Dealing With Real-Event OCD

Remember that thing you did that one time? That thing you said? The way you treated that person? How awful was that? How shameful?! That wasn’t like you, and that definitely is not reflective of who you are, what you believe, and the type of person you want to be. Right? What if it is? If you could go back in time, what would you do differently? How would they respond? Am I going to do that again? How can I make sure it won’t ever happen again?

What is Real-Event OCD?

Wooden Box full of old pictures. Real-Event OCD
Real-Event OCD can feel like a frantic search through a box of one’s memories to find the missing evidence to prove that someone is still OK.

Real-Event OCD, also known as Real-Life OCD, is a manifestation of Obsessive Compulsive Disorder (OCD) where the focus and theme is some event or pattern of events that actually happened and whether those events reflect something about one’s character or cause some personal catastrophe. In response to the thought or remembrance of this event, a Real-Event OCD sufferer may struggle to give themselves reassurance that they are still a good person, that they would not do that again if given the opportunity, and that the event and its results are not as bad as they fear.

As a brief overview, OCD is an anxiety disorder from which the sufferer is plagued by thoughts, sensations, mental images, or emotions that cause a significant sense of dread, guilt, or fear. These obsessions are stories about what could happen, what has happened, or may be true, and these feared stories make the sufferer feel any number of unwanted emotions, including anxiety, fear, sadness, uncertainty, or emptiness. To restore a sense of certainty in oneself, the world, or the future, or at least make the unwanted feeling go away, the OCD sufferer will compulsively engage in rituals, safety or reassurance seeking, checking, or avoidance. Once completed, they receive a temporary sense of relief. However, this feeling is short-lived because new doubts or questions are shortly around the corner.

Real-Life OCD vs OCD?

What sets Real-Life OCD apart from other OCD subtypes like Sexual Orientation OCD (HOCD), Scrupulosity, and Contamination OCD, is that the triggering thought or event actually happened. Typical OCD subtypes revolve around potential events or possible outcomes that could happen if the suffer does, or does not do, something. In this case, they are trying to stop something from happening or eventually being true.

For example, in a case of Sexual Orientation OCD (HOCD), someone may be obsessed with whether or not they are gay, despite the fact that they have never experienced genuine romantic feelings toward someone of the same sex, nor would they acknowledge having interest in pursuing a same sex relationship. Despite this, they may engage in compulsions to prove their heterosexuality by scrutinizing their feelings and thoughts, comparing their level of attraction to the same sex vs the opposite sex, or simply avoiding being around or looking at same sex individuals.

Notice, the obsession is not about a real event that has actually happened, but what could happen or may be true.

On the contrary, Real-Event OCD is triggered by something that has happened. For example, someone with Real-Event obsessions may become fixated on a time they stole something from a store while in high school. This event may have happened years or decades prior and have since not stolen anything nor broken any other laws. Nevertheless, the sufferer may ruminate about their actions in order to find some sense of emotional peace so they can let themselves off the hook and move on with their life.

What Events Can Trigger a Real-Event Obsession?

While not an exhaustive list, the following are some common situations that can be the obsessional source people with Real-Event OCD.

  • Actually kissing someone of the same sex
  • Touching, experimenting, or “playing doctor” with someone when younger
  • Driving drunk
  • Breaking up with someone in “the worst way”
  • Cheating on a test
  • Cheating in a relationship
  • Saying something racist or making racist jokes
  • Actually viewing child pornography
  • Having sex with a person who wasn’t 100% into it

Real-Event OCD Common Obsessions

Woman cheating on a test. Real-Event OCD

Real-Event OCD obsessions focus on questions of moral character and future repercussions. They can be in the form of a “What if…” question, repeating mental image of the event, rapid succession of images or scenes from the event, or even statements of fact about one’s character, personality, or consequences.

  • “What if that thing I did means I’m an awful person?”
  • Repeated mental images from past events
  • Overwhelming feelings of guilt, shame, embarrassment, or fear
  • Thoughts about being punished, cancelled, or caught for your past deeds
  • “I’m a terrible person”

Real-Life OCD Common Compulsions

Compulsions in all OCD subtypes can be both overt or covert, meaning inside one’s mind or outward through physical action. Real Event OCD is no different. Compulsions with this subtype likely consists of a mix of both inward ruminative thoughts and outward behaviors. Real-Event OCD compulsions may include:

  • Calling police officers or lawyers to discuss the ramifications and potential consequences to your past actions
  • Testing family members by asking them about hypothetical situations and progressively adding details to see how far you’d have to go to get rejected or judged
  • Confessing, and sometimes repeatedly confessing, your past actions to get forgiveness
  • Mentally reviewing your actions to evaluate the terribleness of the actions, what you said, what they said, and how they responded to see if they were genuinely hurt or offended so you can let yourself off the hook.
  • Mentally twisting or changing details to see what you would have done differently, how the event would have changed, and to verify that others, and yourself, would still see you as a good person.

Treatment for Real-Event OCD

Treatment for Real-Event OCD, just like the treatment for Harm OCD, Pedophile OCD, and Health Anxiety, is Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and mindfulness-based treatments like Acceptance and Commitment Therapy. Taken together, these approaches help you re-consider your feared thoughts by taking into account logic and reason, helping you progressively face your fears through direct confrontation of the fear, compulsion resistance, and learning that you can experience and tolerate anxiety and uncertainty.

To read more about Real-Event OCD:

Click here to read part 2

Click here to read Part 3

Click here to read Part 4

If you would like to learn more about treatment for Real-Event OCD and how CalOCD can help you start your recovery, please reach out to us through the contact page. We are seeing clients in-person through the Fullerton office, and through online therapy.

This article was written by Kevin Foss, MFT, director of the California OCD and Anxiety Treatment Center

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