Relationship obsessive-compulsive disorder (OCD) can cause a person to have obsessive fears and doubts about their relationship and partner. These negative thoughts can develop into compulsive behaviors.

Doctors consider OCD an anxiety disorder. They characterize it as a condition that causes intrusive thoughts and repetitive behaviors. This can also manifest in someone’s relationship with another person.

This article explores what relationship OCD entails, the symptoms, and how it can affect relationships. We also look at possible causes, treatment, management, and frequently asked questions about the condition.

The National Institute of Mental Health defines OCD as a chronic, long lasting disorder. A person with OCD tends to have obsessions, such as uncontrollable and reoccurring thoughts, and compulsions, which refer to behaviors.

In some people, these obsessive-compulsive traits can focus on a relationship or a partner, causing relationship OCD. Such symptoms may result in:

  • difficulty having relations
  • lower sexual functioning
  • significant changes in mood

Research from 2016 categorized symptoms of relationship OCD as relationship-centered or partner-focused.

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Relationship-centered symptoms

Relationship-centered OCD can cause a person to doubt and worry about the perceived suitability of their relationship. This may cause them to doubt the other person’s feelings and whether the relationship is a right fit for them.

Relationship OCD symptoms often come in three forms:

  • Thoughts: This form may cause a person to question, “Is the relationship right for me?” or “Does my partner love me?”
  • Images: For example, seeing the partner’s face.
  • Urges: A person may feel an urge such as, “Should I leave my partner?”

These forms are often unwanted and may trigger additional emotional or psychological distress.

Partner-focused symptoms

Doubts, concerns, or worries may also relate to a partner’s perceived personality or aesthetic flaws.

Partner-focused OCD causes a person to worry about the suitability of the partner in terms of six domains:

  • Appearance: This concern may cause a person to feel thoughts such as “my partner’s nose is too big.”
  • Intelligence: This may involve thoughts such as, “My partner is not clever enough for me.”
  • Social skills: This may cause a person to question, “Why is my partner so antisocial?”
  • Morals: This may include thoughts, such as “I cannot believe my partner does not care about x.”
  • Emotions: This may involve thoughts that include, “My partner is so emotionally unstable.”
  • Reliability: This may cause a person to question, “Is my partner reliable?”

Relationship-centered and partner-focused concerns can:

  • happen simultaneously
  • occur before the other form
  • reinforce the other form

In addition to obsessive thoughts, both types of relationship OCD cause compulsive behaviors within their relationship.

A person may prioritize negative thoughts about one’s partner or the relationship. This increases relationship doubts, maladaptive, compulsive behaviors, and comparisons between a person’s relationships and other relationships.

Experts are not certain what causes relationship OCD. As a form of OCD, some of the most common factors tend to be:

  • genetic, meaning it tends to run in families
  • behavioral, meaning learned experiences from observations
  • cognitive, which involves a misinterpretation of beliefs with a focus on others
  • psychological, which involves stress and depression that may contribute to the onset or worsening of symptoms

A certain trigger or past event may lead to a person distrusting their relationship or partner, which doctors often observe in people with relationship OCD.

A 2016 study examining participants experiencing relationship OCD and general OCD found possible causes for their symptoms. Certain factors, such as a fear of abandonment or reliance on self-worth in the relationship or partner, may contribute to someone developing and experiencing these symptoms.

A person may notice the symptoms appearing in early adulthood, which affects their later relationships. These symptoms may also date back to the first time they faced an important romantic decision, such as getting married or having a child.

A person must meet certain criteria for a diagnosis of relationship OCD. These criteria include the presence and frequency of obsessions, compulsions, or both. Doctors will also determine how these characteristics affect a person’s quality of life.

Diagnostic tools used in research

Althoughrelationship OCD is not an official entry in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), doctors diagnose it as a form of OCD.

For this reason, researchers from a 2016 study assessed people using a structured interview according to the DSM-5-TR. This helped diagnose people who were reporting relationship-centered and partner-focused symptoms.

Researchers assessed relationship-centered symptoms with a relationship obsessive–compulsive inventory that covered:

  • the feelings toward one’s partner
  • the partner’s feelings toward themselves
  • the “rightness” of the relationship

Meanwhile, researchers assess partner-focused symptoms with the partner-related obsessive-compulsive symptoms inventory. This is a self-report measure of the six domains of partner-focused symptoms from earlier.

The inventory measures symptoms of:

  • anxiety
  • depression
  • stress
  • relationship quality

A person must first recognize that their symptoms impede their ability to fully experience relationships. This recognition will help doctors determine that their OCD obsessions link to romantic involvement with others.

Treatment for relationship OCD tends to overlap with OCD treatments.

Doctors may recommend cognitive behavioral therapy (CBT) approaches such as exposure therapy and cognitive restructuring.

Additional types include experiential techniques, which are imagination-based exposures to help explore and challenge beliefs and views and reduce compulsive behaviors.

A therapist may also assess and gather information to determine when and why a person’s symptoms occur. They will help create effective management strategies and relapse prevention plans for possible setbacks.

Doctors may also prescribe antidepressant drugs such as selective serotonin reuptake inhibitors. These can help treat OCD symptoms.

People should speak with a doctor to determine the best treatment options for their condition.

Below are some answers to frequently asked questions about relationship OCD.

Is relationship OCD real?

Relationship OCD exists. Many people may experience occasional doubts about their relationships, and these thoughts are only natural. However, when these thoughts become obsessive, and behaviors become compulsive, this could signal an anxiety disorder such as relationship OCD.

If someone believes they are experiencing relationship OCD, they can speak with a doctor to discuss their symptoms and receive a suitable diagnosis and treatment.

What are possible triggers?

Possible triggers of relationship OCD may include specific:

  • social scenarios, such as couple’s nights or in certain friendship circles
  • leisure activities, such as romantic movies
  • situations that cast a partner in an unfavorable light
  • situations where potential alternative partners may be present, such as in dating settings

Relationship OCD may cause a person to have obsessions and compulsions specific to aspects of their relationship and partner. While the cause of this form of OCD is unclear, there is evidence that significant triggers or events in a person’s life may lead to this condition developing. People may also develop this type of OCD due to behavioral or psychological factors.

Doctors have developed methods to diagnose and treat this condition, and these strategies closely resemble OCD treatments. People may receive CBT and other forms of therapy to help manage the disorder and prevent relapses. In some cases, pharmaceutical options are available.