Relationship OCD: Signs, Symptoms, and Treatment (2024)

Relationship OCD: Signs, Symptoms, and Treatment (1)

Do you find yourself riddled with thoughts about finding someone better, or questioning everything about your relationship? You may be experiencing Relationship OCD (ROCD), a subtype of obsessive-compulsive disordercharacterized by ongoing intrusive thoughts and compulsive behaviors related to close personal relationships—most often romantic or intimate ones. Often mistaken for relationship anxiety or taken as a sign of relationship issues, ROCD (sometimes stylized R-OCD) is actually a serious and highly treatable mental health condition. Here's what you should know.

Relationship OCD: Signs, Symptoms, and Treatment (2)Relationship OCD: Signs, Symptoms, and Treatment (3)

Relationship OCD: Signs, Symptoms, and Treatment (4)Relationship OCD: Signs, Symptoms, and Treatment (5)

By Dr. Nicholas Farrell

Experiencing doubts and insecurity from time to time is normal in a relationship. But when these thoughts are recurring, deeply troubling, and intrusive, they could be a sign of relationship obsessive-compulsive disorder (ROCD).

“People with ROCD often find themselves questioning everything about their relationship, feeling that they need to be perfectly certain and secure. One may be especially invested in starting a relationship, maintaining a relationship, being a good partner, or being with the right partner, so the slightest doubts can feel impossible to accept,” explains Ryan Ventillo, LMHC, an OCD specialist at NOCD, a leading telehealth provider of OCD treatment.

As a subtype of OCD, ROCD doesn't just stop with the intrusive thoughts. It also entails behaviors (aka compulsions) that people engage in, all in an attempt to quell the distress brought on by the obsessions. This means you might seek reassurance from others, check up on your partner or snoop through their phone, compare your relationship to others', or force a certain way of being in an attempt to be pleasing to your partner.

Relationship OCD: Signs, Symptoms, and Treatment (6)Relationship OCD: Signs, Symptoms, and Treatment (7)

Table of Contents

  • About Relationship OCD
  • Symptoms of ROCD: Obsessions and compulsions
  • What Causes ROCD?
  • The Relationship OCD Cycle
  • Do I actually have ROCD, or is it just "normal" relationship anxiety?
  • Why is ROCD so misunderstood?
  • How is Relationship OCD treated?
  • An ERP Success Story
  • A final word on how ERP therapy can transform your relationships

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Relationship OCD (ROCD): Your guide to symptoms and treatment

Unfortunately, these compulsions don't bring the relief—at least not long term—that you intended. That shouldn't be cause for despair, though. Like all forms of OCD, there is hope for you if you're struggling with ROCD, or think you might be. Keep reading for answers to all your questions—including top signs of ROCD and the best way to recover and keep your relationships strong (and your sanity intact).

Symptoms of ROCD: Obsessions and Compulsions

What are the signs and symptoms of ROCD? As mentioned above, the key components required for an ROCD diagnosis—just as with any type of OCD—are two types of symptoms called obsessions and compulsions.

Obsessions are intrusive thoughts, images, or urges. Experiencing these obsessions on a loop can lead to intense, all-consuming distress. That's what leads someone with ROCD to engage in compulsions—physical or mental attempts to neutralize the thoughts or ease their discomfort. Here are some examples of compulsions involved in ROCD.

Obsession

  • “What if we fall out of love?”
  • “What if they cheat on me?”
  • “Am I still attracted to my partner?”
  • “That other couple seems so happy. Is something wrong with us?”
  • “Could there be someone better out there for me?”
  • “Does this urge I have to kiss a random stranger mean I don't love my partner?”

Compulsion

  • Repetitively taking relationship quizzes online
  • Spending hours on relationship forums to feel better
  • Checking for “signs” that you're attracted to your partner, or vise versa
  • Repeatedly asking your partner for reassurance about their love for you
  • Avoiding certain relationship milestones to protect yourself from getting hurt
  • “Testing” your partner by openly flirting with others

What causes ROCD?

It's only natural to wonder why you're experiencing such distressing thoughts, intense doubts, or why you're so driven to resort to compulsions. Sometimes, ROCD can feel as if it simply popped up overnight. So what's really to blame?

