A comprehensive guide to Relationship OCD (ROCD)
Relationship OCD (also known as ROCD) is a form of OCD that involves obsessive/intrusive thoughts and compulsions regarding the nature of one’s relationship(s).
ROCD is a common subtype of obsessive-compulsive disorder; however, currently, there isn’t a reliable clinical estimate available for how many people have it.
The aim of this article is to provide the reader with practical and helpful information in regards to ROCD – from its symptoms, to what its causes are, to how it is treated and so on.
What causes Relationship OCD?
It is not currently known what causes Relationship OCD; however, the disorder’s emergence could be linked to things like previous relationship-related traumas or having another mental health condition (e.g. anxiety or depression).
In more broad terms, however, Relationship OCD (as essentially other forms of OCD) seems to develop as the result of various environmental (64%) and genetic (36%) factors.
How can Relationship OCD be treated?
Currently, the primary way to treat ROCD is cognitive-behavioral therapy (CBT); specifically, the mental health professional will most likely engage in:
- psychoeducation (the mental health professional providing a systematic explanation to the patient about what ROCD is and how it can be treated);
- case formulation (the mental health professional coming up with an explanation or hypothesis for why the ROCD developed and what the symptoms are);
- identifying/challenging the core maintaining mechanisms (understanding why the symptoms are persistent);
- cognitive restructuring (attempting to change the way the patient thinks about their relationship and themselves);
- exposure and response prevention (ERP) (having the patient confront their “triggers” and find a way to reduce the anxiety they cause by slow exposure).
There are also other options, such as certain medications (e.g. SSRI-type antidepressants such as Prozac, or tricyclic antidepressants such as clomipramine, often combined with CBT) or another CBT technique known as Motivational Interviewing, which is a very individualized, empathy-based and usually more pleasant (for both the patient and the clinician) technique in comparison to ERP.
Examples of Relationship OCD
- Compulsively checking your partner’s phone too often
- Compulsively asking where your partner is at all times
- Compulsively asking your partner about their thoughts and intentions toward you
- Having obsessive doubts about whether you love your partner
- Obsessively ruminating on past fights with your partner
- Having intrusive thoughts about possibly doing something to ruin your relationship
Scales or questionnaires currently being used to assess ROCD symptoms
If you would like to take one of these tests/questionnaires, consult with a mental health professional (e.g. clinical psychologist or psychiatrist):
- The relationship obsessive compulsive inventory (ROCI), which is used to understand relationship-centered symptoms.
- The partner related obsessive compulsive symptoms inventory (PROCSI), which is used to understand partner-centered symptoms.
- The relationship catastrophization scale (RECATS), which is used to understand a patient’s beliefs and whether they’re catastrophizing (exaggerating) certain aspects of their relationship.
- The relationship contingent self-esteem (RCSW) scale and the partner-value contingent self-esteem (PVCSW) scale, both of which are focused on self-worth, self-esteem and one’s perception of oneself in general.
Is ROCD egosyntonic or egodystonic, and what does that mean?
Relationship OCD is usually egodystonic (which means it is caused by intrusive thoughts that simply appear in a person’s conscious mind); one can tell that these thoughts are egodystonic by the fact that they are often in contradiction to what one actually thinks or believes about one’s partner. These types of beliefs are therefore more likely to cause distress.
In contrast, an egosyntonic belief would be something that’s not caused by intrusive thoughts, but is rather something that represents your own, actual thoughts. These types of beliefs are therefore less likely to cause distress.
What is the difference between ROCD and “ordinary” doubts about one’s relationship?
It is not out of the ordinary for people to occasionally have doubts, questions and worries concerning their relationship. Having Relationship OCD, however, means these thoughts are usually much more distressing and anxiety-inducing due to their intrusive nature.
Another difference would be that since ROCD is a form of obsessive-compulsive disorder, it has a clinical diagnosis criteria; in the DSM-V, which is a handbook published by the American Psychiatric Association, for a clinical OCD diagnosis one must have obsessions and/or compulsions that are distressing to the point of taking up at least 1 hour a day. More than likely when someone has “ordinary” doubts, they don’t take up nearly as much time from their day as clinically diagnosed ROCD does.
How is the cycle of ROCD usually maintained?
According to a handful of different explanations and models for ROCD, there most likely are different personality-related factors, societal influences, family and parenting-related factors that contribute to preserving and maintaining someone’s ROCD symptoms.
A primary factor, however, seems to be that people with ROCD tend to interpret certain thoughts or feelings in a catastrophic way; in other words, that the sufferer perceives a presence of some sort of consequences or (imminent) danger in relation to the thoughts they’re having.
Talk to other people with Relationship OCD
Read more about Relationship OCD – a few helpful resources
- This article on ROCD by the International OCD foundation;
- This ROCD presentation by The Center for OCD and Anxiety in Pittsburgh, PA
- About the Author
- Latest Posts
Hello, I am Jonas Eriksson. I suffered from severe OCD for many years and have now recovered. My OCD is related to an autoimmune disorder called Autoimmune basal ganglia disorder. Sadly I was undiagnosed for 27 years. The inflammation put my brain to be in a state of constant terror. By sharing helpful information, I hope someone will get motivated to seek treatment and learn more about OCD and related disorders.