Existential OCD is characterized by excessive fear, worry, and uncertainty surrounding life and death. People with this OCD subtype find themselves trapped in thoughts about the meaning of life, the purpose of one’s existence, what’s real and what isn’t, and what happens when they die.
Philosophy, as a study, intentionally poses and ponders these questions. This is why existential OCD is sometimes known as philosophical OCD.
Pedophilia OCD (POCD) refers to a common OCD theme in which one fears being sexually attracted to and/or sexually harming children.
It is distinctly different than pedophilia disorder.
OCD is egodystonic in nature.
This means that its obsessions inherently go against the sufferer’s true values or desires. In the context of pOCD, alarming, sexual, intrusive thoughts arise that are disturbing in nature, leaving the sufferer questioning why they would think these thoughts and whether they could do such acts.
Transcript
Kimberley Quinlan: Well welcome, I cannot believe this is so exciting. I’ve been looking forward to this episode all week. We have the amazing. Reverend Katie O’Dunne with us to talk all about scrupulosity and religious obsessions. So welcome, Katie.
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5 TIPS FOR HEALTH ANXIETY DURING A DRS VISIT
If you want my five tips for health anxiety during a Drs visit, especially if you have a medical condition that concerns you, this is the episode for you.
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Most OCD subtypes cause the sufferer to fixate on future-focused fears and outcomes. However, those with Real-event OCD – also known as ‘real-life’ OCD – is distinguished by obsessions and compulsions surrounding an event that has happened in the past.
In the case of real-event OCD, the sufferer finds themselves scrutinizing and ruminating over past events. Doubting the things they’ve said and done, leaving them with immense feelings of guilt and shame that they attempt to navigate through compulsive behaviors.
Someone with real-event OCD will exert a great deal of energy to try and find certainty around a past event which makes it very difficult to live and embrace the present moment.
Real-event OCD can feel as though it steals from the present moment as the sufferer remains in a rumination loop, trying to analyze and scrutinize past events that often leave them feeling like they are a bad person.
Here we will explore the ins and outs of real-event OCD.
But first, a quick recap of the OCD basics…
Content
There are two core components that characterize OCD and all of the OCD subtypes.
These are obsessions and compulsions.
OCD is a common mental health condition whereby the sufferer experiences obsessions in the form of thoughts, images, urges, feelings, or sensations, which trigger extreme levels of uncertainty and anxiety.
As OCD is egodystonic – meaning it goes against our values and morals – those obsessions are disturbing in nature and leave the sufferer questioning their sense of self.
This is why intrusive thoughts are often described as ‘sticky’.
Because the very nature of these thoughts has us challenging who we are, they are perceived as a cause for concern and we believe they require our attention.
In a bid to manage the uncertainty and anxiety following these obsessions, the sufferer engages in compulsive behaviors that offer temporary relief.
These behaviors can present as physical or mental compulsions.
Common mental compulsions can include:
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Common physical compulsions can include:
These compulsions offer short-term relief but contribute to long-term struggle as they leave the sufferer trapped in the OCD cycle.
The good news is that this OCD cycle can be broken!
Effective treatment is available so you can begin managing the anxiety and uncertainty without needing to engage in compulsive behaviors.
We can all find ourselves reflecting on past events from time to time, wondering whether we should have done things a little differently.
We might berate ourselves for a moment about the things we have said or done that could have been handled more effectively.
We may even experience momentary guilt over the potential consequences of our past behaviors.
But for those without OCD, these reflections and feelings tend to fade over time. For those with real-event OCD, they find themselves over-analyzing, fixating, and ruminating on past events in a desperate plea to gain a sense of certainty.
They may be searching for definitive answers to suggest that they didn’t do anything wrong and that they aren’t a bad person.
A common compulsion within real-event OCD is mental review.
The sufferer will replay the moment over and over again.
Guilt and shame are overwhelming feelings that occur for those with real-event OCD. And these feelings brought about by such reflections are intense and painful to manage as they leave the sufferer questioning their morality and identity.
OCD takes hold of the past event and warps the sufferer’s perception, positioning them as the ‘bad guy’ or ‘villain’ of the piece, for which they can often call on self-punishment as the compulsion believing they deserve to be punished.
Someone with real-event OCD can experience obsessions about a wide variety of past events. Anything from cheating in an exam, an argument with a partner, a job interview, or even an interaction with a stranger at the local shop.
The common thread is that obsessions are almost always driven by the fear of being a bad person.
An example of how real-event obsessions may occur could look like this…
“A friend of mine told me she kept having heart palpitations and feeling faint but I simply joked and told her she was probably just unfit. She has now been diagnosed with heart disease which they would have caught sooner if I had taken it more seriously and told her to get herself checked. If she get’s seriously ill, this will all be my fault.”
We can use the obsession above to show an example of how the compulsion may then present.
This sufferer may replay the experience repeatedly in their mind noting what they believe they should have said or done differently. They may punish themselves by thinking, “You should have told her to see a doctor. You shouldn’t have joked about it. This is all your fault”
They may ask others whether or not they think this could have been prevented if they had told their friend to see a specialist sooner.
They may go out of their way to make up for their ‘wrong behavior’ by apologizing excessively to their friend. They may also go out of their way to do good deeds in service of the community to be forgiven for their ‘perceived error’ or ‘mistake’.
