Wednesdays With Watson: Faith & Trauma Amy Watson- PTSD Patient-Trauma Survivor

The Hidden Link Between Trauma and Obsessive Compulsive Disorder

• Amy Watson: Trauma Survivor, Hope Carrier, Precious Daughter Of The Most High God

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And I'm no longer a slave to fear. I am a child of God. Rachel told me that she was in her early 20s when she started to notice that something wasn't right. She said that it began with a stove. She said that it began with a stove. Every time she left her apartment she felt this rising panic that was commandeering of her. She kept telling me, like she kept thinking over and over, what if she had left the stove on? And if she left the stove on and she didn't go back and check it, what would happen if the building burned down and it was her fault? So she would tell me how she would check it, not once, not twice, but 10, sometimes 20 times, because in her mind, if she didn't do that, something bad was going to happen. She ran her hands over the knobs, whispering to herself this is off, this is off, this is off. Over and over and over. She even told me that she took photos for proof that she could go back and look at. Eventually, she started filming these short videos and talking to the camera See, look, it's off, everything is fine.

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And still, the moment that she got out the door and to the elevator, and maybe even halfway to work, that doubt would creep in again. These behaviors made her late to work, she told me. It isolated her from friends. She got to the point where she was afraid for everybody's safety so she stopped inviting people over. She was afraid that they would notice the strange rituals that she needed she had to perform before she left the house in order to keep everybody safe. And she said the worst part was that she totally knew that this didn't make sense. She knew it was delusional that's her word, not mine. She knew she felt like a brain of a part of her brain, was screaming. This is irrational. You already checked it 185, 11 billion times. But there was a sense of calm and relief from the anxiety. When she went back and checked, even for a few seconds, it felt necessary. It felt like it was the only way to calm the anxiety, the panic. What she didn't realize at first was how closely this behavior was tied to something deeper, and this is how I came to know her and her story.

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As a child, rachel had lived in a home where unpredictability ruled. She had an alcoholic parent. She saw these sudden explosions of anger. She went to bed often to the sounds of slamming doors, screaming parents broken glass. She didn't have any safety as a child. She didn't have any certainty as a child. So brains do what they do and as an adult, her brain found a way to cope. She wanted to create certainty that was not related to somebody else keeping her safe, even if that certainty was false. Her OCD wasn't just about the stove right. It was about fear. It was about control. It was about making sure, in a world that had never felt safe, that this one thing wouldn't fall apart. Getting diagnosed with obsessive compulsive disorder diagnosed with obsessive compulsive disorder, rachel told me, was a turning point for her. It gave her language for what she was experiencing and through therapy, through a modality called exposure and response prevention, and some trauma informed work to include CBT and EMDR, rachel began to pull back the layers. It wasn't easy, but slowly, slowly, she began to trust that safety did not come from rituals at all and that, unfortunately, she didn't have much control over living in a safe world.

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Hey, everybody, and welcome back to the Wednesdays with Watson podcast. If you are new to this podcast, my name is Amy Watson and I am your host. I am so excited that you have joined us for this episode on obsessive compulsive disorder and how it is connected to trauma. We're going to peel back somewhat the curtain on a term that's often misunderstood and often misused. Obsessive compulsive disorder, or OCD as it is known, is a debilitating disorder that is connected with anxiety and trauma. How many times have we heard someone say I am so OCD about my desk? As if really it's that simple right. But for those like Rachel living with this condition, it's anything but this quirky and cute condition description of why we need to keep our desk clean. It can be exhausting, it can be paralyzing and profoundly isolating. So for today's episode, it is for the misunderstood, the mislabeled and the ones living in silence. This episode is for you.

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Let's talk about what obsessive compulsive disorder really is and, more importantly, what isn't it, as I am working through some of these podcast episodes that cover some pretty common, though ocd is only actually diagnosed about one percent of the population. I came to ocd because I was speaking with a family member who was telling me that her 18, almost 18 year old son was diagnosed with obsessive compulsive disorder. She told me about how he did a loop around the house seven times before he could leave the house, and she and I were on FaceTime. And so I kind of cocked my head and I wanted to understand more. And she said imagine if you thought that the world not falling apart dependent on whether or not you completed a ritual. And so she said to me that my little cousin, when the world doesn't fall apart when he does seven laps around the house, he believes then that he has to do seven laps around the house, as so the world doesn't fall apart. And so this obsessive compulsive disorder is in the field of anxiety and we are going to talk about how trauma is related to it. But obsessive compulsive disorder, as I mentioned, is only diagnosed at about 1% of the population. It's not about being neat, it's not about liking things, just so. It is a disorder and one that, like I said, affects about 1% of the population and it can be debilitating. But you already know that if you're on the Wednesdays with Watson podcast, we're going to provide some hope for you. Ocd is listed, as I mentioned, in the category of anxiety disorders, with about 1% of the population being diagnosed with it.

