Relationship OCD

Relationship OCD (2024 Guide) | Symptoms + Treatment + Strategies

Relationship obsessive-compulsive disorder, or ROCD, is different than normal anxiety about a romantic relationship. It’s a form of OCD that can ruin relationships if not managed properly.

A Comprehensive Guide to Relationship OCD in 2024

Relationship OCD (ROCD) is no joke — like other forms of OCD, it can become all-consuming. If you have this form of OCD you know how much time and energy can get used in thoughts such as, what if we weren’t meant to be together? What if I don’t really love her? What if I’m only in this relationship because I’m confused? Thoughts like these, often dismissed by well-meaning friends, can dominate your mind so that it’s hard to think about much else. ROCD can make it nearly impossible to enjoy spending time with your partner.
Relationship OCD

What Is Relationship OCD?

Obsessive-compulsive disorder is defined, in part, by the presence of obsessions or compulsions. Obsessions are usually thoughts (though they can also be images or impulses) that cause immediate and significant anxiety when you have them. In relationship OCD, obsessions are about an aspect of your romantic relationship.

The obsessions can focus on your feelings for your partner, their feelings toward you, the viability of the relationship, or the attraction you (or your partner) feels.

Obsessive-compulsive disorder

What Is The Cause Of Relationship OCD?

The causes of ROCD are not different than the causes of other forms of OCD. Several factors are known to play a role, including genetic factors and your learning history (including but not limited to your childhood). Ultimately, there is never one event or factor that can be definitively identified as the cause of someone’s ROCD. However, even if we could know the cause with certainty, it wouldn’t change the recommended treatment. (More on that below.)

Obsessive-compulsive disorder is one of the more common anxiety-related conditions, affecting approximately 2% of people at some point during their lifetime. In the United States, that represents nearly seven million people.

Unlike many other anxiety-related disorders, OCD can look quite different from one person to another.

For some people, OCD centers on fears of contamination. For others, the primary symptom is intrusive thoughts. These are unwanted thoughts that cause immediate and significant anxiety as soon as they occur. In OCD they tend to be about topics such as sex and sexual orientation, violence, suicide, or religious themes. For some people, the main theme of their intrusive thoughts is their romantic relationship. This type of OCD is informally referred to as relationship OCD, or ROCD for short.

Is relationship OCD a mental illness?

Obsessive-compulsive disorder is a potentially serious mental health condition, regardless of whether it involves obsessions about relationships or not. OCD is indeed a mental illness. However, that doesn’t mean that the condition is permanent, or that people with OCD can’t hold jobs, excel in school, or be in fulfilling relationships. They certainly can do those things.

Common ROCD Symptoms

Symptoms are of two types: obsessions or compulsions.

Obsessions in ROCD are typically thoughts like the following:

Compulsions in ROCD can take many forms. Here are some examples

How Relationship OCD is Diagnosed and What to Look for

Relationship OCD can be diagnosed by any mental health professional with expertise in obsessive-compulsive disorders. It cannot be self-diagnosed (or even partner-diagnosed). If you suspect that you or someone you care about is suffering from ROCD, some signs to look for include:

  • Repeated questioning one’s friends or family about the relationship
  • Excessive thinking about the relationship and whether it will last, even absent obvious triggers for such doubt
  • Asking many questions of one’s partner with a “secret agenda” to prove whether or not they’re the right person
  • Repeatedly mentally reviewing past relationships comparing them with the present one
  • A preoccupation with or excessive doubt about one’s romantic relationship

If you have a history of other symptoms of OCD, or a past diagnosis of OCD, the odds are higher of your current relationship anxiety being symptomatic of OCD. However, it is no guarantee — people with a history of OCD can spend time thinking about their current relationship in ways that have nothing to do with OCD. It’s normal for anyone who’s in a serious romantic relationship to have some anxiety about it on occasion.

Relationship OCD vs. Relationship Anxiety

Relationship anxiety is not the same as relationship OCD. The main difference is that relationship anxiety is a broader term that encompasses more difficulties. If you’re feeling anxious because you’re afraid your partner might leave or because you anticipate a breakup, this is not ROCD.

