Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Fears or obsessions about speaking

By Justin Trout

Aug 26, 20227 minute read

Reviewed byTaylor Newendorp

People with Perfectionism OCD focused on speaking experience intrusive doubts, thoughts, or fears regarding their verbal communication. Someone with fear of speaking OCD may find it difficult to say specific words, phrases, etc., or to express certain concepts or themes when around others. They may fixate on certain things they’ve said in the past or the specific words they are using while talking, and correct themselves mid-speech if the word isn’t perfectly representative of what they wanted to express. They may feel great shame or anxiety due to doubts they have about how they expressed themselves. They may even feel each sentence must be the same length to be perfect, or become hyper focused on their rate and tone of speech to make sure it feels “just right” when they’re speaking.

There are many fears associated with Perfectionism/Just Right OCD. In particular, in relation to speech, people are often afraid that they might be judged. These feelings align closely with uncomfortable thoughts and urges they experience about something not being “just right” or perfect. Perfectionistic tendencies are often considered ego-syntonic, which means that they are seen as acceptable to oneself, their identity, their intentions, and their values. Most other subtypes of OCD tend to be ego-dystonic, meaning that the thoughts, fears, and urges they involve are unacceptable to oneself and their identity. 

When somebody experiences Perfectionism OCD, they experience unwanted intrusive thoughts, images, doubts, or urges that cause distress and anxiety, called obsessions. To relieve this distress or avoid feared outcomes, people with OCD resort to compulsions, such as avoiding situations where you might speak, or making sure sentences have the perfect length and tone or expression.

OCD fear of speaking – Common Obsessions

In Perfectionism OCD, obsessions are the unwanted, intrusive thoughts and feelings that something does not seem/feel perfect or just right, and they tend to cause anxiety and discomfort. 

  • Fears of making mistakes when talking
  • Feelings of frustration, tension, or anxiety if a word wasn’t said in just the right way
  • Hyperfixation on volume or pitch when speaking
  • Fears of accidentally saying something that might seem embarrassing, odd, or offensive 
  • Worries that you may be judged on your ability to speak
  • Worried that you might not be able to complete a sentence due to mistakes
  • Intrusive feelings of imperfection, hesitation, or rhythmic disruption while speaking
  • Fears that people misinterpreted what you meant to say based on words used or rate & tone of speech
  • Fears that you expressed the wrong emotion in speech

Do these thoughts sound familiar? Learn how you can overcome them.

As an OCD specialist, I know how overwhelming OCD symptoms can be—and how hard it is to open up about your experience. You’re not on your own, and you can talk to a specialist like me who has experience treating OCD.

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Common triggers

  • Starting a conversation
  • Keeping a conversation going
  • Talking to oneself
  • Mispronouncing a word
  • Having to speak in public
  • Projects that involve speaking
  • Answering questions in conversation
  • Thinking about the act of speaking

As a side note, it is very important to recognize that these triggers are often associated with social situations, and sometimes OCD may present itself as Social Anxiety Disorder. This often is not the case, as speaking perfectionism is more a result of intrusive thoughts or feelings around speaking, and not necessarily from being with groups of people. 

It is also important to remember that triggers for perfectionism and speaking OCD include many situations where people are speaking with or to others. If a person feels like they are being judged, credited, or evaluated, then intrusive thought patterns may be stronger. These triggers can appear at home, work, school or even at the grocery store when you run into an old friend. 

How can I tell if it’s OCD fear of speaking, and not just a part of who I am?  

When it comes to fears that involve perfectionism, it can be difficult to determine what is OCD and what is simply a personal characteristic. The best way to understand this is to gain knowledge about OCD. OCD is composed of three basic components: 1) intrusive thoughts, feelings, or urges; 2) anxiety or distress that comes as a result; 3) compulsions done to relieve this anxiety or distress. Understanding this cycle can help you distinguish OCD from other conditions or issues. If intrusive thoughts increase distress and interfere with life, then you may be dealing with OCD. 

The other thing to consider is that when speaking, finishing sentences, or repeating words starts to take up significant amounts of time, it can be a good indicator of Perfectionism OCD. The idea of speaking starts to cause distress and you may engage in compulsions. These compulsions can be physical or mental actions, and people may get “stuck” speaking for unnecessarily long periods of time trying to achieve that “just right” feeling. If you avoid speaking due to the anxiety you feel beforehand, that may also be a sign that you’re experiencing OCD.

The presence of compulsions is the best way to see if you are struggling with perfectionism OCD. If you attempt to avoid social situations, mentally rehearse before you speak, stop mid-sentence to correct yourself, or repeat words until they feel right, then it is highly likely that you have OCD. 

Common compulsions

When people with fear of speaking OCD experience intrusive thoughts, images, feelings, or urges that cause distress, they may engage in a variety of mental or physical compulsions. Compulsions keep people in the cycle of OCD. When somebody feels anxiety from an intrusive thought or feeling, people seek comfort to relieve the anxiety. Once compulsions are eliminated, this anxiety decreases over time, and people learn to accept and tolerate the uncertainty or distress surrounding their obsessions.

Compulsions with this subtype are generally straightforward, as the person tends to correct exactly what they feel problem is.

Compulsions performed mentally or physically by people with speaking OCD include:

  • Stopping mid-sentence to correct errors
  • Excessively practicing speaking before an event/situation occurs
  • Seeking reassurance from others to see if they are judging you
  • Avoiding situations where you might have to speak
  • Saying few words to prevent mistakes
  • Continually talking until it seems/feels perfect or just right
  • Repeating specific words until they feel our sound right

Access therapy that’s designed for OCD

I’ve personally helped many people who struggled with OCD regain their lives. I encourage you to learn about accessing ERP therapy with NOCD.

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How to treat fear of speaking

Perfectionism/Just Right OCD in relation to speaking may make it seem like there is no end in sight, but that is not true. While many people struggle with it, many people also overcome it. It is highly treatable by doing Exposure and Response Prevention (ERP) therapy with an OCD specialist.

ERP is the gold standard treatment for OCD and many other anxiety disorders. It is 80% effective and shows promising results within 12-25 sessions. With ERP, you will be able to teach your brain that your intrusive thoughts don’t have any real meaning; they’re just thoughts. 

In ERP, you’re gradually, safely exposed to thoughts or environments that are likely to trigger intrusive thoughts and anxiety. Then your therapist guides you in resisting the urge to respond to the distress with compulsions. By doing this over time, you learn that you can tolerate anxiety, and as a result, your thoughts become less and less distressful.

If you’re struggling with OCD, “As an OCD specialist, I’ve used ERP to help many people regain their lives from OCD. I encourage you to learn about NOCD’s accessible, evidence-based approach to treatment with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.

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