Relationship OCD: Symptoms, Examples, & Treatment Options

What Is ROCD?

Relationship OCD is a subtype of obsessive compulsive disorder that focuses on romantic relationships, in which the person aims to gain certainty that they are with the right partner. Relationship OCD can manifest with intrusive thoughts and relationship anxiety, but it can also involve intrusive feelings, images, or urges. These could include feelings of dread, disturbing images of your partner, or an urge to leave right away.

The sufferer is often plagued with answering questions like, “How can I be sure that this is the right relationship?” and “How can I be sure that I really love my partner?” Thinking about these questions can consume hours, days, or months, impacting someone’s ability to engage in every-day activities.

Relationship-related intrusive thoughts or feelings often contradict the person’s subjective experience of the relationship (e.g., “I love her but I can’t stop questioning my feelings”) or their personal values (e.g., “appearance should not be important in selecting a relationship partner”).² This is one of the many reasons ROCD can be so distressing, prompting an endless cycle of obsessions and compulsions.

Common ROCD Triggers

The triggers of ROCD will spark a drastic increase in symptoms and damage the relationship. Some commonly experienced triggers of ROCD include:

• Seeing a text on your partner’s phone
• Hearing about a former relationship
• Seeing them speak to someone else
• Having a painful memory
• Seeing an old picture on social media

Types of Relationship OCD

There are two types of relationship OCD that people can experience—relationship-focused and partner-focused. It’s also possible for people to experience both types of ROCD at the same time, though one type may outweigh the other.

The two types of relationship OCD are:

• Relationship-focused OCD: This type considers any feelings and symptoms about the relationship. They may have doubts and fears that are holding them back from enjoying the relationship and may serve as barriers for depth and intimacy.
• Partner-focused OCD: This type is focused more on the partner and who they are as a person. They may focus on their physical characteristics, their personality, or their education, among other things. This type may lead someone to compare their partner with others.

ROCD Symptoms

Relationship OCD symptoms involve obsessions, such as uncontrollable, intrusive thoughts regarding questions regarding a relationship or a partner, and compulsions, like seeking constant reassurance about the relationship.

Common Relationship OCD Obsessions

OCD obsessions are defined as thoughts, images, or impulses that occur repeatedly and feel uncontrollable.³ Obsessions elicit a response (a compulsion) due to their unsettling nature. With ROCD, obsessions focus around the relationship and/or partner. They can feel particularly distressing due to their attack on a valued person in your life—your romantic partner.

Common ROCD obsessions include:

• What if I don’t really love my significant other?
• What if I am in the wrong marriage?
• What if my partner doesn’t know the whole truth, and therefore, wants to leave me?
• What if I’m not as attracted to my partner as I should be?
• What if I feel like this for the rest of my life?
• What if my partner isn’t as smart as I thought they were?
• What if my partner’s social skills are lower than I realized?
• Has my partner’s nose always been that big?
• What if I’m not being 100% honest with my partner and in turn, end up hurting them?

Common Relationship OCD Compulsions

OCD compulsions are repetitive thoughts or behaviors that a person uses with the goal of neutralizing, solving, or making their obsessions go away.³ In short, they are the responses to the obsession. With ROCD, compulsions aim to seek a sense of certainty about the relationship.

ROCD compulsions can include:

Reassurance-Seeking

Studies have found a close relationship between OCD and reassurance-seeking behaviors.⁴ Though a lesser-known symptom, it can be debilitating in a person’s relationships. In ROCD, reassurance-seeking might center around confirming their partner’s love or faithfulness.

Excessive Research

Due to persistent, distressing doubts about their relationship, people with ROCD often engage in excessive research about relationships. By becoming an “expert” in the inner workings of relationships, the person temporarily eases worries about their own connection with their partner.

Mental Tracking & Review

In ROCD, a person might engage in mental tracking and review, keeping a list of “evidence” that either proves or disproves their doubts in their relationship. For example, they might take note of every instance in which their partner does something kind for them as evidence of their love.⁵

Social Comparison

A person with ROCD often looks at the relationships around them that they perceive to be loving, and compares their own relationship to them. Depending on the content of their worries, they will look for similarities or dissimilarities to confirm their fears.⁵

Creating Rules for Your Partner

Creating “rules” for their partner is one way people deal with obsessions in ROCD. The person then observes carefully to see if their partner follows the rules, or not, and makes inferences about the relationship based on their partner’s adherence to the rules. For example, they might question their partner’s love if they fail to follow one of the rules.

Avoidance

Avoidance is a common compulsion in OCD, one that significantly impacts a person’s quality of life. In ROCD, people might avoid relationships altogether, refusing to date or get emotionally close to anyone out of fear that they will end up with the wrong person, or be devastated emotionally by a hurtful break-up.

Other Feelings, Images, & Urges Related to ROCD

Common ROCD intrusive feelings include:

• Anxiety when near the partner
• Dread when engaging in day-to-day activities with the partner
• Guilt when having sex

Common ROCD intrusive images include:

• Intrusive sexual imagery of others (your ex, a co-worker, friend, etc.)
• Sexual imagery of the romantic partner with someone else (their ex-partners, strangers, etc.)

