What does it actually mean for OCD to be “triggered”?

In recent years, you may have especially heard the word “triggered” used frequently. People may say an experience triggered them, or use the word to mock others as oversensitive. But what does it actually mean? 

From an OCD standpoint, to be triggered is to experience something in a situation or an environment that causes you to have an intrusive thought, image, or urge, or reminds you of a previous one. Essentially, a trigger is anything that leads to an OCD obsession. Once triggered, you may start to feel anxiety and discomfort. The members I work with in therapy often say that triggers can seemingly come out of nowhere, immediately demanding their full attention. 

Triggers can come in many forms and are unique to the individual. Perhaps you are spending time with your partner when the feeling that you might not be attracted to them strikes suddenly. Maybe you’re in public and someone brushes against you, causing you to worry obsessively: “How old were they? Could they have been underage? Did I feel an attraction to them?” Or perhaps you drive home from work at night and hear a news story on the radio about a hit-and-run. Worries strike one after another: “Did I drive by there? Could I have hit someone without remembering? I need to turn around to know for certain.” 

When OCD is triggered, these are not just passing thoughts or feelings; they set off obsessive thoughts, anxieties, or fears that can last a long time. 

Why does it happen more when I am having fun?

I often hear from the people I work with that OCD triggers seem to strike right when they’re having fun or relaxing, as it’s not uncommon for people with OCD to experience heightened anxiety during occasions like vacations, holidays, time off from work, or special events. This might mean that they aren’t able to look forward to these things like someone without OCD might. I like to characterize this as OCD seeking control over their life when it senses that they’re feeling free and secure.

There can be many reasons for this; perhaps they are taken out of a comfortable routine, traveling away from home, not sure what to expect, or worried about needing to hide their symptoms. Some people even avoid participating in these situations because of the stress it can bring.

When something triggers OCD, you may feel a rush of emotion: frustration, fear, sadness, anger, and a need for control are common. You may want to isolate yourself from the trigger and from the situation that caused it. Your first instinct may be a flight response or avoidance technique. Or quite the opposite—you may have a “fight” response, feeling angry and defiant. 

The faulty alarm in our brains

Your ability to remain present in the moment has been compromised. Your brain’s danger-monitoring system has been tripped, and you can’t seem to turn it off. On a biological level, your brain is doing what it is trained to do: it senses danger and seeks safety. That’s why to manage a perceived threat, your brain often pursues a fight, flight, or freeze response. 

For example, where I live, there are bears. These bears roam my property from time to time. I am aware of these bears being out there, but unless I am alone in the woods, I don’t think about them much. However, let’s say I am out in the woods walking, and I come face to face with a bear: my brain should react! I hope it responds in a way that helps to protect me—that means my brain is doing its job and alerting me to a real danger. My senses kick in, and I can act to protect myself.

The problem with an OCD trigger is that your brain has the same response, but there’s a catch—it’s a false alarm. You’re not actually in danger. Unfortunately, your brain doesn’t quite realize this, and you feel the way you might in response to a real, dangerous threat. 

Thoughts, images, and urges are not actually dangerous for people with OCD. They are nothing more than thoughts, images, and urges, and they don’t need to have any further meaning. A person without OCD may experience similar things, but their brain simply filters out the noise, rather than feeling threatened. As a result, they feel no need to avoid the things that caused these thoughts, images and urges in the future. 

What can I do about my triggers?

If certain circumstances or events trigger OCD episodes, there is hope: you can receive very effective treatment for OCD. This treatment may not completely erase your triggers, but it can help you learn new ways to respond to them. If you have had OCD long enough, you know that compulsions—things you do either internally or externally to get rid of anxiety in the moment—only help you gain momentary solace, never fully relieving the discomfort. 

Unfortunately, by doing compulsions, you have inadvertently taught your brain that its faulty alarm is responding to real danger, and that your compulsion dealt with it. But this is not the case. Your brain now will need to relearn how to react to triggers. You will need to resist doing compulsions and allow your brain to sit in the discomfort and anxiety that comes. In doing so, your brain will learn that OCD triggers aren’t real danger. This will take commitment, but you can change the way that your brain works by changing your actions. 

Of course, the goal is not to get rid of anxiety. We need healthy responses to danger, and when our brains are working properly, anxiety can actually be helpful. As I mentioned earlier, it can even save our lives from real danger. On the other hand, anxiety from OCD triggers is not useful, leads to confusion and doubt, and doesn’t serve to keep you safe from any actual danger. 

To really combat OCD, you need to do exposure and response prevention (ERP) therapy, which is the most effective treatment for OCD. ERP helps you resist compulsions, which only relieve anxiety temporarily, and teaches you to accept uncertainty, no matter how upsetting and distressing a thought, image, or urge may seem. By resisting compulsions as a response, you retrain your brain to recognize that you are not in actual danger. The goal of ERP is to learn to manage OCD effectively and to provide long-term relief.

ERP therapy is an active form of treatment and requires intentional buy-in from the member through participation in exposures, a willingness to feel discomfort, and honesty with their therapist about their obsessions and compulsions (even if they believe they are shameful or taboo). ERP therapy has been proven to effectively treat people with OCD. About 80% of people with OCD experience positive results, and the majority of people experience results within 12 to 25 sessions. 

ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP. At NOCD, all therapists specialize in OCD and receive ERP-specific training. If you have questions or think that you may need ERP therapy for your OCD, speak to someone on our care team on a free 15-minute call.