Therapy options for severe rumination, shame, past mistakes & potential OCD?
Hi everyone,
I’m currently going through probably the worst mental health crisis of my life and after trying to manage these feelings for over 15 years, I've decided I need to reach out and seek therapy, I can't do this alone anymore. I went through NHS services roughly one year ago but found general talk therapy to be too light touch for what I was dealing with, and it was difficult to really open up about my problems in that setting.
To give some brief context on what I'm going through, I deal with constant anxiety and rumination. Without laying out my life story, the worry is something that has moved around themes throughout my life. While I would always say I've been a "worrier," my earliest memory of this coming to an obsessive level started around age 15 during my exams, where I was terrified I was going to be caught cheating on my coursework. Literally every few seconds the worry would pop into my head to ruminate on, ask friends for reassurance, check my coursework, and search on forums.
This naturally subsided when everything turned out alright, but nothing has been the same since. After a brief respite, my mind latched on to a pretty shitty thing I did a few years earlier that I felt a lot of shame about. The mechanics were identical; constant rumination and compulsive Googling, however this time it was centered around a bad action.
I dealt with this on and off for about 7 years with varying degrees of intensity. Following a bad breakup, I found myself spiking terribly. After Googling obsessively, this is where I first came across articles for "Real Event OCD." This instantly resonated with me and felt like a massive weight had been lifted, only for the relief to be short-lived. The worrying "upped the ante," and I suddenly found myself fixated on a far more objectively serious mistake I made in my early twenties. I won't get into details; it was objectively bad and I can't excuse myself, but for whatever reason, since nobody was harmed, the gravity of the situation didn't hit me right away. It wasn't until this period of reflection years later that I felt the crushing weight of it.
Once again, I carried this for another 6 or 7 years, and mostly resigned myself to isolating myself, avoiding relationship out of fear of feeling like fraudulent person. This sort of a became a baseline "normal", but not necessarily happy, until 2 years ago when I entered a wonderful relationship. This however brought on intense, obsessive worries that, after another rabbit hole of Googling, closely resonated with "Retroactive Jealousy", which has been a constant struggle for the last couple of years.
Things became somewhat manageable for a couple of months earlier this year, perhaps due to a busy period taking my focus away. However, about a month ago, things dialed up to 11. I found myself ruminating on the serious past mistake again. At this point, I've been in a constant back and forth of scouring the internet, opening AI chats to "confess" or try to find a solution, and enduring a barrage of rumination as to how bad what I did was, whether I can even be helped, and the suffocating shame of feeling like a stranger in my own life. I am also flooded with guilt that keeping this past event a "secret" from my loved ones means I am living a lie, which has become an obsession in itself.
My questions for the professionals here are:
- Is this level of moral shame and isolation a common reason people seek therapy? I feel deeply alone, like my actions mean I don't even deserve help or that it's inappropriate for me to reach out to a therapist.
- I haven't been diagnosed, but would seeking out an OCD specialist in the first instance be appropriate? I don't want to put myself in the wrong room and waste anyone's time. Every time I look at the mechanics of my thinking, it relates back to forms of OCD (Real Event, Relationship, Retroactive Jealousy, Moral Scrupulosity). I am in a severe state of doubt that I can even be helped. I know this doubt is common for Real Event OCD, but I genuinely feel like my specific event is something they wouldn't be equipped to deal with.
- If OCD therapy isn't appropriate, what types of Therapists should I be seeking out? I've looked into things such as moral injury which again, I have my doubts about if this fits. I just worry about finding myself in another room like Talk Therapy where I won't find myself comfortable disclosing these things.