Relationship OCD (ROCD) and Its Treatment

OCD & Co.

Sep 13

Written By Turning Point Psychological Services

Photo by: wavebreakmedia / shutterstock.com

Kristina came to therapy to process her relationship with Randy, her boyfriend of three years. She said that the relationship is generally good, but she can’t decide if they should get married. Kristina and Randy tried couples counselling where they worked on issues such as trust, attachment patterns, old traumas, common values and goals, intimacy, and communication.

Kristina liked the couples therapist but felt that even though she and Randy followed the therapist’s suggestions and practiced the strategies learned in therapy, she could never get rid of the constant feelings of doubt about whether Randy was “the One.” She decided to pursue individual therapy to try and dig deeper into the relationship and process potential underlying psychological issues so that she could have certainty whether marrying Randy was the right decision.

Kristina said that one of her biggest fears is looking back at her life many years later and realizing that she made a horrible mistake when she married Randy. SShe was also fearful that she may be missing some important information about her current relationship with Randy and could be basing her decision on incomplete information.

By the time Kristina came to treatment, she and Randy had been living together for two years. Overall, she felt that the relationship was going well. She and Randy had similar interests and got along great for the most part. But she wondered if “going well” was enough to make a lifelong commitment.

Sometimes, after watching a romantic movie, Kristina would catch herself wondering why she wasn’t experiencing the same overwhelming feeling of bliss, love, and passion that she saw in the movie and whether she was missing out on the True Love that the movie's heroine found. This made her ponder that maybe she was settling for the second best. She found this thought very unsettling.

Other concerns also made Kristina question her commitment to this relationship. There were several times when she looked at other men and found them handsome. Surely, she wouldn’t feel this way if Randy was her real true love? A few weeks ago, Randy kissed her, but she didn’t feel anything. This alarmed her a lot – could it be a sign that she wasn’t really passionate about him?

Kristina has read endless blogs and articles trying to find certainty, such as “10 Signs You Have Found Your True Love,” “Five Red Flags That Your Relationship Isn’t Working,” and “How to Know That He is the One.” But instead of finding the answer, she became even more confused and uncertain.

Kristina valued authenticity and commitment in relationships and felt that by making the wrong judgment, she would be responsible for ruining both Randy’s and her lives. She also felt compelled to constantly talk about her doubts with Randy, as well as confess to him every time she had a thought about another person being attractive. She noticed that while Randy initially tried his best to comfort and reassure her, he had become increasingly impatient with her confessions.

Kristina has tried to compare her feelings for Randy to the way her best friends felt about their partners. But, again, instead of being reassured, these conversations only amplified Kristina’s doubts. Many of her friends told her that they were sure their partner was ‘the One’ because they strongly felt like it. And the ones that sometimes experienced concerns about their relationship were surprisingly undisturbed by those concerns, brushing them away as a normal part of the relationship.

At the first session, Kristina confided in her therapist that she often worries that there may be another person out there, the one who is her second half, the perfect match. And if she agrees to marry Randy, she will have to let go of the hope of meeting that person.

Kristina said that she always felt uncertain about her boyfriends in previous relationships. At times she felt that the uncertainty was unbearable, and she broke the relationships early on – but then, after initial relief, she found herself doubting if she had made the right choice, which led to a great deal of suffering.

Kristina said that these thoughts make her feel very guilty. After all, she and Randy have so many great times together, and he treats her very well. But she can’t imagine living the rest of her life with uncertainty. She is tormented by the endless “what ifs” and spends her days trying to figure things out and achieve certainty.

Kristina’s goal for therapy was to figure out once and for all if this relationship was meant to be. She was hoping that after looking deep into her feelings, together with the therapist she would find the answer to her concerns. Needless to say, she was stunned when the therapist told her two shocking things:

1. She may never know for sure.

2. She meets the diagnostic criteria for obsessive-compulsive disorder, with a subtype that is known informally as relationship OCD (ROCD).

What is ROCD?

In every OCD type, intrusive thoughts (obsessions) attack what the person cares about the most. OCD hits where it really hurts. In ROCD, the obsessions attack the relationship. Sometimes it’s the relationship itself that the person has obsessional doubts about (relationship-focused). And other times the doubts are about their partner’s physical, personality, or behavioural traits or characteristics (partner-focused)

The person wants to know for sure whether they truly love their partner. They feel that they have to do everything to be certain they aren’t making a mistake. There’s a sense of urgency to figure it out.

The person then desperately tries to achieve certainty about the relationship by engaging in endless compulsions.

