Let’s get something straight first. There is no such thing as a disease called rOCD. This might shock you or throw you off balance because you are looking for answers and you thought you had found one. No need to panic yet. Let me explain why you have come to the right place and hopefully everything will make sense at the end.
Seeking for answers for your relationship anxiety
The point that I am trying to make is that if you ask the wrong questions, you will get answers that will not be very helpful to help you solve your problems. Even worse, you will be led down the wrong trail, lose precious time and even your relationship.
If you are here, you already know that rOCD stands for relationship obsessive-compulsive disorder. The reason why I say that there is no such thing as a disease called rOCD is because the disease is called OCD. No one will ever suffer from rOCD and will never will because rOCD does not exist! People suffer from OCD. OCD is the real disease! Granted, someone’s OCD might focus on a “relationship” theme rather than a “washing hands” theme.
Why is it important to make this distinction? You might even think that they are both the same thing. But they are not.
The solutions should start here…know your enemy.
If you do not have a good understanding of what it is you are fighting against, you will most likely lose the many battles ahead. For many years, I have seen rOCD sufferers trying to “fix” their relationship OCD by micro-analysing every aspect of their relationship, their feelings, thoughts and behaviours. Most of them did not progress much until their mindset changed. It all boils down to a simple sentence: “If this was right then I would not be feeling/thinking this way“. Hardly anyone stops to consider that the problem is not the relationship (the “R”) but the thoughts and feelings that we experience as real (“the OCD”). The likelihood of recovery success greatly increases if the mindset changes. This is why we purposefully chose to write the acronym for relationship OCD as rOCD and not rocd or ROCD, throughout this site.
What is the definition of rOCD?
From observation, rOCD is a different experience for everyone because we are all different. However, many stories from rOCD sufferers share similar elements. Similar obsessions, compulsions, behaviours, warped thinking, etc…There are many ways of defining rOCD. I like this definition taken from the OCD-UK website:
ROCD is commonly used to refer to fears associated with Relationship OCD, where sufferers obsessively question whether their current partner is really the right person for them, and whether they actually love their partner or not, even in the most loving of relationships.
Unlike other types of OCD, there are no obvious visible compulsions and those around us do not understand what is going on inside our minds and how we feel. It takes both a physical and psychological toll. To make matters worst, in some cases sufferers are also affected by depression, anxiety and other disorders which makes the recovery journey harder.
More importantly, how is OCD diagnosed?
OCD should only be diagnosed by a qualified and experienced professional. In other words, OCD is a clinical diagnosis. The are two reference documents used in the diagnosis of OCD:
- DSM manual – The Diagnostic and Statistical Manual of Mental Disorders. Produced by the American Psychiatric Association.
- ICD manual – International Classification of Diseases (ICD). Produced by the World Health Organisation.
Each of these documents is reviewed periodically. If you are in the US, you are more likely to hear about the DSM manual and if you are in Europe you are more likely to hear about the ICD manual. They employ slightly different diagnostic criteria for OCD:
From the DSM-V we read:
- Presence of obsessions, compulsions, or both.
- The obsessions or compulsions are time-consuming.
- The obsessive-compulsive symptoms are not attributable to the physiological effects a substance.
- The disturbance is not better explained by the symptoms of another mental disorder.
From the ICD-10:
The essential feature of OCD are recurrent obsessional thoughts or compulsive acts. The obsessional thoughts or ruminations are defined as:
These may take the form of ideas, mental images, or impulses to act, which are nearly always distressing to the subject. Sometimes the ideas are an indecisive, endless consideration of alternatives, associated with an inability to make trivial but necessary decisions in day-to-day living.
Of course, each patient will need further consideration than a few lines of text. This is where the clinical expertise and experience comes into play – to assess the different nuances of context and personal circumstances. One of the reasons why we stress so much the importance of experience in diagnosing OCD is because the path to a diagnosis sometimes is not as straightforward as you will see next.
Diagnosing rOCD and my personal journey for a correct diagnosis
I believe that there are two reasons that make the path to a diagnosis sometimes difficult. The first one is lack of professional awareness and the second one is the focus on the relationship aspect rather than OCD. These are somewhat interlinked too.
