A Guide to OCD Triggers

This article will guide you through what triggers are, different types of triggers, and how to cope with them.

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OCD basics

What is OCD?

Before we can look at triggers, we need to understand the cycle of OCD so we can see how triggers work. Obsessive compulsive disorder (OCD) is an anxiety based mental illness which affects people from all over the world, in all walks of life. The disorder is categorized by a cycle of intrusive, obsessive thoughts which cause extreme emotional distress, and ritualized actions known as compulsions.

OCD can vary in severity and symptoms can be debilitating. It affects almost every area of an individual’s life and can be overwhelming. OCD also affects an individual’s loved ones and leads to difficult family dynamics. Thankfully, there are effective, scientifically proven treatments which can help an individual to overcome their OCD and reclaim their life.

What are obsessions?

Let’s take a closer look at obsessions: this will play a vital role in understanding triggers. Obsessions are intrusive thoughts, images, and fears which are unwanted, and which occur over and over again. Obsessions cause the individual a great deal of emotional distress and often shame. The International OCD Foundation explains that: “Obsessions are typically accompanied by intense and uncomfortable feelings such as fear, disgust, doubt, or a feeling that things have to be done in a way that is ‘just right.’”

There are many types or themes of obsessions: this simply refers to the topic the obsessions center around. For example, an individual may struggle with contamination obsessions causing fears of becoming contaminated by dirt or germs. Another person might struggle with sexual obsessions, with shame filled thoughts of sexually inappropriate acts.

An individual might have more than one type of obsession. Even within one theme of obsessions, there are many ways that might be experienced by an individual. They may be aware that their obsessions are not grounded in reality and do not make sense, but feel unable to ignore them despite this knowledge.

It’s important to note that intrusive thoughts do not reflect an individual’s true values or thoughts. This is often what contributes to the shame and embarrassment, particularly with obsessions which focus around taboo subjects. An individual is not at risk of acting on their obsessions. OCD does not make an individual dangerous.

We all have intrusive thoughts, even those of us without OCD. We may even have intrusive thoughts of similar themes to those with OCD. The difference is that the majority of us don’t attach any significance to these thoughts. At most, they might think ‘that was strange’ and then simply let the thought pass them by and never think about it again. An individual with OCD attaches great significance to their intrusive thoughts, which is what makes them obsessions.

What are compulsions?

The severe emotional distress and anxiety caused by obsessions leads the individual to need to do something to try to cope with these heightened emotions. Compulsions are ritualized behaviours or thoughts which the individual carries out to try to cope with their obsessions. The International OCD Foundation describes obsessions as: “repetitive behaviors or thoughts that a person uses with the intention of neutralizing, counteracting, or making their obsessions go away. “

Although carrying out a compulsion might initially alleviate the anxiety a little bit, it soons come back, and often much stronger. This leads the individual to need to carry out more and more compulsions. Unfortunately, compulsions don’t actually deal with the anxiety caused by obsessions, they actually feed the OCD cycle and make it worse.

As with obsessions, there are different types of compulsions an individual might struggle with. For example, an individual may struggle with cleaning compulsions (meaning excessive cleaning and washing), or checking compulsions (repetitive checking either physically or mentally). An individual may display more than one type of compulsion, and may experience any one compulsion in various ways.

Compulsions can take up many hours of the day and be very disruptive to the individual’s life. A compulsion may seem to relate to the obsession, for example cleaning compulsions in reaction to contamination obsessions. Alternatively, the two may not seem to relate to one another at all. Regardless, the individual will feel driven to carry out those compulsions in reaction to their obsessions.

What are triggers?

Now we understand the OCD cycle we can take a look at triggers. When referring to mental illness, triggers can be defined as, “external events or circumstances that may produce very uncomfortable emotional or psychiatric symptoms, such as anxiety, panic, discouragement, despair, or negative self-talk.”

When we look at OCD, triggers are anything which cause a severe emotional reaction or high anxiety in relation to the individual’s obsessions. You might hear this emotional reaction referred to as an ‘OCD spike’. Essentially, a trigger is something which brings your attention immediately to your obsession. This will feel very uncomfortable. Once your obsession is triggered, you will need to carry out compulsions to cope. This is the cycle of OCD.

Triggers can be life events which cause stress and can worsen OCD symptoms in general. Alternatively they can be specific things which trigger an individual type of obsession. Triggers can vary greatly from person to person, and even for one individual. All triggers are valid. None are ‘silly’ even if they seem to have no direct correlation. If they cause you distress, they are valid triggers.

