads to an endless cycle of obsessions and compulsions.
How is ROCD diagnosed?
ROCD cannot be self-diagnosed. It needs to be diagnosed by a mental health professional who is experienced in diagnosing obsessive compulsive and related disorders. Diagnosis involves:
- Asking about symptoms, including obsessions, compulsions, avoidance behaviors
- Clinical assessment including structured interviews and symptom questionnaires
- Ruling out other possible causes
- Ensuring the obsessions and compulsions are not related to another mental disorder
- Considering the duration, frequency and impact of symptoms
The key to diagnosing ROCD is that relationship obsessions and compulsions are time-consuming, uncontrollable, distressing and interfere with normal functioning. The compulsions are performed to try to neutralize obsessions and relieve anxiety, rather than to shape the relationship.
How does ROCD impact relationships?
ROCD can have a significant negative impact on intimate relationships. Common effects of ROCD include:
- Arguments and conflict due to excessive reassurance seeking and distrust
- Reduced emotional and physical intimacy
- Withdrawal and isolation of the ROCD sufferer
- Feelings of guilt and shame about ROCD symptoms
- Partner feeling rejected, unattractive or unloved
- Difficulty making joint decisions
- Poorer relationship satisfaction
ROCD puts strain on relationships that can be hard to withstand. Partners often struggle to understand ROCD behavior. This can lead to resentment and relationship breakdown. However, relationships can be maintained through open communication, education about ROCD, seeking treatment and making joint accommodations.
Does ROCD mean you shouldn’t be in the relationship?
ROCD does not necessarily reflect a poor relationship choice or incompatibility with a partner. The disorder stems from an intolerance of uncertainty and high need for control. ROCD obsessions are exaggerations of normal relationship doubts and insecurities. Sufferers misinterpret these as proof the relationship is wrong, but these interpretations are driven by ROCD.
However, in some cases ROCD sufferers do determine their relationship is unhealthy. ROCD can shine a spotlight on existing problems. But the decision to leave should be based on a realistic appraisal once ROCD is successfully treated. ROCD often continues even after leaving a relationship.
I think I have ROCD. What should I do?
If you recognize ROCD symptoms in yourself, some important steps are:
- Learn more about ROCD so you understand the condition
- Talk to your partner about your experience of ROCD and how it impacts you
- Seek professional assessment and treatment from a psychologist or therapist
- Join a support group to share experiences and advice for managing ROCD
- Identify and minimize triggers that seem to worsen your obsessions
- Practice self-care and be kind to yourself throughout the process
ROCD treatment is available and recovery is possible. The first step is acknowledging the problem and seeking help.
What treatment options are available?
Cognitive behavioral therapy (CBT) with a focus on exposure and response prevention (ERP) is the most effective treatment for ROCD. Treatment involves:
- Identifying obsessions and compulsions – Becoming aware of thought and behavior patterns.
- Exposure – Confronting fears by intentionally triggering obsessions but resisting the urge to do compulsions.
- Response prevention – Refraining from mental and behavioral compulsions and riding out anxiety until it fades naturally.
- Mindfulness – Improving ability to accept intrusive thoughts without reacting to them.
Anti-anxiety or antidepressant medications are sometimes used in conjunction with CBT to help manage ROCD symptoms. Regular psychotherapy can also help to manage anxiety, relationship issues and underlying thought patterns.
What’s the outlook for people with ROCD?
With proper treatment, the majority of ROCD sufferers experience improvement or remission of symptoms. However, ROCD is considered a chronic condition, and some people experience intermittent symptoms or fluctuations in severity over their lifetime.
Relationship and life impacts of ROCD include:
- With CBT + medication, over 50% of people with ROCD have no symptoms or only mild symptoms after 1-2 years.
- Around 30% of people continue experiencing moderate symptoms after treatment.
- Up to 46% of relationships directly affected by ROCD ultimately end in separation or divorce.
- People with ROCD commonly have poorer relationship quality and lower relationship confidence.
- ROCD is linked to increased depression, anxiety, stress, and reduced self-esteem.
Ongoing support, adhering to treatment, and being open with your partner can help manage ROCD and mitigate relationship impacts over the long term.
What’s the difference between ROCD and typical relationship worries?
| ROCD | Typical Relationship Doubts |
|---|---|
| Obsessive, constant doubts about partner | Occasional doubts about partner |
| Rigid or unrealistic standards for partner | Some flexibility in desired partner traits |
| partner | Consider flaws alongside positive qualities |
| Seek constant reassurance from partner | Seek reassurance at times |
| Numerous daily compulsions to relieve anxiety | Take constructive relationship actions |
| Severely impaired functioning due to ROCD | Doubts manageable and relationship functional |
Common obsessions and compulsions in ROCD
ROCD obsessions and compulsions can take many forms but often fall into certain categories:
Appearance fixations
- Obsessing your partner’s looks don’t meet your standards
- Compulsively gazing at attractive strangers to check if you “prefer” them
- Excessively analyzing your partner’s appearance
Preoccupation with “rightness”
- Doubting you truly love your partner
- Questioning whether this is the “right” relationship
- Mentally reviewing your feelings to figure out the truth
Moral thought obsessions
- Thoughts that you are cheating simply by noticing others
- Worrying that being in this relationship makes you a bad person
- Compulsively analyzing whether you have moral failings
Relationship comparisons
- Comparing partner to exes, crushes or others
- Compulsively assessing whether your relationship is as good as others
- Obsessing over couples you think have a better relationship
Hypersensitivity to partner flaws
- Obsessing over partner quirks others would overlook
- Magnifying any flaws no matter how minor or normal
- Seeing neutral behavior as proof of fatal incompatibility
What are self-care tips for ROCD?
Self-care strategies that can help manage ROCD include:
- Joining an ROCD support group to feel less alone
- Making time for relaxation practices like yoga, meditation, deep breathing
- Avoiding reassurance-seeking and other compulsions, even though it’s hard
- Letting yourself feel anxious and not acting on it
- Exercising regularly to reduce overall anxiety levels
- Maintaining good sleep habits
- Practicing mindfulness and living in the present moment
- Spending quality time with loved ones and on hobbies
- Adopting healthy coping statements like “This is just my ROCD”
Conclusion
ROCD is a challenging condition but effective treatment is available. A combination of psychotherapy, medication, self-care strategies and partner support can help manage obsessions and compulsions. While recovery takes time and effort, most people with ROCD experience relief and go on to have healthy, fulfilling relationships.