On This Page:ToggleReal Event OCD ObsessionsWhat Events Can Trigger a Real-Event Obsession?Real Event OCD CompulsionsExampleDo I Have Real Event OCD?How to Manage Real-Event OCD
On This Page:Toggle
On This Page:
Real Event OCD, also known as Real Life OCD, is a unique subtype of obsessive-compulsive disorder (OCD). People who suffer from Real Event OCD will experience unwanted, obsessive thoughts and fears around an actual event that occurred in the past.
Individuals with Real Life OCD become fixated on actual events or past experiences that make them question their character or morality or made them believe that they are not good or ethical people.
Cheating on an exam may trigger Real Event OCD in some individuals, particularly if they consider it a significant moral or ethical violation.
They might replay the event(s) over and over again in their heads, scrutinizing every detail, reciting every word they said, and analyzing any harm they may have caused through their actions.
“For the past 3 years my life has been hell ruminating over things I did/thought as a teenager, and I feel as though I’m putting up a facade whenever I interact with people. Like I’m some awful criminal with terrible secrets I need to hide. I hate myself. Logically, I know that what I did wasn’t that bad, but I just can’t convince myself.”
People who suffer from this type of OCD often overestimate the importance of their actions, and if they can’t clearly remember every detail of what happened, they are likely to assume the worst. These obsessions cause significant anxiety and distress, thus creating an urgent need to seek answers or reassurance.
Likeevery other type of OCD, the more you seek certainty, the less certain you will become. While the compulsive actions will provide a temporary sense of relief, this feeling is short-lived because new doubts or questions tend to re-arise soon thereafter.
Real Event OCD Obsessions
Obsessions often take the form of repetitive, persistent ideas,unwanted or intrusive thoughts, images, or impulses that are experienced as distressing.
Common examples of Real Event OCD obsessions include:
What Events Can Trigger a Real-Event Obsession?
There are an endless number of events that could trigger a real-event obsession.
The event could be something minor, such as making a rude remark to a customer service representative or cheating on a test, or something more major, like driving drunk or making a racist comment.
Essentially, any event that makes someone fear they are a bad person can trigger these obsessive thoughts.
Other examples include: breaking up with a significant other, cheating in a relationship, having sex with someone who seemed reluctant, plagiarizing on an assignment, or stealing.
They can be focused on a recent event or something from far in the past, such as stealing from a store as a child many years ago.
Real Event OCD Compulsions
Compulsions are repeated patterns of ritualistic behaviors, used to reduce anxiety and prevent an outcome, following a strong obsessive urge to do so.
Common examples of Real Event OCD compulsions include:
Example
Real Event OCD is made up of three components:
Do I Have Real Event OCD?
It is common for everyone to reflect on past events occasionally and wonder whether we should have done or said things differently.
We might even berate ourselves about something we said or did that we wish we had handled more effectively, or experience momentary guilt over the consequences of our past behaviors. But, these reflections and feelings often fade over time without much rumination or distress.
Someone with Real Event OCD, on the other hand, will spend hours over-analyzing, fixating, and ruminating on past events.
They will replay events repeatedly in their head and excessively seek reassurance from others to gain a sense of certainty that they did not do anything wrong and are not a bad person. This process of engaging with the thoughts indicates that it may be OCD.
These individuals often find themselves trapped in the past, unable to engage in the present moment. They suffer from excessive feelings of guilt, shame, doubt about their actions, and an overwhelming sense that they are immoral or shameful.
They will find themselves in a never-ending quest to find certainty and relief, but this relief is always short-lived as additional doubts and fears seem to be constantly regenerated in their minds.
Real-Life Personal Experiences
It was bearable for a large part of those years, only coming up every once in a while. This summer and into December, it was the worst it had ever been. Constant feelings of I am a bad person, how can I live with the mistakes I have made, you know the deal if you have real event OCD.”
