138. The Connection Between Trauma and OCD

Welcome to episode 138. Many people that I see in counseling, they’ve been impacted by their childhood, or they’ve been impacted by trauma, but they wouldn’t necessarily meet criteria for a full blown PTSD diagnosis. Not only do we have one fourth of the people, if we were to add in people that were affected by trauma, I would imagine we’re probably over half of that OCD population.

We should be talking about this. We should be taking it into consideration in terms of treatment. Hello and welcome to Christian Faith and OCD with Carrie Bock. I’m a Christ follower, wife and mother, licensed professional counselor who helps Christians struggling with OCD get to a deeper level of healing.

When I couldn’t find resources for my clients with OCD, God called me to bring this podcast to you with practical tools for developing greater peace. We’re here to bust through the shame and stigma surrounding struggling with OCD as a Christian, sharing hopeful stories of healing and helping you replace uncertainty with faith.

I’m here to help you let go of the past and future to walk in the present abundant life God has for you. So let’s dive right into today’s episode. We are going to have our first podcast hangout via zoom. on September the 9th at 7 15 p. m central standard time. This is just an opportunity for me to meet you, the listeners, to hear what’s on your heart, maybe answer a few questions that you have in the time that we have.

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Today we’re talking about trauma, the connection between trauma and OCD. I know it’s a word that gets thrown around a lot and some people will say things like, My childhood wasn’t really that bad. I don’t know if I necessarily have trauma. I wasn’t getting beat in my household. or I didn’t grow up with a parent that was a raging alcoholic, we didn’t have massive things happening, we were just your normal average everyday family.

We weren’t living in extreme neglect or poverty. However, a lot of times you can grow up in an environment that impacts you profoundly and impacts your relationships profoundly in a way that you have to process through as an adult in order to move. Beyond how you were raised. This is especially true if you feel like you are repeating the same exact patterns that you saw in your family that you don’t want to carry into your family right now.

So we would call those types of things family of origin issues, things that you saw growing up or experienced growing up in your family, but you don’t want to repeat that pattern or pass those same things on to your children. The main reason I wanted to do this episode on the connection between trauma and OCD is the statistics that I heard recently that 25 percent of people who meet criteria for an OCD diagnosis also meet criteria for a PTSD diagnosis.

Now I was surprised and not surprised by this at the same time. If you’ve been around here and you’ve been listening for a little while, one of the overlaps that I see quite frequently is a history of childhood trauma and an OCD diagnosis. So I wasn’t surprised, but I was surprised at the same time in the sense that oftentimes when people are talking about OCD treatment, They don’t ever talk about trauma and we’re talking about one quarter of the people meet a PTSD diagnosis.

It’s not easy to get a PTSD diagnosis. There’s very specific criteria. Many people that I see in counseling, they’ve been impacted by their childhood or they’ve been impacted by trauma. But they wouldn’t necessarily meet criteria for a full blown PTSD diagnosis. Not only do we have one fourth of the people, if we were to add in people that were affected by trauma, I would imagine we’re probably over half of that OCD population.

We should be talking about this. We should be taking it into consideration in terms of treatment. Let’s start by defining trauma. I like this definition from the American Psychological Association. They said trauma is any disturbing experience that results in significant fear, helplessness, dissociation, that’s where you’re disconnected from your present moment experience, confusion.

or other disruptive feelings intense enough to have a long lasting negative effect on a person’s attitude, behavior, and other aspects of functioning. They often challenge an individual’s view of the world as a just, safe, and predictable place. When we look at this definition, I see a lot of overlaps between the definition of trauma and what people with OCD experience.

Looking at disturbing experiences, having OCD, Is that traumatic? That’s a very interesting question. It’s very disturbing to have these thoughts. There is significant fear, that was in the definition. Feelings of helplessness, for sure. Intense emotions that have an effect on someone’s behavior. Obviously, OCD is a behavioral disorder.

And they often challenge the individual’s view of the world. Certainly, The individual’s view of the world is affected by OCD. I never necessarily, early on, thought of OCD as traumatic until I started to hear more and more stories of my clients explaining to me what it was like when they first had an onset of symptoms.

This usually happens in childhood, Or adolescence for most people and they discussed with me trying to having this intense fear inside, trying to communicate that to parents who weren’t aware that this is what their child was experiencing. Maybe they were in a system where their parents didn’t have OCD and so they didn’t really understand or know what to look for.

