What is Real Event OCD?
Real Event OCD is a subtype of obsessive-compulsive disorder (OCD), a mental health condition characterized by intrusive thoughts and repetitive behaviors that cause significant distress and interfere with daily functioning. As the name suggests, Real Event OCD can be defined as simply as “having OCD about real events”.
As humans, we have all done things in life that we later look back on and cringe. Most people can move on from these life experiences without incessant suffering and distress. However, OCD can sometimes latch itself on to a specific memory from the past. These events are typically personal in nature and involve a perceived moral or ethical transgression or ambiguous harm caused to others.
Individuals with Real Event OCD often obsessively review and analyze the details of the event, seeking reassurance or certainty about what happened. They may constantly question their intentions, responsibility, or the consequences of their actions. These intrusive thoughts and doubts can lead to intense anxiety, guilt, and a strong desire to prevent similar events from occurring in the future.
Here is an example of what these thoughts can look like:
“I remember I played doctor with my neighbor when we were both young children. I remember asking him to pull down his pants and when he did, I touched his genitals. I’m not sure why I started worrying about it now, but I must have replayed it in my mind a million times in the past few days. People are telling me that it was normal childhood play, but I am not 100% certain that I didn’t do something more sinister. Does this count as pedophilia? Is this boy traumatized because of what happened? If only I could every detail of what happened and exactly what I was thinking at the time….”
Real Event OCD Symptoms
As you can see from the example above, the difficulty with Real Event OCD is that that there is some kernel of truth to it. People might think this is a situation that is exempt from OCD because it actually did occur.
However, one of the big differences between “normal doubts” and Real Event OCD is that there is an extreme sense of urgency that something needs to be figured out right away—usually the question of whether you are a “bad” person. It involves the intrusive and threatening thoughts that urge you to engage repetitive behaviors to neutralize or to alleviate your distress temporarily.
Let’s look at some examples of obsession and compulsions involved in Real Event OCD:
Obsessions
- I drove drunk a few years ago. What if I hit someone and don’t remember because I was blacked out?
- I was roughhousing with my friend a few months ago and now he has a ruptured appendix—did I cause this? How rough was I being?
- Did the person I hooked up with consent to have sex with me? I can’t remember if I explicitly asked them.
- Did I purposely block this memory from my mind in order to forget that I am a bad person?
Compulsions
In Real Event OCD, individuals may engage in various compulsions to alleviate their anxiety. However, these behaviors typically provide only temporary relief and may perpetuate the cycle of obsessive thoughts.
Mental rituals are compulsions individuals perform to gain certainty about the authenticity of their memories and level of terribleness of their actions. They will obsessively replay the life situation and what likely happened, what should have happened, and what a ‘good’ person would have done. You may say things like, “What would I have done if this one factor changed?” and “How would others view what I have done?”
- Reassurance-seeking is the compulsive and urgent need to know how others perceive the incident in an attempt to reach some sort of resolution. This usually involves asking the same people the same question (albeit in different ways) dozens of times. Reassurance seeking can also involve extensive Internet searches to get more “evidence”.
- Confessing is a compulsion that individuals will do to absolve some of the massive guilt they are experiencing about the incident. If they feel that they have done something truly abhorrent, getting it off their chest by confessing their “sins” may make them feel better, as uncomfortable as the process may be. They don’t want to feel as if they got away with the horrible event.
Treatment
Individuals with Real Event OCD have already spent excessive amounts of time evaluating the situation from all angles and still getting nowhere. With that said, discussing and analyzing the event is not the approach want to take when treating this subtype of OCD. The most important thing to remember is that the event is not the problem, the OCD is the problem.
Treatment for false memory OCD usually involves:
Cognitive-Behavioral Therapy (CBT)
CBT is an evidence-based treatment strategy, is also integral in treating those with all types of OCD. This strategy works to identify commonly used thinking errors that serve to reinforce cycles of obsessions and compulsions.
Exposure and Response Prevention (ERP)
ERP is an evidence-based method of treatment within CBT. ERP exposes a person to a stimulus (i.e. person, person, thought or memory) that produces anxiety or discomfort. Throughout the exposure process, the individual is encouraged to actively resist engaging in their typical response to that trigger. This allows people to learn that their feelings of discomfort and doubts naturally subside on their own without them doing anything about it.
Acceptance and Commitment Therapy (ACT)
ACT is an additional treatment modality that can be incorporated into OCD presentation. The intolerance of uncertainty is very common for people struggling with OCD, and acceptance can be an integral part of treatment by learning how to tolerate feelings and thoughts that may have once seemed unmanageable. Excessive value is often placed on thoughts that people with OCD have, as if these compulsions signify some depravity of the person. Instead of trying to fight off compulsions with rituals, ACT helps guide the person towards acceptance of thoughts and feelings as part of the experience of life. ACT works to help teach the individual that these compulsions can come and go rather than being stuck.
Medications
Medications like selective serotonin reuptake inhibitors (SSRIs) may be prescribed to help manage anxiety and obsessive thoughts.
Seeking Mental Health Support
Schedule an appointment with Chicago Counseling Center . Our therapists specialize in OCD and can develop an appropriate treatment plan tailored to your specific needs. — Meet our team to learn more!