The following piece is an opinion and does not reflect the views of The Eagle and its staff. All opinions are edited for grammar, style and argument structure and fact-checked, but the opinions are the writer’s own.
From TikTok videos of people “letting the intrusive thoughts win” to expressions of “I’m so OCD,” when organizing a closet, medical terms pertaining to obsessive-compulsive disorder have been normalized to a degree that makes them feel meaningless at best and harmful misrepresentations of the condition’s symptoms at worst. The casual and incorrect use of OCD further contributes to its mischaracterization, which can not only stigmatize it further but also prevent those who suffer from seeking help.
OCD is a psychiatric disorder wherein patients experience intense, recurring thoughts, called obsessions, and engage in repeated behaviors, called compulsions. Obsessions are not just a desire to organize your pencil case; they are distressing, unwanted thoughts that haunt the person experiencing them. Obsessions do not reflect a person’s actual desires and, in fact, can often contradict them, and acting on compulsions can inadvertently reinforce obsessive thoughts.
While all forms of OCD can be very isolating, there is a type that is especially so: relationship OCD, also known as ROCD.
ROCD generally consists of obsessions focused on the patient’s romantic relationship. These obsessions often manifest in two ways: relationship-centered and partner-focused symptoms. Relationship-centered symptoms tend to focus on obsessions over the relationship itself, including doubts about the sincerity and intensity of both one’s own and one’s partner’s feelings. On the other hand, partner-focused symptoms tend to focus on the partner’s perceived flaws.
Partner and relationship-centered manifestations tend to co-occur and even exacerbate each other. These obsessions are not just typical relationship worries; they are unwanted, distressing thoughts that persist despite the patient’s wishes. ROCD-related obsessions are not reasonable doubts or concerns about a relationship; they are irrational worries.
For example, a person with ROCD may obsess over their partner not being “the one” because they saw an attractive person on the street. This worry is not based on the person’s love of their partner, nor genuine concerns with their partner, but rather, it is triggered simply by seeing an attractive person. This obsession could cause significant feelings of anxiety and guilt in the person. Not only do these symptoms cause significant distress, but they can also lead to significant impairment and negatively impact current or future relationships and the person’s mental health overall.
I believe a major part of what makes ROCD so isolating is the messages surrounding us about what good relationships should be. Media including books, movies and TV have always been romance-obsessed, especially media aimed at or depicting young women, but they rarely show what happens after “happily ever after.”
I remember watching countless movies growing up that ended as soon as the main couple rode off into the sunset, which makes for a satisfying ending but does not show the whole picture. Drama sells — not the mundane ins and outs of a healthy relationship. Although accurate depictions of healthy relationships exist, they are rare and often relegated to side plots.
I believe everything from religious guilt to family dynamics impacts our perceptions of what a good relationship should be and can make managing the symptoms of ROCD that much harder.
Suffering from ROCD, something that is rarely talked about and often demonized, can cause shame, guilt and even fear to seek help. ROCD has a way of making it feel like you are a bad person who doesn’t deserve a relationship, but that is not true.
OCD is often misdiagnosed or presumably not diagnosed at all. Even within the umbrella of OCD, different subtypes have varying likelihoods of proper diagnosis. OCD related to symmetry or contagion is more likely to be accurately diagnosed, and OCD related to social taboos is less likely to be diagnosed.
The truth is that bad thoughts do not make you a bad person, and there is help out there. According to the World Health Organization, OCD is one of the most debilitating disorders, but it is also treatable. Cognitive behavioral therapy is the frontline treatment for OCD and is incredibly effective. CBT treatment for OCD includes exposure-response therapy, wherein a trained therapist gradually exposes a patient to things that trigger their obsession and encourages them to avoid performing the associated compulsion. The idea is to teach patients healthy coping strategies and to allow them to practice those strategies in a safe, therapeutic environment. Triggering obsessions and discouraging patients from engaging in the associated compulsions breaks the cycle of compulsions that reinforce the obsession and ideally reduces the distress and impairment caused by the obsessions.
There are medicinal treatments for OCD, including selective serotonin reuptake inhibitors, which are also commonly used to treat depression by increasing serotonin activity in the brain. There are even options for treatment-resistant OCD, such as deep brain stimulation, which involves surgically implanting electrodes deep into the brain. OCD treatments, especially treatments like DBS, can be very effective, but for many people, they are not accessible due to insurance restrictions as well as a general lack of knowledge regarding treatment options. Additionally, these treatments are generalized to all OCD, not necessarily specifically ROCD.
ROCD has not been a major focus of OCD research in the past, but it has been picking up steam recently. One study showed promising results of a ROCD-specific treatment: a mobile app that uses short, daily CBT exercises to help alleviate ROCD symptoms and build resilience in couples. Couples who used the mobile app showed increased resilience and decreased ROCD symptoms. Not only is this mobile app more accessible than traditional treatment methods, but it also has promising efficacy.
OCD is one of the most common psychiatric disorders in college students, and ROCD is emerging as a subtype that may be more common than initially thought. Though ROCD can make you feel alone, you are not. Increasing awareness of what ROCD is and the treatments available are the best things we can do to help destigmatize ROCD and ultimately help those who experience it. There is hope, and there is help.
Ellie Pryor is a junior in the College of Arts and Sciences.
This article was edited by Quinn Volpe, Alana Parker and Abigail Turner. Copy editing done by Luna Jinks, Olivia Citarella, Emma Brown, Nicole Kariuki and Charlie Mennuti.
If you are a current American University student, faculty or staff member and want to submit a guest column, email us below!
