OCD, Trauma, or Both? Understanding the Overlap

Is it trauma? Obsessive-compulsive disorder (OCD)? Or both? Can trauma trigger OCD? Can OCD feel like trauma?

In this episode, Dr. Nathaniel Van Kirk, a ADAA member and leading clinical psychologist and trauma expert, joins Gabe Howard to unpack the complex relationship between trauma and OCD. While both terms are widely used, few understand how deeply they can intertwine — or how often they’re misunderstood.

Dr. Van Kirk explains why a traumatic event might trigger OCD in some people, how OCD symptoms can mimic trauma responses, and why compulsions often become misguided tools for managing fear. He also dives into the surprising statistic that up to 90% of people experience a traumatic event, and explores how our brains are hardwired to both break down and heal.

Takeaways include:

• the difference between trauma, PTSD, and OCD
• why OCD isn’t usually considered a trauma disorder — but sometimes should be
• how clinicians decide which disorder to treat first
• why healing often means separating fear from fact

If you’ve ever had intrusive thoughts or wanted to better understand the mental health impact of trauma, this episode is essential listening.  

This episode has been sponsored by the Anxiety and Depression Association of America (ADAA).

“For about 19% of individuals with OCD, they tend to have a comorbid PTSD diagnosis. I think that's much higher than what we initially thought as a field. Initially we thought it was rare, and part of the challenge is that for many years these two things were treated as silos. You were either a PTSD and trauma therapist or an OCD therapist. And very rarely did we cross over. It turns out that was not the great approach, because in reality, there's actually a lot more overlap than we thought. And finding out that it's actually a very common experience that people just didn't talk about.” ~Nathaniel Van Kirk, PhD

Our guest, Nathaniel Van Kirk, PhD, is a licensed clinical psychologist, specializing in severe anxiety disorders, obsessive compulsive disorder (OCD), and trauma/PTSD. At McLean Hospital, Dr. Van Kirk is the director of psychological services at the OCD Institute. He is a member of the hospital’s Patient and Family Advisory Committee and Interdisciplinary Recovery Oriented Practice Committee, and also serves as the site facilitator for McLean’s Schwartz Rounds Committee.

Dr. Van Kirk’s clinical research focuses on the role of motivation across treatment and the impact of trauma on treatment outcomes, and on promoting innovative methods to assess and conceptualize recovery. Additionally, he is involved in efforts to reduce mental health stigma (such as participating in McLean Hospital’s Deconstructing Stigma campaign), emphasizing the importance of bridging the gap between therapists, researchers, and those with mental health challenges, including individuals who work in the mental health field.

Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the "Inside Bipolar" podcast with Dr. Nicole Washington.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.

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