Obsessions are thoughts, images, ideas, or urges that are persistent and uncontrollable, intrude on consciousness, and usually cause significant anxiety or distress. Compulsions are repetitive behaviors or mental acts that an individual feels they must perform.
Most people can ignore or dismiss such thoughts, attribute them to their distress, and allow the thought to subside over time. According to cognitive-behavioral theories, what differentiates people with obsessive-compulsive disorder (OCD) from people without the disorder is their inability to turn off these negative intrusive thoughts.
Individuals that are most likely to experience trauma-based obsessive-compulsive disorder include people that are depressed or generally anxious much of the time. When this occurs, even minor negative events can invoke intrusive, negative thoughts.
Differences in thought patterns of people with OCD include:
- The tendency towards rigid normalization thinking
- People who judge their negative intrusive thoughts as more unacceptable than most people may become more anxious and guilty about having them
- Extremely high levels of anxiety make it difficult to dismiss thoughts
Compulsions are mainly developed through operative conditioning. People with anxiety-provoking obsessions have adopted the belief that if they engage in certain behaviors, they can reduce their anxiety. Each time the person uses the behavior to reduce the obsession, the behaviors are negatively reinforced; thus, compulsions are born. Eventually, obsessions and compulsiveness intensify and cause an impaired ability to function in personal and professional settings.
OCD and Trauma
Trauma-related distress has been defined as psychological distress as a direct result of experiencing a stressful event. The psychological distress typically manifests as intrusive thoughts, including flashbacks, nightmares, and hypervigilance. Flashbacks, nightmares, and hypervigilance usually surround the traumatic event the individual experienced.
The symptoms that an individual may experience are variable and situationally dependent. At times, the symptoms are clearly anxiety or fear-oriented. At other times, the clinical picture includes depressive symptoms, anger and aggression, or dissociation. Any combination of symptoms may be present at different times after exposure to an aversive or distressing event.
Cognitive-Behavioral Therapy for Trauma-Induced OCD
Cognitive-behavioral therapy (CBT) is a way for clients to identify thoughts, sounds, and other triggers that create anxiety, flashbacks, and paranoia to stop the compulsive behaviors associated with OCD. Today, it is the most widely used method for treating mental health disorders, including OCD.
The cognitive component of CBT for OCD involves challenging the individual’s moralistic thoughts an excessive sense of responsibility. An example is an individual who writes work emails repeatedly due to an intense and unreasonable fear of making an error and being criticized for it. That fear and obsession with perfection can be the result of growing up in a household with extremely critical parents. Because of this, that person obsessively writes the same email over and over until she is sure that there are no errors.
Exposure and response prevention therapy exposes the client to the focus of the obsession and prevents compulsive responses to the resulting anxiety. Repeated exposure to the obsession while preventing the person from engaging in the compulsive behavior extinguishes the client’s anxiety associated with the obsession. The client is taught to identify and practice behaviors that discourage engaging in compulsive behavior and do not lead to a negative result.
Family-focused therapy is one of the most widely used psychosocial interventions that has been proven to significantly produce positive results in mental health disorder treatments. This type of therapy weakens the impact of mental health disorders through the prevention of reversions, the reduction of disruptive behaviors and intrusive thoughts, encouraging compliance with medication use, and decreasing suicidal ideation. Family-focused therapy is time-regulated and focuses on the present, as well as symptoms respite and symptom control.
Interpersonal and Social Rhythm Theory
In interpersonal and social therapy, clients are offered various tools and techniques that help them develop consistency in their behavior to cultivate a routine. This decreases symptoms and increases a healthy social and home life and work environment. The day is broken into manageable, time-associated segments. With practice, a client can learn to maintain a schedule to ensure the client refrains from ritualizing for an excessive amount of time.
A study published by Health Psychology and Behavioral Medicine states, “The evidence suggesting the impact of trauma on OCD is irrefutable. Because trauma can complicate the treatment of OCD and/or have practical implications about the specific course of treatment, an accurate evaluation of the traumatic event, themes, and impact is necessary.” The primary goals of psychoeducation include providing clients and their families with accurate and consistent information about the diagnosis, causes, and treatment of OCD.
When trauma infuses with obsessive-compulsive disorder OCD, it can significantly alter several aspects of a person’s life. Therefore, individuals must seek treatment from a qualified mental health professional to improve their quality of life. Treating trauma-induced OCD can take various forms, including cognitive-behavioral therapy (CBT), exposure and response prevention therapy, family-focused therapy, interpersonal and social rhythm theory, and pseudo education. At Casa Recovery, located in beautiful San Juan Capistrano, CA, we believe that the most effective, impactful treatment methods are ones that address the individual needs of each client. We continue to discover innovative ways to treat anxiety-induced OCD, helping clients lead happier, more productive lives. Our combination of evidence-based and trauma-informed treatment allows individuals to lead happy, successful lives in mental health recovery. To collaborate with Casa Recovery on treating your clients struggling with OCD or to refer a client to our treatment facility, call us today at (888) 928-2272.