Many people have generalized anxiety, an unhealthy tendency to worry excessively about several topics. If you have this type of anxiety, it’s possible that your relationship is just another one of those topics. In such situations it’s good to address this tendency — there are effective treatments for this condition just as there are for OCD.

Can you have both ROCD and relationship anxiety?

This is quite uncommon but not impossible. Many people do have generalized anxiety as well as OCD. However, for those with both conditions, it’s typical for acute anxiety about one’s relationship to be more attributable to either OCD or generalized anxiety rather than both.

Is It Hard to Be in a Relationship with Someone Who Has OCD?

If your partner has OCD that does not focus on their love life, it is unlikely to significantly affect your relationship with them. However, if they have relationship OCD, they may engage in compulsive behaviors in order to reduce doubt they’re feeling about the relationship. This can take the form of asking you repeatedly how you feel about them, confessing attractions or conversations they’ve had with others, or intensively mentally reviewing interactions the two of you have had. Any of these can affect the relationship.

Sometimes relationship OCD can lead someone to end a relationship they otherwise wouldn’t — although it’s very difficult to discern when this is the case. Some people with ROCD will repeatedly break up with their partner in the expectation they’ll feel better afterward, only to decide they were wrong. They may then try to restart the relationship — but sometimes, the breakup has irreparably damaged things, and getting back together isn’t an option.

How bad can relationship OCD get?

Sadly, relationship OCD can become severe enough that it prevents a relationship from continuing. Many relationships have ended because of ROCD. However there are effective treatments and strategies (see below) to cope with ROCD that help prevent relationships from suffering too much. Many relationships, however, survive despite one person having relationship-related compulsions.

How do you cope with a partner who has ROCD?

Unfortunately, there is no quick fix or foolproof advice if your partner is suffering from relationship OCD. There are, however, two helpful strategies to keep in mind:

Speak your mind

If constant doubting or questioning from your partner is taking a toll on you, let them know! No one benefits from your bottling up your resentments and misgivings. If your partner is, for example, asking you for frequent reassurance about your feelings for them, tell them that you’d prefer to hear that question less often. Since it bothers you, say so. If you don’t, the problem is likely to worsen.

Don’t overindulge them

It’s tempting to gratify the compulsive questions if your partner has ROCD. After all, you care about them and want to put them at ease. Unfortunately, if you reassure them every time they ask for it, you can inadvertently worsen the problem. It’s often more helpful in the long run to — at least sometimes — refrain from answering their questions and assuaging their doubts. It’s also wise to let them know if you find the questions to be excessive or concerning.

How Do You Fix Relationship OCD?

A specific type of cognitive-behavioral therapy called exposure and ritual prevention (or exposure and response prevention), or ERP/ExRP is the treatment of choice for OCD. This is also true of ROCD. ERP/ExRP therapy should only be administered by therapists with specific training in this type of treatment — traditional therapy is typically not helpful for ROCD. The reason for this is that to overcome ROCD you need to improve certain coping skills. These skills are best improved by the specific exercises taught in ERP/ExRP.

Tolerating uncertainty

Perhaps the most important coping skill you’ll work on in ERP/ExRP is tolerating uncertainty. If you have relationship OCD, you move quickly from having the impulse to check something to the action of checking it. For example, picture a woman with ROCD spending time with her boyfriend. She finds herself doubting whether she truly loves him. So she says his name, hoping that a glance from him will produce a spark within her, relieving any doubt in her mind about her feelings.

In the above situation, saying his name is a compulsion — something she does specifically to reduce the doubt brought on by an anxious thought. Notice how quickly she went from having the doubt to having the impulse to say his name to actually saying it. In ERP/ExRP therapy, she would improve her ability to tolerate that doubt, that uncertainty about her feelings for him. This would be in contrast to her current approach, which is to always to try eliminate that doubt as quickly as possible.

ERP/ExRP leads you through a sequenced series of exercises that will improve exactly this ability. However, even if you’re not in therapy and suffer from ROCD, you can try to improve your own ability to tolerate doubt and uncertainty. Delaying compulsions is often a great help in doing this.