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The key with OCD it produces a tremendous amount of anxiety and we have talked about on this podcast of when the brain is in an anxious state. The prefrontal cortex is offline, the PFC gives us access to all the things that make us right and appropriate and good executive function, and so when anxiety is ruling, there is no access to logic. And so we see people with OCD doing these repetitive behaviors like lapping the house or washing hands or the stove or light switches, because they have an extraordinary amount of doubt. They may turn off a light and then go back and go. Oh, what if that little piece of dust stopped it from turning off? And if I don't turn it off, the entire apartment complex is going to be engulfed in fire, as we saw with the Rachel story. Because the key with obsessive compulsive disorder is that it produces an extraordinary amount of doubt and it's not like post traumatic stress disorder in the sense that there is a felt sense.

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People feel unsafe Either they are unsafe or others are unsaved and they believe that these repetitive behaviors are a way to keep people safe. And so it's kind of the pseudo safety to calm the doubt, to calm the anxiety and all of the hormones and adrenaline and cortisol that comes with this constant anxiety. That is because if I don't do this repetitive behavior, something bad will happen to me or somebody else. Because, you see, ocd patients are unaware if a task is complete, and so they will repeat that task over and over and over until somehow they find some calmness in their mind. The mind creates a narrative related to the task, like the world will end if I don't complete this task, or I will be unsafe if I don't complete this task, or somebody that I love will be unsafe if I don't complete this task, I will get sick from the germs. The brain then goes into action to stop that narrative from actually happening calm the fears until the patient is either completely exhausted or somehow they've completed enough of the obsessive compulsions to calm the brain down.

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When we talk about OCD, we often think of it as a condition centered in on these thoughts, intrusive thoughts that come without our permission and repetitive behaviors. But what is commonly less discussed and why we're talking about it on this podcast is how trauma can be deeply connected to the intensification of OCD symptoms. Remember, trauma means that we feel like our safety has been compromised, and so when that happens, then the same thing the PFC goes offline, no access to logic, no access to the executive function. So when trauma is experienced early in life or over a long period of time, it can overwhelm the brain's natural ability to regulate fears and uncertainties and distress. And so for some people, ocd becomes a kind of survival strategy because the brain, in response to the trauma, starts looking for ways to create order and safety in an unpredictable world. That's where these compulsions come in. And compulsions can look like rituals, constant checking, constant counting or cleaning. They can feel like a shield against chaos or threat. Those intrusive thoughts might not be about the trauma itself, but the emotional residue of that trauma. Fear, shame, helplessness those things can find their way through the brain through these OCD patterns.

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Research also shows us that people with a history of trauma may be more vulnerable to certain subtypes of OCD, especially those obsessive compulsives rooted in. There's going to be a fear of harm, moral scrupulosity or hyper-responsibility. It's not that trauma directly causes the obsessive compulsive disorder, but it can shape how it appears, how intense it becomes and how hard it is to treat. Here's the key If the trauma isn't also acknowledged in the healing process. And so trauma has a significant connection to obsessive compulsive disorder.

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Again, we don't think that experiencing trauma particularly early in life causes OCD. We believe that probably is already there that propensity to have OCD. But the trauma is going to show is going to be different how it expresses itself. So, going back to the example of my little cousin who was diagnosed with OCD, he didn't have any trauma in the home, no childhood trauma, nothing like that. Now he was a micro preemie, and actually they weren't micro preemies, but he was a preemie and had a rough start in life, but he didn't have any. His safety wasn't compromised in any way, in the sense there was no childhood abuse or anything like that. And so his obsessive compulsives are not necessarily rooted in fear in his own house, but rooted in fear of the world. And so had he had some childhood trauma, then it may be expressing itself a little bit differently, in that he thinks that his, his compulsions and his obsessions solve a problem inside his house, like if I do this lab, then my mom or dad won't hit me, or something like that. And so we believe that trauma just changes the way that the OCD is expressed in the patient right.

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And so let's talk about those obsessions. They're unwanted. So the obsession part of OCD, obsessive, compulsive right. And so the obsessions, the unwanted intrusive thoughts, images or urges, causes this anxiety which again makes the PFC go offline, no access to executive function. Obsessions can look like related to contamination, unwanted urges, sexual thoughts, religious thoughts causing harm, horrific images, numbers, letters and sounds, and so that's some of the obsessions, the most common obsessions, compulsions to offset, if you will. Those obsessions, the most common obsessions, compulsions to offset, if you will, those obsessions checking things, counting things, washing, repeating, following these really strict rules.

