It’s no surprise that childhood trauma can impact your mental health long into adulthood. After all, trauma has a devious way of sticking by your side and emerging at the most inopportune times.
It’s not often known due to misunderstanding, stereotypes, and stigma, but experiencing a trauma earlier in life can also set the stage for obsessive compulsive disorder (OCD). If you’re trying to figure out if there’s a connection between your experiences and how to get help, this article will provide a roadmap to help you figure that out.
What is Childhood Trauma?
There is often a lot of talk on social media about trauma, and though the trauma can mean a lot of different things to different people, there is a clear-cut definition for childhood trauma.
The National Child Traumatic Stress Network (NCTSN) defines childhood trauma as an event or several that are “frightening, dangerous, or violent…that poses a threat to a child’s life or bodily integrity.” In addition, the trauma event doesn’t have to have been done to the child themselves, but could be something threatening they saw happen to a loved one.
Certain experiences are considered traumatic events, says the NCTSN, such as:
- Physical, sexual, or psychological abuse and neglect
- Natural disasters
- Terrorism
- Family or community violence
- Parental loss or injury
- Substance use disorder in the family
- Military trauma (such as deployment or parental death)
A traumatic event tends to cause persistent emotional and physical responses, such as depression or anxiety, difficulty at school, problems sleeping and eating, all of which can in turn impact a child’s ability to function and form and maintain relationships. And the impact of one of these events doesn’t just disappear as you get older—it can stay with you for decades.
Amalia Sirica, LCSW, a licensed therapist with NOCD, points to the definition of trauma by Dr. Gabor Maté:
“Trauma is a Greek word for wound. That’s literally what it means. So when you understand that, then you realize…trauma is not what happens to you. Trauma is what happens inside you as a result of what happened to you.”
That’s why you can feel trauma so viscerally. “It’s a psychic wound that leaves a scar on you and shows up in multiple ways,” explains Sirica. “The behaviors and thought patterns you develop around that may have allowed for survival, but—often ironically—those means of survival can get in the way of a full, thriving life,” she says.
You should never feel guilty for your trauma, either: “It’s the natural response to having gone through something,” Sirica says. It’s helpful to remember that a traumatic event affects people in unique ways: what one person considers traumatic might not be so for another. How much something impacts you also depends on personal factors, like your own resilience.
What is OCD?
Obsessive compulsive disorder, or OCD, is a mental health disorder defined by obsessions and compulsions that feel out of your control, consumes lots of time causing significant distress, and interfering with the things you enjoy, says the International OCD Foundation. Here’s a closer look at compulsions and obsessions:
- Obsessions include unwanted, intrusive thoughts, images, or urges that cause anxiety or distress. A few examples of obsessions include fear of contamination (from germs, chemicals, or dirt, for instance), unwanted sexual thoughts, or fear of being responsible for something bad happening.
- Compulsions are repetitive thoughts or behaviors made in an attempt to try to prevent negative consequences or reduce the anxiety from an obsession. Compulsions may include behaviors such as excessively washing hands, checking your body, repeatedly going in and out of doors, or arranging things in specific ways.
Obsessions and compulsions tend to form a vicious cycle: something triggers an obsession, and then the compulsion is done to neutralize the obsession to relieve distress and bring about feelings of safety. However, a compulsion doesn’t make obsessions go away in the long run. Instead, obsessions come roaring back over and over again, leading someone to rely more and more on compulsions until they receive the appropriate treatment.
The Link Between Childhood Trauma and OCD
Childhood trauma can absolutely set the stage for the development of OCD, says Patrick McGrath, PhD, Chief Clinical Officer at NOCD. “OCD is an opportunistic disorder. No matter when the trauma occurred—whether it was in childhood or later in life—OCD can try to finagle its way into your life,” he says.
How? Imagine if OCD had a voice. It might say something like “oh, I see you had something bad happen to you. I know how to prevent bad things from happening. I’ll introduce you to some compulsions,” describes Dr. McGrath.
Importantly, your compulsions don’t have to be related to whatever you’re trying to prevent. So, while obsession-driven behaviors or thoughts might feel illogical even to yourself, you’re still compelled to do it. That’s how tricky OCD can be.
Having childhood trauma can also impact how bad your OCD symptoms can become. In a meta-analysis of 10 studies and more than 1,600 OCD patients published in Frontiers in Psychology in 2021, childhood emotional, physical, or sexual abuse was associated with more severe symptoms of OCD, compared to OCD patients who didn’t have a similar trauma background. That said, it’s not clear based on current research if people with early trauma experience higher rates of OCD compared to the general public, note the Journal of Psychiatric Research in 2021.
