Guest Blog: Relationship OCD or Anxious Attachment? How to Spot the Difference

Written by: Emma Beale, MA, LPC, Owner of Superbloom Therapy Services 

Relationships are Complex 

Humans are complex beings - we are a compilation of internal coding and external experience, the intersection of which makes each of us unique. Standing alone, it can be a challenge to understand oneself, but when in relationship with others, that equation becomes even more complex. Our partners can be our mirrors in wonderful and terrifying ways and navigating these complexities together can be one of the most rewarding and challenging experiences in life. 

For many people, a strong feeling of anxiety can be a part of this experience. Understanding the root cause of this anxiety is essential for effective treatment. The anxiety might be communicating something to us, but that doesn’t mean it needs to linger forever. 

In my practice as a Licensed Professional Counselor in Arizona working with neurodivergent couples, two very common roots of anxiety I see in relationships are Obsessive Compulsive Disorder and Anxious Attachment. Though presentation of these challenges can look very similar (questioning the relationship, your partner, your own intentions), the underlying mechanism and appropriate treatment are very different. Treating one as the other can often increase the suffering of both partners. If you think you may be experiencing one or both, it’s important to work with a therapist well versed in these relationship experiences to get help. As you reflect on your own relationship and if OCD or anxious attachment may be present, here are a few things to consider. 

What is OCD? 

OCD is short for Obsessive Compulsive Disorder. It’s related to anxiety, but works in a very specific way in the mind. Where anxiety takes a concern primarily rooted in reality and magnifies the intensity, OCD takes a concern that could be possible, but that the sufferer knows deep down currently is not, and magnifies it even more. 

OCD latches on to something that you very much fear to be true, but that you also know is not, and it won’t let go. 

In relationship OCD (ROCD), this might look like a loving relationship where you know your partner is very unlikely to cheat, but where you fear this outcome so much, you spend hours thinking about ways in which they might cheat, looking through their phone for evidence, or asking them to promise they won’t cheat over and over again. 

This is painful for both the person suffering from OCD as well as the partner. The person suffering feels a near constant anxiety that their worst fear is right around the corner and if only they try hard enough, they can avoid it (which of course, is never possible to 100% guarantee). The partner in turn perceives correctly that they have a relatively loving and healthy relationship and so cannot really understand or empathize with their partner’s fear. This drives a wedge for both and the cycle continues until interrupted. 

What is Anxious Attachment? 

Attachment Theory indicates that one of the most basic human needs and instinctual processes for survival is secure attachment to other humans, especially and from birth, primary caregivers. Secure attachment starts in infancy when a child is in distress and the parent is calm, available, and attuned to the child’s needs in the moment. When the nervous system learns this safety, the person can then grow to be regulated in distressing relationship situations in adulthood, intuitively knowing they can always come back to their own internal emotional safety. 

When the child’s primary caregiver cannot support secure attachment - and many cannot due to their own attachment deficits from childhood - the child develops some variety of maladaptive attachment in an effort to have their needs met. 

One version of this maladaptive attachment is anxious attachment. Someone experiencing anxious attachment is very attuned to shifts in the relationship dynamics in the room, especially with those they are close to. When they sense distance in the attachment, they often protest in an attempt to bring their partner back to closeness and emotional safety for both. This might look like asking their partner for reassurance constantly, looking through their phone to find clues, or thinking often about how they can ‘fix’ the distance in the relationship. 

What is the overlap between ROCD and anxious attachment? 

So, though one is rooted in maladaptive thought patterns and one is rooted in early developmental trauma, both ROCD and anxious attachment can look like one partner anxiously and incessantly reaching for the other. 

Depending on both partners’ individual emotional capacity and understanding of what is going on, this can be extremely distressing and detrimental for the relationship. 

What are some characteristic differences? 

Though ROCD and anxious attachment may look very similar, treatment approaches are very different because of the differing root causes. 

For ROCD, it’s important that the OCD loop be interrupted with Exposure and Response Prevention Therapy (ERP) and that the partner not experiencing OCD doesn’t feed into the cycle with the suffering partner, but is still able to provide emotional support. 

For anxious attachment, working on secure attachment patterns in the relationship as well as individual trauma work are both important factors in helping the anxiously attached partner’s nervous system return to (or enter for the first time) a securely attached state. 

While there can be some overlap in the two experiences and some may experience both ROCD and anxious attachment, discerning between the two is critical because feeding into the OCD cycle will make it worse while disengaging from the need for secure attachment will make the anxious attachment worse.

Because of this, working with an experienced therapist knowledgeable about both presentations is an important step in seeking relief. 

If you think you may be experiencing ROCD or anxious attachment patterns in your relationship, reach out for a consultation and get connected with someone who can help. 

The content of this blog is for educational purposes only and is not therapy or advice. Reach out to a licensed professional for specific support or call 911 if you are having a mental health crisis.