What You Need To Know About Real Event OCD

Obsessive-compulsive disorder (OCD) is a mental condition in which you experience uncontrollable recurring thoughts or obsessions that make you anxious, forcing you to take action or engage in compulsive behavior to relieve the obsession.

However, if you have OCD, you will not stop at a single action but will repeatedly perform it to the point that it interferes with your ability to carry out life activities. For instance, if your obsession is cleanliness, you might spend the whole day cleaning the same spot for fear that you will fall sick due to germs, even when the space is already spotless. 

As such, you might be unable to take up more productive engagements during the day. Your compulsive behavior takes up much of your time.

While OCD usually stems from theoretical thoughts and worries about what might occur if you do not take action, there is a subtype of OCD that has to do with events that have already happened. This is called real event OCD and arises as a result of rewinding and ruminating on events that have already occurred in the past.

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Symptoms of real event OCD

Real event OCD¹ can involve obsessively thinking about what has already happened, from traumatic events and situations to seemingly minor details.

If you suffer from this kind of OCD, you will most likely think over and over again about what could have happened if you did things differently. Here are the symptoms of real event OCD:

Replaying past events in your head

If you have this condition, you will likely spend a lot of time analyzing your past actions, often trying to determine whether they reflect your morals. You might ask yourself whether your past behavior makes you a bad person.

Apologizing excessively to those you supposedly wronged

You could also find yourself apologizing to those you wronged, even though some may have let it go or forgotten about such an event.

Seeking reassurance

You may find yourself narrating the event and your feelings to friends or those close to you to get confirmation that what you did is not as bad as you think.

Imagining the worst

What you should otherwise let go of lingers in your mind for a long time, and you try to find problems by drawing the worst conclusions regarding those events.

Events that may trigger OCD

The exact cause of real event OCD is unclear, but experts speculate that events that have to do with the following may trigger the condition:

  • Family disruption

  • Traumatic events

  • Neglect

  • Abuse

Actions you believe were wrong, such as cheating in a relationship or test, driving drunk, or breaking up with someone acrimoniously, may also have you thinking about your overall moral code. 

You may constantly think of these single events, even though there may be other good things you have also done with your life.

How to deal with real event OCD

Real event OCD usually involves doubts about your morals and character. Understandably, you want to believe that you are a good person, but you may experience doubts when you become aware of something that puts question marks on your ethics. 

You may be able to overcome this feeling by undertaking the following strategies:

Accept your imperfection

While self-evaluation and thinking about past mistakes is something we all do, you should let go of such thoughts if there is nothing you can do to change what happened. While trying to do what is right is an admirable endeavor, you will slip up once in a while, and that’s okay because no one is perfect.

Practice self-compassion

Be kind to yourself. Calling yourself a monster or a terrible person will only increase your anxiety about what happened. If negative thoughts come up, try to look inward and forgive yourself; chances are, it wasn’t as much of a big deal as you might have perceived. 

Perhaps you did it because you didn’t know it was wrong at the time or were offended and did not know how to make your feelings known, so you lashed out instead. Therefore, try to let it go and focus on doing what’s right should you find yourself again in such a situation in the future.

Challenge your assumptions

If a negative thought about a past event pops up in your head, and you find yourself obsessing over it, you should try to challenge the assumption that it was the worst thing that ever happened or the worst thing you ever did. 

Be counterintuitive about it and try not to ruminate further as you may fall into the trap of obsessively thinking about it.

Practice self-care

Take up activities that distract these thoughts, such as taking a walk, interacting with other people, or doing physical activities that require focus. These will help shift your mind from what you are thinking about. 

Practicing mindfulness by being conscious of all your thoughts when they occur will also prove helpful in helping you cut off these obsessive thoughts when they occur.

Mindfulness helps you separate the action from the individual. For instance, instead of chastising yourself and labeling yourself as a terrible person, mindfulness enables you to acknowledge the action as terrible without categorizing your entire being as horrible. 

