Emma and Rob have been a in a relationship for two years. Initially, they both felt a strong sense of closeness and intimacy. However, over time Emma’s focus shifted towards evaluating whether or not Rob met her intellectual expectations. This preoccupation gradually took more and more of her time and energy and grew stronger when they considered moving in together. Emma sought validation to her questions by frequently consulting friends about Rob’s intelligence, comparing his cleverness to others, and evaluating his knowledge through initiating conversations about diverse topics.

Emma experienced shame and guilt for having such thoughts about the man she loved and did her utmost to conceal them. Consequently, she gradually withdrew from Rob as their interactions intensified her shameful feelings. On his part, Rob grew anxious and disheartened as he felt Emma withdraw from him while failing to understand why. His efforts at initiating closeness and having her open up to him only pushed her further away.

Emma’s struggle aligns with Relationship OCD (ROCD). ROCD is a type of obsessive-compulsive disorder (OCD) characterized by obsessive preoccupation with the suitability of one’s relationship or certain traits of one’s partner, such as their appearance, sociability, trustworthiness, or intelligence (Doron et al., 2012a, 2012b).

Individuals with ROCD are often tormented with the decision of whether to hide or reveal their concerns to their partners. Let’s consider this dilemma by delving into the impact of concealment on individuals and relationships.

The dilemma of disclosure

Like Emma, many people dealing with ROCD attempt to conceal their relationship doubts and uncertainties from their partners, deeming them abnormal and inappropriate. This might stem from notions such as: “True love shouldn’t involve doubts; therefore, I shouldn’t even have doubtful thoughts, let alone share them.” However, while some level of questioning is inherent and natural in romantic relationships, ongoing concealment reinforces the idea that these doubtful thoughts are menacing, catastrophic, or abnormal, further intensifying anxiety when these thoughts emerge (Newth & Rachman, 2001; Wheaton et al., 2016).

Thus, the more one conceals their doubts, the more meaningful these doubts become, triggering heightened anxiety whenever doubtful thoughts arise. This, in turn, prompts compulsive and draining efforts to suppress these thoughts. Ultimately, this perpetuates the ROCD cycle of struggling with one’s thoughts and feelings, trapping individuals in a mental loop rather than letting them fully engage in their relationship.

Furthermore, prolonged concealment nurtures feelings of shame and guilt, both for having doubtful thoughts and for withholding what’s experienced as a great secret, making sufferers distance themselves from their partners. Over time, this withdrawal could leave partners perplexed and delving into their own interpretations.

As discussed in a previous post, many people with ROCD deeply fear becoming trapped and alone in an endless cycle of suffering. Consequently, they resort to compulsions to avoid this feared outcome. Concealing doubtful thoughts is often rooted in a fear of rejection from one’s partner, potentially leading to isolation. Ironically, this prolonged concealment often creates distance within the relationship, generating feelings of loneliness and isolation.

By contrast, sharing the experience of doubts can alleviate the isolation that plagues those with ROCD, lessening the burden of these thoughts and emotions. Thoughtfully planned disclosure might even help normalize the experience of relationship uncertainties, offering relief from the heavy burden of concealment.

In the treatment of ROCD, a general framework can be applied. Collaborating with the client, decisions around disclosing ROCD and the approach to take can be considered. Naturally, revealing ROCD to a partner is a delicate issue that requires sensitivity and finesse. These guidelines are adaptable to the unique dynamics of each client’s relationship and their specific needs.

 

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A roadmap to disclosure

In navigating the process of revealing ROCD, our starting point involves examining the potential costs of concealment and the potential benefits of disclosure, as outlined above. These insights help individuals make informed choices about whether or not to embark on the journey of disclosure.

For those choosing to share their ROCD struggles with their partners, we recommend beginning by ensuring that the partner has a fundamental comprehension of OCD. This knowledge-sharing can occur through a joint session involving the client's therapist or through trustworthy resources.

Our goal is to outline OCD as a condition characterized by distressing and intrusive thoughts, images, or urges (obsessions), accompanied by compulsive actions—both physical and mental—undertaken to alleviate or address the distress stemming from these intrusive thoughts. It's important to note that while some individuals with OCD may focus on concerns related to contamination, harm, or morality, others grapple with issues within their relationships.

Notably, we seek to portray the experience of relationship-related doubts and questions as a natural phenomenon that commonly arises in romantic relationships—something partners themselves might encounter and identify with. However, for those with ROCD, these doubts and questions manifest as urgent, deeply meaningful, and highly distressing. This heightened emotional response triggers extensive and time-consuming compulsive preoccupation.

When disclosing ROCD to a partner, it’s advisable to avoid delving into the specific content of intrusive thoughts. Even caring partners may struggle to comprehend the extent to which their loved one is preoccupied with aspects like relationship compatibility, appearance, intelligence, or success. Instead, engaging in a broader conversation about relationship inquiries, their distressing impact on ROCD sufferers, and how they escalate into compulsions is recommended (Littman et al., 2023).

Additionally, it’s crucial to create space for partners to express their questions or concerns. Throughout this dialogue, it’s essential to emphasize that while ROCD can be distressing, effective treatment empowers individuals to cultivate loving, meaningful, and fulfilling relationships.

Creating a supportive partnership

Lastly, our objective is to cultivate a collaborative alliance in the relationship to bolster the client’s well-being. Specifically, we aim to address the issue of accommodation, where the partner engages in the client’s compulsive behaviors. For instance, partners frequently responding to questions like “Do you genuinely love me?” or “Will we remain together forever?” contributes to accommodation. While this might offer temporary relief to the individual grappling with ROCD, it inadvertently reinforces their compulsive efforts to abolish unwanted thoughts and feelings, thereby perpetuating the ROCD cycle.

Our approach is to guide partners in supporting the individual rather than the ROCD itself. This involves compassionately addressing their distress while refraining from accommodating their compulsions. A possible response to the aforementioned questions could be “I recognize that these questions bring you pain and distress. Although I don’t think answering them will aid your coping, I’m here with you in this difficult moment.”

It’s important to acknowledge that sharing one’s struggles with ROCD carries a degree of risk, as some partners might perceive it as too demanding to handle. However, in addressing this valid concern, it’s essential to consider the alternatives. Reflecting on the impact of concealment on daily life and the sustainability of such concealment is crucial.

For many individuals coping with ROCD, thoughtfully-planned disclosure signifies a transformative juncture that marks the beginning of a new chapter where their partner evolves into a steadfast ally, supporting them in coping with ROCD. Working with an ROCD specialist can greatly aid in navigating the sensitive journey of disclosure.