If there were ever a mental health condition that met the criteria for being a "family disease," then it would be obsessive compulsive disorder. I have been working alongside OCD sufferers for years now and it is a rarity that their OCD is not playing a role with in the dynamic of the other family members or with a romantic partner.

OCD Infiltrates Relationships

OCD certainly shows up in quite a few different ways, but I have found that no matter the subtype of OCD that somebody is working through it had potential to impact the person's relationships. We will explore "relationship obsessive-compulsive disorder" in more detail a bit later, which certainly tops the list in terms of potential for negative impact, but let's begin with understanding a bit more about how OCD shows up in general.

OCD begins with intrusive thoughts that one has in which some sort of negative outcome is going to occur that carries a certain level of uncertainty with it. Everybody has intrusive thoughts to some degree but we want to look at when these thoughts turn into obsessive thoughts. For somebody experiencing the effects of OCD, this thought will stick around almost endlessly as rumination begins to set in. People will describe cycling over a thought for hours or even days, hoping and praying for some bit of certainty to come their way. And as the OCD experience begins to way on the person, they will look for some way to relieve the experience. This is when our compulsive behaviors begin to enter the situation.

Now, whenever most people think of a common compulsions, their mind is going to move to checking locks and washing hands repeatedly. And it's true that these sorts of compulsive rituals are common, but compulsions look like so much more than that. People often describe to me how their OCD looks "different" than others, and the description that comes next usually is filled with feelings of shame as somebody describes the gut wrenching fear they have that they might harm their children some day. This is referred to as harm OCD and is one of the most common types of OCD that we work with at Thrive.

As the person attempts to gain some space and relief from their obsessions, they will either try and engage in avoidance behaviors or look for reassurance. Both of these have a massive chance of influencing the other people who live in the house, especially until the non-ocd partner or family member gains a higher level of awareness and education about how to be helpful in OCD treatment.

Working Example

Let's continue on with our example of harm OCD, as I think it can be an easy form of OCD to describe. Some of this information might be upsetting to read about. It is important to note that we always find that these are unwanted thoughts and that is why they are causing so much distress and affecting quality of life so much. A previous supervisor told me that OCD always takes plan in what is nearest and dearest to one's heart, and I've rarely seen OCD patients that didn't fit that bill.

Please note that as I am describing this example it is influenced by the work I have done in the past with people with OCD and does not depict any specific case. Similarly, the exact same case may play out entirely differently and we are only drawing these conclusions to gain a better sense of understanding.

Let's say there is a woman who has a fear that she is going to stab her husband. Logically, she knows that she loves her husband and would never do something like this, but she continues to get repetitive thoughts about this happening. She gives herself some minor reassurances throughout the day, reassuring herself that she is a loving caring woman who has never been in any sort of physical altercation, but those only bring temporary relief. Occasional doubt creeps in as any relationship carries feelings of frustration with it to some regard, and she fears that the anger she sometimes experiences might boil over to the point that she grabs a knife and stabs him.

At this time we normally see compulsive behaviors, avoidance, and reassurance seeking come into the mix. This will normally start with some minor forms of avoidance such as not chopping vegetables when her husband is in the same room as her. But when we start to give an inch to OCD it normally wants to take a mile. It becomes not enough to just wait until he is out of the room. He might need to be out of the house. Or perhaps she moves to a place of needing knives to be totally absent from the house for fear that she might wake up in the middle of the night and grab one.

As of now, we have only described the experience that she is having and have not made out way to how this might show up in interpersonal relationships. But this is often temporary as it is nearly impossible to not bring this sort of dynamic up in romantic relationships, plus the partner probably begins to notice.

At this point, she will then begin to ask husband to make accommodations for to experience less anxiety. Rather than waiting for him to leave the room, she might ask him to leave the room. And as most people in intimate relationships do not want to see their partner suffer anymore, they assume that the best thing to do would be to oblige the request. However, this should be seen as giving reassurance which only further helps the OCD take root. Additionally, she might ask her husband or other family members for reassurance that she would never act out in any sort of violent way.

Other forms of reassurance might look like needing to lock all of the knives away if such symptoms continue to increase. Perhaps there becomes new rules and ways OCD forced both people to live, affecting the daily life for both people involved.

Relationship OCD

Perhaps the biggest way that OCD might show up in close relationships is through symptoms of relationship OCD. Often times this is taking place in healthy relationships where the problems that one is imagining are out of proportion to the actual nature of the relationship. Most often we see that people are either fearing that they are not with the right person and have made a mistake by staying in the relationship, or that their partner is going to leave them for somebody else. You can already see how both of these become problematic. In the former, one might put their partner through consistent tests to see if the person they are with is the right one. In the latter they might consistently check on their partner to make sure they are not cheating or being unfaithful to any regard. It is important to note in this one that the behaviors associated with this subset do not match the potential of betrayal actually happening. For instance, if somebody is afraid their partner who has cheated a number of times, might cheat again and wants to check in with their partner more often than average, this would not be considered a sign of ROCD.

Resources

If you are looking for a support group to help improve your OCD, Thrive will be offers a OCD Group with personalized ERP. If your relationship has taken a hit due to an OCD diagnosis and you are in need of support, I recommend checking out our Couples' Services to find the right fit for you!