OCD Subtypes

OCD Symptoms

OCD Treatment

<h2 id="h-false-memory-ocd-symptoms">False Memory OCD Symptoms</h2>



<p class="has-drop-cap">False Memory obsessive-compulsive disorder (OCD) is an OCD subtype characterized by ongoing intrusive doubting thoughts and compulsive behavior around a past event. People with False Memory OCD experience frequent doubts about things that have happened to them and may be convinced they’ve done something wrong despite no evidence of these memories being true (e.g., “Did I accidentally steal and don’t remember?”). The recurrent doubting thoughts are often viewed as an indication that their fears <em>are </em>true (e.g., “if I’m so concerned I stole, then I must have. Otherwise, why am I thinking about it?”), which fuels anxiety about their memories and drives sufferers to engage in various compulsions aimed at gaining certainty about their memories (e.g., asking for continual reassurance from a friend about whether you accidentally stole or searching through your home for the receipt).&nbsp;</p>



<p>Most people with False Memory OCD find their doubting obsessions can feel impossible to let go of. Their false memories can feel like real events. The more the person fixates on them, the more their brain may fill in these false memories with even more false information, further convincing themselves they are guilty of things they haven’t done. Furthermore, even though behaviors aimed at feeling more certain of one’s memory (e.g., repeated checking) might seem to increase confidence in memory accuracy, research actually shows the opposite: these behaviors actually <em>decrease</em> one’s confidence in their memory (Cuttler &amp; Graf, 2009).&nbsp;</p>



<p>Alcohol use can play a significant role in False Memory OCD. When a person can’t clearly remember what happened for long periods of time, their OCD may take over and start spinning tales of false memories.&nbsp;</p>



<p>Let’s say Joe is in a committed relationship. He was drinking that night and can’t exactly remember everything that happened at the bar with his friend. He has a hazy memory of a brief interaction with a woman. He might begin to fixate on this specific interaction and wonder: “Did anything else besides a brief conversation take place between us? Did I cheat on my partner last night? How can I be certain?” Joe’s uncertainty and anxiety may feel overwhelming and drive him toward compulsive behaviors in order to alleviate it. This could look like asking his friend to recall what happened last night. Do they remember you interacting with anyone? Was it a normal interaction? Joe may also be compelled to find physical evidence, like asking the bar for last night’s video footage, just to be sure. These compulsions only ease the person’s anxiety temporarily. For someone with OCD, eventually, the anxieties start up again. (e.g., Joe might start thinking, “Yes, my friend told me he saw me interact with this woman, and we only exchanged a few words, but what if something happened when he stepped outside?”)&nbsp;&nbsp;</p>



<p>In some cases, False Memory OCD can have devastating consequences for a person’s life. A person could be convinced that they committed a terrible act, even if there’s no evidence to prove this. Out of shame, they could isolate themselves from others, convinced they are a bad person. In more extreme cases, people with False Memory OCD have been convinced they’ve committed a crime like murder and will confess because they believe they are guilty and should face punishment.&nbsp;</p>



<h2 id="h-false-memory-ocd-some-examples-of-obsessive-thoughts">False Memory OCD: Some Examples of Obsessive Thoughts</h2>



<ul><li>Did I do this immoral/taboo action?</li><li>Did I accidentally say something inappropriate to my friend yesterday?</li><li>Did I interrupt my partner when he spoke? </li><li>If I’m wondering about this, doesn’t it mean it’s true?</li><li>Did I hurt my brother or sister when we were younger and playing at the park?</li><li>When my sister fell and fractured her arm when we were children, was it actually because I pushed her? Would I have done something like that? Am I a bad person? </li><li>Did the person I “hooked up with” actually consent to sex with me?</li><li>Did I walk out of the restaurant without paying by mistake? Maybe it wasn’t by mistake. Was I trying to steal?</li><li>Did I touch my student inappropriately when they came to see me after class? Am I a pedophile? Did I purposely block this memory from my mind in order to forget that I am a bad person?</li></ul>



<h2 id="h-false-memory-ocd-some-examples-of-compulsive-behaviors">False Memory OCD: Some Examples of Compulsive Behaviors</h2>



<p>Mental review: A common False Memory OCD compulsion is to mentally review past experiences to try and prove or disprove your doubts about what happened. So if your obsessive thought is that you walked out of a restaurant without paying, you might try and review every single moment of that experience in your head. You’ll try to mentally replay when exactly the waiter came over, and the moment you asked for the bill. You might try to remember whether you paid with cash or a credit card. Wouldn’t they have said something if you tried to steal? Did anyone look at you? You might replay every past dining experience you can remember to reassure yourself that you have always remembered to pay, and that you have never stolen anything in your life.</p>



<p>Reassurance seeking: People with False Memory OCD might turn to friends or other people who witnessed the memory in question in an effort to validate the information they are doubting. In this example, the person might call the restaurant to be sure they paid. They may ask the friend they were with or go back in person to confirm their bill was paid with the waiter. The questions may be more general as well, like asking a friend or family member: Have you ever walked out of a restaurant without paying? Do you think that could possibly happen?&nbsp;</p>



