Relationship OCD And Intrusive Thoughts
Apr 05, 2024
What Is Relationship / Relational OCD?
Obsessive compulsive disorder (OCD) is a long-term mental health condition that includes recurring unwanted thoughts or impulses (“obsessions”), which lead to unwanted repetitive behaviours (“compulsions”). Clinically, it is classified as a form of neurodivergence (ND), and often someone will have OCD with another ND presentation such as ADHD or autism.
These unwanted thoughts or obsessions are also called intrusive thoughts or Automatic Negative Thoughts (ANTs). Typically, they can be loud and repetitive thoughts that fill the mind with noise, much like nearby traffic. On a good day, it might seem like the soft hum of distant passing traffic, on a bad day, you’re stuck in a rush hour traffic jam with roadworks and honking horns.
Intrusive thoughts can be difficult to overcome in everyday life, such as about your body or career success. Or, for example, if someone has hygiene-related ANTs, they may feel the need to wash their hands multiple times per hour, which can interfere with their work, sleep, and family time.
Similarly, intrusive thoughts about our personal relationships (rOCD) can be damaging and have negative consequences for us, our relationship(s), and partner(s). It can be very confusing to someone who feels they love their partner(s) but also has violent, vile, or desperate thoughts about them. How do you know what is real and what isn’t?
To be clear, it’s normal and natural to have doubts and insecurities in a relationship – we all do that. So, what’s the difference with relational OCD, you might ask? This video is a great overview of rOCD and this video gives a personal account of someone’s journey to overcoming it.
What's rOCD Like For The Partner?
It can often feel like the rOCD partner is clingy and needy. They can simultaneously need a lot of reassurance, which may feel exhausting, and have unrealistic expectations of the partner or relationship. In turn, this can feel like you're always being criticised or never able to give your partner as much attention or reassurance as they're looking for.
At its most simplistic, relationship OCD is a request for reassurance and confirmation of love and connection. Put simply, “do you love me?” or “do you really want to be with me?”. This can manifest in repeatedly requesting reassurance, having sex more frequently that the person's libido wants in order to feel connected, testing the partner in terms of undivided attention or remembering special occasions or shared memories.
These seemingly needy or demanding behaviours can be distressing both to the person with OCD and to their partner(s). It can also put strain on the relationship and give it a transactional or performance-based feeling.
Often, as this article explains, relationship OCD can also lead to, or increase the chances of, sexual dysfunction.
What Causes Relationship / Relational OCD?
Short answer: we’re still not sure, but we have some good ideas and are gathering evidence to substantiate these hypotheses.
As with all neurodivergent traits, there is a wide range physiological and behavioural aspects including brain chemistry, hormones, and the typical socialisation of children displaying ND behaviours. There may also be individual causes at play, such as a history of abusive relationships, an anxious attachment style, or the loss of a partner.
As a therapist, I’m more interested in what my clients feel and experience. What I’m told is that OCD feels like a sense of incompleteness or things just not being quite right. This is often linked to a strong sense of wrong and right or a black and white worldview that many ND folks hold.
Moreover, relationships, particularly at the beginning or in times of rupture, can create especially high levels of anxiety in ND people. This anxiety can fuel the wrong/right thinking and turn up the volume on intrusive thoughts.
How Should I Talk About This With My Partner?
Let’s take a deep breath, relax, and drop the should, shall we? This is your journey with yourself. You may well find it helpful to explain to current or prospective partner(s) what is going on in your head and what behaviours you’re trying to change.
Assuming they are supportive, they may be able to help you explore what your emotional and relational needs are.
For some partners, this is too challenging a topic to manage just the two of you. If you want to, rOCD is a great issue to take to relationship therapy or couple’s counselling, so you have the support of both your partner and a therapist.
What Other Help Is Available?
Relationship OCD is an issue I work with, both at the more superficial level as described above, and at the deeper level, addressing attachment styles, chronic anxiety, and healing trauma held in the body. To be clear, I have no desire to make you less yourself or less neurodivergent, but I do want you to suffer less and to thrive more in your intimate relationship(s).
Although this is a sweeping generalisation, you may find that a neurodivergent therapist is easier to work with in terms of their own understanding and experiences of intrusive thoughts. There is a UK register and a US register of ND therapists and counsellors.
Google and Youtube are overflowing with people wanting to talk to you about and support you with relationship OCD. As always, please do your due diligence and check that the person you’re learning from, or working with, meets your personal criteria for relevant expertise.
If you’re not sure if you need help, let me remind you that you deserve it anyway. Your mental health and wellbeing are important for you and those you’re in relationship with. I invite you to reach out to me or another mental healthcare professional to get the help and support you need and deserve.