CBT Treatment for Relationship OCD

CBT Treatment for Relationship OCD

If intrusive thoughts about your relationship constantly plague you, you may be suffering from Relationship Obsessive-Compulsive Disorder (ROCD). But don’t worry, relief is possible. In this article, I will delve into Cognitive Behavioral Therapy (CBT) and how it can effectively treat ROCD.

Understanding Relationship OCD (ROCD)

Relationship Obsessive-Compulsive Disorder (ROCD) is a subtype of Obsessive-Compulsive Disorder (OCD) where individuals experience intrusive thoughts and doubts about their romantic relationships. These thoughts can be distressing and can often lead to compulsive behaviours, such as seeking constant reassurance, checking behaviours, or even avoiding intimacy altogether.

ROCD can manifest in various ways, such as doubting one’s partner’s fidelity, questioning compatibility, or obsessing over minor flaws in the relationship. These thoughts can significantly impact both the individual and their partner, leading to emotional distress and relationship dissatisfaction.

What is Cognitive Behavioral Therapy (CBT)?

Cognitive Behavioral Therapy (CBT) is a well-established psychological therapy that aims to modify negative thought patterns and behaviours. It is based on the idea that our thoughts, emotions, and behaviours are interconnected, and by changing our thoughts, we can change how we feel and behave.

CBT is a structured and evidence-based therapy that focuses on the present rather than the past. It helps individuals identify and challenge irrational beliefs and negative thinking patterns, leading to a more realistic and positive outlook.

How CBT can help with Relationship OCD

When it comes to ROCD, CBT can be a game-changer. It helps individuals identify and challenge obsessions about their relationships, such as doubts about compatibility or thoughts of betrayal. Through various CBT techniques, therapists work with clients to reframe these thoughts and develop healthier thinking patterns.

CBT for ROCD typically involves both individual and couples therapy, depending on the client’s specific needs. Individual therapy focuses on the individual’s thoughts and emotions, while couples therapy aims to improve communication and address relationship issues.

The principles of CBT for Relationship OCD

In CBT for ROCD, therapists work with clients to identify and challenge their negative thoughts and beliefs about their relationships. Individuals can gain a more balanced perspective by examining the evidence for and against these thoughts.

One of the fundamental principles of CBT for ROCD is the recognition that thoughts are not facts. Just because you have a thought doesn’t mean it’s true or accurate. By learning to question and challenge these thoughts, individuals can reduce their anxiety and gain a clearer understanding of their relationship.

Setting goals for CBT treatment

Setting goals is an essential part of CBT for ROCD. By working collaboratively with their therapist, individuals can identify specific areas they want to work on and set achievable goals.

These goals can range from reducing anxiety and intrusive thoughts to improving communication and increasing intimacy in the relationship. Individuals can track their progress and stay motivated throughout therapy by setting clear and measurable goals.

The role of exposure and response prevention (ERP) in CBT for ROCD

Exposure and response prevention (ERP) is a core component of CBT for ROCD. ERP involves gradually exposing individuals to situations or thoughts that trigger their obsessions without engaging in compulsive behaviours.

For example, suppose a person has intrusive thoughts about their partner’s fidelity; ERP may involve intentionally exposing themselves to situations that trigger these thoughts, such as watching a romantic movie or talking to an attractive person. By resisting the urge to engage in compulsive behaviours, individuals can learn that their fears and anxieties are unfounded, reducing their symptoms.

Cognitive Restructuring Techniques for ROCD

Cognitive restructuring is another essential technique used in CBT for ROCD. It involves identifying and challenging irrational beliefs and thoughts and replacing them with more realistic and positive ones.

For instance, if someone has a recurring thought that they are not good enough for their partner, a therapist might help them examine the evidence for and against this belief. Individuals can develop healthier thinking patterns by questioning the validity of this thought and replacing it with more accurate and positive alternatives.

Maintaining progress and preventing relapse

Once individuals have made progress in CBT for ROCD, it’s crucial to develop strategies to maintain their gains and prevent relapse. This may involve practising the skills learned in therapy, such as challenging negative thoughts or engaging in exposure exercises, even after treatment has ended.

Additionally, maintaining open communication with one’s partner and addressing relationship issues can prevent relapse. Regular check-ins with a therapist or attending support groups can provide ongoing support and guidance.

Finding a qualified CBT therapist for ROCD

When seeking CBT treatment for ROCD, it’s essential to find a qualified therapist who specializes in OCD and relationship issues. Look for therapists with CBT experience and training in CBT, specifically in treating ROCD.

Establishing a good rapport with your therapist and feel comfortable discussing your concerns. Don’t hesitate to ask questions and seek recommendations from trusted sources, such as your primary care physician or mental health professionals.


CBT is a highly effective treatment for Relationship OCD (ROCD). By challenging and re-evaluating irrational beliefs, individuals can gain control over their thoughts and reduce anxiety. Through techniques such as exposure and response prevention and cognitive restructuring, individuals can transform their relationship anxiety and find confidence in their relationships.

If you’re struggling with ROCD, consider reaching out to a qualified CBT therapist who can guide you on your journey towards a happier and healthier future. Relief is possible, and you don’t have to face ROCD alone.

Relationship OCD – IOCD Foundation

Recommended Reading:
Doron, G., & Derby, D. (2017). Assessment and treatment of relationship-related OCD symptoms (ROCD): A modular approach. In J. S. Abramowitz, D. McKay, & E. A. Storch (Eds.), The Wiley handbook of obsessive-compulsive disorder across the lifespan. Hoboken, NJ: Wiley.

author avatar
Federico Ferrarese Federico Ferrarese - Chartered Psychologist and Cognitive Behavioural Therapist
I am deeply committed to my role as a cognitive behavioural therapist, aiding clients in their journey towards recovery and sustainable, positive changes in their lives. This involves strategising to maintain long-term mental well-being and identifying and mitigating the risks of relapse or the return of issues. My approach is empathetic, warm, inquisitive, and collaborative, creating a secure and comfortable environment for clients to delve into their difficulties. I am proficient in delivering Cognitive Behavioural Therapy (CBT) online and hold accreditation from the British Association of Behavioural and Cognitive Psychotherapies (BABCP). I provide CBT sessions in both English and Italian. With several years of experience in the NHS and my private practice, I am a qualified CBT Therapist treating individuals with moderate to severe depression and anxiety disorders. My expertise includes the treatment of Obsessive-Compulsive Disorder (OCD), Depression, Generalised Anxiety Disorder (GAD), Social Phobia, Health Anxiety, Panic Disorder, Low Self-Esteem, and Stress Management. I am currently pursuing an MSc programme in Applied Neuroscience at King's College London. Prior to obtaining my postgraduate diploma in cognitive behavioural therapy from Queen Margaret University, I earned a three-year degree in neurocognitive rehabilitation and a five-year degree in psychology from the University of Padua. I am a Chartered Psychologist and a British Psychological Society (BPS) member.