OCD And Trauma

Does trauma cause OCD? Kristina Orlova explains how a predisposition to OCD can be set off by trauma or a big, stressful life event, and how OCD and PTSD can overlap. She also walks through the approaches that can help, including CBT, ERP, prolonged exposure, EMDR, ACT and grounding techniques. This content is educational and is not a substitute for one to one professional care.

Transcript

In today's episode, I want to talk to you a little bit about OCD and PTSD. So obsessive compulsive disorder, It's a neurobiological disorder. And we also have a bio-social model that people are looking at these days, Which basically says that biologically in the brain, There's a way that our brain is essentially not. Firing correctly, So we're not getting information processed correctly. And then if we look at environmentally, We can understand how our surroundings, Our environment, Where we grow up. What messages we get from society about what's right or wrong, What messages you get from your own family about what's considered right or wrong. What things to value. Those things influence us as humans and influence our value system. And so the way this works for OCD is that. . . Usually what happens is when you're born, You already have that predisposition. The OCD brain, If you will. So what can happen is you can go for a long period of time in your life without any manifestations of anything. And then a stressful event can happen. Trauma can happen for kids. Something like pandas, Which is strep throat, Can occur. And what seems like very quickly, Kind of almost overnight, Is what people typically say. You'll see more severe intense OCD symptoms show up. What this really shows us and what also research is showing and finding is that The connection between PTSD and OCD is the following. Is that if you are somebody who has experienced a traumatic event, So either you experienced it or you witnessed it, If you already have OCD as well, You are more likely to start to have and show OCD symptoms within a year. And one research study shows that it's about 30% more likely. Now, I've heard people often say things like, I developed OCD as a coping mechanism to my trauma. So I wanted to take a little time today to address this concept. Here's what we know so far. Trauma is something that Of course, First of all, I think just all humans being alive, We all go through so many different stressful and traumatic experiences. So when we use the word trauma, Or when I use the word trauma here in this case, I want to make sure I'm on the same page with you. You know, In the diagnostic manual, In the DSM-5, There's criteria that has to be met for something to be considered clinically relevant trauma, I will say. In order for meeting that criteria. You know, If there's some other events that are happening in someone's life that we would say are really stressful or uncomfortable. They might not meet the criteria to be qualified as. Trauma per se via the DSM-5. So you might not actually have the clinical diagnosis of PTSD. But you might be experiencing. Some symptoms or some of the distress signals. How does this all work together with OCD? So for example, You might have gone, Let's say, Through a long period of your life Seemingly, There's no big OCD symptoms, Nothing much, Maybe some anxiety. Maybe you could feel sometimes your flight and fight response kind of kick in, But nothing major. Then let's say a big stressful life event occurred like moving to another country or Let's say that there was, In fact, A trauma where you were physically hit or abused or, God forbid, Sexually or financially or emotionally, Psychologically, Anything like that. And once you experience that kind of trauma, Then what can happen is that oftentimes because those experiences will shape your internal world and how you look at the world now how you relate to things meaning, You might perceive the world to be as maybe more dangerous now, You might perceive anything related to that event as more dangerous. If you were hit, For example, You know, Depending on the circumstance of, You know, Who you were hit by and how and. That will shape how you will look at a person like that. Like if it's a male, Was it a family member? Was it a partner? That will shape how you look at, In this example, Males in the future. What that does in terms of OCD is that the traumatic event will also become very often your theme and focus that the OCD brain can latch onto, And you'll start to have intrusions that are surrounding that particular topic. So those two things can be happening simultaneously. Now the other thing is that what you want to be able to do is learn Where is something? More of you still dealing with trauma and where is that the trauma triggered your OCD and now you're also having OCD so you could have both and So it is really important when you're dealing with this kind of a presentation that you do have professional help. Working on things on your own is not always going to be easy and oftentimes people get stuck, They get confused. Working with somebody who specializes in this can help you learn how to understand how different things manifest and what to do when. The biggest thing with OCD work is that oftentimes people really still. Quite a bit misunderstand what OCD really is and how it actually shows up. And it gets really confused with a lot of other disorders. And