Relationship OCD and its symptoms

Obsessive Compulsive Disorder (OCD) has been present in the DSM for decades and has historically taken many forms. The media often limits depictions to only extreme versions of compulsive behaviors, but OCD presents so differently in manner, setting, and symptoms for each individual.

This post will not be on OCD as a whole, as the disorder has been something that has been studied for quite some time and has a lot of clinicians/researchers who have far more expertise on it than I do who can comment on it better than I can... and they do! If you would like OCD resources, please reach out and I can send them along.

This post is more on what has been coined "Relationship OCD" - and while that is not an official subtype in the DSM-V, it can be treated as a subset of symptoms that have OCD-type qualities. While individuals who are experiencing these symptoms do and do not meet the criteria for an OCD diagnosis, these symptoms can still be very distressing to the person and on their attachments.

What are the obsessive symptoms commonly experienced with "Relationship OCD"?

1. Constant wondering whether the relationship you are in is the relationship you are "supposed to be in"

2. Worrying that if a fight, miscommunication, disagreement happens, that this indicates that it could potentially mean that you are not "meant to be"

3. Honing in on a particular flaw or inconsistency in the relationship and thinking that it is something that has to change in order for the relationship to work in the future

4. Perpetual feelings of anxiety and thoughts about perceived happiness (in an all-or-nothing mindset) in the future

Checking/compulsive behaviors:

1. Asking friends and family whether or not your partner is right for you

2. Comparing your relationship to those of your friends/family

3. Googling certain situations to match them to what others have gone through

4. Depending on the context, asking for frequent reassurance from partner, friends, family, etc.

All of the above might be things that have happened in any relationship, and the concern that arises around more OCD-related concerns is around how much distress this causes and how much it impacts the person's life. For example, if you have this thought here and there (especially after a particularly distressing fight), that is normal, but if you are able to work through those feelings and have more open communication with your partner, you typically find that it is not something that extends far beyond any given incident. For folks who are dealing with relationship OCD symptoms, these thoughts and feelings persist and cycle back into the forefront with a subtle trigger or at complete random.

As an attachment-based therapist, I often view relationship OCD as a sign that something else might be going on with the underlying attachment and could be then triggering self-esteem related concerns. In particular, I want to know what in particular that person is afraid of in that worst case scenario -- "so what if your partner is the wrong person?" or "so what if your brother has a 'better' relationship than you do?" and usually from those questions, we get back to a core belief/pathway that is triggering the fear behind these anxious thoughts. For example, oftentimes we are seeing that is actually a fear connected to "I am alone" or "I am not okay" that is fueling these anxious thoughts/feelings and then the checking behaviors. If we can target those negative core beliefs and to try to identify when/where those initial pathways were laid down in the person's brain, we can work through how the brain may be sending messages from the past that are no longer necessary in the present. For example, is an "I am alone" belief as scary for you as a 35 year old person as it was when you were a 3 year old person? Probably not. Is the "I am not okay" belief actually based in any functional reality? Are you worried about survival? If so, that goes back to the fear being fueled from the past - you can survive as an adult far differently than as a child. That doesn't mean that it is not distressing, or that you should just shut down those thoughts/feelings because they aren't necessary anymore. Those messages have been key to survival in the past, and that is why they are so core to who we are, so we want to find a way to honor them without letting them take over. We also can choose at any point to be in relationship with others - we are relational creatures and want to be with other people - but the belief that we need other people in the way that we needed other people when we were babies is just not true.

In All About Love, author Bell Hooks writes about how love is a verb, an active choice. And that is what is incredible about love and attachment in adulthood - we are choosing relationship even when we do not need it. We are choosing to be present with one another through good times, hard times, imperfections, and an abundance of joy. No love feels the same on day 124 as it does on day 3 as it does on day 17652. It changes, it grows, and it is a beautiful choice.

Supporting a friend?

So while many people may want to give someone with relationship OCD symptoms "encouraging" words such as "He's perfect for you" or "They are your soulmate, don't worry!" - the most important aspect of it is to encourage that person to talk through with their therapist how to understand the underlying fears and core beliefs/pathways that are fueling these thoughts. You want to make sure that they are able to discern that there are differences in every relationship, and that they are able to identify what the most important aspects of partnership are for them and how those are playing out in the present dynamic. And you want to make sure that: a) they are not aiming for a perfect relationship, but rather one that works on the levels that matter to them; b) they have the choice to keep choosing that love; c) they are able to cope in the moments that it doesn't work; and d) they are able to survive if it ultimately ends.