Real event OCD involves obsessing over your past actions, which causes intense guilt and shame. Learn how to overcome real event OCD. Obsessive-compulsive disorder (OCD) is a mental health condition in which a person experiences intrusive thoughts (obsessions) and engages in specific actions (compulsions) to relieve anxiety caused by the obsessions. The compulsions are often
Obsessive-compulsive disorder (OCD) is a mental health condition in which a person experiences intrusive thoughts (obsessions) and engages in specific actions (compulsions) to relieve anxiety caused by the obsessions. The compulsions are often unrelated to the nature of the obsession, and the adverse consequences are almost always imagined and irrational.
Unlike most manifestations of OCD, real event OCD centers around an actual event that occurred in the past, instead of imagined expectations of future events. While everyone experiences guilt or regret, people with real event OCD become fixated on an experience that makes them question their character or morals, engaging in thoughts and actions that seek to reassure themselves.
Read on to learn more about real event OCD and its treatments.
People with real event OCD (also called real-life OCD) become fixated on actual events or past experiences that caused them to question their morality, making them feel as though they aren't a good person. They may replay the event over and over in their minds, analyzing all the details, and scrutinizing their role in it and any harm they may have caused through their actions.
They may worry about potential consequences of the event, such as losing a relationship with a loved one. They are also likely to take actions to reassure themselves, though this reassurance is short-lived.
The event can be something minor such as a rude remark to a customer service representative, something major like drinking and driving, or anything that makes them fear they are a bad person.
They may be focused on a recent event or something well in the past, such as an item they stole from a store as a child decades ago.
OCD symptoms may also be triggered by real-life experiences, like trauma. Traumatic experiences can include abuse, neglect, or other disruptions to family life.
Real event OCD is made up of the following three components:
For example, a person with real event OCD might experience:
Real event OCD obsessions can arise from anything that causes the person concern about their moral character, such as whether they are a good person, or potential future fallout stemming from the event.
These obsessions may include:
People with real event OCD tend to overestimate the importance of their actions. For example, they may ruminate regularly on a hurtful thing they said to a classmate in elementary school, worrying it caused them lasting harm, when their classmate doesn't remember the incident.
If they can't clearly remember every detail of the event, they are likely to assume something bad happened.
These obsessions cause anxiety that creates an urgent need to seek answers or reassurance.
A person with real event OCD will try to relieve the anxiety caused by their obsessions through compulsive actions. These might include:
The relief brought on by these compulsions is usually temporary. The intrusive thoughts seep back in, and the cycle begins again.
Guilt and shame have distinct differences from real event OCD, such as:
First-line treatment for OCD is behavioral psychotherapy (talk therapy). Medication can be helpful for some people in combination with therapy.
Cognitive behavioral therapy (CBT) involves identifying problematic thought and behavior patterns and gradually changing them into healthy ones.
The main form of CBT used for OCD is exposure and response prevention (ERP).
Under the guidance of a mental health professional, people with OCD are exposed to their fears at gradually increasing intensities. For a person with real event OCD, this might mean:
During this exposure, the person is urged to resist doing any compulsions or actions to try to reduce the anxiety.
Over time and repeated exposures, the person builds an increased capacity to resist the compulsions and, ideally, the obsessions reduce.
Medication like antidepressants may be used to help manage symptoms, particularly along with therapy to strengthen the effectiveness of both treatments. Sometimes, other types of medications are used to increase the benefit of antidepressants.
Antidepressant medications that may be prescribed include:
Selective Serotonin Reuptake Inhibitors (SSRIs)
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
Mindfulness involves allowing thoughts to come and go without assigning them judgment.
Acceptance and commitment therapy (ACT) is a type of psychotherapy that integrates aspects of mindfulness that can be used to teach people with OCD to accept their intrusive thoughts, rather than reacting or responding to them.
One of the goals of ACT is to separate the intrusive thoughts from the thinker, allowing them to be seen as separate entities and taking actions based on a person's values, not their obsessions. This way, they can acknowledge the thought as an "OCD thought," not as a fact.
Thoughts can also be reframed. For example, instead of thinking, "I am a horrible person," they might think, "I feel bad that I did that." Labeling the action—not the person—allows room for positive change.
From there, the person can take actionable steps to make the situation better now and/or avoid repeating the behavior in the future. This helps to move past the situation in a healthy, productive way, instead of being caught in an obsessive-compulsive cycle.
Support groups are not a substitute for professional treatments like therapy, but they can be very valuable. Talking to others who understand your experiences firsthand is a great way to foster community, share resources, and offer and receive support.
The International OCD Foundation offers great information on how to find (or start) support groups.
OCD cannot be treated with lifestyle changes alone, but developing healthy habits is important for overall health and can be a great support for traditional treatments.
Healthy habits worth adopting include:
Real event OCD is a form of OCD in which a person becomes consumed by thoughts and feelings of guilt about a real event that happened sometime in the past. These thoughts cause them to question their own morality. Compulsive actions follow in an effort to manage the anxiety triggered by the obsessions.
Real event OCD is typically treated with medication and/or behavioral therapy. Healthy lifestyle habits and mindfulness may also be beneficial.
Feeling a degree of guilt over an action that you believe caused harm is normal and can even be healthy. But if that guilt becomes consuming, is disproportionate to the actions, or you can't seem to stop fixating on it, see a healthcare provider or mental health professional. They can help you find healthy ways to manage your feelings and move past the experience.
OCD has previously been categorized as an anxiety disorder. However, it is now classified as its own disorder by the American Psychiatric Association. Real event OCD is one way in which OCD can manifest, but it is not a separate condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the American Psychiatric Association's manual for diagnosing mental health disorders.
Real event OCD centers around actual memories of specific experiences. While no one's memories are 100% accurate, the memories involved with this form of OCD are based in reality.
False memory OCD is a kind of OCD in which a person has intrusive doubting thoughts around past events. For example, a person may worry they have hit someone with their car while driving sometime in the past, but are unable to determine if that event really happened or was fabricated by their mind.