<p>Distracting, replacing, or suppressing thoughts: People with False Memory OCD may try to distract themselves from these obsessive thoughts, try to fill their mind with positive thoughts instead or attempt to suppress their thoughts. They might repeat to themselves: I am not a thief. I have never stolen anything in my life.</p>



<p>Confessing: When someone with False Memory OCD has convinced themselves they are guilty of an action that happened in the past, they may confess to important figures in their life, or to authority figures on what they’ve done wrong. For example, a person may see a news report of a murder and become convinced they were the ones to do it on the basis that they cannot exactly remember what they were doing when the murder took place but recall being in the vicinity. They may turn themselves in on the basis that they think they may potentially be guilty, even though there is no evidence at all that they had done this.&nbsp;</p>



<p>Physical Checking: People with False Memory OCD may try to recreate a scene they have in their mind. They may physically revisit the location they are concerned about, try to access recorded footage, spend hours researching news archives about an event they may have possibly been implicated in.&nbsp;&nbsp;</p>



<p>Self-punishment or Avoidance: Someone may act on the guilt from what they may have done in an effort to ease their anxiety. For example, if someone is convinced they have forgotten to pay at a restaurant, they may decide that the best course of action is to never eat at this restaurant again, for fear that they’ll be publicly identified as a thief.</p>



<p>Even though everyone might have doubts about what they’ve done in the past or worry that they may have forgotten to pay at a restaurant at one point or another, these thoughts usually leave a person’s mind without much difficulty. That’s unfortunately not the case for someone with False Memory OCD. The fear of false memories does not go away once the person with OCD has gotten reasonable evidence they are innocent. Instead, their brain starts spinning further possibilities of uncertainty, creating new scenarios that start the obsessive-compulsive cycle over again. One criteria for a diagnosis of False Memory OCD is that a person spends at least one hour per day on these obsessions and compulsions. Often, the obsessions and compulsions can take control of a person and their ability to function in their everyday life.&nbsp;</p>



<h2 id="h-false-memory-ocd-erp-therapy">False Memory OCD ERP Therapy&nbsp;</h2>



<p>The best course of treatment for False Memory OCD, like all types of OCD, is Exposure and Response Prevention (ERP) therapy. ERP is considered the gold standard for OCD treatment and has been found <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181959/#ref42">80% effective</a>. The majority of patients experience results within <a href="https://www.treatmyocd.com/blog/how-long-does-ocd-treatment-take">12 - 25 sessions</a>. As part of ERP therapy, you’d be tracking your obsessions and compulsions around your false memory and making a list of how distressing each thought is. You’ll work with your therapist to slowly put yourself into situations that bring on your obsessions. This has to be carefully planned to ensure it’s effective and so that you’re gradually building toward your goal rather than moving too quickly and getting completely overwhelmed.</p>



<figure class="wp-block-pullquote"><blockquote><p>The idea behind ERP therapy is that exposure to your fears is the most effective way to treat OCD. When you continually reach out for the compulsions, it only strengthens your need to engage in them. </p></blockquote></figure>



<p>On the other hand, when you prevent yourself from engaging in your compulsions, you teach yourself a new way to respond and will very likely experience a noticeable reduction in your anxiety.</p>



<h2 id="h-example-of-false-memory-ocd-exposures">Example of False Memory OCD Exposures&nbsp;</h2>



<p>Let’s take the example where someone is afraid they’ve left a restaurant without paying and have decided to avoid this restaurant at all costs for fear of being identified as a thief. A therapist may work with you to eventually face your fear and dine at this restaurant again. This may take time, especially if this exposure feels overwhelming and touches on one of your biggest fears (public humiliation). Together with your therapist, you’ll work to rank different exposures by difficulty. A less stressful exposure in this scenario might be to repeat to yourself, “I may or may not have walked out of this restaurant without paying. It’s impossible to know for sure.” ERP therapy aims to acquaint you with uncertainty and become more comfortable with it so that the anxiety of the unknown no longer feels as terrifying or unmanageable.&nbsp;</p>



<p>Other exposures for False Memory OCD may be to prevent yourself from seeking reassurance about a particular event you’re unsure about. Instead of calling friends or trying to verify a particular event by researching news reports, a therapist might have you describe this memory as if it actually happened, walk through the worst-case scenario, and what this might mean for your life. If you’ve spent years avoiding speaking about a false memory, this might sound terrifying, but the intention is that once you’ve mentally walked through the worst-case scenario in your mind, it will no longer hold as much of a grip on you.&nbsp;</p>



<h2 id="h-how-to-get-help-for-false-memory-ocd">How to Get Help For False Memory OCD</h2>



