Thematic Analysis of the Experiences of Individuals with Obsessive Thoughts in Managing Interpersonal Relationships

Abstract

This study aimed to thematically analyze the experiences of individuals with obsessive thoughts in managing interpersonal relationships. This qualitative study was conducted using thematic analysis. The participants were 18 individuals with obsessive thoughts living in Tehran, selected through purposive sampling until theoretical saturation was achieved. Inclusion criteria were a clinical diagnosis of obsessive-compulsive disorder by a psychiatrist or clinical psychologist, predominance of obsessive thoughts in interpersonal contexts, age between 18 and 45 years, and willingness to provide informed consent. Data were collected exclusively through individual semi-structured interviews. Each interview lasted between 45 and 75 minutes, was audio-recorded with participants’ consent, and was transcribed verbatim. Data were analyzed according to Braun and Clarke’s thematic analysis framework using NVivo software. Four main themes were extracted from the data: “obsessive self-monitoring in interaction,” “reassurance seeking and relational exhaustion,” “avoidance, concealment, and emotional distancing,” and “relational reconstruction through boundaries and conscious dialogue.” Participants described that intrusive thoughts about harming others, being judged, contaminating others, being unlovable, or making relational mistakes led them to manage everyday interactions through excessive control, persistent doubt, mental review of conversations, and repeated reassurance seeking. At the same time, some participants reported that therapeutic awareness, reduced reassurance seeking, and limited but honest expression of needs helped them improve relational quality. The interpersonal experience of individuals with obsessive thoughts is not merely a direct consequence of symptoms; rather, it reflects a cycle of intrusive thoughts, threat appraisal, shame, reassurance seeking, avoidance, and efforts to preserve relationships. Clinical interventions should therefore address not only obsessive symptoms but also communication skills, tolerance of uncertainty, reduction of reassurance-seeking behaviors, and psychoeducation for significant others.