The Double Burden of OCD and Social Anxiety: How Therapy in Boston, MA Offers Relief Without Judgment
Having OCD and other anxiety disorders — like Generalized Anxiety Disorder (GAD), specific phobias, or Social Anxiety — is really common. In fact, social anxiety is actually described as a type of phobia — often called Social Phobia Disorder. I often see people with OCD also dealing with social anxiety, and that makes total sense. Having OCD increases your vulnerability to developing other anxiety disorders.
So, what’s the difference between anxiety and an anxiety disorder?
The Difference Between Anxiety and an Anxiety Disorder
Well, everyone experiences anxiety. It’s part of being human and having a human body with a nervous system. And anxiety serves a purpose. It’s a signal that something matters to us or that something isn’t quite right.
For example, if you’re running late to work and start feeling anxious — that anxiety is trying to help you focus, move quickly, and avoid consequences like being reprimanded or losing your job. Or if you’re going to give a speech in the future then you might feel nervous, that’s your body saying, “Hey, this is important — you care about doing well, so it might be helpful to prepare.” That kind of anxiety is situational — and it’s a part of life.
And then there’s the anxiety that comes from living in a fast-paced world — where systemic oppression, discrimination, and chronic stress are baked into everyday life. That anxiety is real, and unfortunately, it’s societal and also part of our everyday life.
But when does anxiety cross the line into an anxiety disorder that can be treated in therapy?
When Worry Becomes Something More
An anxiety disorder often develops when we start believing that feeling anxious means something is wrong with us — when we become preoccupied with the anxiety itself and feel a need to get rid of it immediately, or to avoid situations that trigger it. This response can create a feedback loop, where our fear of anxiety actually intensifies it, turning it into a self-fulfilling prophecy.
How Everyday Nerves Can Turn Into Avoidance
Let’s use Social Anxiety Disorder (Social Phobia Disorder) as an example of how situational anxiety about meeting new people, which is something most people experience, turns into an anxiety disorder:
Say you’re about to meet your partner’s parents for the first time. You’re feeling nervous — makes sense, right? It’s a new situation, and you want to make a good impression, so your anxiety is telling you that this is important to you so you might want to put some effort into how you present yourself. A person without an anxiety disorder might think, “Okay, I’m nervous — that tracks. I’ll just go, try my best, and see how it goes.” And then they move on.
But someone with Social Phobia Disorder might have a very different internal experience. It might sound more like:
“Oh my god, why am I so nervous?! What if they can tell? What if I get more anxious and I freeze up and then I can’t even talk? What is wrong with me?!” And through the repetition of these thoughts they become completely preoccupied with their anxiety — trying to make it go away, attempting to predict how things will unfold, or imagining worst-case scenarios. They might end up postponing or avoiding meeting their partner’s parents altogether, just to escape the discomfort.
The Trap of Trying Not to Feel Anxious
You can see how that kind of inner dialogue just adds more anxiety and emotional dysregulation. The brain starts to interpret the whole situation—not just the people involved, but even the anxiety about feeling anxious—as dangerous. So now, meeting new people feels threatening not just because it's unfamiliar, but because you're afraid of your own internal state and how that could come off to others.
This is one of the main reasons it's so common for people with social anxiety to avoid situations that might trigger it—which often means avoiding social situations altogether. And the hardest part? These are often situations they genuinely want to be part of. But the fear of having anxiety, looking anxious or awkward in front of others, and feeling embarrassed becomes so overwhelming that they avoid those experiences, even if they matter deeply to them.
So what can you do if you have social anxiety?
Facing What You Fear in Small Steps
Like with OCD, social anxiety is treated with Exposure and Response Prevention (ERP). ERP is a powerful therapy when avoidance starts taking over, which we see not only in OCD but also in social anxiety and other phobias.
As an OCD and anxiety therapist, I approach social anxiety somewhat differently than OCD. For example, by encouraging clients to consider how likely their feared outcome actually is. This is done by helping them develop a more realistic perspective on social situations—not by simply “thinking positive” or telling themselves everything will go perfectly (because that’s neither honest nor realistic; not everything goes well, and uncomfortable moments do happen), but by learning to see things more clearly and in context.
Calming the Body While Reframing the Mind
In addition, I use grounding and mindfulness skills more frequently in treating social anxiety than I do with OCD, since these tools can be especially helpful in managing the panic or overwhelm that can arise during social interactions. Through a combination of exposures, mindfulness, and cognitive work, clients begin to learn that they can tolerate feeling anxious or awkward in social situations—and that over time, they can actually show up more fully and confidently in the very situations they once avoided.
Part of what makes this possible is learning to recognize the thinking patterns that fuel social anxiety. One of the most common is misinterpreting neutral social cues. Someone not smiling, yawning, or glancing away gets interpreted as a sign they dislike you or are scrutinizing you. I once heard it described perfectly: people with social anxiety are great observers but terrible interpreters. They notice everything—but assume it all means they’re being judged.
Learning to See People and Yourself More Clearly
In therapy, we work on becoming better, more realistic interpreters, while also facing social fears head-on. That means practicing tolerating the discomfort and embracing the uncertainty—because at the end of the day, you can’t actually know what someone is thinking about you and you will never know for sure.
But also... does it even matter?
I was once at a meditation retreat where the teacher said something that stuck with me: “How could it possibly matter what another human—with all their flaws, confusion, and imperfections—thinks of you?” Through OCD and anxiety therapy, I help clients move toward this realization—not just intellectually, but in a way they can genuinely feel and live out in their everyday interactions.
Finding Support for OCD and Social Anxiety in Boston, MA
If you’re struggling with constant self-doubt, fear of judgment, intrusive thoughts, or overwhelming anxiety in social situations, I can help you figure out whether you’re dealing with social anxiety, OCD, or a combination of both.
As an OCD therapist in Boston, MA, I provide guidance and clarity with specialized OCD therapy services designed to help you understand your symptoms and move toward relief. Together, we’ll clarify what’s going on and use the most effective, evidence-based treatments to help you find more peace of mind and build confidence. From there, we’ll create a clear plan to begin your therapy journey—one step at a time.
Here’s how to begin:
Schedule a free 15-minute consultation to share what you’ve been experiencing and learn how specialized OCD therapy can support your goals.
Start virtual OCD therapy sessions from anywhere in Massachusetts or California, personalized to your unique needs and pace.
Begin building confidence and calm as you practice evidence-based tools that create lasting relief for OCD and social anxiety.
Specialized OCD Treatment Available Across MA and CA
You don’t have to live in Boston to begin working on OCD recovery. I provide virtual therapy for adults across Massachusetts and California, so you can access specialized, evidence-based care wherever you are without the stress of traffic, commuting, or added barriers. All you need is a quiet space, an internet connection, and the willingness to take that first step toward support.
In our work together, OCD therapy focuses on helping you break free from fear-based patterns, build tolerance for uncertainty, and strengthen confidence from within. Whether you’re new to therapy or returning after a break, you’ll receive the same compassionate, research-backed care delivered from the comfort and privacy of your own home.
Additional Resources to Support Your OCD Healing Journey
In addition to one-on-one OCD therapy, I provide several resources to help you maintain progress and stay supported between sessions. The Common OCD Themes page explores intrusive thoughts and behaviors many people experience, helping you recognize familiar patterns and feel less alone in your journey. The OCD and Social Life page discusses how OCD can affect friendships, dating, and everyday interactions, offering tools to strengthen connection and self-confidence while managing symptoms.
These resources are designed to enhance your therapy experience, giving you ongoing guidance, practical strategies, and reassurance as you continue to grow and heal.