A double occurrence word (DOW) is a word in which every symbol appears exactly twice; two DOWs are equivalent if one is a symbol-to-symbol image of the other. We consider the so called repeat pattern ($αα$) and the return pattern ($αα^R$), with gaps allowed between the $α$'s. These patterns generalize square and palindromic factors of DOWs, respectively. We introduce a notion of inserting repeat/return words into DOWs and study how two distinct insertions into the same word can produce equivalent DOWs. Given a DOW $w$, we characterize the structure of $w$ which allows two distinct insertions to yield equivalent DOWs. This characterization depends on the locations of the insertions and on the length of the inserted repeat/return words and implies that when one inserted word is a repeat word and the other is a return word, then both words must be trivial (i.e., have only one symbol). The characterization also introduces a method to generate families of words recursively.