Similarities and Differences Between ROCD and Other Forms of Obsessive-Compulsive Disorder

What is ROCD?

ROCD stands for Relationship Obsessive Compulsive Disorder and is a subtype of OCD. It involves both obsessions and compulsions regarding a person’s romantic relationships, including doubts about the suitability of the relationship, feelings of not experiencing ‘true love’, questioning one’s partner’s loyalty, morality, ethics, and other attributes, and worry over past and future relationships.

You can read more about ROCD here.

ROCD can cause significant distress and is present in early adulthood, though it can arise at any age. Common symptoms include unwanted thoughts, feelings of anxiety, and compulsions such as reassurance seeking. Treatment typically involves cognitive-behavioural therapy and medication.

ROCD Self-help Course

Dr Ryan’s online course for ROCD

What are the symptoms of ROCD?

Excessive preoccupation with romantic relationships

The symptoms of excessive preoccupation with romantic relationships due to ROCD include:

  • Constantly seeking reassurance from one’s partner.
  • Avoiding behaviours that suggest a commitment to the relationship.
  • Analyzing and scrutinizing one’s partner’s behaviour.
  • Checking for feelings or thoughts that indicate love or the lack thereof.
  • Mentally testing out scenarios about the future of the relationship.
  • Asking the partner to behave or not behave in specific ways to avoid being triggered.

Additionally, maladaptive beliefs, such as the fear of “settling” for second best and being unable to accept unwanted traits in a partner, can fuel these relationship-themed obsessions.

Intense anxiety and distress about being rejected by or abandoning a romantic partner

Symptoms of intense anxiety and distress about being rejected by or abandoning a romantic partner may include:

  • obsessive thoughts about whether one is in the right relationship;
  • comparing one’s relationship to those of others; seeking excessive reassurance from friends and family;
  • coming up with lists of reasons why one and their partner are meant to be together;
  • subjecting oneself and their partner to various relationship tests or online quizzes;
  • constantly replaying all of the good and bad times they had with their partner; obsessing over their partner’s “flaws” (i.e., face, hair, body, and other physical characteristics);
  • obsessing over their partner’s personality and other emotional, social, or intellectual attributes;
  • comparing their partner’s appearance and other qualities to those of another person;
  • comparing their romantic relationship to romantic relationships seen on social media or in romantic movies;
  • avoiding watching romantic movies or TV shows out of fear;
  • searching the internet for love stories and then comparing their romantic relationship to others;
  • comparing previous relationships to their current ones;
  • avoiding committing to relationships or making long-term plans out of fear;
  • initiating sex with their partner to feel reassured;
  • Avoiding being intimate with their partner.

Intrusive thoughts about having inappropriate or unwanted thoughts about a romantic partner

Symptoms of intrusive thoughts about having unsuitable or unwanted thoughts about a romantic partner can include:

  • Intrusive thoughts about the relationship or partner, such as whether your partner really loves you or if you could have found a different partner
  • Excessive concern about your partner’s happiness or well-being
  • Always thinking about your partner’s flaws
  • Seeking reassurance from your partner
  • Feeling distracted and unable to focus due to intrusive thoughts about your relationship or partner
  • Inability to make an informed decision about the relationship due to intrusive thoughts
  • Obsessions about the strength, quality, and nature of your love for your partner
  • Compulsively ask friends or family if you’ve made the right partner choice or compare your relationship to a previous, more exciting (if often unhealthy) relationship.
  • Doing Internet searches to find “the one” or feeling that sex is a chore

Trouble functioning due to ROCD

The symptoms of trouble functioning due to ROCD symptoms can be severe and can include the following:

  • Low self-esteem.
  • Attachment insecurities.
  • Less satisfaction in relationships.
  • Difficulties with sexual functioning.
  • Other OCD symptoms.
  • High levels of perfectionism.
  • Constant testing of one’s feelings.
  • Focusing on flaws in the partner.
  • Avoiding social situations.
  • The feeling of anxiety.
  • Feeling like one has no control over the situation.
  • Feeling overwhelmed.
  • Emotional suffering for the person they love.

In addition, those with ROCD might have difficulty maintaining relationships due to the constant questioning of their partner’s love and their doubts about the relationship. All of these symptoms can cause significant emotional distress. They can hurt one’s personal, professional, and academic life.

What are the different types of obsessive-compulsive disorder (OCD) and their similarities with ROCD?

