What Is False Memory OCD, and how is it treated?

Almost everyone doubts their memories from time to time. We don’t always remember things perfectly, and it’s normal to occasionally have concerns or worries about what you’ve done in the past or whether you remember something accurately. 

For some people, concerns about the integrity of their memory can become all-consuming. Since they can’t be 100% sure about the memory, they fill in the blanks with worst-case-scenarios. They obsessively worry about a memory when in fact that memory is untrue, exaggerated, or distorted. 

What’s going on here? Often the explanation is a subtype of obsessive-compulsive disorder (OCD) called False Memory OCD. 

These experiences can be overwhelming and confusing, but they’re more common than you may think—and there are qualified professionals like myself who help people recover from their symptoms every day. Let’s explore more about what leads to False Memory OCD, how to make sense of what’s happening, and ways to find relief.

OCD and False Memories

False Memory (OCD) is an OCD subtype characterized by ongoing intrusive doubting thoughts and compulsive behaviors performed to neutralize anxiety related to one’s memories. People with False Memory OCD experience frequent doubts about things in the past and can become convinced they’ve done something wrong despite there being no evidence these memories are accurate. These recurrent doubts give rise to anxiety, guilt, shame, and other negative emotions, which drive people to engage in various compulsions to alleviate distress and gain certainty about their memories.

Is there a time limit for when memories can surface? No. “I’ve treated people who are still worried about things from decades ago coming back to haunt them in some way,” says my colleague Dr. Patrick McGrath, Chief Clinical Officer at NOCD. 

False Memory OCD symptoms

As with all forms of OCD, the primary symptoms are obsessions and compulsions. 

In the context of False Memory OCD, the obsessions—or unwanted and intrusive thoughts, images, and feelings—are related to the memory of a past experience. The doubt about what may or may not have happened feels so intense that then the person with OCD feels they need to engage in physical or mental compulsions (repetitive, often ritualistic behaviors) to relieve the distress.

Remember, “OCD always focuses on whether something is immoral, bad, wrong, awful, or horrible,” notes Dr. McGrath. So, unsurprisingly, people with False Memory OCD are trying to draw some conclusion about what their memories mean. For instance, “Am I a terrible person?”

Let’s review some common obsessions and compulsions associated with False Memory OCD.

Obsessions common in False Memory OCD

• Did I do this immoral, sinful, or 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?
• Did the person I “hooked up with” actually consent to sex with me?
• Did I walk out of the restaurant without paying by mistake? Was I trying to steal?
• Did I hit someone while driving and forget about it?
• 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 something?

False Memory OCD compulsions

The distress caused by the obsessions and doubts of False Memory OCD results in a variety of compulsions done to alleviate anxiety or increase confidence in one’s memory. 

Mental reviewing

One common False Memory OCD compulsion involves mentally reviewing past experiences to try to prove or disprove one’s doubts about what happened. So, if one’s obsessive worry is that they walked out of a restaurant without paying, they might try to replay every single moment of that experience in their head to isolate when the server came over, what they paid with, or if anyone was looking at them when they walked out of the restaurant. 

Reassurance-seeking

People with False Memory OCD might enlist friends or others who witnessed the event in question to validate the information they are doubting. In the example above, they might call the restaurant, ask a friend they were with, or go back in person to confirm they paid their bill.

Distracting, replacing, or suppressing thoughts

People with False Memory OCD may try to distract themselves from their obsessive thoughts by filling their minds with positive beliefs or directly suppressing negative ones. 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 what they think they’ve done to others. For example, someone may see a news report of a murder and become convinced they did it because they remember being nearby when it took place. They may even turn themselves in even though there is no evidence they committed the crime. 

Physical checking

Rather than assessing their memory or seeking reassurance from others, people with False Memory OCD may examine physical evidence more directly. For example, they may recreate their memory, physically revisit the location they are concerned about, try to access recorded footage, or spend hours researching news archives.

Avoidance

Someone may engage in various avoidance behaviors in an effort to ease their anxiety. For example, someone convinced they have forgotten to pay at a restaurant may decide that the best course of action is to never eat there again for fear that they’ll be publicly identified as a thief.

Am I experiencing normal doubts or False Memory OCD?

Since everyone has doubts about some of their memories and may even occasionally engage in certain safety behaviors like reassurance-seeking, one might wonder whether the doubts they experience are “normal” or healthy, or if they may be a symptom of OCD.