ROCD Obsessions

These are typical questions that an OCD brain throws at an ROCD sufferer:

Am I in the right relationship?
Is this True Love?
Is my partner the One?
Does my partner love me?
How can I make sure I will never get divorced?
What if I am unauthentic for choosing to continue to be in the relationship without being sure about it?
I have to make a decision about staying or breaking up. And I have to make this decision ASAP.
What if there’s a better-matching person for me somewhere out there?
I have to know for sure that this relationship will last forever.
What if my partner and I are not the best fit?
Why did I find another person attractive?
What if I’m not attracted to my partner enough?
How can I know for sure that I am in love with my partner?
What if I’m actually gay and am just pretending? (Or, in a gay relationship, - What if I’m actually straight and am just pretending?)
Why do I keep concentrating on the flaws of my partner’s appearance?
I will never be able to stop being bothered by my partner’s unattractive appearance features or mannerisms.
What if I’m settling for second best?
What if my partner is not intelligent enough?
What if my partner is a bad person?
What if I’m in denial?
What if I’m making a mistake?
What if I’ll never be able to completely trust my partner?
What if I’m leading my partner on and am, therefore, an immoral person?
What if I will regret my choice of a partner in the future?
What if others know that my partner isn’t good enough for me and are judging or pitying me?
What if I will be embarrassed by my partner?
What if I’m not good enough for my partner?
What if I’m in the wrong relationship?

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ROCD Compulsions

Compulsions are the things that people with ROCD do to get rid of their anxiety, distress, or fear. As you can see, they can be overt (external, visible) or covert (mental). Usually, most people will have both overt and covert compulsions such as:

Mentally reviewing all the good and bad times with your partner.
Trying to figure out for sure if you are true soulmates.
Asking friends and family how they feel (or felt initially) about their partners and comparing that to how you are feeling about your partner.
Subtly (or not so subtly if the sense of urgency is high), steering conversations with friends toward discussing relationship issues so that you can engage in comparisons or find reassurance.
Googling love stories and comparing them to your relationship.
Comparing your past relationships to this one.
Comparing your partner’s appearance, physical, emotional, social, or intellectual qualities, sense of humour, or achievements to others.
Comparing your relationship to the relationships of the couples whose pictures you see on social media (do these couples look happier, more committed, or more connected than you and your partner)?
Focusing on the flaws of your partner’s face, hair, body parts, or any other physical attributes.
Focusing on your partner’s bad habits.
Carefully watching how others react to your partner, trying to ascertain whether they may be judging him or her to reassure.
Confessing to your partner that you are not sure if you love him or her, or that you saw somebody you found attractive on the street, or that you didn’t feel aroused sexually when you kissed, etc.
Checking if you are sexually aroused by your partner.
Having sex with your partner for the purpose of reassuring yourself that you are still attracted to him/her.
Submitting yourself or your partner to all kinds of tests to achieve certainty about the relationship.
Taking online tests and quizzes such as “Do I Really Love Him/Her?” of “Is He/She the One?”
Creating your own tests in your head, such as “If he truly loves me, he’ll cancel plans with his friends,” etc. Proceeding to the next test regardless of the outcome of the previous test.
Writing pros and cons lists of the relationship.
Ruminating about all relationship-related things.
Constantly monitoring/checking how you feel toward your partner.
Using therapy to figure out if you truly love your partner.
Breaking up with your partner due to the distress caused by the uncertainty.
Watching romantic movies and comparing your relationship to the one in the movie.
Avoiding committing to the relationship or making any long-term plans in the relationship.
Avoiding intimacy or closeness.
Avoiding watching romantic movies.
Avoiding hanging out with single friends out of the fear that it may show you that that’s what you truly want

But How Do I Know if My Partner is the One?

The short answer is – you may never know for sure.

OCD will always make you question everything. And trying to figure out the “correct” answer is one of the most prominent OCD symptoms.

Accepting the uncertainty of the future is the essential step in the treatment of OCD. Most of us don’t know for sure at all times that the relationship we are in is the right one. Some people may FEEL that they know for sure. Some people also have the propensity to feel certain about things in general (for better or for worse). Others are just as afraid of the uncertainty as you are but choose to declare certainty to avoid feeling doubtful.

But feeling certainty clearly doesn’t decrease anybody’s chances of getting a divorce sometime in the future (as evidenced by divorce stats). Feelings are just feelings and don’t have much to do with reality and with future probabilities.

ROCD Treatment

The treatment for ROCD is the same as for other OCD types – a combination of Exposure and Response Prevention (ERP) and Acceptance and Commitment Therapy (ACT).

It may sound counterintuitive, but OCD is always driven by compulsions, not obsessions. The more you compulse, the more frequent and stickier your obsessions become. But when you learn to stop your compulsions, you step out of the tug-of-war with OCD and begin your recovery.

OCD pulls you into an endless chasing of the sense of certainty. But even if you can achieve some relief by getting reassurance or by avoiding external or internal triggers, the urgent “what ifs” always come back.

In ERP, you will learn to put yourself in situations that will trigger obsessions and stay in these situations without resorting to compulsions. This practice teaches your brain that the intrusive thoughts (obsessions) may come and go and you don’t have to do anything to get rid of them.

The exposures will be a bit different for every person as they will depend on the person’s specific obsessions, compulsions, and core fears.

