Obsession and Complex Trauma

Consumed by uninvited thoughts

As a complex trauma therapist and survivor, I am well acquainted with the persistent regurgitation of disturbing memories. The intractability implied by the need to go over week after week, month after month and even year after year of injurious occurrences and mortifying motifs is understood as an essential part of the remembrance and mourning stage of recovery in trauma-informed care.

Indeed, restoring one’s dignity in the aftermath of traumatic assault is a prolonged, harrowing and formidable task. Pernicious symptoms such as flooding, dissociation, night terrors and flashbacks continuously remind the survivor of how they were stripped of their essential worth. Along with these afflictions, the trauma survivor is plagued by splintered recollections of what occurred. Recurrent intrusive thoughts comprised of fragments of traumatic remembrances create a schema of their plight.

Paradoxically, perseverating over traumatic experiences is a desperate attempt to decipher inconceivable harm and to regain control.

For those presenting with a form of complex trauma due to narcissistic abuse, the quest for redemption and closure exacerbates the victim’s cognitive dissonance and ignites an obsessive preoccupation with discerning what was real.

The prevalence of a pathological power-submission attachment in which the victim perceives their tormentor as their redeemer, is coupled with the activation of the stress hormone cortisol when under siege, and the rush of dopamine when relief is proffered through ‘reward’. These addictive properties comprise the trauma bond with a malignant abuser, which makes the final rupture especially brutal and debilitating. When withdrawal sets in obsessive thoughts are a chronic source of distress.

Although relentless and exhausting, mentally recreating traumatic themes assists with coming to terms with surreal experiences. Memories are revisited and feared outcomes of shattered dreams, excruciating loneliness, helplessness, being replaced, forgotten, and debased invade one’s consciousness. The tenacity of the pain keeps the trauma alive until it is fully assimilated and accommodated.

Similar to a rape survivor iterating safety measures and precautions, ruminating over scenarios of traumatic oppression is often an effort to establish protection and a much-needed sense of agency in the present. By regurgitating memories of helpless victimization momentary relief can be attained through imagined volition and mastery.

For example, the fixation on redemption fantasies is a powerful locus of control for many of my therapy clients in recovery from complex trauma. Likewise fantasies of revenge assist the trauma survivor with coping and sublimating instinctual aggression. Repeatedly attending to fictitious scenarios in which abusers are put in their place, brought to justice, or beg for forgiveness offers a temporary escape from the excruciating pain of outrage and humiliation.

Similar to maladaptive daydreaming or what is known as daydreaming disorder, seeking escape from traumatic abuse through obsessive rumination and fantasy can be destructive or palliative depending on how it is channeled.

When a trauma survivor’s efforts to make sense out of regurgitating thoughts and memories does not lead to a remission of symptoms and a neutralization of obsessive reverie, and to the contrary incorporates repetitive ritualistic behaviors, it’s possible that trauma related obsessive compulsive disorder (OCD) has taken root.

In these instances, obsessions are not limited to the past, but also include future scenarios and feared outcomes. Moreover, compulsive behaviors are geared towards preventing feared consequences as opposed to simply avoiding painful triggers and memories.

OCD and PTSD was evaluated by researchers Pinciotti CM, Horvath G, Wetterneck CT, Riemann BC, who discovered that compared to the 1% prevalence of OCD in the general population, between 19% and 41% of those who present with PTSD also have a diagnosis of OCD.

Suggesting that a dynamic interplay between both disorders exists brings to light that traumatic symptoms and stressful life events can ignite a litany of obsessive cognitions and rituals, resulting in comorbidity. Interwoven are repetitive behaviors and obsessions, designed to prevent imagined threats (OCD) and attenuate intrusive symptoms linked to traumatic memories (PTSD).

Although behavioral therapy, specifically ERP is the treatment of choice for obsessional disorders I have found that treating trauma-related obsessions by exploring and interpreting the subjective unconscious conflicts underscoring preoccupations, is a meaningful intervention.

Extrapolating from a psychodynamic perspective, the content comprising a relentless loop of thoughts and scenarios may reveal charged sexual and aggressive impulses or conflictual wishes and themes seeking corrective resolution.

In the case of my client M, her ongoing obsession with a former romantic parter evidencing signs of malignant narcissism is a stubborn defense against profound grief, rage and helplessness. Consumed by injurious thoughts of his attaining marital bliss with an imaginary other, M sublimates her pain as the rejected child who has morphed into the spurned unwanted woman.

Ralph Waldo Emerson conveyed, “You become what you think about all day long.”

This is precisely why, as M regurgitates the excruciating parallel between her malignant father’s cruel indifference and her disordered significant other of ten years, she stays locked in an identity in which she is scorned and unloveable. Moreover, the underpinnings of her obsessions also awaken the repercussions of her mother’s choice to tolerate domestic violence and maintain her function as a narcissistic extension. By rejecting M’s pleas for safety and care by choosing instead to remain with a man who wreaked havoc on their lives, M’s identification with being prized as primary supply was reinforced.

Like M, complex trauma survivors beset by histories of systemic neglect and abuse seek illusory control and security by cogitating over painful remembrances and feared outcomes. As much as they yearn to move on with their lives, to let go is to unleash a lifetime of complicated grief, a necessary, but grueling part of recovery and reclamation.

Accordingly, for complex trauma survivors dismantling and releasing one’s obsessions is tantamount to fully facing the agony of what was endured. Although this is the route to acceptance, it is an attainment that many consider to be both a blessing and a curse.