Social Anxiety and Obsessive-Compulsive Disorder (OCD)

Social anxiety and OCD are often misunderstood as problems of confidence or control. In reality, both involve complex relationships with uncertainty, self-perception, and perceived risk. They are not failures of will, but highly adaptive systems that have become rigid or overextended.

Social anxiety is characterized less by shyness than by heightened self-monitoring and concern about evaluation. Attention becomes directed inward—toward one’s own thoughts, behaviors, and perceived flaws—often at the expense of genuine connection. Over time, avoidance or over-preparation may reduce discomfort in the short term, while reinforcing the belief that social situations are inherently threatening.

OCD involves intrusive thoughts, images, or urges that are experienced as unwanted and distressing, alongside behaviors or mental rituals intended to reduce anxiety or prevent harm. The content of these thoughts is less important than the process itself: an intolerance of uncertainty and an exaggerated sense of responsibility. Attempts to neutralize anxiety through reassurance or compulsion tend to strengthen the cycle rather than resolve it.

Therapeutic work with social anxiety and OCD focuses on understanding these patterns without reinforcing them. This includes examining how attention, interpretation, and behavior interact to maintain distress, as well as gradually increasing tolerance for uncertainty, discomfort, and imperfect outcomes. Treatment is collaborative and paced, emphasizing skill development alongside insight.

Importantly, individuals with social anxiety or OCD are often highly conscientious, thoughtful, and sensitive to their environments. Therapy does not aim to eliminate these traits, but to help disentangle them from anxiety-driven processes that limit flexibility and choice.

With appropriate support, it is possible to relate differently to anxious thoughts and urges—allowing them to arise without allowing them to dictate behavior. The goal is not the absence of anxiety, but increased freedom in how one responds to it.