There are several factors that can clearly distinguish normal memory doubts from False Memory OCD. Your experiences may be a sign of OCD if: 

#1: Your memory doubts won’t go away

Even though everyone has doubts and worries about what they’ve done in the past, they usually leave a person’s mind without much difficulty. That’s unfortunately not the case for someone with False Memory OCD. In OCD, a fear of false memories does not go away once the person has gotten reasonable evidence they are innocent. Instead, their brain starts finding further possibilities of uncertainty, creating new scenarios that start the cycle over again.

#2: Your false memories feel very convincing

A related point is that false memories that occur in the context of False Memory OCD feel very real, accurate, or believable. This is one of the reasons why they are so hard to let go of. If you find that your memory doubts are relentlessly compelling, that could be a sign that OCD is the culprit. 

#3: You have a lot of memory doubts

While everyone experiences doubts about specific memories here and there, they are generally limited in number. If you experience memory doubts for a significant portion of every day, or if these continue to pop up about new events, it’s far more likely that False Memory OCD is involved.  

#4: You attribute a lot of meaning to your false memories

A common thread among all types of OCD is a tendency to attribute importance or meaning to intrusive events. In the case of False Memory OCD, people may think their doubts or the things they might have done mean they are a bad person or that they deserve punishment.

#5: Your memory doubts cause a significant amount of stress

Another key difference is that doubts in False Memory OCD cause a significant amount of distress. People with the condition may feel overwhelming anxiety, guilt, or shame about what they fear they did or didn’t do, partly because they attribute more meaning to their doubts and find them more persuasive than those without OCD would.

#6: You perform compulsions 

Because these memories or memory doubts are so attention-grabbing and distressing, people with False Memory OCD engage in behaviors to neutralize their doubts. Moreover, while these behaviors might bring relief for those without OCD, they tend to increase doubt and, ultimately, the need to perform more compulsions in people with OCD. 

Treatment for False Memory OCD: 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 highly effective through decades of rigorous clinical research. 

As part of ERP therapy, you will track your obsessions and compulsions related to false memory and make a list of how distressing each thought is. You’ll work with your therapist to slowly put yourself into situations that trigger your obsessions. This is carefully planned to ensure you’re gradually building toward your goal rather than moving too quickly and feeling overwhelmed.

Exposure to these thoughts and discomfort in a controlled and supervised environment, while resisting the urge to engage in compulsions, is the most effective way to treat OCD. When you continually give into the urge to do the compulsions, it only strengthens your need to engage in them more over time. On the other hand, when you prevent yourself from performing compulsions, you teach yourself a new way to respond. 

For an OCD specialist like myself, I find this recovery process inspiring. When people make progress through ERP, they gain a whole new ability to tolerate uncertainty and manage their symptoms—even when they confront memory doubts that used to overwhelm them with anxiety.

Let’s take the example where someone is afraid they’ve left a restaurant without paying and has decided to avoid going back at all costs for fear of being identified as a thief. A therapist may work with them to eventually face their fear and dine at this restaurant again. This may take time, especially if this exposure feels overwhelming and touches on one of their greatest fears (e.g., public humiliation). Together with their therapist, they’ll work to rank different exposures by difficulty. 

A less stressful exposure in this scenario might be for them to repeat to themselves: “I may or may not have walked out of this restaurant without paying. It’s impossible to know for sure.” Then, as a next step, they could repeat that phrase while walking past the restaurant, until eventually going in and eating there again. ERP therapy aims to help people with OCD become more comfortable with uncertainty about their obsessions, so the anxiety of the unknown no longer feels as terrifying or unmanageable. 

How to get help for False Memory OCD

False Memory OCD can be difficult to diagnose because it’s not what people traditionally associate with OCD—often, it’s not identified by mental health professionals. However, a therapist who truly specializes in OCD and has been trained to treat it with personalized ERP therapy—just like myself and my colleagues here at NOCD—will be able to make an accurate diagnosis and work with you to design a treatment plan specifically for your unique symptoms.

NOCD Therapy also gives every member access to live support groups, between-session support from your therapist, and OCD management tools that were developed by people who have suffered from OCD and successfully achieved recovery.

Recover from False Memory OCD with NOCD Therapy

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