False Memory OCD: What It Is, Symptoms, & Treatment

What Is False Memory OCD?

False memory OCD is a presentation of obsessive compulsive disorder that includes experiencing unsettling feelings about a particular event that may or may have not happened. False memories in OCD are often related to the theme or content of the person’s obsessive intrusive thoughts, such as having caused harm, offended someone, or cheated on their partner.

Obsessions may also consist of uncertainty about whether a mistake was made that resulted in negative consequences, which signals the overlap of OCD and perfectionism. Some may experience a nagging and unshakable feeling about perceived important details of an event that they can’t remember. These imagined or real events are almost always negative or immoral, often causing people to question their virtue or morality.

The OCD Cycle

The three components of false memory OCD include:

• The event: This refers to the event that causes one’s obsession and intrusive thoughts. For example, a student worries that he can’t remember if he glanced over at somebody else’s answers to a test that he aced.
• The obsession: This is the actual action or mistake a person is concerned about. For instance, the student worries that he cheated on the test and will lose a scholarship he was offered because of it.
• The compulsions: OCD compulsions are the behaviors one utilizes to reduce distress caused by the obsession. For example, the student goes to confess to his teacher, friends, family, and clergy wanting to know if they thought he cheated.

OCD False Memory & Guilt

As with regular OCD, those with false memory OCD experience more excessive feelings of guilt and sense of responsibility than the general population. When the feeling of guilt pops up, they’ll dwell on it until they can find the improper past behavior to account for the guilt.¹

On the other hand, someone with typical feelings of guilt may have remorse about something that they actually did wrong. However, they have the ability to process their emotions, rectify their actions, and move forward.

False Memory OCD Symptoms

People with false memory OCD typically experience other symptoms of OCD, which mainly stem from “not-feeling-right” and perfectionism. They may struggle with having a vague sense that they did something wrong in the past, or experience doubt about the reality of the event in question. They will then perform compulsive behaviors in order to alleviate their negative feelings.

Examples of Obsessions in false memory OCD may include:

• An obsessive need to know about or remember an event
• Intense feelings of guilt over an alleged event
• Rumination and doubt about memories being real
• Intrusive thoughts of fictional memories

Examples of compulsions in false memory OCD may include:

• Mentally checking or reviewing an event to achieve certainty
• Reassurance seeking from others about whether an event happened
• Avoidance behaviors towards people and places in their false memory
• Punitive actions toward self for perceived misconduct

What Causes False Memory OCD?

Anyone can have false memories.² Perceptions and memories of the past may change as they become more distant over time or as our memory becomes less reliable. Two people may each have an entirely different account of one event. However, both individuals may be generally correct in their details, as we all have subjective experiences of things.

With OCD, a person interjects false details into memories of an event to determine if they are responsible for having caused a negative consequence. False memories can manifest not just from OCD, but can also be symptomatic of post-traumatic stress disorder or from disturbing events that cause dissociation.

False memories can be caused by factors such as:

• Self-doubt
• Self-mistrust or lack of confidence in the accuracy of memories
• Sounds or other sensory experiences associated with being triggered
• Distorted perceptions causing “false” emotions
• Misattribution of other events
• Memories related to PTSD or other disorders triggering a higher-intensity response
• Blackouts from substance use creating concern about inappropriate behaviors

Types of OCD False Memories

False memory OCD consists of doubting obsessions that cause symptoms of anxiety or guilty feelings of being responsible. Compulsions, such as checking or asking others for reassurance, are performed out of a sense of morality. How these behaviors are exhibited can vary depending on a variety of factors, such as the type of event in question.

Common obsessions in false memory OCD include:

• Harm OCD: This involves the fear of having caused physical, mental, or emotional damage to others, either inadvertently or on purpose.
• Existential OCD: This involves fear of causing psychic harm by putting obsessive thoughts out into the universe.
• Sexual OCD: This centers on the fear that one may have raped or sexually assaulted someone, watched underage pornography, made inappropriate comments to someone, or sexually aroused someone without knowing.
• Moral perfectionism: People are concerned they might have unknowingly offended someone, cheated on a test, or provided false information on their tax return.
• Scrupulosity OCD: Someone worries about having committed a sinful act in the past and continues to compulsively confess to his priest

How Do I Know It’s OCD Vs. an Actual Memory?

It’s human nature to question the accuracy of how we remember things and even try to find ways to validate those recollections every now and then. But if you are unsure if you’re experiencing typical doubts regarding your memories or false memory OCD, there are ways to tell.