Limiting ROCD compulsions

For many people with ROCD, limiting compulsions can be a prerequisite for doing the exposure exercises that comprise the heart of exposure and response prevention therapy. One common way in which therapists will help their patients do this involves internet searching. If you have ROCD and see an OCD therapist, that therapist may ask you about whether you often Google information relevant to your ROCD.

For example, if you frequently search for terms like “how to know if my partner is right for me” and “how to know whether to break up with my girlfriend,” your therapist may task you with reducing these searches as a first step in your treatment.

Improving self-esteem

Low self-esteem is often related to ROCD, but it’s not the same thing. Having one of these two issues doesn’t mean you have the other.


However, many people with ROCD do suffer from low self-esteem. Often, a CBT therapist will address any self-esteem issues after the above skills have been mastered. This work can take many forms, and is tailored to the specific issues the patient has. Sometimes it will involve an examination of how you think about yourself and how you compare yourself to others. Other times it will focus on changing certain patterns in your life that consistently lower your self-esteem.

Mindfulness in ROCD treatment

Overcoming the torment of relationship obsessions typically requires us to come to a clear understanding of what these thoughts are and how they have their effect. Mindfulness is a key to accomplishing this. Mindfulness is a relaxed but focused awareness of what’s happening in the present moment. When we’re mindful we are aware of what we’re seeing, hearing, smelling, tasting, feeling, and thinking.

By practicing mindfulness we improve our ability to see our thoughts arise and see them fall away. (We also get better at noticing our emotions wax and wane.) This ability helps us manage obsessions — in fact, it’s critical to our ability to manage obsessions. If we’re not aware of something when it happens, we can’t do much to address it.

Your OCD therapist may or may not include mindfulness exercises or mindfulness meditation as part of your treatment plan. Let your therapist know if you’re interested in making mindfulness part of your OCD solution. Research has thus far not supported mindfulness as a replacement for exposure and response prevention therapy for people with OCD. It can, however, be an important supplement to ERP therapy.

Relationship OCD and Cheating

Fortunately, ROCD does not make someone more likely to cheat on their partner. What may happen if you have ROCD is that you will become irrationally afraid that you will cheat or have cheated on your partner.

This fear can then give rise to mental or behavioral compulsions. For example, if you have ROCD you might be prone to feeling unusually guilty after having enjoyed a conversation you had recently with someone you’re slightly attracted to. Or even someone you’re not attracted to. This might lead to wanting to confess the experience to a friend or to your partner. It may also lead to mentally reviewing each sentence of the conversation you recently had with this other person to “make sure” that you didn’t say something that was out of bounds.

Sometimes ROCD will lead people to mentally review interactions they had with others to make sure they didn’t cheat with them and then forget about it — as implausible as this may sound, it’s actually a common ROCD obsession. If you have this fear, you’re not alone! The important thing to do in such a situation is to recognize that this desire to mentally review the evening or the conversation is in fact a compulsion. As such, the wise move is to try to resist it. That means refraining from mental review as best you can.

ROCD and Anxiety

Anxiety and relationship OCD overlap significantly. If you have ROCD, you have anxiety that stems from the obsessive thoughts themselves. For example, what if he’s not right for me? What if something’s off with us? What if moving in together is a mistake?! To be sure, these are daunting concerns — most people would feel anxious if they had those thoughts and thought there was real reason to worry. If you have ROCD, these thoughts will lead to anxiety. The anxiety can take the form of physical tension and other symptoms. It can take the form of rumination and worry about the topic. Or both. There are many treatments and strategies that help with anxiety. However if your anxiety stems from relationship OCD, it’s important to make sure your efforts to address anxiety center on your relationship OCD. For example, relaxation training is one effective strategy to manage anxiety, especially anxiety that involves more physical symptoms. However relaxation training is not going to adequately address ROCD, unfortunately. It might lower the intensity of the anxiety to some extent. But if you don’t have good strategies in place to cope with the obsessive thinking, you may not see much improvement.

