To continue the conversation from our last blog, “Infatuation or Love?” I want to expand upon this conversation by discussing how infatuation can be exacerbated when paired with symptoms of Obsessive Compulsive Disorder (OCD). The obsessive thoughts and compulsive behaviors regarding the infatuated relationship can become all-encompassing, putting other aspects of self on hold, including sleeping, eating, work, and self-care. This blog will begin to identify how these symptoms come together, ways to manage them, and how to prioritize yourself and your needs.
Infatuation is the intense and overwhelming feeling of attraction towards someone or something. It is described as a whirlwind experience, with a deep captivation that will cause a person to create ideals and assumptions that may not be the reality. It can include overlooking certain behaviors or boundaries for the other person. Limerence comes into the picture when the infatuation evolves into an involuntary state of obsessive and intrusive thoughts. There is often uncertainty in this relationship that the person, or Limerent Object (LO) that the obsession falls over, shares the same desires. That uncertainty can then begin to play into certain symptoms for those who are managing obsessive-compulsive disorder (OCD), mainly around perceived feedback and reciprocation of those desires.
Relationship Oriented Obsessive Compulsive Disorder (ROCD) picks up when the typical symptoms of OCD, like obsessive thoughts and compulsive behaviors to qualm the anxiety surrounding the obsessive thoughts, are directed towards an infatuated person or relationship. These ruminating thoughts may be driven by fear of losing the relationship, like fear of rejection and abandonment or the safety experienced because of the relationship. These thoughts typically express themselves in two different ways depending on the connection structure to the individual. Partner-focused is defined when the individual is in a defined relationship; there may be a constant obsession with flaws in their partner. For example, an obsessive flaw can be physical attractiveness or suitability on an emotional level. It can stoke compulsive behaviors to soothe the anxiety about the success of dating this person. Relationship-focused is when there is a fear or concern that the relationship will not succeed. There may be obsessive thoughts about getting that person to like them back or when they will see them again the next time, anything to strengthen the connection despite set boundaries. Compulsive behaviors can then begin to review what was said to redefine past conversations into something soothing instead of anxiety-provoking. Checking social media and text messages for additional communication can include fear of sending information that would be too revealing or jeopardize the safety or success of the relationship.
The causes of intrusive thoughts in both limerence and ROCD are similar from a biopsychosocial perspective. The brain has lower serotonin levels and elevated neurotransmitters like dopamine and norepinephrine. When there is a focus on partner-centered thoughts and behaviors, maybe a desire to engage in a romantic relationship or a genuine extreme physical attraction to someone, the hormones can increase in the central nervous system, instigating the obsession. Many clients have also shared that an overall obsession with the role of a partner and a desire to be in a relationship can create a situation where infatuation can latch onto an individual and place them into that role.
When treating limerence and ROCD outside of medication management of SSRIs, Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention Therapy (ERP) are the treatments with the most evidenced-based success. There is importance in challenging these rigid and obsessive thoughts, understanding how the compulsive behaviors fit into the situation, and cognitively challenging those as well. Using grounding techniques like physical and mental grounding or guided breathing and meditation can be helpful in situations where the thoughts and behaviors are overwhelming. As always, reach out to a mental health professional and support systems when things are too much to manage independently.
Case Study
The client, a 32-year-old heterosexual Caucasian female, was seeking treatment for their ROCD symptoms as they related to a new co-worker where infatuated intrusive thoughts were causing extreme discomfort. The client shared intense physical attraction to this person and a lack of activity in their love life over the past few years, creating a perfect storm of attaching these feelings of infatuation and limerence onto this individual. From the start, there was a concern over the reciprocated feelings of attraction. Still, when the client eventually shared their feelings with the co-worker, he confirmed that he wanted to keep their relationship professional. It was challenging for the client to accept this boundary, and the individual redirected their attention into becoming best friends with the co-worker to secure a connection to the Limerent Object.
The client reported symptoms of obsessive thoughts for hours about when would the next time they would be together outside of work be, including a great deal of energy reading and rereading text message conversations for fear of saying something that would jeopardize the friendship and reveal that the client still had romantic feelings for the co-worker. The client reported symptoms of additional compulsive behaviors, replaying any interaction they had in their mind for hours each day, preventing them from leaving the house and impacting their performance at work. When friends suggested space between the two of them, this only increased their anxiety about losing the relationship altogether.
For this client, it was essential to explore and contextualize the desire for a partner and the extreme infatuation of this one person. A large portion of the client’s work came to accepting and respecting the boundary that their co-worker set and understanding that other options can meet the needs and desires of their long-term relationship. The clinician and the client spent much time challenging the cognitive beliefs that were so rigid around the co-worker being the only person for them, as well as challenging the paranoid and delusional thoughts surrounding the behavior with factual and grounding information.
Ultimately, it became very important to contextualize for the client how their behavior and infatuation had monopolized their life’s focus onto something they had no control over. The client was no longer prioritizing their own needs and instead putting all their energy and affection into someone who could not give it back in return. Through the client’s treatment plan, the client and clinician identified that the lack of romantic relationships at this stage in life had significantly impacted the individual’s self-esteem, adding additional complexity to the situation as they perceived their entire self-worth from the connection to this external relationship. It was then important, in addition to CBT and ERP, to focus heavily on increasing self-esteem from within and not relying on external factors. Prioritizing self, identifying desires, and setting reasonable goals became the foundation of the individual’s care plan.