so I really wanted to take the time today to just give you a little bit of explanation about OCD and in this case with trauma and PTSD. OCD is intrusive content that pops in your head without your control. It's something that every human experiences some random intrusive thoughts. It's just a person without a CD brain is able to recognize that intrusion as something that's there. Not really worthy of attention. It's not a valuable thought process. They kind of look at it and go, What's that? And they could toss it and move on. Now, A person with OCD, The way the brain is working is that when the intrusion comes in, It's usually paired with immediate anxiety. And so when you're having that combination together, It's really difficult not to assign meaning to that and think something must be terribly wrong. And also because when you're having an intrusion, It's often triggering our fight and flight response. Now our fight and flight response is important for us because that's what helps us understand if in fact there's a threat or if there's danger. So when that system is activated, It's really difficult to perceive things objectively and more neutrally. So when you're having intrusions that are popping into your head without your control, Now you're having physiological symptoms of anxiety, Like maybe your heart's really racing, Or maybe your thoughts are racing, Or you're getting kind of clammy or sweaty or cold, Or maybe even your eyes feel like they're starting to glue shut. Anything like that that's happening physiologically with the intrusive content is going to produce the stress of alarm and you will perceive it as a threat. Now that is different than when you have experienced a trauma, Physical, Sexual, Emotional, Psychological, Financial, Or you've witnessed a trauma. When you have had anything like that. You're not just having an intrusion per se of something that's just popping in randomly. You actually can have intrusive kind of reliving of. Memories of the traumatic event. Now here's the thing, There is a line where there's a subtype of OCD called false memory OCD that oftentimes can get confused because you might think that maybe you're reliving some sort of a trauma and you're not sure, Is it really, Did I maybe have a traumatic event and I'm suppressing maybe my thoughts or memories? Because we've heard in society and in media that sometimes that is a way that trauma can present itself. Where it's going to be really important that you see a specialist so they can really help to delineate and understand and do an assessment to help figure out, You know, Is it really a trauma or is it actually OCD that's maybe presenting or looking like it could be a trauma, But it's not. So there's a lot of nuances to this process. But when we are talking about OCD and PTSD, And we're talking about clinically relevant, You know, Presentations, We're talking about PTSD, Meaning that it meets the clinical criteria to have the official diagnosis. Same thing with OCD. We're really talking about this intersection between the two and that both. Can really feed each other and it's really going to be important to then understand your own trauma, To do the work to make sense of it, To be able to release it enough so you can actually start to help yourself. Learn how to regulate yourself a little bit better. And then with OCD also learning how and when your OCD brain is using and experience from the trauma and is latching on and now you're having a lot of intrusions. Around the traumatic event. Both can coexist. They do coexist. I've definitely treated clients who have a presentation of both. Treatment really is going to be using a combination of tools, Including cognitive behavioral therapy, Exposure response prevention, Prolonged exposure for PTSD. We'll be looking at acceptance commitment therapy strategies. We will be looking at seeing how are you able to ground or regulate because for some people with PTSD, They might be out of body a bit. So we'll be looking at a whole slew of different strategies and tools, But predominantly, It's also being able to help you understand and make sense of what's happened and how to help yourself get out of that place so that you can come back to being, You know, Basically, There's a stronger, Better version of yourself as much as you can be. And really make sure that you are. Doing this as best you can to give yourself a lot of love and self-compassion because, You know, Humans, We go through so many different things and experiences. We face so many different things that we don't have control over. And when something happens and is really difficult for us, It's really important you get help and you get the right help. So please know that OCD is not, You don't develop OCD as a safety mechanism out of PTSD. It's more that if you've experienced a traumatic event and you already have the predisposition towards OCD, Your OCD will most likely flare up. And that is true because I've treated plenty of clients who do not have a traumatic. Experience or a big trauma that they've had in their life, And yet they come and they exhibit really severe symptoms of OCD. So when you have both, They do feed off each other, But it doesn't mean that PTSD causes OCD. But if you do have PTSD, You definitely are more likely to have OCD start to show up for you in your life, Especially if you already have that predisposition.