Let me talk about reason number 1 first. The first time I experienced rOCD symptoms I looked for help from a qualified professional. I displayed the classic symptoms – intrusive thoughts about my relationship, I was consumed with doubts and seeking for reassurances. It was an emotionally confusing period. I did not understand what was happening and why it was happening as I had no apparent reason to be unhappy. Two sessions with this professional were enough for me as our sessions were focused on psychoanalysis rather than focusing on possible solutions. I wanted relief of my symptoms and not a never-ending talk about the past. This is not to say that the psychoanalysis approach is not useful in certain cases. It was just not useful for me.
In parallel, I was also looking for help from my family doctor. I knew I had had depression symptoms in the past and I always managed to manage them. Everyone has some bad days, right? What was slowly “killing me ” was the sleepless nights due to anxiety and sometimes panic attacks. When I first went to see my GP, she signed me off from work for a while to get some rest. The approach had more to do with “fixing” my physical symptoms. After I dropped the word “depression” in my GP’s office, I did a computer test for the severity of my depression and I was prescribed a drug – Citalopram. It was a rough ride in the beginning but it helped with my anxiety and depression in the long run.
I still felt that I needed to go through talk therapy instead of just focusing on drug therapy. I found help and in the form of psychotherapy (cognitive behavioural therapy or CBT). I had sessions with two different therapists but progress was minimal. It was useful as it opened up a different world on how to tackle anxiety and depression but I still felt that something was missing.
Then I decided to google my symptoms and found out about rOCD. It was the answer that I was looking for. Now I just needed a plan. I found a professional that understood OCD and I felt that I was on the right path now. Unfortunately, I had to end at the 4 session mark because I could not afford more sessions. However, now I could move forward with hope and had a new resolve in life.During these 4 sessions, I also learned about mindfulness and ended up enrolling on a 8-week course. It was great and helped me gain a better understanding on how to further tackle OCD.
One thing that all of these professionals had in common was that they used the tool that they were most familiar with to treat the perceived problem. At the beginning of my journey, none of the therapists said ” I think that this might be OCD and maybe it is best that I refer you to a OCD specialist”. I think this happened because of reason no.2.
Now for reason number 2, how to distinguish rOCD from “normal” relationship problems? This might keep most rOCD sufferers awake at night and fuel the anxiety and constant barrage of thoughts. In addition, it does not help us when everything else points us in the direction of relationship related issues:
- Friends that we discuss these things with and they project their fears on us.
- Hollywood, TV and magazines that portray “real love” in an unrealistic way i.e. if it is true love, they will live happily ever after with no problems at all.
- Our misconceptions about love and relationships caused by our own perception or poor role models.
- Our brain that is constantly looking for exceptions and making associations e.g. “if this was love I would be feeling this way”.
By far, the most important issue is the amount of focus that we put on the relationship related aspects vs. the OCD aspects. Yes, it is true that in some instances there might be some underlying relationship issues that occur at the same time as OCD. These should not be ignored either (e.g. physical and emotional abuse). Nonetheless, our sole focus on the relationship might mislead and misdirect from the real issue – OCD.
Taking the First Steps into your recovery journey
Knowing where we are in our journey or even where to start can sometimes be a difficult thing to do. On my road to recovery, there were some distinguishable landmarks and I suspect that this might be similar to many rOCD sufferers:
- Finding out about ROCD
- Figuring out if I had ROCD
- Accepting ROCD
- Committing to daily change
- Learn and develop better coping strategies
- Moving forward with courage and patience
- Accepting and embracing uncertainty
Knowing and accepting we have rOCD is not the end of our journey but just the beginning. And we should treat it as such. The real hard work is done on a daily basis and there is real Hope for relationship OCD sufferers. If managed properly, we can fully enjoy our relationships and live life more fully.
I believe that in order to get better from rOCD, we need to understand how rOCD works. A good analogy would be going to an amusement park for the first time as a child and ending up trying out the haunted house. Very scary experience! But once you understand that the things there are not real and you know when the scary bits show up, your fear factor decreases considerably. After a few rides, we are not scared anymore.
If you would like to explore further resources on this website, these are the relevant links:
- Blog page with many useful tips
- Assessing the severity of OCD symptoms (rOCD test)
- Book in PDF format
- Online course to help you tackle OCD in a structured way