596 - Relationship OCD and Non-monogamy (with Sheva Rajaee MFT)
Welcome, Sheva!
We’re excited to welcome Sheva Rajaee to the show this week to talk about relationship OCD! Sheva is a licensed marriage and family therapist, director of The Center for Anxiety and OCD, and the author of the book Relationship OCD. She is globally recognized for her work treating and addressing chronic doubt, commitment phobia, and anxiety in romantic relationships.
During this episode, Sheva talks to us about the following topics and answers some questions:
Things people get wrong about ROCD and how it differs from standard OCD.
The spectrum of severity in ROCD and the clinical line between ROCD and someone intuitively knowing something is not right in the relationship.
Where does ROCD come from? Trauma, attachment style, gendered socialization, etc.?
ROCD and non-monogamy.
ROCD-driven commitment-phobia.
Tips for redirecting unhelpful thought patterns if you know you’re in a good relationship.
Bringing ROCD up to a partner.
Treatment options.
Why is ROCD important specifically to you?
Find Sheva on social media at @theshrinkwrap, or learn more about her and her work at www.caocd.com.
Transcript
If you find any transcription errors, please let us know at info@multiamory.com and we will fix it ASAP.
Sheva: The OCD brain is a hyper-attuned threat detector, and that's the biology. And then you get into the understanding, the psychology and the sociocultural implications, which is that we live in a world that is obsessed with finding the one as this spiritual salvation.
Dedeker: Sure.
Sheva: And very, very monogamous and very much the story that when you find the one, all of your troubles will be solved. And it's the finding that's the hard part. It's not the being in. It's you find the right person and it's easy. There's a real pull to get away from discomfort. And so you have individuals with a brain that is oftentimes wired to feel more discomfort than normal, and also a narrative that's really frickin' compelling. Find the one and you basically find God.
Jase: Welcome to the Multiamory Podcast. I'm Jase.
Emily: I'm Emily.
Dedeker: And I'm Dedeker.
Emily: We believe in looking to the future of relationships, not maintaining the status quo of the past.
Dedeker: Whether you're monogamous, polyamorous, swinging, casually dating, or if you just do relationships differently, we see you and we're here for you.
Dedeker: On this episode of the Multiamory podcast, we're diving into the topic of relationship OCD with our special guest today, Sheva Rajaee. Sheva is a licensed marriage and family therapist. She's the director of The Center for Anxiety and OCD, and she's the author of the book Relationship OCD. She's globally recognized for her work treating and addressing chronic doubt, Commitment phobia and anxiety in romantic relationships. And just a side note, Jace is not joining us today. He is currently working very hard on a work trip in Germany. But Sheva, thank you so much for joining us on the show today.
Sheva: It's a pleasure to be here. Thank you so much for having me.
Dedeker: Okay, well, let's start off with what do you think is the number one thing that people get wrong about relationship OCD?
Sheva: Great question. The number one thing people get wrong about relationship OCD is that it's just having doubts, or it's just having concerns in your relationship. If we're talking about relationship OCD, we're talking about a level of dysfunction, we're talking about a level of relational interruption that is pretty marked. It is clinically significant. So relationship OCD itself, that is not a diagnosis. A person with relationship OCD is actually suffering from OCD. And so when you're talking about somebody who is at an OCD level of concern, you're talking about oftentimes greater than an hour a day, usually hours a day of fixation, of preoccupation. There's compulsions, it's pretty disruptive. So I think when we're talking about what is Relationship OCD versus, hey, I have anxiety in my relationship, you're really talking about a level of preoccupation that's pretty dramatic.
Dedeker: I see. I just had a quick question about that. Do you think that with the rise of social media making people more aware of ROCD and OCD in general, do you think that that has helped people or hurt people? Do you think more people are self-diagnosing something that's maybe more garden variety relationship anxiety, or do you think that's helped more people understand what's actually might be going on for them?
Sheva: Like all things with the internet, it's probably a bit of both, right? It's the devil and the angel. I've seen such a huge rise in awareness and individuals coming in saying, hey, I heard about this from this, whether it's an influencer or a coach or a therapist. Some people have great information on there. And, I think about when I was going through my early diagnosis phase and it was one subreddit, you know, 15 years ago you were in some back channel learning about ROCD and OCD. And now I love that there's so much access. So I think in that way it's clearly a positive. The other end of that is you're going to get a lot of overdiagnosis, a lot of misinformation. And then especially, coming at things from a therapist's perspective, you're getting a lot of people saying they can treat this and work with this and they really can't, or they just don't understand the advanced and evidence-based treatment of OCD. So always devil and angel with the internet, right?
Dedeker: Of course. Yeah. And 15 years ago also was a time I feel like where we were still tossing around the term OCD just to describe someone who liked to keep their house clean, right? The cultural competency around OCD, much less ROCD, I feel like was a lot worse 15 years ago.
Sheva: Yeah, absolutely. And, you know, unfortunately, a lot of that is still used. People feel like it's a light condition, and so you could say, oh, it's just my OCD, oh, that's just my OCD. And people even do that in front of me, and I might or might not correct you at a party or a baby shower or something. But yeah, if it's OCD, it's really distressing. World Health Organization identified OCD as one of the top 10 most distressing and intense conditions that you can have from a mental health standpoint. So it is— it's messed up. It's really hard to have.
Dedeker: Yeah.
Emily: Can you talk about the distinction between specifically relationship OCD and regular OCD? And also just for our listeners out there who maybe have an idea of what OCD is, but maybe not from a clinical perspective. Can you define what those two things are and how they differentiate from one another?
