Relationship obsessive-compulsive disorder (ROCD) is a specific manifestation of obsessive-compulsive disorder (OCD) wherein one’s romantic relationship becomes the focus of obsessive preoccupation. People with ROCD experience influxes of intrusive and distressing relationship-related doubts and questions, and resort to compulsions, whether mental or behavioral, in an attempt to alleviate discomfort and eliminate intrusive thoughts (Doron et al., 2014).
Alongside such thoughts, feelings, and behaviors, individuals with ROCD often hold extreme and maladaptive beliefs about the way love and relationships “should” be and feel like. These beliefs play a pivotal role in maintaining the disorder and therefore require special attention when coping with ROCD.
According to Aaron Beck, a prominent psychiatrist regarded as the father of cognitive-behavioral therapy (CBT), beginning in childhood, people develop core, enduring beliefs about themselves, others, and the world, which they regard as absolute truths (Beck, 2002). Shaped by cultural influences, parental guidance, and life experiences, these beliefs influence one’s behavior and decision-making processes. Believing in a just world (e.g., “good things happen to good people”) or believing that hard work is the key to success, are examples of common beliefs many of us hold.
Just as some beliefs can propel individuals towards growth and success, dysfunctional beliefs can impede personal growth, leading to anxiety, depression, and obsessive tendencies (Ellis, 2000). For example, a child who receives consistent negative feedback about their performance can develop the belief that “I’m incompetent”. Later in life, this fundamental way of viewing oneself may lead them to avoid applying to an appealing job, approaching an attractive person, or following desired but challenging life paths. In turn, this ongoing missing out on life’s opportunities further reinforces their self-conception of incompetence.
ROCD sufferers often cling to excessive beliefs about various facets of relationships and the way they “should” be experienced. Such convictions may dictate the way one should feel (e.g., always euphoric, in love, without any negative feelings), think (e.g., constantly thinking about one’s partner, having no doubtful or critical thoughts), and act (e.g., never looking at other people) when in the “right” relationship (Doron & Derby, 2017).
These extreme love beliefs also extend to attaching profound meanings to specific feelings (e.g., “If I don’t constantly experience feelings of love, it is unlikely to be 'true love'”), thoughts (e.g., “doubtful thoughts indicate the relationship isn’t right”), and behaviors (e.g., “If you look at others, you don’t really love your partner”).
Love beliefs are influenced by early exposure to relationship models, particularly those of parents or significant caregivers. However, these beliefs can continue evolving throughout an individual’s life.
The influence of popular romantic notions that are prevalent in Western society, disseminated through various mediums like movies, songs, social media, and societal influences, further shape people’s love beliefs. These notions often portray an image of a single soulmate with whom individuals should continuously experience feelings of love.
Unfortunately, these portrayals seldom acknowledge the natural fluctuations of intense emotions within relationships or the reality that individuals can feel closeness and attraction to more than one person (Phillipson, 2012). Expressions like “true love has no doubt” or “you should always feel in love with your partner” serve as fertile ground for the development of extreme love beliefs.
In a previous post, I described the vicious ROCD cycle. Within this cycle, individuals experience intrusive, unwelcome thoughts, accompanied by unpleasant feelings such as anxiety, shame, and a sense of urgency. To these unwanted thoughts and feelings individuals react with compulsive behaviors, whether overt or covert, aimed at easing their distress and achieving a sense of resolution to their doubts. Unfortunately, resorting to compulsions only intensifies the return of those unwanted thoughts and feelings, trapping individuals in ongoing loops.
The accompanying figure illustrates how extreme love beliefs contribute to the maintenance of the ROCD cycle. Extreme love beliefs guide the interpretation of one’s thoughts and feelings in a way that catastrophizes their experience, pulling one deeper into an ongoing, spiraling obsessive loop.
Effectively treating ROCD involves addressing extreme love beliefs alongside other therapeutic interventions. Throughout the therapeutic process, therapists collaborate with clients to identify and comprehend these beliefs, emphasizing that the beliefs are learned as opposed to absolute truths. It is important to understand and validate the life circumstances under which those beliefs were shaped and formed, for example, by inquiring “where did you learn that?”.
When searching for such beliefs, close attention should be paid to notions about how one “should” or “shouldn’t” feel, think, and behave, alongside rigid “if – then” thinking patterns.
Upon recognizing their extreme love beliefs, clients can make them more tangible by documenting them. For example, a client might articulate, “From an early age, I was repeatedly exposed at home to the message that true love is characterized by ongoing feelings of love and devoid of unpleasant emotions. This influenced and shaped the way I tend to view and evaluate relationships”.
The next step involves supporting the client in shifting focus from treating these beliefs as absolute truths to observing how closely adhering to them affects their experiences and behavior within the relationship. Evaluating the impact on their mood, motivation, investment in the relationship, and ability to be present is important.
Throughout this process, clients become more aware of the costs associated with closely adhering to these beliefs. This newfound understanding can be utilized to broaden their perspective. For example, they may write a note to themselves: “By closely following the belief that true love is devoid of unpleasant emotions, I’m often ashamed of my thoughts and feelings, distance myself from my partner, and engage in lengthy deliberations about my relationship”.
Subsequently, clients are prompted to consider to what extent they wish to continue following these beliefs. When sufficiently open to exploring alternative, more flexible beliefs, therapists and clients collaborate to develop and experiment with these new beliefs, akin to trying on a new suit, different from the one the client is used to wearing. Though initially unfamiliar, over time, clients can assess the suitability of these alternative beliefs.
To facilitate this process, clients articulate the new beliefs they are trying on. For instance, they can write to themselves: “Although I was taught that true love is devoid of unpleasant emotions, I can choose whether I wish to follow this belief. In fact, I am learning that a loving relationship is characterized by a wide range of emotions, some pleasant, some neutral, and some unpleasant”.
Through this therapeutic journey, clients expand their “wardrobe of beliefs”, granting themselves greater flexibility in shaping their relationships, and their lives. This greater flexibility aids clients in accepting the full range of their thoughts and feelings, thus gradually weakening the ROCD cycle and promoting healthier, more balanced relationships.
References
Beck, A. T. (2002). Cognitive models of depression. Clinical advances in cognitive psychotherapy: Theory and application, 14(1), 29-61.
Doron, G., & Derby, D. S. (2017). Assessment and Treatment of Relationship‐Related OCD Symptoms (ROCD): A Modular Approach. The Wiley handbook of obsessive-compulsive disorders, 1, 547–564.
Doron, G., Derby, D. S., & Szepsenwol, O. (2014). Relationship obsessive compulsive disorder (ROCD): A conceptual framework. Journal of Obsessive-Compulsive and Related Disorders, 3(2), 169–180.
Ellis, A. (2000). Rational emotive behaviour therapy. Six key approaches to counseling & therapy. London: Paston PrePress, 181-227.
Phillipson, S. (2012). I think it moved. https://ocdzone.wordpress.com/tag/i-think-it-moved/
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