OCD & Social Anxiety Therapy

Therapy can help with intrusive thoughts, compulsions, reassurance seeking, perfectionism, fear of mistakes, social anxiety, rejection sensitivity, avoidance, rumination, shame, people pleasing, and the exhaustion of trying to anticipate every possible outcome.

We begin by understanding what happens before the pattern, how you respond, what brings temporary relief, and what keeps the cycle going. This helps us choose support that fits instead of treating every form of anxiety the same way.

Everyday worry usually shifts as situations change. OCD involves recurring obsessions, compulsions, or both that can become time consuming, distressing, and disruptive. Obsessions may involve unwanted thoughts, images, sensations, or doubts. Compulsions are behaviors or mental acts used to reduce distress, prevent a feared outcome, or create a sense of certainty.

Not every repetitive thought is OCD. We look at the full pattern, including the meaning attached to the thought, the urge to neutralize it, the relief that follows, and how much the cycle interferes with daily life.

Yes. Compulsions are not always visible. Mental reviewing, replaying a conversation, checking your memory, counting, replacing a “bad” thought, analyzing what a thought means, silently repeating phrases, or trying to feel completely certain can all become part of an OCD cycle.

Someone may appear calm on the outside while spending significant time and energy responding to obsessions internally.

An unwanted intrusive thought is not the same as an intention, desire, value, or prediction. People with OCD often become distressed precisely because the thought feels inconsistent with who they are or what they care about.

Therapy focuses less on proving the thought false and more on changing the cycle of fear, analysis, checking, avoidance, or reassurance that can give the thought more power. If you are concerned that you may act on a thought or someone is in immediate danger, seek urgent professional or emergency support.

Reassurance can bring immediate relief, but repeated reassurance may teach the brain that uncertainty is dangerous and that you cannot move forward without someone confirming that everything is okay. The relief fades, doubt returns, and the urge to ask, check, search, confess, or review may become stronger.

We work on recognizing this cycle and building the ability to respond to uncertainty without needing complete certainty first.

ERP is a specialized form of cognitive behavioral therapy and a first-line psychological treatment for OCD. It involves collaboratively and gradually approaching feared situations, thoughts, images, or sensations while reducing the compulsions and avoidance that maintain the OCD cycle.

ERP should be planned with a clinician who has specific training in the approach. You should not be surprised, tricked, or forced into exposure. Treatment is collaborative and adjusted to your needs and readiness.

I provide OCD-informed therapy and will be honest about the type and level of care that best fits your needs. General reassurance and stress management are not substitutes for specialized OCD treatment. If structured ERP, medication consultation, or a higher level of OCD care would be more appropriate, we can discuss referral or coordinated support without shame.

Perfectionism may involve rigid standards, fear of mistakes, procrastination, overpreparing, indecision, or tying your worth to achievement. OCD involves obsessions and compulsions that are used to reduce distress or prevent a feared outcome. The two can overlap, but perfectionism by itself is not OCD.

We look at what is driving the behavior. Wanting to do something well, fearing judgment, trying to prevent catastrophe, and needing something to feel “just right” may look similar from the outside but require different support.

Therapy can help you notice all-or-nothing expectations, separate worth from performance, make decisions with incomplete information, tolerate ordinary mistakes, and recognize when high standards have become avoidance or self-punishment.

The goal is not to stop caring or lower every standard. It is to build more flexibility so your values, relationships, rest, creativity, and real life are not controlled by the demand to get everything exactly right.

Rejection sensitivity describes an intense emotional response to actual or perceived criticism, disappointment, exclusion, or rejection. You may replay interactions, assume someone is upset, become defensive, overexplain, people please, withdraw, or feel a wave of shame that seems much larger than the moment.

“Rejection sensitive dysphoria,” often shortened to RSD, is a commonly used term, especially in ADHD communities, but it is not a separate formal diagnosis. We explore the pattern without using one label to explain every reaction.

Therapy can help you recognize the first signs of activation, slow down the story your mind is building, recover after feedback, communicate directly, and decide what the situation needs before reacting, apologizing, withdrawing, or trying to repair something that may not be broken.

We also explore earlier experiences, nervous system responses, ADHD or autistic patterns, relationships, and environments that may make rejection feel especially threatening.

Shyness and introversion are not disorders. You may prefer quiet, smaller groups, deeper conversations, or more time alone and feel comfortable with those preferences. Social anxiety involves significant fear of being judged, embarrassed, rejected, watched, or evaluated and may lead you to avoid situations or endure them with intense distress.

Therapy is not about turning an introvert into an extrovert. It is about helping fear take up less space so you have more choice in how you connect.

Yes. You may review what you said, search for signs that someone disliked you, or imagine everything you should have done differently. This post-event processing can feel like problem solving, but it often increases shame and makes future interactions feel more threatening.

We practice noticing the review cycle, responding differently to uncertainty, and returning attention to the life happening outside the analysis.

Yes. Avoidance often brings short-term relief while making the feared situation feel larger over time. We identify what is driving the avoidance and create manageable, meaningful steps toward what matters to you.

Those steps are collaborative and may include preparation, accommodations, communication, nervous system support, or gradual practice. The goal is not to overwhelm you or force social performance.

Autism and ADHD can shape sensory needs, executive functioning, emotional intensity, communication, processing time, masking, and experiences of being misunderstood. Those experiences may coexist with OCD, perfectionism, rejection sensitivity, or social anxiety, but they should not automatically be treated as the same thing.

We consider the reason a pattern exists. A supportive autistic routine is not automatically a compulsion. ADHD task difficulty is not always avoidance. A direct communication style is not a social skill failure. Accurate understanding helps us support neurodivergent needs without allowing fear-driven cycles to take over.

Trauma and difficult relationship experiences can teach the nervous system to scan for danger, anticipate criticism, prevent mistakes, overread other people's reactions, or stay prepared for rejection. These patterns may have once helped you survive or stay connected.

Trauma can also coexist with OCD or social anxiety without being their sole cause. We look carefully at history, function, and context rather than assuming every symptom comes from the same place.

Therapy can help teens recognize intrusive thoughts and compulsions, cope with school pressure, tolerate mistakes, manage post-social overthinking, communicate needs, respond to feedback, and take manageable steps toward situations fear has made smaller.

Parent involvement can also help families reduce shame, respond differently to repeated reassurance, understand avoidance, and support progress without turning home into another place where the teen feels evaluated.

My approach may draw from mindfulness, Acceptance and Commitment Therapy, DBT skills, trauma-informed and attachment-based care, Polyvagal Theory, nervous system regulation, and practical strategies for everyday life. When appropriate, we also identify OCD cycles and discuss whether specialized ERP or coordinated care is needed.

Therapy is adapted to your goals, neurotype, communication style, identity, current capacity, and the patterns affecting your real life.

No. You do not need to know whether the pattern is OCD, social anxiety, perfectionism, rejection sensitivity, trauma, or neurodivergence before reaching out. Assessment and curiosity are part of the therapy process. If formal testing, medication evaluation, specialized ERP, or another service would be helpful, we can discuss referrals and coordinated support.

I provide fully virtual therapy to clients who are physically located in South Carolina or Colorado at the time of each session. I accept select insurance plans, and self-pay options are available. Because coverage can vary by plan and service, visit the rates and insurance page or contact the practice to confirm current details before beginning.

You can request an appointment through the secure client portal or use the contact page to ask a question. We can talk about what has been happening, what you hope will change, and whether online therapy feels like the right fit.