Sheva: Yeah, absolutely. So the clinical diagnosis is obsessive compulsive disorder. So whether you have your obsessive compulsive disorder that is focusing on relationships or it's focusing on harm— sometimes people are more familiar with OCD and this fear of like, what if I'm a murderer? What if I am secretly a pedophile? What if I want to push someone into the subway line or something like that. So, whether it's focused on your relationship harm, whether it's focused on am I a good enough person, there's like a morality angle to it, or cleanliness. People think about— of course we understand like handwashing as an OCD theme. All of that is OCD. So you're not going to see those things in the DSM, the Diagnostic Statistical Manual, which is what all mental health professionals and medical professionals use. You're gonna see OCD, but we use these thematic differences to basically describe what it is that your OCD is fixated on in this moment. And relationships are a huge one.
Emily: Mm.
Sheva: So when you're asking that great question of, okay, but then what is even OCD? So it is a clinically significant, and what we mean by that is it's getting in the way of your quality of life. There are plenty of people who are rigid or they are obsessive, but it doesn't reach this level of dysfunction for them, whether in their workspace or in their relational space or in their day-to-day. You know, they might not warrant a diagnosis. But if you're coming in here and you're again spending multiple hours a day obsessing about a concern, for example, what if I'm in the wrong relationship? What if, um, they're not the one? Should I open my relationship? Or even, is this lifestyle for me? All of those questions can get caught up in an OCD loop. And then in order for it to be OCD, you're answering those obsessions with compulsive behaviors. And people think of compulsive behaviors as just the hand washing, but it's so much more. It's ruminating, so spending hours a day going, well, are they right? Well, are they not right? Well, would they be right if this happened? Would I be okay if this happened? Or Googling.
Dedeker: Oh no. Oh no.
Emily: And I'm assuming now also asking AI and having lots of conversations. That's maybe the new form of Googling now.
Sheva: Yeah, absolutely. Absolutely. ChatGPTing the question and getting caught in these cycles, or even the way a person with OCD might ask a question and it's never enough of an answer. Like, Dedeker could give me a beautiful answer and I'd be like, Okay, cool, cool. And then that evening I have the same question again. So this unending cyclical search for relief really is what it is.
Dedeker: So, well, first of all, you're previewing that clearly this shows up in non-monogamous relationships and populations as well. That's something we're going to get to a little bit later in the episode. By the time a client comes to you, have they already gotten maybe a diagnosis or a suggestion or referral from somebody else that they may have relationship-focused OCD? Or is this something that you're sometimes discovering along with a client that this is how it's manifesting with them.
Sheva: Yeah, I would say that since I released my book a few years ago, and since the conversations online have gotten more specific, this is a pro, is that we do get a lot of informed intake calls where people say, I think I have relationship OCD, or I'm pretty sure I have OCD. And of course, many times they're referred by other clinicians. And I'm so happy to hear when that happens, because that also means those clinicians are more informed about what OCD looks like in the room. And even ROCD, which you would never see that referral come through 5 years ago, you just wouldn't see it. It's really, it's entering the zeitgeist. It's really much more top of mind than it was 5 years ago, 10 years ago, 15 years ago. So a lot of people come in informed these days.
Dedeker: So as far as distinguishing though, if this might be a clinical case or not, something that strikes me is, obsessing over a romantic relationship or being worried about it or wondering, am I with the right person, or am I gonna screw this up, or whatever, that it does seem like that's under the general umbrella of human experience. We all can sometimes go through chapters of that depending on what relationship we're in, right? Where this is top of mind for me because I'm in the early dating phase with someone. And so it's like I have my own sort of anxiety cycles that kick off because of that, or, this kind of attachment chemical driven, sometimes obsessiveness or attachment or whatever. And I guess I'm curious, you kind of kept bringing up this sense of— the sense of time that it takes away from your life, right? So as in, it's not just small moments or things that pop up here and there, but you're finding that it's several hours out of your day that you're spent ruminating or maybe ChatGPTing or things like that. Are you just, for the spectrum of severity, I suppose, of presentation, are you just looking at that of amount of time or are you looking at other factors?
Sheva: Amount of time would be one, but certainly that idea of, does it keep getting asked and answered and it's not enough?
Dedeker: Interesting.
Sheva: So there's this real itchiness concept with OCD and ROCD, again, any manifestation of OCD, bug bite-like where you'll itch and you're like, okay, that scratched the itch for a moment. But what it actually did is it sort of released more histamine.
Dedeker: Yes.
Sheva: I actually have no idea if that's how bug bites work, but it feels like that's how it works.
Emily: Sure.
Dedeker: Sure.
Emily: We can believe that that's how it works.
Dedeker: Yeah.
Sheva: Sure.
Dedeker: Yeah.
Sheva: But you make yourself itchier the more you scratch. So what if the main giveaways from a clinical perspective that you're dealing with something that is above and beyond typical doubt, or even a typical anxiety process is how persistent the thought pattern is and also how impervious to rationality it is as well. It can be very sticky. And that's because when you're dealing with OCD, an OCD function, you're really talking about somebody who's looking to escape discomfort on a pretty existential level. And that is impossible. So we'll talk more about this maybe later, you know, but—
Dedeker: Big, big if true. I don't know about that. Yeah.
Jase: Yeah.
Sheva: It's like, if I can just find the right person, if I could find the right person who had all the right qualities, if I could know that I was a good person, if I could just get this thing clean, there's such an existential fantasy of perfection and cleanliness, and you can so understand how that comes up in relationships. Again, regardless of setup, regardless of container, right?
Dedeker: Yes.
