Understanding the Link Between Trauma and Anxiety/OCD/Eating Disorders: Integrated Treatment in Melbourne

Healing from trauma is often complex. For many survivors, the journey involves more than just addressing the direct impact of the traumatic events, especially when the trauma was prolonged or repeated. While single-incident trauma can certainly lead to PTSD, experiences of prolonged or repeated trauma (particularly during childhood or within relationships) often result in more complex presentations (C-PTSD) which very frequently co-occur with other mental health conditions. Common examples include anxiety disorders, Obsessive-Compulsive Disorder (OCD), eating disorders, or behavioural addictions (such as problematic gaming or internet use).

Recognising this link is crucial because effective recovery often requires an integrated treatment approach – one that addresses both the trauma and the co-occurring condition simultaneously. At Shaw Psychology in Melbourne, we specialise in providing this kind of comprehensive care.

Symbolises the integration of different aspects of a person's experience (trauma, co-occurring conditions) and the integrated therapeutic approach that weaves different strategies together.

Why Do Trauma and Other Conditions Often Co-occur?

The connection between trauma and conditions like anxiety, OCD, or eating disorders is multifaceted:

• Impact on Emotion Regulation: A primary reason for the link is that prolonged trauma severely impacts the brain and nervous system's ability to regulate emotions. This core vulnerability, as highlighted by experts like Courtois & Ford, can manifest as anxiety, OCD, EDs, or addictive behaviours.

• Maladaptive Coping Mechanisms: Symptoms of these other conditions can develop as attempts – often unconscious – to cope with overwhelming trauma-related emotions (like fear, shame, emptiness), intrusive memories, or a terrifying loss of control. For example, the intense emotional pain or numbness from trauma might lead someone to use eating disorder behaviours or compulsive gaming as a way to avoid or numb those unbearable feelings. Similarly, OCD rituals might arise as an attempt to control overwhelming anxiety or intrusive thoughts stemming directly from the trauma.

• Cycle of Vulnerability: Trauma can lead to difficulties with trust, isolation, and increased vulnerability. This can sometimes lead to engaging in unhealthy coping strategies (like substance use or emotional avoidance), which in turn can increase the risk of further difficulties or even re-traumatisation.

• Shared Underlying Factors: Issues stemming from trauma, such as profound negative self-beliefs ("I am bad," "I am worthless"), difficulty trusting others, or chronic feelings of unsafety, can also be driving factors in conditions like depression, social anxiety, or eating disorders.

  
  

Common Links:

• Trauma & Anxiety: Trauma survivors frequently experience heightened anxiety, panic attacks, social anxiety, or generalised worry, stemming from a nervous system primed for threat.

• Trauma & OCD: Intrusive trauma memories might trigger obsessive thoughts. Compulsive behaviours can develop as attempts to regain control or manage overwhelming anxiety originating from the trauma.

• Trauma & Eating Disorders: Behaviours like restricting food, binging, or purging can be attempts to numb overwhelming emotions, cope with body-related trauma, assert control, or dissociate.

• Trauma & Behavioural Addictions: Compulsive gaming, internet use, pornography use, or gambling can serve to escape painful memories, numb emotional distress, or temporarily fill a void left by trauma.

The Critical Need for Integrated Treatment

Treating only the co-occurring condition without addressing the underlying trauma often leads to limited success. Conversely, trying to process trauma without addressing severe co-occurring symptoms can be destabilising.

Integrated treatment, provided by a general or clinical psychologist skilled in both trauma and the co-occurring condition, is essential. It aims to:

• Understand the function: A crucial part of integrated therapy is understanding the function of the anxiety, OCD, ED, or addictive behaviour serves – often, it's an attempt to manage underlying trauma-related distress, even if it causes further problems. Addressing this function directly is key.

• Develop Broad Coping Skills: Equip clients with practical skills applicable to both trauma reactions and comorbid symptoms.

• Follow a Phased Approach: Ensure stability and adequate coping resources are built (Phase 1) before processing traumatic material, which is vital in complex cases.

• Tailor Interventions: Carefully adapt specific techniques (like exposure therapy or nutritional support) within a trauma-informed framework.

• Address Core Issues: Work on underlying factors like negative self-beliefs or relational difficulties.

An example:

Michael is a Melbourne IT professional who survived significant emotional neglect and verbal abuse in his childhood. As an adult, he struggled with C-PTSD symptoms (intense shame, emotional flashbacks) but also developed severe OCD focused on contamination fears and checking rituals. He first saw a therapist who used standard Exposure and Response Prevention (ERP) for the OCD. While Michael tried hard, the exposure exercises often triggered overwhelming panic and feelings of worthlessness rooted in his trauma, making progress difficult. Feeling discouraged, he sought additional help. His new psychologist recognised the deep link between the C-PTSD and OCD. Therapy took an integrated, phased approach: first building emotion regulation skills (drawing on DBT), understanding how the OCD provided a (false) sense of control over underlying feelings of being 'bad' or unsafe, and then gently using Schema Therapy principles alongside modified ERP, always within a safe therapeutic relationship. Addressing both the trauma roots and the OCD branches simultaneously allowed Michael to experience more lasting relief.

(Please note: This is a fictional vignette created for illustrative purposes only.)

Integrated Treatment Approaches at Shaw Psychology

At Shaw Psychology, our Melbourne general and clinical psychologists understand the complexities of co-occurring conditions. We provide:

• Comprehensive Assessment: Evaluating the interplay between trauma and other conditions.

• Phased Treatment: Prioritising safety, stabilisation, and skill-building first.

• Tailored Integration: Drawing from therapies effective for both trauma and co-occurring issues, such as Schema Therapy, Acceptance and Commitment Therapy (ACT), Dialectical Behaviour Therapy (DBT) informed skills, adapted Cognitive Behavioural Therapy (CBT), and EMDR (when appropriate and safe). Many skills learned (like mindfulness, distress tolerance, or challenging unhelpful thoughts) are useful across both trauma and comorbid symptoms.

• Collaborative Care: Working with other providers (like dietitians for eating disorders) when necessary.

Finding Integrated Care Expertise in Melbourne

When dealing with trauma alongside anxiety, OCD, an eating disorder, or addiction, it's vital to find a therapist or clinic with expertise in all relevant areas. Look for general and clinical psychologists who explicitly mention experience with trauma/PTSD/C-PTSD and the specific co-occurring condition, and who describe an integrated treatment philosophy.

Untangling the Web with Expert Support

Living with the combined weight of trauma and another mental health condition can feel incredibly difficult, but integrated treatment offers a path towards holistic recovery. Addressing the interconnected issues together provides the most significant opportunity for lasting change.

If you are struggling with the effects of trauma complicated by anxiety, OCD, an eating disorder, or problematic behaviours, specialised integrated support is available at Shaw Psychology.

Contact us today on (03) 9969 2190, visit our website at www.shawpsychology.com to learn more, or book an initial consultation directly online here: https://bit.ly/bookshawpsychology