ROCD and attachment representations:
In his seminal work, Bowlby (1973,1982) proposed that interpersonal interactions with primary caregivers (“attachment figures”) early in life are internalized in the form of mental representations of self and others (“internal working models”). When attachment figures are absent, inconsistently available, or rejecting in times of need, the sense of attachment security (a sense that the world is generally a safe place, others are helpful when called upon, and it is possible to explore the environment curiously and confidently and engage rewardingly with other people; Mikulincer & Shaver, 2007) is undermined and negative models of self and others are developed. Such models increase the likelihood of self-related doubts and emotional difficulties later in life (Mikulincer & Shaver, 2007). Parents are most frequently the main attachment figures during childhood. In adulthood, however, romantic partners often take parents’ place as main attachment figures (Mikulincer & Shaver, 2007).
Research has supported a two-dimensional representation of individual differences in attachment insecurities in adulthood, organized around two orthogonal dimensions of anxiety and avoidance (Brennan, Clark, & Shaver, 1998; Mikulincer & Shaver, 2007). Attachment anxiety involves worries regarding the availability of significant others to adequately respond in times of need, and the adoption of “hyperactivating” attachment strategies (i.e., energetic, insistent attempts to obtain care, support, and love from attachment figures) as a means of regulating distress. Attachment avoidance involves distrust in significant others and a striving to maintain autonomy and emotional distance from them. Avoidantly attached individuals commonly endorse “deactivating” strategies, such as denial of attachment needs and suppression of attachment-related thoughts and emotions. Individuals who score low on both insecurity dimensions are said to hold a stable sense of attachment security (Mikulincer & Shaver, 2007).
Attachment insecurities may hinder adaptive coping with self-related challenges by activating dysfunctional distress-regulating strategies, further exacerbating anxiety and ineffective responses (Doron et al., 2009). For instance, anxiously attached individuals tend to react to self-relevant failures by amplifying the negative consequences of the aversive experience, ruminating on it, and increasing mental activation of attachment-relevant fears such as fear of being abandoned because of one’s “bad” self (Mikulincer & Shaver, 2003). Thus, in addition to disrupting functional coping with experiences that challenge sensitive self-domains, anxiously attached people’s coping strategies may render them particularly vulnerable to relationship-centered obsessions.
Recent findings clearly indicate that self-sensitivity in the relational domain and attachment anxiety jointly contribute (i.e., double-relationship vulnerability) to the development and maintenance of ROCD symptoms (Doron et al., 2013). In one study, attachment anxiety was linked with more severe ROCD symptoms mainly among individuals whose self-worth was strongly dependent on their relationship. In a second study, subtle hints of incompetence in the relational self-domain (i.e., mildly negative feedback regarding the capacity to maintain long-term intimate-relationships) lead to increased ROCD tendencies mainly among individuals high in both attachment anxiety and relationship-contingent self-worth. Thus, jointly with sensitivity in the relational self-domain, attachment anxiety may result in increased susceptibility to relationship-related obsessive doubts and worries.