Emily: Yeah, it's interesting what you just brought up, Dedeker, regarding being in the throes of new relationship energy and how that can feel so unbelievably overwhelming and also sometimes very debilitating as well. When we get in these processes of thinking about that person all the time, having it affect our life in various ways, and, having a huge dopamine rush when we see them and then an unbelievable withdrawal when we don't see them. And I guess I could see someone potentially listening to this and kind of conflating the two almost where they feel as though, oh gosh, I can't stop thinking about this person. I can't stop ruminating about them, and it's difficult for me to think about anything else. But I guess the distinction that you are saying is just the ability to see, you know, through the trees and know that eventually it may end, those feelings of rumination and intensity, that it's for a brief moment, but eventually they will maybe leave, is that when you're in relationship OCD, it's very difficult to move past some of those ruminations.
Sheva: It's a really good question, Emily. There's a piece that I think is so important to note with an OCD diagnosis that brought up that I'm so glad you asked it in that way, which is when you're talking about— so you're talking about a limerence phase, a honeymoon phase, new relationship energy. That's really— that's lovely, right? Like, I'm sure if Dedeker, if that's where you're—
Dedeker: I mean, I'm in it and I could argue about which parts are not so lovely. Some of it is really lovely and some of it is not.
Emily: But I was talking to a client today who said, I'm not loving every part of this. It actually is really not great at times. And it just brought to mind some of the things that you were talking about, about, yes, of course, wonderful things can happen from that phase, but it can also be devastating at times and really difficult when you feel like this person is gone. I don't know how I'm going to be able to survive without them in moments.
Sheva: Absolutely. Absolutely. That it's consuming in a way, I think, is part of what you guys are saying there. But the fundamental energy would be syntonic. So what I mean by that word is that this is something that fundamentally you're moving towards, you like fundamentally, even though it's hard, there's emotions that come up, withdrawal, jealousy, whatever it may be, that it's still fundamentally what you want and is aligned with the direction you're heading in. Whereas when you're thinking about an OCD process, it's really not. Like it's a person who's ruminating on a question of, do I, again, am I, am I loved enough? Is this the right setup for me? Am I, do I love them enough? Could go as granular as do I, am I attracted enough to them? And those aren't, those aren't at all fun. There's sort of nothing about that process typically that's positive or enjoyable. So we call those ego dystonic experiences. And that is a hugely important distinction when you're talking about diagnosis. OCD is not fun. And that's where you see people saying, oh, I organize my shoes, I have OCD. And you're like, you like to do that. That's not— that's not egodystonic. You're particular. That's fine, right? Or this is consuming, but it's fundamentally aligned with your values. And it is— the majority, I'm hoping, would be a positive experience.
Dedeker: Okay. So just to make sure that I'm understanding that, I guess the distinction in my brain then is if we think about the NRE phase, that yes, it can have uncertainty, obsession, ups and downs. But at least to speak from my personal experience, again, like you said, it's still positive. It's still like, I still want this, I still feel safe enough to keep exploring this, and I still sort of have a sense of faith that as I get to know this person, maybe the uncertainties will start to go calm down a little bit, right? As opposed to maybe if I come in at the beginning of a relationship with this worry of, oh no, what if they turn out to be a jerk? Oh no, what if they turn out to be a jerk? And then still like 5 years later, it's still that kind of obsessive, oh no, they suddenly wake up one day and they're a jerk and nothing that they do to reassure me and no outside gut check I get reassures me. I guess that's kind of how I'm starting to distinguish it in my brain.
Sheva: Yeah. And I'll add one more layer because it's complicated. Of course, it's hard to know and you have to know each person in each case, but you can have a thought of, oh my gosh, what if they're a jerk? Or even I have NRE and I also have doubts. They're both are existing simultaneously. But then to your point, those doubts don't resolve eventually. They don't— and resolve not as in you get an answer to them, but you come to peace with them. Or also that you find yourself, yeah, I'm in this phase of a relationship. I wanna pursue it. I like this person. I wanna see where this goes. And also I'm really finding myself quite obsessed and ruminative over the potential risk of this relationship. Or, if you're in some kind of a— what jealousy that would set up, what loss that would bring up for me. If a person's noticing that that cycle is getting a bit intense, you could be experiencing an OCD level of preoccupation during a positive stage 2. So it's complicated.
Dedeker: Yes, it is complicated.
Emily: So when you are working with someone and you're seeing maybe specific behaviors exhibited that look like potentially they have relationship OCD, can you name what some of those maybe yellow or pink flags might be in that scenario?
Sheva: Yeah, absolutely. So it would be somebody who, I call it too much temperature taking. So it's kind of like you wanna know how hot or cold the pool is, and that's normal, right? But it's erring into the side of more, well, let's take a look at this when you're out checking the pool temperature 5 times a day. Or, you're consulting about, well, is 80 degrees the right amount of degrees or is it the wrong degree, and if it were 2 degrees hotter, if it was— like, do you hear the difference in that tone? That's where you're cruising into, uh, hold on a second. We are trying to get a sense of certainty from the situation that's not available to us. There is— there's no exact right temperature, right?
Dedeker: Okay, but to beat this metaphor to death, what if you suspect the pool might be broken, the pool heater might be broken? And I guess that's where I'm thinking, like, putting myself into the clinician's shoes of, if you're working with someone who maybe is exhibiting OCD-like behaviors around the relationship, but if you're getting a sense of, but maybe the relationship they're in also is not good or does have some fundamental problems, or maybe the person they're with is super inconsistent. I guess that seems like a really tricky place to be in as a practitioner when it's not like, oh, clearly they have a very solid, stable, good, healthy relationship but they have these OCD behaviors that are disrupting their life. What if it's more complicated than that, where there is maybe something not very healthy happening in the relationship?
