OCD in a relationship: when doubt about your partner won't let go

“We were sitting on the sofa, he was laughing at something on his phone, and suddenly I thought: do I even love him? If I really did, I wouldn’t be asking. Then I spent until two in the morning reading forums about how you know someone is the right person for you.”

Plenty of people know an evening like that. Doubt about a partner is part of almost every long relationship, and in itself it means nothing bad. For some people, though, the doubt does not come and go. It returns every day, sometimes several times an hour, it demands an answer, and when it gets one, the answer lasts a few minutes. Someone who is actually content in their relationship spends hours checking their own feelings and feels like a fraud while doing it: “If I were honest with her, I’d tell her I’m not sure.”

In this post I write about how the field understands doubt about a partner when it becomes intrusive, what separates it from ordinary doubts, and who the right person to turn to is. Two things from the start. Obsessive-compulsive disorder (OCD) is a mental disorder that is assessed and treated by a psychiatrist or a clinical psychologist, not by me. And this post is not a test: you cannot work out from it whether you have the disorder, but it may help you judge whether it is time to talk to someone about it.

A doubt that does not behave like a question

An ordinary question has an answer, or at least a direction. “Do we both want children?” “Does it bother me that she works so much?” You think a question like that over, you talk about it, sometimes you decide, sometimes you leave it open. After a while it carries less charge than it did at the start.

Obsessive doubt behaves differently. It arrives as an intrusive thought: suddenly, with no trigger or with a trigger that is tiny compared with the reaction. It does not feel like curiosity; it feels like an alarm. You have the sense that the matter must be settled now, otherwise you are living a lie or making a huge life mistake. And the most telling part: every answer opens a new question. “I love him.” “But how do you know it’s love and not habit?” “Because I miss him when he’s away.” “You didn’t miss him yesterday.”

Why unwanted thoughts appear in the mind at all, and why they say nothing about your character, is something I wrote about in Intrusive thoughts: why you have thoughts that frighten you — and why they are not your character. Here I am interested in a narrower topic: what happens when such thoughts latch on to a relationship in particular.

What relationship-focused OCD is

In the English-language literature the abbreviation ROCD (relationship obsessive-compulsive disorder) has become established. The Israeli clinical psychologist Guy Doron and his colleagues began studying it systematically, and the first studies were published in 2012. It matters to know that this is not a diagnosis in its own right. The official classifications do not list it as a separate disorder; it is one of the themes that obsessive-compulsive disorder can attach itself to, much as it can attach itself to cleanliness, safety or religion. What OCD actually is, and why it is far more than tidiness and hygiene, I explain in Obsessive-compulsive disorder: more than tidiness and cleanliness.

Doron and colleagues describe two forms, which often intertwine:

• Relationship-centred doubts. They revolve around three questions: do I really love my partner, does my partner really love me, and is this relationship the “right” one.
• Partner-focused doubts. Attention sticks to a supposed flaw: appearance, intelligence, sociability, morality, emotional stability, success. The person knows the “flaw” is small, or that others do not see it at all, and still cannot stop watching it.

What the two share is that these thoughts are not pleasant daydreaming about a different life. They are experienced as alien, distressing and at odds with what the person wants. That is exactly why they bring so much guilt and shame.

How common it is, and why caution is needed

For OCD as a whole we have good data. In a large American study of a representative sample of adults, 2.3 per cent of people met the criteria for it at some point in their lives (Ruscio et al., 2010). What share of them have obsessions that revolve around a relationship, we do not reliably know, and it is right to be honest here about the limits of what is known.

Research on this form is young. Most of it comes from one research group, and much of it was done with people without a diagnosis, using self-report questionnaires. From it we know that symptoms of this kind are linked with lower relationship satisfaction, with more anxiety and low mood, and with other OCD symptoms. What we do not yet know well is how the difficulty develops over the years, how common it is in the general population, and which adapted treatment approaches work best for it. Anyone offering you precise percentages online has probably pulled them out of thin air.

This caution does not mean the phenomenon is not real. It means it is wise to describe it modestly: as a recognisable form of a known disorder, not as a fashionable new diagnosis that explains every doubt in every relationship.

What separates obsessive doubt from ordinary doubt

The content separates nothing. “Is this the right person for me?” is asked by someone about to marry, someone in a crisis, someone in a relationship that genuinely is not working, and someone with OCD. The difference lies in how the doubt behaves and what you do with it.

