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  • Writer's pictureKatie Merrill, LCSW

Real Event OCD - Symptoms and Treatment

I was once reviewing a new client’s OCD questionnaire that I administered to them upon the start of treatment. In it, she endorsed her brain being stuck on an event from her past - a poisoning at a party. I thought to myself, wow, sounds intense! Lo and behold, during the assessment, she clarified that the “poisoning” she was convinced she would go to jail for was actually her just witnessing someone at the party put a medication pill into someone’s drink whom the partygoer didn’t like. There were no reports of any harm coming to the recipient of the drink. It wasn’t a roofie and they were fine afterward. 


Anyone might feel a little uncomfortable with the memory, but for the real-event OCD sufferer, this situation could (and in this case, did) lead to hours upon hours upon months of rumination about the event. Why did I allow this? What sort of person am I that I didn’t step in? Am I complicit in attempted murder? Will I go to jail? What happened to the recipient of the cup and are they psychologically ok today?


We all wish we hadn’t done certain things. We might remember certain events from our past and have a little cringe or a jolt of guilt or regret. But for the OCD sufferer, such memories can lead to overwhelming anxiety, shame, regret, guilt, and hours spent trying to get certainty about them.



Common memories that real-event OCD can latch onto:

  • Something you said or did that could have caused another harm

  • Treating peers poorly as a child

  • Early awkward sexual experimentation/exploration

  • Drunken sexual encounters

  • Engaging in behaviors insensitive to other groups of people

  • Flirtations or transgressions with non-partners

  • Telling a white lie or omitting information to someone

  • Having done something illegal


These are some common examples, but by no means an exhaustive list. OCD can attach to any event in life, but it tends to generate more ammunition when it can convince a person to question their morality, a beloved area for OCD generally. 


The Me Too movement, cancel culture, and our society’s focus on public accountability can be a minefield for morality-focused OCD. Not only could I feel like a terrible person for the rest of my life because of what I did, but the whole world could be talking about it shortly and I could lose all my relationships and credibility, a sufferer may think. That may be so, but possible does not mean probable and nothing you do now will change the events of the past. We’re all embracing uncertainty all the time that we could be publicly defaced at any moment over any of our past actions. Radically accepting this truth may be hard, but probably not harder than doing all the compulsions OCD is having you do. 



“This can’t be OCD, because it really happened”


Well, it can be. OCD loves to attach to uncertainty. Period. Whether that uncertainty lies in the future (what if I lose control and murder my family?) or in the past (what if that thing I did is unforgivable?) real-event OCD is actually an incredibly common category of theme. 


If you are reading this and think you may be suffering from this form of OCD, take a minute and reflect on what I’m about to say: every real-event OCD sufferer I’ve ever worked with thought that their event was really super duper especially bad, no matter how actually innocuous it was. Look, I’m sorry, but your “real-event” is not special. It feels special, and disgusting and abhorrent and unforgivable and different from all the rest, but that’s OCD for ya. You’re actually just a messy human being with a messy past like the rest of us. Your problem is not this one event, but that your brain is having trouble laying it to rest. 


Here are a list of common compulsions a real-event OCD sufferer may be engaging in. They don’t all apply to everyone. Remember, OCD presentations are as unique as people!


Common real-event OCD Compulsions:

  • Reviewing the past event to reveal some crucial piece of information you could have missed - about its meaning or your morality

  • Getting reassurance from others that what you did was ok

  • Checking in with people connected to the event to see if they’re ok/alive/going to press charges against you/ suffering from PTSD/hate you/about to shame you on social media, etc.

  • Googling dates/events/people that could some way be connected to the event

  • Googling similar scenarios for reassurance

  • Getting rid of social media

  • Confessing to people about event

  • Asking alleged wronged person(s) for forgiveness

  • Mentally berating yourself. By doing so, you “serve a little sentence” for what you did and get to be emotionally free of it for the moment 

  • Avoiding things you love to do for the reasons just stated. OCD convinces you that you’re not deserving because of what you did. This one is huge and horrible and devastating. It can make you avoid: romantic relationships, being around children, having children, connecting with others, doing things that allow you to be happy at all in the name of serving OCD’s imaginary sentence or protecting others from your wrath of moral darkness that could be unleashed (and the event is proof of that darkness latent within)

  • Memory hoarding - “holding onto” a memory so you can review at a later time to reassure yourself

  • Comparing the morality and actions of people you read/see/hear about to your “big one,” and pointing out differences between them and you to reassure yourself

  • Pointing out ways you’re the same as the scary person in the TV show and therefore you are also terrible (if OCD can’t get certainty that you’re all good, it wants to get certainty that you’re all bad)

  • Defending the morality of such individuals because, OCD says, if they’re in the clear, maybe you’re in the clear too!