Sheva: Yeah, it's a great question. It's such a stellar question because we do see that all the time. You have some what we call sort of clearer-cut cases where the relationship is super solid. And what does that mean, right? It's just fundamentally safe. There's a lot of respect, there's a lot of consent, there's a lot of conversation. That is a rela— when you see those relationships and then you have an ROCD sort of level to it, it's a little cleaner, right? Because as a clinician, you're able to go like, oh, this is, this is pretty good. And you're allowed to think that. You have to use yourself as a tool. Where it gets a little more complicated is to your point, well, what if you actually do have some differences in the relationship that feel pretty important, or in the communication style, or there's been an infidelity, right? There's been a breaking of an agreement, and now there is anxiety that is real and true. So the way that we think about that is, for the most part, so if you check the pool 5 times a day or 10 times a day, you're actually not getting yourself clear-headed as to what temperature you want. So it would still be beneficial to get that person cleaner when it comes to their obsessive-compulsive tendencies. And then what you'll find clinically that's so interesting is then a person can kind of dip more into what's real for them. And that's when you can have a conversation with someone around, like, hey, now you're not obsessing about this in this distracting way, quite honestly. Can we now talk about your value system? Can we now talk about what is it like to sit in the risk of this person breaking an agreement again? Or what comes up a lot of times for people is their own attachment insecurities. Like, wow, I just really— I find worth really difficult and I struggle with that. And you can't get to those conversations when you're distracted by, oh, I'm gonna check the temperature of the pool, the pool, the pool, the pool, the pool.
Dedeker: I see. Okay, so it's like someone— it's kind of like you're teasing out that someone may have some legitimate doubts about whether or not their partner's treating them well enough, or if this is the kind of relationship they want to be in. But if they're in that OCD loop about it, they're not actually getting real clarity about it, right? It's just kind of scratching that itch, scratching that itch, scratching that itch. So I'm guessing that then your approach as a practitioner is like, okay, let's treat that, let's treat the loop, let's find the ways to break out of that loop. And then we can have those deeper conversations now that we're here and you have more tools about, okay, now let's actually talk about does this relationship match up with what you're wanting in a relationship or in a partner?
Sheva: That's right. It's going to go that way most of the time. That's really well said. With the exception of a pretty obvious element of the relationship that feels—
Dedeker: sure.
Sheva: Yeah, like there's, there's, there's abuse, there's toxicity, there's, a person again is really consistently breaking agreements. Like, I actually don't like to go at those cases with the OCD approach first.
Dedeker: For sure.
Sheva: Because that feels like you're calling something that's really— your nervous system's telling you you're unsafe, right?
Dedeker: Mm-hmm.
Emily: Yeah.
Sheva: And I don't wanna go in there and be like, oh, let's override that. And let's play like we are. So definitely case by case. But if I see mostly a healthy, safe setup, then yes, I would wanna get the person more regulated. And from that place of regulation, we're gonna talk about, but do you want this, right? Or, but what is that doubt really about? So often it's about, it's about self, right? It's so fascinating.
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Dedeker: And what are the ways that you get people regulated? Because this seems like this could be approached from many angles depending on the person.
Sheva: Yeah, absolutely. So when we're talking about the work of of OCD in particular, because there are so many orientations and you can regulate through so many ways to regulate. You can go on a walk and feel regulated, right? But when you're thinking about capturing this kind of OCD loop, you want to stop engaging, so you're cutting compulsions. You might ask the person, hey, I know this feels incredibly difficult, but what would it be like if we didn't Google this for a few days? What if we—
Dedeker: the torture. Dedicate some homework. I can hear. I know I do. Well, actually it's something I'm aware of, but like so hard in this day and age when there's just so much access to information. And I think even worse now that there's, you know, so many like LLM chatbots that can deliver to you instantaneously.
Sheva: Yeah. I've been known to suggest if you're gonna be using the chatbots, any of them, anything, give it a little tag and be like, hey, I'm kind of ruminating about this. Or I might be spiraling about this. Or even I have OCD. Because it can assist the technology to kind of be like, maybe we should stop now, because otherwise it will never stop. It will continue to chat with you. Yeah. And that is such a trap because you're getting that short-term reinforcement, but you're actually— you're actually dissociating yourself from your true intuition and your true— whatever it is, grief, right? Like, whatever it is you have to work through. Sometimes the distraction of, but is this exactly the right one? Or what, what if it was left instead of right? What if they were blonde instead of brunette? These kind of sillier sounding distractions are typically keeping us from feeling something or contending with something that we don't wanna feel.
Dedeker: Okay. So you said an example of helping someone regulate might be encouraging them, hey, let's see what it's like when you have this particular rumination to spend a couple days not Googling it, not taking it to ChatGPT. What are some other examples?
Sheva: Yeah, so you might, cutting compulsions is hugely helpful because it stops feeding the cycle. So you naturally get more regulation when you stop scratching the itch. At first it's really hard. Another thing that people never think of is to almost play like you're agreeing with your thoughts. We'd consider them intrusive thoughts. So once you recognize that, oh, this thought is beyond the scope of a regular concern, I'm spinning out on this, I will have clients say, yeah, I probably made the wrong decision. Yeah, I'm probably, I'm probably in for a big crash. Or yeah, I'm going to be— I'm going to get cheated on left, right, and center. That's probably what's going to happen. Because you're sort of treating the thought like a bully and you're not going—
Emily: You're calling its bluff. What if?
