You may have heard of OCD before, but if you’re curious about something called Real Event OCD, and the symptoms that distinguish it from other types of OCD, we’re pulling back the curtain on this condition and sharing what it actually is, how it might manifest in different individuals, how to cope with it in the moment, and how to treat it.

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about any type of OCD — whether for yourself or someone else — we’re here to help.

What is OCD?

OCD (which stands for obsessive compulsive disorder) is a common mental health condition affecting an estimated 1.2% of the UK population. Although it tends to look different for each person who suffers from it, people with OCD have obsessive thoughts and compulsive behaviours that can be difficult to manage and can interfere with everyday life.

When you think of someone with OCD, you may picture behaviours you have seen on television such as obsessively washing hands or turning on/off light switches a certain number of times. In reality, OCD can take many forms, including but not limited to behaviours like checking things over and over again, counting things, ordering and arranging objects, repeating words internally, obsessively worrying about making a mistake or doing something wrong, fear of contracting a disease, or something else.

OCD can affect anyone of any gender, age, or background, and although it can be very distressing for the person suffering and those around them, there are treatment options to help them cope with their intrusive thoughts and behaviours.

What is Real Event OCD?

Understanding OCD is a good starting point for understanding one particular type of OCD called Real Event OCD. This type usually involves a real-life event that has happened to the person in the past, where they feel an almost overwhelming sense of guilt or regret at their past actions.

Their thoughts may become fixated on what they would have done differently, and questioning their own morals. In Real Event OCD, the person might go over and over events in their head, studying them to see if their participation in the event may have caused harm in some way.

"This is an excessive rumination about something that really happened. OCD is more about something that won’t happen and is an irrational belief however both contain elements of rumination and intrusive recurrent thoughts. It may be helped through medication and cognitive behavioural therapy." - Dr Adrian Lord, Consultant Psychiatrist

What causes Real Event OCD?

The causes of any kind of OCD can be quite tricky to identify, but most fall under one of three categories: Personal experience, personality, or biological factors.

Personal experience

OCD symptoms can be brought on by experiences from a person’s past, such as the trauma of abuse, bullying, or the disturbance of having a family member leave or pass away. OCD symptoms may arise due to a subconscious desire to maintain control in some way.

Personality

People with specific personality traits (for example, a very neat and tidy person) are thought to be more likely to develop OCD behaviours.

Biological factors

There is also a theory that OCD could be caused by an imbalance of serotonin in the brain, however further study is required to determine whether this is caused by OCD or vice versa.

How Real Event OCD different from guilt or shame?

Real Event OCD is not the same as the general feelings of guilt or shame we all tend to feel when we know we have done something wrong. Feelings of guilt can be healthy, as they encourage us to avoid repeating past mistakes, but those with Real Event OCD feel guilt and shame at an intense level which tends to affect their ability to function in day-to-day life, and is harder to accept and move on from.

What are the symptoms of Real Event OCD?

Some common symptoms of Real Event OCD include compulsions such as:

• Obsessively thinking about past behaviours and scrutinising their actions
• Feeling the need to confess or apologise for their actions, even if years have passed
• Wanting to be punished in some way for their actions, and calling authority figures to find out potential repercussions
• Wanting to be reassured from loved ones that they are not a bad person
• Trying to prove their morality to those around them
• Catastrophizing events, and assuming their feelings about the event are true
• Mentally reviewing the event, revising the ending, and obsessing about what they should have done or said differently

When people with Real Event OCD carry out the above compulsions they may feel some sort of relief, but this is often short-lived and the intrusive thoughts come back later.

What sort of events does Real Event OCD involve?

The type of events that can trigger such obsessive and intrusive thoughts differ depending on the individual. It can be something as traumatic as childhood abuse, or something most people would consider to be relatively unimportant, like a heated exchange with a customer service employee.

Here are a few examples that could cause Real Event OCD:

• Stealing an item from a shop as a child
• Saying something offensive to a work colleague
• Bullying a classmate in school
• Driving a vehicle while drunk
• Having a verbal confrontation with a friend
• Having a physical altercation with a stranger at a bar
• Encouraging a friend to try recreational drugs

In general, Real Event OCD can involve any event that makes the person believe they have caused either physical or emotional harm to someone, even if time has passed and they have no way of knowing whether or not their actions had any knock-on effect.

How can you manage Real Event OCD in day-to-day life?

Managing the symptoms of Real Event OCD in your everyday life can be tricky, but it is possible. Here are a few things you could try:

Recognising the thoughts

In many cases, the first step to removing the power from the intrusive thoughts is to recognise them as such, and not identify them as the truth, or anyone else’s truth. Too often we allow negative thoughts to spiral out of control before we even realise they are just that; thoughts. Start to notice them when they arise, and see if anything in particular tends to trigger them.

Mindfulness

You can learn to use mindfulness practices to fully experience the thoughts and feelings you are having, and allow them to be present in your mind without letting them further spiral out of control and catastrophise the event you are remembering.

Living a healthy lifestyle

By focusing on eating well, getting plenty of sleep and exercising, you can keep your mind and body feeling healthy and reduce mental tiredness. This will allow any further treatments you are undergoing (see below) to be even more beneficial.

How can Real Event OCD be treated?

Although it can take some time and hard work, and often the help of a professional, it is possible to treat Real Event OCD and let go of any intrusive and obsessive thoughts. The most common treatments for this condition include:

Medication

If you are working with a specialist who feels medication could help you, you may be offered selective serotonin reuptake inhibitors (SSRIs), which are sometimes prescribed to those with OCD. These medications work by affecting chemicals in the brain in order to slow down any intrusive thoughts, and can often help people with different kinds of OCD better manage their symptoms.

Psychotherapy

Certain therapies can be beneficial for those with OCD symptoms, such as cognitive behavioural therapy (CBT) and something called habit reversal training. The point in these therapies is to teach people to redirect any intrusive thoughts before they take hold.

Exposure and Response Prevention (ERP) therapy

ERP is considered by many to be the best treatment for those with OCD, with around an 80% success rate. In the case of Real Event OCD, it repeatedly exposes people to their obsessive thoughts, minus the compulsions, in order to break the connection between the past event and the negative feelings disrupting day-to-day life. Instead of using compulsions as a crutch, this type of therapy offers a new way to respond when they flare up.

What should I do if I think I have Real Event OCD?

If you think you’re experiencing Real Event OCD, it may be helpful to acknowledge the existence of the issue as a recognised condition. Many people with OCD feel their behaviours are somehow shameful and do not believe others share these kinds of thoughts. Although your thoughts will be unique to your own experiences, many people suffer from obsessive compulsive disorder and you are not alone.

The first step for most is to contact a healthcare professional who can help. This could be through your doctor, but you can also find a specialist who works with OCD patients and has experience treating people with Real Event OCD.

At Augmentive, we offer a free 15 minute consultation to help guide you towards a specialist who can help with your specific needs and answer your questions on Real Event OCD, as well as specialists for a private OCD assessment to get a better understanding of your situation and the best way forward.

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private psychiatric assessments to helping you find a therapist near you for support on your journey.

DISCLAIMER: The content published by Augmentive is not designed to treat, diagnose, cure, or prevent any disease or condition. Always consult your GP or a qualified healthcare provider with any questions regarding a medical condition and before starting any therapy, diet, exercise, or any other health-related programme.