<p>False Memory OCD might be difficult to pinpoint because it’s not what people traditionally associate with OCD. A person with this subtype may also be convinced their memories are real, and not a part of False Memory OCD. However, a mental health professional who specializes in OCD will be able to make an accurate diagnosis. If you’re interested in learning about False Memory OCD and how it’s treated with ERP, you can <a href="https://home.treatmyocd.com/calendar?src=homepage">schedule a free call</a> with the NOCD clinical team to find out how this type of treatment can help you. All of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is. NOCD offers live face-to-face video therapy sessions with OCD therapists, in addition to ongoing support on the NOCD telehealth app, so that you’re fully supported during the course of your treatment.</p>



<p>Learn More About False Memory OCD<br><a href="https://www.treatmyocd.com/blog/false-memory-ocd-symptoms-causes-and-treatment"><strong>False Memory OCD: Symptoms, Causes, and Treatment</strong><br></a><a href="https://www.treatmyocd.com/blog/a-quick-guide-to-some-common-ocd-subtypes"><strong>A Quick Guide to Some Common OCD Subtypes</strong></a></p>

What is False Memory OCD?

false-memory-ocd

False Memory OCD

ERP Therapy

Obsessive compulsive disorder (OCD)

<h2 id="h-just-right-ocd-symptoms"><strong>Just Right OCD Symptoms</strong></h2>



<p>Just Right obsessive-compulsive disorder (OCD) is an OCD subtype that is characterized by ongoing intrusive thoughts and compulsive behaviors around organization, perfection and making things feel “just right.” People with Just Right OCD experience frequent intrusive thoughts around organization and symmetry, and they perform certain actions until they feel it is complete or “perfect” (e.g., switching a light switch on and off seven times before leaving a room). While other subtypes are motivated by specific fears and trying to avoid particular outcomes, with this subtype, the underlying anxiety is characterized by an unsettled feeling that something is just not right.</p>



<p>People who have Just Right OCD may fixate on parts of their body, like making sure their fingernails are the exact same length, their hair is perfectly arranged, or their makeup is applied perfectly and symmetrically. They may fixate on a certain structural asymmetry, like their nostrils, and attempt to perfect it by breathing in a certain way or spend time researching plastic surgery options that could correct it. Another common obsession for this OCD subtype is being fixated on physical sensations. So if someone touches your right arm by mistake, you must touch your left arm in the same place to “even it out”. This may also look like not avoiding stepping on cracks on the sidewalk, or making sure your steps are even.</p>



<p>Other people with Just Right OCD may experience doubting thoughts about their written or verbal communication. A person may fixate on certain things they’ve said, or the specific words they are using while talking, and correct themselves mid-speech if the word isn’t perfectly representing what they wanted to express. A person may feel each sentence must be exactly the same length to be perfect and rewrite them until they are. Or they may reread texts or emails over and over before and after they are sent. They may struggle to make the shape of each word symmetrical and keep on finding new ones until they are.&nbsp;</p>



<p>Someone with Just Right OCD may also be fixated on making their surroundings look just right and symmetrical. For some people, looking at a slightly tilted picture frame or images of houses where the windows and doors are uneven can cause intense anxiety.&nbsp;</p>



<p>The compulsions people with this subtype experience are usually pretty straightforward and centered around trying to fix what they perceive to be imperfect or incomplete. Rearranging the picture frame. Fixing their hair. Choosing the right words. Tying the shoe on their right foot to match the tension of the shoe on their left foot. Reading emails 15 times before and after sending them. These compulsions can be incredibly time-consuming and can often cause people with Just Right OCD to run late to scheduled commitments in their life. It can also be socially isolating for people when their OCD forces them to engage in physical compulsions in the presence of others (e.g., switching a light switch seven times in front of a friend. People with this OCD subtype may find themselves avoiding situations entirely so that they don’t have to deal with the time and stress required to make things just right. Instead of re-reading an email 15 times before and after sending, they’ll just avoid writing the email in the first place. Just Right OCD can demand a tremendous amount of mental energy from a person, and cause them to lose hours of their day to compulsions.&nbsp;</p>



<ul><li>Just Right OCD Obsessive Thoughts, Impulses and Urges: Some Examples</li><li>If I don’t fix this picture frame, something bad will happen. </li><li>The pillows don’t look just right, and I can’t handle that - I must fix them. </li><li>When I do my hair, it has to be perfectly even. </li><li>I need to make sure this text message is phrased just right and gets my message across perfectly, otherwise, this person will judge me.</li><li>Every time I walk outside, I have to make sure I’m stepping on an even number of sidewalk cracks.</li><li>If someone accidentally touches my left shoulder, I have to touch my right shoulder to make it even. I won’t be able to concentrate until I do.  </li><li>When I’m typing, I need to make sure my fingertips on both hands are touching symmetrical keys. </li><li>I can’t concentrate on my assignment until the word document is properly aligned. </li><li>I’m not sure if I measured out the right amount of coffee beans for my machine, so I need to do it again. I have to make sure it’s perfect. </li></ul>



<h2 id="h-just-right-ocd-compulsive-actions-some-examples">Just Right OCD Compulsive Actions: Some Examples&nbsp;</h2>



