Everyone who is living with a mental illness deserves safe and effective treatment. That said, they also deserve an accurate diagnosis. Part of that exacting process involves an ability to differentiate between disorders and to identify when more than one condition is present. However, mental health conditions can have overlapping symptoms and this complicates any diagnostic effort.
Case in point: Complex post-traumatic stress disorder (C-PTSD) and obsessive-compulsive disorder (OCD) can indeed occur together. Understanding the relationship between C-PTSD and OCD is precisely how safe and effective treatment begins. An experienced therapist can guide you on this journey but, for now, this post will introduce the basics.
What Is OCD?
Let’s begin by saying what it’s not. OCD is not the stuff of pop culture and memes. It’s not merely a desire to be organized and orderly. Rather, as the name suggests, OCD is a chronic condition that creates cycles of obsessions and compulsions. People with OCD feel intense anxiety over intrusive, obsessive thoughts. They may worry about virtually anything and therefore feel compelled to do anything to ease this discomfort.
That is where compulsions enter the picture. Even if the person realizes that the compulsions won’t protect them or others, they feel they must still perform such rituals. They live in such a state of worry and fear that everyday functioning is negatively impacted.
What Is C-PTSD?
Everyone has potentially traumatic experiences. If these events are chronic or prolonged, they can lead to complex trauma and, in turn, C-PTSD. Complex trauma survivors have endured situations from which they saw no escape. They had to cultivate whatever coping mechanisms they could just to get through each day. These mechanisms operate, in a way, like compulsions in OCD. People with C-PTSD also live in such a state of worry and fear that everyday functioning is negatively impacted.
Understanding the Relationship Between C-PTSD and OCD
Since both disorders feature intrusive thoughts as a driving factor, an excellent starting point is to understand the different ways such thoughts manifest in C-PTSD and OCD. Such differentiation can help demonstrate whether OCD, C-PTSD, or both are present. From there, the proper interventions can be identified.
Types of C-PTSD Intrusive Thoughts
- Memories and Flashbacks: Distressing memories can appear quite suddenly and unexpectedly. They may be triggered through sensory input and when they are particularly vivid, such thoughts are called flashbacks. Essentially, the complex trauma survivor will relive distressing past events.
- Negative Self-Image: C-PTSD shifts one’s self-perception into places of hopelessness and worthlessness. Hence, intrusive thoughts can take the form of a severe internal critic — ever ready to dish out harsh assessments of oneself.
- Perpetual State of High Alert: Called hyper-vigilance, this state is typically reserved for times of extreme risk or danger. However, due to the presence of unresolved trauma, someone with C-PTSD may remain stuck in a stress response.
Types of OCD Intrusive Thoughts
- Order: As touched on above, this is the big stereotype. People with OCD may have anxiety over orderliness and/or use the quest for symmetry as a compulsion.
- Contamination: Worries about germs or dirt become an obsession and cleaning rituals are the corresponding compulsion
- Harm: OCD can bring about obsessions related to harm and self-harm.
- Taboo: Anything deemed morally unacceptable is possible here, e.g. sex, violence, blasphemy, and more.
Discerning the character of the person’s intrusive thoughts can go a long way toward an accurate diagnosis. From there, of course, a practitioner can chart out a plan for management and treatment. C-PTSD and OCD are challenging on their own and daunting when they co-occur. A skilled trauma therapist can be your indispensable guide as you move forward.