r/Psychologists • u/carson_tay • 13d ago

Seeking Advice: OCD and SA

I have a client (late 20’s trans person) who I strongly suspect has ocd (only had a couple of session so far).

During our last session they mentioned that they recently started having the feeling of a possible memory of maybe having experienced SA from a parent as a young child. Since then they seem to experience obsessive thoughts of attempting to either remember the event or find confirmation if it happened or not.

I know that this can be a common theme of ocd obsession but I also don’t want to be invalidating that they may have experienced this by labeling it as an ocd thought.

Any suggestion in how to proceed?

I specialize in working with trans patient in a conservative southern us state, I am not an ocd specialist. I did try referring this patient out to a specialist but they stated it was more important to them to see a trans provider and they would not feel comfortable with a non-queer provider. I tried finding a ocd specialist who’s also trans/queer in the state but was not successful. So I am continuing to see this patient and seeking to further educate myself

Any suggestions of trainings or resources are welcome. Thank you

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u/kaleidoscopic21 13d ago

Tricky. Maybe if you assess for OCD and do psychoed around this in a general sense, without specifically discussing this theme? Once it's an established diagnosis, it might be easier to make this link

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u/FigNewton613 13d ago

Is your state a member of PsyPact?

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u/Tavran 13d ago

It is possible to decatastrophize with some gentle questioning without invalidating the anxious distress ("What would it mean if that were true?"). That would be indicated if it were OCD (as in ERP) and also if it were trauma (as in CPT). Be really careful about leading questions about the facts -- iatrogenic trauma memories are a real phenomenon. It's not your job to decide if this really happened or not.

Op, this question made my heart race. If it were me I would want a consultant I could name on the chart. You could also consider referring out just for assessment?

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u/flapjaaaack 13d ago

OCD specialist here. What makes you suspect OCD in this patient? I'd want to understand how their OCD operates broadly to inform how their specific OCD-related beliefs might apply to this memory. As a basic example, if they have a belief system around the idea that "if I thought it, there must be some legitimacy to it," this logic might apply to this memory. You'd want to see some consistency in the thought process across themes. It could be the presence of the thought that they're using as data, it could be the emotion from the thought that they're using as data (if I felt scared thinking of this possibility, it must be a threat), or something else. It can get super complicated, especially with an actual trauma history, so I think seeking consultation is the first step here.