<p>Fixing behaviors to make things just right: This is the most common compulsion for this subtype of OCD. When something appears out of order or incomplete, a person with Just Right OCD will try to make it right. This could mean measuring out their coffee as many times as needed until they are sure it’s the perfect amount. Or spending hours rewriting a brief email until it is perfect. The compulsion to fix things could be ritualized, like needing to turn a light switch on and off 5 times before leaving each room. It could look like repeatedly putting a shirt on until it feels right. These compulsions can range from quick activities that take a few seconds but can demand hours of a person’s day.</p>



<p>Avoidance: Because people with Just Right OCD experience high levels of anxiety when things appear to be incomplete, they may avoid certain situations or places where they know their OCD will likely be triggered. For example, if someone needs to make sure each handwritten letter is exactly aligned, and this process takes hours, they may find themselves avoiding writing by hand. If sending a text message consumes hours of a person’s day because they have to read it repeatedly, they may decide it’s best to stop texting.&nbsp;</p>



<p>Reassurance seeking: In certain situations, people with Just Right OCD may turn to friends or family for reassurance. They may ask, “Does this picture frame look straight to you?” They may repeatedly ask friends for a second opinion on an email to make sure it’s coming across as they intend, or check that the person they spoke to understood what they meant to say exactly as they intended it.</p>



<h2 id="h-just-right-ocd-erp-therapy"><strong>Just Right OCD ERP Therapy</strong></h2>



<figure class="wp-block-pullquote"><blockquote><p>The best course of treatment for Just Right OCD, like all types of OCD, is Exposure and Response Prevention (ERP) therapy. ERP is considered the gold standard for OCD treatment and has been found <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181959/#ref42">90% effective</a>. The majority of patients experience results within <a href="https://www.treatmyocd.com/blog/how-long-does-ocd-treatment-take">12 - 25 sessions</a>. </p></blockquote></figure>



<p>As part of ERP therapy, you’d be tracking your obsessions and compulsions around your Just Right OCD and making a list of how distressing each thought or situation is. You’ll work with your therapist to slowly put yourself into situations that bring on your obsessions. This has to be carefully planned to ensure it’s effective and so that you’re gradually building toward your goal rather than moving too quickly and getting completely overwhelmed.</p>



<p>The idea behind ERP therapy is that exposure to your fears is the most effective way to treat OCD. When you continually reach out for the compulsions, it only strengthens your need to engage in them. On the other hand, when you prevent yourself from engaging in your compulsions, you teach yourself a new way to respond and will very likely experience a noticeable reduction in your anxiety.</p>



<h2 id="h-example-of-just-right-ocd-exposures"><strong>Example of Just Right OCD Exposures</strong></h2>



<p>Let’s say you struggle with Just Right OCD and feel the need to read an email 15 times before it feels just right and you can send it. With a therapist, you’ll work toward overcoming this compulsion, with the goal of sending emails effectively and efficiently, without your compulsions interfering. A therapist may ask you to send an email without reading it <em>at all</em>. You might think, “That’s impossible!” If an exposure feels too overwhelming to start though, you’ll work with the therapist to find the right intensity for you. Maybe that’s reading the email twice before sending it. Once you choose a plan, you’ll work with your therapist on the emotions that come up during the exposures. It will be scary at first. It may bring up many of the fears you’ve been trying to alleviate with your compulsions (e.g., what if my email has mistakes and people judge me?) But with practice, you’ll find the intense need to engage in your compulsion will wane. You will get to a point where the anxiety subsides, and you no longer feel the need to reread your email at all.&nbsp;</p>



<h2 id="h-how-to-get-help-for-just-right-perfectionism-ocd"><strong>How to Get Help for Just Right/Perfectionism OCD</strong></h2>



<p>Often sufferers of Just Right OCD have been engaging in the same obsessions and compulsions since childhood. For this reason, they may come to think of their OCD as part of their personality, or something everyone just does, or something they’ve learned to live with and cannot possibly change. Just Right OCD can impose tremendous challenges for someone’s personal, professional and social life.&nbsp; Even if these behaviors are something you’ve been doing since childhood, and it seems like there’s no way to overcome them, treatment is available. If you’re interested in learning about Just Right OCD and how it’s treated with ERP, you can <a href="https://home.treatmyocd.com/calendar?src=homepage">schedule a free call</a> with the NOCD clinical team to find out how this type of treatment can help you. All of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is. NOCD offers live face-to-face video therapy sessions with OCD therapists, in addition to ongoing support on the NOCD telehealth app, so that you’re fully supported during the course of your treatment.</p>



<h2 id="h-learn-more-about-just-right-ocd"><strong>Learn More About Just Right OCD</strong></h2>



<p><a href="https://www.treatmyocd.com/blog/a-quick-guide-to-some-common-ocd-subtypes"><strong>A Quick Guide to Some Common OCD Subtypes</strong><br></a><a href="https://www.treatmyocd.com/blog/what-is-a-compulsion-ocd-erp"><strong>What is a Compulsion?</strong><br></a><a href="https://www.treatmyocd.com/blog/journey-through-erp-for-ocd"><strong>Here’s What a Typical Journey Through OCD ERP Therapy Looks Like</strong></a></p>

