Relationship Issues

Abstract

This chapter discusses the impact of sexually themed obsessive-compulsive disorder (OCD) on relationships, with a focus on intimate partners. Discussed is the role of family accommodations on relationships and how OCD can interfere with relationship and marital satisfaction. Included are strategies for therapists surrounding family counseling and interventions that may include partners in the OCD treatment process. A review of common sexual problems associated with OCD is provided, which includes difficulties surrounding impregnating obsessions, sexual orientation obsessions, obsessions surrounding sexual deviance, and contamination fears. Also discussed is the mechanism by which anxiety and depression contribute to sexual difficulties by reducing sex drive. Several medications for OCD can result in sexual side effects, and clients should be warned of these difficulties in advance. Also discussed is how to talk to partners and others about sexual obsessions in OCD. The relationship itself can become an obsessional concern for clients, sometimes called relationship OCD, which may require an approach to treatment that combines OCD-specific cognitive-behavioral approaches and couples therapy.