The Comprehensive Guide To Relationship Obsessive-Compulsive Disorder (ROCD)
Updated June 25, 2020
Medically Reviewed By: Lisa Cooper
What is Relationship Obsessive-Compulsive Disorder and is it Impacting Me?
Do you constantly obsess over your relationship and wonder if you (or your partner) made the right decision when you committed to each other? Having intermittent concerns and relationship doubts from time to time is normal.
Obsessing about the potential demise of a relationship and consistently worrying that your relationship is doomed, however, isn't, and it can put you in a world of stress that might put strain on existing relationships or make you want to avoid relationships altogether. In this article, we discuss Relationship Obsessive-Compulsive Disorder (ROCD). We also provide strategies for dealing with this potentially debilitating and life-altering relationship disorder and offer resources for getting therapy online. Let's start with the basics.
Relationship Obsessive Compulsive Disorder - The Basics
According to the latest DSM 5 diagnosis, there is a subset of obsessive-compulsive disorder (OCD) where symptoms manifest as maladaptive beliefs about relationship patterns.
referred to as relationship obsessive-compulsive disorder (ROCD). OCD is a commonly misunderstood mental health disorder in which sufferers experience obsessions and compulsions in tandem. Obsessions are often cyclical, anxiety-inducing patterns of thought surrounding certain topics -- more than a preoccupation, obsessions can be very difficult to dispel and can grow to give sufferers an inflated or distorted sense of how dire or unpleasant the object of their obsession is. Compulsions are repetitive and difficult-to-control impulses toward certain actions or rituals which, to the sufferer, might relieve some of the stress or anxiety of their obsessive thoughts. For instance, if a sufferer is particularly worried about the possibility of leaving the stove on, they might ritualistically check all the knobs on it every few hours, even if it hasn’t been used.
Some non-OCD disorders are thought to exist on a spectrum of shared traits with OCD, such as body dysmorphic disorder, autism, eating disorders, and a few other disorders characterized by impulsivity and obsessiveness. Relationship obsessive compulsive disorder (ROCD) is not one of these disorders -- it is simply OCD with a relationship-centered focus, where sufferers experience relationship-centered obsessions and compulsions. However, relationship OCD may be comorbid with some of these which can sometimes be diagnostically confusing in addition to being mentally exhausting for the sufferer when they’re presenting with ROCD.
It’s not uncommon for symptoms of OCD to have a ‘theme’ in how they manifest for different individuals --
In this case, people with ROCD have issues with continuously and obsessively doubting their partner, themselves, and their relationships as they struggle with feelings of worth and the idea that the relationship should (or could) abruptly end for reasons outside of their control. This undue focus on intimate relationships can be quite anxiety-inducing.
The secondary component of this two-faceted relationship disorder is that although someone suffering from relationship OCD may fear the outcome of staying in a relationship where they may deem themselves unworthy, they fear the thought of being alone even more. People with ROCD often report having concurring and conflicting beliefs about relationships and develop an obsession as a result.
While others without ROCD might experience relationship thoughts as fleeting concerns throughout the day, ROCD sufferers are consumed by them. Thankfully, being able to identify the symptoms and patterns that accompany ROCD can help to let qualified mental health providers know they are suffering from the stress and worry of this relationship-based form of obsessive-compulsive disorder With ROCD, relationship-centered symptoms take center stage, and they focus symptoms on the relationship, while other areas of life may be functional.
Living with Relationship Obsessive-Compulsive Disorder
Ruminating thoughts on images, thoughts, and urges that all center on the relationship. These repetitive thoughts and actions surrounding the relationship can become debilitating to the person suffering from ROCD, as thoughts of the relationship have the potential to consume their lives.
According to The National Center for Biotechnology Information (NCBI), examples of obsessive thoughts associated with ROCD are as follows:
The RECATS scale is a three-part scale that involves the following three key components and can give ROCD a conceptual framework:
- Overestimation of the consequences of being alone.
- Overestimation of the consequences of separation.
- Overestimation of the consequences of being in the wrong relationship.
They further subdivide these three categories into scenarios in the form of questions that commonly apply in cases where one partner is suffering from ROCD.
RECATS Scenario examples from the NCBI
- Being without a partner would cause great pain to me and everyone around me.
- The thought of going through life without a partner scares me to death.
- I believe there is nothing more important than romantic relationships.
If you find that you're constantly obsessing over your romantic relationships to the point where it is affecting your life, or you see reflections of your own life in the examples above it's time to seek help with a licensed mental health professional.
Having heart-to-heart conversations with close friends and family members may provide ROCD sufferers with some emotional support. However, it is unlikely that conversations with a friend or family member will get to the root of what's causing obsessive behavior and related symptoms.
Today's licensed professional counselors and therapists are board-certified and trained professionals that have been educated on how to use evidence-based therapy to successfully mitigate the negative symptoms of mental illness and mental health-related disorders.
Relationship centered symptoms are the hallmark of ROCD. When clients find themselves consistently occupied with the state of their relationships, ROCD symptoms can become debilitating. This is especially true if they leave the disorder untreated as the person who is experiencing the symptoms spirals into an increasingly obsessive state of mind.