ROCD and Depression

Relationship OCD can cause depression, especially if it leads to the end of a relationship. People with ROCD sometimes suffer from low self-esteem, which is a risk factor for depression. For many people with relationship OCD or other types of OCD, the lingering difficulties presented by the condition can lead to depression over time.

In these cases, fortunately, once people can make progress on their OCD, the depression typically improves as a result of that.

How to Manage OCD Relationship Anxiety

Dealing with relationships is challenging even if you don’t have OCD! We need to strike a balance between maintaining a commitment to our partner while at the same time honoring our own instincts and values. Sometimes honoring our own instincts and values can mean ending a romantic relationship. It’s hard to know which principle applies sometimes.

If you have relationship OCD, it may often feel as though you have doubts about your relationship that your friends don’t. It’s hard to ignore that. You may even feel as if it’s dishonest to stay in a relationship with someone while having such strong doubts.


Tolerating such doubts is a skill, however. If we abandoned everything we did while having doubt, few things would get done. Ask yourself whether you’re striving to tolerate some doubt. If the answer is “no,” or “oh, I’m really bad at that,” you may want to seek out a consultation with an OCD expert.

Is it real or is it ROCD?

For some people with ROCD, it feels nearly impossible to tell the “real thoughts” from the “OCD thoughts.” This is typically something people do in an effort to determine which thoughts to pay attention to and which ones to ignore. People often complain that the OCD thoughts “feel so real!” It’s not that the obsessive thoughts aren’t “real,” but they’re the product of an unhealthy process that brings too much attention in our minds to the topic. Sometimes trying to distinguish the “OCD thoughts” from the “real thoughts” can become a compulsion unto itself.

If you find yourself struggling to tell the “real thoughts” about your relationship from the “OCD thoughts,” you might try taking a break from the effort to distinguish one type of thought from the other. This will likely feel unappealing and even irresponsible! After all, don’t you owe it to yourself and your partner to know how you really feel about him or her?

Unfortunately that type of thinking is an OCD trap. By abandoning all efforts to figure out our true feelings, we’ll be depriving OCD of the fuel it needs to keep going. It’s easier said than done, but if can do it, try taking a break — give up! At least give up for today. Tell yourself you can always come back to the topic tomorrow if it still feels urgent then.

For some people, this strategy won’t be as effective as they’d like. In those cases, I recommend a consultation with a mental health professional who specializes in OCD.

When you’re ready to get help with ROCD

It’s true that not everyone with doubts about their relationship needs therapy. However, if you find that the above description of relationship OCD symptoms describes you well, it might be worth at least doing a one-time consultation with an OCD specialist.

To schedule a call to talk about OCD, please contact us.

Frequently Asked Questions about Relationship OCD

Yes! ROCD is typically not a lifelong problem. However, it’s much more likely to improve if you make some changes. Seeking a therapist trained in exposure and response prevention (ERP) therapy is one excellent strategy to overcome relationship OCD. Another is to try to recognize what your compulsions are and to try to limit them. For more, see the strategy sections above.

Dating someone with relationship OCD will come with some challenges, but don’t let that stop you if you think they’re the right person for you. Remember that relationship OCD is not who they are, it’s just a challenge they have right now. They likely won’t have it forever, especially if they seek treatment. For strategies to navigate the challenges of dating someone with ROCD, see the relevant section above.

There is no one test for relationship OCD, unfortunately. However, if you have this question, three strategies are recommended. 1) Ask yourself whether your relationship anxieties are making a real impact on your life or your relationship. 2) Ask yourself whether your symptoms are causing you significant emotional distress. 3) Seek an evaluation with a mental health professional who specializes in OCD.
Medication does help for many people with obsessive-compulsive disorder (OCD). There is little reason to think it would not be helpful for those with relationship OCD, which is a subtype of OCD. However, to date there have not been any published clinical trials of medication specifically for people suffering from relationship obsessions as a primary OCD symptom.
Sometimes, yes. Relationship obsessions can make things very confusing for someone trying to sort out their true feelings toward a dating partner, or even a spouse. It can rob you of the easy confidence that many other people have about their feelings toward their partners. Fortunately, effective help is available for those suffering from this condition.

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