Then this process of getting help, sometimes that felt very stigmatizing to them, or they were looking at their life, recognizing, I’m erasing my paper so hard I’m burning holes in it, but none of the other kids around me are doing that. I’m spending two hours studying for a math test, but nobody else is doing that.

Or, my family is able to go into a public restroom, but I feel like I can’t. All these little pieces cause a shame to build up and oftentimes they didn’t really understand. What they were experiencing and so we’re able in the process of going through like some EMDR or trauma therapy to go back to those places where those experiences first started to happen and Unravel and provide this level of adult care and compassion to their younger self of hey You didn’t know that this was going on back then but now we know And if we could just even paint this like perfect scenario of healing what would have been what you absolutely needed in that point was somebody to come and tell you, Hey, this has a name.

You’re not crazy. It’s called OCD. Let’s get you some help. Let’s figure out how to manage this. Fortunately, we’ve come so far now that people are starting to get diagnosed earlier than they used to, but for many people listening to this, you may have lived with OCD for years without even knowing it.

Another thing that I would point out that I’m seeing in a lot of clients I work with, as a family of origin issue, as a trauma issue, But probably is not going to meet full criteria for PTSD would be a rigid family systems that people grow up in. Let me give you some different examples of this. A lot of times what I see is there’s a rigid religious rules, maybe even just the structure of the household of we go to church every single Sunday, every single Wednesday.

Doesn’t matter if you feel up to it or not. Doesn’t matter what else is going on in our household. Could be there is only one right way to do things. And if you don’t do it that way, you’re made to feel bad or feel a sense of shame. If you know that dad is coming home and you’re anxious every day because dad’s going to find that one spot in the house that’s not clean or that one thing in the house that’s not put away, the one surface that isn’t wiped down properly, that’s obviously going to put you in a state of high alert.

A state of watching for potential danger if mom goes off because she felt like you didn’t clean the dishes exactly the way they were supposed to be cleaned or you didn’t follow an OCD ritual, you didn’t come in and take a shower right after school. That’s very stressful to a child to experience those types of things over and over again.

It has a cumulative effect on your nervous system versus a one time, very scary, very intense, I almost died type of trauma. There’s also this sense of developmental trauma, and we do not have a diagnosis for this in the DSM, but we absolutely should. That is another tangent. I won’t fully go down. There is a difference.

When something happens to you, when your brain is fully developed, Versus something that happens to you in the process of your brain developing. You’re going through trying to figure out who you are, who the world is, whether or not the world is a safe place. The people closest to you that are supposed to be providing safety and connection and support you may feel like I never can be good enough for these people or I have to be perfect in order for my parents to love me because they have such high standards or such unrealistic standards.

It could look like a situation where your parents demand that you bring home straight A’s, and if you get a B plus, they shame you for it and say, why were you so stupid? Why didn’t you study more? It’s really important in the process and development of children for them to feel competent, for them to feel like they can do something and do it well.

Part of kids learning to feel competent is allowing them to take healthy risk and make mistakes. The very beginning of that is when your kids are really young, obviously you’re not letting them run out into traffic or jump off, you know, a bookshelf in your house. Those things would be very unsafe. But you’re letting them make small choices to have a sense of agency.

And you’re the parent, you’re creating those choices. So for a toddler, for example, or a preschooler, you’re saying, would you like the blue cup or the red cup? And this gives the child a sense of like, oh, I get to choose. I get to make a decision. That’s the very beginning of teaching your children about decision making.

And then as they get older, And they talk about situations that are happening at school instead of just jumping in and saying, Hey, do this. Don’t do that. You know, that’s right. This is absolutely wrong. You can say, okay, let’s look at maybe the different options for how you could handle this situation and allowing them to evaluate the choices saying, okay, well, you could yell at your teacher, but what do you think will happen if you do that?

Okay, like, you’re probably gonna get in trouble, so do you think that that’s the best choice? Or as you’re guiding younger children, and they’re acting out in some way, or pouting, or stomping, or whining, you might prompt them, hey, can you say that a little bit of a different way? Or let’s try that again one more time.