What is Just Right (Perfectionism) OCD?

just-right-ocd

Just Right (Perfectionism) OCD

<h1 id="h-real-events-ocd-symptoms">Real events OCD symptoms</h1>



<p class="has-drop-cap">Real events obsessive-compulsive disorder (OCD) is a subtype of OCD characterized by ongoing intrusive thoughts and compulsive behaviors around someone’s past actions. While most types of OCD cause a person to fixate on feared future-oriented events, someone with real events OCD experiences intense anxiety over what they did or potentially could have done in the past. Someone with this OCD subtype will spend extensive energy attempting to gain certainty about a past event and whether they’ve done something potentially immoral or wrong.</p>



<p>Practically everyone experiences regret or doubt about the past. However, people with real events OCD often experience all-or-nothing thinking about these events. This is one of the main symptoms of this subtype. A person without OCD may think, “I probably shouldn’t have made fun of that boy in middle school,” reflect on their feelings, and move on. For someone with real events OCD, guilt over this reflection can feel overwhelming, equivalent to committing a murder. Their OCD will take hold of past events and warp them until they are a villain who can never be excused. Even if the person dismisses these thoughts in their mind with rational explanations of their innocence (e.g. everyone makes mistakes when they are growing up), the OCD will morph to find even more reasons they are guilty.</p>



<figure class="wp-block-pullquote"><blockquote><p>Real events OCD will latch onto even the slightest doubt and cause fear that is not proportional to the action one is worried about. It often focuses on your teenage years, when there was more ambiguity and higher potential for regret. People with real events OCD will generally spend at least one hour per day and often greater on these obsessions and compulsions.</p></blockquote></figure>



<p>These obsessions often pop into the person's mind seemingly out of nowhere and can occur with or without any apparent connection to the present. For example, during a workday, you might suddenly experience obsessive thoughts about cheating on an exam in middle school. The thoughts will take over your mind, and you won’t be able to concentrate on anything else. The fear of potentially harmful past actions drives people with this OCD subtype to engage in various compulsions aimed at gaining certainty about what exactly they’ve done and what this means about who they are as a person (e.g., searching for the person they bullied in middle school).&nbsp;</p>



<p>Real events OCD can be incredibly time-consuming, drain someone of energy, and send them on a downward spiral of guilt as their OCD warps minor regrets into inexcusable crimes. These thoughts will go on and on, often for hours or days, and won’t leave until the person has engaged in a compulsion or found reassurance either internally or externally to dismiss these concerns. Often the person will replay the event in their mind and experience doubting thoughts about whether they remember the event correctly (e.g., “What if I didn’t accidentally cause my sister to trip when we were 5? What if I did it on purpose?”)</p>



<h1 id="h-examples-of-real-events-ocd-obsessions">Examples of real events OCD obsessions</h1>



<ul><li>I told my friend 10 years ago that I supported her choice of partner, and I didn’t tell her that I noticed a few potential red flags. Now they are getting a divorce. What if it’s my fault because I didn’t tell her what I really think?&nbsp;</li><li>Last year, I gave a restaurant a bad review, and I just found out they’ve shut down. It was all my fault their business tanked.</li><li>When I was 12 I laughed at my classmate. What if they are still suffering because of what I did to them?</li><li>A month ago, I told my friend she should get the haircut she wanted even though I didn’t think it would look good. Now she is miserable and hasn’t left the house in weeks. I could have prevented this.</li><li>As a teenager, I drove after drinking a glass of wine. Nothing happened, thankfully, but what if something had? I can’t believe I risked that.&nbsp;</li><li>When I was a teenager, I stole chips from a deli. I haven’t done anything like this since, but what if this act is still somehow a part of me? What if part of me is still a thief, and I unknowingly transfer this characteristic to my kids? What if they become thieves and it’s my fault?</li></ul>



<h1 id="h-examples-of-real-events-ocd-compulsions">Examples of real events OCD compulsions</h1>



<ul><li><strong>Mental reviewing:</strong> This is the most common compulsion for people with real events OCD. They will replay the event they are concerned about in their mind over and over until they feel like they’ve gained clarity and experience relief. Because it’s impossible to know exactly what happened in the past, it’s usually only a matter of time before these obsessive thoughts return and the cycle begins again.</li><li><strong>Reassurance seeking:</strong> Someone who is concerned that stealing potato chips as a teenager makes them a bad person may ask the people in their life questions like, “Have you ever stolen anything when you were younger?” and, “Do you think stealing one time makes someone a bad person?” These questions are aimed at giving this person relief from their fear of being guilty. They may also confess to a friend, “Hey, when I was 12, I stole chips from a deli. Does this make me a bad person?” They may also engage in compulsive research online, searching things like, “How to know if you’re a bad person?” “Why do people steal?” or “How to make sure your children won’t steal?”&nbsp;</li><li><strong>Confession:</strong> The guilt people with real events OCD experience can be very intense. This can drive people to confess to figures of authority. A person with this subtype may consider this the only way they can experience relief from their guilt.&nbsp;</li></ul>



