I’m a Licensed Marriage and Family Therapist (LMFT) who also specializes in working with folks struggling with Obsessive Compulsive Disorder (OCD). As a relational and systemic thinker, here are some common ways I see OCD impacting the relationships in my clients’ lives.

With OCD, it’s not a question of “if” OCD is impacting your relationships, it’s actually a question of “how much.”

If you have an OCD diagnosis, you already know how much OCD can impact your daily life, functioning, the way you view yourself and the way you view the world. Folks who struggle with OCD often doubt almost everything – “Did I really lock that door before I left?” / “How do I know I’m not a bad person?” / “What if my life turns out to be horrible?”. These thoughts are often fueled by anxiety and turn into obsessions – thoughts we just can’t stop thinking about that urge us to do something. The “something” we feel urged to do is the compulsion – seek reassurance from someone, neutralize the thought somehow, double/triple/quadruple check something, etc. However, sometimes it can be more difficult to see the ways in which OCD may be impacting the relationships in your life.

But OCD doesn’t just impact someone individually in isolation. We’re all part of relationships – this term doesn’t just mean romantic partners. We have relationships with friends, family members, pets, other people in our house, neighbors, etc. For the relationships we hold closest, OCD can interfere the most intensely. This often leaves those struggling with OCD and those closest to them feeling overwhelmed, frustrated, and unsure of how to move forward.

Sometimes the ways OCD interferes in relationships is obvious and sometimes it is sneakier and harder to identify. We’re all generally just doing our best to get through the day, and often OCD uses up so much mental/emotional energy we may not have much left over to consider the more systemic impact OCD is having on our life.

Here are some of the ways OCD can affect relationships:

• Family/Partner Accommodation Cycles
  • Family/Partner Accommodation happens when the family of a person with OCD changes their routine/behavior to “protect” their loved-one unnecessarily from an obsessional fear (Abramowitz, 2021).
  • Family members/partners adopt accommodation cycles to cope with the difficult dynamics of OCD when they typically don’t know what else to do. Accommodation does not cause OCD, but it does play a role in keeping it in place.
  • For example, if someone with OCD has a fear of contamination and notices that a family member doesn’t wash their hands after touching something they perceive as contaminated, they may demand that the family member participate in the ritual. If the family member complies, they have just accommodated the OCD. The person with OCD is likely to get a temporary relief in anxiety, however the OCD cycle will likely be reinforced – the person with OCD has just learned that the way to feel less anxious is to have their family member engage in the compulsion. This makes it more likely the same thing will happen again the next time the obsession occurs.
  • Other Examples:
    • Parent keeps buying more soap for a child who uses a full bottle of soap per day to wash his/her hands
    • Husband starts his morning routine earlier because he knows his partner gets stuck in OCD rituals in the morning and will lock him out of the bathroom at a certain time and make him late for work.
    • •The family is ready to leave the house but waits around for the child who gets stuck turning a light switch on and off and checking that all the appliances are unplugged.

• Conflict, Stress, & More
  • Families and partners affected by OCD function fundamentally different from those where it is not present. Family members and partners may find themselves stuck in patterns of accommodating rituals or walking on eggshells in an attempt to not set off the OCD. As we all can imagine, this can leave room for frustration, overwhelm, resentment and even hopelessness to take root. Families in these situations often feel stuck and confused for how they can possibly move forward.
  • Families/partners may also be confused about what OCD is and how it works. People with OCD may have varying degrees of comfortability in sharing information about their OCD symptoms with their loved ones, or worry that their family members will not understand or judge their thoughts and feelings. This can keep people with OCD from sharing information that could be helpful in changing dynamics within the system, keeping families/partners feeling stuck.
  • The person with OCD is often aware of these feelings experienced by the other family members/partner, yet may not have the ability, skills, or confidence at that time to do anything differently. For some, this can intensify OCD fears related to being a bad person/hurting others in some way. This may lead to the person with OCD to avoid their loved ones or cut off communication with them for fear of making things worse. This can lead to increased feelings of isolation, loneliness, and hopelessness among people struggling with OCD.
• Relationship OCD
  • It is common for most people to have some doubts about the suitability of their partner (or qualities/attributes), or the relationship itself at some point, and this can even be considered a natural part of developing an intimate relationship.
  • However with Relationship OCD (a specific subtype of OCD), common relationship doubts and concerns or worries about the partner’s perceived flaws becoming increasingly impairing, time-consuming, and distressing.
  • There are 2 main types of Relationship Obsessions:
    • Relationship-Centered: focuses on the “rightness” of the relationship experience
    • Partner-Focused: focuses on the perceived flaws of the other partner
    • Partner-Focused and Relationship-Centered Obsessions can occur at the same time and often reinforce one another.
    • These obsessions can occur within or outside of an ongoing romantic relationship (IOCDF)
  • Relationship OCD can keep people from engaging in the kind of relationship they value or actually want based on the obsessional fears about what the relationship/partner “might or might not” be.
  • People struggling with Relationship OCD may find themselves stuck in a relationship they don’t really want to be in but the fear uncertainty related to leaving, or having trouble getting into a relationship due to uncertainty about their partner being just-right, and everything in between.

What to do if OCD is Impacting Your Relationship or Family

Self-Compassion is Key

If you have OCD, it is very common that OCD would impact your relationship or family dynamics, and this doesn’t make you a bad person. Additionally, if you’re a family member recognizing you’ve been engaging in family accomodation of OCD symptoms, this is also a normal dynamic and does not mean you haven’t been trying to support your loved one as best as you can.

OCD is Treatable and Family Patterns are Changeable

The good news is that OCD is treatable and unhelpful family/relationship dynamics can also be changed. First, it is important to make sure the person with OCD is getting the right kind of support. Exposure and Response-Prevention therapy (ERP) is the gold-standard treatment for OCD, and can help improve your functioning with OCD which will have a ripple effect into your relationships. (Click here for IOCDF info on finding an OCD Therapist).

Additionally, there are therapists out there (like myself) who specialize in specifically helping families/partners navigate the impact of OCD on their dynamics. Finding a family or couples therapist who also has a specialization or good working knowledge of OCD can help you learn how to break unhelpful patterns and create new and more preferred ways of interacting. If you are doing OCD work with an individual therapist, they may be able to provide you with referrals for a family/couples therapist who understands OCD and its unique impacts on family dynamics.

I also recommend checking out the books:

• “Thriving in a Relationship When you have OCD” by Amy Mariaskin
• “When a Family Member has OCD” by Jon Hershfield
• “The Family Guide to Getting Over OCD” by Jonathan Abramowitz

And, visit the International OCD Foundation (IOCDF) Website for more resources and info on finding evidence-based care for OCD.

The first step in changing unhelpful dynamics is noticing that they are no longer working for you! If reading this has helped you to take that first brave step, you’re doing great & you can handle this!

If you’re a therapist/mental health professional and interested in learning more about how to work on these things with your clients, check out my upcoming workshop for June 2025 “OCD and the Family System” here.

Ashley Lanier-Pszczola LMFT is a licenced therapist, practice owner, clinical supervisor, and professional speaker. Ashley specializes in working with teens, young adults, OCD and related disorders, and family work for clients of all ages.