It’s common for everyone to find themselves dwelling on past events from time to time. But here is a breakdown of symptoms to consider if you think you may have real event OCD:
Someone with real event OCD can lose hours of their day ruminating and fixating on these past events.
It’s almost always impossible to gain 100% certainty, but even more so when it comes to analyzing past events that have come and gone. Because of this, those obsessions always tend to crop back up.
You can find yourself trapped in the past and unable to engage and enjoy the present moment and struggle to shake this overwhelming sense that you’re not a good person.
However, if you are able to change your relationship to those obsessions and resist the urge to do compulsions, you can find long-term relief from real-event OCD.
As with all OCD subtypes, the best course of treatment for real-event OCD is ERP therapy (exposure and response prevention).
ERP is deemed the gold standard treatment for OCD and has been shown to be highly effective. This means that it is highly possible for you to fully recover from OCD using this treatment.
In ERP, you work with your therapist to place yourself in scenarios that gradually and intentionally trigger your obsessions. You will work together to navigate the uncertainty and anxiety and resist the urge to do compulsions.
Your brain learns that you are capable of managing anxiety and uncertainty without the use of compulsions. Each time you engage in compulsive behaviors you strengthen OCD’s hold. When you resist the urge to engage in compulsions, you can learn new ways to respond to your obsessions that will – over time – reduce the anxiety.
Most highly trained ERP therapists will first provide thorough psychoeducation on real-event OCD and train you to engage in effective response prevention.
Response prevention is a component of ERP where we practice reducing any compulsions that the person with real-even OCD is engaging in.
Research has shown that ACT (acceptance and commitment therapy) is a highly effective modality supplement to ERP, where the person with real-event OCD practices working with value-based behaviors rather than fear-based behaviors and learns how to manage their intrusive thoughts using tools like diffusion and mindfulness skills.
In the case of real-event OCD, a common form of ERP therapy is to use an imaginal exposure script.
An imaginal script for real-event could be writing out the story as it happened, as specifically as possible, so that you can use their mindfulness, ACT, and ERP tools to resist the urge to do compulsions.
In addition, other exposures that may be helpful and beneficial are engaging back in any behaviors that you have been avoiding. You and your therapist will work together to make sure the exposures you do are exposures that you feel will be helpful and worth engaging in.
Real-event OCD can sometimes be tricky to diagnose and treat. The nature of most OCD types means they are driven by the fear of what might happen in the future whereas real-event OCD is driven by the fear of what’s happened in the past.
We highly recommend you want to do your due diligence and be sure to work with an OCD specialist who is ERP trained as this is the most effective treatment for OCD and yields incredible results. It is important to work with a qualified mental health professional who can offer an accurate diagnosis and support you with the best treatment plan.
If you are based in California, our friendly team of elite OCD specialists can help you navigate your OCD and support you on your recovery journey.
Please reach out to us by submitting an initial intake form here to see how we can best support you.
If you do not live in California, you can use the IOCDF directory to find support from a qualified clinician in your area.
For an affordable and accessible alternative to private therapy, top OCD specialist Kimberley Quinlan, LMFT, has created ERP SCHOOL.
Learn to identify your specific real-event obsessions and compulsions and use science-backed ERP practices to manage your OCD symptoms.
This online program will help you change your relationship with those haunting thoughts and resist the urge to engage in compulsions.
You can no longer feel limited by fears of the past and live life fully in the present!
We all understand what it feels like to have that instinctual feeling that something just isn’t right, it just feels a little bit ‘off’.
We can’t always explain why, but we have that overwhelming desire to go and ‘fix it’ in some way. We do this until we feel as though things are as they should be.
Everyone experiences this, but for someone with Just Right OCD that feeling is relentless and hard to shake.
Unlike most other OCD subtypes, Just Right OCD is driven by a sense of incompleteness or incorrectness.
Today, we’re talking about the Top 5 Relationship Rules I have that have changed my life. This episode was inspired by a letter I wrote to all of you. For those of you who signed up for my newsletter, I give you tools and tips, and stories, and I tell you funny jokes sometimes. But I was writing the newsletter while I was in Australia just before I left when I was there in December, and I was reflecting on how beautiful my relationships are with my family now. And I was reflecting on why. Why are they so beautiful? Well, number one, they’re beautiful people. But number two, more importantly, I have learned these relationship rules, which have allowed me to have the most beautiful relationship with my family and the most beautiful relationship with my husband, my kids, my friends, and you guys.
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Number One, it’s so scary to do an exposure, and number two, there’s so many things that people have brought up as things to do, even me, this being Your Anxiety Toolkit. Maybe you get overwhelmed with the opportunity and options for tools that it gets too complicated. So, I want to make this super easy for you, and I want to go through step by step, like what you’re supposed to do during or after an exposure.
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Studies have shown that those with obsessive-compulsive disorder (OCD) struggle with increased rates of insomnia compared to those without OCD.
We all have sleepless nights from time to time.
The stressors of daily life can have our minds racing and us tossing and turning through the early hours of the morning. This is very common.
However, for those with OCD, obsessive thoughts can keep them stuck in a miserable cycle of not being able to switch off their minds. Trapped in a restless cycle of racing thoughts and sleepless nights, insomnia adds a new layer of difficulty when managing OCD.
Obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) are two common psychiatric disorders.
A person with little knowledge of these disorders could confuse the symptoms associated with attention and concentration, believing one disorder to be the other.
However, the two conditions are wildly different.