Relationship concerns can become relationship obsessions, inflated and disproportionately distressing for the sufferer -- what might be thought of as a minor hitch can transform into obsessive thoughts and compulsive behaviors about the issue. Additionally, sufferers of ROCD might believe unrealistic things about what the “ideal” relationship looks like, like that ongoing romantic relationships shouldn’t change over time, or that ongoing romantic relationships should always be worry-free and completely passionate.
There are two types of ROCD -- relationship-centered or partner-focused ROCD. Relationship-centered obsessions are characterized by concerns about the quality of the relationship itself and the purity of the love either or both partners feel, while partner-focused obsessions are concerned with the quality of the non-ROCD partner’s attributes and characteristics.
Relationship obsessive compulsive disorder might be present if one of the relationship members is always second-guessing their love for their partner and constantly seeking affirmation and confirmation that that relationship should even exist. People with ROCD rarely feel they are good enough for their partner and worry that their partner will leave them.
People with ROCD might feel undue worry about their partner’s compatibility with them, too, or worry persistently about the rightness of the relationship. Despite having been together for a long time, and without any particular inciting incident, an ROCD sufferer might fear that their partner is not “the one” and be unable to think about much else outside of their romantic relationships.
ROCD sufferers might also have compulsions that impel them to do things like repeatedly and ritualistically checking if everything is alright with their partner, doing “tests” in their heads to see if they love their partners enough, doing tests in their heads to see if their partner is sufficiently attractive, intelligent, good-natured, or otherwise good enough for the sufferer. These compulsive behaviors may not truly reflect the feelings of sufferers about their partners -- and the sufferer might intellectually register that they really do find their partner to be “good enough” -- but they are patterns that are difficult to resist.
Repetitive thoughts and compulsive behaviors can lead to a string of negative circumstances in the other areas of the ROCD sufferer's life that can make the condition feel even worse. Non-OCD partners in an ROCD relationship experience related symptoms themselves sometimes, too, as they might feel uncertain about their self-worth and value (both inside and outside the relationship).
The constant focus of one partner on the other can leave other critical areas of the couple's life beyond either partner or the relationship unattended when it comes to career, home, and family. Familial relationships and job performance can suffer as the ROCD sufferer has become consumed with thoughts regarding the relationship.
Relationship Obsessive-Compulsive Disorder Therapy Types
Now that you know what ROCD symptoms look like, we'll move on to how to treat the symptoms and reduce the negative effects on your life. Below are three therapy types that today's board-certified and licensed therapists are using to treat this new DSM-5 diagnosis.
Cognitive-Behavioral Therapy (CBT)
CBT is a form of behavior therapy that teaches clients to focus on identifying triggers of negative behavior and learning how to place new behaviors in their place. This brain-based therapy operates under the assumption that people behave negatively or positively in response to their perception of their environment. Therefore, according to the principles of cognitive-behavioral therapy, changing negative perceptions can also change (or eliminate) negative responses to the environment.
Exposure Therapy with Response Prevention (ERP)
Exposure therapy is a graduated form of therapy that gradually introduces people with mental health challenges to the stimulus that triggers them. People who take part in exposure therapy are gradually exposed to the object or situation of their fear and coached through the process until the negative response to the situation is reduced or eliminated.
Mindfulness-Based Cognitive Therapy (MBCT)
MBCT is a form of therapy that combines key components of mindfulness-based therapy (MBT) with the key components of cognitive-behavioral therapy (CBT). The result is a therapy type that focuses on combining mindfulness with cognitive processes. In other words, being more aware of what you're thinking and purposefully changing your thoughts by choosing new behaviors or responses.
Where to Get Therapy
People suffering from relationship OCD now have a wide variety of options to get therapy. ROCD clients can opt to attend sessions with traditional in-office therapists or online therapists to get advice, support, and resources for medication management. Whatever treatment avenue they choose, ROCD clients must comply with all the components of their treatment plan to successfully manage or combat the symptoms of ROCD. Ongoing therapy sessions with licensed professionals are likely to be a regular part of their lives now.
Where ongoing therapy is a new component of people's lives, many people are opting for online therapy options like video, SMS, and phone chat. The couples who are dealing with the effects of obsessive-compulsive relationship disorder can benefit from attending joint and individual therapy sessions from the privacy of their own homes, offices, or other private locations.
Taking part in ROCD therapy online eliminates the need for long or frustrating commutes and saves the couple's time and money, which is another stress-relief for the relationship. Couples can access online relationship therapy platforms like ReGain.US twenty-four hours a day. The ReGain.US platform has licensed and board-certified therapists and counselors that specialize in managing the symptoms of ROCD.
Getting started with online therapy is as easy as completing a simple email registration process and an online questionnaire that will help your therapist assess your symptoms and determine your treatment plan. Your treatment plan will include your therapist's recommendations for the number of therapy sessions you're scheduled to attend online, medication management resources, and other related local resources and referrals.