Types of triggers

These triggers are things which can make it more likely that you will develop OCD, or which can trigger existing OCD symptoms.

Ongoing stress

If your life is particularly stressful, this can trigger OCD symptoms. While in the short term, stress is a helpful response to let us know that something is wrong and prepare us for action, in the long term this becomes detrimental. Our body and mind is simply not designed to deal with prolonged stress.

Ongoing stress may be caused by your lifestyle. For example, if you have a busy work schedule and don’t make time for relaxation, this can cause built up stress. You might have a job which is particularly stressful. You might live in a home where there are tense relationships with loved ones which causes stress.

There are endless things in our day to day life which can cause stress. Simple things such as missing your bus, being late to an appointment, or getting something wrong at work are stressors. While they may be mild for some people, if you have OCD these could be enough to trigger your obsessions. This 2020 article on the topic explains that: “People with OCD often report experiencing an increase in the number or severity of stressors just prior to their symptoms becoming worse.”

Big changes

Big changes in your life can also cause a lot of stress and anxiety, which can trigger your OCD. Even positive changes can evoke feelings of anxiety and be difficult to cope with. Big changes might include moving home for example: the change in environment can be very stressful. Getting a new job, even though it’s exciting, can also be nerve wracking. Changing schools or starting a new study topic could be triggering for someone with OCD. Even going on holiday could be enough of a change to trigger OCD symptoms. The list goes on.

Trauma

Experiencing a traumatic event can be a trigger for someone with OCD, or can be a trigger for OCD to develop. A trauma refers to a deeply distressing event which exceeds your ability to cope. This might include the death of a loved one for example. It could be a divorce, or the breaking up of a significant relationship in your life. It may be losing your job, or finding out you have a serious illness. It could be a natural disaster or a significant global event.

A trauma may be sexual, such as being abused or raped. It could be experiencing domestic violence or being attacked. It might be witnessing such an event. Just as with our list of changes, there are many potential traumas which could trigger OCD symptoms.

Pregnancy and giving birth

During pregnancy and up to a year after a woman gives birth can be a vulnerable time for OCD symptoms to develop or worsen. This is known as perinatal OCD. Obsessions and compulsions around this time tend to be centered around fears of contamination of the child, or of aggression towards the child.

There are many reasons this time period can trigger OCD symptoms. Hormone levels during this time can influence a change in chemical activity in the brain. It’s thought that a rise in the hormone oxytocin, in particular, can play a part. Oxytocin plays a vital role in the mother and child bond, and scientists believe this can create an over-protection response in someone with OCD.

The increased responsibility can make anxiety and stress levels rocket. Of course, it’s also one of the biggest changes you will go through in your life. The change in itself can be triggering for someone with OCD.

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Triggers specific to individual obsessions

As well as the more general factors which can trigger OCD, there are triggers which are specific to individual types of obsessions. It’s important to bear in mind that there are many types of obsessions, and they can be experienced in many ways. We’re all individuals and can experience the same symptoms differently.

Triggers can be anything and are personal to each person with OCD. Things we would come across in daily life can be triggering for some, and not for others. This article from Psychology Today explains that: “OCD can be triggered by almost anything, including things we see, random thoughts we have, sensations we experience, and objects we encounter.”

Just as with intrusive thoughts, it’s the significance we attach to these things which makes them a trigger. A normal object or a daily activity which, for someone without OCD holds no significance, someone with OCD may find triggering. It’s also important to remember that not all triggers will ‘fit’ with the type of obsessions an individual experiences.

Therefore, there are endless things which can be triggering within any one type of obsession. We’ll cover the more common types of obsessions and some examples of what could be triggering: if you don’t see your trigger here don’t worry.

Contamination

Contamination obsessions center around fear of yourself or your loved ones becoming contaminated. This might include fear of, or the urge to avoid, dirt, germs, ‘dirty’ places, bodily fluids, or even environmental and chemical contaminants.

An individual with contamination obsessions might find places they feel are dirty triggering. This could include a location like a public toilet or a shower block. Alternatively it could be surfaces or objects which lots of people touch which they feel could be contaminated, such as door handles and handrails. Simply being around these objects or in these places could be triggering.