Here are some tips for how to recognize false memories in OCD:³

• Your doubts about the memories won’t go away: Anyone may have doubts about past actions, but can usually move past them. But for someone with OCD, even with reasonable evidence of no wrongdoing or innocence they’ll still try to find cracks in the story, continuing to fuel their obsessive cycle.
• Your false memories feel really real: For people with false memory OCD, their recollections feel very authentic and believable which is why it’s so hard for them to let them go. When the memory doubts are very convincing, this may be an indicator that it is stemming from OCD.
• You let the false memories have power over you: Generally, people might experience terrible thoughts about themselves from time to time that eventually dissipate. Yet for an OCD sufferer much importance is placed on their intrusive thoughts making them believe that their doubts or past actions means they’re awful and deserve punishment.
• Your false memories cause you a lot of stress: People with false memory OCD tend to experience a great deal of stress because they are hyper focused on finding reasons for why their doubts are convincing.
• You perform compulsions to try to rid yourself of the doubt and anxiety: Intrusive doubts are often very prominent in any form of OCD which increase reassuring behaviors to pacify those doubts. While these actions might bring relief to people without OCD, the opposite is true for those with OCD as this only intensifies their doubts and compulsions.

Why Do the False Memories Feel So Real?

People with OCD can experience false memories that feel extremely real and graphic. This can occur because the same regions of the brain are stimulated whether a person is imagining something or recalling a real-life experience. So, if someone with OCD has a thought of harming another person or believes that they have done so, it’s possible that this idea or image can turn into a false memory and be stored in their brain as an actual event.^3,4

OCD sufferers can also develop strong disturbing feelings related to the false memory, making it feel even more credible. Thus, those with OCD may think that they feel a certain way for a reason and convince themselves that such feelings mean that the memory is not made-up and conclude that it has to be real.^3,4

How Is False Memory OCD Diagnosed?

OCD is commonly assessed by using the Yale-Brown Obsessive Compulsive Scale Symptom Checklist.⁵ Because OCD is considered the “doubting disease,” any symptom can trigger a false memory and provoke the need to compulsively check.

Questions to ask your doctor about false memory OCD include:

• Where can I find specialized false memory OCD treatment?
• Can you refer me to someone who provides exposure and response prevention treatment?
• What does a typical treatment plan look like?
• Where can I find specialized false memory OCD treatment?
• What outcome can I expect from treatment?

False Memory OCD Treatment Options

In terms of treatment, therapy is generally considered the most common psychological approach for false memory OCD. Adjunctive strategies such as stress management, self-compassion, and mindfulness also contribute to mitigating this challenging disorder.

Therapy

In many cases, exposure and response prevention will be recommended when treating false memory OCD. However, a few other methods may be utilized throughout treatment as well. It is important to find the right therapist who specializes in OCD in order to receive effective treatment.

Therapy options for false memory OCD may include:

• Exposure and response prevention (ERP) therapy: ERP is a form of behavior therapy that helps people learn to accept the possibility of their feared memory having happened and to live with uncertainty. It also helps one determine how to move forward in life if the event did occur.
• Cognitive behavioral therapy (CBT): CBT for OCD helps people challenge their irrational beliefs and reframe their cognitive distortions. It provides the opportunity to perform role-plays about the catastrophic outcomes as if they did happen.
• Acceptance and commitment therapy (ACT): ACT is a form of CBT centered on remaining in the present moment, not fighting thoughts and feelings, and taking action. ACT helps people become more mentally flexible and less impacted by thoughts, sensations, and feelings associated with OCD.

Medications

Medications for OCD generally include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Atypical antipsychotics may also be prescribed to enhance the effects of SSRIs or SNRIs.⁶

Tips for Coping With False Memory OCD

Coping with false memory OCD is challenging because it is like an itch you can’t scratch. However, resist this urge to “scratch” by performing compulsive checking–this feeling will pass on its own if you let it run its course. With consistent practice, you will experience less distress and urgency. Along with this, there are several healthy coping mechanisms you can adopt to help you deal with the accompanying anxiety of sitting with the feeling.

Here are some tips for how to overcome false memory OCD:

• Practice grounding techniques: Grounding techniques help people remain in the present moment by encouraging them to focus on their surroundings. Try doing this by feeling your feet on the floor, the weight of your body in your chair, or the impact of your steps on the ground.
• Practice mindfulness: Mindfulness helps a person focus on the here and now by objectively using any of their five senses to describe what they can observe. It also teaches people to let go of something over which they have no control.
• Adopt stress management skills: Stress management may include engaging in physical exercise, getting adequate sleep, maintaining a healthy diet, or having a wellness lifestyle.
• Find a healthy distraction: Try staying busy doing something you enjoy, such as a hobby or other pleasurable activities.
• Reframe your thoughts: Sometimes, finding humor by exaggerating the details and outcome of the event can help you feel better.

Final Thoughts

False memory OCD can feel like being chased by a haunting phantom. There can be a faint sense of dread over a real or imagined event about which the OCD demands certainty. However, there is effective treatment available to help you overcome your challenges and improve the overall quality of your life.