Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Relationship OCD: Signs, Symptoms, and Treatment

By Taneia Surles, MPH

Oct 25, 20249 minute read

Reviewed byDiana Matthiessen, LMSW

Do you seem to question everything about your relationship? Are you bothered by persistent thoughts about finding someone “better”? Do you need repeated reassurance that your partner really loves you?

These are all signs of relationship OCD (ROCD), a subtype of obsessive-compulsive disorder (OCD) characterized by ongoing intrusive thoughts and compulsive behaviors related to close personal relationships. ROCD most often involves romantic or intimate relationships, but it can affect platonic ones, too. 

While it’s often mistaken for relationship anxiety or taken as a sign of relationship issues, OCD is actually a complex mental health condition. However, OCD is highly treatable, regardless of whether you’re dealing with ROCD, or another OCD subtype.

Keep reading to learn about the most common signs of ROCD and the best way to recover and keep your relationships strong.

What is relationship OCD?

Experiencing doubts and insecurity from time to time is completely normal in a relationship—but when these thoughts are recurring, deeply troubling, and intrusive, they could be a sign of relationship obsessive-compulsive disorder (ROCD).

“People with ROCD often find themselves questioning everything about their relationship, feeling that they need to be perfectly certain and secure,” explains Ryan Ventillo, LMHC, an OCD specialist at NOCD. “One may be especially invested in starting a relationship, maintaining a relationship, being a good partner, or being with the right partner, so the slightest doubts can feel impossible to accept.”

Relationship OCD doesn’t just stop with persistent intrusive thoughts (aka obsessions). It also involves behaviors (aka compulsions) that are performed in an attempt to quell the distress caused by the obsessions. This means you might seek reassurance from others, check up on your partner, snoop through their phone, or compare your relationship to others’. Unfortunately, these compulsions don’t bring relief—at least not long-term. 

People with ROCD often find themselves questioning everything about their relationship, feeling that they need to be perfectly certain and secure. One may be especially invested in starting a relationship, maintaining a relationship, being a good partner, or being with the right partner, so the slightest doubts can feel impossible to accept.


Ryan Ventillo, LMHC

Relationship OCD symptoms

The two key symptoms of ROCD—just as with any type of OCD—are obsessions and compulsions.

ROCD obsessions

Obsessions are intrusive thoughts, images, feelings, or urges that can lead to intense, all-consuming distress. Here are some examples of ROCD thoughts:

Compulsions in ROCD

Compulsions are physical or mental behaviors performed in an attempt to cope with the distress caused by the obsessions and/or to stop something bad from happening. Some examples of compulsions in relationship OCD are:

  • Repetitively taking relationship quizzes online.
  • Spending hours on relationship forums to feel better.
  • Checking for “signs” that you’re attracted to your partner, or vice versa.
  • Repeatedly asking your partner for reassurance about their love for you.
  • Avoiding certain relationship milestones to protect yourself from getting hurt.
  • “Testing” your partner by openly flirting with others.

The relationship OCD cycle

As long as compulsions help you feel better in your relationship, there’s no problem with engaging with them, right? Nope. Unfortunately, compulsions only provide, at best, fleeting relief. When the relief fades, the obsession returns, and you’re right back in what’s called the OCD cycle.

What causes relationship OCD?

It’s only natural to wonder why you’re experiencing such distressing thoughts, intense doubts, or why you’re so driven to resort to compulsions. Sometimes, relationship OCD can feel as if it simply popped up overnight. So, what’s really to blame?

Believe it or not, your intrusive thoughts, doubts, feelings, urges, and other triggers aren’t actually the cause of relationship OCD. In fact, everyone has intrusive thoughts, and anyone in a relationship is likely to experience similar thoughts from time to time. What distinguishes ROCD is your response to them: while others might dismiss these thoughts as random or unhelpful, ROCD makes them feel like real threats and demands that you respond with compulsions.

The underlying causes of OCD aren’t known for certain, but research has shown that genetics, brain chemistry, and life events may all play an important role in how and why people develop the condition. For relationship OCD, in particular, your relationship history might also come into play.

“Certain aspects of one’s relationship history may sometimes have an influence on why a person’s OCD fixates on this theme,” explains NOCD therapist Melanie Dideriksen, LPC, CAADC. “Many people develop OCD in the wake of especially stressful or traumatic events, so it stands to reason that severely negative experiences involving relationships could lead OCD to latch onto similar themes.”

Another reason that OCD might latch onto your relationship in particular is simply because it’s so important to you. Research has shown that one’s personal values impact the content of their obsessions, so your ROCD symptoms may reflect just how important your relationship is to you.

Many people develop OCD in the wake of especially stressful or traumatic events, so it stands to reason that severely negative experiences involving relationships could lead OCD to latch onto similar themes.


Melanie Dideriksen, LPC, CAADC

Do I actually have ROCD, or is it just “normal” relationship anxiety?

It’s worth repeating that practically everyone feels anxiety and doubt about their relationships at some point. The difference between relationship anxiety and ROCD often comes down to the amount of time and energy that these obsessions and compulsions consume. 