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Now here's the thing as I prepared for this episode, I wondered if I myself have OCD and I don't. But certainly there is some things that I have, but it doesn't mean that I have obsessive compulsive disorder. Everyone has strange thoughts like that, everyone has a few quirks, but for someone with OCD, those thoughts stick, they loop and they don't feel optional. There's no way to click them off right. It's not just about things being tidy or organized, it's not a personality quirk. It is a mental illness that often requires therapy and sometimes medication to manage. And so I wanted to make sure that we talked about a little bit about what OCD was, how it was expressed, and then we're going to talk about some hope here in a minute. But let's talk about faith and obsessive compulsive disorder, because this is a Christian podcast.

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Danny Gokey made news several years ago when he came out and said that he had something called scrupulosity, religious scrupulosity, the religious form of OCD, right, and so here's this layer of guilt, and what this is is, if I don't do these certain things to a degree that is absurdly compulsive, that's absurdly repetitive, then God is going to be unhappy with me. And so Danny Gokey lived with this for many years, and this is something that we see in patients with obsessive compulsive disorder. I asked the doctor the other day. I said what is it with religion, god and that kind of thing that is connected to severe mental illness and, moreover, connected with OCD? And we don't know.

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But we know that this is a particularly harmful type of OCD, when a person thinks that the God of the universe is going to strike them dead if they don't do a certain thing certain number of times in a certain way. And so if you know somebody in your church, in your life group, at work that has OCD, and as a Christian you want to try to come alongside of them and do life with them and make sure that somebody is aware if they are doing certain things, so that God will be happy with them, because this is too much for one person to bear. God is not standing by with a clipboard counting how many times we do things in order to get a good standing in front of an almighty God. Our good standing in front of an almighty God has nothing to do with us, but everything to do with the completed work of Jesus on the cross, and so this type of OCD is particularly important for us to address, because these are actions at all. Nothing we can do makes us more whole and more complete in front of an almighty God. But for those with OCD, they don't believe that and you should go if you are interested and take a deep dive in Danny Gokey's story.

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But you know we're always going to bring some hope here on the Wednesdays with Watson podcast. So if you or somebody you know is struggling with OCD, there is help and there is hope. We know that there's hope in the completed work of Jesus on the cross. We know that there is hope in the three C's that we talk about on this podcast community. Right, if you're able to talk to somebody about it, find somebody that you trust and say, hey, I got this going on. Will you pray for me? Will you help me? You got to be out there in the world, guys and looking for people that are struggling with things like this. But if that is you, there is help and there is hope. Talk to somebody, get a therapist.

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There is a treatment for OCD called exposure response prevention. This is the gold standard for obsessive compulsive disorder, essentially what this is. I'll give you back to the case of my little cousin who needs to do the lap around the house seven times in order for the world not to end, and so what we will do is we will have him do it six times and go, observe that the world did not in fact end, and then he will do it five times and four and so on. And so if you are struggling with obsessive compulsive disorder, this is a fantastic modality to treat. It is not easy. It does expose patients to their biggest fear, raising anxiety in the moment, and so exposure response prevention therapy would also include some exercises to get the brain out of that go mode, out of that incredible anxiety that will be generated as a result of doing things that the person is afraid is going to turn into a bad outcome. Definitely, talk to your doctor.

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There are lots of medications that help with obsessive compulsive disorder. Most of them are in the SSRIs, so things like Zoloft medications and that family are also the gold standard. Also, join the support group. Nothing like being around other people who are struggling the same way you are. You could find information on the International OCD Foundation, which is iocdforg. There's also another podcast called the OCD stories, and then a book, freedom from obsessive compulsive disorder, by Jonathan Grayson. And, of course, you could always reach out here to me in any way that I can help you. In your podcasting app right there, there's an option to send me a text message. Now I am the only one that gets that. I cannot respond to your text, but if you give me an email address or a way to contact you, I will try to answer your questions. So the bottom line is, guys is obsessive compulsive disorder is a mental illness that affects 1% of the population.

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As Christians, ocd is particularly important because the overwhelming emotion related to OCD is doubt, and there are so many scriptures that help us with doubt. I love Proverbs 3, 5, and 6. Trust in the Lord with all of your heart and lean not into your own understanding. In all of your ways, acknowledge him and he shall direct your path. Guys, god did not promise us that we would not have things like an OCD in this world. In fact, he told us in this world, you will have suffering, but take heart. I have overcome the world.

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If you are, somebody you know is living with OCD, there is hope, and I hope that we have provided a little bit for you today and understanding those people who are in your life that live with OCD. It is something they cannot help and they think that there is constant danger around them. Please help them. Please be the reason why they understand that that is not true. We'll be back here in two, maybe three weeks. We are still in the dissertation process, and so the podcast is fitting in where we can fit it in.

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I do hope that you have found hope in this podcast. You know what I'm going to say. From here on out, you are seen, you are known, you are heard, you are loved and you are so, so valued. See you, guys next time you split the sea so I could walk right through it. My fears are dimed in perfect love. You rescued me so I can stand and sing. I am a child of God. I am a child of God. I am a child of God. I'm no longer a slave to fear. I am a child of God.

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Amy Watson

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