Real event OCD involves preoccupation with repetitive, intrusive thoughts involving an individual’s past actions. It is normal to experience some regret, guilt or doubt about the past, and people without OCD can accept that they cannot change or be completely certain about the past. As such, they can move past these thoughts, accepting the uncertainty that comes with them.
People who have done something wrong in the past think about their actions voluntarily. Real event OCD develops when an individual becomes consumed with obsessing over these thoughts, begins to feel anxiety, distress, doubt, confusion, or another difficult emotion because of these obsessions, and may develop some compulsive behaviours (physical or mental) to find short-term relief from these difficult emotions. The individual feels responsible for the consequences of their actions and overestimates the severity of potential consequences.
What are the symptoms?
Obsessions: The obsessions in real event OCD revolve around an individual’s past actions. This can involve regretting or doubting their past actions. Some examples of the intrusive thoughts associated with real event OCD include: “In high school, I made fun of my friend, and now she has depression. What if this is my fault?”, “I left my local barista a bad review and now he has closed his business. I ruined his business.”, and “I cheated on a board game when I was 10. What if this is an inherent part of me that I pass onto my children?”. The thoughts can take an infinite number of forms and are only limited by the brains capacity to imagine.
Compulsions: To manage the anxiety and distress associated with the uncertainty of one’s past actions, people with OCD seek to reduce the amount of anxiety and distress caused by these thoughts by behaving in repetitive ways that provide short-term relief. They may find themselves attempting to seek certainty by mentally reviewing past events, seeking reassurance, and/or confessing their guilt to others.
Why does it occur?
Real event OCD can occur when the thoughts clash with an individual’s morals or values (e.g., being honest and having integrity). This clash can cause anxiety and distress, and the individual may attempt to suppress the thoughts, causing a rebound effect where the thoughts come back more often and more intensely. Individuals with real event OCD may try to find relief from the anxiety and distress by performing certain compulsions. They may find themselves stuck in a cycle of obsessing, feeling anxious or distressed, and engaging in a compulsion to relieve the anxiety or distress for the short period until the obsession returns.