Relationship OCD (ROCD) Is a Real Diagnosis—Here’s What to Do If You Have It

Intrusive doubt and anxiety can eat away at your relationship.

Have you ever found yourself gazing at your significant other and entertaining the fleeting thought, “What if you’re not the one?” If so, you’re not alone. Moments of doubt and wavering levels of attraction toward your partner are ordinary experiences within the realm of romantic relationships. However, when these doubts become incessant, anxiety-inducing, and all-encompassing, you may be dealing with Relationship Obsessive-Compulsive Disorder (ROCD).

Yes, ROCD is a real diagnosis.

“Most people experience occasional doubts about their relationships, but for individuals grappling with Relationship OCD, anxiety and doubt become overwhelming, hijacking their emotional well-being and relationships,” explains Misti Nicholson, PsyD, Director, and Clinical Psychologist at Austin Anxiety and OCD Specialists.

What is Relationship OCD (ROCD)?

Relationship OCD is a subtype of Obsessive-Compulsive Disorder (OCD) that centers around doubts, obsessions, and compulsions related to romantic relationships. According to Kristin Bianchi, PhD, a licensed clinical psychologist specializing in anxiety disorders and OCD, individuals with ROCD frequently experience unwanted, intrusive, and distressing doubts about their romantic partners.

The precise causes of ROCD, like those of general OCD, are not definitively known. While genetics, brain abnormalities, and environmental factors are believed to play a role in the development of OCD, the exact triggers for ROCD remain a topic of ongoing research.

There are two common manifestations of ROCD: relationship-centered symptoms and partner-focused symptoms, with many individuals experiencing both types simultaneously, notes Dr. Nicholson.

1. Relationship-Centered Symptoms: These encompass doubts concerning the nature of the relationship itself. Individuals with relationship-centered ROCD worry about whether their feelings of love are genuine, whether their partner reciprocates those feelings, and whether their relationship is the “right” one.

2. Partner-Focused Symptoms: In contrast, partner-focused ROCD revolves around doubts about the characteristics and qualities of the romantic partner. Despite experiencing love for their partner, individuals with partner-focused ROCD may question their partner’s physical attractiveness, intelligence, and various other attributes.

While it’s common for individuals who have dated or been in relationships to have experienced occasional doubts or fluctuations in attraction, individuals with ROCD differ in their interpretations of these doubts. People with ROCD tend to perceive these ordinary uncertainties as glaring indications of fundamental problems within their relationship.

Recognizing Signs of Relationship OCD

One key distinguishing feature of ROCD is the presence of compulsive behaviors triggered by obsessive doubts. Individuals with ROCD often respond to these intrusive thoughts with various compulsive actions, hoping to alleviate the resulting anxiety. Some common compulsions associated with ROCD include:

1. Seeking Reassurance: People with ROCD frequently seek reassurance about their relationship, either from their partner or others, as a way to alleviate their doubts.

2. Scanning for Evidence: They engage in a relentless search for evidence to validate the legitimacy of the relationship or to gauge their level of attraction or their partner’s love.

3. Making Comparisons: Another hallmark of ROCD is the compulsion to compare one’s relationship to those of others, be it friends, family, or even fictional characters. Comparisons can also extend to previous relationships.

4. Mental Rituals: People with ROCD may spend extensive periods monitoring their thoughts and emotions concerning the relationship.

It’s essential to recognize that these compulsive behaviors do not lead to healthier relationships; instead, they perpetuate anxiety and uncertainty. Dr. Nicholson emphasizes, “The problem with compulsions is that they provide only temporary relief and ultimately reinforce the anxiety, making it worse over time.”

Additionally, the symptoms of ROCD have been linked to various forms of distress, including general OCD symptoms, negative affect, low self-esteem or relationship satisfaction, attachment insecurity, sexual functioning difficulties, and more.

Effective Treatments for Relationship OCD

Recognizing the presence of ROCD and seeking help is crucial for individuals and their relationships. ROCD is highly treatable, and seeking treatment can significantly improve one’s quality of life. Dr. Bianchi states, “OCD is very treatable.”

To determine if you might have ROCD, consider factors such as the amount of time spent on obsessive thoughts or compulsive behaviors. Tracking whether these thoughts and actions consume over an hour per day is a valuable initial step. For a formal diagnosis of ROCD, the obsessions and compulsions must cause significant distress or impair various aspects of life, such as relationships, work, or daily functioning.

The primary treatments for ROCD are cognitive-behavioral therapy (CBT) and exposure and ritual prevention (Ex/RP). These therapeutic approaches aim to help individuals refrain from engaging in compulsive behaviors. Simultaneously, they facilitate gradual exposure to intrusive thoughts, reducing the compulsion to react to these thoughts. This process helps individuals realize that experiencing doubts or fluctuations in attraction is normal and not necessarily indicative of relationship failure.

A promising avenue in ROCD treatment is the use of technology. A small randomized controlled trial involving college students demonstrated the potential effectiveness of a mobile app for ROCD treatment. This app featured short, game-like daily cognitive interventions and showed improvements in ROCD symptoms and self-esteem over a 15-day period. While further research with larger clinical populations is necessary, this suggests that technology-assisted interventions may offer benefits.

For severe cases, a combination of medication and therapy is often the most effective treatment approach. Medications such as serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to manage OCD symptoms. In addition, transcranial magnetic stimulation (TMS), an FDA-approved treatment initially developed for depression, is emerging as a potential adjunct treatment for OCD and ROCD. TMS utilizes magnetic fields to stimulate nerve cells in the brain.

If you suspect that you may be experiencing symptoms of ROCD, it is crucial to seek help from a healthcare provider who can refer you to specialists experienced in treating OCD and related disorders. Early intervention and appropriate treatment can lead to significant improvements in your well-being and relationships.

In summary, ROCD is a real and treatable disorder characterized by overwhelming doubts, obsessions, and compulsions related to romantic relationships. Seeking therapy, engaging in exposure-based treatments, and considering technological interventions can help individuals regain control over their relationships and emotional well-being. If you or someone you know is struggling with ROCD, don’t hesitate to seek professional help for a path towards a healthier, happier love life.