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.
- 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.
- 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.
- 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.
- 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”.
- 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.
- Manage dysfunctional responses (e.g., self-reassurance, reassurance form others, checking, comparing etc.,) using ERP and other cognitive technics.
- 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.
- Introduce the concept of self-sensitivity (i.e., an overvalued domain of self-worth) while normalizing the importance of relationships.
- 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.
- Uncover and deal with self-criticism (e.g., It is shallow and immoral to judge my partner for her appearance).