A relationship OCD diagnosis requires obsessions and compulsions to:

  • Take up to an hour or more per day
  • Cause significant distress
  • Interfere with your ability to function in day-to-day life

For instance, you might find that worrying thoughts are relentless, hanging on for hours or even days, and you simply cannot focus on anything else in between your worries and compulsions. You may even discover that the more energy you put into “making things okay,” the more disconnected you feel from your partner.

If you find that you need to ask your partner the same question over and over again because it’s the only way you’ll feel less anxious about your relationship—even though they’ve already given you the same answer 10 times—that’s a telltale sign of ROCD.


Keara Valentine, PhD

Why is relationship OCD so misunderstood?

Unlike the symptoms that can be obvious with other kinds of illnesses or disorders, it’s easy for ROCD symptoms to go undetected. After all, so much of ROCD happens below the surface, in the minds and hearts of people living with this mental health disorder. Not only that, but it’s easy to rationalize obsessions as having a “healthy concern” for your relationship life.

The reasons why you might not notice ROCD symptoms—or even brush them off—can include factors like:

  • You think you’re just insecure and feel that working on your self-esteem alone could improve how you feel about your relationship.
  • Your brain tries to convince you that your worries aren’t intrusive and you’re effectively coping with relationship issues.
  • OCD is only about obsessive hand-washing or cleaning, not about things like relationships (a very common myth).

Find the right OCD therapist for you

All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.

Exposure and response prevention (ERP) for relationship OCD

Until you learn how to break the cycle of relationship OCD and stop responding to obsessions with compulsions, it will always feel like OCD is running the show. But “breaking the cycle” isn’t about mustering up the willpower to stop. So, if you’ve ever felt bad about being unable to do that, here’s the permission to let go of any guilt.

The most successful treatment for ROCD is a form of behavioral therapy called exposure and response prevention (ERP) therapy. ERP—which was developed specifically to treat OCD—is clinically proven to be highly effective in the majority of people, with 80% seeing a significant improvement in their symptoms.

ERP is customized for each person and their unique needs, but here’s an overview of how it generally works. After asking you about your specific symptoms, a therapist specializing in OCD creates your ERP therapy plan. Based on that, you’ll work together to rank your fears or triggers based on how stressful they seem—this way, you can gain these skills gradually without getting overwhelmed.

This specialized therapy starts with exposures, in which your therapist prompts you to face a fear that’s not too scary—maybe you start by simply saying the word “cheating” out loud. When you start feeling anxious or distressed, instead of responding with a compulsion, you gradually learn to tolerate the discomfort you feel—which are strategies known as response prevention techniques

As you progress through these exercises with your therapist and on your own between sessions, you’ll gradually move on to more difficult ones. For example, your goal may be to resist the urge to ask your partner if they love you before going to sleep and learn to accept any uncertainty or anxiety you feel.

When you see that you handled the discomfort better than you thought, your brain learns that you can live with uncertainty and anxiety—they don’t need to rule your life. And as a result, you feel less of an urge to engage in compulsions to feel better.

“ROCD makes you believe that you need to feel 100% certain about the state of your relationship, but this is an emphatic lie,” says Patrick McGrath, PhD, Chief Clinical Officer at NOCD. “A key part of progress in ERP is learning to accept uncertainty because it exists everywhere in our lives.”

ROCD makes you believe that you need to feel 100% certain about the state of your relationship, but this is an emphatic lie. A key part of progress in ERP is learning to accept uncertainty because it exists everywhere in our lives.


Patrick McGrath, PhD

How ERP therapy can transform your relationships

You and your partner(s) deserve to be in charge of your relationship, not OCD. ERP is the most effective treatment for reducing the severity of symptoms, for the majority of people with OCD.

When one person in a relationship has OCD, both partners must rearrange their daily lives to make room for symptom management. When you go through ERP treatment, you learn how to manage your triggers and reduce your anxiety so you and your partner aren’t so strained. It’s one of the most important things you can do to make your relationship healthier.

While it’s certainly not a requirement, there are some instances where an OCD therapist might encourage you to ask your partner to join for a session or two to learn about your symptoms and how they can best be supportive. This might involve teaching your partner how to respond to requests for reassurance and decrease accommodations.

As you gain better control over your symptoms, you and your partner can focus less on your OCD and more on your time together. Daily life gets easier, and most importantly, the relationship takes on the equality and balance that every healthy relationship should have.

Key takeaways:

  • Relationship OCD (ROCD) is a subtype of obsessive-compulsive disorder (OCD) that involves intrusive thoughts and compulsive actions related to close personal relationships, intimate or otherwise.
  • ROCD is often mistaken for relationship anxiety, but many forms of treatment for anxiety disorders are ineffective for OCD, and can even make symptoms worse.
  • Seeking constant reassurance about your relationship from your partner or others is often a tell-tale sign of ROCD.
  • Exposure and response prevention (ERP) therapy—which was developed specifically for OCD and is backed by decades of research—is the most effective form of therapy for ROCD.

We specialize in treating Relationship OCD

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