Can childhood trauma cause OCD?

Content/Trigger Warning: Please be advised, the below article might mention trauma-related topics that include types of abuse & violence that could potentially be triggering.

During childhood, the brain forms connections based on our physical, emotional, and relational environments.  This is the time in which beliefs are molded regarding ourselves, other people, and the world.  Trauma can play a large part in shaping the formation of those connections in ways that are generally damaging and can cause long-term issues.

When trauma happens, the event overwhelms the child’s available coping mechanisms.  This, in turn, can cause intense emotional dysregulation and imbalance as the child attempts to understand their experience(s).  Because unprocessed emotions and visceral remnants of trauma become trapped, the brain seeks to find alternative methods of expression in an attempt to rebalance the body and return to equilibrium; however, these attempts ordinarily show up as repetitive symptoms that only serve as short-term solutions.  For example, a physically abused child may discharge emotion by exerting violence toward others (which can provide a momentary sense of power that depletes quickly). 

Most children who have sustained trauma adopt coping skills that help them feel in control of their environment---one of which can develop into Obsessive-Compulsive Disorder (OCD).  OCD is a pattern of obsessions (unwanted repetitive/intrusive thoughts) that drive compulsions (to reduce anxiety accompanying the thoughts).  Whether or not the obsessions and compulsions are directly related to their experiences of trauma, these responses come from attempts at resolving intense feelings of anxiety and internal dysregulation (which were forged as a result of trauma).  Many people with OCD often fear harm will come to others if compulsions aren’t completed.

OCD, however, does not have to be permanent.  Exposure and Response Prevention (ESP) is one of the more effective forms of treatment to eliminate compulsions and gain new ways of productively working through anxiety, therefore releasing the individual from the dreadful cycles and symptoms of OCD.  For example, the client is exposed to something that triggers an anxious response (obsessions, fear-based thoughts, etc.) but sits with the anxiety with new coping skills (instead of using a compulsion to reduce anxiety).  This helps to unpair obsessions and compulsions and teaches tolerance of anxiety through mindfulness, breathwork, etc.  Some clients may also need to verbally recount past traumas to process through related emotions and sensations.  Each pathway here is individualized and depends on the unique factors of the client.

If you are a survivor of childhood trauma and have struggled with OCD, therapy can be a great way to start healing.  We have plenty of research to support desired outcomes, so there’s always hope that these methods can work for people!