A module based treatment approach
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1 A module based treatment approach
2 Heterogeneous Intimate relationship are important OCD and intimate relationships Functioning, marital distress, less likely to get married OCD symptoms impair relationship quality
3 Clients More complex than OCD No Studies No documented solutions
4 Relationship-related obsessive-compulsive symptoms
5 IT consultant, lives with partner 3 years in relationship (12 months living together)
6 Relationship-Related OC Symptoms Centering on the relationship itself My feelings Partner s feelings Rightness of relationship Partner s flaws (Appearance, morality, etc.,) Relationship-centered OC symptoms Partner-focused OC symptoms
7 Obsessive form pop into head Egodystonic values and experience Unwanted Associated with neutralizing behaviors Significant distress/impair functioning
8 Answer criteria of OCD Obsessions intrusive thoughts, images or urges the person attempts to neutralize and recognizes as a product of their own mind not excessive worries about life problems Compulsions compulsive reassurance seeking (e.g., sanity checks ) checking (e.g., monitoring of emotions) comparing (e.g., looks, feelings in past relationships) Causes significant distress and dysfunction
9
10 Relationship-Related OC Symptoms Centering on the relationship itself My feelings Partner s feelings Rightness of relationship Partner s flaws (Appearance, morality, etc.,) Relationship-centered OC symptoms ROCI Partner-focused OC symptoms PROCSI
11 12 items Feelings towards one s partner (α=.84) I feel that I must remind myself over and over again why I love my partner The "rightness" of the relationship (α=.89) I constantly doubt my relationship Partner's feelings (α=.87) I find it difficult to dismiss doubts regarding my partner's love for me
12 24 items Partner's perceived in six domains When I am with my partner I find it hard to ignore her physical flaws I am troubled by thoughts about my partner's social skills I am constantly bothered by doubts about my partner's morality level
13 Domain specific Self-vulnerability (relationships) Response (compulsive monitoring of own emotions) Domain specific triggers (dinner with partner) Insecure Attachment Strategies OCD beliefs Catastrophic relational beliefs Appraisal (maybe I don t love my partner) Intrusion (I am bored)
14 Domain specific Selfvulnerability Response Domain specific triggers Attachment Strategies Appraisal Intrusion OCD beliefs Catastrophic relational beliefs
15 Self Structure Contingency on relationship domain Contingency on partner value Sensitivity in relationship domain Personality Characteristics Narcissistic tendencies OCPD Attachment Insecurities Self Vulnerability
16 Personality Self Structure Domain specific Selfvulnerability Increased Attention (inwards and/or outwards) Attachment Strategies Response Appraisal Domain specific triggers Intrusion Contextual Interaction with partner Romantic cues Emotional States Boredom Anger Anxiety OCD beliefs Catastrophic relational beliefs
17 Obsessive Beliefs if not perfect it is worthless having a thought means it is important harmful events will happen unless I m careful Intrusion I am bored Relationship Beliefs if I leave, I will hurt my partner regret is unbearable "you should only marry once leaving my partner will have disastrous personal and social consequences Catastrophic Appraisal Maybe I don t love him/her, I have to leave I have to make sure I love my partner I will regret this forever
18 Personality Self Structure Domain specific Selfvulnerability Increased Attention (inwards and/or outwards Insecure Attachment Strategies Response Domain specific triggers Contextual Interaction with partner Romantic cues Emotional States Boredom Anger Anxiety OCD-related beliefs Appraisal Relationship beliefs Intrusion
19 Response Insecure Attachment Strategies Catastrophic Appraisal
20 Catastrophic Appraisal Insecure Attachment Strategies Response
21 Catastrophic Appraisal Emotional regulation attempts Exacerbation of distress Insecure Attachment Strategies Response Emotional responses Anxiety Guilt Shame Jealousy Cognitive-Behavioral responses Reassurance(self/others) Monitoring (feelings/behaviors) Comparisons
22 Emotional responses Cognitive- Behavioral responses Personality Response Self Structure Domain specific Selfvulnerability Self criticism Conditioning prevents refuting Domain specific triggers Attachment Strategies Appraisal OCDrelated beliefs Relationship beliefs Intrusion reinforcing relationship doubts
23 Emotional responses Cognitive- Behavioral responses ROCD Responses ROCD responses Commitment
24 Rusbult Investment Model Investment Commitment Alternatives Satisfaction
25 Rusbult Investment Model Investment ROCD Commitment Alternatives Satisfaction
26 Investmen t ROCD Commitment Alternative s Satisfaction
27 ROCD responses Commitment
28 Domain specific Self-vulnerability (relationships) Response (compulsive monitoring of own emotions) ROCD Domain specific triggers (dinner with partner) Insecure Attachment Strategies Commitment OCD beliefs Catastrophic relational beliefs Appraisal (maybe I don t love my partner) Intrusion (I am bored)
29 Development
30 Predisposing general vulnerabilities (biological/psychological) Insecure attachment representations Self vulnerabilities Schemas May be latent Maladaptive Relationship beliefs and OCD-related beliefs Assumptions biases Triggering event Negative relationship appraisals NATs Symptoms Cognitive, behavioral, emotional, physiological
31 Early experiences Parenting Parenting models (parental conflict, idealized parents) Criticism Preoccupation with relationships Conditional parenting in specific domain Overprotective parenting
32
33 ROCD/OCD Correlated but distinct Depression Relationship/sexual satisfaction General worry Processes Self vulnerabilities Attachment and emotional regulation Maladaptive relationship biases
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