Sheva: Exactly.
Emily: Yeah. Interesting.
Dedeker: Huh.
Sheva: That's a very sneakily effective tactic. Because you're putting it in its own place. Like, that was okay, whatever, maybe, instead of going and kind of grasping at your, you know, grasping your pearls and getting involved in a 40-minute process with it or whatever it's going to be.
Dedeker: Well, fascinating. That's super fascinating.
Emily: Gosh, I think that makes sense though. We often will say to kind of lean into the emotion as opposed to trying to shy away from it or trying to do a bunch of things to take our mind off of it. Sometimes the best thing— the best way is through as opposed to trying to go around. So that's interesting. And I'm not sure that this is a question that you can necessarily answer, or maybe there is a clinical reason for OCD, but where does this all come from? It feels like maybe a more extreme version of attachment style, like anxious attachment, for instance. But I'm assuming that there's something more to it than that. So can you talk about what exactly is going on here? Why do people have this negative issue in their lives?
Sheva: Yeah, absolutely. Great question. And it's sort of biopsychosocial. So I'll touch on, I think, 3 pieces of where this comes from. One thing is when you have OCD neurobiology, you have a more hyperactive amygdala. So we have scans that show people with OCD having more of the fear center of their brain lighting up. And that's genetics. You see people who this is inherited through families. They're just more sensitive. They might identify as being neurodivergent. Oftentimes there's a lot of comorbidity with things like ADHD. So we are, I put myself in this category as well, but we are just wired with more sensitivity and also more of an eye for what's wrong. It's just so fascinating when you think about it, the tribe needed that person.
Dedeker: Sure. Yeah, it helped us, I guess. Yeah, it helped us, helped us to evolve.
Sheva: Exactly. We're all wired to be anxious to some degree because it kept us alive. So the OCD brain is a hyper-attuned threat detector, and that's the biology. And then you get into the understanding, the psychology and the sociocultural implications, which is that we live in a world that is obsessed with finding the one as this spiritual salvation. Mm-hmm.
Dedeker: Sure.
Sheva: And, very, very monogamous, and very much the story that when you find the one, all of your troubles will be solved. And it's the finding that's the hard part. It's not the being in. It's you find the right person and it's easy. And so you have a lot of preoccupation with, oh, there's some clique out there. And if I can find that clique, right? Whether it's a person, whether it's a relationship container, whether it is a job, whether it is a city that you live in, there's a real pull to get away from discomfort. And so you have individuals with a brain that is oftentimes wired to feel more discomfort than normal, right? And also a narrative that's really frickin' compelling. Okay. Find the one and you basically find God. It's so— it's so cracked out, right?
Dedeker: Boy, yeah. We could do a whole other, like, hours-long conversation just unpacking that. That's— but that's— yeah, I don't think anyone has ever put it that way before.
Sheva: I talk about that as the myth of the one in my book, and I think the phrasing speaks for itself, that it is mythologized, it is spiritualized. I could go on and on too, But you've got biology, you've got society and culture pulling you towards this kind of preoccupation, and then you have attachment that plays in as well, which is that individuals with ROCD are disproportionately represented in attachment insecurities. When you have early experiences of love and belonging that are tainted in some way, you are made to believe that you are not enough. That's anxious attachment. Or you are engulfed in some way, right? That's avoidant attachment. And then disorganized attachment is both. But when you have an anxious attachment style, you come at relationships with much more understandable anxiety about how to feel comfortable in them, about how to settle your nervous system in them. So I hope that that answers it on some level.
Dedeker: We could—
Sheva: each of those are its own.
Emily: It's complicated, clearly. Yes. And probably very individual to the person that is in front of you that's getting treated, for sure.
Sheva: Yeah, absolutely.
Dedeker: I'm curious about what you see in your practice, because I know in my own practice, 90% of the people that I've worked with who either are diagnosed ROCD or suspect that they might be, tend to be women. Or people who were socialized as women. And I have some of my own pet theories about why that might be, but does that track with both the research and your experience has been?
Sheva: Not necessarily. And I will share, you know, women are overly represented in therapeutic contexts.
Dedeker: Sure.
Sheva: Identify as women, so naturally we're going to be seeing more female-identifying individuals in therapy. And that's— that has its own— of course we know why. And men are not allowed to show emotion in the same way or talk about it. Access is really stigmatized. So there's that piece of it. But I think if I were to say that there's any trend that I really see overrepresented in ROCD, it's actually people who are really seeking a monogamous setup. Because— sure, because the— again, the role, the myth, the lore and then the commitment, right, that this one person is supposed to satisfy all of your needs— that is sort of a recipe for the brain to turn on and to begin to scan, well, what if they don't? Well, what if they're not perfect, right? And so we see a lot of monogamous-minded people with relationship OCD.
Dedeker: Well, so that sets us up pretty well to open up the conversation about ROCD and consensual non-monogamy, because this is uniquely a monogamous issue, but I do find there's not a lot of people out there talking about that intersection. So let's start with what it is that you see and you notice in your practice.
Sheva: Yeah, absolutely. So again, I think it's, a lot of times the people who are coming to me, I'm seeing that they're coming with the initial goal of, how do I reconcile my anxiety around choice in a monogamous relationship? Again, where you expect to have it all, right? And I think by the time people have moved into alternate sort of setups and containers, there is thankfully some more flexibility around that idea. However, OCD affects individuals. And so I wish it was as easy as to say when you get an individual who's now going, I'm opening up the marriage, or I'm now in a, my orientation's different, or whatever it may be, that that sort of solves it. Of course it doesn't. Then there's going to be, you know, then the person is still carrying that anxious predisposition and has to think about, now how am I bringing this preoccupation to my new container or to the unique challenges of non-monogamy, right? So it's, it doesn't solve anything, although I think people oftentimes think maybe that's the answer.
