Is Relationship OCD Real?

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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.

References to ROCD^1-7 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 colleagues⁸ 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.

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.

To learn more about Relationship OCD, click here.

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