While obsessive-compulsive disorder (OCD) typically involves recurrent thoughts about a feared future event, real event OCD involves thoughts that a past event triggers.

OCD is a condition where a person experiences persistent, unwanted thoughts and actions that they feel compelled to repeat.

A person performs these repetitive behaviors, known as compulsions, to alleviate anxiety and avert potential harm to themselves or others.

These fears often have an association with future outcomes. Sometimes, a person may have obsessions centered around past events. Some refer to this as real event OCD.

This article explores real event OCD, its symptoms, triggers, and more.

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Real event OCD, or real life OCD, is a manifestation of OCD where the obsession centers around a past event or situation. This contrasts with the more widely known manifestation of OCD in which worries and fears focus on an imagined dreaded future event.

A person with real life OCD may excessively ruminate about what they did or did not do in the past, which causes them excessive guilt, shame, and anxiety. They may become fixated on the event and concerned about their character, morality, and goodness.

They may also attribute the cause of a recent event to past actions or behavior or a fear of the future repercussions of their behavior.

As a response, a person typically engages in compulsions that involve spending extensive time playing the event repeatedly in their minds to answer questions, gain reassurance, and find validation for their actions.

Real event OCD generally comprises the following elements:

  • Event: An actual past event that triggers a person’s shame and guilt.
  • Obsession: Cognitive distortions or exaggerated and irrational thought patterns that have an association with the event.
  • Compulsions: Steps a person takes to validate or reassure themselves and relieve their guilt.

Most people with real event OCD experience intrusive thoughts like those with OCD. However, the hallmark symptom of OCD is how a person processes, interprets, and reacts to these thoughts and the meaning they apply to them.

Aside from intense feelings of guilt and shame and repeated rumination on past actions, obsessions, and compulsions, real event OCD typically has the following features:

  • avoidance of places, people, or things that are reminders of the event
  • intrusive, unwanted, or distressing thoughts that occur without warning
  • anxiety
  • need for reassurance

It is also common for real event OCD to co-occur with other conditions, such as post-traumatic stress disorder (PTSD) and depression.

It is unclear what types of life experiences or events trigger real event OCD. However, repeated trauma exposure in childhood may play a role in OCD development.

Some also trace the onset of their symptoms to a traumatic incident or a stressful period in their life.

Each person with real event OCD may experience different triggers that are unique to them and their circumstances.

It is natural to recall events in the past and experience doubts and regrets about them. However, a person with real event OCD typically spends excessive energy and time experiencing intrusive thoughts.

Similar to the typical features of OCD, obsessions in relation to real event OCD can cause significant distress and impair a person’s social, personal, and professional life.

A person with real event OCD may experience the following:

  • extreme, overwhelming guilt
  • excessive rumination over a past event that hinders their ability to concentrate on anything else
  • feeling that the actions done in the past are inexcusable
  • thoughts that randomly appear and are difficult to control

The Anxiety and Depression Association of America explains that real event OCD is still OCD regardless of its content or the trigger of the obsessions.

Like OCD with other manifestations, the mainstay treatments for OCD are medications, therapy, or a combination of both.

Serotonin-specific reuptake inhibitors (SSRIs) are the mainstay medications for OCD. Other medicines for OCD include serotonin-norepinephrine reuptake inhibitors (SNRIs) and antipsychotics.

A specific type of cognitive behavioral therapy (CBT) — exposure response prevention (ERP) — is the most common psychotherapy for OCD. People also use mindfulness-based cognitive therapy, such as relaxation and meditation.

Learn more about psychotherapy for OCD here.

Living with real event OCD can be difficult. In addition to treatments, below are some helpful practices that can help ease obsessive thoughts:


People with OCD often experience poorer sleep quality and more sleep disturbances than people who do not have OCD. Tiredness can worsen OCD symptoms. This means getting enough sleep is important for coping with OCD.

Eating a healthy and balanced diet and getting regular exercise can also be beneficial for helping manage anxiety and depression symptoms.


Learning self-compassion can help people acknowledge failures and forgive themselves for their mistakes.

Mindfulness and relaxation

Relaxation practices such as deep breathing, guided imagery, and progressive muscle relaxation can help promote physiological and psychological relaxation and overall well-being.

Read more on how to cope with OCD here.

The following are questions people frequently ask about real event OCD.

What causes real event OCD?

The exact cause of real event OCD is unknown. However, childhood trauma and stressful life events may trigger the onset of symptoms.

How is real event OCD different from PTSD?

People with PTSD experience disturbing and intense thoughts, memories, or experiences that relate to a traumatic event a person has previously experienced.

Meanwhile, the past life events in real event OCD can be typical or nontraumatic life events that a person distorts or magnifies to be more important than they are.

Real event OCD is not a different type of OCD but is a manifestation of OCD. It generally presents with intrusive and distressing thoughts in relation to past life events.

These thoughts can propel a person to replay them in their minds repeatedly in an attempt to find answers and justify or vindicate their actions.

It is important for a person who frequently has disturbing or uncontrollable thoughts to seek help from a mental health professional for a proper diagnosis and treatment. Self-care and relaxation techniques, as well as practicing self-forgiveness, can also help manage symptoms.