Relationship OCD Is a Real Diagnosis. Here's What to Do If You Have It
Doubt and anxiety can become intrusive—and eat away at your relationship.
Ever gazed over at your significant other and thought, “What if you’re not the one?”
You probably have. Fleeting moments of doubt about your relationship or wavering levels of attraction to your partner are very ordinary experiences.
But if you feel subsumed by relationship-focused uncertainty and anxiety—and these feelings are frequent and pervasive—you may have relationship obsessive-compulsive disorder or ROCD.
And yes, that’s a real diagnosis.
“Most people experience occasional doubt about relationships, but for people experiencing relationship OCD, anxiety and doubt hijack their relationships,” Misti Nicholson, PsyD, director and clinical psychologist at Austin Anxiety & OCD Specialists, tells Health.
What is relationship OCD?
Relationship OCD is a common subtype of OCD, says Kristin Bianchi, PhD, a licensed clinical psychologist who specializes in treating anxiety disorders and OCD. People with this disorder, she says, have unwanted, intrusive, and upsetting doubts about their romantic partners.
There are two common types of ROCD. “Some people experience relationship-centered symptoms, others experience partner-focused symptoms, and many experience both types,” Nicholson says.
Doubts focused around the relationship—worrying if you’re truly in love, if your partner is in love, and if this is the “right” relationship—point to relationship-centered symptoms, Nicholson says. And, logically enough, partner-focused ROCD manifests in doubts about your partner’s characteristics. Despite feelings of love, she says, people with ROCD may question a partner’s attractiveness, intelligence, and other qualities.
If you've dated or been in a serious relationship, these symptoms likely have a familiar ring. “Doubts and fluctuations in phenomena like attraction and loving feelings are inevitable in all relationships,” Bianchi says. But for people with ROCD, these doubts go far beyond a typical uncertainty, she says.
Here’s the difference, Bianchi says: People who have ROCD interpret those ordinary doubts to mean that something's seriously wrong with the relationship.
Signs of relationship OCD
Another difference: People with ROCD respond to doubts with compulsive behavior. “In an attempt to feel relief from the anxiety associated with these intrusive thoughts, people with ROCD often engage in rituals or repetitive behaviors known as compulsions,” Nicholson says.
Here are some common compulsions in relationship OCD:
- Seeking reassurance: Compulsively consulting with others about your relationship is a common indicator of ROCD, Nicholson says. Sometimes this takes the form of seeking reassurance from a partner about their love, Bianchi adds.
- Scanning for evidence: Like emotional detectives, people with ROCD seek evidence—for a partner being a good match, for attraction levels, to quantify a partner's love—to affirm the relationship, Bianchi says.
- Making comparisons: Another indicator of ROCD is compulsively comparing your relationship with other people's relationships—from friends and families to fictional characters on TV, Nicholson says. The comparisons can also be between your current and previous relationships, Bianchi adds.
- Mental rituals: People with ROCD can spend hours monitoring their thoughts and feelings around the relationship, Nicholson says.
These behaviors aren’t productive—that is, they won’t ease relationship doubts. “The problem with compulsions is that they provide only temporarily relief and ultimately reinforce the anxiety, making it worse over time,” Nicholson notes.
Relationship OCD can be challenging to diagnose, but it is treatable
As you may imagine, the symptoms and compulsions that accompany ROCD do not lead to healthy relationships, Bianchi says. But often, people fail to realize there’s a disorder involved. “People will dismiss their symptoms and label themselves as ‘too picky’ or a ‘worrywart,’ or ‘bad at relationships,’” she says.
So how can you tell if you’re “bad at relationships” or suffering from ROCD?
Time is one factor, Nicholson says—track if obsessive thoughts or compulsions eat up more than an hour a day. To be diagnosed with relationship OCD, the thoughts and compulsions also have to cause you significant distress or impair your relationships, your work, or other areas of your life, she says.
But the good news, Nicholson adds, is “OCD is very treatable.” Therapists typically turn to two tactics: Cognitive behavioral therapy and exposure and ritual prevention (Ex/RP). With these treatments, therapists have patients forgo engaging in compulsive behaviors. “Simultaneously, we have them engage in gradual exposure to their feared intrusive thoughts,” Bianchi says.
Doing this, she explains, reduces the compulsive response to thoughts and helps people see that having doubts in a relationship or seesawing levels of attraction is common—and not a signal the relationship is failing.
With severe symptoms, Nicholson says, the most helpful treatment is typically a combination of medication and therapy.
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