Some thoughts on Relationship OCD (ROCD)
Centre director Stuart Ralph was recently asked by a journalist about relationship OCD (ROCD) for a magazine targeted at women. Here are Stuart’s answers to those questions:
Online culture constantly tells us to “spot the red flags”, “trust our gut”, “never settle”, and assess whether our partner is “right”. How do you think this is shaping the way young women interpret normal relationship uncertainty? At what point does healthy reflection become unhealthy over-analysis?
I think these buzzwords you have mentioned can be very triggering for anyone that experiences high levels of anxiety and doubt. Relationships can take work. It’s the meeting of two unique individuals with their own psychologies colliding together, often initially in passion, and as that passion settles into a normal rhythm those psychologies can start to rub. Relationships are about growing together, building something special and helping one another, warts and all. We of course do want to be mindful about any real red flags or values violations, however these buzzwords mentioned can trigger someone's anxiety, as anxiety makes us hypervigilant to any little issue or perceived issue. The person with any anxiety disorder and OCD can suddenly read into this. If they are anxious it must mean the relationship is wrong, or the partner is not the “prince charming” they were promised in all those rom coms. These buzzwords in combination with anxiety don’t allow for the normal human imperfections, as anxiety disorders often work in black and white thinking with no nuance.
Healthy reflection is very important, especially if we are choosing a partner for life. However, in anxiety disorders and OCD this reflection can quickly become rumination. Spinning our wheels endlessly trying to figure out if our partner is right for us. Going over the same material we figured out yesterday, a week ago, a month ago and some cases years ago. Rumination can feel like problem solving, however if we have already thought about something in detail, going over it for the 10th time is potentially just seeking certainty where certainty can’t be found. Rumination never feels enough, and in people with OCD they get pulled into an endless cycle of trying to figure it out, when they have often already drawn their conclusions. OCD can be called the doubting disorder, because it makes the person doubt what they know.
Do you think ROCD is on the rise?
Yes and no. I think OCD has been prevalent for a long time, but mental health professionals are better at assessing it now and the general public have more information to identify the possibility of it in themselves. We have seen this in the reduction of the time it takes to get therapy for OCD, which is great. My prediction is that ROCD has risen as a theme of OCD purely because of the sheer amount of romantic triggers there are in the world now, such as rom coms, articles looking at the rightness of a relationship, and social media accounts talking about red flags, relationships, and not settling among other topics. All these triggers I predict will be focusing people's existing OCD on their relationships. As OCD often latches on to the things we care about most.
How do you spot the signs of R-OCD vs typical relationship doubts?
Good question, however it could be rephrased as how do you spot OCD? Because all the varying “themes” of OCD are masks the OCD is using. At the core of all these themes of OCD they share the same common thread: obsessions and compulsions, fuelled by intense emotions. In ROCD the person can be severely preoccupied with the rightness of the relationship, their partner's physical or mental attributes, whether they are in love or not among many other things. This intense preoccupation leads to compulsions such as continuously asking for reassurance, avoiding their partner, checking whether they are compatible, googling things like ‘how to know if I love my partner’ over and over, or more recently, having ‘conversations’ with AI about the relationship, compulsions are also infinite. OCD can be a trap of uncertainty, with the person constantly seeking certainty. OCD can ask a lot of what if questions continuously feeding the doubt.
Compulsions give certainty momentarily, but the doubt soon creeps back. This endless cycle of feeling certain and then uncertain can be a hallmark of OCD. People with OCD that has latched on to relationships can also feel in love one moment and that their partner is right for them, and then the next moment they feel completely overwhelmed with anxiety about the relationship, this pendulum can indicate there may be a larger issue with anxiety here. None of these signs are guarantees of OCD and assessing it is not this simple, it is always advisable to consult with a psychotherapist, psychologist or psychiatrist who understands OCD if you want to be more sure. They can also monitor and check their feelings so intensely that they disrupt the natural ebb and flow of emotions. Like watching a movie and analysing ‘do I like this, is it as good as the director's last movie, is Timothée Chalamet right for this part, do I like the lighting…’ We can’t know how we feel about the movie with this much analysis. Relationships are much the same.
Relationship OCD can at times be present in a relationship that isn’t right for us. Partners can have very different values and goals in life or there may be immovable barriers that the couple may not be able to work through. In relationship OCD it is common to want to eject out of the relationship to escape the intense anxiety. If leaving the relationship, it is key to do it from values, anxiety may also be present because of the emotions involved in a relationship ending, rather than OCD doubt alone. Values will be a calm knowing rather than the doubtful urgency of OCD. Values will be about moving towards something important rather than just escaping doubt and distress which is common in relationship OCD.
Why can the phrase ‘trust your gut’ be unhelpful advice for anxious minds?
Trusting your gut can be a useful phrase at times, however when someone has an anxiety disorder it is not that simple. People experiencing high levels of anxiety can start to interpret anxiety as their gut informing them. In ROCD someone may interpret that intense guttural doom that can come with anxiety as a sign that their thoughts about the incorrectness of the relationship are justified. When I personally dealt with ROCD I used to flip flop between feeling this perceived gut feeling as the wrongness of my relationship, and then an hour, day or week later when the anxiety had dropped, I felt at peace and certain in my relationship again. And so this pattern went on for years. In hindsight, I was interpreting my anxiety as my gut instinct. Useful information from our gut comes in a calm grounded way rather than full of doubt, urgency and distress. It's like background classical music rather than heavy metal grabbing at our attention.
What strategies are available for managing intrusive thoughts?
Intrusive thoughts are a normal human experience, meaning most humans get them. However in OCD we get hooked by them, making them sticky and repetitive. In OCD therapy we are more focused on reducing and stopping the compulsions someone does, as it’s these physical and mental compulsions that keep the OCD cycle going. The main therapy for OCD is cognitive behavioural therapy (CBT) including exposure and response prevention therapy (ERP). ERP works through gradually confronting one's triggers, and stopping the compulsions, this teaches the brain to be less afraid and as a result anxiety lowers. Learning psychological flexibility can help; acceptance and commitment therapy (ACT) can teach skills to deal with uncomfortable thoughts and feelings such that come up with relationship OCD. ACT ultimately helps us learn to focus back on the relationship and our values within that relationship.
When should someone with ROCD seek professional help?
It is always a personal choice when to enter therapy, however ROCD, as with all OCD, can overwhelm, reduce quality of life, and in ROCD’s case ruin relationships. If someone is finding that their anxiety is impacting their romantic relationships in a way that is both negatively affecting themselves and or their partner and has gone on for a while, it may be time to seek professional help. OCD is very treatable, and ROCD is no exception.
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