One more sign is the person’s relationship to the thought itself. Someone with an ordinary doubt generally believes the doubt means something and treats it as information. Someone with obsessive doubt often already senses that something is wrong with the way they doubt: “I know this is excessive, but I can’t stop.” That gap between what they know and what they feel is one reason the distress is so great.

Checking that cannot be seen from outside

At the word compulsion most people think of handwashing or checking the cooker. With relationship doubt, compulsions are mostly quiet and take place in the head, which is why people can go a long time without recognising them as part of the problem. Among the most common, Doron’s group describes:

• Testing feelings. You look at your partner and check whether you “feel something”. During a kiss you observe yourself instead of them. A feeling watched through a magnifying glass fades, of course, which then looks like proof.
• Comparing. With previous partners, with couples in the street, with friends, with relationships in films and on social media.
• Seeking reassurance. Asking your partner, friends, your mother; online quizzes, forums, articles titled “Ten signs he’s the one”.
• Mental reviewing. Hours spent analysing memories: “Was I happy on holiday? What about that evening when he got on my nerves?”
• Confessing. The urge to tell your partner every doubt, because staying silent would be “dishonest”.
• Avoiding. Romantic films, weddings, conversations about the future, sometimes closeness too, because all of it sets off the doubt.

From outside this looks like someone who thinks a lot. From inside it is a full-time job. The difference between brooding and real deciding is the subject of Thinking isn’t solving: how to tell brooding from real decision-making; with obsessive doubt that difference is sharper still, because thinking is no longer a route to an answer but a way of silencing anxiety for a moment.

What it does to the person on the other side

The partner has a thankless part in this story. If they do not know about the doubts, they feel only the consequences: withdrawal, preoccupation, absence in moments that ought to be lovely. If they do know, they hear the doubts as a verdict on themselves. It is hard not to take “I don’t know if I love you” personally, even when it is said by someone in tears.

“Do you think we’re really meant to be together?”
“Yes. I told you that this morning.”
“I know. But you said it rather quickly. Are you sure?”
“I’m sure.”
“And what if I’m not? How do you know I love you enough?”
(a composed dialogue, not a real person)

Two things happen in this short scene. The partner answers honestly and patiently, yet the answer lasts only until the next question. And second: the partner slowly becomes part of the checking. Their tone, the speed of their reply, the look on their face become new material for analysis. After a few months both are exhausted, each for their own reason, and both are convinced the problem is the relationship, although the problem is the loop they have been caught in.

Here obsessive doubt can be mistaken for something related. A person with marked anxious attachment also often seeks confirmation of being loved, and jealousy can have an intrusive side too; I wrote about that in Jealousy in a relationship: when it is a signal and when it is an old wound. The behaviour may look similar from outside, but the background and the route to help are not the same. That, too, is why a professional assessment is worth more than hours of reading online.

Why an answer does not help

It seems illogical: if a question is tormenting someone, an answer will help. With an ordinary question that holds. With obsessive doubt, however, the problem is not a lack of information. The person has more than enough. The problem is that they are looking for a kind of certainty that relationships do not offer. Nobody can prove that a partner is “the one”, that they will feel the same in twenty years, or that there is not someone out there with whom things would be better. A healthy relationship rests on a decision and on trust, not on proof.

Each act of checking brings brief relief, and that relief is the trap. The brain remembers that the anxiety eased after checking, and next time it demands the same, only sooner. I describe the mechanism in more detail in Checking and reassurance-seeking: why the relief is so short-lived.

I want to be careful here. This does not mean that reassuring a partner is wrong, or that a loved one who answers the questions is to blame for the problem. Reassuring someone you love is a natural and loving response. It only means that with this disorder reassurance does not heal on its own, and that how to reduce it is a matter of agreement, best worked out together with the professional leading the treatment. Coldly refusing to answer in the middle of a partner’s distress is not therapy.

Who treats this, and where couples therapy fits

If you recognise yourself in this description and the doubts take up a great deal of time or weigh heavily on the relationship, the first step is a conversation with your GP, who can refer you to a psychiatrist or a clinical psychologist. For OCD the best-researched form of help is cognitive behavioural therapy with exposure and response prevention: guided by a professional, the person gradually faces what sets off the doubt and learns not to reach for checking. Sometimes a psychiatrist also prescribes medication. Both are recommended by international guidelines. For the form that revolves around a relationship, there is still little treatment research adapted specifically to it, so professionals rely on what works for OCD in general.

