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Is Relationship OCD Real?

Updated: Sep 19

And if so, how common it is really?

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  • There is skepticism surrounding the legitimacy of Relationship OCD as a genuine condition linked to OCD.

  • A recent study analyzed obsessions described by a substantial number of individuals with OCD.

  • The results highlight the widespread prevalence of relationship-related obsessions among individuals with OCD.


In recent years, the concept of “Relationship OCD (ROCD)” has emerged in scientific literature, media, and within therapeutic circles. It characterizes individuals who exhibit intense preoccupation and doubts regarding the suitability of their romantic relationships or partners, leading to significant distress and impairment in daily functioning.


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References to ROCD1-7 typically classify it as a distinct manifestation of obsessive-compulsive disorder (OCD). Those with OCD often experience distressing intrusive thoughts (obsessions) and feel compelled to engage in behaviors or mental rituals (compulsions) to alleviate the resulting distress. While OCD themes encompass concerns like contamination, symmetry, harm, morality, and religion, ROCD centers on relationship-related obsessions.


However, skepticism exists regarding the legitimacy of ROCD as a clinical condition. Some argue that it merely reflects common relationship challenges exaggerated by media and clinicians, while others perceive it as a milder form of OCD wherein individuals are “just a little too focused on their relationships.” Furthermore, there are assertions that ROCD is uncommon and affects only a minority of OCD sufferers. A recent study examining different OCD subtypes shades light on these debates.


In their 2021 study, Feusner and colleagues investigated prevalent obsessional themes of people with OCD by analyzing data from a mobile app designed for OCD treatment. Their analysis focused on extracting the vocabulary individuals used when spontaneously describing their obsessions, compulsions, and triggers. While previous studies have delved into the primary themes occupying those with OCD, Feusner and colleagues’ approach introduced two notable advancements:


  1. Large sample size. By leveraging data obtained via a mobile app, the researchers gathered responses from over 25,000 individuals who self-identified as having OCD. This is a notably large sample in comparison to typical studies that include dozens to hundreds of participants. This large dataset potentially provides a more comprehensive understanding of the themes of OCD obsessions.

  2. Free-form reporting. Previous studies regarding obsessional themes of individuals with OCD frequently relied on predetermined symptom checklists. These checklists encompass a variety of established OCD-related themes, including fears pertaining to harm, contamination, and religious concerns. However, because these checklists were devised before ROCD was recognized, they fail to include relationship-related themes, potentially resulting in the underrepresentation of relationship-related obsessions. Through the analysis of individuals’ spontaneous descriptions of their obsessions and compulsions, Feusner and colleagues bypassed the constraint of depending on predefined checklists, allowing for the identification of themes not included in such lists.


The researchers obtained 7,001 unique words representing obsessions from 25,369 individuals. They focused their analysis on the top 7% of the most commonly appearing words in the dataset. Notably, terms such as relationship, partner, love, break, attractive, girlfriend, boyfriend, wife, husband, and other relationship-related expressions appeared prominently among the top 7% of words.


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The study identified three main clusters of obsessive preoccupations, each centering around distinct themes reflected in the words examined. The second-most-frequent cluster featured relationship-related themes alongside “not-just-right” experiences. This cluster closely trailed the most prevalent cluster, which included contamination, somatic, or harm themes. The third-most-common cluster encompassed doubt or checking themes.


Through analyzing the free responses provided by participants, this study underscores the notable prevalence and relevance of relationship-related obsessions among individuals seeking treatment for OCD. This finding resonates with the expanding scientific comprehension of ROCD and echoes the observations of clinicians specializing in OCD treatment. These professionals often encounter relationship-related obsessions in their clients, witnessing the profound distress they induce. Raising awareness of ROCD among therapists and clients could facilitate better recognition, comprehension, and implementation of suitable treatment for those affected by this condition.


Ran Littman, Ph.D., - Website -


References


Brandes, O., Stern, A., & Doron, G. (2020). “I just can't trust my partner”: Evaluating associations between untrustworthiness obsessions, relationship obsessions and couples violence. Journal of Obsessive-Compulsive and Related Disorders, 24, 100500.


Doron, G., & Derby, D. (2017). Assessment and Treatment of Relationship‐Related OCD Symptoms (ROCD) A Modular Approach. The Wiley handbook of obsessive compulsive disorders, 1, 547–564.


Doron, G., Mizrahi, M., Szepsenwol, O., & Derby, D. (2014). Right or flawed: Relationship obsessions and sexual satisfaction. The Journal of Sexual Medicine, 11(9), 2218–2224.


Fernandez, S., Sevil, C., & Moulding, R. (2021). Feared self and dimensions of obsessive compulsive symptoms: Sexual orientation-obsessions, relationship obsessions, and general OCD symptoms. Journal of Obsessive-Compulsive and Related Disorders, 28, 100608.


Kılıç, N., & Altınok, A. (2021). Obsession and relationship satisfaction through the lens of jealousy and rumination. Personality and Individual Differences, 179, 110959.


Melli, G., Bulli, F., Doron, G., & Carraresi, C. (2018). Maladaptive beliefs in relationship obsessive compulsive disorder (ROCD): Replication and extension in a clinical sample. Journal of Obsessive-Compulsive and Related Disorders, 18, 47–53.


Mısırlı, M., & Kayanak, G. K. (2023). Relationship Obsessive Compulsive Disorder: A Systematic Review. Current Approaches in Psychiatry, 15(4), 549–561.


Feusner, J. D., Mohideen, R., Smith, S., Patanam, I., Vaitla, A., Lam, C., Massi, M., & Leow, A. (2021). Semantic linkages of obsessions from an international obsessive-compulsive disorder mobile app data set: big data analytics study. Journal of Medical Internet Research, 23(6), e25482.



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