Common ROCD intrusive urges might include:

• Urges to leave the relationship
• Urges to leave the setting (your shared space, a dinner, etc.)
• Urges to kiss someone else
• Urges to cheat or explore a new relationship

What Does ROCD Look Like?

While understanding ROCD can be nuanced, there are some signs that you are struggling with ROCD, like having repeated intrusive thoughts about the relationship, needing constant reassurance from your partner, always focusing on the flaws of the relationship, or having difficulties with sex.

Here are some potential outward signs of ROCD:

Repetitive, Disturbing Thoughts About the Relationship

Having intrusive thoughts about the relationship, thoughts about your partner leaving you, about finding someone else, or thoughts about escaping the relationship.

Consistently Focusing on the Flaws of the Relationship

Having an emphasis on flaws in the relationship can be a sign of ROCD as well. This feeds into the intrusive thoughts that you may be having and give you a confirmation that your intrusive thoughts are based in reality, creating a self-fulfilling prophecy of negative aspects in the relationship.

Needing Reassurance From Your Partner

While everyone needs reassurance from their partner from time to time, recurrent and frequent need for reassurance can be a sign of relationship OCD.

Always Comparing Your Relationship or Partner to Others

Comparisons are easy to make, but they are rarely based in reality. When we spend time comparing our relationships and partners, we are limiting the meaning of what that relationship and partner is in our life. Each person and relationship is going to be different, and all you can control is yourself.

Difficulties With Sex

When ROCD is a part of the relationship, there is a strong possibility for sexual difficulties. Whether from physical or psychological issues, the couple could find it challenging to connect in a healthy, loving, and respectful way.

Obsessive Use of Social Media

Obsessive use of social media is a common sign of ROCD. Constantly checking on and scrutinizing what your partner “likes” on social media can feed obsessions about your partner’s love for you, or their commitment to the relationship. Constant social media checking can lead to relationship issues like increased anxiety, self-criticism, and doubt.

How Do I Know If It’s ROCD Or the Wrong Relationship?

People with ROCD often cannot discern whether they have ROCD or if they are in the wrong relationship. The first step is to normalize doubt in romantic relationships, and it’s important to understand that strong feelings of love are not always constant, even in healthy relationships.⁶ You might be annoyed with your partner, notice an attractive stranger, or have doubts about your commitment. In ROCD, these normalized behaviors are forbidden, used as indication that the investigation and rumination should continue.

Relationship OCD tends to focus on feelings of “rightness” in a relationship. These intrusive thoughts, feelings, or images will often be unwanted and intrusive, unlike normal relationship concerns.² There will also be compulsions, such as confessing, seeking reassurance, mentally reviewing, or checking. In contrast, worries tend to be in verbal format and related to future consequences of real situations.²

Despite ROCD being nuanced, there are relationship barriers that shouldn’t be ignored. These include experiencing physical, sexual, or verbal abuse from a partner.

What Causes Relationship OCD?

Causes of relationship OCD insecurity continue to be researched. It is important to note that anxious attachment styles can be tied to relationship anxiety and relationship OCD, and understanding any underlying anxiety, depression, or other mood disorders comorbid with OCD is important when considering treatment options for relationship OCD.

Relationship OCD can be influenced by:

• A history of abusive relationships
• Inconsistency in caregivers
• Trauma of any kind
• Physical changes to the brain
• Certain medications

Relationship OCD Treatment

The gold-standard treatment for OCD is exposure and response prevention (ERP) and occasionally medication.¹ The goal in ROCD treatment is to build skills to handle the presence of unwanted thoughts without engaging in compulsions.

Exposure and Response Prevention (ERP)

With ERP for OCD, someone faces their triggers head-on while resisting engaging in compulsions. Although this may sound intimidating, it is a gradual and collaborative process. People in ERP build the skills to notice their fire alarm going off, so to speak, while recognizing that it may just be a fire drill.

Working with an OCD specialist, a person develops skills to deal with their unwanted thoughts through therapeutic exposures for OCD, where they gradually expose themselves to feared stimuli while resisting compulsions. When completing ERP, the person gradually builds tolerance for more challenging exposures.

Medication

OCD medications can be helpful for any form of OCD. Specifically, a group of medications called selective serotonin reuptake inhibitors (SSRIs) can help reduce symptoms. Medications may work well alone, but can make a more significant impact when combined with therapy.¹

How to Get Help for ROCD

If you feel you may be struggling with obsessive compulsive disorder focused on intimate relationships, don’t hesitate to ask for help. A good first step is visiting the International OCD Foundation’s website, which provides valuable resources to individuals, partners, and families. You could also search for a specialist by asking for a referral from your primary care physician, or by using an online therapist directory. For those looking for online therapy, NOCD could be a great option for getting treatment at home.

Does ROCD Treatment Work?

