Sensorimotor OCD

by ambro

There are so many different types of obsessions and compulsions when it comes to OCD. Perhaps one of the less talked about are sensorimotor, or body-focused, obsessions which involve a heightened awareness and focus on involuntary bodily activities and processes. Hyperawareness of swallowing, breathing, or blinking are common examples of  these types of obsessions. Additionally, overattention to bladder and digestive processes, indeed any unhealthy focus on a specific body part or organ, might also fall into the category of sensorimotor obsessions.

To me, these types of obsessions seem particularly brutal because they involve necessary, ongoing processes in our bodies. There truly is no escape, and this fact often plays into the obsessions of the sufferer. The fear of never being able to stop thinking or focusing on their swallowing, or beating heart, can cause intense anxiety in OCD sufferers. OCD sufferers who are consumed with worry about swallowing might actually be afraid of choking, or they might just be tormented by the thought that they will never be able to stop thinking about swallowing. Not surprisingly, compulsions that help distract the OCD sufferer follow. Counting, for example, might briefly help sufferers focus away from their swallowing. Avoidance behaviors such as avoiding certain foods might also be a compulsion in this case.

But as we know, performing compulsions never helps for long, and will make the OCD stronger in the long run. Those with OCD who suffer from sensorimotor obsessions often find their lives greatly affected. They have trouble concentrating on anything other than their obsession(s), and have trouble socializing and sleeping as well.

So what is the treatment for this particularly torturous type of OCD? The same as for all types of OCD: Exposure and Response Prevention Therapy. OCD sufferers dealing with sensorimotor obsessions need to face their fears and voluntarily pay attention to whatever bodily activity they are agonizing over. They need to feel the anxiety that ensues, and it will eventually diminish. In other words, they need to do the opposite of what their OCD dictates.

Dr. Steven Seay has written a great three-part series discussing many aspects of and treatment for sensorimotor OCD. I highly recommend checking it out for more information. Sensorimotor OCD, like many other types of OCD, can be complicated, confusing, and debilitating. For those suffering from sensorimotor obsessions, it is crucial to work with a therapist who specializes in treating OCD. With the right treatment, those who suffer from this type of OCD will soon be able to breathe easy….literally.

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49 Responses to Sensorimotor OCD

  1. 71 & Sunny says:

    So after reading this, Janet, I realize that I struggle with this to some extent. I just never considered it before. Ugh. It IS frustrating. Because it follows you everywhere. But thankfully, it doesn’t interfere too too much. It’s still a pain though.

  2. I have some problems with this. I have times when I focus on my breathing. What makes it worse is that I have asthma and will become obsessed with whether or not I’m having trouble breathing and should use my inhaler. Sooooo frustrating. Thanks for the link to the articles.

  3. Rose says:

    Wow…I didn’t realize there was a name for my obsession with my breathing. I get super-focused on it, count it, monitor it when it becomes heavy and when it becomes lighter, sometimes unintentionally/intentionally (not sure) make it heavier, think about it all the time. Thank you so much for this post. I think I will bring it up in therapy.

  4. Nancy says:

    I can see the connection to my daughter’s OCD which is focused on contamination and washing. She talks about washing until her skin feels ” right”. How our skin feels is something that can be the focus of hypersensitivity and is also hard to escape ( as would be purely obsessive thoughts). OCD is maddeningly good at finding ways to trap people.

    • Absolutely, Nancy. You are so right that OCD finds ways to trap people by targeting what is most important to them. I am sure it must be incredibly difficult for your daughter to be hyperfocused on how her skin feels. Thank you for sharing.

  5. Katie says:

    My son has suffered with this form of ocd for over a year. He was originally diagnosed with ocd in 2008. His ocd always revolves around intrusive thoughts. Even with therapy and medication, its an ongoing battle.

  6. megan says:

    I always felt so alone when it comes to my conscious breathing. I was just really conscious breathing one day . After that I had a fear that it would never become subconscious again. I at times I don’t know why I am so.different. I was never afraid that I would stop breathing. Although I was always upset when things would trigger me to focus on it again.

  7. Martin OCD says:

    Yeah thanks to all of you for sharing your fears. There is so little information around about this and for a long time I didn’t even know it was OCD and thought I was these type of bizaar thoughts. For me, my attention is often focused on the sensation of the clothes on my chest and then I have this terrible fear that I will hallucinate that my chest is caving in and I will go insane with fear. Sounds peculiar doesn’t it I? I believe it all stems from bad experiences I had with LSD when I was a teenager which were truly tortuous. I need to be certain that I am safe from all that now, but somehow I can never be sure even though I haven’t touched it for over twenty years. It is good to be able to share my fears with others. I wish you all the best and if any of you would like to message me, please feel free to do so!

