How OCD can manifest in relationships (ROCD)

Obsessive-compulsive disorder (OCD) is a mental health condition characterised by recurrent, unwanted thoughts(obsessions) and repetitive behaviours(compulsions). 

OCD can manifest in any area of a person’s life that is of value and importance to them. Symptoms can consume significant time and energy, interfering with normal daily activities and routines.

OCD can significantly impact relationships (and not only romantic relationships), as obsessions and compulsions can lead to distress, and interfere with communication and intimacy, causing tension, frustration, and misunderstandings between partners. 

Relationship OCD

Relationship OCD (ROCD) is a subset of OCD. It has become increasingly prevalent over the years due in part to societal expectations, social media and pressures attached to the "perfect" relationship.

While there is no specific timeline for how OCD manifests in relationships, here are some key points related to OCD in relationships:

The onset of OCD

OCD can typically begin in childhood or adolescence but can start in early adulthood or later in life. Some individuals may already have OCD before entering a relationship, while others may develop symptoms while in a relationship.

Relationship obsessions

People with OCD may have specific obsessions related to their relationships, such as constantly doubting their partner's faithfulness or their fear of cheating, fear of contamination from physical intimacy, excessive concerns about harming their partner emotionally or physically, fear of losing their partner, fears around their uncertainty of love and commitment towards their partner, or their partner's commitment to them. These obsessions can consume their thoughts and cause anxiety.

Relationship compulsions

OCD can also manifest as compulsive behaviours within relationships. For example, individuals may engage in repeated checking behaviours, constantly seeking reassurance from their partner, or excessive cleaning or organising to prevent harm or maintain control.

ROCD compulsions can be much more subtle than the stereotypical idea that OCD sufferers only carry out excessive handwashing, counting or checking behaviours that are commonly purely visual. ROCD sufferers can suffer secretly, mainly in their minds and often in silence.

Impact on intimacy

The fear of contamination or intrusive thoughts related to intimacy can cause distress and avoidance, leading to physical or emotional intimacy difficulties.

Limited spontaneity

People with OCD often have a strong need for structure, predictability, and control. This can limit spontaneity and flexibility in relationships, making engaging in impromptu activities or adapting to last-minute changes difficult.

Guilt, shame and embarrassment

People with OCD often experience intense guilt, shame and embarrassment related to their obsessive thoughts or compulsive behaviours concerning the relationship. They may feel guilty about doubting their partner, not being "good enough," or burdening their partner with their OCD-related concerns. These feelings can contribute to low self-esteem and relationship difficulties.

Communication and understanding within a relationship

Education and open communication about OCD can be crucial in supporting relationships. It is helpful for partners to educate themselves to understand the nature of OCD, its impact on their loved ones, and ways to provide support and encouragement.  

Quite often, the reassurance seeking that a ROCD sufferer carries out is repetitive and therefore considered a compulsion. Partners may unwittingly maintain the vicious cycle of OCD by unintentionally enabling the OCD sufferer’s compulsions by participating in them or making accommodations. This makes it harder for the person with OCD to break free from the compulsions.

Out of love and concern, partners also engage in these reassurance-seeking behaviours, inadvertently reinforcing the ROCD sufferer's need for validation and preventing them from confronting their fears on their own. They might also modify their own behaviour to accommodate the OCD sufferer’s fears to avoid triggering certain situations. Although this may alleviate any immediate anxiety and distress, this again maintains the vicious cycle of OCD symptoms.

The impact and timeline of OCD in relationships can vary significantly from person to person. Obsessions and intrusive thoughts can be debilitating, preventing you from enjoying healthy relationships.

If you or someone you know is feeling overwhelmed, trapped and struggling with OCD (ROCD) in relationships, it is essential to consult with a mental health professional for an accurate diagnosis and appropriate treatment, which may include medication. Cognitive-behavioural therapy (CBT) is the most effective treatment for OCD, combined with building self-awareness of triggers related to obsessive thoughts and compulsions and exposure and response prevention (ERP), which focuses on gradually facing fears and reducing compulsive behaviours.