Real event OCD: what if I really did do something wrong?

If you did do something you regret, I am not going to tell you it was fine. Therapy is not a laundering service, and treating your guilt as a symptom is not the same as declaring you innocent. Plenty of people with this theme did do something they regret, and the treatment still applies. Here is how.

Two things that are both true

The first is that something may have happened. A thing said in anger, a night that went further than it should have, a boundary you are not sure you respected, a moment of cruelty or carelessness. Real events, with real weight. The second is that what you are doing about it now, the reconstructing, the rereading, the checking of your own reaction, is not addressing the event. It is a compulsion, and it is repairing nothing for anybody.

Both are true at once, and the treatment holds both.

What wrongdoing actually asks of you

Genuine wrongdoing has a route, and it is a short one. Acknowledgement: this happened, and it was wrong, or at least not what I would want of myself. Repair, where repair is possible: an apology, a making-good, a conversation, if those are available and appropriate and would help the other person rather than only you. And then living differently: knowing better, and doing better.

That route is finite. It can be walked. Once it has been walked, or once it is clear that some part of it is not available, because the person is gone, or because contact would do harm, the conscience has done its work and can settle, if not vanish.

What the reviewing does instead

Reviewing the event ten thousand times is not on that route. It does not acknowledge, because acknowledgement is a single act and reviewing is endless. It does not repair, because nothing reaches the other person. And it does not lead to living differently, because a person spending their days inside a memory from years ago is not living at all. The rumination feels like taking responsibility, and it keeps you in the event instead of moving you through it.

Very often, too, the weight being carried is far larger than the event. People describe to me things that were unkind or clumsy or drunk, and the guilt attached to them is the guilt of a crime. The mismatch is itself a sign of the OCD engine, which inflates responsibility and demands certainty about a moral verdict that no one can give with certainty about anything.

The certainty you are looking for

Underneath the reviewing is usually a demand: I need to know, for certain, whether I am a bad person because of this. That certainty is not available. Not because the answer is hidden, but because character is not the kind of thing that gets settled by a sufficiently rigorous examination of one evening. What people do next is what makes the difference, and rumination is not an action.

How treatment handles it

We deal with it honestly rather than pretending otherwise. Part of the early work is working out, together, what actually happened as far as you can tell, what the honest weight of it is, and whether any repair is owed and possible. If it is, we plan it, deliberately, in daylight, rather than as a two-in-the-morning confession that functions as reassurance-seeking.

Then the treatment proper: CBT with exposure and response prevention, which withdraws the reviewing, the reconstructing and the checking, gradually and by agreement, and lets the memory sit there un-investigated until it goes back to being what it is. A memory of something you regret, doing nothing, that you have already answered for in the only way that answering is possible.

I will not tell you it was fine. I will also not take the bait when the verdict is asked for, because my telling you anything would last an hour and cost you a fortnight.

If you have been carrying a real thing at a weight it does not warrant, there is more on how I treat real event and false memory OCD, and honesty about the event is part of it.