[View original article published in Psych Central here]

When Adam was about 9 years old, he began to experience contamination obsessive-compulsive disorder. At 14, his fears about possibly getting sick subsided, but he began questioning his religious and moral values. His OCD had morphed. Throughout his high school years, he experienced scrupulosity OCD.

His first year in college, he dated on and off, and his OCD continued to target his religion. Then, he met someone special and got married, but he did not live happily ever after. One year into his marriage, he began to question his relationship. He often wondered, “Did I make the right choice? Do I really love my wife? What would my life be like if I had I married my previous girlfriend?” His anxiety was triggered by his wife’s presence.

Adam’s scrupulosity OCD had fused into his relationship with his wife. “I’m not worthy of my wife’s love. I should not be thinking about my previous girlfriend when I am with my wife. What’s wrong with me?” were his constant obsessions. He wanted to be completely honest with his wife. He felt the need to confess. His guilt often diminished, but only temporarily. His wife became insecure about their relationship. She began to question Adam’s devotion and love. Their intimate relationship also began to suffer.

Relationship OCD can be complicated, especially if scrupulosity OCD is in the mix. It’s not only tormenting for the sufferer but also for the partner. Both individuals’ confidence in the relationship decreases and hurt feelings prevail.

If Adam’s story seems familiar, consider the following points:

• Though you may be experiencing conflicts in your relationship, it’s highly recommended that you see a practitioner who understands OCD and has had previous experience treating this OCD subtype. Couples counselors will be helpful, but if they don’t understand OCD, the advice they offer may backfire. Reputable sites (https://iocdf.org/and http://psychcentral.com/) can provide information regarding relationship OCD and how to find appropriate treatment.
• Keep in mind that OCD treatment studies indicate that CBT that includes exposure and response prevention can provide the most lasting results. Studies also show implementation of mindfulness in the treatment of OCD can also enhance treatment.
• When individuals are challenged by OCD, several structures in the brain aren’t functioning at their best. The communication between these structures appears to get interrupted. This is what gives individuals the sense of incompleteness. The good news is that people struggling with the illness can learn skills to help those structures function at a higher level.
• When individuals struggle with doubts, they create rituals (mental or behavioral) that will satisfy their doubt and decrease their unpleasant feelings. For example, Adam would look for reassurance within his mind or read stories on the Internet and other media to decrease his anxiety and guilt. He would ask relatives, friends, and just about anyone that could possibly help him decrease his constant doubts regarding his marriage relationship. Adam often imagined his doubts were like doors that were available for him to open every time he felt uncertain. He believed that if he opened one door, the answer would be there. If it wasn’t there, he’d try another one. He was determined to find the right door. The problem was that he had not yet found the one that could completely vanish his doubts. He was exhausted. He didn’t know what else to do.
• Keep in mind that complying with the urges will reinforce the doubts. Suppressing, fighting, avoiding, rationalizing, trying to figure things out, and even ignoring the thoughts will also strengthen the illness. Instead, try these two ideas to get you started:
  • Notice the effect that your everyday reactions are having in your life. Have you noticed how those reactions (compulsions) are strengthening your doubts? Are your thinking habits perpetuating the problem? You may want to keep a log of situations and reactions (thoughts, feelings, sensations, urges, and behaviors) for a few weeks. This may help you increase your awareness.
  • As you become aware of what is happening, acknowledge the thoughts that OCD is presenting in a given time. Questions such as, “If I break up, will I find true love? Do I deserve happiness? Will he forgive me? Do I deserve him?” can go on for a while. Before you know it, you will feel exhausted, anxious, and still unsure.

Adam began to change his brain pathways by becoming aware of his thoughts and acknowledging them. He also learned to acknowledge his OCD by personifying it. He’d say, “There you are, OCD mind! Doing what you do best, giving me doubts. I’ll check back with you later.” Then he would notice the way he was breathing, take a couple of deep breaths, and get back to the activity he was engaged in at that time. It took knowledge of specific skills and then putting the learned skills into practice.

While you seek the right treatment, be willing to do something different. Stay hopeful and know that you can have a meaningful and loving relationship without having to open the doors of uncertainty.

Don’t give up. Help is just one door away!

Doors photo available from Shutterstock