If you have contamination obsessions you might find physical interaction with other people triggering, such as shaking hands, giving cuddles, or kissing for example. Sex can be problematic for some people with contamination obsessions, particularly if they center around bodily fluids.

Some people might find being in places where they are large crowds of people triggering, for fear others will pass on germs. This might include being at school, in a workplace, or out in a social situation. Others may struggle with being in a healthcare setting where they might be around people who are unwell, such as at the doctor’s office or in hospital.

Harm

Obsessions around harm include images, thoughts, or fears about harming yourself or someone else (whether it’s someone you know or a stranger). It may focus on directly causing harm, or be centered around fears of causing accidental harm. It’s common to feel very responsible for the safety of your loved ones. Many people with these obsessions feel that if a loved one comes to harm, it’s their fault because of their intrusive thoughts.

If you struggle with harm obsessions, you might find being around objects which you could potentially use to cause harm triggering, such as knives in the kitchen. You could find carrying out a daily task such as cooking with knives triggering. If your obsessions are centered around causing accidental harm, for example starting a fire accidently and harming your loved ones, you might find lighters, smoke, or even cooking appliances triggering.

If your obsessions focus on a specific person, for example a loved one, just being around them could be triggering for you. If your harm obsessions focus on strangers, you might find being in crowded in places around new people triggering.

Sexual

Sexual obsessions can focus on a variety of sexual themes, including sexual abuse, inappropriate or taboo sexual acts, peodphilia, or sexual indentity for example. These are understandably some of the most shame-filled obsessions. It’s so important to remember, as we discussed earlier, that these intrusive thoughts don’t reflect the individual’s actual beliefs or indicate risk.

Those who struggle with sexual obsessions could find any situation which involves physical interaction triggering. When shaking hands or cuddling someone else, they may find that their obsessions are triggered. If the sexual obsessions are focused around a particular individual, being in the presence of this person is likely to be triggering.

Depending on the sexual theme of an individual’s obsessions, triggers may vary. For example, if an individual struggles with peophilia obsessions, they might find just walking past a child triggers an onset of shame, doubt, and fear. If a parent with these obsessions baths their child, they might find this simple act triggering.

A person who struggles with obsessions around sexual identity might worry that they are gay, even though they know they are straight, or visa versa. In this case, they might find being around someone of the same sex triggering. They may find watching a homosexual scene in a film triggers them, or walking past a same sex couple on the street.

Relationships

These obsessions focus around concerns that your partner isn’t ‘the one’, worries about compatibility, or other concerns about a relationship. This is sometimes referred to as Relationship OCD (ROCD). These obsessions can occur even within an otherwise healthy and happy relationship.

If you have relationship obsessions and you’re in a relationship, being around your partner could be enough to trigger your obsessions. Being sexually intimate could be a trigger, or being out in public together. You might find that walking past another person you find attractive can trigger worries about whether your partner is really the one, or fears about whether you’re happy in your relationship.

If you have these obsessions and you’re single, you might find dating triggering. You may find being around people you find attractive troublesome, or even being in a social setting where you could potentially meet someone new.

Religious

Religious obsessions focus on fears and concerns about being religious enough, being good enough, and acting in a way that sticks to strict morals. This is often referred to as scrupulosity. You might fear judgement or punishment from a religious figure if you do not meet the standards your OCD has set in your mind.

An individual struggling with religious obsessions could potentially find anything relating to their religion triggering. This might include attending church, praying at home, reading religious texts, talking about their religion, carrying out religious rituals, and so on. They may find being around religious figures triggering, or even just thinking about their religious beliefs.

If someone has moral scrupulosity, which means they have obsessions around strict morals rather than religious beliefs, they are likely to find anything which could potentially break these morals triggering. Likewise, an individual with religious obsessions will find the concept of, or the act of, breaking any religious rules triggering.

Losing control

Those who struggle with obsessions around losing control might fear that they are going to lose control of themselves and say or do something they will later regret or be embarrassed about. It’s also common to worry about losing control and acting on another obsession. They might find that they fear the actions of others, because they can’t control them.

There are such a wide spectrum of potential triggers which come with obsessions around losing control. An individual could find any situation when they are around other people triggering. They might find meeting new people or being around strangers triggering. They could find special occasions triggering, for fear they will do something which will ruin the event. They may find public speaking problematic, whether formal or informal.

It’s possible that someone who fears losing control may find situations within which their brain chemistry is altered, triggering: for example if they drink alcohol or take drugs (even if this is prescription medication). They could find situations where things don’t go exactly to plan, or where people don’t act as the individual might expect, triggering.