You might say something like, is there another way for you to ask that to get what you need? But in very rigid systems, these types of conversations don’t happen, and as a result, kids don’t feel competent to choose. They don’t feel competent in making decisions. Because there’s been no guidance, literally all the decisions are made for them.

I’m going to tell you that to wear this shirt on this day, and there’s no options. Or, you know, absolutely not. You cannot hang out with that friend. You can hang out with that friend, but they need to come to our house because it seems like maybe their house isn’t the best environment for you to be in.

Conflict resolution is modeled in healthy family systems where we can have conflict but still know that we love each other or we can have differences of opinions and still be in the same family and still love each other. If you have an enmeshed family, you don’t have that freedom to make your own decisions or make your own choices and know that that’s going to be okay.

What does this lead to in adulthood? It can lead to overdependence on others. It can lead to massive amounts of reassurance seeking because I haven’t ever felt competent in being okay with what I’m doing or knowing that I can do something. I will talk with clients sometimes about how They may be going through what I’d call a delayed adolescent period.

A healthy adolescent period is where you are given some boundaries, structures, rules, but then you’re also allowed the freedom and you go out into the world. And yes, you have the freedom to make some mistakes. You know, we hand teenagers the keys to cars knowing that it’s quite possible they might get in an accident.

But before we let them do that on their own, we’re in the car with them, we’re showing them how to drive, we’re teaching them, we’re training them. But we also know that when we give them those car keys and give them the freedom, they may get in an accident. For some families, that’s just the It’s too much, you know, and they can’t handle it or makes them too anxious.

So then the kid is restricted from having that freedom because we’re so afraid that the bad thing is going to happen. And the idea here is not just in the driving accident sense. is that while you’re in the safety of your family system, you can go out into the world, you can make mistakes, but you can come back and process it.

You can say, Hey, I did this in a friendship situation. It didn’t go so well. How should I have handled it? Or what do you think? Or I have this paper due on Friday. I don’t know how I can break down my studying to make sure that I get my studies done and my paper done by this Friday. Like, you have this healthy accountability and guidance system while also looking at all of your options.

One of the trainings I received in working with teenagers is we would have the kids make a list of all the potential solutions to their problem. Knowing that as an adult, we just throw some of those out, right? Like, oh, that’s a really bad idea. It doesn’t matter. The idea was to get them to think through healthy problem solving.

Just put all of the options on the table and then we can go through each one to get them to think through. Okay, so if you did do that, what do you think the consequences would be? Would you have a positive outcome? Would you have a negative outcome? This keeps people, teenagers, from being impulsive and allows them to to think through their choices in a more logical, reasonable fashion, not based on emotion or just what they want to do right in that moment, getting them to think a little bit longer term.

What I’m finding is that many individuals who are dealing with OCD now were never taught how to make decisions as a child and adolescent. And know that if that’s your case, that’s okay. You can learn those skills in adulthood. It’s just a delay because it’s something that you should have been gradually eased into as a child and adolescence.

Our daughter likes feeding the cats sometimes. So she knows how to get the scoop and scoop the cat food and put it in the bowl and say, Hey, good job. That’s awesome. You scoop the cat food. If there’s a crumble or two that falls out, not a big deal. Who cares? I’m not gonna say, oh, you didn’t do that. Go back and do it again.

But if you’re in a very rigid household system, those types of things happen. It’s either the standard’s perfection or you’re nothing. And that can keep you on this performance, people pleasing hamster wheel where you’re just going around and around again. Trying to make someone proud of you. I was in this training eons ago, this was so profound to me, and one of the things they asked us to do, it was a little weird, to be honest with you, because I think it was some type of ministry development training, I can’t even remember.

But, we had split the table in half, and half of us were walking around the table to the people that were sitting down, and we were supposed to whisper stuff in their ear that we wish we had heard more of as a child. Like I said, this was a very strange activity, never seen it repeated. However, I’ll tell you the two things that people repeated most often.

One was, I love you, and another one was, I’m proud of you. So if you have kids, that’s your cue. Go find some way to tell them today that you love them and that you’re proud of them. Because those are just so important for us to hear. And when you’re trying to please your parents, it’s not just a matter of, Yes, I want them to approve of me.

