Online treatment for ROCD using CBT, ERP, and ACT
Dr. Ran Littman
Clinical Psychologist, ROCD Specialist.
Understanding ROCD
What is ROCD?
Relationship OCD refers to obsessive-compulsive symptoms centered on intimate relationships, often involving distressing doubts about one’s feelings, the “rightness” of the relationship, the partner’s feelings, or the partner’s perceived flaws.
Why does ROCD keep going?
ROCD is maintained by ongoing efforts to solve uncertainty. Checking, analyzing, comparing, confessing, or seeking reassurance may briefly reduce distress, but strengthen the significance of the doubt and keep the obsessive-compulsive cycle active.
Common symptoms of ROCD include repetitive questions such as “Do I really love my partner?”, “Is this the right relationship?”, or “What if I am missing a better partner?”, alongside compulsions such as checking feelings, comparing, reassurance seeking, and testing the partner. Symptoms may be relationship-centered, partner-focused, or both.
How is ROCD different from ordinary relationship doubt?
Relationship doubts are a normal part of close relationships. In ROCD, these doubts become persistent, distressing, and difficult to let go of, often interfering with daily functioning, emotional well-being, or the relationship itself.
Treatment Approach
How is ROCD treated?
ROCD is typically treated using evidence-based approaches such as CBT, ERP, and ACT. Treatment focuses on applying these approaches in a way that is specifically adapted to the OCD processes involved in Relationship OCD. In some cases, medication may also be considered alongside therapy.
What does treatment target?
Treatment targets the processes that keep ROCD active, including compulsions, rumination, over-monitoring of thoughts and feelings, intolerance of uncertainty, and exaggerated meaning attached to thoughts and doubts. A central part of treatment involves learning to approach triggers and uncertainty without becoming pulled into compulsive attempts to resolve them.
Will treatment help me determine whether I’m in the right relationship?
Treatment does not aim to determine whether a relationship is objectively “right” or “wrong,” or to eliminate all uncertainty. Instead, it focuses on helping people make conscious choices that are less driven by fear, urgency, and compulsive attempts to resolve distress and uncertainty.
What tends to change in therapy?
With effective treatment, less time and mental energy is spent in loops of checking, analysis, and reassurance seeking, and more attention becomes available for relationships, life, and personal values. People often become more able to experience relationships directly and be present, rather than mainly through doubt and distress.
About Dr. Littman
I am a clinical psychologist specializing in the treatment of Relationship OCD (ROCD) using evidence-based approaches such as CBT, ERP, and ACT, adapted specifically to ROCD.
Alongside clinical work with individuals struggling with Relationship OCD, I am involved in research and clinical projects focused on improving the understanding and treatment of ROCD and expanding access to evidence-based care. I also participated in the development of a dedicated ROCD treatment protocol and self-guided treatment program.
I write the Relationship OCD column at Psychology Today, where I write about understanding, discerning, and coping with ROCD.
Selected Articles
Insights into understanding, discerning, and coping with ROCD
Additional Resources
Self-Guided ROCD Program
Evidence-based self-guided program for individuals seeking structured support and psychoeducation around Relationship OCD.
Psychology Today Column
Articles and reflections on understanding, discerning, and coping with Relationship OCD.
Contact Dr. Littman
Fill out the form below, or reach out directly by email at ran.littman@gmail.com