Perfectionism

These obsessions focus on the need to be perfect or to have things ‘just right’. There may be a great deal of fear around the idea of things being imperfect. If you struggle with perfectionism, it’s likely that anything which you perceive as imperfect would be triggering.

This could include a special event not going exactly to plan, or even just a daily routine within which a step goes wrong. It could be that being late for an appointment is triggering. It may be that not getting the mark you anticipated on a test, or not getting the praise you expect at work, could trigger you. It’s likely that if someone voices criticism, even if it’s constructive, this would be difficult to cope with.

Physical illness

This is a separate type of obsession than contamination, as it doesn’t relate to germs or dirt. These obsessions focus on fear that yourself or a loved one is going to become physically ill, or that something is wrong with your body. This might involve being hyperconscious of normally unconscious bodily functions, such as breathing and swallowing.

If you have obsessions around physical illness, you might find any talk of illness (whether in person or on TV) triggering. You might be triggered by being around other ill people, such as in a doctor’s waiting room, at a hospital, or even just hearing someone cough as you walk past them.

You may experience a great deal of fear if you notice anything ‘different than normal’ about your body, for example if you feel you’re breathing a bit faster, if you have a runny nose, or if your toilet habits are different than normal. You might also feel this way if you notice similar things in a loved one.

Superstitious

If you struggle with superstitious obsessions, you might gravitate towards numbers, words, colours, or phrases which you feel are ‘lucky’, and away from those which you think are ‘unlucky’. You are likely to feel as though something awful is going to happen if you interact with something unlucky. You may also feel the urge to carry out specific superstitious actions, such as knocking on wood.

Someone who has superstitious obsessions will find anything that doesn’t fit in with their beliefs triggering. This might be accidentally saying an ‘unlucky’ word, or hearing another person doing so. It might be ordering an ‘unlucky’ number of items when you’re shopping online, or seeing an ‘unlucky’ number on a door you walk past. It could be being in a room with a colour scheme you feel is ‘unlucky’. Similarly, if you had obsessions around a superstitious action, like knocking on wood in our example, if you didn’t carry this action when you felt it was needed, this would be triggering.

Order or symmetry

These obsessions cause the individual to feel that they need to have things in a specific order or arranged symmetrically. This may apply to anything in their daily life, from clothes and belongings, to food on their plate at mealtime. They may feel as though something terrible is going to happen if this order is disrupted.

If you have order or symmetry obsessions, anything which interferes with this order could be triggering. For example, if someone didn’t put something back in the right way, or if a family member rearranged your belongings when tidying up (even if they were trying to be helpful).

You might also find specific items triggering, such as clothes or toiletries, if these are what you usually order. You may find a time of the day triggering, such as mealtimes if you usually order your food on your plate as in our previous example.

Urge to hoard

An individual with obsessions focused on hoarding will feel the urge to keep or collect items, even if they’re worn out or don’t have any particular use. They are likely to deeply fear the idea of throwing these items away.

The thought of throwing any of your hoarded items away would be triggering if you struggled with an urge to hoard. Likewise, so would someone suggesting you get rid of any of your items, or a loved one trying to help you tidy up. You might also find coming across items in your daily life which you would normally collect triggering.

How to deal with triggers

Now that we’ve taken a look at what triggers are and covered some examples, we need to take a look at how to deal with triggers. As we discussed earlier, once an individual with OCD is triggered, they will typically react with compulsions to try to ease their emotional distress. However, this only perpetuates the OCD cycle, so how can you deal with triggers in a more helpful way?

Be self aware

Learning to identify your triggers is key to learning how to react to them effectively. This can take time but as you become more self aware and pinpoint what your triggers are, this will give you the power to fight your OCD. You could choose to write down or keep note of your triggers as you identify them, so that you can deal with them as you move forward. Therapy can also help you to identify your triggers.

Face triggers

As scary as it sounds, once you’re aware of your triggers it’s time to face them. This can be done gradually, and you don’t have to do it alone: we’ll talk about seeking treatment in a moment. Avoiding them, although a natural response, doesn’t deal with the trigger, it just pushes it aside.

In fact, avoidance in itself can actually become a compulsion. This avoidance actually feeds into the OCD cycle and worsens it over time, because you’re effectively telling your brain that these triggers are significant and important, and that they should be feared. To overcome OCD it’s vital to face your fears to break this cycle.