<h1 id="h-real-events-ocd-erp-therapy">Real events OCD ERP therapy</h1>



<p>The best course of treatment for real events OCD, like all types of OCD, is exposure and response prevention (ERP) therapy. The idea behind ERP is that repeated exposure to obsessive thoughts, without engaging in compulsions, is the most effective way to treat OCD. When you continually reach out for the compulsions, it only strengthens your need to engage them. On the other hand, when you prevent yourself from engaging in your compulsions, you teach yourself a new way to respond and will very likely experience a noticeable reduction in your anxiety.&nbsp;</p>



<figure class="wp-block-pullquote"><blockquote><p>ERP is considered the gold standard for OCD treatment and has been found to be <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181959/#ref42">80% effective</a>. The majority of patients experience results within <a href="https://www.treatmyocd.com/blog/how-long-does-ocd-treatment-take">12-20 sessions</a>. As part of ERP therapy, you will track your obsessions and compulsions, and make a list of how distressing each thought is. You’ll work with your therapist to slowly put yourself into situations that bring on your obsessions. This has to be carefully planned to ensure it’s effective, and so that you’re gradually building toward your goal rather than moving too quickly and getting completely overwhelmed.</p></blockquote></figure>



<h1 id="h-examples-of-real-events-ocd-exposures">Examples of real events OCD exposures</h1>



<p>Using an imaginal exposure script is a common form of ERP therapy for real events OCD. This is where you take one of the fears driving your obsessive thoughts and play it out to the worst possible end. For example, you might play out the fear that you stole something as a teenager and are still somehow a thief. What if that’s true? What will happen if your children do turn out to be thieves and it’s because of something you unknowingly taught them? Then what? Will they get caught? What happens next?</p>



<p><br>As you can imagine, using imaginal exposure scripts can be uncomfortable because it requires unfolding hypothetical scenarios your mind has labeled the worst possible thing that can happen. However, the idea behind ERP is to habituate yourself to these fearful thoughts so that they will loosen their grip on you. Eventually you’ll get to a point where you are relatively comfortable with the uncertainty of these past actions, and the obsessive thoughts will reside.</p>



<h1 id="h-how-to-get-help">How to get help</h1>



<p>Real events OCD can be a tricky diagnosis to spot because it’s an unconventional type of OCD. Instead of being driven by fears of things that may happen in the future, this subtype is driven by what’s already happened. A mental health professional who specializes in OCD will be able to make an accurate diagnosis. If you’re interested in learning about real events OCD and how it’s treated with ERP, you can <a href="https://home.treatmyocd.com/calendar?src=homepage">schedule a free call</a> with the NOCD clinical team to find out how this type of treatment can help you. All of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is. NOCD offers live face-to-face video therapy sessions with OCD therapists, in addition to ongoing support on the NOCD telehealth app, so that you’re fully supported during the course of your treatment.</p>



<h1 id="h-learn-more-about-real-events-ocd">Learn More About Real Events OCD</h1>



<p id="h-what-is-real-events-ocd-overview-examples-and-treatmenta-quick-guide-to-some-common-ocd-subtypeswhat-is-a-compulsion-here-s-what-a-typical-journey-through-ocd-erp-therapy-looks-like"><a href="https://www.treatmyocd.com/blog/real-events-ocd-overview-examples-treatment"><strong>What is Real Events OCD? Overview, Examples and Treatment</strong><br></a><a href="https://www.treatmyocd.com/blog/a-quick-guide-to-some-common-ocd-subtypes"><strong>A Quick Guide to Some Common OCD Subtypes</strong><br></a><a href="https://www.treatmyocd.com/blog/what-is-a-compulsion-ocd-erp"><strong>What is a Compulsion?</strong><br></a><a href="https://www.treatmyocd.com/blog/journey-through-erp-for-ocd"><strong>Here’s What a Typical Journey Through OCD ERP Therapy Looks Like</strong></a></p>

What is Real Events OCD?

real-events-ocd

Real Events OCD

<p class="has-drop-cap">Religious or scrupulosity obsessive-compulsive disorder (OCD) is an OCD subtype characterized by ongoing intrusive thoughts, images or urges, as well as compulsive behaviors or mental actions around violating a religious, moral or ethical belief. People with religious or scrupulosity OCD experience frequent worry and guilt about violating a religious or ethical code and what it means about them as a person (e.g., “Did I allow myself to have an “impure” thought in church? Does it mean that I’m a sinner and must repent?”). The guilt and anxiety drive these people to engage in various compulsions aimed to alleviate their distress (e.g., confessing to a religious figure).&nbsp;</p>



<h1 id="h-religious-or-scrupulosity-ocd-symptoms">Religious or Scrupulosity OCD Symptoms</h1>