Believe it or not, your intrusive thoughts, doubts, feelings, urges, and other triggers aren't actually the cause of ROCD. In fact, everyone has intrusive thoughts, and anyone in a relationship is likely to experience similar thoughts from time to time! What distinguishes ROCD is your response to them: while others might dismiss these thoughts as random or unhelpful, ROCD makes them feel like real threats and demands that you respond with compulsions.

The underlying causes of OCD aren't known for certain, but research has shown that genetics, brain chemistry, and life events may all play an important role in how and why people develop the condition. For ROCD in particular, your relationship history might also come into play.

Many people develop OCD in the wake of especially stressful or traumatic events, so it stands to reason that severely negative experiences involving relationships could lead OCD to latch onto similar themes.

Melanie Dideriksen, LPC, CAADC

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“Certain aspects of one's relationship history may sometimes have an influence on why a person's OCD fixates on this theme. Many people develop OCD in the wake of especially stressful or traumatic events, so it stands to reason that severely negative experiences involving relationships could lead OCD to latch onto similar themes,” explains Melanie Dideriksen, LPC, CAADC, a therapist who specializes in OCD treatment.

In a cruel twist of fate, another reason that OCD might latch onto your relationship in particular is simply because it's so important to you. Research has actually shown that one's personal values impact the content of their obsessions, so your ROCD symptoms may reflect just how important your relationship is to you.

The Relationship OCD Cycle

As long as compulsions help you feel better in your relationship, there's no problem with engaging with them, right? Unfortunately, compulsions only provide, at best, fleeting relief. When the relief fades, the obsession returns, and you're right back in what's called the OCD cycle.

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Do I actually have ROCD, or is it just “normal” relationship anxiety?

It's worth repeating that practically everyone feels anxiety and doubt about their relationships at some point. The difference between relationship anxiety and ROCD often comes down to the amount of time and energy that these obsessions and compulsions consume. An ROCD diagnosis requires obsessions and compulsions to:

  • take up to an hour or more per day
  • cause significant distress
  • interfere with your ability to show up for your life (work, social life, and yes, your relationship)

For instance, you might find that worrying thoughts are relentless, hanging on for hours or even days, and you simply cannot focus on anything else in between your worries and compulsions. You may even discover that the more energy you put into “making things okay,” the more disconnected you feel from your partner.

If you find that you need to ask your partner the same question over and over again because it's the only way you'll feel less anxious about your relationship—even though they've already given you the same answer 10 times—that's a telltale sign of ROCD.

Keara Valentine, PhD

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Why is ROCD so misunderstood?

Unlike the symptoms that can be obvious with other kinds of illness or disorders, it's easy for ROCD symptoms to go undetected. After all, so much of ROCD happens below the surface, in the minds and hearts of sufferers. Not only that, but it's easy to rationalize obsessions as having a “healthy concern” for your relationship life.

The reasons why you might not notice ROCD symptoms—or even brush them off—can include factors like:

  • You think you're just insecure and feel that working on your self-esteem alone could improve how you feel about your relationship
  • Your brain tries to convince you that your worries aren't intrusive, and that you're effectively coping with relationship issues
  • OCD is only about obsessive hand-washing or cleaning, not about things like relationships (a common myth!)

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*When people join the NOCD Community, they are able to select the theme(s) of OCD that they identify with. By collecting and anonymizing their responses, we can gain insight into the experiences of nearly 300,000 people struggling with OCD.

ROCD can keep you stuck in an endless cycle of doubt.

An experienced, specialty-trained therapist can help you find a path forward, with a virtual evaluation and personalized treatment plan.

How is Relationship OCD treated?

As mentioned above, until you learn how to break the cycle of ROCD (meaning, you stop responding to obsessions with compulsions), it will always feel like OCD is running the show. But “breaking the cycle” isn't about mustering up the willpower to stop. (So if you've ever felt bad about not being able to do that, here's the permission to let go of any guilt.)

The most successful treatment for ROCD, like all forms of OCD, is a form of behavioral therapy called exposure and response prevention (ERP). Unlike traditional talk therapy, which can backfire and make ROCD worse, ERP—which was developed specifically to treat OCD—is clinically proven to be highly effective in the majority of people.

It's customized for each person and their unique needs, but here's how ERP generally works: After asking you about your specific symptoms, a trained therapist who specializes in OCD creates your ERP therapy plan. Based on that, you'll work together to rank your fears or triggers based on how stressful they seem—this way, you can gain coping skills gradually without getting overwhelmed.