What’s most impactful, though, is that having both trauma and OCD can affect the success of OCD treatment, suggests research. That suggests that having childhood trauma and OCD warrants a thorough and holistic treatment plan, developed with a therapist who has experience working with both trauma and OCD. We’ll look further into treatment options below.
Does That Mean Childhood Trauma Causes OCD?
Researchers don’t yet know if childhood trauma can directly lead to OCD, particularly since the results of the studies on that question are inconsistent, and OCD can have many contributing factors. However, it is clear that childhood trauma can set the stage for OCD development later in life, making treatment for both mental health conditions more nuanced.
In childhood, there is so much that you have no control over, including where you live and the family you’re born into. The feeling that something harmful is happening to you and you’re helpless to control it as a child can linger long into adulthood—and, indeed, trigger OCD. “OCD is a lot about maintaining control when you may feel out of control, and that’s where I see a strong overlap with traumatic experiences in childhood,” Sirica says.
Some people with OCD find that their obsessions latch onto a past traumatic event, making their OCD symptoms worse. “I think both childhood trauma and OCD can make each other worse. OCD is like a heat-seeking missile. If you’ve experienced any kind of disaster, there’s a higher likelihood you’ll be worried about something bad happening again, and engage in any number of compulsions to prevent it,” she says.
Does OCD Get Better On Its Own?
No, OCD is a chronic condition that does not get better on its own. It’s critical for your health and wellbeing that you seek treatment. Otherwise, even if symptoms reach a point where they feel like they’ve gone away, you will likely relapse. Treatment does not cure OCD, but it makes it manageable in the long term, so you can live a full and fulfilling life without having to be continually sucked back into a chronic cycle of obsessions and compulsions.
How to Treat OCD when Childhood Trauma is a Factor
When childhood trauma is a contributing factor to your OCD, you might think that trauma-focused therapy will effectively treat both conditions. That’s not the case—you will need to focus on both trauma and OCD, often separately.
If another condition is impacting you along with OCD—major depression, suicide, eating disorder, trauma—then it is most often addressed first, says Dr. McGrath. “You have to deal with those things first before you can get to the OCD. This allows you to get to a safe place where you can then add in OCD treatment,” he explains.
With a background of childhood trauma, prolonged exposure therapy is the first treatment on deck. It’s a type of cognitive behavioral therapy (CBT) that helps you slowly approach traumatic memories. When you face your fears in a safe environment instead of avoiding them, they begin to release their grip on you, allowing you to move forward.
After, you’ll move onto treating the OCD with exposure and response prevention (ERP). ERP is the most effective tool in the treatment of OCD, research shows. If you’re nervous about treatment, it’s completely normal. That’s because approaching treatment can be scary and uncertain. It’s encouraging, though, that in research on 11 controlled trials on young people, drop-out rates for ERP were lower than medication, control, or placebo groups, evidence that the work may be tough—but it’s worth it.
“I have a conversation with therapy members and I tell them that this is going to be hard, but I’ve been doing this for 10 years. If you keep showing up, it will get better,” says Sirica. In addition, she also suggests writing down why you’re doing this therapy, which you can revisit if you get nervous approaching a session or feel doubts about treatment.
“The primary goal as a clinician is to create a space as safe as possible because traumatic events can mess with a person’s sense of safety,” says Sirica. This is especially important if your trauma feels deeply buried—it’s often the case that people don’t remember a lot of the trauma event itself. “Patients know that their behavior is not making sense, and they don’t know why it’s happening. Treatment can involve a slow unearthing of this trauma,” she explains.
Where to Get Treatment for OCD
NOCD clinicians are specifically trained in ERP for the treatment of OCD, and many have additional specialty training in prolonged exposure for PTSD.
In addition, childhood trauma and OCD can also be helped with community support, which is offered around the clock in the community feed and dozens of live, virtual support groups that NOCD Therapy members can attend at no additional cost. These elements can be critical in one’s healing journey: “You’d be surprised how quickly people start to feel better once they feel loved and safe. There is nothing braver than doing this treatment,” she says.All NOCD therapists are trained in ERP, and OCD treatment is designed to be completed in a few weeks using live, personalized one-on-one video therapy, along with 24/7 access to support between sessions. I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment.