The “Reality” of Real-Life OCD

The “Reality” of Real-Life OCD

Lynn S. Gots, PhD

Lynne S. Gots, PhD is a licensed psychologist in private practice in Washington, DC and Assistant Clinical Professor of Psychiatry and Behavioral Science at The George Washington University School of Medicine. She specializes in the treatment of OCD and anxiety. Dr. Gots is an ADAA Clinical Fellow and a graduate of the Behavior Therapy Training Institute of the International OCD Foundation.

The “Reality” of Real-Life OCD

Share
No

In the past few weeks, two people have contacted me seeking help for “real-Iife OCD.” I had never heard the term before, which is surprising because I am an OCD specialist. I spend roughly 75-80% of my clinical hours working with people who have OCD. I teach a course on OCD to psychiatry residents. I attend anxiety and OCD conferences every year and keep up with the latest research and treatment. So why didn’t I know about this disorder?

I turned to the Internet— the source of most people’s information and, unfortunately, misinformation about medical and psychological conditions—and my search yielded many links to articles about “real-life” or “real-event” OCD. As it turns out, I’ve treated countless patients with it. More than a handful of the people I’m currently seeing have it. I just never knew it had acquired a message-board-worthy name.

From what I have read, the term refers to obsessional rumination about past events that actually have occurred rather than the more widely known OCD worries about consequences that might arise in the future, such as starting a deadly fire by leaving on the oven. But even though the content and focus of the obsessions differ, the underlying thought processes driving them are identical: an extreme sense of responsibility, an overestimation of danger, and a poor tolerance for uncertainty.

While I understand the need for people to categorize their personal OCD struggles in order to make sense of them and feel less alone, I take issue with defining OCD by its content. Even when a real event is the trigger for OCD rumination, the actions—compulsions—taken to deal with the thoughts about a true or imagined occurrence are the problem, not the thoughts about it or its potential consequences.

You can call it “hOCD,” “rOCD,” “scrupulosity OCD,” “pOCD, “ and, yes, “real-event OCD,” if you like.  But in the end, the classifications do not describe different disorders. They are all just OCD.

Here are some examples of obsessions about real events and the compulsions associated with them:

Event: I talked my college roommate into taking LSD with me. He became paranoid. A few years later, he was diagnosed with schizophrenia.

Obsession: It’s my fault he’s schizophrenic.

Compulsions: Researching the causes of schizophrenia, reviewing the event to remember if I pressured him, asking friends who were there if they thought he had been reluctant to try the drug, reviewing conversations I’d had with him prior to the event for signs of mental illness.

Event: I caught the flu when I was pregnant because I didn’t get a flu shot. I had a high fever and took Tylenol for a week. My child has dyslexia.

Obsessions: If I had gotten the flu shot, I wouldn’t have had a fever, I wouldn’t have taken Tylenol, and she wouldn’t be having learning issues. She won’t do well in school. She won’t get a good job. Her life will be ruined. I’m a bad mother.

Compulsions: asking my husband if he thinks I’m a bad mother, researching the causes of dyslexia, reading stories about celebrities who struggled in school but are successful anyway, asking other moms if they had fevers during their pregnancies, looking at parenting message boards for posts about kids with dyslexia, checking several times a day to see if my child can read simple words.

Event: When I was in law school, I made extra money by helping high-school students write college admission essays.

Obsessions: I didn’t think about it until the recent news about the college-admissions’ scandals, and now I think I committed a crime. I work for the government and am applying for a security clearance. I don’t know if I should tell them about it. I’m worried I’ll fail a polygraph test if they ask me to take one.

Compulsions: researching the criminal statutes about fraud, reading the news and comparing myself to Felicity Huffman and Lori Loughlin, deleting the correspondence with the students from my computer, looking at their social media to see where they went to college and what they’re doing now, confessing to a few trusted friends, asking my boss repeatedly if I will have to take a polygraph.

All of these examples are ambiguous—the perfect medium for OCD to flourish. They also share another feature common to obsessions about past rather than future-oriented events: they generate feelings of guilt and shame, along with anxiety.