Dedeker: Hmm.
Emily: Yeah.
Dedeker: Yeah. It's interesting because as I've thought about this, I could see someone making that argument. That, oh, someone with some kind of ROCD-driven commitment phobia, maybe that's why they might want to choose non-monogamy, and maybe that's why even non-monogamy might be the perfect fit for them, right? Like that myth that you're laying out. But then on the flip side, I could also see this argument that non-monogamy would be a bad choice for someone with ROCD because now you're dealing with a higher volume of dating, relationship building, uncertainty, still making choices on that, right? I guess I'm curious about your thoughts on all that.
Sheva: It's so that, it's so that, Dedeker. It's so interesting. And I think like any couples therapist who might be navigating that discussion, forget the OCD for a second, right? It's, you're thinking about how is this an informed choice for this person or for this couple? And you would be wondering the exact same thing if you have a person with ROCD in the room. And one of the things I'd want to be really mindful of is making sure that that's not functioning as an escape hatch. And you want to make sure that that's the case, whether you're treating a couple where there's no OCD present or a couple where one individual has ROCD and they're wanting to open the marriage or the relationship. First and foremost, what's the why here? Because to your excellent point, it's not like opening something instantly makes it easier. Maybe it makes some aspects easier. Now we're having an easier time with desire discrepancy or something. But there's so much more uncertainty that it also opens up. So really informing and making sure the couple is informed and the individual is quite informed of nothing solves the existential problem of being human.
Dedeker: Yeah, that's the uncomfortable truth you keep coming back to in this episode. And I didn't think that we were gonna go that deep in this episode, but I guess there's no avoiding it. I love it.
Sheva: Yeah. So much of why we do what we do comes back to, as humans, we're swimming up against the tide. We just don't wanna feel bad. I get it. It's just gotta feel bad.
Emily: Something that we talk a lot on the show about is that anxieties can be very different in different relationships. So for instance, if I was in one relationship with someone, I could feel extremely secure in that relationship, but another relationship might present a lot of insecurity. Do you find with people who exhibit signs of Relationship OCD that it's within each specific relationship, or is it potentially relationship OCD and the other one may be more secure and not have these kind of ruminative tendencies?
Sheva: That's a great question, again, and it's somewhat diagnostic in and of itself. I'll tell you why is if you see an individual who's exhibiting similar mechanics across various relationships, regardless of their safety, regardless of how each attachment style is triggering one another, which they all do in some way.
Dedeker: Mm-hmm.
Sheva: But if you see similarities in the person's level of preoccupation, even if the content is different, right? You're looking at sort of a more classic OCD brain that is likely going to be scanning in every setup that they're in. Whereas if I saw an individual come in and their brain is pretty quiet in certain setups, I would be curious about that. So I'd be curious about what feels different about this one versus this one.
Emily: Yeah.
Sheva: Are the stakes higher in one relationship which can actually up the anxiety, right? If something feels a little easier or lower stakes, yeah, it's not your highest stakes setup, you actually will oftentimes see less anxiety there. It's breezier, right? It's easier. And that would be a situation that could really open up really interesting conversations around why are you feeling this in this particular setup but not here?
Dedeker: I'd be so curious.
Emily: For sure.
Dedeker: Yes.
Sheva: Yeah.
Dedeker: No, that's such rich territory in particular. I guess it seems like the recurring theme here is that if you already have a brain that's maybe predisposed, that has that neurobiology towards obsessive-compulsive behavior, that it seems like that obsessive-compulsiveness and the anxiety, life will find a way, the anxiety will find a way. It seems kind of regardless of what the relationship is or what the content is or what's going on, but if it's a situation where, let's say someone's non-monogamous and one partnership, their brain feels much more quiet, they don't tend to go into these loops versus another partnership, that maybe there's just something more specific to look at in that relationship situation in particular.
Sheva: That's absolutely right. Yeah, that's where I would start. That's where I would start. And I'd be curious as to, oh, what does that say about the setup? But yes, to your great point there too, Dedeker, if you have an OCD brain, if you're somebody and you're wired this way We all tend to find something to look at everywhere.
Dedeker: Yeah.
Jase: Real quick, before this next section, did you know that you can get ad-free early releases of this show as well as access to monthly video processing groups and exclusive private channels on our Discord server, all by becoming a subscriber at a sliding scale pay-what-you-can price? If you go to multiamory.com/join, you can read more, get access to that. We would love to have you as part of our community. In the meantime, take a moment to check out the sponsors on this episode. If any of them seem interesting to you, use the promo codes or the links that we have in our episode description because that also goes a long way to supporting this show. This episode is sponsored by Belessa. All right, stop, collaborate, and listen closely because we've teamed up with Belessa to send a free rose to every single one of you. You get a rose and you get a rose and you get a rose. And by that I mean the rose suction toy that has taken over a lot of people's social media. I'll be honest, as a man, this has not been in my For You page on social media.
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Dedeker: So if somebody is listening to this and this sounds like them, but they know that they're in a good relationship, what would you recommend? Like, where would you recommend they go first?