Yes, I want them to love me. When you’re a child, you are dependent on these individuals for survival. You can’t just check out and say, Hey, I’m going to go live with the neighbor down the street because their parents are nicer. Or, I think I’ll get a hotel tonight because all y’all are doing is screaming at each other.

That’s another situation that can cause this being on the edge of your seat, feeling like you’re waiting for the next shoe to drop. In trauma therapy, we call that hypervigilance. If you feel like you’re in that fight, flight, or freeze mode all the time, there’s some trauma work to be done. I don’t care what you call it.

It’s not healthy for your nervous system. It can cause all kinds of problems to you digestively. Because your digestive system shuts down when you’re in that survival state, you’ll have issues, irritable bowel, constipation. You can have autoimmune deficiencies from complex trauma, fibromyalgia. I’ve had people come in and do EMDR surrounding chronic pain, constant headaches, things like that, really have been able to get some relief.

Because we can help them get out of that fight or flight state. Let’s say you’ve had some trauma from your childhood. Then we throw in OCD on top of that, which is already, can be traumatic in its own way. Now OCD is using the trauma and past painful experiences or memories as reasons for possibility. Oh, see, because this happened to you over here, that means that it’s gonna happen again automatically.

We really have to do some work to tease these things out as we’re going through this process of being trauma sensitive in terms of OCD therapy. And it depends on the situation. There are times where we really focus on the trauma first, and then after we clear through a lot of the trauma, we’re talking about, like, severe, ongoing issues, then we’ll see, okay, what remains of the OCD?

And a lot of times, Whatever’s left over is a lot easier to manage or to treat once the trauma response is reduced. In other situations, someone may say, No, like trauma’s not really on my radar. All I can see right now is the OCD. That’s all I can focus on, all I can think about. I really need some help with this.

Okay, so as we start to work through modules of ICBT, And we get to like reasons for obsessional doubt and we get to the obsessional story, then we’re starting to see family of origin issues or things be untangled. Oh, you were told this as a child and that really got stuck, like OCD latched onto that.

And then seared that into your brain as a truth. Is that really the truth? What you’re believing? And it could be something about God. It could be something about yourself. But being able to work through and dismantle some of these beliefs, look at, is there an alternative story that I can tell myself about the situation?

I’m telling myself that. I have to perform for God or otherwise he’s not going to love and accept me because that was my experience growing up with my family. Is that the character of God that I know to be true in the scripture? We have such a hard time with this because our earthly father sets that tone for how we view our heavenly father, positive or negative.

I’ll tell you, it was a long time and process and healing that the Lord brought me through. Before I could even say, Dear Heavenly Father, that was tough for me for a long time. Not because my father was not loving, but because there wasn’t a lot of emotional vulnerability and connectivity. I carried that into my prayer life and had a hard time really connecting emotionally and authentically with God until he healed me from some things that I experienced.

So if you’re on that same journey or process, I just want to let you know that I’ve been there. It takes time. It does take a process with you and God and healing emotionally and spiritually, but you can get there. If this episode has resonated with you and you’d say, Yes, I have experienced trauma. I have experienced OCD.

Then what I want to encourage you to do is to make sure that you’re getting trauma informed OCD treatment. That may look a lot of different ways, but making sure that whoever you’re seeing is taking that into account and is able to treat both of those issues effectively and interweave what needs to happen.

I know I have many people who contact me from out of state that have a hard time finding a good fit of a Christian. OCD therapist in their area. And I just want to open it up and let you know that I do quite a bit of EMDR intensive therapy. I have done some multi day intensives with individuals who are out of state or out of this local area who were able to get to a deeper level of healing with EMDR.

We can certainly incorporate EMDR ICBT, parts work. Whatever it is that you’re needing, we can incorporate those things and customize a treatment plan to help you achieve your goals. If you’re interested in that opportunity, please go on the website and contact me, I’d love to hear from you. I want you to know that there is life on the other side of what you are wrestling with right now, so hang in there and don’t give up.

Until next time, may you be comforted by God’s great love for you. Were you blessed by today’s episode? If so, I’d really appreciate it if you would go over to your iTunes account or Apple Podcasts app on your computer if you’re an Android person and leave us a review. This really helps other Christians who are struggling with OCD be able to find our show.

Christian Faith and OCD is a production of By the Well Counseling. This podcast is for informational purposes only and should not be a substitute for seeking mental health treatment in your area.