When you find yourself obsessively worrying about false memory, your brain’s unconscious mind previously picked up on something and triggered you. In other words, it alerts your brain’s amygdala to warn you of danger. As a result, it activates anxious feelings, so you do mental and physical checks to ensure things are safe, albeit unsuccessfully. Specifically, the problem repeatedly comes back to doubt and fearing hypothetical scenarios.
For example, consider Sam, who developed a false memory obsession several months after attending a party. He contemplated for hours on end, thinking he’d caused injury to someone. As a result, he anticipated a fearful outcome, such as being arrested and imprisoned.
The party he attended was an actual event that Sam remembers. However, since he could not recall hurting someone there, he repeatedly asked friends at the party if they remembered. Of course, each person said no. They said he wasn’t aggressive and that he got a taxi home relatively early.
But Sam had doubts. He worried that what his friends were telling him didn’t fit the facts. Or, more specifically, what he felt were the facts. Sam mistakenly believed he must have been drunk. Otherwise, he wouldn’t have a hazy memory of doing what he thought he did. That is to say, if he were sober that night, he would remember everything, wouldn’t he?
And so, Sam could not rest. As a result, his “need to know” compulsion continued, and friends wondered why he repeatedly asked the same question. Worse, the compulsion to check otherwise only increased the intensity of the obsession, for example, phoning the hospital to check admissions the night of the party. Also, he began avoiding triggers that reminded him of the party, such as turning down invitations to meet up with friends for a drink.
Before the obsessional doubt
Sam’s therapist pointed out that he had no concerns about being aggressive and hurting someone before the obsessional doubt. For example, months after the party, it seems his unconscious mind triggered him into questioning his actions but not before that. He and his therapist discovered the trigger was hearing of a mild-mannered man who lunged into a violent attack at a gathering after drinking too much alcohol. They then discussed how Sam questioned if he could turn out the same. It seems hearsay* (the trigger) brought on the onset of false-memory OCD. Further, it added credibility to the obsession, even though it could not validate it.
Nonetheless, Sam continued to think of how he is a mild-mannered person. “If only I hadn’t gone to the party,” he thought. He could not get past the idea that he could have turned violent, causing injury to an innocent person. It made him think that doubt didn’t feature anymore; he just needed to remember.
That being the case, Sam contacted the hospitals again to check if no one had been admitted that night, but nothing. Still, images flashed across his mind about what might have happened, and so he did not trust that the pictures in his head were intrusive. It was so unbearable that imaginary scenarios and fearing the outcome of committing a terrible crime terrified him.
At this stage, his therapist talked with him about uncertainty. She explained that anticipation of a “what-if” scenario is a result of the amygdala releasing epinephrine, causing a fight, flight or freeze response. Or, in other words, a defence reaction. The amygdala doesn’t know if the situation is real or intrusive. So it will raise the alarm either way. Therefore, when Sam’s colleagues ask him if he wants to join them for a drink after work, his amygdala fires up automatically, signalling danger. Consequently, he turns down their invitation, an avoidance behaviour (compulsion) that feeds his fear.
So what can Sam do?
Sam can train himself to avoid avoidance. So, let’s suppose he agrees to go to the pub with friends. Next, he would focus on nothing negative happening. While doing so, he would utilise response prevention. That means avoiding avoidance. In other words, he would stay at the gathering, have a drink, and be around gentle-looking people, maybe at a distance to start with. In doing so, he would sit with the uncomfortableness of doubt about the earlier false-memory event.
After repeating this new action several times, his amygdala will learn that the earlier triggering event does not correlate with aggression and harm. Consequently, it creates a positive association.** As a result, it will form new memories and stop Sam’s defence reactions, including checking. On that account, his anxiety will increase less the more he does response prevention.
Then, Sam will see that in most cases, mild-mannered people who go to the pub are not threatening. He would then apply the same principle and see himself as someone who can go out, enjoy a drink and not worry about turning violent, hence, the positive association.
Furthermore, Sam learns to resist the urge to ruminate about the party and the false memory of causing harm. His therapist explains that if he continues to ruminate, it will fire the anxious part of his brain, as all rituals do, and keep OCD going in a circle. In that case, Sam learns to move away from the stories inside his head. In short, he does mindful exercises that strengthen the positive association. One of his favourites is reading. When he shifts state like this, he doesn’t feed his imagination with misinformation about his specific fear. Similarly, the mind can only think of one thing at a time. So, for example, when Sam’s mind sways to ruminating, he realises it’s crucial to bring himself back to reading, the mindful activity.
Another available treatment is inference-based therapy, which is also evidence-based. So, if you are someone who has tried ERP but haven’t taken well to it, check out the book below by Kieron O’Connor and Frederick Aardema. It does not involve exposures. Instead, it discusses the inferences (.g., hearsay) added to an obsessional story, how to uproot them and replacing them with sense information in the here and now. In doing so, it separates you from your imagination (the obsession) and reality.
You might never know the pairing as to why a false memory began for you or the trigger for OCD onset. And that’s okay. The point is not to rely on your amygdala in an OCD situation. Instead, take a moment to stop, take a breath, and observe what’s happening. Next, put in some perspective and then practice what works. In short, that would be the repetition of exposure and response prevention (ERP), which reduces the associated fear. It means defence reactions diminish, and you find you can live more comfortable with uncomfortable. More specifically, like Sam, you stay in control of your life instead of OCD drawing your attention to false memories. Another available treatment is inference-based therapy, which helps remove inferences from your obsessional story and replace them with the here and now. Consequently, it helps bridge the gap between imagination and sense information in the here and now.
Source: * Kieron O’Connor & Frederic Aardema: A Clinician’s Handbook for Obsessive Compulsive Disorder. **Catherine M. Pittmann, PhD & William H. Youngs Phd: Rewire Your OCD Brain