Relationship OCD: Symptoms, causes, and treatment options

Reviewed by Susan Radzilowski, MSW, LMSW, ACSW

Written by

therapist.com team

Last updated: 09/25/2024

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What is relationship OCD?

Relationship obsessive-compulsive disorder (ROCD) is a presentation of OCD characterized by intrusive thoughts and compulsive behaviors related to intimate relationships. Research suggests that ROCD can be just as distressing as other presentations of OCD, and is more likely to lead to both relationship dissatisfaction and depression.¹

Relationship OCD symptoms

Relationship OCD symptoms can be divided into two main categories: relationship-centered or partner-focused.² 

Relationship-centered symptoms involve constantly worrying about the relationship and the emotions surrounding it. Obsessive thoughts might include:

• Doubts about the “rightness” of the relationship
• Questioning if you truly love your partner
• Worrying if your partner truly loves you
• Constantly comparing your relationship to others
• Seeking reassurance about your relationship’s status

Partner-focused symptoms involve fixating on your partner’s specific traits, such as:

• Obsessing over their physical attributes or flaws
• Fixating on their personality traits or quirks
• Constantly analyzing their intelligence or sense of humor
• Worrying about their social skills or career prospects

These obsessions can lead to compulsive checking behaviors like:

• Excessively monitoring how you’re thinking, feeling, and behaving
• Comparing your partner to imaginary “ideal” partners
• Seeking reassurance about your relationship from friends, family, therapists, or even psychics
• Using past positive experiences to try to convince yourself that all is well in your relationship
• Testing your partner to see if they measure up to your expectations
• Trying to fix “mistakes” your partner makes or change certain qualities they have
• Avoiding situations that trigger doubts about your relationship, such as going to see a romantic movie
• Misinterpreting common relationship experiences as signs of incompatibility 

If you’re having doubts or worries about your relationship, a licensed therapist can help you determine if they’re related to ROCD or stem from another source. 

Relationship OCD examples

Nine months into a relationship, a woman constantly wonders if her boyfriend is “the one.” She obsessively analyzes their interactions and compares him to people she sees both in-person and on social media. She frequently seeks reassurance from friends about everything from their chemistry and compatibility to their shared interests and future plans. She finds herself unable to fully enjoy their time together, constantly questioning if she’s truly happy or if there might be someone better out there for her.

Two years into dating, a man obsesses over his girlfriend’s minor physical “flaws.” He compulsively compares her to his exes and other people he finds attractive. Even though he knows looks aren’t the foundation of their relationship, he can’t stop fixating on them. His constant focus on the perceived flaws causes stress and makes it hard for them to be close.

Two years into a marriage, a nonbinary person becomes obsessed with their partner’s intelligence. They begin analyzing conversations and questioning responses, fact-checking their statements online. Although they have a genuine connection and their partner has a successful career, they begin to fear they’ve settled for someone “not smart enough.” Their preoccupation strains the relationship and overshadows their partner’s other qualities.

What causes relationship OCD?

Experts don’t know the exact causes of OCD, but they believe a combination of genetics, brain abnormalities, and environmental factors plays a role.³ Personality traits, life events, or attachment issues can all shape how a person thinks about and experiences relationships.

Relationship OCD symptoms often coexist with other OCD symptoms, and are also associated with negative emotions, low self-esteem, dissatisfaction in relationships, and attachment insecurities.⁴ 

One theory suggests relationship OCD may develop and continue when people catastrophize normal thoughts or events.⁵ Events that are typical are misinterpreted as threats, and relationship-related decisions are suspected to have dire consequences. For example, a person might think that staying in a relationship will make them miserable once the “honeymoon” phase is over. Or they may think that if their partner breaks up with them, they’ll never recover from it. 

People in the LGBTQIA+ community may be more prone to experiencing certain symptoms of ROCD. Research shows they tend to have greater doubts about their partner’s love, experience heightened negative emotions, and display more perfectionistic traits compared to those in heterosexual relationships.⁶ It’s possible that this is the result of certain societal factors LGBTQIA+ people are forced to face, such as discrimination, marginalization, and internalized stigma.

How relationship OCD impacts mental health

People with ROCD are more likely than others to feel overly responsible for their thoughts.⁷ They tend to believe thoughts can and should be controlled, making them feel even worse when they have doubts about their relationship. The guilt and self-blame they experience can contribute to stress and negative reactions toward their partner. 

People with relationship OCD also tend to think the negative consequences of being alone are much worse than those without the condition.⁸ They often imagine terrible situations where they’re stuck in unhappy relationships, but also fear being alone.

How does relationship OCD affect relationships?

Relationship OCD symptoms are strong predictors of relationship dissatisfaction and depression.⁹ These symptoms can create a self-fulfilling prophecy, where constant doubting and checking behaviors strain the relationship, eventually leading to problems. 

Partners may feel scrutinized, misunderstood, or emotionally distant due to their partner’s obsessive thoughts and compulsive actions. The person with relationship OCD might struggle to fully engage in the relationship, missing out on genuine moments of connection and intimacy. 

It’s a vicious cycle that can erode trust, communication, and overall relationship satisfaction. If not addressed, relationship OCD can lead to breakups or long periods of distress for both partners.

Relationship OCD treatment

Treating relationship OCD is similar to treating other forms of OCD.¹⁰ Effective forms of treatment include cognitive behavioral therapy (CBT) techniques like cognitive restructuring or exposure and response prevention (ERP).

In cognitive restructuring, therapists work with clients to challenge their obsessive thoughts about their partner or relationship, helping them identify and reframe distorted beliefs. ERP, on the other hand, might involve exposing clients to situations that trigger relationship doubts, then preventing the compulsion that follows.

Research suggests that it can also be helpful to look into how much a person’s self-worth depends on their relationship and to address any attachment issues, like fear of being abandoned.¹¹ Working on certain social skills, such as how to communicate effectively and resolve conflicts, can also be beneficial.

Other helpful forms of therapy include acceptance and commitment therapy (ACT) and couples therapy. ACT can help people with ROCD symptoms embrace uncertainty and experience their thoughts without judgment.¹² Couples therapy, on the other hand, may be needed if ROCD symptoms are significantly impacting both partners in the relationship. 

How to deal with relationship OCD

If you think you might have relationship OCD, it’s important to seek professional help from a therapist experienced in treating OCD. In the meantime, you can:

• Challenge your intrusive thoughts and question their validity 
• Practice mindfulness techniques to help ground you in the moment
• Avoid constantly seeking reassurance, as this can reinforce obsessive thinking
• Journal about positive relationship moments
• Engage in activities as a couple that don’t trigger your doubts
• Remember that certain worries about relationships are normal
• Engage in self-care activities to reduce overall stress and anxiety
• Communicate openly with your partner about your struggles
• Join support groups to connect with others facing similar challenges

Using mobile apps designed for OCD management may also help. Research shows they can reduce symptoms in subclinical levels of relationship OCD.¹³ Couples who use apps together may also improve ROCD symptoms by decreasing negative thoughts and boosting relationship satisfaction.¹⁴

Dating someone with relationship OCD can present its own challenges. If you’re wondering how to help your partner with relationship OCD, consider:

• Approaching them with empathy and understanding 
• Having honest and respectful conversations about their concerns and experiences 
• Creating an open and supportive environment 
• Encouraging them to seek professional help 

Keep in mind that supporting your partner shouldn’t come at the expense of your own mental health. It’s important to set healthy boundaries, maintain your own self-care practices, and seek support if needed. 

Visit our directory to find a qualified therapist specializing in OCD treatment, relationships, or couples therapy.