ROCD: the fear of making the wrong decision.
The concept of relationship OCD (ROCD) can be demonstrated or easily explained through the thought of a football player, ‘What if this isn’t the right sport for me to play in the long run?’. What would you say to the footballer? Probably something like ‘If you enjoy it now, see how it goes?’ but a person with OCD can’t do that, they develop a ‘thought buffer’. This is where the thought loop gets stuck and excessively repeats. The footballer then says ‘I spend every waking moment of the day worrying and trying to figure out whether football is right for me in the long run’.
Life with ROCD
Imagine this thought buffer was dictated by whether your partner was ‘the one’ or not. Surely that’s something you just know isn’t it? Unfortunately, it’s not that simple for those who experience ROCD. Obsessing over whether someone is ‘the right one’ or what a gut instinct may be signalling becomes central. Not being able to find certainty is what maintains the thought buffer, which can lead to break up compulsions.
Cross cultural research shows relationship longevity is based on the degree of similarity, particularly in morals and goal aspirations (1). Those who suffer with ROCD need every single aspect of a connection to be perfect: the same preferences and decisions. Black or white. No grey. It’s also common to obsess over a partner’s physical imperfections. Every human has flaws. If a ROCD sufferer senses any imperfection – they think surely this person cannot be ‘the one’. They then may have a thought dialogue similar to: ‘But then we don’t want to let go, as we still love them? Wait, so which is the right decision here? How am I supposed to know what I want or what is right?’. See the obsession with right or wrong is a trend here? How can anything be 100% ‘the right thing’? When people say ‘you’ll know when you meet the right one’, ‘it’ll feel right’. This is a huge trigger for ROCD. Those with ROCD have a tendency to want to eliminate error for protection against non-existent danger.
What are the treatment options for ROCD?
Thankfully ROCD is treatable. Research shows several different types of therapy have aided recovery when provided by an ROCD specialist, including Cognitive Behavioural Therapy (CBT) and Exposure and Response Prevention (ERP) (2). There are other helpful resources such as several ROCD online courses such as ‘Awaken Into Love’, providing an online community of sufferers. Treatment places emphasis into bringing sufferers to humility. We aren’t perfect robots, life involves risks.
The stigma is slowly being broken by programmes like ‘PURE’ on channel 4 which presents a different subset of OCD formed around sexually intrusive thoughts. It’s common to think OCD is simply the need to obsessively keep the house clean or repetitively wash hands. There is actually so much more to it than that, which needs to be talked about. Let’s break the pursuit of perfectionism that doesn’t really exist.
Written by Hannah Galloway, BSc Psychology, MSc Abnormal and Clinical Psychology
At Smart TMS, we recommend that OCD patients follow the NICE treatment guidelines for psychological treatment such as cognitive behavioural therapy (CBT) and exposure response prevention (ERP) as first line treatment. If CBT and ERP are unsuccessful, medication such as SSRIs can be added in. Treatments such as electroconvulsive therapy (ECT) is only offered in severe cases of OCD. However, ECT is invasive and requires inpatient treatment. Repetitive transcranial magnetic stimulation (rTMS) has also shown to be beneficial for the treatment of OCD. Our remission rate for OCD patients is 44% (3).
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- Franiuk, R., Cohen, D., & Pomerantz, E. M. (2002). Implicit theories of relationships: Implications for relationship satisfaction and longevity. Personal Relationships, 9(4), 345-367.
- Doron, G., & Derby, D. (2017). Assessment and treatment of relationship-related OCD symptoms (ROCD): A modular approach. The Wiley Handbook of Obsessive Compulsive Disorders, 547.
- Smart TMS internal audit, December 2019