  8. Henry says:

    Thanks for putting attention on this type of OCD. I have dealt with this particular OCD for ~1 year now, and it is very frustrating. I am dealing with the breathing obsession, but also blinking and swallowing some times. The breathing OCD is the one i fight with the most, and i hate it. I have dealt with OCD through my whole life – but a more common type of OCD: fear(obsessions) of my family’s well being which led to compulsions. I had a 1 year period being almost OCD free, but then this SOCD hit me and i have been dealing with it since. I am now 22 years old.
    I am about to go see a doctor, and hopefully i will see the light at the end of the tunnel.
    I understand that ERP therapy should be useful. What about SSRI-medication? Do you think that those combined with therapy is the best solution? Also taking my age into account.
    Thank you.

    • Hi Henry, thanks for sharing your various struggles with OCD, and I’m so glad to hear you will be getting help for your SOCD soon. As with all types of OCD, ERP therapy should be helpful. As far as whether you should try medication, I can’t really advise you, and I’d recommend discussing this with your doctor. Everyone is different. Meds weren’t helpful for my son, but I’ve certainly heard from many people who have benefited from them. Good luck as you move forward!

      • Nancy says:

        I think seeing a doctor is really important BUT many regular doctors don’t really understand OCD very well. I’d really encourage you to find a psychiatrist who is familiar with this. My daughter’s is very good and willing to listen, make adjustments , try new stuff. But if course how you feel is also very important so be sure to share that with a doctor!

      • Thanks, Nancy. I just assumed when Henry said “doctor” he meant psychiatrist or clinical psychologist who specializes in OCD. I agree that a primary care physician is not typically who you’d want to see.

  9. Hello, I’m an 18 years old law student suffering from this type of ocd. Reacently I have bought a book called the ocd workbook (which I highly recommend) & I’ve been to therapy and it was not that successful to be honest, because this type of pure o and obssessive thoughts is not very common, they know how to treat generalised anxiety pretty well, but not really ocd ! So I managed on my own to accept the thoughts and to start working on a structured program with the book I suggested earlier starting this summer after the law school exams. So you’re maybe asking what’s the problem then, well here it is: As I said before I’ve been preparing for my finals in law school lately, and it’s been so tough for me because of the obssessions and the anxiety I can’t even focus on my studies + I’m afraid I will get distracted by the intrusive and obssessive thoughts in the exam and in my study sessions that I won’t do well… So I would like because you seem to know a lot about this type of obssessions or thoughts related to ocd to help me with some suggestions on how to cope with these thoughts in a better way in these situations (exams, study sessions…) ! Because you can’t do ERP and study on the same tine, specially when you’re busy working or studying, how to get over this dilemna between intrusive thoughts and the thing I’m working on ? Any suggestions would be helpful… Sorry for the long message, and thanks for taking your time to read this, such a great article btw and it helped me a lot 🙂

    Sincerely, Ibrahim

    • Nancy says:

      Hi- I’m not a doctor, therapist or lawyer …”just a mom” of someone with OCD. My husband is a lawyer and he was at a professional devlopment conference where they talked about getting a disability designation for OCD. This is, of course , something most people with OCD would be leery of because of the stigma and the fear of not getting hired later. But this MIGHT be something to consider. It won’t help with the studying but you might get some accommodation (perhaps extended time on the test). Best wishes. Keep going on the treatment. Good for you tackling law school and OCD!

    • Hi Ibrahim, Thanks for your comment, and good for you for tackling OCD on your own. Unfortunately, as you found out, there are still therapists who don’t know how to treat the disorder. I am not a therapist, and so I don’t have specific advice as to how you can just let your intrusive thoughts go while you are studying. But, as Nancy says, you should be entitled to some type of accommodation through your school. If you are in school in the United States, you are legally entitled to accommodations through the Americans with Disabilities Act:
      Good luck as you move forward. You are brave and determined, and you can do this…….I wish you all the best and hope to hear from you again.

  10. Hey everyone. I just wanted to help people who are going through this. I used to have it. The weird thing is I’ve known this information for a long time but somehow i came upon a website Googling NPAD and found a different NPAD website with this information on it.

