Relationship OCD (ROCD) — Why we must become comfortable in uncertainty

One presentation of Obsessive Compulsive Disorder involves obsessive doubts about a romantic relationship and compulsions that aim to establish certainty.  Relationship OCD, otherwise known as ROCD, may present as anxiety that our partner doesn’t love us or worries that we have made a mistake in our choice of partners.  Similarly, relationship OCD may cause us to evaluate and re-evaluate every interaction in our relationship to dissect if our partners are upset with us, or if perhaps they have demonstrated that that they are cheating, may leave us, or cannot be depended on.   ROCD may cause compulsive checking of a partner’s location, intentions, and true feelings.  Sometimes, sufferers may obsessively compare current relationships with past bonds and experience deep seated fear that a past love was somehow better.

ROCD may become a self-fulfilling prophecy, as it can be incredibly draining and hurtful to the health of a relationship.  This manifestation of the “doubting disorder” (a nickname for OCD) may actually break up an otherwise healthy bond.  No-one enjoys being doubted, and few relationships can thrive under constant scrutiny.

What is the solution for ROCD? We must utilize Cognitive Behavioral Therapy to become comfortable in uncertainty.  A client with ROCD often comes to therapy seeking reassurance about whether or not their relationship is healthy.  Instead of offering this reassurance, a therapist trained in ROCD will gently lead their client into a tolerance for the inherent uncertainty of relationships.  A therapist may offer comments such as “we cannot predict the future, but what do you enjoy in the now?” These comments are both exposures and mindfulness exercises. The aim is to allow our client to experience doubt about the future while also centering them in the present.

In therapy, a client cannot be allowed space for obsessive rumination about what may happen in their relationship. Many people use therapy as a place to let out all their doubts about their relationship. However, with ROCD, this can be destructive rather than productive. Through CBT, a client may be interrupted and trained to notice the distortions in their rumination about their partner, including all-or-nothing thinking, catastrophization, and personalization, which may cause clients to engage in anxiety spirals that depart significantly from reality.

Therapists may also apply Exposure Response Prevention in the treatment of ROCD.  For example, we may utilize imaginational exercises.  Together, clients and therapists create a scenario wherein the relationship does in fact end.  During this session, we encourage our clients to sit in the distress of this possibility while not performing any of their safety compulsions.  Actually confronting what we fear allows us to take back power from our anxiety and dread.  Fearing the loss of a relationship may cause years of suffering that never manifests in reality.

ROCD exposures, as well as Cognitive Behavioral Therapy, will grow our clients’ confidence in their ability to handle disappointment and the uncertainty inherent in every human bond.  Once we are free of the destabilizing doubt about what may happen in our relationship, we open up to enjoying what does exist.