Janine is a 38-year-old married woman with two young children. She obsesses continuously about whether her house is neat and clean enough. She frequently stays up until three in the morning scrubbing and straightening. In addition, Janine is painfully shy and has few friends. She worries about what other people think of her and is terribly afraid of rejection. Some of her neighbors get together with their children to play in a nearby park or each other’s homes, but Janine never joins them.

You may easily recognize that Janine has obsessive-compulsive disorder (OCD). What you may not recognize is that she has an additional anxiety disorder called social phobia. Janine is not alone; recent research (1) estimates that 24% of individuals diagnosed with OCD receive an additional diagnosis of social phobia. In fact, this study found that social phobia is the most common additional anxiety disorder diagnosis made for those individuals with OCD. *

Having both of these anxiety disorders together can make your recovery more difficult. In this article, we will describe social phobia, explain how it can complicate treatment, and call your attention to four key issues in dealing with the combination of OCD and social phobia.  PAGE 2

Intro to Obsessive Compulsive Disorder and Social Phobia--page 1

What is Social Phobia?--page 2

How Do I Know If I Have Social Phobia?--page 3

Can't I Deal With Social Phobia Later?--page 4

Key Issues to Consider When Dealing With Both OCD and Social Phobia--page 5

As a child Cynthia's hyperactive behavior often annoyed others. Her teachers frequently reprimanded her in school. The other students called her "stupid" and refused to let her join them in activities. At home, her father criticized her and beat her with a belt whenever her parents received a negative report from school. Due to depression, her mother tended to ignore Cynthia's needs for emotional support and attention. As a result, she grew up expecting rejection from others. It seemed that no matter how hard she tried, all she experienced was rejection.

As an adult she had numerous unsuccessful relationships. She desperately wanted the acceptance to be found in a relationship; however, she perceived her partner's behavior negatively often thinking about how he wasn't as committed to the relationship and that she was just good enough until someone else came along. These thoughts led to hostility toward him and accusations "You don't care about me!" Due to her focus on her worries about losing him she did not focus on his needs and provide him with emotional support. Her partner tried to reassure her and comfort her at first but the constant negativity and hostility drained his ability to respond to her needs.

Jake was physically abused as a child; for seemingly no reason to Jake his alcoholic father became enraged and beat him leaving bruises and welts. These beatings included screaming at Jake about how worthless he was and that no one could possibly ever want him or love him. His mother was rejecting in a more subtle way by tending to blame him for his father's behavior "If you just wouldn't set him off, he wouldn't hurt you."

When Jake developed an intimate relationship as an adult, he perceived his wife's behavior as indicating she was cheating on him. He examined her phone records and questioned her endlessly about calls she made. He didn't allow her to go out socially unless he was present and even then he questioned her about her interest in other men if she talked to someone. His wife could not convince him she was not having an affair. Eventually, his irrational jealousy led to slapping her when she denied his accusations.

What do these two people have in common? They developed rejection sensitivity due to childhood experiences which led to irrational thinking and behavior about their adult relationships. This thinking and behavior often reinforced itself by creating situations in which they were more likely to be rejected.   PAGE 2

Intro to Rejection Sensitivity.--page 1

What is Rejection Sensitivity? and What is Irrational Jealousy?--page 2

How is Rejection Sensititivity Related to Childhood Abuse or Rejection?--page 3

How are Rejection Sensitivity, Self-Esteem and Social Anxiety Related?--page 4

How does Expectation of Rejection Affect Perception of Rejection?--page 5

How does Rejection Sensitivity Impact an Intimate Relationship?--page 6

How is Rejection Sensitivity Self-Perpetuating?--page 7

How is Rejection Sensitivity Changed?--page 8
 

Copyright © 2009 by Monica A. Frank, Ph.D. and  www.excelatlife.com Permission to reprint this article is granted if it includes this entire copyright and link.