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To begin with, your therapist will typically prompt you to face a fear that's not too scary—maybe you start by simply saying the word “cheating” out loud. When you start feeling anxious or distressed, instead of responding with a compulsion, you gradually learn to tolerate the discomfort you feel. As you progress through these exercises with your therapist and between sessions, you'll gradually move on to more difficult ones—eventually, your goal may be to resist the urge to ask your partner if he loves you before going to sleep, learning to accept any uncertainty or anxiety you feel.

There's science at play here, because when you see that you handled the discomfort better than you thought you could, your brain learns that you can live with uncertainty and anxiety—they don't need to rule your life. And as a result, you feel less of an urge to engage in compulsions to feel better.

ROCD makes you believe that you need to feel 100% certain about the state of your relationship, but this is an emphatic lie. A key part of progress in ERP is learning to accept uncertainty, because it exists everywhere in our lives.

Patrick McGrath, PhD

Chief Clinical Officer at NOCD

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Relationship OCD: Signs, Symptoms, and Treatment (22)

An ERP Therapy Success Story

Relationship OCD: Signs, Symptoms, and Treatment (23)Relationship OCD: Signs, Symptoms, and Treatment (24)

Victoria Aukland

Read more about Victoria's OCD Journey →

I wanted to know with 100% accuracy whether or not I was with the right person. Questions bombarded my head, 'Should I experience more?' I wondered: 'Is it too soon to settle down?' Even if I was happy in my relationship, 'Could I be happier?'

I met a friend who happened to have OCD. One day I finally opened up to this person and poured out all that I had been experiencing, all that I held in for so long.

This process, painful as it was, opened up a whole new world. I resonated with their story so much. They showed me the NOCD app.

For me, medication paired with ERP has been beneficial. ERP has helped me learn so much. I have learned how important it is to let thoughts be there. Let them be there and I don't need to respond, I don't need to do anything with them.

Relationship OCD: Signs, Symptoms, and Treatment (25)

A final word on how ERP therapy can transform your relationships

You and your partner(s) deserve to be in charge of your relationship, not OCD. Effective treatment exists, and ERP is—for the majority of people—the most promising option for them to regain their lives.

When one person in a relationship has OCD, both partners must rearrange their daily lives to make room for symptom management. When you go through ERP treatment, you learn how to manage your triggers and reduce your anxiety so you and your partner aren't so strained. It's one of the most important things you can do to make your relationship healthier.

In fact, while not the case for everyone (and certainly not a requirement), there are some instances where an OCD therapist might encourage you to ask your partner to join for a session or two to learn about your symptoms and how they can best be supportive. This might involve teaching your partner how to respond to requests for reassurance and decrease accommodations.

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As you gain control over your OCD, you and your partner are able to focus less on your OCD and more on your time together. Daily life gets easier, and most importantly, the relationship takes on the equality and balance that every healthy relationship should have.

NOCD Therapists specialize in treating Harm OCD

View all therapists
Adriana DelgadoLicensed Therapist, LMHC
Anika Carrasco TrujilloLicensed Therapist, LISW

I started treating people for OCD, as well as other mental health challenges such as depression, in 2004. Now, I specialize in OCD and use Exposure and Response Prevention (ERP) therapy to treat any OCD subtype. As much as I’ve learned as a licensed therapist, seeing family and friends deal with OCD has made my work more personal. ERP allows me to treat any subtype while tailoring treatment to your specific needs.

Vic ChaperonLicensed Therapist, LCSW

I have over 20 years of experience practicing psychotherapy, running my private practice for over 15 years specializing in OCD. I’ve also gained experience working in hospitals and clinics where I treated anxiety, depression, relationship & family dynamics, and more. The most effective approach to treat OCD is known as Exposure and Response Prevention (ERP) therapy. ERP is backed by research and is incredibly effective in showing you how to manage your OCD with confidence.

Taylor NewendorpNetwork Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Gary VandalfsenLicensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

Madina AlamDirector of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

Teri BullisLicensed Therapist, BCBA

I’ve seen people with OCD improve within a fairly short amount of time using Exposure and Response Prevention (ERP) therapy, but it does take work. With my help, you’ll see that the hard work pays off and will completely change your life. I've been a licensed psychologist since 1999. I have a Ph.D. in Clinical Psychology, am a board-certified behavior analyst, and have training in ERP therapy.