Maybe you showed poor judgment. Maybe you said or did something you now regret. Maybe you acted carelessly or irresponsibly. Maybe you even committed a crime. But unless we’re talking about murder (and with OCD, it is rarely so clear-cut), do you really deserve a life sentence for your actions with no chance of parole? Instead of condemning yourself for a past misstep, try a more self-compassionate approach. Acknowledge you may have behaved regrettably and learn from your mistake. And, most important of all, forgive yourself for your shortcomings. They don’t make you a bad person--merely human, and one with OCD,“real-event” or not. 

Lynn S. Gots, PhD

Lynne S. Gots, PhD is a licensed psychologist in private practice in Washington, DC and Assistant Clinical Professor of Psychiatry and Behavioral Science at The George Washington University School of Medicine. She specializes in the treatment of OCD and anxiety. Dr. Gots is an ADAA Clinical Fellow and a graduate of the Behavior Therapy Training Institute of the International OCD Foundation.

ADAA Blog Content and Blog Comments Policy

ADAA Blog Content and Blog Comments Policy

ADAA provides this Website blogs for the benefit of its members and the public. The content, view and opinions published in Blogs written by our personnel or contributors – or from links or posts on the Website from other sources - belong solely to their respective authors and do not necessarily reflect the views of ADAA, its members, management or employees. Any comments or opinions expressed are those of their respective contributors only. Please remember that the open and real-time nature of the comments posted to these venues makes it is impossible for ADAA to confirm the validity of any content posted, and though we reserve the right to review and edit or delete any such comment, we do not guarantee that we will monitor or review it. As such, we are not responsible for any messages posted or the consequences of following any advice offered within such posts. If you find any posts in these posts/comments to be offensive, inaccurate or objectionable, please contact us via email at [email protected] and reference the relevant content. If we determine that removal of a post or posts is necessary, we will make reasonable efforts to do so in a timely manner.

ADAA expressly disclaims responsibility for and liabilities resulting from, any information or communications from and between users of ADAA’s blog post commenting features. Users acknowledge and agree that they may be individually liable for anything they communicate using ADAA’s blogs, including but not limited to defamatory, discriminatory, false or unauthorized information. Users are cautioned that they are responsible for complying with the requirements of applicable copyright and trademark laws and regulations. By submitting a response, comment or content, you agree that such submission is non-confidential for all purposes. Any submission to this Website will be deemed and remain the property of ADAA.

The ADAA blogs are forums for individuals to share their opinions, experiences and thoughts related to mental illness. ADAA wants to ensure the integrity of this service and therefore, use of this service is limited to participants who agree to adhere to the following guidelines:

1. Refrain from transmitting any message, information, data, or text that is unlawful, threatening, abusive, harassing, defamatory, vulgar, obscene, that may be invasive of another 's privacy, hateful, or bashing communications - especially those aimed at gender, race, color, sexual orientation, national origin, religious views or disability.

Please note that there is a review process whereby all comments posted to blog posts and webinars are reviewed by ADAA staff to determine appropriateness before comments are posted. ADAA reserves the right to remove or edit a post containing offensive material as defined by ADAA.

ADAA reserves the right to remove or edit posts that contain explicit, obscene, offensive, or vulgar language. Similarly, posts that contain any graphic files will be removed immediately upon notice.

2. Refrain from posting or transmitting any unsolicited, promotional materials, "junk mail," "spam," "chain mail," "pyramid schemes" or any other form of solicitation. ADAA reserves the right to delete these posts immediately upon notice.

3. ADAA invites and encourages a healthy exchange of opinions. If you disagree with a participant 's post or opinion and wish to challenge it, do so with respect. The real objective of the ADAA blog post commenting function is to promote discussion and understanding, not to convince others that your opinion is "right." Name calling, insults, and personal attacks are not appropriate and will not be tolerated. ADAA will remove these posts immediately upon notice.

4. ADAA promotes privacy and encourages participants to keep personal information such as address and telephone number from being posted. Similarly, do not ask for personal information from other participants. Any comments that ask for telephone, address, e-mail, surveys and research studies will not be approved for posting.

5. Participants should be aware that the opinions, beliefs and statements on blog posts do not necessarily represent the opinions and beliefs of ADAA. Participants also agree that ADAA is not to be held liable for any loss or injury caused, in whole or in part, by sponsorship of blog post commenting. Participants also agree that ADAA reserves the right to report any suspicions of harm to self or others as evidenced by participant posts.

RESOURCES AND NEWS
Evidence-based Tips & Strategies from our Member Experts
RELATED ARTICLES
Block reference