People in relationships who constantly question whether their partner loves them, or whether they've found Mr. or Ms. Right, may have a condition known as relationship obsessive-compulsive disorder.
Now, a new study finds that, perhaps not surprisingly, people with these symptoms may be less satisfied with their sex lives than those who don't have this condition.
In the study, people with symptoms of relationship obsessive-compulsive disorder (ROCD) — which can include behaviors such as constantly reassessing whether you love your partner, doubting your partner's love or thinking about a partner's physical flaws — were less likely to be satisfied with their sex lives than people without these symptoms.
This lower level of sexual satisfaction was explained by a decrease in relationship satisfaction — in other words, it seems that ROCD symptoms reduce relationship happiness, which, in turn, affects sex life, the researchers said. [5 Ways Relationships Are Good for Your Health]
The findings, which were published online June 6 in the Journal of Sexual Medicine, could have implications for the treatment of some people with relationship and sexual problems, the researchers said.
"ROCD symptoms are often overlooked by family and couple therapists," said study researcher Guy Doron, of the School of Psychology at the Interdisciplinary Center (IDC) Herzliya in Israel. The new findings mean that people's sexual problems might stem from having ROCD and not knowing it, Doron said.
What is ROCD?
ROCD is a form of obsessive compulsive disorder — a condition that can bring unwanted thoughts or worries (obsessions), and repetitive behaviors that are carried out to address those worries (compulsions), usually to no avail.
With ROCD, obsessions usually fit into one of two categories: Questioning whether you love your partner, or questioning whether your partner loves you, said Steven Brodsky, a psychologist and clinical director at the OCD and Panic Center of New York and New Jersey. Brodsky was not involved in the study but has treated patients with ROCD.
For example, one of Doron's patients said that although he loved the woman he was in a relationship with, he couldn't stop thinking about whether he might be happier with women he saw on the street, or on Facebook.
Compulsions can involve going to great lengths to check that your partner is loyal, such as repeatedly calling them, looking at their email or Internet search histories or constantly asking them whether they "really mean it" when they express their love, Brodsky said.
It's normal to have some of these thoughts in relationships from time to time, Brodsky said, but a person is considered to have a disorder if the thoughts impair everyday life, such as the ability to do his or her job.
Brodsky also noted that people with ROCD have unwanted thoughts even when there is no rational reason to question the relationship (i.e., their partner really does love them).
Ultimately, these symptoms can lead to rocky relationships. "These relationships can often repeatedly break up and reunite multiple times a week" or month, Brodsky said. ROCD can also become a self-fulfilling prophecy if the symptoms end up pushing a partner away, he said.
About 1 percent of U.S. adults have OCD in any given year, according to the National Institutes of Health, and a portion of these have ROCD. Brodsky estimated that at any given time, about 20 percent of the patients he treats have ROCD.
In the new study, 157 men and women in Israel filled out an online questionnaire intended to assess ROCD symptoms. Couples had been together for about 15 years, on average. Although the survey could not diagnose ROCD, Doron estimated that about 1 percent of participants had the condition, based on their responses.
The more severe participants' symptoms were, the more likely the participants were to be unsatisfied with their sex lives.
ROCD symptoms may undermine the ability of a couple to bond emotionally, and lead to stress and sadness, all of which may interfere with pleasure during sex, the researchers said.
"When you're constantly questioning and obsessing over the quality of the relationship, or the fulfillment of the relationship, it's going to impact both your physical and emotional connectedness," said Anthony Ferretti, a private-practice psychologist in Florida who specializes in relationship therapy and who was not involved in the study.
It may be better for people whose ROCD symptoms are the main cause of sexual and relationship problems to have these symptoms treated before entering couples therapy, Doron said.
In fact, typical couples counseling could worsen symptoms for people with ROCD, Brodsky said.
In couples counseling, counselors may try to sort out the relationship's problems, and find ways to help the couple communicate better, or discuss what each person sees as lacking in their partner, Brodsky said.
"If you were to begin to really analyze issues within the relationship, you would be helping the OCD sufferer to [have] a compulsion, and you would be perpetuating or worsening the OCD," Brodsky said.
Instead, people with ROCD should receive treatment for OCD. The goal of such treatment is "to help the person develop a greater tolerance for ambiguity or bothersome thoughts," Brodsky said.