  1. Pure Obsessional OCD

Pure obsessional OCD, also known as “Pure O,” is a form of obsessive-compulsive disorder (OCD) in which a person experiences recurring obsessions without outwardly visible compulsions. It is characterized by intrusive, unwanted, and adverse thought content that the individual can’t shake, regardless of how hard they try. The individual may have rituals or behaviours to help them cope with the obsessive thoughts.

Still, these are often subtle and hard to identify. In comparison, Relationship OCD (ROCD) is a type of OCD in which a person obsesses over their thoughts and doubts about their relationships, such as questioning the validity of their feelings. Both Pure O and ROCD involve the presence of obsessions and intrusive thoughts. However, the content of these thoughts can vary significantly. While Pure O may affect more general intrusive thoughts, ROCD focuses more on doubts and questions about the person’s relationship. 

  1. Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a mental health condition characterized by intrusive, unwanted thoughts and repetitive, time-consuming, and often ritualistic behaviours. It is estimated that 2% of the population worldwide have OCD. OCD is often hard to identify, as its behavioural symptoms are initially rationalized as personal eccentricities rather than signs of a mental health condition.

The four most common types of OCD-related obsessions are cleanliness and worrying about the chance of becoming ill due to contamination; catastrophizing concerns revolving around a terrible occurrence affecting the individual’s life or that of a loved one; organization or “just right” thinking, which focuses on items that are out of place; and taboo thoughts, which cause the individual to imagine actions or scenarios that go against social norms.

Regardless of the type of OCD, compulsive behaviour and compulsive thinking are two critical components of the disorder. Compulsive behaviour often stems from OCD-related obsessions and can involve repetitive rituals such as sanitizing all surfaces in one’s home. Obsessive thinking can include repeating words or phrases in one’s head to ward off disturbing thoughts. These behaviour patterns can become impossible to skip and significantly impact one’s quality of life.

How are ROCD and other forms of OCD different?

Similarities


Presence of obsessions and compulsions
All forms of OCD have both obsessions and compulsions. Obsessions are your unwanted thoughts and images that pop into your head, and compulsions are what you do to stop bad things from happening. In ROCD, obsessions and compulsions are related to romantic relationships.

Anxiety as a common symptom
Anxiety is a core feature of OCD and is often triggered by obsessions or worries. In ROCD, anxiety is related to uncertainty or doubt about the relationship and the fear of losing the partner or making the wrong choice. The anxiety can be severe and persistent and may lead to avoidance behaviours or relationship dissatisfaction.

Impact on daily life
ROCD and other types of OCD also have a similar impact on daily life. OCD can significantly impair your ability to function in work, school, and social relationships. In ROCD, the preoccupation with the relationship can lead to excessive time and energy spent on checking, reassurance-seeking, or analysing your partner’s behaviour. This can lead to conflict in the relationship and interference with work or other responsibilities.

Differences


Focus of obsessions and compulsions
One of the main differences between ROCD and other types of OCD is the focus of obsessions and compulsions. In ROCD, obsessions and compulsions are related to the romantic relationship, such as doubts about the partner’s love or compatibility and compulsive checking or seeking reassurance. In contrast, in other types of OCD, obsessions and compulsions are related to different themes, such as contamination, harm, or symmetry.

Prevalence and incidence rates
Another difference between ROCD and other types of OCD is the prevalence and incidence rates. Research has shown that ROCD is a relatively new and understudied subtype of OCD, with limited data on its prevalence and incidence rates. However, studies suggest that ROCD may affect approximately 6% of individuals with OCD, with a higher prevalence among those seeking treatment for OCD.

In contrast, other types of OCD have been studied more extensively and have well-established prevalence and incidence rates. For example, contamination OCD is one of the most common subtypes of OCD, with a prevalence rate of around 25%.
Impact on relationships

ROCD also differs from other types of OCD in its impact on relationships. As the obsessions and compulsions in ROCD are focused on the romantic relationship, they can significantly impact it. For example, constant doubts and reassurance-seeking may lead to tension and conflict in the relationship. They may even contribute to the dissolution of the relationship.

In contrast, other types of OCD may have less impact on relationships, as the obsessions and compulsions are focused on different themes. For example, in contamination OCD, the individual may engage in compulsive cleaning or avoidance behaviours. Still, these may not directly affect their relationships.