When you connect with a ReGain.US therapist, you're matched with a therapist who is licensed to practice in your state of residence to assure an uninterrupted continuum of quality care in the case that you should need an offline referral for resources and services related to your condition.
If you're serious about managing your symptoms of ROCD, you suspect that you have ROCD, or you already have a ROCD diagnosis, reach out to one of the relationship specialists at ReGain.us who can get you matched with the best therapist to help you finally win the battle with ROCD.
Frequently Asked Questions (FAQs)
What are the 4 types of OCD?
There are thought to be four general obsession types for OCD, though an individual’s obsessions will take on unique dimensions depending on what they fear and value:
Contamination obsessions are typically characterized by outsized fear of certain contaminants, whether they be germs, dirt, dust, bodily fluids, or coming into contact with certain animals/bugs. Common compulsions involved in these obsessions often revolve around personal cleanliness, like urges to frequently wash your hands, wash yourself, and wash “contaminated” objects.
2. Unintentional harm
Unintentional harm obsessions revolve around fears of accidentally harming others through unintentional wrongdoing, like leaving the gas stove on, or hitting a pedestrian in your car. These obsessions can involve intrusive thoughts of accidental harm, and common compulsions can involve extreme wariness and repetitive “checking” of things to make sure there is no possibility for harm.
3. Exactness and order
Obsessions regarding exactness and order can involve focuses on symmetry, organization, orderliness, and aesthetic appeal. Sufferers might count objects or frequently re-organize personal belongings in particular and specific ways to avoid feelings of incompleteness or discomfort.
4. Taboo thoughts
Obsessions surrounding taboo thoughts involve sufferers experiencing both increased amounts of intrusive thoughts that the individual might find distressing and morally wrong, accompanied with high amounts of guilt over having had those thoughts even though they were involuntary. These obsessions often have the fewest visible/physical compulsions, but they may still cause sufferers to engage in mental rituals such as prayer, thinking positive thoughts, or avoiding thoughts that might trigger the obsession.
What ROCD means?
ROCD is relationship obsessive-compulsive disorder, a subset of obsessive-compulsive disorder that focuses the sufferer’s attention on relationship issues, or imagined relationship issues. Having ROCD is not an indictment on an individual’s character, and it doesn’t make the sufferer vain or unloving -- the thoughts of concern or perfectionism that can accompany ROCD are involuntary, and are nothing the sufferer should feel guilt over.
Can ROCD go away?
Because relationship OCD is a particular manifestation of OCD that is relationship-centered and partner-focused, it’s only as likely to simply go away on its own as traditional OCD symptoms are -- that is to say, relationship based OCD generally only gets better with proper treatment. While ROCD symptoms can wax and wane in intensity dependent both on internal and external factors, the most reliable factor in the reduction of symptoms is pursuing counseling or other forms of treatment from a certified mental health professional. OCD is a chronic condition, which means that it generally doesn’t go away entirely; however, the brunt of negative symptoms can be significantly reduced with combinations of counseling and potentially the inclusion of medications, allowing sufferers to lead healthy lives that are largely unobstructed by anxiety.
If you believe that medication may be right for you, consult with a licensed professional.
How does ROCD make you feel?
The symptoms of relationship obsessive compulsive disorder can make sufferers experience a complex and variable web of emotions, but feelings of stress, anxiety, and uncertainty are often at the core of ROCD; ROCD and OCD are, at core, anxiety disorders. Seeing relatively normal and mundane relationship concerns or doubts through the lens of ROCD can be distressing in a variety of ways, and it can additionally lead to feelings of depression or despair. In some cases ROCD symptoms can lead to guilt, disgust, and other unpleasant feelings that can be more difficult to treat with certain therapies that work well with anxiety-centered symptoms, according to a study in the Journal of Obsessive Compulsive and Related Disorders.
Is ROCD a real thing?
Relationship obsessive compulsive disorder is a real and legitimate mental health condition that requires proper care and treatment in order to alleviate symptoms. Like other forms of OCD and related disorders, ROCD is intangible from the outside, but the effects on sufferers or even their loved ones can be as significant as they might be with any other chronic condition.
How is ROCD treated?
Treatment for ROCD can include particular therapies like CBT, ERP, and MBCT, which all aim to augment the sufferer’s harmful behaviors over time and provide mental relief. Additionally, these therapies are often pursued in combination with psychiatric medication.
What causes ROCD?
While the causes are unable to be definitively pinned down, ROCD and OCD are thought to be triggered by a combination of an individual’s genetics, brain structure, and environment. Similarly to other hereditary mental illnesses, OCD and ROCD are much more likely to manifest in people with close family members with OCD, people with particular brain structures, and people who might have experienced particular traumas in childhood.
Do I have ROCD?
If the symptoms and behaviors of obsessive and compulsive patterns surrounding relationships described in this article sound familiar to you or seem reminiscent of your own behavior, there may be a chance that you are currently suffering from ROCD. Consider seeking a diagnosis from your doctor or a licensed psychiatrist -- they should be able to say for sure if you are experiencing relationship OCD, and they might additionally be able to set up an appropriate treatment plan for you and your needs.