Sheva: You know, there's fantastic resources through the International OCD Foundation website. That is such a solid place to start. To learn a little bit more without worrying about getting stuck on the misinformation you might see online. If you're going to be following people on social media, just making sure that they're licensed, that they're therapists, ideally that they're specializing in OCD. Although again, many people will say that. So doing your due diligence on that. And certainly it does not hurt at all to book an assessment session with a specialist. But I have to be clear, specialist is an overused term. Really going through a governing body, like an organizing body like the IOCDF, finding somebody who is truly a specialist in OCD, it's going to make the world of difference versus somebody who might say, I treat this, but I treat 40 other things, right? Um, it's really its own world of understanding. So we got to looking for somebody who does exposure with response prevention, who's possibly doing some acceptance and commitment therapy in there, and who's CBT-oriented.
Dedeker: If someone thinks this is them, should they bring it up to their partner? How— if so, how should they bring up their partner? I feel like I've got this question for people before of like, I've noticed that maybe I have these little OCD loops in my brain around my relationship, but I really don't know how to talk about it to a partner, if I should talk about it. What do you recommend?
Sheva: Fabulous questions. Yeah, so definitely there's so many thoughts on this. I think one way to look at it is if you have the safety in the relationship, right? So any kind of disclosure that we're going to be doing with a partner, we want to make sure that it's a safe setup for that. So the first time you meet someone is probably not the best moment to share that you have OCD or think you have OCD or anything like that. Having a person who has responded historically well to disclosure creates a safer environment for you to hazard this kind of disclosure. But if you are, let's say you're already in a relationship or relationships, or you are like, no, I'm with a safe person. What I love about diagnosis in general is it can be the beginning of such understanding for the couple. And you'll have setups where the partner is like, oh, that's so makes sense. That explains why we get stuck talking about something for 40 minutes, or I feel like I'm always answering the same question, or you're asking me if I love you all the time, or picking on certain aspects of me. That can be very validating to have an organizational structure around, but timing is really important with that. And I like to tell people that if you know that you are experiencing an intrusive process around your partner, it's very kind to begin backing away from sharing that with them actually, because relationship OCD is, it's unique in the OCD spectrum in that the focus is my partner or partners. And it's really relationally taxing for a person who's in that setup to constantly hear about how their partner's worried that they are not enough, or the relationship's not enough, or what if this is wrong, or what if you're wrong. So beginning to educate the person— this happens in treatment— they don't need to know everything that's on your mind, that that's actually damaging for security of a relationship.
Dedeker: So it's— yeah, so it's sounding like you'd recommend, if there is safety in the relationship, to like let your partner into your inner world, at least to the point of this is the whole process that's going on, that that can help create more understanding. But you're saying that it's kind to maybe from then not to like every single day subject your partner or partners to just an unending ticker tape of what's happening for you in real time.
Sheva: Yeah, which I think would be true if you were working through an attachment piece in therapy or an OCD piece in therapy. That's just kind, right? It's to sort of be like, this is my shit. And so I, if I recognize that it is, and even better if I've been assessed, if I'm working with a therapist, then not everything is the purview of the relationship, right? People mistake privacy and secrecy quite a bit.
Dedeker: Yeah.
Sheva: But not everything is, we have to talk about this, we have to share this. Some of it is really best left unsaid and processed and dealt with with a professional.
Emily: Yeah. So on the flip side, if you think that your partner may have relationship OCD, what should you do?
Sheva: I think that finding and approaching them at a time that is not defended, timing is everything with these kind of conversations, and perhaps sharing with them an article. Again, IOCDF has amazing articles. Perhaps finding a reputable source, whether it's a book, whether it's a page, and just saying, have you ever heard of this? Or, you know, I was looking into this and some of these symptoms sort of reminded me of what it feels like to be in this relationship with you. And it's a risk that we take. We don't know how a partner will respond. But yes, offering that and being in a relationship where you can offer that It's very important if that's something that you suspect, is that you would put that out there and potentially be the door that opens for that person who might have never heard of this before. Because I will say, and I think your listeners will really understand this piece, is talking about relationships is super normalized in our culture. And so it's not typical that you would sit down with your girlfriends at lunch and say, I'm having these doubts, and they would go, stouts seem ego-dystonic. And you said those 40 times to us. That doesn't happen. People will go, oh, well, maybe you're just not that into them, or, oh, well, maybe this container is not for you. Maybe non-monogamy is not for you. Maybe monogamy is not for you. People go to, oh, must be wrong then. And so it takes a trained eye to slow down and be like, hold up, this doubt feels different.
Dedeker: Yeah, that's— gosh, that's so interesting to think about. Yeah, the way that our culture is set up in that way. I wanted to bring it back to the partner though. Again, if someone's listening to this and they're like, ooh, this really sounds like my partner. And yeah, so like maybe they can find a time where we're not in conflict, the person's not defended, we find the right time to start opening up this conversation, share a resource, ask an open question. I guess I'm also curious though of, you know, because you work with couples through this too, so the person who's on the receiving end of the obsessive-compulsive behavior, it's like How do you coach them through how to receive that in a way that doesn't make things worse?
Sheva: Yeah. And you're speaking, Dedica, about the person who's receiving the, the intel.
Dedeker: The intel. The intel. The download. Yes.
Emily: Who is not the one who has the relationship OCD, but the other member of the couple.
