Talking Relationship OCD with Dr. Steven Phillipson

Read the full transcript below:

1) What is Relationship OCD (ROCD)?

I call ROCD Relationship Substantiation. It’s a subset of OCD where a person is preoccupied with establishing whether their feelings for their partner are sufficient to maintain the relationship or be in the relationship.

People with ROCD have a tsunami of emotional distress over often more meaningless aspects of their partner, in terms of whether they would be a suitable partner, and so there is a tremendous amount of endless navigation or rumination about the qualities of what they think are correct or justified to continue in the relationship with.There is just an endless preoccupation, there is an endless answer seeking, sometimes even reassurance seeking from one’s partner.

2) What are common symptoms of ROCD?

Being in a relationship is one of the most complicated endeavors we take on voluntarily as human beings. Relationships involve tremendous compromise and also a natural evaluation as it’s developing in terms of the justification of remaining in it, or finding someone more suited for us. And sometimes even after a year, where we transition to the idea that is this someone i want to spend the rest of my life with, reignites once again that kind of questioning about is this the right person? is this the right time? does this person’s qualities match with my ideal of a life long partner. So these are just natural questions that everyone in relationships have to transition through.

Common symptoms of ROCD involve endless answer seeking and endless rumination about their partner's qualities, and whether their internal feelings justify being in the relationship. They become very focused on their level of arousal as a proof that the person that they are with is justified to remain with. The probably is, the more that we focus on and put pressure on ourselves to have a very passionate response, the less likely we are to have that response. So it’s common that there is a tremendous amount of sexual malfunctioning or sexual apathy, because of that inverse relationship between the pressure to be sexually aroused, and then the way the brain responds to that pressure to be sexual, it’s very paradoxical.

There can be a focus on a partner’s appearance there can be a focus on a person’s character. I’ve had patients have associations about loved one’s own dating history, in terms of how long did their partner wait before they engaged in certain sexual acts as if that would provide them with reassuring evidence, or uncomfortable evidence about their partner’s character.

They might read articles about definition of a successful relationship, they might speak to friends about what makes their relationships by definition successful. There is a very emotionally driven basis for people with ROCD to establish whether or not they might love the person enough or whether the person’s minor defects might justify ending the relationship.

3) What are common misconceptions surrounding ROCD?

I think one of the most common misconceptions about relationship OCD is the idea of not understanding that relationships evolve. From the first two months of it being a very passionate romantically experienced driven process to a more calm and intimate process with one's partner. Another misconception is the idea that if we’re with our significant other, and they are meant to be our significant other, that we shouldn’t find other people attractive. I’m always amused at the lack of insight that so many people have, that they still posses this idea that their one and only actually existing in the world, as opposed to, there are many one and only’s in the world, it’s just how we manage the negotiations and the endless maintenance of a relationship. So that we can be with someone who is very meaningful to us, and that we’re very committed to, and yet still notice that there are others in the world that we find very attractive, and that doesn’t mean that we’re not with someone that justifies our incredible devotion to. That’s one of the most common misconceptions.

4) How can you help someone suffering from ROCD?

I encourage partners of patients with ROCD to encourage a lot of transparency in the spike theme, the association, the intrusive thought. I encourage a lot of transparency and I encourage the partner to not bring their ego into that disclosure. It’s really important that the partners understand that these topics are completely illegitimate and not driven by an authentic distress or authentic disdain. So once again, I encourage partners to be comedic in their willingness to hear about their bushy eyebrows or to hear about they might have bad breath and to not personalize that.

5) How do you treat ROCD?

Persons with Relationship Substantiation almost always carry a co-diagnosis, comorbid diagnosis of perfectionism. There is a never ending scrutiny of their partner when you have this subset of OCD. It’s very driven by the idea that one should feel a certain way in a relationship, and that idea that one should feel a certain way in a relationship, and that kind of rule-bound attachment to processing one’s partner, through not only the emotional component, i should be feeling attracted, i should be feeling in love, i should feel passion… has these very inverse effects. The idea of looking for love detracts from experiencing love. And the idea that being very rule-bound in how should people function in relationships, how should their partner’s function, and to then take those rules, and see that the person that they are with doesn’t uphold those rules. With this subset of OCD there is almost always a co-existent perfectionist personality style.

Treatment for Relationship Substantiation often will involve bringing the significant other into treatment with the patient. It’s difficult often for the partner to hear that they’ve been under such incredible scrutiny by their partner, or that their minor defects have created such a tremendous amount of stress. But I always try to educate the significant others of my patients that these focuses have no legitimacy.

Once again we always go back to the reminder that OCD is predicated completely malfunctioning in the emotional system of the brain, and there is no real authentic link between the person’s concerns and the legitimacy of the topic.

And for the most part, I’ve found partners to kinda get that. And for the most part I’ve found that the relationship of people with ROCD are actually some of the most healthy relationships I’ve run into. And I do a lot of marital therapy, so I am a bit of an expert to really gauge the quality of relationships. It’s often common that partners of people with ROCD can see their partner’s concerns as being bizarre and unrealistic and un-legitimate. And in those cases, it’s easy for that partner to engage in kinda a comedic response. You know to be in bed with a partner, and say, it’s OK you’re not enjoying this, it’s OK you’re just a manikin without any emotional experiences so that a patient talks off their focus and pressure on having these sexual responses act as confirmation and reassurance.

I think recovery with ROCD would look like the person engaging in the natural complexity of any relationship. All relationships are complex and have challenges and deserve endless maintenance. But a person in recovery would take on these challenges in a way that didn’t involve a paired emotional distress signal.

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