When treated with ERP and/or medication, outcomes for OCD are promising, with about 70% reporting benefiting from medication and/or ERP.¹ The timeline for OCD treatment varies based on the patient and the severity of their symptoms.

How to Deal With Relationship OCD

Relationship OCD can be very overwhelming and leave you feeling helpless, but there are ways to treat it and cope with OCD, such as making sure your partner is aware and involved in helping you cope with the issues at hand.

Here are four ways to cope with relationship OCD:

1. Get Your Partner Involved

Sharing your struggles with your partner can help show you their availability and commitment to the relationship. Also, the more education your partner has about the condition, the more they may be able to support you. It can also help you to build trust and allow your partner to show you they are trustworthy.

2. Maintain Open & Honest Communication

It’s critical that open and honest communication is happening regardless of your circumstances. If you feel like you are having specific symptoms, it’s important to note them and communicate them to your partner so they understand where you are mentally and can extend support.

3. Join a Support Group

Support groups are a great way to find a community with an issue that can feel very isolating. It can be a place to learn about how others cope and manage their relationship OCD and leave you feeling restored and with a sense of hope for yourself and your relationship. There are many online resources and support groups for OCD if you’re having difficulty finding a local option, or if you just want the flexibility of an online platform.

4. Journal About Your Thought Patterns

Journaling is a great way to get out on paper what is going on in your head. When you routinely journal, you are able to go back and challenge the intrusive thoughts by journaling all the ways in which the relationship works well. It can be helpful to learn more about your own triggers and patterns and journaling is one way to capture that information.

Advice for Partners of Someone With ROCD

Dating someone with OCD comes with unique challenges, and being partnered with someone who has ROCD can be a frustrating and sad experience. Though you could choose to leave the relationship anytime, if you decide to stay, there are ways you can help someone with their OCD without enabling them or making their symptoms worse.

Here are some tips if you’re partnered with someone who has ROCD:

Educate Yourself

Knowing what ROCD is, how it affects relationships, and the prognosis of the condition will be essential. Learning about the condition will put you in a better position to respond your best when symptoms flare.

Identify Your Own Worries

After you learn about ROCD, you need to learn about yourself. What are your worries, concerns, and fears in the relationship? Know yourself, so you can share with your partner.

Maintain Boundaries Around Reassurance-Seeking

ROCD takes an incredible set of boundaries to make the relationship possible. You’ll need to do what you say and say what you do to reinforce the appropriate, healthy behaviors.

Empathize With Your Partner

Empathy is a powerful tool in any relationship. You can maintain boundaries and not give in to reassurance-seeking, while also recognizing that these symptoms can be difficult to deal with. Validate how hard your partner is working in ERP, and offer compassion for how hard it can be to undergo therapy for OCD, facing their fears head-on. Balancing healthy boundaries and empathy can help you to best support your partner as they work to overcome ROCD.

Try Couples Therapy

With ROCD, it’s never too early or too late to call in the professionals. A couples therapist with experience in ROCD could be a wonderful tool to help maintain or improve the satisfaction in the relationship.

Examples of ROCD

Relationship OCD will present differently depending on the person. Some may have a history of OCD, while others will experience ROCD as their first time with obsessive thoughts and compulsive behaviors.

Here are some examples of what ROCD could look like:

Example of Relationship-Focused ROCD

Gemma has been with her girlfriend for two years. It was a whirlwind romance and they rarely quarrel. But recently, Gemma has started questioning the relationship. She is constantly preoccupied with questions like, “Should I have broken up with my last girlfriend? Would she have been the right partner? Is this the right relationship?” These intrusive thoughts result in a cycle of reassurance-seeking from friends and family.

Gemma speaks with her best friend daily, asking for her perspective on the situation, and seeking information on how she knew her partner was “the one.” She often compares her relationship to other relationships, and reads relationship blogs for information. The search for certainty has impacted her personal and professional life. She finds it hard to focus at work, and can’t stay present with her partner.

Example of Partner-Focused ROCD

Max and his wife, Shelly, have been married for six years. They are discussing starting a family together, and he thinks she’ll be a wonderful mother. But, Max begins to wonder whether or not his wife is ambitious enough. She recently finished an MBA program, and is still looking for a new job.

Although Shelly is well-accomplished, the intrusive feeling of doubt overtakes Max when he’s around her. He finds himself comparing Shelly to his co-workers, wondering if she’s as ambitious as them. The question of, “Does she have what it takes to be successful?” comes up multiple times a day. Max notices he’s distracted at work, and engaging in checking behaviors when he’s with Shelly. This continuous loop of analysis is emotionally exhausting for both parties.

Each case demonstrates a presentation of ROCD. Gemma experiences relationship-focused obsessions. This subset latches onto the “rightness” of the relationship, feelings towards a relationship partner, or the partner’s feelings about them.⁷ Max presents with partner-focused obsessions. This subset latches onto specific attributes of the partner, such as physical features, social qualities, or personality attributes.⁵ Although relationship doubts are normal and expected, the impairment and sheer distress of the OCD is a defining feature.