Relationship OCD (ROCD): Symptoms, Causes, and Treatment

Relationship OCD (ROCD) is a subtype of obsessive-compulsive disorder (OCD) in which people experience unwanted and persistent thoughts about their current or past relationships, known as obsessions. 

Many of us experience varying levels of relationship anxiety from time to time. However, for those with ROCD, these obsessions are all-consuming and uncontrollable and often get in the way of establishing and maintaining romantic relationships. 

Obsessions are intrusive and distressing, and people usually try various strategies to quell them.

Whilst it might be common for people to experience uncertainty in their partners or relationships, such uncertainty for an individual with ROCD can fuel disproportionate levels of stress and anxiety and compel them to perform compulsions to neutralize negative feelings and ease anxieties. 

Compulsions are repetitive behaviors, rituals, or thoughts that are used to neutralize negative feelings and ease anxieties. 

People with ROCD find these unwanted thoughts and feelings impossible to let go of, and eventually, these unrelenting obsessions and compulsions can sabotage a relationship.

People with ROCD tend to experience the most distress over their current romantic relationships. However, some might even ruminate over their past relationships or relationships that are yet to occur. 

Even once a relationship ends, one might become obsessed with thoughts that their previous partner was the “right” one for them and become highly fearful that they will never find someone like their ex. 

Types of ROCD

There are 2 “types” of ROCD: 

Relationship-centered ROCD

This type of ROCD involves fears and doubts about the relationship itself. For example, someone who suffers from relationship-centered ROCD might perpetually fear that they are not in the “right” relationship or experiencing “true love” with their current partner.

They might worry that their partner is not truly in love with them or that their partner is not “the one.”

Relationship focus entails a greater emphasis on the temperature or tenor of the relationship, such as worries like, “We’re not in love enough,” “We’re not happy enough,” “What if you don’t love me enough,” or “What if our relationship isn’t strong enough and you leave me.”

People with relationship-centered ROCD might also experience thoughts such as, “What if there is someone better for me out there?” or “What if I am in the wrong relationship?” 

Partner-focused ROCD

Partner-focused ROCD is more specific and person-centered. Individuals who struggle with this type of ROCD tend to over-evaluate their partner’s attributes rather than the relationship as a whole.

For example, they might question their partner’s intelligence, manners, intentions, loyalty, attractiveness, morals, values, or ethics.

Partner-focused obsessions are something like your nose is too big, you’re not funny enough, what if you’re not smart enough, what if.

They might question “What if my partner is a terrible person?” or “What if my partner is not intelligent enough for my liking?”

It is also possible to have both relationship-centered ROCD and partner-centered ROCD at the same time. People with both types of ROCD stress about their relationships and their partner’s traits simultaneously.

Examples of ROCD Obsessions

Obsessions are intrusive and distressing, and people usually try various strategies to quell them. Individuals with OCD might be aware that what’s happening feels out of proportion.

• Is this “true love?”
• Is my partner the “One?”
• What if there is someone better for me out there?
• Is my partner good enough for me? 
• What if my partner and I are not a good match?
• What if I am attracted to other people? Does it mean I am not in love with my partner?
• I didn’t feel turned on when they kissed me just now. Does that mean something is wrong with our relationship?
• How can I tell if I am truly in love with my partner?
• Are we a happy couple? Are other people happier than we are?
• Why do I keep obsessing over my partner’s “flaws?”
• What if I am making a mistake by being with my partner?
• What if I am never able to completely trust my partner because of previous relationships or a past betrayal?
• What if I am just leading my partner on?
• What if I regret my choice to be in a relationship in the future?
• What if I am not good enough for my partner? What if he is not good enough for me?
• What if other people can see that my partner is not good enough for me, and are judging me or pitying me because of it?
• What if I am in the wrong relationship?

Examples of ROCD Compulsions

Compulsions are repetitive behaviors, rituals, or thoughts that are used to neutralize negative feelings and ease anxieties. 

According to Sheva Rajaee, MFT, author of Relationship OCD, people with ROCD have compulsions, like checking the ‘temperature’ of their relationship every day, frequently asking themselves or their partner questions such as, “Are we right for one another? How do I feel about you? How do you feel about me?”

