It is normal to have some degree of anxiety related to being involved in a romantic relationship. Doubting a partner can be quite common, especially when things seem not to be going well and fights are frequent. Though many of us experience some amount of anxiety while in a relationship, those who suffer from Relationship OCD (R-OCD) may find being in a partnership extremely stressful and quite difficult.
Relationship OCD is a subset of Obsessive Compulsive Disorder (OCD) where an individual is overly consumed with worry and doubt focused on their romantic commitments. Symptoms are similar to other OCD themes whereby the sufferer experiences intrusive thoughts and images. However, with ROCD the worries are related specifically to their significant other. Some common fears include: What if I’m not really attracted to my partner?, What if I don’t really love my partner?, Is this the right person for me?, What if there is someone better out there? The overall worry is that one might be with the wrong partner.
Most of us experience intrusive thoughts and images on a daily basis, but people who do not suffer from OCD usually find it easy to dismiss them. However, it is quite the opposite for sufferers. To them, intrusive thoughts are almost always followed by a strong emotional reaction. They might experience a tremendous amount of distress (e.g., anxiety, guilt) and that makes it hard to see the irrelevance of the message and, therefore, dismiss it. Sufferers feel the urgency to engage with the idea and, in the case of ROCD, seek answers. It is a survival instinct that pushes ROCD sufferers to take action to eliminate the ‘perceived’ danger. It is also the uncertainty that is difficult to tolerate. Sufferers might end their relationships, not because they found the ‘answer’, but because they are no longer able to tolerate the distress and anxiety of ‘not knowing’ or they do so out of guilt (“How can I lie to my partner and ruin their life?”).
With ROCD, both obsession and compulsion are mental, so there are not always visible rituals. In order to make sure that the relationship is worth investing time in, sufferers begin to seek reassurance. They will engage in endless rumination, spending countless hours seeking answers. They might also compare their significant other to their previous partners or use Google’s ‘help’ (e.g., Googling “How do I know that I’m with the right person?”). Some observe other couples to get an idea of how a ‘successful’ relationship should appear. It is also common to try to control a loved one or pay attention to little details (e.g., partners appearance, character, etc.). Avoidance is also a shared trait among ROCD sufferers. They might avoid being close and intimate with their partner or refuse to engage in otherwise romantic activities.
ROCD is also often linked to perfectionism. A distorted thought pattern most common to perfectionism is all-or-nothing (dichotomous) thinking. So if things are not exactly the way they ‘should’ be, they are wrong. There seems to be a belief among sufferers that one should feel a certain way (e.g., “One should always feel 100% connected to one’s partner”) or that there are certain factors or behaviors that will define a successful relationship (e.g., holding hands when in public, always feeling passionate about the partner). The desire to feel a certain way can create a lot of pressure. It can also cause sexual challenges in a relationship, as it is difficult (if not impossible) to perform under pressure.
When we desire to feel an emotion ‘perfectly’ then we end up not really experiencing the emotion. For example, if you were at a party and kept asking yourself “Am I having fun right now?” This would take away from your experience at the party. This also means that we are not focusing on the present. So instead of struggling to feel a certain way, one might want to focus on continuing everyday life and the tasks it involves. Thus, if one decides to take their partner out for a romantic dinner, they should try to make an effort to still do so even though they might experience intrusive thoughts and feel uncomfortable (e.g., anxious, guilty). It can be helpful to remind ourselves that the goal is not necessarily to enjoy the occasion (or feel good about it), as we might be setting ourselves up for a failure.
There is a false understanding that one cannot be attracted to more than one person at the same time and, therefore, whenever the sufferer finds themself feeling a certain attraction towards someone else they tend to feel tremendous guilt and anxiety. They either try to hide those feelings by withdrawing (i.e., avoiding) or they confess to their partner. Sufferers may feel that they need to be ‘honest’ with their significant other and share or “confess” their doubts. The truth is that it is perfectly normal to find other people attractive while in a committed relationship. We know that we most likely chose the person we are with for greater reasons and not just based on feelings that we experienced at one time. It is good to remind ourselves that feelings and moods tend to change on a daily basis, but our values hardly sway. It is not possible to feel 100% connected to and passionate about our partners all the time. Relationships change with time, so we might struggle if we wish to feel the same way we did at the beginning of our relationship.
Treatment.
Couples therapy is likely to be challenging when the therapist is not familiar with this condition. It is necessary to not only educate the sufferer but also the partner about OCD and ROCD. Exposure and response prevention (ERP) is the treatment approach known to have the most success in treating OCD. ERP techniques require the sufferer to voluntarily allow themselves to be exposed to the very things and ideas of which they are afraid (e.g., ‘There is a possibility I’m with the wrong partner’). Practicing exposure exercises repeatedly over time allows sufferers the opportunity to learn how to live with their doubts and worries and how best to manage intrusive thoughts about the relationship and their significant other.