Couple coping effectively with OCD, walking outdoors with their son

“Side by Side: Navigating OCD Treatment with EFT Couple Counseling”

Last week I did a presentation on what I was very surprised to find is an under-recognized area of OCD treatment: the impact of attachment theory on relationships affected by OCD.  Thrive Wellness co-sponsored an OCD Symposium in Reno that provided the opportunity to discuss OCD from a relational perspective. This article shares (in broad strokes) some key points from the presentation. In the “conclusions” section I focus on specific ways Emotionally Focused Therapy (EFT) can support couples facing the challenges posed by OCD in a connected, teamed-up way.

Understanding OCD within the Relationship Context

OCD’s influence on relationships extends beyond the individual symptoms of compulsions and obsessions. It can disrupt the normal flow of emotional connectivity and communication, leading to misunderstandings and emotional distance.

Assessment and Education

The therapeutic process begins with assessing the specific ways OCD affects the relationship and educating both partners about the disorder. This foundational step helps demystify OCD and sets the stage for collaborative problem-solving.

Identifying Patterns

Identifying negative interaction patterns is crucial to improving your relationship. For instance, compulsive behaviors might lead to frustration in one partner, resulting in a cycle of withdrawal and disconnection. Recognizing these dynamics allows couples to start addressing them.

Facilitating Emotional Engagement

Creating a Safe Space: A core aspect of EFT is creating a safe environment for both partners. This involves encouraging openness and vulnerability, especially for the partner with OCD, to share their fears and needs without fear of judgment.

Expressing Emotions: The therapist guides both partners in expressing their feelings related to the OCD symptoms, uncovering often-hidden emotions like isolation or resentment. This step is vital for understanding each other’s experiences.

Reframing the Problem: Viewing OCD as a shared challenge rather than a source of division is a powerful reframing technique. It encourages a united approach to managing the disorder’s impact on the relationship.

Enhancing Connection and Understanding

Through guided conversations, the therapy helps deepen the emotional connection. The partner with OCD explores and expresses their deeper fears, while the other partner learns to articulate their emotional experiences, leading to a strengthened bond.

Promoting Acceptance and Building New Patterns

Accepting the presence of OCD in relationship while working on effective management strategies is a delicate but necessary balance. The therapist works with the couple to develop new responses to OCD symptoms that foster connection rather than disconnection.

Consolidating Gains

Therapeutic progress is solidified by experiencing and discussing new ways of interacting outside of therapy sessions. This step is crucial for ensuring that the relationship continues to grow stronger, even in the face of OCD.

Collaborative Approach with Individual Therapy

A collaborative approach, involving coordination with the partner’s individual OCD treatment, ensures that therapy addresses both the couple’s relationship dynamics and the individual’s OCD management.


The OCD Symposium in Reno served as a valuable forum for discussing the integration of attachment theory into the treatment of OCD-affected relationships. Emotionally Focused Therapy offers a framework for couples to navigate OCD’s challenges, emphasizing the importance of a secure emotional bond and effective communication.

Here’s how EFT could be effective for couples where one or both partners have OCD:

  1. Improving Communication: EFT helps couples communicate more effectively, especially about sensitive issues like the impact of OCD on their relationship. It encourages partners to express their feelings and needs more openly and empathetically.
  2. Enhancing Emotional Support: By focusing on emotional attachment, EFT helps partners become more responsive to each other’s needs. For someone with OCD, having a supportive partner who understands their struggles can be crucial for managing symptoms.
  3. Reducing Relationship Stress: OCD can add significant stress to a relationship, which can exacerbate OCD symptoms. EFT aims to reduce relationship tensions by improving emotional connection, which can, in turn, create a more supportive environment for managing OCD.
  4. Building a Secure Attachment: A secure attachment can provide a solid foundation for individuals with OCD to face their fears and engage in exposure and response prevention (ERP) therapies more effectively. Knowing they have a supportive and understanding partner can make facing OCD challenges less daunting.
  5. Improving Coping Strategies: Couples can learn to identify and modify maladaptive coping strategies that may be reinforcing OCD symptoms. EFT encourages healthier ways of coping with emotional distress, which can indirectly help in managing OCD.
  6. Enhancing Treatment Compliance: Individuals with OCD who feel supported in their relationships may be more likely to adhere to individual OCD treatment plans, including medication and cognitive-behavioral therapy (CBT).

Closing thoughts about OCD and Relationship

It’s important to note that while EFT can improve the relationship dynamics that affect and are affected by OCD, it does not directly treat OCD symptoms. For direct treatment of OCD, evidence-based approaches such as CBT and ERP are recommended. Couples therapy, including EFT, can be a complementary approach to these treatments, especially for addressing the relational aspects of living with OCD.

The journey towards understanding and managing the relational impact of OCD is ongoing. As we continue to explore this intersection, the insights gained can guide more nuanced and effective approaches to support couples in strengthening their relationships in the face of OCD.

Feedback and dialogue on this topic of OCD in relationship are welcome. Please share your thoughts or experiences regarding the role of attachment theory in OCD treatment. For further discussion or inquiries, feel free to contact me at:

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