The War Within: Anxiety & OCD in High-Functioning Adults
I sometimes describe it to clients this way: it's like being at war with yourself. Two sides pulling, each promising safety, neither delivering it. If you let go of control, something bad will happen. If you maintain control, you're exhausted and still not at peace. You can't win, and you can't stop fighting.
From the outside, this isn't always visible. You look like you've got it together. One of my mentors has described this internal state as a duck gliding along the water: peaceful on the surface and frantically spinning underneath. You might be thriving at work, known for being competent and intelligent, maintaining relationships while managing the logistics of a full life. People might even describe you as calm and confident. They may envy how effortless you make it seem.
Inside, the mind never stops.
There's a constant tension, even when things are going well. Perfectionistic standards that shift every time you get close to meeting them. Thoughts that loop and snag, circling back to the same anxieties no matter how many times you've addressed them. The temporary relief of checking, preparing, organizing, controlling, followed by the tension building again.
This is high-functioning anxiety. This is what OCD looks like when it's wrapped in competence. Not the dramatic portrayals, not always visible rituals or obvious panic, but an internal experience of relentless vigilance. The war nobody sees.
The False Self at Work
Winnicott wrote about the "false self," a concept I find endlessly useful in this work. The false self develops when a child learns, early on, that their authentic experience isn't welcome. Maybe the environment was chaotic and required constant monitoring. Maybe a parent's needs took up all the oxygen in the room. Maybe emotions were dismissed or punished. Whatever the specifics, the child learns: who I actually am is not safe to be. I need to become someone else.
So they do. They build a self that performs, manages, anticipates, achieves. A self that is watchful and responsible and always slightly braced for disaster, often already predicting it. This isn't a conscious strategy. It's an adaptation, a survival mechanism that runs so deep it feels like identity.
The problem is that the false self, however functional, is exhausting to maintain. You're always performing, always monitoring the gap between who you are inside and who you're presenting. The authentic self doesn't disappear; it becomes hidden and starts to surface in strange ways. Ever find yourself crying for "no reason"? The real self keeps sending signals: anxiety, obsessive thoughts, a persistent sense that something is wrong, that you're about to be found out.
I have heard it described as this: a fear that if people saw who you really were, a person who is not always competent and in control, they would be unloved. Things could fall apart. So they keep the mask on. The war continues.
How the Nervous System Learns
This pattern often traces back to early experiences, though not always in obvious ways. Children who grew up in unpredictable environments learn that vigilance is necessary. You couldn't relax because relaxing wasn't safe. Your nervous system calibrated itself to threat and never fully recalibrated.
Genetics play a role too. Some people inherit a predisposition toward anxiety or OCD that the environment then activates or softens. The biology creates vulnerability; the relational world determines what happens with it. How your early caregivers responded to your anxiety, whether it was met with attunement or dismissed or treated as inconvenient, shapes how you relate to your own mind now.
I want to be clear that this isn't about blame. Most parents are doing the best they can. We're just trying to make sense of what you learned and why it persists. Your nervous system learned something about the world, and that learning continues even when the original conditions have changed. You're still fighting a war that ended years ago.
Why Relief Feels Dangerous
Here's the bind, and it's the thing I find most important to name: you want the noise to stop, but you're terrified of what happens if it does.
When your mind has always been "on," it feels like that vigilance is the only thing keeping everything from falling apart. Every decision feels urgent. Every mistake, even a small one, triggers a disproportionate wave of anxiety or shame. The idea of letting go, of not checking, not controlling, not preparing, feels reckless. It feels like tempting fate.
There's also the identity piece. You've built a sense of self around being capable, around being the one who does it all, the one others can lean on. Asking for support can feel like failure, like revealing that the competent person everyone sees isn't real. If you're not that person, who are you? The question is terrifying enough that most people don't ask it. They just keep performing.
This is why insight alone doesn't resolve anxiety. You can understand exactly where your patterns come from and still feel unable to change them. The knowledge lives in one part of the brain; the survival response lives in another. Telling yourself to relax is like telling yourself not to flinch. The body doesn't listen to logic. If it were that easy, you would simply do it.
What Changes Look Like
Therapy for high-functioning anxiety and OCD isn't about eliminating the patterns entirely. That's not realistic, and it's not the goal. The goal is a different relationship with your own mind.
This means understanding the purpose your defenses serve. Recognizing when the alarm system is firing in response to an old threat rather than a current one. Slowly, carefully, experimenting with loosening the grip, not all at once, but in small ways that let your nervous system learn that safety is possible without total control.
It also means grieving. There's loss in recognizing that the false self, however well-constructed, has cost you something. That the years of vigilance were survival, yes, but also a kind of absence from your own life. Therapy makes room for that grief, which is part of what allows something else to emerge.
Over time, something shifts. I watch it happen with clients. The mind becomes less of an oppressor and more of a companion, a part of themselves they can listen to without being ruled by. They start to tolerate uncertainty without being overtaken by it. They rest without waiting for disaster. They begin to discover who they are when they're not performing, and they find that person is someone worth being.
The war doesn't end with victory. It ends with setting down the weapons. With realizing, finally, that you were never fighting an enemy. You were fighting yourself.
If This Resonates
I work with adults who are tired of managing and ready to start understanding. If you recognize yourself in any of this, I'd welcome the chance to talk.
