C-PTSD and Scrupulosity Walked into a Bar Together. There was no Punchline and Everyone Felt Bad.

Shame

As a young sociology graduate student I was struggling with scrupulosity that I thought was in remission. It had stopped being so religious in nature but I was dealing with guilt and shame around everything all the time. I constantly felt the desire to be literally anyone else. My worth was very attached to my accomplishment.

Then I failed a test. And this isn't one of those times when someone says "failed" but means a B-plus. This was a legitimate up in flames failure. I got about a 30%. I spiraled for days and refused to tell anyone because I felt so ashamed of the failure. I knew that I wasn't smart enough, hadn't worked hard enough, and that I would never be good enough.

Then something crazy happened, I went to a lecture and the professor giving the lecture cried. She told us that her grandfather had died the week previously and that she was feeling stressed an inadequate. That lecture changed my life more than any event in my whole BS or MS. For the first time in my life I realized that someone else had imposter syndrome. I realized that someone I respected had failed at something at least once or twice. I realized that maybe I wasn't as broken as I thought and that 30% grade didn't mean as much as I thought it did.

Four years later I was in a math class in my masters program. I had just passed a test with flying colors and I knew from listening in the hall that others hadn't. The test was about 1/3 or our grade and if we failed it we were required to do remediation in order to continue in the program. I raised my hand at the beginning of class and asked my professor to explain the remediation process. I didn't need it, but I didn't want anyone else to feel like they were the only ones that had failed. I wanted them to remember that I was imperfect too and that they were not wrong or separate or dumb.

Now as a adult I spend most of my time treating C-PTSD and Scrupulosity. All my clinical friends think it's funny that I focus on two very different disorders. The thing that ties them together is shame. People with C-PTSD and Scrupulosity are absolute guilt-a-holics. They eat shame for breakfast and can feel bad about anything. Both make you feel alone, isolated and different.

The Child’s Mind: What Causes C-PTSD

When children face trauma or adverse experiences, their subconscious minds go into overdrive, attempting to make sense of the chaos surrounding them. A key question emerges: "Is this my fault?" This is not merely a philosophical inquiry; it is a survival mechanism. Children, often feeling powerless, will default to the belief that they must be at fault. After all, if they are to blame, then they have some semblance of control over their lives. They can change their behavior, try harder, and be "better."

Conversely, the idea that their parents or the world could be responsible is far too frightening. This acknowledgment implies a lack of control over external factors, which can lead to more unpredictable trauma. Consequently, children internalize these beliefs, leading them to perceive themselves as inherently flawed. This leads to C-PTSD and onging self worth and shame problems.

In a person with the neuro-biological underpinnings of OCD, their brain will take all the evidence that there might be something wrong with them and run it on a loop. It will turn things that might have slid off of the back of other children into core memories. It will instill the belief that the child is not good enough.

An associate I met through the OCD community once shared with me that she tried to make herself breakfast as small child in an attempt to be responsible. She lit and napkin on fire in the toaster. Her parents were worried and put it out and cautioned her not to do it again. They didn't punish her but she spent the next two years having intrusive thoughts about the memory and came to believe deep in her soul that she was incompetent.

The Long Shadow of Trauma

Fast forward to adulthood, and the ramifications of this internalization are profound. Even when we logically understand that the traumas we faced were not our fault, the feelings persist. Adults who were once children grappling with these issues often find themselves plagued by inappropriate guilt and shame, leading to a distorted sense of self-worth.

When these adults encounter challenges, such as their children misbehaving or making a mistake at work, their minds can spiral into catastrophic thinking. They might think, “I’m failing as a parent; this is all my fault” or “I must be the most incompetent person in this office.” This relentless self-criticism becomes a vicious cycle that can feed into scrupulosity. The underlying belief that they are "bad" leads to obsessive thoughts about morality and the need to constantly prove their worth to themselves and others.

I once discussed the influence on childhood trauma on OCD with a friend. She reported that she went through ERP therapy and stopped all her scrupulosity symptoms but still felt guilty all the time. She was "doing better" but her self worth was 0 and she she felt hatred for her weaknesses. I suggested she try seeing a trauma therapist this time.

