By Dr. Jackie Kantor

Trauma, anxiety, and OCD often co-occur. Experiencing trauma may intensify an underlying vulnerability, such as genetic or biological predispositions, leading to the development of an anxiety disorder and/or OCD. Additionally, if someone with an existing anxiety disorder or OCD experiences a traumatic event, it may worsen symptoms. Trauma impacts individuals’ views of safety, control, trust, esteem, and intimacy. 

Being In Control Equates to Safety

At the core of OCD and anxiety disorders is a strong desire to be in control; this is also the case in many trauma presentations. Individuals with OCD, anxiety disorders, and trauma often seek control as a means of ensuring safety. Those who have experienced trauma and have anxiety and/or OCD will often engage in actions to gain a sense of control that are usually aimed at making themselves or loved ones feel safe. However, while practical safety behaviors like locking a door once contribute to actual safety, compulsive safety behaviors such as repeatedly checking locks do not.

A crucial aspect of trauma, anxiety, OCD treatment involves identifying which behaviors enhance safety and working on reducing or eliminating those that do not. Intolerance of uncertainty is a major construct that links trauma, anxiety, and OCD. Therefore, a portion of treatment works on increasing your tolerance of uncertainty. This looks like practicing acceptance of aspects that are outside of your control and feeling empowered to change what is inside of your control.

Lack of Trust Impacts Esteem and Intimacy

Following trauma, people often report that they no longer trust their decision-making abilities and judgment. The lack of trust often extends to seeking excessive reassurance from others, which is common for those who have experienced trauma. For example, someone asks others to read and re-read an email they wrote several times because they fear if the email is not perfect, then something awful will happen. Not being able to trust in yourself can make it difficult to feel confident in yourself. 

Trauma can negatively impact self-esteem, and when combined with anxiety and/or OCD, it can further diminish self-confidence. In addition to low self-trust, individuals who have experienced trauma may say that they do not trust anyone else. Not trusting others may show up as compulsions in OCD. For example, someone with a trauma history and OCD may not eat food prepared by others or will not shake strangers’ hands for fear that they have been poisoned or will catch a disease. It can become challenging to form strong relationships with others when experiencing lack of trust in others.

Because of all the previously mentioned factors, individuals with a trauma history or experience anxiety and/or OCD may avoid people, places, and situations even more. The good news is that there are several types of treatment for anxiety disorders, OCD, and trauma, like Cognitive-Behavioral Therapy (CBT),

Exposure and Response Prevention (ERP Therapy), and Acceptance and Commitment Therapy (ACT Therapy)

If your therapist believes you have posttraumatic stress disorder (a specific presentation of trauma) alongside an anxiety disorder or OCD, a comprehensive approach combining treatments like cognitive processing therapy for PTSD, eye movement desensitization and reprocessing (EMDR), or ERP may be recommended to address your symptoms. Following treatment, individuals often describe how their worlds became so much bigger and they were able to get back to what they loved.

Trauma, anxiety, and OCD can co-occur. Trauma can disrupt your sense of safety, trust, and control. Anxiety and OCD themes are often centered around these themes as well and can negatively impact self-esteem and feeling close to others. All of these conditions often lead to unhelpful avoidance. Treatment options focus on avoiding avoidance to get you back to what these common mental health challenges has prevented you from doing. If you have experienced trauma and think you may be experiencing anxiety and/or OCD, contact Vivid Psychology Group to request a free consultation and discuss treatment options.

Exposure Therapy