Seek treatment

You aren’t alone in trying to cope with your triggers. There are very effective, proven treatments you can access. The primary treatment for dealing with triggers is exposure and response prevention (ERP). This is a form of cognitive behavioural therapy (CBT), which helps an individual with OCD to face triggering their obsessions (the exposure part), without reacting with compulsions (the response prevention part).

ERP can sound really scary at first, but it’s done in a very gradual way. You’ll start with your least feared situation and work your way up under guidance. It does take work and can be uncomfortable at first, but it’s well worth it to overcome your OCD. As you carry out each exposure and realise that you can do it, and that nothing bad happened when you didn’t carry out a compulsion in reaction to your obsession, your anxiety will gradually fall. By engaging in ERP you are actively breaking the OCD cycle and regaining control.

You can access ERP by talking to your doctor or mental health professional: they may be able to refer you for face to face therapy. Alternatively, you could seek therapy privately, or through an online OCD treatment programme.

Learning that the OCD, not the trigger is the problem

As you begin to face your triggers and engage in therapy, you’ll learn that it’s not the trigger itself which is the problem. We’ve talked about the fact that it’s the significance you attach to an event or object which makes it triggering, and this is something you will learn in a very real way. It’s the OCD which is the problem, rather than the object or event itself.

This article explains that, “If you blame the trigger (i.e. the feared thought or object) and label it as the problem, you are being misdirected. OCD, and the history of repeated compulsions, exaggerate the importance of a select number of mental associations.” Over time, the fear and other heightened emotions around a previously triggering situation, will become neutralized. You’ll be able to be in that situation and see it clearly for what it is, without an OCD reaction.

Use relaxation techniques

As you’re learning not to react to triggers with compulsions, you can look at ways to deal with the emotions that come with being triggered. Utilizing relaxation techniques can be a great way to calm that anxiety and distress. This might involve mindfulness meditation, visualization, or breathing exercises.

Mindfulness is all about being present in the moment, accepting it for what it is, and being in a state of deep relaxation. This can be very useful in coping with anxiety. You might find that mindfulness is involved in therapy when you seek treatment, or you can find resources online to help you get started. Once you learn the skills of mindfulness, you can use them in the long term to help you regulate your emotions and achieve a state of calm.

Consider distraction techniques

Another great way to cope with triggers, is to use distraction techniques. These can be anything which helps to distract your focus from solely being on the trigger itself. It might be changing your environment, doing some exercise, or doing a craft for example. You’ll figure out what works for you. Don’t worry if your mind isn’t completely off your trigger at first: the goal is to distract yourself enough to ease your anxiety slightly and keep you from carrying out compulsions. Over time, this will get easier.

Ask loved ones for help

It’s so important to see help from loved ones. You don’t have to do this alone. Let them know what you’re going through and allow them to be there for you. They may just be there to listen, which can be invaluable. They might help you with practical tasks, such as going with you to therapy appointments. They might even get involved in therapy so they can learn how to help you break the OCD cycle.

Seek support from others who understand

As helpful as support from loved ones can be, they may not be able to fully understand what you’re going through. Sometimes that can feel very lonely. Seeking support from others who understand what you’re going through, because they’ve experienced it themselves, can be so helpful. You might be able to find a local OCD support group. You may be able to access OCD helplines. You could also find people online through forums, OCD chat rooms, and even social media, who can create a sense of community for you.

Practice self care

Practicing self care is vital to your physical and mental health. You might not feel like it. In fact, when you’re going through OCD it might feel like your last priority, but you need to try and keep up with self care as best you can. Self care refers to any activity within which you are proactively taking care of your health. This could include keeping a regular sleep schedule, doing exercise, eating well, keeping up with personal hygiene, and making time to relax.

Remember that things can get better

Lastly, remember that there is always hope. Even when things are at their hardest and you can’t see the light ahead, remind yourself that hope exists. With therapy and the right management techniques, you can reclaim your life from OCD. Things can get better.

References

International OCD Foundation, (2020), “What is OCD?”

Center for Mental Health Services, (2013), “Triggers”. MentalHelp.net

Owen Kelly, PhD, (2020), “Managing Stress When You Have OCD”. Very Well Mind.

Kevin Foss MFT, (2019), “OCD Isn’t a Thought Problem, It’s a Feeling Problem”. Psychology Today.

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