Sheva: Yeah. So what we've developed at our center, it's something that we saw a need for so much, which is this ROCD-informed couples therapy. And we are actually not first and foremost couples therapists. We're behaviorists, we're OCD specialists, but we saw this massive gap where if we're sending couples into couples therapy to talk about ROCD, couples therapist doesn't know what they're looking at. And if we bring individuals into OCD therapy, they're not getting to talk through those moments that y'all are bringing up. Of like, whoa, this is a bombshell for me. This feels great. This feels terrifying. What if this never goes away? What does this mean about me? How do I respond to your OCD in a way that's helpful and is not just another compulsion? So we actually took it upon ourselves because we needed this resource to develop an entire 10-session protocol for couples where one person or multiple people struggle with OCD. And it's really, it's fascinating to see what that's like for the non-sufferer to sort of witness and watch and feel so validated oftentimes. And also to have their experience be seen as well, because it's kind of a mind trip to be like, I don't think this person means this per se, but I am containing it with them. I'm trying to manage it with them. It's quite messy.
Dedeker: Yeah, yeah, because I just imagine, from a human perspective, right, that like, let's say if your partner has this recurring rumination around, do you love me, do you love me, do you love me, that I think the human tendency is, I don't know, to want to respond to that, to reassure that, right, to be honest about that. But that also could get grating over time, right? And so yeah, I think the point I'm making is that it's like, when you're dealing with OCD OCD, I feel like our culture hasn't set us up to properly respond to that within the context of a relationship OCD, right?
Sheva: Absolutely. And we see this with lots of relationship setups. So like when we work with parents and children, we also have children with OCD and the parents are responding, whether it's an inquiry or we call them accommodations. So, the child needs breakfast to be set up in a certain way. And the parents, of course, our natural instinct as caregivers, as lovers, is to accommodate. That's that so interesting point with OCD is oftentimes it's like we don't click off that this is OCD until things start getting a bit funky in there. Like, wait a second, now I'm accommodating for hours a day, or this accommodation didn't help you get better, right? I talked to partners a lot about your role is going to be to support the person while they save themself, and taking yourself as the partner or partners out of this role of like, I'm going to solve this for you I'm gonna fix this for you. I'm gonna find the right answer for you. No, you love them while they save themselves.
Dedeker: Oh, so hard. I mean, that's like— that is wisdom that applies in so many situations.
Emily: And it almost feels like Al-Anon, or, you know, that the partner needs to go through some healing on their own to not continue to progress the ruminations and the constant questions or the constant reassurances or any of the above.
Sheva: Absolutely. And it's so— it is so— I just have so much— I honor so much for clients how counterintuitive it is. Yeah, to have that process, like questions and anxiety and distress, and not to go to your partner with it, or not to go to Google with it, you know, but to sort of recognize like, oh no, this is my brain sort of like sparking off. It's an alarm. It's a faulty alarm system. And then what do I do instead? And that's where the work comes in. That's where the practice comes in.
Dedeker: Why is working with people with relationship OCD specifically important to you personally? Thank you for that.
Sheva: That's a beautiful question. I think that we are held so hostage by the myth of the one. I was personally held hostage by the myth of the one and then found the comedown when I entered into relationships and then marriage and then mothering. I just feel like this fantasy that we're sold about something's gonna save you and it should be perfect and it will be transcendent to be such a disservice to good love. And, um, that's why I think I, you know, have so much respect for the work and platform that you you all are doing here. It's like there are so many right answers. There are so many right answers. And we're like completely stripped of that curiosity and mystery when we think and when we're told, right? When we're told, it's like a consumerist machine that if you just look a certain way and wear this perfume and do enough plastic surgery, you're going to transcend because you're gonna find the one. And it's just bananas to me. So I'm very dedicated to— I like to say in my work, it's like freeing good love from the grip of perfection.
Emily: Oh, that's what a banger.
Dedeker: Yeah, what a banger. Yeah, cross-stitch that one on a pillow, folks. That's a good one indeed.
Sheva: Because I think people are sort of, you know, I, I've called myself out on— people might say, oh, she's against— she's not that he doesn't like love or doesn't believe in— I'm like, no, quite the opposite. I just want to open up the story to include all of this multitude of the ways that we can find good, healthy connection with people. So I'm deeply passionate about that. I'm deeply passionate about correcting these lies that we've been told and helping people manage their anxiety to a place where they can find the thing that humans want most, which is to be seen, to connect, right? To relate.
Emily: Yeah. That's gorgeous.
Dedeker: Well, yeah, that's gorgeous. That's a wonderful note to end on. So before we close out, let our listeners know, where can they find more of you and your work? Absolutely.
Sheva: I am on Instagram @theshrinkwrap. My practice is located in Orange County, California, but we practice all over California virtually. And also see clients internationally as well. And if the conversation that we had today is of interest to you all, my book Relationship OCD is able to be purchased anywhere books are sold and is a great place to start if this piqued your interest.
Dedeker: Sheva, thank you so much for your time. Thank you for your wisdom. I feel like a lot of wisdom in this episode that's applicable to a lot of relationship setups, not just people in this particular setup. So again, thank you so much. Hopefully we can talk some more in the future.
Sheva: Absolutely, my pleasure, and thank you so much for having me.
Dedeker: So for all of you listening out there, our question this week that's going to be on our Instagram: when it comes to relationships, how do you tell the difference between your anxiety speaking versus your intuition speaking? Again, you can go to our Instagram page to answer that question. We're super curious to hear from all of you out there. But also, the best place to share your thoughts with other listeners on this episode is in the episode discussion channel in our Discord server, or you can also post about it in private Facebook group. You can get access to these groups and you can join our exclusive community by going to multiamory.com/join. In addition, you can share with us publicly on Instagram @multiamory_podcast.
Dedeker: MultiAmory is created and produced by Jace Lindgren, Emily Matlack, and me, Dedeker Winston. Our production assistant is Carson Collins. Our theme song is Forms I Know I Did by Josh and Anand from the Fractal Cave EP. The full transcript is available on this episode’s page on MultiAmory.com.