The Comprehensive Guide To Relationship Obsessive-Compulsive Disorder (ROCD)

 What is Relationship Obsessive-Compulsive Disorder, and is it Impacting Me?

Do you constantly obsess over your relationship and wonder if you (or your partner) made the right decision when you committed to each other? Having intermittent concerns and relationship doubts from time to time is normal.

Obsessing about the potential demise of a relationship and consistently worrying that your relationship is doomed, however, isn't, and it can put you in a world of stress that might put a strain on existing relationships or make you want to avoid relationships altogether. In this article, we discuss Relationship Obsessive-Compulsive Disorder (ROCD). We also provide strategies for dealing with this potentially debilitating and life-altering relationship disorder and offer resources for getting therapy online. Let's start with the basics.

Relationship Obsessive Compulsive Disorder - The Basics

According to the latest DSM 5 diagnosis, there is a subset of obsessive-compulsive disorder (OCD), where symptoms manifest as maladaptive beliefs about relationship patterns.

Referred to as relationship obsessive-compulsive disorder (ROCD). OCD is a commonly misunderstood mental health disorder in which people experience obsessions and compulsions in tandem. Obsessions are often cyclical, anxiety-inducing patterns of thought surrounding certain topics -- more than a preoccupation, obsessions can be very difficult to dispel. They can grow to give people an inflated or distorted sense of how dire or unpleasant the object of their obsession is. Compulsions are repetitive and difficult-to-control impulses toward certain actions or rituals which, to the person, might relieve some of the stress or anxiety of their obsessive thoughts. For instance, if a person is particularly worried about the possibility of leaving the stove on, they might ritualistically check all the knobs on it every few hours, even if it hasn’t been used.

Some non-OCD disorders are thought to exist on a spectrum of shared traits with OCD, such as body dysmorphic disorder, autism, eating disorders, and a few other disorders characterized by impulsivity and obsessiveness. Relationship obsessive-compulsive disorder (ROCD) is not one of these disorders -- it is simply OCD with a relationship-centered focus, where people experience relationship-centered obsessions and compulsions. However, relationship OCD may be comorbid with some of these, which can sometimes be diagnostically confusing and mentally exhausting for the person when they’re presenting with ROCD.

It’s not uncommon for symptoms of OCD to have a ‘theme’ in how they manifest for different individuals --

In this case, people with ROCD have issues continuously and obsessively doubting their partner, themselves, and their relationships. They struggle with feelings of worth and the idea that the relationship should (or could) abruptly end for reasons outside of their control. This undue focus on intimate relationships can be quite anxiety-inducing.

The secondary component of this two-faceted relationship disorder is that although someone living with relationship OCD may fear the outcome of staying in a relationship where they may deem themselves unworthy, they fear the thought of being alone even more. People with ROCD often report having concurring and conflicting beliefs about relationships and develop an obsession as a result.

While others without ROCD might experience relationship thoughts as fleeting concerns throughout the day, people with ROCDare consumed by them. Thankfully, identifying the symptoms and patterns that accompany ROCD can help to let qualified mental health providers know they are experiencing the stress and worry of this relationship-based form of obsessive-compulsive disorder. With ROCD, relationship-centered symptoms take center stage, and they focus symptoms on the relationship, while other areas of life may be functional.

Living with Relationship Obsessive-Compulsive Disorder

Ruminating thoughts on images, thoughts, and urges that all center on the relationship. These repetitive thoughts and actions surrounding the relationship can become debilitating to the person experiencing ROCD, as thoughts of the relationship can consume their lives.

According to The National Center for Biotechnology Information (NCBI), examples of obsessive thoughts associated with ROCD are as follows:

RelationshipCatastrophizingScale (RECATS)

The RECATS scale is a three-part scale that involves the following three key components and can give ROCD a conceptual framework:

1. Overestimation of the consequences of being alone.
2. Overestimation of the consequences of separation.
3. Overestimation of the consequences of being in the wrong relationship.

They further subdivide these three categories into scenarios in the form of questions commonly applied in cases where one partner is experiencing ROCD.

RECATS Scenario examples from the NCBI

• Being without a partner would cause great pain to me and everyone around me.
• The thought of going through life without a partner scares me to death.
• I believe there is nothing more important than romantic relationships.

If you find that you're constantly obsessing over your romantic relationships to the point where it is affecting your life, or you see reflections of your own life in the examples above, it's time to seek help with a licensed mental health professional.

Having heart-to-heart conversations with close friends and family members may provide people experiencingROCDwith some emotional support. However, it is unlikely that conversations with a friend or family member will get to the root of what's causing obsessive behavior and related symptoms.

Today's licensed professional counselors and therapists are board-certified and trained professionals educated on how to use evidence-based therapy to successfully mitigate the negative symptoms of mental illness and mental health-related disorders.

ROCD Symptoms

Relationship-centered symptoms are the hallmark of ROCD. When clients find themselves consistently occupied with the state of their relationships, ROCD symptoms can become debilitating. This is especially true if they leave the disorder untreated as the person experiencing the symptoms spirals into an increasingly obsessive state of mind.

Relationship concerns can become relationship obsessions, inflated, and disproportionately distressing for the person -- what might be thought of as a minor hitch can transform into obsessive thoughts and compulsive behaviors about the issue. Additionally, people experiencing ROCD might believe unrealistic things about the “ideal” relationship looks like that ongoing romantic relationship shouldn’t change over time or that ongoing romantic relationship should always be worry-free and completely passionate.

