“Trauma can make fears related to past events feel more plausible and threatening, leading to the development of OCD behaviors. A history of trauma increases the likelihood of developing OCD.”
A quote from Dr. Williams A member of the institute of trauma research.
To understand the potential link between OCD, obsessive Compulsive Disorder symptoms and trauma, we must first understand and define the OCD core features.
OCD involves random, recurring, distressing thoughts and behaviors that sufferers find difficult to dismiss the way other people, without the condition, do.
Instead, they engage with these thoughts and behaviors and seek meaning and purpose in them. These thoughts then become obsessions, and to reduce or relieve the anxiety they cause, people with OCD perform repetitive and often ritualistic behaviors or mental acts called compulsions. These compulsions tend to reduce anxiety for a short while, but only end up reinforcing this sequence, often called the “OCD cycle.” The Behaviors occur to act as a distraction from the compulsive, anxiety causing, thoughts.
The diagnostic criteria for OCD include the presence of obsessions and compulsions that take up more than an hour a day, cause distress, and impair everyday functioning. OCD is distinct from other anxiety disorders, often focusing on specific themes. The most well known are contamination, this would be displayed as hand washing and or symmetry, symmetry being displayed in ways such as opening and closing the door three times, locking and unlocking a door three times, counting while walking up stairs, and perfectionism, displayed thru nothing can be out of place, to the point, where if the subject suspects they have moved a vase but can’t remember if they have put it back in the correct place will return over and over to the scene to be sure, and there are cases where many people’s obsessions can be violent or sexual in context.
OCD as a trauma response
There is a genetic component to OCD as research has discovered. “However, some people’s OCD might stem from their own experiences. Perhaps a child grows up in a difficult home environment and would get in significant trouble for not cleaning their room properly or keeping the house clean. This can become an unhealthy need to clean that they carry long afterward, growing into Contamination OCD.
Studies that investigate the relation between OCD and post-traumatic stress disorder, found that the conditions co-occur between 19% and 30% of the time. Other studies have found that 50% of people diagnosed with OCD have experienced one or more traumatic life events, and somewhere between 30 and 83% of those diagnosed with OCD have a trauma history or multiple trauma experiences. Seems OCD certainly can be related to trauma for
a significant portion of the people living with the disorder.
I knew a woman personally, sadly she has passed on, who had contaminate OCD, I found out later she had been raped as a young girl and had not had any intervention of the trauma she experienced, which does indicate the OCD could possibly be a result of unresolved trauma, she was also an alcoholic, and as studies show is also a side affect of severe unresolved trauma. Unresolved trauma can and does affect a large part of our population.
Treating trauma-related OCD with ERP
The distress caused by the traumatic experience can cause the patient to believe the OCD behavior is necessary, and with out the preferred behavior, life would most certainly go off the rails. Even when a history of trauma poses a roadblock for treatment, trauma-related OCD remains highly treatable. The gold-standard treatment for OCD is a specially created technique called EXPOSURE AND RESPONSE AND RESPONSE PREVENTIION THERAPY (ERP), and it can accommodate the challenges created by trauma.
Treating OCD related to trauma with ERP can present several challenges due to the complex nature of trauma and its interaction with OCD. Some of the common challenges specially trained ERP therapists consider include:
Emotional distress: Trauma-related OCD often involves intense emotional distress, and exposure to trauma-related triggers during ERP can evoke strong emotions and anxiety.
This emotional intensity can make it more challenging for individuals to engage in exposure exercises and resist the urge to engage in compulsions. Trained therapists need to provide a supportive and safe environment for individuals to process these emotions effectively.
Trauma triggers during exposure: “Exposure exercises in ERP may run the risk of inadvertently triggering trauma-related memories or sensations,” explains Williamson. “Especially if the trauma is fresh or hasn’t previously been addressed in a therapeutic setting.” This can lead to heightened anxiety or emotional flooding, potentially hindering treatment progress. Therapists who specialize in treating OCD with ERP are prepared to address these triggers and have strategies in place to help people manage and process trauma-related emotions and memories.
Overlapping symptoms: Trauma-related OCD often co-occurs with anxiety disorders. The overlapping symptoms can complicate the treatment process, as exposure exercises in ERP may trigger OCD-related anxiety and PTSD symptoms. It requires careful assessment and targeted interventions to address both OCD and trauma-related symptoms effectively.
Safety behaviors and rituals linked to trauma: People with trauma-related OCD may develop safety behaviors or rituals specifically related to their traumatic experiences. These safety behaviors provide a sense of control and comfort, making it challenging to resist engaging in them during ERP. Addressing these trauma-related safety behaviors and rituals becomes essential to treatment, as they can reinforce compulsive avoidance and
hinder progress.
Therapeutic rapport and trust: Building a solid therapeutic alliance and trust between the therapist and the member is crucial for successful OCD treatment. However, trauma-related OCD can involve deeply personal and sensitive topics, making it more challenging to establish rapport and trust. Specialty-trained therapists are attuned to a person’s unique needs, provide a safe and non-judgmental space, and can adapt the treatment approach accordingly.
Although it may be initially challenging and anxiety-provoking—especially for those with trauma-related OCD—by working collaboratively with a therapist trained in ERP, you can develop increased confidence in your ability to tolerate distress and resist compulsions. Through this process, you’ll likely experience significant improvements in your overall well-being and regain control of your life as a growing number of people have.
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