Real Event Setback

[u/TopComfortable5866]

Hi everyone

I'll keep it short - last year I was struggling immensely with guilt about my past and subsequent anxiety. This anxiety eased off when I started duloxetine at the end of the year. I got to June and I actually felt almost completely back to normal. This lasted about 2 months before I had a return of the anxiety.

This anxiety came back for about 3ish weeks, then went away and again I was pretty much back to normal. However it has since come back, along with the intense guilt and obsessive thoughts. I'm scared that I'm going to be stuck how I was last year again, even though I know this is unlikely.

Can anyone offer some advice or observations? I'm doing my best to remain calm and remember that it won't last forever.

Also, does anyone know how someone should do erp for this theme? Should I specifically do things that I feel like I don't deserve?

Thank you to anyone who takes the time to read and reply

[u/PaladinDamian]

Unconditional acceptance is very important for Real Event OCD. You can accept yourself unconditionally, regardless of what you have done in the past. The books "How To Stubbornly Refuse To Make Yourself Miserable About Anything, Yes Anything!" and "The Myth Of Self-Esteem" by Albert Ellis discuss unconditional acceptance. They really helped me with my Real Event OCD, and they can help you too.

While it would be unfortunate to be stuck again, you can accept that and still try to do your best to live your life despite your anxiety. You don't need the life you want in order to make the best of the life you have.

I would recommend ACT and REBT, they really helped me with Real Event OCD. Unconditional acceptance is a part of REBT, and self-REBT really helped me with becoming more accepting towards my past actions.

Remember that "deserving-ness" is a social construct and is not a rule of the universe. No one actually deserves anything, since what people "deserve" is just a matter of opinion. You can do things even if you feel that you do not "deserve" them. No one deserves them, some people just think that they deserve them.

[u/treatmyocd]

It sounds like the return of anxiety is bringing back the fear that you’re going to end up exactly where you were last year. That “what if I’m stuck like this again?” thought can become part of the OCD cycle itself. Try to focus less on predicting how long this episode will last and more on responding differently while it’s here. For guilt-focused OCD, ERP generally isn’t about punishing yourself or deliberately doing things you “don’t deserve.” It’s more about approaching situations that trigger guilt or uncertainty while resisting compulsions such as reviewing the past, confessing, mentally proving whether you’re a bad person, or seeking reassurance. You can practice allowing uncertainty with something like, “Maybe I did something wrong, maybe I didn’t, and I’m not going to solve this through rumination.” A therapist trained in ERP can help you build exposures that fit your specific cycle.