In 2004 I first noticed my clients presenting with relationship obsessions. Naturally, OCD sub-types can have a cultural or sociological influence (HIV, CJD, paedophilia obsessions), but pathological obsessions about one’s relationship? Could this be a hitherto unrecognised sub-type? It didn't feature in the accepted assessments for OCD. And how might these obsessions differ from the growing cultural absorption with all things relationship? To answer the latter, the obsessions and compulsions of ROCD follow a similar, highly specific symptomology with often devastating impact upon the sufferer and their significant other. I happened to discuss my observations during a radio interview and there were floods of enquiries. From that point on, the incidence has consistently grown. All OCD is tough, often bizarre, yet this is the sub-type that most can relate to, albeit in a less obsessed sense. Most people have been preoccupied with their relationship but ROCD is an occupation – full time at that!
ROCD is both aggressive and subtle. It is able to disguise itself and become habitual long before the sufferer realises. Then it is both triggered and reinforced daily by a media obsession with relationships – seemingly every magazine, internet article, TV show, movie, advertisement, blog and song. Furthermore, everyone else is discussing their relationships, and those of Brad & Angelina or Kim & Kanye, so that the unsuspecting sufferer takes some time to realise that they have a problem. Sadly this may be after they have spent years (and a few failed relationships) obsessing with friends and family who are all too keen to become involved. The ROCD sufferer may have no idea that their obsessions & compulsions have become pathological. Their behaviours may include mental ruminations that can occupy 90% of their waking hours, comparing their relationship to others, endless researching online whether they are ‘in love’ or their partner is right for them, seeking reassurance constantly from friends/family or their partner and incessant problem solving about whether to end their relationship or not. I always say that ROCD is ‘hidden in plain sight’.
Despite hours of subjecting themselves and others to their quest for certainty, the ROCD sufferer may (or may not) eventually see the destructive, repetitive pattern or become so overwhelmed or depressed that they cannot function in their daily life. As a therapist, it appears to me that the unique characteristics of ROCD are likely to be:
Ruminating (thinking) about your relationship for most of your waking hours (accompanied by intense anxiety)
Asking yourself specific questions such as "Are they 'the one'?", "Is this really love that I'm feeling?", "Am I sexually attracted to them?", "Is there someone more suited to me out there?", "Am I missing out on life by being in a relationship?"
Seeking reassurance from your partner about the questions above, often indirectly
Confessing that you are thinking the above questions to partner, family or friends
Reading prolifically about relationships and completing relationship questionnaires
Discussing your relationship obsessively with others, particularly friends and family
Comparing your relationship to others, particularly when out and about or socialising
Scrutinising your partner, particularly their physical characteristics, personality or achievements
Avoiding certain situations, for example, romantic movies or friends in successful relationships
Sufferers of ROCD tend to present later for therapy since they tend not to identify their symptoms as a clinical condition. The world seems to be obsessed with relationships and the line between interested and obsessed isn't clear for most of us. By the time sufferers seek treatment, they are likely to have moderate or severe symptoms and may have already sabotaged one or more significant relationships.
Relationship counselling may seem an obvious solution to a person obsessing about their relationship. However, if it is relationship OCD, OCD this would be an unhelpful strategy. A relationship therapist may not identify ROCD and may focus on the relationship and not the ROCD. Naturally, further investigation or analysis of a relationship is counter-productive and even detrimental to those with OCD.
Even for therapists experienced in treating OCD, ROCD can be idiosyncratic: unlike other subtypes which rarely stand alone, relationship OCD can present without any other OCD symptoms. For those of use who regularly treat OCD, the symptoms are pronounced.
Another complication is the fact that a partner or significant other may not accept the existence of ROCD or cannot cope with the nature, intensity or frequency of the obsessions which are essentially saying ‘I’m not sure I love you’ or ‘you may not be right for me’ or ‘I may not be right for you’. Even if a partner is ultimately empathetic and understanding, they can eventually become worn down by the unending deliberation and obvious distress of their loved one. A takes a robust relationship to weather the barrage of uncertainty generated by OCD.
Like all manifestations of OCD, ROCD treatment must be based upon the premise that ROCD is bombarding the sufferer with questions that don’t need answering and problems that don’t need to be solved but it does require expertise to navigate the subtle ways in which this disorder can manifest and consistency in focusing the treatment away from relationships and towards OCD.