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“I really care about my wife,” my new patient Ed told me, “but I just can’t get this idea out of my head that I don’t actually love her.” Ed was a fifty-one year old successful businessman and entrepreneur. Over the last two years he had been increasingly troubled by repetitive thoughts about his wife not being “the right one” for him, that he would never be happy with her, and that unless he left her, he would forever feel trapped in this unhappy relationship. He would stare continually at other women as a way of double-checking, to see if he found them more attractive than his wife. As he looked, he wondered, “Do I have to leave her because she isn’t attractive enough for me, or because these other women look more attractive?” This staring had gotten him into difficulties on several occasions. He and his wife had two children and their marriage had always been a generally happy one. He felt very isolated with these thoughts, and had never shared them with his wife.