This is the blog of India Haylor, writing on behalf of OCD First Aid.  OCD First Aid is a treatment centre based in London which offers highly effective treatment programmes for OCD. Uniquely, the treatment is designed by clinicians with OCD to provide tangible, lasting relief and is based upon cognitive behavioural and third generation techniques. OCD First Aid has 14 years of experience as specialists in treating OCD, supporting families and carers and raising awareness.

Relationship OCD (ROCD) – Hidden in Plain Sight

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:

  • Sufferers present later since they tend not to identify their symptoms as a clinical condition
  • By the time sufferers seek treatment, they are likely to have moderate or severe symptoms
  • Sadly, sufferers may have already sabotaged one or more significant relationships
  • Unlike other subtypes which rarely stand alone, relationship OCD can present without any other OCD symptoms
  • Even a therapist (inexperienced in OCD) may not identify ROCD. They may focus on the relationship and not the ROCD which is counter-productive and even detrimental
  • 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’

 

 

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.

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