    So one thing you should know, all the sensorimotor sensations you think are voluntary or conscience are actually sub-conscience when you’re not experiencing anxiety. Some of you will say duh, but I remember freaking out and wondering if swallowing was something I always had to consciencly do but didn’t notice.

    Anyways, this website describes common anxiety symptoms.

    I would wager that most of you developed your sensorimotor OCD after experiencing one of those common symptoms and then reacting with a “volitional” movement of what is normally a sub-conscience act.

    Here is the thing, the reason blinking, breathing, swallowing all allow you to exert control over those processes is that when you react of your own volition, yopu are using more muscles and that is better if you are facing a threat. Your breath is supposed to be slow and barely noticeable. But if you are suffocating or choking you need to be abel to take big deep breaths to compensate. When you blink subconsciencely, your brain shuts off parts of your vision so you don’t see darkness every second. You never notice it. However if your eye is under attack from a lot of dust it requires you to be able to blink on your own to flush out the eye and moisten them. If your throat is tight or you are producing more saliva than usual you need to be able to swallow the excess saliva.

    So I’m telling you guys all this because it gives you some relief. I remember how scary having this was. However, knowing this, and knowing that this will go away once you relax isn’t going to cure you. You can’t fight anxiety by fighting or flighting. You only reinforce it. You fight it through acceptance and rewiring your brain to no longer respond the same.

    But anyways, since these obsessions can be so bad and I know many of you want a quick fix, some things that worked for me:

    Blinking: Look in a mirror and look at your eyes. Relax the eyes. See if you can notice your blinking but do not blink of your own volition. You will see your eye twitch very rapidly cleaning it even if you don’t do anything, after awhile, you will also notie your vision will slightly change, this means you have just had a blink and you didn’t notice it.

    Breathing: Mirror also. Lift your shirt so that your stomach and ribs are exposed and put the part of the shirt you’ve lifted into your mouth. Focus on your chest and stomach and do not try to breathe of your own volition…also try to relax the belly, you will see your ribs and stomach move up and down on their own.

    Swallowing: Do not swallow. Let your mouth fill up with saliva and eerytime you get the urge to swallow don’t. This will be annoying but eevntually your throat will sort of spasm and force a swallow. Keep doing this and eventualy your swallowing will just return to normal.

    Also, you may think you are experience EVERY breath, every blink,every swallow, but that is actually impossible. Your conscience brain is very very bad at multi-tasking. If you are doing something, working, reading, etc, and get into whateer it is you are doing, you might still notice 50% of your blinks/breath/swallows or maybe even 75% but you will not experience 100%,

    But one last thing, I can’t stress this enough, you have to accept it. Just say i feel cruddy today but I’m going to be a human and just like peop;le with broken legs or people in wheelchairs etc live life I am going to do my best to live life too. It’s not gonna be 100% awesome, but hey, that’s life.

    You will get better. I have faith in all of you. And once you do, come back and give other people hope but DO NOT LINGER on any message boards or subreddit’s or anything with other sufferers because there is a tendency to get sucked into other people’s misery and then it becomes a sort of pitty party. Help people yes, but if you can’t handle reading other peoples symptoms, don’t go on and on about yours once you make progress. This keeps you sucked in. It’s good for support when you’re bad, but once you get better, try not to stay and write and post everytime you have a new symptom or feel bad. It just feeds it.

    Also OCD is not your enemy, it is actually trying to protect you from a threat, but in a really really abnormal way. Going to OCD and anxiety forums can become a compulsion in itself.

    HUGS to you all.

    • Thank you so much for sharing your insight, thoughts, and what has worked for you. There’s nothing like hearing from those who “have been there.” Wishing you all the best!

    • Nate says:

      Hi I have had this compulsion for over a year and I was wondering how long you have had it and how long it took you to get over it. I am currently letting my mouth fill up with saliva like you said, but I have been doing it for three months to no avail. Please help

    • Nisha says:

      Can u please suggest any medicine or naturopathic medicine to deal with sensormitor ocd

  11. Rakesh Mehta says:

    my sister is suffering from swallowing, breathing and blinking ocd but swallowing ocd depressed her a lot she is now 32 and suffering this problem since last 20 years. i got to know about her pbroblem last month when she could not sleep for 4 days and got a seizure attack due to wrong medication by psychiatrist .she is slightly stable now and want to start right treatment. could anyone please advice me should i counsult a phycologist or again psychiatrist.