“This cropped up for me the other day. I had a small verbal confrontation with someone while out with my daughter for March break (they failed to stop at pedestrian stop and then chose to honk and complain to me about it.) I kept replaying it throughout most of the day. Did I respond right, was I wrong, etc.”
“I am still scared of death and sometimes I am afraid that If I don’t do something, something bad will happen to someone I love or to me. I had some bad experiences with OCD. One of them was when one my friend’s dad died and the thoughts made me think that it was my fault because I didn’t do something that my brain wanted to.”
How to Manage Real-Event OCD
Someone with Real Event OCD will exert much energy and time to try and find certainty around a past event, making it very difficult to live and embrace the present moment.
OCD can be treated and managed effectively. You canlearn to manage how your symptomsaffect your daily life through medication, therapy, mindfulness, or a combination of treatments.
Self-Management Techniques
In addition to seeking professional help, people with OCD can practice several techniques in their daily lives to manage their obsessive thoughts.
One of the problems with OCD is people treating their intrusive thoughts as enemy, not accepting them:
Exposure and Response Therapy
As with all OCD subtypes, Exposure and Response Therapy (ERP) is a type of CBT considered the first-line psychotherapy for OCD.
At least half of the people who seektreatment for OCDwill show symptomatic remission over the long term and experience an increased quality of life and improved functioning.
The best outcomes occur in individuals who are diagnosed early and start an intense treatment program right away. Depending on the severity of OCD, some people may need longer-term or more intensive treatment.
InERP, a person works with a therapist to identify both external and internal triggers that cause them stress and make them want to behave compulsively. ERP is designed to gradually reduce theanxietythat feeds the obsessions and compulsions through a process called habituation.
The goal of habituation is to purposely invoke anxiety in attempts to disrupt the neural circuit between the processing and action parts of the brain.
In the case of Real Event OCD, a common form of ERP therapy is to use an imaginal exposure script. Imaginal Exposure involves vividly imagining the feared object, situation, or activity. The goal is to create a first-person, present tense, detailed narrative of the worst-case scenario occurring.
By writing out the story as it happened, as specifically as possible, people can learn that catastrophes are less likely than they expect and that they can cope with the catastrophe if it ever does happen.
As part of this exercise, you can also draw a picture of the location, the event, or the person involved, or listen to music that makes you think of the time.
Sources
Pozza, A., & Dèttore, D. (2019). “Was it real or did I imagine it?” Perfectionistic beliefs are associated with dissociative absorption and imaginative involvement in obsessive-compulsive disorder.Psychology Research and Behavior Management, 603-607.
Rosso, G., Albert, U., Asinari, G. F., Bogetto, F., & Maina, G. (2012). Stressful life events and obsessive–compulsive disorder: clinical features and symptom dimensions.Psychiatry research,197(3), 259-264.
Vidal-Ribas, P., Stringaris, A., Rück, C., Serlachius, E., Lichtenstein, P., & Mataix-Cols, D. (2015). Are stressful life events causally related to the severity of obsessive-compulsive symptoms? A monozygotic twin difference study.European psychiatry,30(2), 309-316.
Florence Yeung
BSc (Hons), Psychology, MSc, Clinical Mental Health Sciences
Florence Yeung is a certified Psychological Wellbeing Practitioner with three years of clinical experience in NHS primary mental health care. She is presently pursuing a ClinPsyD Doctorate in Clinical Psychology at the Hertfordshire Partnership University NHS Foundation Trust (HPFT). In her capacity as a trainee clinical psychologist, she engages in specialist placements, collaborating with diverse borough clinical groups and therapeutic orientations.
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Julia Simkus
BA (Hons) Psychology, Princeton University
Julia Simkus is a graduate of Princeton University with a Bachelor of Arts in Psychology. She is currently studying for a Master’s Degree in Counseling for Mental Health and Wellness in September 2023. Julia’s research has been published in peer reviewed journals.
