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By Rodrigo Santos Andrade
What kind of a person am I? How fear and rejection can underpin OCD
visibility comment0 event September 22, 2026 timer 02:00
Some people with obsessive-compulsive disorder have experienced traumatic events as children, and develop a deeply held fear of who they are or might become.
FG Trade/GettyWhen you think about obsessive-compulsive disorder, or OCD, does being a “neat freak” or “germaphobe” come to mind?
In fact, OCD is not a personality quirk. It’s a distressing and disabling psychiatric condition that affects around one in 50 of us.
Read more:
Obsessive compulsive disorder is more common than you think. But it can take 9 years for an OCD diagnosis
But up to half of those with OCD who receive the best psychological treatments don’t significantly benefit from them. This is likely because our understanding of OCD is incomplete.
It’s unclear what causes the disorder, and is likely a combination of genes, biology, and environment, including traumatic or stressful experiences.
In a recent study, we interviewed 16 adults with OCD. Our findings point to the role early experiences of rejection and trauma can play, for some people, in developing the disorder.
What is OCD, really?
OCD is characterised by obsessions, compulsions, or both.
Obsessions are recurring, unwanted and intrusive thoughts, images or urges. They commonly centre on contamination, harm, symmetry, or repugnant themes such as unwanted sexual or violent thoughts.
Compulsions are repetitive behaviours (such as checking and re-checking the car is locked, or arranging objects so they’re “just right”) or mental acts (such as repeating certain numbers in your head). People perform these to directly address the feared consequences of the obsession and to ease distress.
For example, someone with OCD might believe someone they love will die or be injured if they don’t pray in a certain way or if they step on footpath cracks.
The disorder typically begins around age 20 and, without treatment, tends to be lifelong.
What’s behind intrusive thoughts?
Psychological theories have traditionally suggested that everyone has random, intrusive thoughts. What makes them obsessions is their frequency, the distress they cause, and how much they interfere in daily life.
But a more recent theory suggests intrusive thoughts and obsessions in OCD are not always random. For some people, they stem from core beliefs about who they are or dread becoming – their “feared self”.
If someone believes, “I am a dangerous person” or “I might be immoral,” for example, intrusive violent thoughts can feel like evidence of this feared self. Compulsions can become desperate attempts to disprove it, by controlling the thoughts.
The feared self model is not the only account for what causes and maintains OCD symptoms. But there is evidence to suggest people who view themselves in this way are more likely to experience OCD symptoms.
What we did
We wanted to explore the feared self theory in people with OCD.
We interviewed 16 Australian adults, mostly women, with a current, formally confirmed diagnosis of OCD. They had a range of symptoms (moderate to extreme) and the full spectrum of obsessions (contamination, harm, symmetry and repugnant thoughts).
We asked them about their sense of self and the life experiences they felt had shaped it. Two major themes emerged.
1. Most had experienced childhood trauma
These experiences often happened within the family, and included sexual, physical or emotional abuse, harassment or bullying, and parental neglect.
Many feared they could become a bad person – capable of the very harm done to them. One man described how, after his parents’ divorce, his father:
became very verbally abusive towards me […] just became a really angry person [..] I’m just so scared that […] I’ll do something like my dad.
Another participant, whose father was “quite violent and an alcoholic”, told us:
I’d never wanted to drink on my own because I worry that I’d just become dependent.
Harassment and bullying planted similar seeds of doubt. As one participant put it:
I guess it makes you question, what you’re capable of, what you’re not capable of.
Parental neglect also fed the fear of being negligent or irresponsible. One participant remembered checking the house as a child because their parents wouldn’t:
I would sort of go downstairs to make sure that everything had been locked, like the stove was off […] I’d do that so I could feel more safe.
For many participants, taking on responsibilities well beyond their years in childhood became the template for their obsessions and compulsions as adults.
2. Rejection can be formative
The second theme was rejection – feeling dismissed, betrayed, or not good enough.
This could mean a sense of failing to live up to parental expectations – for example, about getting high marks at school – no matter what they did. Emotional coldness from parents also played a role.
One participant described a mother who was
very up and down […] you never knew when she was going to be nice to you […] she would say things that indicated that I was a bad person […] bring up tiny mistakes.
Early experiences of rejection could lead to an unstable and vulnerable sense of self, becoming the fertile ground for a feared self to take root.
What this means
Our findings strengthen the theory that, for some people, OCD is rooted in a “feared self” developed through experiences of trauma and rejection.
Understanding this may lead to better OCD treatments that target deeply held beliefs. For example, imagery rescripting is an established technique used to help people revisit and “rewrite” the meaning attached to negative memories, which could be effective for challenging “feared self” beliefs in OCD.
More broadly, a trauma-informed approach may help clinicians and clients understand that terrifying “what if I’m dangerous?” thoughts often say more about a person’s past wounds than their present character. And if these experiences are risk factors, identifying them early could inform prevention.
Read more:
What does being ‘trauma-informed’ actually mean?
The takeaway
This was a small, in-depth study – rich in detail, but not designed to generalise. It relied on people recalling childhood experiences, which can come with memory bias. As such, we can’t yet say these experiences cause OCD. And not all OCD has its roots in trauma.
Future research should test these links in larger, more diverse samples, and examine whether treatments that directly target these formative experiences reduce OCD symptoms.
The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.
Tags: Academic Journalism, The Conversation, The Conversation Academic News
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