I do not diagnose or treat OCD; I do not carry out exposure and response prevention, and I do not prescribe medication. As a marriage and family therapist in training under supervision, I work with couples and individuals on relationships, in person in Ljubljana, in Slovenian or in English. That has its place with this topic, but not the first place. Once someone already has a professional assessment and treatment, the couple may also need a space where the partner comes to understand what is going on, where tiredness and hurt on both sides can be spoken about, and where the relationship gets back on its feet after months of checking.

There is, however, a trap that professionals warn about. Couples therapy in which, session after session, the two of you weigh up whether you are really right for each other can, with obsessive doubt, become just another form of checking, this time with the therapist in the role of judge. So the order matters: first an assessment by a psychiatrist or clinical psychologist, then work on the relationship.

An exercise: a question or a loop?

This exercise is not treatment and does not replace professional help. It is a way of observing that can help you notice the difference between a doubt that is asking something and a doubt that is only spinning. If you are in treatment for OCD, follow your therapist’s instructions.

1. Write the doubt down in one sentence. Word for word, as it came: “What if I don’t love her enough?” A thought on paper is smaller than a thought going round.
2. Ask yourself whether anything is new. Has anything actually happened since you last thought about this? Or are you answering the same question as yesterday, with the same information?
3. Name what you are pulled to do. Ask your partner, compare, search online, check what you feel. Just name it, for instance: “I’m pulled to ask.”
4. Put it off for fifteen minutes. Not to prove anything to yourself, and not to chase the thought away. Go back to what you were doing and let the thought come along if it wants to. A sentence from the exercise I notice that I’m thinking … can help.
5. After fifteen minutes, rate the urge from 0 to 10. Write the number down. After a week you will see whether the urge ever drops by itself, and which questions keep repeating without any new information.

If you find that most of your doubts are “loops”, that is not yet a diagnosis. It is, though, a useful piece of information you can bring to a doctor in place of a vague “I think too much”.

Where this explanation does not apply

The greatest danger of this post is that someone might read it as proof that all doubts about a relationship are “just OCD”. They are not. Some doubts are exactly what they appear to be: a sign that something in the relationship is not right.

If your partner humiliates you, controls you, isolates you from people, or you are afraid of them, your doubt is not an intrusive thought but sound judgement. In that case an explanation in terms of obsessions can even do harm, because it teaches you not to trust your own sense of things. In Slovenia, the SOS helpline for women and children who are victims of violence is available on 080 11 55; in immediate danger, call the police on 113 (in Slovenia).

Even without violence there are doubts that carry a message: different wishes about children, values that diverge, years of loneliness within the couple. A doubt like that is usually tied to something specific, does not jump from topic to topic over time, and shifts when it is talked about. It deserves a conversation, not techniques for silencing it.

A third limit: the feeling of “I feel nothing” can also be a sign of depression, exhaustion or the period after major stress, when feelings go numb towards everything, not only towards a partner. And a fourth: even if it is obsessive doubt, that does not mean the relationship is certainly a good one. A person can have OCD and, at the same time, a relationship in which something really is wrong. That is why it is unwise to make big decisions, such as separating or marrying, in the middle of the worst of the loop; better when, with help, it has settled and you can again see what is doubt and what is the relationship. How to trust your own judgement when there is no certainty is the subject of Deciding without endless doubt: how to trust your own judgement.

What to remember

• Doubt about a partner is ordinary. It becomes obsessive when it returns without new reasons, takes up a lot of time and no answer settles it for long.
• Relationship-focused OCD is not a diagnosis in its own right but one of the themes of obsessive-compulsive disorder. The research on it is young, so caution with numbers is right.
• The compulsions here are mostly quiet: testing feelings, comparing, asking, analysing memories. The brief relief keeps the loop going.
• OCD is assessed and treated by a psychiatrist or clinical psychologist; work on the relationship comes alongside or afterwards, not instead.
• Not every doubt is an obsession. If you are afraid of your partner or they humiliate you, the doubt is a judgement worth listening to.