How OCD Impacts Relationships--And What You Can Do About It

Obsessive-Compulsive Disorder (OCD) is often misunderstood as simply being “extra neat” or “overly cautious.” In this blog post, we want to spotlight the deeper impact this disorder can have—not just on the individuals who experience it, but also on the people they love the most.

While the person with OCD endures intense anxiety and emotional distress, their family members, partners, and close friends often struggle too. Feelings of guilt, helplessness, frustration, and emotional exhaustion are common on both sides. But understanding the way OCD works—and the ways it draws loved ones into its cycle—is the first step toward healing.

OCD Often Targets What We Care About Most

A hallmark of OCD is that it tends to latch onto the very things a person values deeply—often their loved ones. Many individuals with OCD experience overwhelming anxiety that something terrible will happen to someone they care about unless they perform specific rituals or avoid certain actions. Jamie in Birmingham feels compelled to organize her home in very specific ways: she must turn all bottles in her pantry in a certain way, fold each towel so that the seams line up precisely, and ensure containers in her refrigerator never dip below half full. Beyond simply wanting her home in order, she feels that harm will come to her husband if she fails to follow these precise rituals. Though she knows this fear isn’t rational, the anxiety is all-consuming. When her husband puts groceries away “incorrectly,” she feels angry and hyper-responsible for his safety. Ian adores his newborn daughter, but he can’t shake the constant fear that something terrible will happen to her. He is compelled to pray for her safety multiple times per day and must start over if he does not say to the words to his prayer exactly right. His faith has always been a key part of his life, but unlike others in his Sunday school class, he finds that reassurance from praying for his daughter only lasts a few minutes before anxiety returns. He is also becoming increasingly sleep-deprived, as he feels compelled to repeat his prayers even while she is sleeping longer at night. He also must ensure that he was thinking  “good thoughts” when holding her and feels that he must always tap her crib exactly 7 times when putting her to bed.

OCD Pulls Loved Ones into Rituals

Heather in Huntsville is overwhelmed by anxiety about enjoying every moment of her children’s lives. She frequently seeks reassurance from her husband and mother that she’s cherishing her children enough and compulsively documents daily moments—ironically missing out on the very presence she craves. Even though her husband and mother try to be patient with her, she can tell they get frustrated by her endless need for reassurance. Sarah, a 13-year-old in Montgomery, is haunted by obsessive fears that she has harmed her family's or neighbors’ dogs. She checks in with her parents constantly, retraces her steps, and scours social media for tragic animal stories—all in a desperate attempt to relieve the crushing doubt. Her siblings aren’t allowed to keep any chocolate in the house because Sarah fears she will accidentally give it to one of their dogs. Sarah has become so distressed during the school day that her parents have left work to check on their dogs’ safety.  Carl in Mobile struggles with contamination fears, especially around food. His girlfriend has tried cooking romantic dinners for him. But when he repeatedly refused to eat unless he could check expiration dates on all ingredients she used, the tension took a toll on their relationship. A date at a food truck festival ended in conflict when Carl insisted on checking meat temperatures.

The Good News: OCD Is Treatable

The most effective treatment for OCD is Exposure and Response Prevention (ERP), a form of cognitive-behavioral therapy that helps individuals face their fears and resist the urge to engage in compulsions. It’s not just about reducing symptoms—it’s about regaining freedom and connection in relationships.

At Upward, in addition to measuring OCD-related distress, we also measure family accommodation (the ways loved ones unintentionally support OCD behaviors). During ERP, we often see not only symptom reduction in clients, but also dramatic improvements in family dynamics and stress levels.

What If a Child Doesn’t Want Therapy?

It’s not uncommon for individuals with OCD—especially children and teens—to resist treatment at first. SPACE (Supportive Parenting for Anxious Childhood Emotions) can be an extremely valuable tool for parents of children with OCD.

SPACE is a parent-based program that helps caregivers change their responses to a child’s anxiety or OCD. Even though the child isn’t directly involved in therapy, families often see significant improvements.

For example, Asher, a 14-year-old from Nashville, hadn’t slept in his own room for four years. With guidance through SPACE, his parents learned how to gradually support him—first by sitting with him while he fell asleep, then staying outside the door, and eventually moving downstairs. Over time, Asher was able to regain his independence at night and move on to address other OCD-related obsessions and rituals.

You Are Not Alone

OCD can create deep isolation—for both individuals and their loved ones. That’s why we at Upward are committed to supporting entire families and couples affected by OCD. In addition to ERP and SPACE, we offer treatment for related issues such as sleep problems and PTSD. We also provide couples therapy, which can be a powerful tool for navigating one partner’s OCD together or co-parenting a child with OCD.

We highly recommend the International OCD Foundation (IOCDF) for additional support, resources, and community. Loved ones of individuals with OCD often carry silent guilt or feel like they "shouldn't" be worn down. But your experience matters too. Support groups, educational programs, and the IOCDF’s virtual and in-person conferences are incredibly valuable both in helping you support your loved one and maintain your own mental health.

Here in Alabama, the newly formed OCD Alabama affiliate of the IOCDF will begin offering educational events and programming in 2026—so stay tuned for updates!

Final Thoughts

OCD is a tough opponent—but not an unbeatable one. With evidence-based treatment, education, and community support, both individuals and families can reclaim their lives.

If you or someone you love is struggling with OCD, know that help is available—and healing is possible.