Symptoms

Types of "Real Event" Obsessions:

a. Harm to Others: Individuals may obsessively fear that they have caused harm to others, intentionally or unintentionally. This may involve concerns about physical harm, emotional harm, sexual behaviour, making others uncomfortable, having "missed" cues of discomfort or non-consent in others, or damage to relationships. They may even obsess over whether or not events happened, or whether they perceived them accurately at the time. These "events" are only "real" in that the obsessive-compulsive scrutiny is pointed at an event that did happen, e.g., they went on a date with someone years ago, but their obsessive fears are attached to something that may not have happened, e.g., "did I make them uncomfortable when I leaned in to kiss them, did they only kiss me back because they were uncomfortable?: 
 

b. Mistakes and Responsibility: Obsessions may revolve around the fear of having made a mistake with significant consequences, such as financial errors, professional errors, or mistakes with lasting impacts on oneself or others.
 

c. Moral Scrutiny: Individuals with "real event" OCD may engage in intense moral scrutiny of their past actions, questioning whether they have acted in ways that conflict with their moral or ethical values. Often, this may involve scrutiny over events from childhood (e.g., being mean to a friend) where they hold themselves to the standard of their adult selves, and view their intent and awareness of their child self at the time as being as mature as their moral standards and awareness of adulthood. 

 
Compulsive Behaviours: 

Compulsive Rumination and Mental Scrutiny: In response to intrusive thoughts and fears surrounding e.g., whether or not something bad occurred in their past unknowingly, or whether or not they misperceived an event of the past, the individual may engage in compulsive scrutiny of their memories and compulsive ruminative thinking patterns trying to reassure themselves. Scrutiny over their mind and memories inadvertently increases uncertainty (like when you repeat a word until it loses all meaning, scrutinising your memory makes it feel more and more uncertain, with an attentional bias fixated on what is not known rather than what is known or remembered), which they may perceive as appearing to"confirm" the validity of these fears, manufacturing guilt in the process, which further appears to validate their fears, rather than seeing this as an inevitable byproduct of their ruminative thinking patterns. That is, the search to prove their innocence to themselves makes them feel like they don't already know this to be the case, and in feeling like they do not know this to be the case, and the inability to find this "proof" through their compulsive rumination which only increases the amount of uncertainty, only makes them feel increasingly guilty. This manufactured guilt may then lead to avoidance of certain topics e.g., in discussion with others, which only appears to validate the sense of guilt, and in relating to themselves as guilty, they may even compulsively confess their "sins" to others. This compulsive confession is also characterised by the obsessive need to "ensure" that all details are encountered for in their confession, else the confession "does not truly count" and the acceptance they received from the individual they confessed to must "not be based on the full picture and thus not count". 

Reassurance-Seeking: Individuals may seek reassurance from others or repeatedly analyse the events in question to gain certainty about the consequences of their actions.

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Avoidance: Avoidance behaviours may include avoiding situations or people associated with the feared events. Individuals may also avoid activities that trigger distressing thoughts.

Self-Punishment: Some individuals may engage in self-punishment rituals, such as self-blame, self-criticism, or attempts to "make amends" for perceived wrongs, or to "prevent" themselves from acting in an undesired way again. 

 
Impact on Daily Functioning:

a. Interference with Daily Life: "Real event" OCD can significantly interfere with daily functioning, affecting work, relationships, and overall well-being. The constant preoccupation with past events can be mentally exhausting.
 

b. Emotional Distress: Individuals may experience intense emotional distress, including guilt, shame, anxiety, and depression, related to their perceived role in the past events.
 

c. Isolation: The fear of causing harm may lead to social withdrawal or isolation as individuals try to minimise their perceived impact on others.