    • In my opinion, a clinical psychologist who specializes in treating OCD with exposure and response prevention (ERP) therapy is the place to start. This CBT is the first-line psychological treatment for OCD, and with a good therapist, a motivated person with OCD should improve. Good luck to you and your sister as she moves forward!

      • rakesh says:

        thanks for your valuable reply mam……i think here in India even psychiatrist doctors having more than 30 years of experience do not know about this ocd….one of the doctor from a very renowned hospital gave her very heavy medicines left her in seizure attack…… her condition is stable but still taking pills for sleep, anxiety, depression etc…. could you pl z tell me that should i consult a psychologist with psychiatrist medicines.

      • rakesh says:

        one more thing mam i would like to ask that she met with an accident ( head injury) when she was just 2 years old. recently we did CT scan and all other examination but all were positive. can head injury also be a cause of this problem……

      • Hi Rakesh, Unfortunately there are many doctors who do not know the proper treatment for OCD. This is a widespread problem. A clinical psychologist who specializes in treating OCD with ERP therapy is what is usually needed. If there are none available to you, there are helpful web sites on the Internet, as well as some good self-help books to get started on ERP therapy. You can find information on the sidebar of my blog, in the Resource section of my book, and at the IOCDF website.
        As far as I know, head injuries do not generally cause OCD.

  12. Natalie says:

    Hello Everybody ! I’m so glad I’ve found this conversation thread. I have been suffering from obsessive swallowing for over a year now ! I am on medication and taking cbt but I feel like the swallowing is my life and I can’t control it. Sometimes when I’m busy I don’t notice it as much but I can’t sit back and relax. If I’m not distracted it is just constant and debilitating. Does anybody have any advice on how they deal with this ? I’d love to chat to people going through the same thing !

    • Thanks for sharing, Natalie, and many people experience sensorimotor OCD. You don’t say if your CBT is specifically exposure and response prevention (ERP) therapy, but that is what is needed to conquer all types of OCD. Good luck as you move forward!

  13. Adam says:

    I’ve been suffering obsessions with my breathing/swallowing and blinking for 2 years now. My swallowing obsession is affecting me greatly at the moment but I have gone months where the condition has barely affected me. When I get these obsessions I think I will never be able to perform that body function involuntarily again but every time it seems to clear up for a while then come back at a later point. Interestingly I seem less affected in summer so for me I guess it may be connected to seasonal moods or perhaps the fact that I tend to be more active in summer and therefore doing activities to take my mind of my condition. I generally have been able to manage this but am in a bad spot at the moment so I’m hoping my condition will ease up some point soon.

    • Hi Adam, Thank you so much for sharing. It’s not clear to me whether you have ever tried ERP therapy but that’s the treatment that could help with your sensorimotor OCD. I wish you all the best!

  14. Elijah Wiorek says:

    Well its 4 years after this was posted. Hope someone will respond but i have really bad issues with controling my breathing. I cant stop it and its making me dizzy and numb in my fingers. I am getting some help but it doesnt really help.

    • Hi Elijah, I’m sorry you are having such a tough time. I don’t know what kind of help you are getting but good ERP therapy is helpful for those with sensorimotor OCD. If your therapist doesn’t use ERP or is not experienced with it, it might be time to explore other options for therapy. I suggest you visit the IOCDF website for more info on finding a good therapist. Good luck!

  15. Jo says:

    I think I might have this pertaining to my vision. Not floaters or blinking but I just can’t seem to stop think of the fact that I can see and its causing me. a lot of distress. I think it is is because i recently was battling an obsession with the fear of becoming blind and i got depressed because i thought that i was going to go blind eventually. Now that I’m not obesssing over that fear, im hypersentivive to the fact that i can see and it makes me anxious. I sleep a lot because closing my eyes seems to get rid of it but I don’t want to live like this forever. Is this curable? I haven’t felt like this until recently since I’ve been suffering from anxiety.


    • Hi Jo, I am not a therapist but I know that all forms of OCD are treatable. The hard part is finding an OCD specialist who really understands these sensorimotor issues and ERP therapy. I’d recommend checking out the IOCDF website for more info. Good luck!

  16. Camille says:

    I suffer also from the blinking OCD and it’s horrible, I can’t stop it even when I’m busy ! It makes me feel terribly anxious and depressed. I tried ERP but it doesn’t work, I’m totally scared.