<p>The term “scrupulosity” was first used by the Roman Catholic church to describe obsessive concern with sin and compulsive acts for the purpose of atonement. Today, mental health professionals also use the term to describe OCD thoughts related to ethics and morality in a secular context.&nbsp;</p>



<blockquote class="wp-block-quote"><p>OCD tends to fixate on what is most important to the individual, and when being moral or religiously devout is central to a person’s identity, OCD will latch on and cause a person to have obsessions and compulsions centered around their core values, which makes the doubting thoughts all the more anxiety-provoking (e.g., <em>Am I a “true believer” in my faith?</em>). </p></blockquote>



<p>Many religious people may be concerned they have sinned and want reassurance. However, with religious or scrupulosity OCD, the concern is never-ending, and these doubting thoughts can feel impossible to let go of despite extensive reassurance. Someone with this condition may have a thought come into their mind about eating a meal on a day when they are fasting. They might begin thinking: “Is it okay I thought about food right now? Am I fasting correctly? Have I sinned? Will I not have access to the afterlife?”&nbsp;</p>



<p>This unrelenting anxiety and fear about committing a sin may cause a person to confess to their religious leader. But confirmation they haven’t sinned may only ease the anxiety temporarily. It’s a matter of time before the thoughts kick back in, and they begin to think: “I didn’t share how I wished I could break the fast when I saw a family barbecue at the beach. Maybe I should go back and confess this as well.” Regardless of the confirmation, the person’s OCD will come up with more and more fuel for their doubting thoughts.&nbsp;</p>



<h1 id="h-examples-of-religious-or-scrupulosity-obsessions">Examples of religious or scrupulosity obsessions</h1>



<p>People with religious or scrupulosity OCD experience obsessive thoughts focused around their adherence to religious or moral beliefs. Here are some examples of common themes:</p>



<p>Religious-focused OCD thoughts:&nbsp;</p>



<ul><li>Have I prayed correctly? Have I prayed for the correct amount of time? I was a bit distracted. Maybe I should do it again.&nbsp;</li><li>Today I thought my religious leader is ugly. Does that make me a bad person?&nbsp;</li><li>During religious services, I found it hard to concentrate and thought about my to-do list for a few minutes. Is that a sin?</li><li>At the supermarket, I accidentally picked up the pork and immediately put it down. Am I contaminated from having touched it? Should I confess?</li><li>I wanted to laugh today during services. Does this mean I don’t take my religion seriously?&nbsp;</li></ul>



<p>Moral/secular-focused OCD thoughts:&nbsp;</p>



<ul><li>I told someone I’ll call them at 5 p.m., but I called them at 5:01 p.m. Have I lied? Am I a bad person?</li><li>Did I offend my friend without knowing during our conversation yesterday?</li><li>Was the question I asked in class rude? Have I accidentally offended the teacher?</li><li>Is it OK that my friend edited my essay? Does that count as cheating?</li><li>I didn’t say ‘thank you’ to the person who held the door for me. I am a bad person.&nbsp;</li><li>I told my spouse that I am great when they asked how I am. But the truth is I’m upset. Am I deceiving my partner? Do I deserve to be in this relationship?</li><li>I told a prospective tenant that I ended up choosing someone else, but the truth is I let my cousin stay in the apartment. Am I a horrible person for “telling a white lie?”</li></ul>



<h1 id="h-examples-of-religious-or-scrupulosity-ocd-compulsions">Examples of religious or scrupulosity OCD compulsions</h1>



<p>In response to their obsessive thoughts, a person with religious or scrupulosity OCD will engage in compulsive actions as an attempt to alleviate their anxiety. Here are some examples of what that might look like:</p>



<ul><li>Excessive prayer: People with religious OCD may pray extensively — longer than the standard for their particular faith, sometimes hundreds of times a day, in order to make sure their prayers have been performed perfectly. If there’s a mistake or hesitation, the person may repeat themselves until they believe the prayer is flawless.</li><li>Excessive confession: People with religious OCD may repeatedly go to their religious leader/authority to ask about or confess sins they are worried about having committed. It could be minor questions, like, was it a sin when I found a woman attractive, even though I’m married? The person may return multiple times to confess about the same event, for fear that they haven’t communicated the sin properly and may still be guilty.&nbsp;</li><li>Excessive rituals: People with religious OCD may develop excessive rituals to calm their obsessive thoughts. This may look like coming up with a number of minutes to pray, asking for God’s forgiveness a certain number of times, or performing established religious rituals a certain number of times.&nbsp;</li><li>Reassurance seeking: People with religious and scrupulosity OCD may repeatedly turn to the people in their life for reassurance. They may ask family or friends if they’ve ever experienced the same thoughts they have, to affirm whether or not they are sinful. They may also spend hours in online forums asking strangers whether something they’ve done would be considered a sin. Someone with scrupulosity OCD may ask their teacher if it’s okay that a friend helped them with their homework, even if the teacher already clarified it is. They may ask a friend if they would consider this cheating.&nbsp;</li><li>Mental checking: People may mentally review past experiences and try to evaluate whether they behaved in an immoral or sinful way. Someone who is concerned about having offended their friend might replay the face he made over and over, and think back to other times their friend has made this face. Is this the face he makes when he’s offended?&nbsp;</li><li>Avoiding: Someone with religious OCD may avoid their place of worship for fear of behaving in a sinful way. They may avoid certain people who cause them to have thoughts they’ve determined are immoral or sinful.&nbsp;</li></ul>



