Tips for Therapists

Treating relationship obsessive-compulsive symptoms may be complex. We have gathered together 10 Tips that we thought may be useful for professionals trained in cognitive-behavioral therapy (CBT). These treatment tips are based on our experience and research data.

Participate in Research

  1. Assess for Relationship Obsessive Compulsive Disorder (ROCD) and related disorders (e.g., other forms of OCD, Body Dysmorphic Disorder[BDD], depression and other anxiety disorders). Use clinical interviews, semi-structured interviews and questionnaires like the ROCI and PROCSI to assess for severity and content.
  2. Collaboratively formulate the problem as ROCD as opposed to a decision that has to be made. That is, differentiate problem solving/decision making from obsessive thinking.
  3. Agree on a mid-term goal of postponing decision making regarding the relationship until the obsessive thinking is significantly reduced. A useful rule of thumb, postpone the decision until fear of obsessing about the problem is no longer used by the client as an indicator of the quality of the relationship/relationship partner.
  4. Identify and challenge positive and negative beliefs about worry and obsessing (e.g. “if I will not worry about, I will end up in a terrible relationship”  “obsessing about the relationship I make me go mad”.
  5. Detect and contest OCD related beliefs (e.g.,  importance/control of thoughts; perfectionism/intolerance of thoughts) as well as ROCD related beliefs (e.g., catastrophizing the consequences of separation and/or of being alone and/or being in a relationship that is not perfect). Use cognitive tools (e.g., cognitive restructuring) and behavioral experiments such exposure and response prevention (ERP) in this process.
  6. Manage dysfunctional responses (e.g., self-reassurance, reassurance form others, checking, comparing etc.,) using ERP and other cognitive technics.
  7. Build a contingency plan for separating from partner (i.e., how would you deal with such a situation? What would you feel? what would you need to practically do? Imagine how you will feel immediately after/ a year after the seperation) as an exposure, competence building and exploration exercise.
  8. Introduce the concept of self-sensitivity (i.e., an overvalued domain of self-worth) while normalizing the importance of relationships.
  9. Broaden the client’s self-concept (e.g. by drawing attentions to other areas of life and building competencies in other life domains) and work on softening the criteria of success in the intimate-relationship domain.
  10. Uncover and deal with self-criticism (e.g., It is shallow and immoral to judge my partner for her appearance).