    • Hi Camille, I am so sorry you are suffering. Usually when ERP “doesn’t work,” it’s either because the treatment isn’t being done properly or the person with OCD isn’t totally invested in it. I would suggest finding a new treatment provider who has experience with ERP and sensorimotor OCD. You absolutely can get better! Good luck as you move forward.

  17. Nate Fujan says:

    Hi I have had compulsive swallowing for over a year now. At the beginning of the year, I had severe anxiety that lasted about 6 months. I was swallowing compulsively the entire time and I continue to do so. Now that it isn’t anxiety related, I feel very desperate and am in need of another option. I have tried mindfulness and erp and find that they do not work. I would like to hear your advice or find of another helpful source, because online not much is said about it aside from the Erp that you mentioned and a bunch of forums where people aren’t having much luck. Thanks

    • Hi Nate, I’m sorry you have been suffering for so long. It is hard to direct you as I don’t know your situation….for example if you have OCD or not. But perhaps the best thing at this point would be to see you general doctor for a full exam. Assuming all is well, I still advocate for ERP as the main approach to sensorimotor OCD. Many times if it “doesn’t work” it’s because the therapy is not being done correctly. Connecting with a qualified therapist would be extremely helpful. Some even use Skype or FaceTime. There are also good self-help books available – I have many listed in the resource section of my book. You can also check out the IOCDF website. Good Luck!

  18. JS says:

    Hi — I have been suffering from sensorimotor OCD for over 20 years – ugh. Have had some of the traditional ones (breathing, digestive processes) but WAY more prominently have complete focus on what my face is doing and voice sounds like. Constantly worried about “being out of control” or doing something unpleasjng. Have been in therapy for 20 years including ERP but hasn’t seemed to improve — mainly because the awareness never goes away, even when I don’t care what my face/voice are doing? It’s exhausting and has really prevented me from getting into relationships. I am sometimes so frustrated with the “why me” stuff but know that serves no purpose. Sigh. Onwards I guess. Thanks (on a particularly hopeless day!)

    • I’m so sorry you’ve been suffering so much for so long. I know this type of OCD can be particularly challenging to treat, but I also know of many people who have been able to overcome their sensorimotor OCD. Perhaps trying a different therapist who has had success treating this type of OCD with ERP therapy? I know they are not typically easy to find, but I can’t help thinking there is someone out there who could truly help you. I wish you all the best as you continue your journey!

  19. Mark says:

    Hi i been suffering with severe anxiety problems and depersonalization from the whole past year and from the last 3 months i started whit the blinking obssesions it all started when i was readin a lyric for a song and i think “what if i forgot how to blink?” I started to panick about that and the fears glue this obsession it lasted like 2 days for me to notice this was just anxiety and i cand distract for ir so for like 3 weeks ir really doesnt boether me until i read this problem was related to ocd that increase the fear for me reading that other people are struggling with this for 10 plus years and i totally freak out like 10/10 anxiety leves so long history short i developed the swallowing too just for reading about i know it sounds funny. Well i think that im afraid of this bodily obsessions but im more afraid of ocd because read about this was a problem related to this triggers more fear in me and make it worse so im going to therapy now so she say it just an anxiety problem but im not sure im insecure about that because she doesnt make any particular therapy with me only talk by the way she is a really good psicologyst and she got GAD too so she can understandme should i show this researchs so he can hel me more? Sorry for my inglesh im not from the usa and i dont talk this lenguaje

    • Hi Mark, I’m sorry you are suffering so much. I’m not a therapist so I can’t diagnose you but my suggestion would be to determine first whether or not you have OCD. The Y-BOCS test is a good screening tool. I think you should show your therapist your research as it is very important to have a proper diagnosis.If you do have OCD, talk therapy will not help and might even make things worse. For OCD, ERP therapy is what is needed. It is good you are catching this early on and if you do have OCD, with the right help you should be able to beat your sensoimotor OCD. Good luck and hope to hear from you again.

  20. Maysa says:

    Hello, I have been suffering from sensorimotor OCD for over 2 months, especially breathing, and it’s making life so hard 😦 I think about inhaling-exhaling literally 24hrs a day; while i’m eating, using the toilet, watching tv, driving … etc and it’s driving me crazy. I haven’t slept for 2 months, I have panic attacks, even my speech has been affected and can’t talk in a normal way because of the inhale-exhale thing 😦
    Please tell me what should I do?

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