<h1 id="h-religious-or-scrupulosity-ocd-erp-therapy">Religious or scrupulosity OCD ERP therapy&nbsp;</h1>



<p>The best course of treatment for religious or scrupulosity OCD, like all types of OCD, is exposure and response prevention (ERP) therapy. ERP is considered the gold standard for OCD treatment and has been found <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181959/#ref42">80% effective</a>. The majority of patients experience results within <a href="https://www.treatmyocd.com/blog/how-long-does-ocd-treatment-take">12-25 sessions</a>. As part of ERP therapy, you will track your obsessions and compulsions, and make a list of how distressing each thought is. You’ll work with your therapist to slowly put yourself into situations that bring on your obsessions. This has to be carefully planned to ensure it’s effective, and so that you’re gradually building toward your goal rather than moving too quickly and getting completely overwhelmed.</p>



<blockquote class="wp-block-quote"><p>The idea behind ERP therapy is that exposure to these thoughts is the most effective way to treat OCD. When you continually reach out for the compulsions, it only strengthens your need to engage them. On the other hand, when you prevent yourself from engaging in your compulsions, you teach yourself a new way to respond and will very likely experience a noticeable reduction in your anxiety. </p></blockquote>



<p>People with religious OCD may face particular challenges during ERP therapy because they may be convinced certain exposures will make them unfaithful to their religion. Working with a trained therapist who understands your faith and how important it is in your life will help you feel confident to begin the process of separating your faith from your OCD thoughts about it. As the nature of these OCD thoughts is to convince you that you aren’t devout, a therapist who’s familiar with religious OCD will be able to help you work through these thoughts in a way that isn’t overwhelming.&nbsp;</p>



<h1 id="h-example-of-religious-or-scrupulosity-ocd-exposures">Example of religious or scrupulosity OCD exposures</h1>



<p>ERP therapy works to get you acquainted and comfortable with the unknown, since it’s the fear of the unknown and the need for certainty driving the obsessions and compulsions.</p>



<p>Let’s say you’re someone with scrupulosity OCD and excessively concerned about telling the truth. You’ve just told your spouse you’ll be home at 3 p.m., but you actually arrived at 3:30 pm. Each time this happens, you spiral into obsessive thoughts about being a liar, and the need to know if you’ve done something wrong, and sometimes ask your spouse for confirmation that this isn’t a serious lie and that you are still a good person.&nbsp;</p>



<p>In ERP therapy, the goal is to prevent yourself from acting on your compulsions. Instead of asking your spouse for reassurance, a therapist may have you think to yourself, “Maybe I am a liar. Maybe I’m not. It’s impossible to know for sure.” This teaches your brain a new response to your anxiety and begins to get you comfortable with the uncertainty fueling your obsessions and compulsions. In order to avoid becoming overwhelmed, you’ll work with a therapist to come up with a hierarchy of anxieties and related exposures and gradually work your way through them.&nbsp;</p>



<h1 id="h-how-to-get-help">How to Get Help&nbsp;</h1>



<p>Religious or scrupulosity OCD can be a tricky diagnosis to make because many of the behaviors can appear as concern about being faithful or ethical. A religious leader may tell you you’re simply overly concerned and have nothing to worry about, without knowing they are actually helping fill your need for reassurance. However, a mental health professional who specializes in OCD will be able to make an accurate diagnosis.&nbsp;</p>



<p>If you’re interested in learning about religious or scrupulosity OCD and how it’s treated with ERP, you can <a href="https://home.treatmyocd.com/calendar?src=homepage">schedule a free call</a> with the NOCD clinical team to find out how this type of treatment can help you. All of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is. NOCD offers live face-to-face video therapy sessions with OCD therapists, in addition to ongoing support on the NOCD telehealth app, so that you’re fully supported during the course of your treatment.</p>



<p>Learn more about religious or scrupulosity OCD:</p>



<p><a href="https://www.treatmyocd.com/blog/scrupulosity-religious-ocd-symptoms-treatment"><strong>Religious or Scrupulosity OCD: Symptoms, Causes, and Treatment</strong></a></p>

Blog

What is False Memory OCD?

What is Just Right (Perfectionism) OCD?

What is Real Events OCD?

What is Scrupulosity (Religious) OCD?

What are Somatic OCD Exposures? Explanation and Examples

What are Scrupulosity (Religious) OCD Exposures? Explanation and Examples

What Is Compulsive Staring?

How Long has OCD Been Around?

Managing OCD in College

My Personal Battle with Multiple OCD Subtypes

How OCD Can Affect Academic Success

A Quick Guide to Children with OCD