Episode 15
Existential OCD
In this episode of Purely OCD, Lauren and Kelley talk about Existential OCD. They discuss common obsessions and compulsions as well as exposure ideas. They also explore ideas specific to this subtype and answer your questions.
So what is Existential OCD?
It involves intrusive thoughts related to:
- The after life
- Meaning in life
- The nature of reality
Existential OCD might even involve thoughts about – you guessed it – Keanu Reeves’ film Matrix…

Lauren: “How do we know we’re not in the Matrix?”
Kelley (whispers): “We don’t”
Lauren: “Spoiler alert!”
Kelley: “How do you want to live your best life in the Matrix, folks?”
Kelley points out that other OCD subtypes, like religious scrupulosity, overlap with this form of OCD.

Obsessions can sound like:
- What’s the meaning of life?
- Am I living my life “right”?
- Is this even reality?
- How do we know it’s real?
- How do we know we don’t live in a Matrix?
- What if I’m already dead?
- Maybe I’m in the Truman Show.
Lauren talks about her lived experience with Existential OCD.
She shares that when she was 7 years old she had Existential OCD. Her obsessions involved worries like:
- “What happens when we die”?
- “Maybe I won’t like Eternity”?
- “What will happen to my parents when they die?”
- “I might go to hell?”
“Cool when you are 7 and your parents are going, ‘What the hell?!’”
Lauren Rosen, LMFT
Lauren goes into how it was debilitating, distressing, time consuming and caused general impairment in her life.
Kelley and Lauren discuss how dissociation & déjà vu can both be triggers in Existential OCD.
Kelley also talks about her lived experience with dissociation. She recalls being in the shower and reaching for shampoo while wondering “Who made the choice to reach out for the shampoo?”
Kelley mentions related checking compulsions. “I look in the mirror and ask “Is that really me?” Of course, if you check and you don’t “feel real” then this compulsion can re-trigger further anxiety.
To illustrate what dissociation is, they talk about staring at a simple word for too long and starting to wonder if the spelling is correct. For example “the.”
THE
THE
Okay, you get the point.
In Existential OCD, common compulsions include:
- Rumination
- Research
- Mental review
Lauren gives an example from her own experience: If you have a thought like what’s going to happen after I die, and what if you don’t like eternity, you might ask your parents over and over again whether or not you are going to be ok. This is an example of compulsive reassurance seeking.
Here’s the thing, this topic is naturally quite anxiety provoking. There’s a lot of unknown around existential questions.
Kelley: Who doesn’t have anxiety or questions around this?
Lauren: The problem is it becomes OCD when it takes up large quantities of time, is debilitating in some respects, is distressing or causing general impairment in life. Essentially when people spend an inordinate amount of time responding to the obsessions.
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Disclaimer: This information is meant to be general information not unique to any individual. Before following any guidance or advice found on this site or in the Purely OCD Podcast a visitor or listener should always consult with their own licensed healthcare practitioner. The Purely OCD Podcast and Website are not therapy or intended as a replacement for therapy. They are for educational purposes only.