• Seeking reassurance by asking friends and family what they think about your partner and whether they think their relationship is working. 
• Coming up with lists of reasons why you and your partner are meant to be together.
• Subjecting yourself and/or your partner to various relationship tests or online quizzes to feel more assured about your relationship.
• Continuously replaying all of the good and bad times you have had with your partner.
• Constantly obsessing over your partner’s “flaws” (i.e., face, hair, body, and/or other physical characteristics) or “bad habits”.
• Obsessing over your partner’s personality and other emotional, social, or intellectual attributes.
• Comparing your partner’s appearance and other qualities to those of another person, and even feeling relieved. when your partner has more positive qualities or less negative qualities than another. 
• Comparing your romantic relationship to romantic relationships that you see on social media or in romantic movies.
• Avoiding watching romantic movies or TV shows altogether because they bring up unwanted thoughts and anxieties about your relationship.
• Searching the internet for love stories and then comparing your romantic relationship to other people’s romantic relationships.
• Comparing your previous relationships to your current one.
• Avoiding committing to relationships or making long-term plans with a partner out of fear that it will not last. and fear that something is missing in the relationship.
• Initiating sex with your partner with the intention of determining whether you are still sexually attracted to them.
• Or, avoiding being intimate with your partner for fear of not being able to sexually satisfy them, or for fear they will not sexually satisfy you.

Causes of ROCD

The root of ROCD could be shaped by an incessant need to feel like your partner and/or romantic relationship is “perfect” or “right.”

For example, the “myth of the one” is reinforced by popular culture, which suggests that a partner should fulfill every emotional, intellectual, sexual, and spiritual need.

This leads to unrealistic expectations of relationships, and dissatisfaction when these standards aren’t met and can exacerbate relationship anxiety or relationship OCD.

Sheva Rajaee, MFT, challenges some common misconceptions in romantic relationships. The idea of “the one” suggests that there is a single person who is a perfect match for us in every way.

This notion can create unnecessary pressure on both partners and can lead to unrealistic expectations. No one person can fulfill all our desires and needs.

Similarly, the concept of the “spark” refers to an immediate and intense attraction or connection when meeting someone for the first time.

While this can be an exciting experience, it may lead people to overlook important aspects of compatibility and long-term relationship potential.

Furthermore, the desire for intimacy, while natural, can be a trigger for individuals with anxiety, as it involves letting go of control and can induce fear and discomfort.

Constantly seeking fulfillment from a partner can lead to increased anxiety, especially in those prone to it. If expectations are not met, our brain interprets it as something being wrong, magnifying the experience in people who are prone to anxiety.

Sheva Rajaee also emphasizes the importance of considering one’s upbringing and attachment styles in the treatment of ROCD. These factors play a crucial role in shaping our relationships.

ROCD typically manifests in early adulthood, however, it can also arise during one’s teenage years, or even later in life. ROCD symptoms tend to follow you in all of your romantic relationships unless treatment is sought. 

How OCD Can Affect Your Relationship

Relationship OCD can make maintaining relationships more complex as it poses challenges on both sides. As people with ROCD have a heightened sense of fear and lack of emotional security in their relationships, they constantly seek reassurance from their partner. 

A partner might find themselves incessantly saying things such as, “Yes, I love you” or “Yes, I am happy to be with you.” The need to constantly feel validated and the need to continually provide this validation can be exhausting for both members of a romantic dyad.

It can also lead to feelings of annoyance and confusion when the partner doesn’t understand the source of the anxiety. 

Most people will experience doubts in their relationships occasionally, but for those suffering from ROCD, this insecurity and doubt will often become the primary focus of the relationship.

Sufferers will speculate obsessively about their relationship, and their thoughts will center around their loved ones.

“I went out with him for more than five years. I really loved him, but I started to obsess that perhaps I didn’t love him. I felt compelled to confess this to him. It was the OCD telling me that I didn’t love him; I know it was. I thought that if I wasn’t in love with him, then I was wasting his life and hurting him, and he should go find somebody else that loves him, really loves him. So again I was afraid of hurting him. The doubt about my love for him was not rational at all. The doubt just came out of nowhere. “

Lived Experience of Relationship OCD (Linda)

Partners of people with OCD must take on a lot of emotional responsibility. Depending on the severity of one’s OCD, this anxiety and mistrust can result in resentment on the other side.