There are two types of ROCD -- relationship-centered or partner-focused ROCD. Relationship-centered obsessions are characterized by concerns about the quality of the relationship itself and the purity of the love either, or both partners feel. In contrast, partner-focused obsessions are concerned with the quality of the non-ROCD partner’s attributes and characteristics.

Relationship obsessive-compulsive disorder might be present if one of the relationship members is always second-guessing their love for their partner and constantly seeking affirmation and confirmation that that relationship should exist. People with ROCD rarely feel good enough for their partner and worry that their partner will leave them.

People with ROCD might feel undue worry about their partner’s compatibility with them, too, or worry persistently about the rightness of the relationship. Despite having been together for a long time and without any particular inciting incident, a person experiencing ROCDmight fear that their partner is not “the one” and cannot think about much else outside of their romantic relationships.

People living with ROCDmight also have compulsions that impel them to do things like repeatedly and ritualistically checking if everything is alright with their partner, doing “tests” in their heads to see if they love their partners enough, doing tests in their heads to see if their partner is sufficiently attractive, intelligent, good-natured, or otherwise good enough for the person. These compulsive behaviors may not truly reflect people's feelings about their partners -- and the person might intellectually register that they really do find their partner to be “good enough” -- but they are patterns that are difficult to resist.

Repetitive thoughts and compulsive behaviors can lead to a string of negative circumstances in the other areas of the person’s life that can make the condition feel even worse. Non-OCD partners in an ROCD relationship experience related symptoms themselves sometimes, too, as they might feel uncertain about their self-worth and value (both inside and outside the relationship).

The constant focus of one partner on the other can leave other critical areas of the couple's life beyond either partner or the relationship unattended when it comes to career, home, and family. Familial relationships and job performance can suffer as the person experiencing ROCDhas become consumed with thoughts regarding the relationship.

Relationship Obsessive-Compulsive Disorder Therapy Types

Now that you know what ROCD symptoms look like, we'll move on to treating the symptoms and reducing the negative effects on your life. Below are three therapy types that today's board-certified and licensed therapists are using to treat this new DSM-5 diagnosis.

Cognitive-Behavioral Therapy (CBT)

CBT is a form of behavior therapy that teaches clients to identify triggers of negative behavior and learn how to place new behaviors in their place. This brain-based therapy operates under the assumption that people behave negatively or positively in response to their perception of their environment. Therefore, according to the principles of cognitive-behavioral therapy, changing negative perceptions can also change (or eliminate) negative responses to the environment.

Exposure Therapy with Response Prevention (ERP)

Exposure therapy is a graduated form of therapy that gradually introduces people with mental health challenges to the stimulus that triggers them. People who take part in exposure therapy are gradually exposed to the object or situation of their fear and coached through the process until the negative response to the situation is reduced or eliminated.

Mindfulness-Based Cognitive Therapy (MBCT)

MBCT is a form of therapy that combines key components of mindfulness-based therapy (MBT) with cognitive-behavioral therapy (CBT). The result is a therapy type that focuses on combining mindfulness with cognitive processes. In other words, being more aware of what you're thinking and purposefully changing your thoughts by choosing new behaviors or responses.

Where to Get Therapy

People experiencing relationship OCD now have a wide variety of options to get therapy. ROCD clients can attend sessions with traditional in-office therapists or online therapists to get advice, support, and resources for medication management. Whatever treatment avenue they choose, ROCD clients must comply with all the components of their treatment plan to manage or combat the symptoms of ROCD successfully. Ongoing therapy sessions with licensed professionals are likely to be a regular part of their lives now.

While ongoing therapy is a new component of people's lives, many people opt for online therapy options like video, SMS, and phone chat. The couples dealing with the effects of obsessive-compulsive relationship disorder can benefit from attending joint and individual therapy sessions from the privacy of their own homes, offices, or other private locations.

Taking part in ROCD therapy online eliminates the need for long or frustrating commutes and saves the couple's time and money, which is another stress-relief for the relationship. Couples can access online relationship therapy platforms like ReGain.US twenty-four hours a day. The ReGain.US platform has licensed and board-certified therapists and counselors that specialize in managing the symptoms of ROCD.

Getting started with online therapy is as easy as completing a simple email registration process and an online questionnaire that will help your therapist assess your symptoms and determine your treatment plan. Your treatment plan will include your therapist's recommendations for the number of therapy sessions you're scheduled to attend online, medication management resources, and other related local resources and referrals.

When you connect with a ReGain.US therapist, you're matched with a therapist who is licensed to practice in your state of residence to assure an uninterrupted continuum of quality care in the case that you should need an offline referral for resources and services related to your condition.

If you're serious about managing your symptoms of ROCD, you suspect that you have ROCD, or you already have a ROCD diagnosis, reach out to one of the relationship specialists atReGain.us who can get you matched with the best therapist to help you finally win the battle with ROCD.

“Sessions with Natalie are very insightful and give practical advice on implementing new habits and changes. Be prepared to engage and be challenged to think in a different way. I know that my partner and I can already see improvements in our relationship and feel more positive about working through our issues together.”

“Austa has been wonderful thus far. She has helped my partner and I during an unimaginably difficult time... She has also guided us in communicating effectively and setting appropriate boundaries in our relationship. I was hesitant to pursue counseling at the beginning, but I truly believe that it is making a difference for our relationship. Austa is easy to talk to and she is a great listener. I would wholeheartedly recommend her as a counselor.”

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