Relationship OCD: When the doubts become an issue

Am I in love enough? Is my partner in love with me? Do I feel attracted enough to my partner? Is this relationship right for me? Am I sure I want to be with my partner? Is my partner good-looking enough? Smart enough? Successful enough?

Having these questions popping up in our minds and feeling unsure about our relationships can happen to everyone.

But for some of us, these doubts can turn into a nightmare as they can become pervasive, intrusive and interfere in our daily life, bringing high levels of anxiety and stress. 

Avoidance is usually the preferred strategy to cope with these difficult emotions. Indeed, it may feel so natural to avoid what triggers these feelings and thoughts, such as places, specific situations, books, movies, and specific people. Avoiding getting too emotionally involved or avoiding romantic relationships at all may give us a false sense of being in control. 

Furthermore, many of us may find ourselves repetitively checking and controlling our reactions, thoughts or memories to find certainty around these nagging questions.

These dynamics can significantly interfere with the quality and satisfaction of our relationships.

People experiencing these kinds of mental challenges might suffer from relationship obsessive-compulsive disorder (rOCD), a particular subtype of obsessive-compulsive disorder. 

OCD’s symptoms include intrusive and recurring obsessions that create significant distress, and often compulsions, which are rigid rituals (either behaviours or mental acts) that could decrease the levels of anxiety. 

Generally, OCD can target several topics, from the fear of contamination, order and symmetry to doubts, aggressiveness or sexual fantasies. 

In relationship OCD, the topic of the obsessions is a relationship, either with a romantic partner or in general with a loved one. Usually, the doubts target either the relationship itself, bringing fears around its righteousness, or some physical traits/qualities of the partner. 

People suffering from relationship OCD struggle to tolerate any possible doubt regarding their relationship and desperately seek a certain answer to these questions. 

Their doubts are intolerable as they usually trigger the core beliefs that define their identity, often morality and perfectionism. Typically, these doubts can be triggered or exacerbated by particular milestones or commitments in the relationship’s life, such as becoming an official couple, getting married, introducing the partner to the family, having children, moving in or buying a home together. 

Despite OCD being known for centuries, relationship OCD has gained the clinicians’ attention more recently, and there is not enough awareness in the general population yet.

In general, the recommended treatment for relational OCD is the same as for classic OCD.

Even if it targets a relationship, it is treated in individual psychotherapy. Sometimes the partner can be involved in one or two sessions, if deemed appropriate, to shed some light on the dynamics of the disorder and how to support the patient.

Cognitive behavioural psychotherapy, sometimes combined with pharmacological treatment, can help deal with these thoughts, rituals and break the vicious cycles that maintain the problem.