At the end of it all, you will be able to recognize that what you did was bad, but it does not mean that you are a bad person.

Treatment options

If you cannot manage your thoughts, it is a good idea to seek treatment. Some treatment options for OCD include:

Medication

Your doctor could prescribe drugs to keep your mind off the obsessive thoughts. Serotonin reuptake inhibitors are some of the go-to drugs that can reduce OCD symptoms. They are usually effective within 3 to 4 months of use, although you could also experience improvement before then.

Ask your doctor about the side effects of the particular medication. Don’t discontinue use without consulting a healthcare professional, as this could worsen the symptoms. You could also experience withdrawal symptoms. 

Also, remember to report concerns about the side effects, as the healthcare professional may decide to change your medication if this occurs.

Psychotherapy

Therapies such as cognitive behavioral therapy² equip you with the tools to deal with compulsions. When combined with medication treatment, it can even be more effective than medication alone. Strategies such as reversal training can also prove effective in curbing recurring thoughts. 

There are types of psychotherapy such as exposure and response prevention. These entail triggering the obsession and then preventing you from undertaking the automatic response, which can help you better deal with symptoms in the future.

Frequently asked questions

Is OCD a form of PTSD?

No. OCD is not a form of post-traumatic stress disorder (PTSD). While both involve anxiety symptoms, people with OCD engage in compulsive behaviors to neutralize intrusive thoughts. People with PTSD, on the other hand, may employ strategies such as isolation and avoidance to suppress traumatic thoughts.

Despite these differences, the conditions may co-exist. Research indicates that a person diagnosed with PTSD has a 30% chance of developing OCD³.

Can OCD cause psychosis?

There is evidence⁴ of OCD being misdiagnosed as psychosis in certain patients, while other patients also present with symptoms of both conditions. Thus, healthcare providers must make a differential diagnosis that rules out conditions that usually have similar symptoms.

How does OCD distort reality?

If you have OCD, there is a chance that you will equate your thoughts to your actions. Therefore, if you think of something such as stealing, you might believe that deep down, it means you want to act on these thoughts. 

People with OCD do not view negative or unwanted thoughts as harmless but instead ruminate and examine further to find why they thought of them.

You are also likely to overestimate danger if you have OCD. You could, for instance, believe that a simple mistake in your paperwork will get you fired, thus developing a habit of compulsively checking your work before submission to avoid this fate.

If you are afraid of fires, you could also make several trips to the kitchen throughout the day to check whether you turned off various appliances.

People with OCD also have the constant urge to be certain about situations; in reality, it is unrealistic to be certain about everything. This need for certainty further compounds your anxiety. The constant need for reassurance may also drive away friends and those close to you, further making you believe that your situation is worse than it is.

The lowdown

Real event OCD occurs when you obsessively think about past events in your life without the ability to get over them. Your mind replays these past events to find answers, but none seem forthcoming. 

If you have this condition, you will likely spend much of your time reviewing these events, drawing the worst conclusions, and seeking reassurance from those close to you about your feelings concerning what happened. 

While the cause of real event OCD is not precisely known, experts suggest traumatic events, abuse, neglect, and relationship changes may trigger the condition. You can deal with it by not being too hard on yourself for being imperfect or getting things wrong sometimes. A single action does not necessarily define who you are as a person. 

Challenging your assumptions can also help you achieve a more comfortable alternative view of what happened. You could visit a qualified healthcare professional who can prescribe medication or recommend psychotherapy as a form of treatment should you find it challenging to cope with the condition on your own.

Have you considered clinical trials for Obsessive compulsive disorder (OCD)?

We make it easy for you to participate in a clinical trial for Obsessive compulsive disorder (OCD), and get access to the latest treatments not yet widely available - and be a part of finding a cure.

Joining community groups and exercise programs for my condition made me feel empowered – but I want to be part of finding a cure.
Peter, 64

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