unhappy couple sitting on a bench

Understanding the Connection Between OCD and Relationships

Your favorite rom-com or reality show might depict someone continually questioning their relationship — comparing it with others, perhaps, or sharing doubts with a friend. Normal levels of anxiety about a new (or established) relationship are one thing, but when doubts about your partner or your relationship consume you, it might be relationship obsessive-compulsive disorder, or relationship OCD (via NOCD).

Relationship OCD is a subtype of OCD in which a person has intrusive and unwanted thoughts, fears, and doubts about their relationships. You may find yourself obsessing over worries such as whether your partner is the right person for you, how your partner feels about you, or whether you’re “meant to be.” Someone with OCD might also need continual assurance from others to assuage their anxieties about a relationship. They might continually hold their relationship up against other people’s relationships. These intrusive thoughts can cause significant emotional distress and can lead to erratic behavior patterns in relationships.

Symptoms of relationship OCD

woman pushing off a kiss from a man

People with relationship OCD often center their thoughts on their relationship or a specific partner, according to the International OCD Foundation. Relationship-centered OCD is concerned about whether the relationship is the right one or whether it’s “real love.” Someone with partner-centered relationship OCD will have intrusive thoughts about the other person’s characteristics or past relationships. This might include whether the person has suitable physical, social, or personality characteristics. Often people will have partner-centered thoughts first before turning to relationship-centered thoughts. Relationship OCD isn’t restricted to romantic relationships. People can have OCD in a parent-child relationship or a relationship with God.

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According to the Gateway Institute, relationship OCD can strain a relationship because someone with relationship OCD needs to be continually reassured about the relationship. Symptoms of relationship OCD also include excessive doubts about how attracted one is to the other and comparing a partner’s attractiveness to others. Sometimes people with relationship OCD might end the relationship for fear of being hurt or fear that the relationship wasn’t “meant to be.”

Treating relationship OCD

crying woman looking away while meeting with therapist

The Gateway Institute says that relationship OCD can be treated through two types of cognitive behavioral therapy (CBT) called exposure with response prevention (ERP) and mindfulness-based cognitive-behavioral therapy. Mindfulness-based CBT teaches people that responding to their intrusive thoughts strengthens their fears and obsessions. ERP briefly exposes people to situations that trigger their relationship OCD while confronting distressing thoughts. This type of therapy progresses from less-distressing triggers to more challenging ones so people can learn to handle their anxiety and control their compulsiveness.

Impulse therapy also suggests that finding ways to channel anxiety can help in managing relationship OCD. Acceptance and commitment therapy (ACT) can be used with ERP in helping people accept their fears and doubts so that they no longer have control over their lives. Various types of therapy can also be combined with medications, such as selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, and atypical antipsychotics such as quetiapine used off-label. It’s always best to work with a licensed professional to find the right type of therapy and possible medication to work through relationship OCD.

Lesa O'Leary
Lesa O'Leary

Lesa is a dynamic member of OzHelp’s Service Delivery Team as the Service Delivery Team Leader and Nurse. She has been with OzHelp for five years and believes in leading by example. Lesa has experience in the not-for-profit sector, as well as many roles throughout different industries and sectors, including as a contractor to the Department of Defence. She has expertise in delivering OzHelp’s health and wellbeing programs and engaging with clients in a relaxed and comfortable manner that aligns with the organisation’s vision and objectives.

Lesa has a Certificate 4 in Nursing from Wodonga Tafe, Certificate 4 in Mental Health from Open Colleges, and is currently undertaking a Certificate 4 in Training and Assessment from Tafe NSW. For the past few months Lesa has been an Education and Memberships committee member of the ACT Branch of the National Association of Women in Construction (NAWIC).