need help with Relationship OCD

[jeremy dutch]

I have a unique form of Relationship OCD and I wanted to see if there was anyone else out there with this type of OCD.

Brief history: I've had OCD since I was 13. It started with contamination OCD, and then turned into Gay OCD when I was 17 and lasted for 7 years. Then I learned about H-OCD and my Gay OCD vanished.

I'm 35 y/o and I've dated girls since my early 20's, but none of them turned into a girlfriend for 10 years. I found that there was always "something wrong" with the appearance of the girls I dated, they were never good looking enough, so I wouldn't commit.

After 10 years of this I decided I needed to do something or I'd stay single forever. I've always valued companionship enormously, and spending my life alone just doesn't fit me. So, 2 years ago, when it things started going well with one of my dates, I decided to "push through" the anxiety of her not being perfect and the urge to end it. I wanted to get out of this perfectionistic pattern because it hasn't been working well for me. It didn't got that well. My R-OCD became really obvious. Intense and near constant anxiety, panic attacks triggered just by seeing her, etc. Eventually I broke up with her after 7 months.

Which leads us to the present moment (I'm now 35 yo). I went on a date once with a girl and we had the best talk I ever had on a date. As always, though, there was a "but" : she was below my "bar" in terms of attractiveness. At the end of the date I remember kissing her anyway, but I didn't think I'd see her again. After I talked about it to my OCD therapist, he told me he thought it would be a good idea to see her again. I immediately started crying. Maybe I knew the pain that was ahead. To be clear, the flaws I obsess about are exclusively on her face: her nose (too big), her upper lip hair (too much of it), her skin defects, and sometimes more generally an overall felling of "ugliness".

Fast forward a year and a half. I'm still with her.  We're in a relationship now. I think I really liked her (she's really amazing) and also I didn't want to let my OCD win. The ROCD about her face never stopped, and it's been a very tough year and a half. I've kept on seeing the same therapist (a renowned OCD therapist) who keeps on telling me to treat the topic with irrelevance, but I'm stuck. My OCD is as bad as on day one.

I spend most of my days in "fight or flight" mode. It is only about her face, nothing else. I think her nose is too big, or she's not attractive enough.
The typical scenario is like this: I'm going to look at her:
- 50% of the time I'm gonna think she's "acceptable", no anxiety, phew
- 50% of the time I'm gonna think she's not acceptable. In most cases I'm going think she looks ugly as hell. Massive anxiety. I'm going to sit with the anxiety. Sooner or later I'm going to look at her again, and it's a coin toss again. But usually I have "streaks" when I'm going to find her ugly most of the day and those days are hell. Some days I think she looks "acceptable" all day. How much of that is reality and how much of that is in my head: i don't know, and that question itself terrifies me.

My greatest fear is that her ugliness is real and I should break up with her. The paradox is that I think that she really is bad looking (or ugly) a good deal of the time, but somehow I don't want to break up with her.

Our relationship, besides that, is really great. I tell her I love her and I think i mean it. That also is so ****** up: how can you love a woman and at the same time find her ugly most of the time? We have sex, I'm never in the mood but I still do it like every week and enjoy it. She knows I have OCD but has no idea it's about her.

I've never asked anyone what they think about her face, because that would be a compulsion, right? My best friend told me she's pretty but well he's my best friend. Another guy once implied she didn't look stunning. But that's pretty much it, I don't have anything but my own perceptions to base "reality" on. And my perceptions tell me she's ugly 50% of the time I look at her. My therapist once told me I have BDD by proxy (it's like BDD but targeted at someone else). I don't know if he's right: I can't prove or disprove her flaws are really that bad. But it's clear I have hyper-vigilance to her facial flaws.
 
I don't know what to do, I feel stuck, I'm desperate. I've worked so hard and done hundreds of hours of exposures, in vain. I suffer a lot. I'm crying typing this.

I stopped meds 2 months ago and the anxiety is massive, I don't know how long I can take this. I meditate and run every day.

Any help is greatly appreciated.

[Ashley]

Hello Jeremy,

I'm sorry that you're having such a challenging time right now because of OCD.     You mentioned coming off meds a couple of months ago, I wonder if it's worth you talking to your GP about perhaps going back on them?  Obviously I am not a doctor, so this may not be the right choice for you if you are struggling  at the moment it may be worth considering go back on meds. That's perhaps one for you to discuss and chat with your GP.

But how fantastic you have managed to stand up to the OCD to be with your gf for the last 18 months, fingers crossed you can get some good help and support to ensure OCD doesn't impact on your relationship in the future too. 

I do have a couple of other more generic thoughts (which you are of course welcome to ignore), but based off what you have written.

 

1 hour ago, jeremy dutch said:

I've kept on seeing the same therapist (a renowned OCD therapist) who keeps on telling me to treat the topic with irrelevance, but I'm stuck. My OCD is as bad as on day one.

 

1 hour ago, jeremy dutch said:

My therapist once told me I have BDD by proxy (it's like BDD but targeted at someone else).

 

I think you might need to consider finding a new therapist, partly because by your own admission you are not making any progress at all. You didn't say how long you have been with them, but is it the full year and a half? If so then definitely time to change.  A fresh approach, a fresh dynamic can something be a great way to kick start therapy.

The other reason is the BDD by proxy comment, whilst I am not a therapist that sounds ridiculous to me. I would suggest the problem is clearly the OCD, which unfortunately is focussing on your girlfriends looks. I could be wrong, but it sounds questionable to me, and coupled with the no therapy progress time to find a new therapist IMO.

If you're in the UK then of course one of the specialist OCD treatment clinics may be a good option (although some wait times).

 

 

1 hour ago, jeremy dutch said:

Brief history: I've had OCD since I was 13. It started with contamination OCD, and then turned into Gay OCD when I was 17 and lasted for 7 years. Then I learned about H-OCD and my Gay OCD vanished

I hear this all too common, how OCD changes, especially with people insisting using terms like HOCD and ROCD.  This is really important to focus on recognising the problem, not the R part but the OCD part so it is important to not think of yourself as having ROCD, you don't, you have OCD.  

That's not to say the fact your OCD is focussing on the relationship is irrelevant, part of the cognitive process of helping you understand what's driving the OCD will be to look at that, understand why that causes so much anxiety. A similar process could be applied to your past worries about sexuality and what that really meant to see if there is any common area of concern driving the OCD for both themes.

 

2 hours ago, jeremy dutch said:

've worked so hard and done hundreds of hours of exposures, in vain.

They've not been in vain Jeremy, you're still with your gf after 18 months and that's amazing!  Also, all the exposures in the past, can help us make further progress in the future!  So they're not in vain. 

What you may need to do with your therapist, or new therapist is review some of those exposure exercises, make sure you were not subconsciously neutralising. Also all the behavioural exercises in the world won't matter if we are not fully exploring the cognitive aspect of therapy (which I partly mentioned above).

Stay strong, you can do this!