At the same time, partners must live with that daily questioning of the relationship, watching their significant other “check out” strangers, take relationship tests online, or express their doubts verbally to others. 

Additionally, relationship OCD may make it hard to enjoy sex with your partner, as obsessive thoughts can be distracting and all-encompassing. 

If left untreated, ROCD can create a great deal of stress for both parties and pose a serious challenge to your love life.

How Do I Stop OCD From Ruining My Relationship?

Other than seeking professional treatment (which is the optimal way to stop OCD from affecting your relationship), there are several ways you can learn to manage your relationship, so it is both healthy and satisfying. 

First, it is essential to recognize that your thoughts and doubts are just symptoms – not facts! Just because you are questioning whether your relationship is right does not mean that it is not right; it simply means that your OCD voice will not allow you to feel settled and comforted by your relationship. 

Open communication is the foundation of any romantic relationship, but it is particularly essential in a relationship where one partner suffers from ROCD. 

Your partner must understand what you are thinking and how you are feeling so they can support you and respond appropriately. The more your partner understands your symptoms, the more you can trust one another.  Poor communication will result in misunderstandings and miscommunications, jeopardizing the relationship. 

Practicing mindfulness is another strategy to help manage ROCD. Obsessive thoughts tend to run rampant when your mind tries to fight against them, so people with OCD can practice mindfulness techniques to learn how to be aware of their thoughts and to accept them in order to regain control.

They can practice recalibrating their mind and thoughts throughout the day to catch themselves before their obsessive thought patterns run rampant. 

Journaling, self-talk, and joining a support group are other examples of ways you help reduce the impact of ROCD on your relationship. 

ROCD Treatment

Like most other OCD subtypes, ROCD is most effectively treated using Exposure and Response Prevention (ERP) therapy. ERP is a type of Cognitive-Behavioral Therapy considered the first line of psychotherapy for OCD. 

In ERP, people are deliberately and gradually exposed to their OCD triggers so that they can become desensitized to them over time.

This therapy is intended to purposely invoke more anxiety in attempts to disrupt the neural circuit between the processing and action parts of the brain and “rewire” the brain so that the intrusive thoughts and ritualistic behaviors lose their power. 

By staying in a feared situation and leaning into the discomfort and uncertainty without anything terrible happening, patients learn that they do not need their compulsions to cope and that their fearful thoughts are just thoughts, and nothing else. 

An ERP therapist would review which thoughts or scenarios are causing you the most anxiety, and then work with you to alleviate them through gradual, controlled exposure to them. 

People with ROCD might learn to sit with the anxiety of thinking they may be with the wrong partner. They are taught to take power back from the relationship anxiety and to reframe their thoughts.

For example, “I have no clue if this is the right relationship, and I’m choosing to go forward anyway because this person matters to me.”

While ERP can feel very challenging and time-consuming, over time, patients learn that they can cope with their thoughts without relying on ritualistic behaviors.

ERP is one of the most powerful tools for treating OCD because it directs the person to live with the anxiety and see that nothing terrible will necessarily happen.

Sources

• Doron, G., Derby, D. S., & Szepsenwol, O. (2014). Relationship obsessive compulsive disorder (ROCD): A conceptual framework. Journal of Obsessive-Compulsive and Related Disorders, 3(2), 169-180.
• Hezel, D. M., & Simpson, H. B. (2019). Exposure and response prevention for obsessive-compulsive disorder: A review and new directions. Indian journal of psychiatry, 61(Suppl 1), S85–S92.
• Rajaee, S. (2022). Relationship OCD: A CBT-Based Guide to Move Beyond Obsessive Doubt, Anxiety, and Fear of Commitment in Romantic Relationships. New Harbinger Publications.
• Stossel, C. (Host). (2023, July 30). Relationship OCD: Expert Insights with Sheva Rajaee, MFT [Video]. YouTube. https://www.youtube.com/watch?v=y8Wh5ezL4c0