Erin CrowleyLicensed Therapist, LMFT

I want you to have a life with the ability to make the choices you want, but that can be hard to do when you have OCD. Exposure and Response Prevention (ERP) therapy allows you to do that.I’ve been practicing as a licensed therapist since 2014, and I know that learning how to manage OCD takes time, but not as much as you might think. After only a few sessions and a commitment to doing ERP, you may notice feeling significantly better.

Andrew MoellerLicensed Therapy, LMHC

I've been a licensed counselor since 2013, having run my private practice with a steady influx of OCD cases for several years. Out of all the approaches to OCD treatment that I've used, I find Exposure and Response Prevention (ERP) therapy to be the most effective. ERP goes beyond other methods and tackles the problem head-on. By using ERP in our sessions, you can look forward to better days ahead.

Ruthie BrooksLicensed Therapist, LPC
Adriana DelgadoLicensed Therapist, LMHC
Anika Carrasco TrujilloLicensed Therapist, LISW

I started treating people for OCD, as well as other mental health challenges such as depression, in 2004. Now, I specialize in OCD and use Exposure and Response Prevention (ERP) therapy to treat any OCD subtype. As much as I’ve learned as a licensed therapist, seeing family and friends deal with OCD has made my work more personal. ERP allows me to treat any subtype while tailoring treatment to your specific needs.

Vic ChaperonLicensed Therapist, LCSW

I have over 20 years of experience practicing psychotherapy, running my private practice for over 15 years specializing in OCD. I’ve also gained experience working in hospitals and clinics where I treated anxiety, depression, relationship & family dynamics, and more. The most effective approach to treat OCD is known as Exposure and Response Prevention (ERP) therapy. ERP is backed by research and is incredibly effective in showing you how to manage your OCD with confidence.

Taylor NewendorpNetwork Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Gary VandalfsenLicensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

Madina AlamDirector of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

Teri BullisLicensed Therapist, BCBA

I’ve seen people with OCD improve within a fairly short amount of time using Exposure and Response Prevention (ERP) therapy, but it does take work. With my help, you’ll see that the hard work pays off and will completely change your life. I've been a licensed psychologist since 1999. I have a Ph.D. in Clinical Psychology, am a board-certified behavior analyst, and have training in ERP therapy.

Erin CrowleyLicensed Therapist, LMFT

I want you to have a life with the ability to make the choices you want, but that can be hard to do when you have OCD. Exposure and Response Prevention (ERP) therapy allows you to do that.I’ve been practicing as a licensed therapist since 2014, and I know that learning how to manage OCD takes time, but not as much as you might think. After only a few sessions and a commitment to doing ERP, you may notice feeling significantly better.

Andrew MoellerLicensed Therapy, LMHC

I've been a licensed counselor since 2013, having run my private practice with a steady influx of OCD cases for several years. Out of all the approaches to OCD treatment that I've used, I find Exposure and Response Prevention (ERP) therapy to be the most effective. ERP goes beyond other methods and tackles the problem head-on. By using ERP in our sessions, you can look forward to better days ahead.

Ruthie BrooksLicensed Therapist, LPC
Adriana DelgadoLicensed Therapist, LMHC
Anika Carrasco TrujilloLicensed Therapist, LISW

I started treating people for OCD, as well as other mental health challenges such as depression, in 2004. Now, I specialize in OCD and use Exposure and Response Prevention (ERP) therapy to treat any OCD subtype. As much as I’ve learned as a licensed therapist, seeing family and friends deal with OCD has made my work more personal. ERP allows me to treat any subtype while tailoring treatment to your specific needs.

Vic ChaperonLicensed Therapist, LCSW

I have over 20 years of experience practicing psychotherapy, running my private practice for over 15 years specializing in OCD. I’ve also gained experience working in hospitals and clinics where I treated anxiety, depression, relationship & family dynamics, and more. The most effective approach to treat OCD is known as Exposure and Response Prevention (ERP) therapy. ERP is backed by research and is incredibly effective in showing you how to manage your OCD with confidence.

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Relationship OCD: Signs, Symptoms, and Treatment (2024)
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