Some Common Exposures for ROCD:

Thinking about looking back at your life several years from now and realizing that you made an awful mistake and have wasted your life settling for the person who is not the right one for you.
Carrying around a very unflattering photo of your partner and looking at it throughout the day.
Focusing on the unflattering aspect of your spouse.
Expressing feelings of love and commitment to the partner via texts, phone calls, notes, or conversations.
Allocating time to reflect on the fact that there isn’t much we can do to prevent making a mistake.
Watching a romantic movie and allowing the anxiety about not having a passionate enough relationship to be there without trying to get rid of it.
Creating a script about never knowing for sure if your partner is the One and living your life in ambiguity. Then playing/reading the script often, letting difficult emotions come, and doing nothing to get rid of them.
All of the exposures are accompanied by “response prevention,” which means that you learn to face discomfort without resorting to any compulsions to alleviate it, thus, breaking the vicious OCD cycle.

The Choice

While your OCD may be screaming at you to remove all the uncertainty ASAP, the reality is that you have very little control over your intrusive thoughts and feelings, including the ones about uncertainty. Intuitively, you know this already. You have been spending your days trying to either figure things out or get rid of the thoughts. You know that the thoughts and feelings always come back and the more you try to achieve certainty, the more doubt you feel.

Nevertheless, you probably continued engaging with your obsessions hoping that you will finally find THE ANSWER and then everything will be fine, you will be sure, and you’ll live happily ever after.

You have been trying to dig yourself out of the hole for a long time. And the more you are invested in your digging, the deeper you dig yourself in. Ask yourself, have you ever found anything that your partner said or did that has resolved your doubts for good? Or, have you ever felt absolutely over the moon in love with your partner 100% of the time? If yes, then why are you reading this article? And if not, then are you really willing to spend the rest of your life in the tug of war with your obsessions?

The definition of insanity is to continue doing the same thing over and over again while expecting a different result. So how about doing something radically different for a change?

The sooner you accept that no amount of effort can help you permanently get rid of your obsessions and doubts, the faster you can be on your way to recovery. You don’t have to like your obsessions, but you need to come to terms with the fact that they will come and go in their own time regardless of whether you are doing anything about them.

When another “what if” thought comes, notice and acknowledge it – “Oh yeah, here’s another doubt” or “I’m noticing that I’m having a thought about whether this relationship is forever.” Even though you’ll feel compelled to engage with the thought by either trying to figure it out or push it away, try to instead gently unhook from it. Observe it with curiosity and then reconnect to the present moment.

So, we agree (hopefully) that you can’t control your thoughts and feelings. What CAN you control then?

You have full control over the kind of partner you are CHOOSING to be in your relationship.

Instead of desperately trying to make THE RIGHT decision, you need to make A decision and then take the steps toward making it right.

When you give up the pursuit of certainty, you can choose to just BE in the relationship. Does it mean that the relationship is for sure the right one? No, of course, it doesn’t. But you can decide that you are not willing/ready to leave, say, for the next six months (make it three months or even three weeks if it’s easier). Unless your relationship has some severe problems such as abuse or very obvious, extreme incompatibility, give yourself permission to spend these six months practicing being the best partner you can be – whatever this means to you.

How would you act if you were sure of your love for your partner? What kind of partner would you want to be in a relationship? Maybe you value being caring, kind, compassionate, fun, authentic, engaging, patient, sexual, or supportive? Maybe you want to be the one to initiate things? Act “as if.” Write a love note to your partner. Talk about the future. Keep bringing your partner to your family events. Take the next six months to practice taking steps toward these values and then, if needed, after the six months are over, take an hour to consider if you are leaving or staying for another six months.

Your OCD will tell you that this can’t wait. It will urge you to figure things out before you ruin your life. It will ask you just to look deeper. It will push you to seek reassurance. Remember – all of these thoughts are obsessions. It doesn’t mean they are either true or untrue. You can allow them to come and go while you are making a choice TO BE IN THE RELATIONSHIP instead of living in your head. If you let OCD dictate how you live your life, you’ll continue to spend your time evaluating the relationship instead of being in the relationship and experiencing it in real time. You will continue to miss out on the relationship and on life.

Take this time period to practice being present in your relationship and to be the best partner you can be. Take this time to also refrain from discussing the relationship, confessing, testing, ruminating, and all the other compulsions. Avoid doing these with your partner, family, friends, the therapist, and yourself. Just be.

Will any of this help with figuring out for sure if you are with the One? Nope. Will it help you be on your way to recovery from OCD? You bet!

Think you or your loved one may have an ROCD? Share your story in the comments below!

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Anna Prudovski is a Psychologist and the Clinical Director of Turning Point Psychological Services. She has a special interest in treating anxiety disorders and OCD, as well as working with parents.

Anna lives with her husband and children in Vaughan, Ontario. When she is not treating patients, supervising clinicians, teaching CBT, and attending professional workshops, Anna enjoys practicing yoga, going on hikes with her family, traveling, studying Ayurveda, and spending time with friends. Her favorite pastime is reading.

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