  • Avoiding triggering content related to themes of the event altogether

  • Convincing yourself that you’re a good person based on things you do

  • Convincing yourself that you’re a bad person based on things you do

  • Deciding to accept you’re a bad person (because OCD is not allowing you to think of yourself as a good person)

  • Wishing that it didn’t happen and you could change the past

  • Blaming circumstances around the event for causing your OCD 

  • Wishing you didn’t suffer from OCD

  • Making moral “amends” by being extra kind or careful around similar topics/situations



Now let’s talk about some of the most common thinking errors experienced by real-event OCD sufferers. In becoming aware of these distortions, a sufferer is able to call out OCD’s tricks and engage in fewer compulsions. 


Mental filter: This is when your brain notices anything and everything remotely related to your trigger and connects them back to you, your theme, and probably your morality. Ex: That person in the TV show was a sexual abuser, does this mean I’m the same as them because the sexual experimentation I engaged in was possibly sexual abuse? 


Black and white thinking: You’re either a moral saint and have never done anything condonable in your life (no one actually lives in this space) or you’re the same as the cheer coach that you just read about in the news who has 15 counts of sexual misconduct laid against him. Are you allowing yourself to just be another human being with unfun memories? Doesn’t sound like it. OCD is instead putting you in the box of terrible and dangerous.


Emotional reasoning: This is OCD making a conclusion based on a current emotional state. Big one here. With real-event OCD, sufferers often feel a hefty dose of anxiety when their theme is triggered, but often with some side dishes of shame and guilt. You interpret those emotions as evidence that you did, in fact, do something terrible. But with OCD, those feelings are false fire alarms. They’re annoying, but you can stay where you are because there’s not an actual fire. And a feeling, no matter how scary, is not a mandate to act. 


Catastrophizing: OCD loves to get you thinking about the worst case scenario. Quickly in the moment, something might trigger your OCD, and it feels like your world is imploding and you might as well head to the police station and turn yourself in for what you did. Or say goodbye to your family because jail it is for you! Guess what? The odds of all of that happening are extremely low, and it’s not a good use of your time to calculate exactly what those are.


Mind-reading: A real-event OCD sufferer might think, if that person only knew the truth about me, they would think I’m sick/disgusting/terrible. Na, they’d probably be like, oh ya, I’ve done that too. Or if not the thing you’ve done, something else much worse that they’re not spending many of their waking hours trying to get certainty around. 



Luckily, real-event OCD is highly treatable with Exposure and Response Prevention (ERP) treatment, the gold standard treatment for OCD. Here are some ways an ERP therapist may help you apply ERP to your theme: 


ERP for real-event OCD

  • Try not to solve the problem. Imagine the mental rate race of OCD as a treadmill and every step is a compulsion. OCD is doing everything in its power to keep you on that treadmill. It’s your decision to press STOP and step off and do something else with your time. Anything else.

  • Limit all compulsions listed above

  • Watch movies/TV shows related to event

  • Write out the event

  • Write scary stories about your life being ruined by the event

  • Phone reminders that you’re life could be ruined by event

  • Read content that remind you of the event

  • Visiting locations that trigger feelings about event

  • To borrow a great metaphor from therapist Jon Hershfield, let it be a cold case. It’s closed and it’s on the shelf. You’re not gonna solve it. In fact, in order to beat OCD, you have to intentionally leave it unsolved. Don’t take it down and open it back up. 

  • Allow yourself to be uncomfortable. OCD will trick you into thinking that you have to get rid of painful feelings by doing compulsions, but compulsions are the food for OCD. Paradoxically, when we let painful emotions exist and observe them and make peace with them, they have much less power over us. By doing so, you show yourself that you can handle emotions OCD tries to convince you you can’t.

  • Don’t get mad at what happened, get mad at the OCD by not feeding it with compulsions. 

  • Stop engaging with the content of the matter COMPLETELY. OCD is a game that's rigged against you. If you’re analyzing the content at all, you’re playing and you’re losing.

  • Be radically, radically kind to yourself around this. Actively let yourself off the hook. It will make the OCD very uncomfortable.

  • Accept that you cannot change the past.

  • Surrender to the uncertainty that you’ll never, ever know what it all says about you

  • Enjoy your life exactly the way you want to if this obsession were not present. Show OCD who’s boss and that you’re choosing not to care whatever the real-event may say about you. Get your life back.


My message to you if you’re suffering from real-event OCD: You’re a human being. You cannot solve your real-event OCD by trying to figure it out and get certainty. You’re too smart for that. You’ll always be able to come up with something else to question any temporary certainty you find. You would not have made your way to this article if those compulsions worked and you knew for sure. 


The freedom is in the not knowing.  Can you go on living your life not knowing? You can. Of the many real-event OCD sufferers I’ve treated, they’ve all shown themselves that they can do exactly that. Not one of them found total certainty around their event (it’s impossible). 


Hope is real and OCD in any form is highly treatable. You are not alone and if you’re living your life while dealing with OCD, you’re already a superhero. 


To seek help for real-event OCD or other mental health concerns, please contact Santa Monica OCD and Anxiety Center at 323.673.0645 or katie@santamonicaocd.com.

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