The idea of “attachment styles” has cemented itself in our cultural lexicon—you’ve probably seen online quizzes, books, and social media accounts dedicated to the topic. And it may have prompted you to reflect on your own attachment style, like the way anxiety shows up in your relationships with your partner and friends.
While having an anxious attachment style is a valid experience, it’s possible that what you’re feeling is something more—specifically a type of obsessive-compulsive disorder (OCD) called Relationship OCD, or ROCD, says April Kilduff, MA, LCPC, LMHC, a therapist and clinical trainer at NOCD. The two have many overlapping signs that are worth knowing about. Keep reading to learn more about attachment styles, and how you can build less anxiety-filled relationships.
What is an attachment style?
Attachment theory was born from the research of British psychoanalyst John Bowlby in the 1950s. While he focused his research on infants’ relationship to their caregivers, Bowlby believed that attachment is a cornerstone of human experience from “the cradle to the grave.”
As other researchers built upon his work over the following decades, four categories of attachment style emerged and were applied to adult romantic relationships: secure, anxious, anxious-avoidant, and avoidant. The latter three are all categorized as “insecure” attachments.
Our early relationships with caregivers are thought to inform our adult attachments. However, there are other possible factors, such as your environment and other relationships, including friendships. If you have one of the insecure attachment styles, you might experience a lack of trust or reliability in your relationships.
If you have an anxious attachment style, for example, it could manifest as appearing clingy, fearful, and in need of regular reassurance that the relationship is going well. You might fear abandonment, have low self-esteem, and not like being alone. You may also feel desperate for intimacy and closeness, as this is a signal that you’re not being abandoned and can get your needs met.
“There’s often a lot of reassurance-seeking among those with an anxious attachment style—a need to know exactly where they stand in the relationship,” says Kilduff. “But what’s characteristic of ROCD is when you feel unable to tolerate this kind of uncertainty.” So if you find that doubts or worries about your relationship are taking up significant amounts of time and causing you intense distress, it’s worth learning more about ROCD, and seeking treatment to address your needs.
Could you have Relationship OCD?
ROCD follows the same pattern as any other theme, or subtype, of OCD: It causes recurrent, unwanted, often uncomfortable intrusive thoughts, images, urges, sensations, or feelings—or obsessions. In the case of ROCD, the focus is on your relationship, typically the “rightness” of it. It most often latches onto romantic partnerships, but can manifest in other kinds of relationships, too.
While everyone experiences intrusive thoughts sometimes, if you have OCD you aren’t able to simply dismiss them. Intrusive thoughts are ego-dystonic, meaning that they don’t align with your thoughts, values, beliefs, or morals, but they do make you terrified that the thoughts actually “mean something” about who you are.
OCD is a wily condition, which means that intrusive thoughts can vary from person to person. But here are some examples of what they commonly sound like with ROCD:
- What if my partner doesn’t really love me?
- What if we break up?
- What if they’re secretly cheating on me?
- What if they’re not attracted to me enough?
- What if I’m not attracted to them enough?
- What if we’re not really in love?
- What if there are red flags I’m missing?
- Should we break up?
- Why can’t I shake the image of them cheating on me?
- Why do I feel disdain toward my partner?
Thoughts like these can bring intense distress—anxiety, fear, panic, shame, embarrassment, guilt, confusion. As a result, you may become fixated on solving the intrusive thoughts before something bad happens in your relationship. This may propel you to engage in compulsions – physical or mental acts done in an attempt to banish intrusive thoughts and the distress that they bring.
Obsessions can include:
- Reassurance-seeking. This is one of the most common compulsions among those with ROCD, and involves seeking reassurance from others, or from yourself, that your intrusive thoughts aren’t true. For example, you may repeatedly ask your partner, “What if we break up?” or you may repeat to yourself, Of course we won’t break up.
- Rumination is the process of intense overthinking or overanalyzing. It may feel like getting stuck in a “thought loop” where you replay the same thoughts, images, questions, or worries over and over in your head, hoping that new evidence will emerge that supports or denies your intrusive thoughts.
- Mental review. This is the act of combing through specific memories or interactions to look for signs that prove or disprove your intrusive thoughts. For example, if you’ve become fixated on the idea of your partner cheating on you, you may reflect on all the recent times they’ve gone to hang out with friends: Were they acting weird before they left or when they got home? Did they act coldly toward you? Did they have a strange scent on them? There is the perception that you can’t trust your memories or your interpretation of them.
- Excessive research. Similar to reassurance-seeking, you might seek validation through the internet or other sources, rather than people. You may read article after article about relationships, take quizzes about whether you’re really in love, or search for stories of people who were cheated on in order to compare your relationship to others.
- Confessing is common with ROCD because you may feel guilty about all the doubt-filled thoughts you have about your relationship. By telling your partner your thoughts, you can relieve that guilt, clear your conscience, and maybe even get some reassurance in the process.
- Avoidance. This is the process of steering clear of any stimuli that triggers your intrusive thoughts, including people, situations, places, or any media that has themes of romantic love. You might avoid going on double dates so that you can’t compare your relationship to that of another couple, or that you start to avoid your partner.
Compulsions promise you safety and relief, but while they may bring short-term relief, they ultimately keep you stuck. They reinforce the idea that your intrusive thoughts—and the uncomfortable feelings that come with them—are dangerous. As long as you continue engaging in compulsions, you’ll be caught in the web of intrusive thoughts. Luckily, there is an evidence-based treatment for ROCD that can help alleviate these fears, obsessions, and compulsions.
How to get help for ROCD
All themes of OCD can be successfully treated with exposure and response-prevention (ERP) therapy. It’s a type of cognitive-behavioral therapy (CBT) that’s specifically used for OCD.
ERP is a collaborative where you and your therapist work together to gain the best possible understanding of what your intrusive thoughts sound like, what triggers them, and what compulsions you engage in. Then the two of you will continue to work together to develop a hierarchy of exposures to confront your ROCD—meaning you’ll start with small challenges and work your way up to exposures that bring the highest levels of distress. All the while, your therapist will give you tools to resist performing compulsions (that’s the response-prevention part).
Some examples of what exposures could look like:
- Writing out a worst case scenario, such as If I end up alone, then…
- Watching a video from the perspective of someone who was cheated on
- Going on a double-date and not comparing your relationship to the other couple’s
Each exposure gives you an opportunity to practice sitting with discomfort and uncertainty rather than relying on compulsions. Over time, this desensitizes you to your intrusive thoughts, and ultimately, your brain will stop sounding the alarm when they occur. You learn that they’re not dangerous, and they cease to hold power over you.
If you don’t relate to the experience of obsessions and compulsions, but still recognize an undercurrent of anxiety in your attachment style, there’s hope for you, too. Notably, it’s widely believed that attachment styles can change over time.
You may find it useful to seek out a cognitive-behavioral therapist who can help you understand the relationship between your thoughts, feelings, and behaviors that are contributing to your anxious attachment. Kilduff also recommends reading Attached: The New Science of Adult Attachment & How it Can Help You Find—and Keep—Love by Amir Levine, M.D. and Rachel S.F. Heller, M.A. It offers practical tools for transforming your anxious attachment style to a more secure one.
No matter how you currently show up in relationships, with the right help you can live a more present life, and love more securely.