Six months later she told me she wished she had seen a trauma therapist first. Her OCD had been feeding off of her childhood guilt and shame. When she realized the abuse and instability was not something she could have prevented (or had fault for) as a child she stopped feeling all the self blame in the present.

She shared "I don't know if I can say I like myself but I do feel a lot of compassion for myself. When things go wrong now my first thought is that I was trying really hard."

Scrupulosity: A Coping Mechanism

Scrupulosity often manifests as an obsessive fear of committing moral or ethical wrongs. Those who struggle with this condition may spend excessive amounts of time worrying about their thoughts, actions, and decisions, constantly seeking reassurance. They may engage in compulsive behaviors or rituals in an attempt to quell their anxiety, believing that these actions can prevent them from being "bad" or "wrong."

For individuals with a history of childhood trauma, scrupulosity can serve as an especially potent form of self-punishment. The internal narrative—that they are inherently flawed—creates a need for constant vigilance against perceived moral failings. This relentless self-scrutiny can feel exhausting and isolating, making it challenging to connect with others or find joy in everyday life.

Additionally, trauma disorders come from feeling out of control. OCD is all about trying to take control. For those wondering how to cope with C-PTSD, finding some sort of control and avoiding shame seem like and answer. It isn't so surprising that so so many people with C-PTSD end up with OCD/Scrupulosity.

How To Heal C-PTSD and Scrupulosity

As a therapist, my approach to helping clients navigate the complexities of scrupulosity and its roots in childhood trauma goes beyond simply offering platitudes like “It’s not your fault” or “You’re good enough.” While these statements are true, they often feel empty to someone who has spent a lifetime feeling inadequate.

Instead, my goal is to guide clients through the deeper, often unexamined emotions tied to their past experiences. Therapy becomes a space for exploration and healing—one where clients can confront their beliefs and begin to understand the mechanisms behind their guilt and shame.

This process often involves recognizing the child within who felt the weight of the world on their shoulders and beginning to untangle the false narratives that have persisted into adulthood. We work together to identify the roots of these beliefs and challenge them with compassion and understanding. We're going to feel it, process it, and heal it. We're going to learn about how beautiful it is to be imperfect and how your worth is not attached to your performance.

Building New Narratives

One of the key objectives in therapy is to help clients rewrite their internal narratives. This means moving from statements like “I am bad” to affirmations such as “I did the best I could” or “That was not my fault.” I aim for my clients to leave sessions feeling empowered and capable of embracing their inherent worth, even amidst imperfections.

Through various therapeutic techniques—such as cognitive-behavioral therapy (CBT), mindfulness practices, and self-compassion exercises—we work to instill these new beliefs at a deeper, more visceral level. The goal is for clients to genuinely feel statements like “I’m actually really great!” and “I deserve to experience life without shame.” We also use EMDR to help you feel deep in your bones that this is true. Believing it and feeling it are different things. I won't stop with letting you know better, I want to help you actually feel better.

The Journey Towards Self-Compassion

In the realm of scrupulosity and childhood trauma, self-compassion is a game-changer. Learning to be imperfect and recognizing that mistakes are a part of being human can liberate clients from the prison of their past. As they begin to adopt a kinder, gentler approach toward themselves, they often find that their anxiety lessens, and their obsessive thoughts begin to wane.

Moreover, clients who engage in this process frequently report improvements in their relationships with others. When they learn to treat themselves with the compassion they’ve long denied, they become more capable of extending that same understanding to those around them.

Conclusion: You Are Not Alone

If you resonate with these experiences, know that you are not alone. The journey to healing from childhood trauma and overcoming scrupulosity is deeply personal and often challenging, but it is also entirely possible. As a therapist, I am here to support you in uncovering the layers of your past, helping you to emerge as the adult you were meant to be—one who can navigate life with authenticity, joy, and a sense of self-worth.

It’s essential to remember that you deserve to experience life without the shackles of shame. Together, we can work towards breaking the cycle of guilt and internalized negativity, allowing you to reclaim your sense of self and embrace the beautiful complexity of being human. My name is Grace Bithell, and I look forward to guiding you on this path of healing and self-discovery.