What to Read
False Memory obsessive-compulsive disorder (OCD) is an OCD subtype characterized by ongoing intrusive doubting thoughts and compulsive behavior around a past event. People with False Memory OCD experience frequent doubts about things that have happened to them and may be convinced they’ve done something wrong despite no evidence of these memories being true (e.g., “Did I accidentally steal and don’t remember?”). The recurrent doubting thoughts are often viewed as an indication that their fears are true (e.g., “if I’m so concerned I stole, then I must have. Otherwise, why am I thinking about it?”), which fuels anxiety about their memories and drives people struggling with these thoughts to engage in various compulsions aimed at gaining certainty about their memories (e.g., asking for continual reassurance from a friend about whether you accidentally stole something, or searching through your home for the receipt).
Most people with False Memory OCD find their doubting obsessions can feel impossible to let go of. Their false memories can feel like real events. The more the person fixates on them, the more their brain may fill in these false memories with even more false information, further convincing themselves they are guilty of things they haven’t done. Furthermore, even though behaviors aimed at feeling more certain of one’s memory (e.g., repeated checking) might seem to increase confidence in memory accuracy, research actually shows the opposite: these behaviors actually decrease one’s confidence in their memory (Cuttler & Graf, 2009).
Alcohol use can play a significant role in False Memory OCD. When a person can’t clearly remember what happened for long periods of time, their OCD may take over and start spinning tales of false memories.
Let’s say Joe is in a committed relationship. He was drinking one night and can’t exactly remember everything that happened at the bar with his friend. He has a hazy memory of a brief interaction with a woman. He might begin to fixate on this specific interaction and wonder: “Did anything else besides a brief conversation take place between us? Did I cheat on my partner last night? How can I be certain?” Joe’s uncertainty and anxiety may feel overwhelming and drive him toward compulsive behaviors in order to alleviate it. This could look like asking his friend to recall what happened last night. Do they remember you interacting with anyone? Was it a normal interaction? Joe may also be compelled to find physical evidence, like asking the bar for last night’s video footage, just to be sure. These compulsions only ease the person’s anxiety temporarily. For someone with OCD, eventually, the anxieties start up again (e.g., Joe might start thinking, “Yes, my friend told me he saw me interact with this woman, and we only exchanged a few words, but what if something happened when he stepped outside?”).
Some Examples of Obsessive Thoughts:
- Did I do this immoral/taboo action?
- Did I accidentally say something inappropriate to my friend yesterday?
- Did I interrupt my partner when he spoke?
- If I’m wondering about this, doesn’t it mean it’s true?
- Did I hurt my brother or sister when we were younger and playing at the park?
- When my sister fell and fractured her arm when we were children, was it actually because I pushed her? Would I have done something like that? Am I a bad person?
- Did the person I “hooked up with” actually consent to sex with me?
- Did I walk out of the restaurant without paying by mistake? Maybe it wasn’t by mistake. Was I trying to steal?
- Did I touch my student inappropriately when they came to see me after class? Am I a pedophile? Did I purposely block this memory from my mind in order to forget that I am a bad person?
Some Examples of Compulsive Behaviors:
Mental review: A common False Memory OCD compulsion is to mentally review past experiences to try and prove or disprove your doubts about what happened. So if your obsessive thought is that you walked out of a restaurant without paying, you might try and review every single moment of that experience in your head. You’ll try to mentally replay when exactly the waiter came over, and the moment you asked for the bill. You might try to remember whether you paid with cash or a credit card. Wouldn’t they have said something if you tried to steal? Did anyone look at you? You might replay every past dining experience you can remember to reassure yourself that you have always remembered to pay and that you have never stolen anything in your life.
Reassurance seeking: People with False Memory OCD might turn to friends or other people who witnessed the memory in question in an effort to validate the information they are doubting. In this example, the person might call the restaurant to be sure they paid. They may ask the friend they were with or go back in person to confirm their bill was paid with the waiter. The questions may be more general as well, like asking a friend or family member: Have you ever walked out of a restaurant without paying? Do you think that could possibly happen?
Distracting, replacing, or suppressing thoughts: People with False Memory OCD may try to distract themselves from these obsessive thoughts, try to fill their mind with positive thoughts instead, or attempt to suppress their thoughts. They might repeat to themselves: I am not a thief. I have never stolen anything in my life.
Confessing: When someone with False Memory OCD has convinced themselves they are guilty of an action that happened in the past, they may confess to important figures in their life, or to authority figures on what they’ve done wrong. For example, a person may see a news report of a murder and become convinced they were the ones to do it on the basis that they cannot exactly remember what they were doing when the murder took place but recall being in the vicinity. They may turn themselves in on the basis that they think they may potentially be guilty, even though there is no evidence at all that they had done this.
Physical Checking: People with False Memory OCD may try to recreate a scene they have in their minds. They may physically revisit the location they are concerned about, try to access recorded footage, spend hours researching news archives about an event they may have possibly been implicated in.
Self-punishment or Avoidance: Someone may act on the guilt from what they may have done in an effort to ease their anxiety. For example, if someone is convinced they have forgotten to pay at a restaurant, they may decide that the best course of action is to never eat at this restaurant again, for fear that they’ll be publicly identified as a thief.
Even though everyone might have doubts about what they’ve done in the past or worry that they may have forgotten to pay at a restaurant at one point or another, these thoughts usually leave a person’s mind without much difficulty. That’s unfortunately not the case for someone with False Memory OCD. The fear of false memories does not go away once the person with OCD has gotten reasonable evidence they are innocent. Instead, their brain starts spinning further possibilities of uncertainty, creating new scenarios that start the obsessive-compulsive cycle over again. One criterion for a diagnosis of False Memory OCD is that a person spends at least one hour per day on these obsessions and compulsions. Often, the obsessions and compulsions can take control of a person and their ability to function in their everyday life.
ERP Therapy
The best course of treatment for False Memory OCD, like all types of OCD, is exposure and response prevention (ERP) therapy. ERP is considered the gold standard for OCD treatment and has been found 80% effective. The majority of patients experience results within 12 – 25 sessions. As part of ERP therapy, you’d be tracking your obsessions and compulsions around your false memory and making a list of how distressing each thought is. You’ll work with your therapist to slowly put yourself into situations that bring on your obsessions. This has to be carefully planned to ensure it’s effective and so that you’re gradually building toward your goal rather than moving too quickly and getting completely overwhelmed.
Adapted from Nicholas Farrell.
What to Watch
Please watch the video below about False Memory OCD.
[VIDEO]
What to Do
Create your ERP hierarchy following the example and instructions below.
What to Measure