Sensorimotor OCD, also known as somatic OCD, is a subtype of obsessive-compulsive disorder (OCD) characterized by intrusive thoughts and compulsions related to bodily sensations. People with this subtype of OCD become hyper-aware of functions, like breathing, blinking, swallowing, or even the sensation of their heartbeat.
Sensorimotor OCD and somatic OCD are terms that are used interchangeably to describe a subtype of obsessive-compulsive disorder (OCD) that centers around physical sensations.
You may have thoughts like, Am I breathing correctly? What if I swallow the wrong way and I choke? I can feel my heart racing, is there something wrong? The constant monitoring of your breath, heartbeat, or movements can make everyday activities feel overwhelming. The more you focus on these sensations, the more distressing they can become, leading you to perform compulsions like excessive checking, adjusting your posture, or mentally counting breaths.
Fortunately, there is treatment for sensorimotor or somatic OCD through exposure and response prevention (ERP) therapy. Here’s what you need to know about sensorimotor OCD, its symptoms, and how to find a personalized treatment plan tailored to your specific needs.
What is sensorimotor/somatic OCD?
Sensorimotor or somatic OCD is a subtype of OCD that fixates on autonomic bodily processes and functions, such as breathing, blinking, swallowing, heartbeat/heart rate, chewing, the movement/feeling of one’s tongue, bladder or bowel pressure, itching, or even the internal mechanism of thinking, among others.
Patrick McGrath, PhD, Chief Clinical Officer at NOCD, says the core fear for someone with this theme tends to be, “What if my body is not doing something the right way?” As a result, you may feel the need to take control of the function you’re fixated on. This hyperattentiveness can cause a problem where there isn’t one, as the more you focus on something, the more likely you are to find something “wrong” with it.
People with sensorimotor/somatic OCD experience obsessions—which can manifest as intrusive thoughts, sensations, images, feelings, or urges—surrounding one or more bodily functions. Because autonomic processes are, by definition, happening all the time, people with this OCD subtype likely find their obsessions constantly triggered. In order to relieve themselves of the distress caused by obsessions or to stop a bad thing from happening, they perform repetitive behaviors or mental acts known as compulsions.
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Signs and symptoms of sensorimotor/somatic OCD
Sensorimotor/somatic OCD obsessions
The symptoms of sensorimotor OCD will vary from person to person, but they involve obsessions surrounding one or more bodily functions, which results in high levels of distress, guilt, shame, or embarrassment.
Common sensorimotor or somatic OCD obsessions can look like:
- “What if I never stop noticing my swallowing?”
- “What if my breathing is not normal?”
- “I have to make myself blink, so I can ‘check’ that it’s normal.”
- “I can’t stop noticing every time I move my head.”
- “My tongue feels so weird in my mouth. Is it sitting in the right place?”
- “Is my bladder working normally? I can always notice its pressure.”
- “I notice every tingle or itch on my body and worry that they happen too often.”
- “What if I forget how to chew?”
- “Is my heartbeat normal? I have to pay attention to it to check.”
- “What are my eyes doing when I’m talking to someone?”
- “What if I can never yawn?”
- “Will I keep noticing my breathing forever?”
Sensorimotor/somatic OCD compulsions
Compulsions will also vary depending on each person and which process or function their intrusive thoughts latch onto.
Common sensorimotor or somatic OCD compulsions can look like:
- Doing excessive research online to find similarities between your experience and others’, attempting to “get to the bottom” of whether your function is “normal” or find out how you can stop paying attention to it.
- Seeking reassurance from yourself or others. You might repeat to yourself, “My breathing is totally normal, and I’m not paying attention to it,” or ask a loved one, “Do you think my breathing sounds normal?”
- Avoiding places or activities where your intrusive thoughts are especially triggered. For example, if your intrusive thoughts focus on chewing, you might avoid going out to dinner with friends because you won’t be able to be present.
- Mentally reviewing past experiences when you didn’t feel hyperaware and trying to figure out how you can get back to that state
- You might try to distract yourself with books, movies, or other activities.
- You might induce the function (i.e. make yourself swallow) so that you can “check” its normalcy.
Community discussions
How is sensorimotor/somatic OCD treated?
Exposure and response prevention (ERP) therapy
ERP is a specialized form of cognitive behavioral therapy (CBT) designed to treat OCD by disrupting the cycle of obsessions and compulsions. During ERP, you’ll work with a trained therapist, who will gradually expose you to your intrusive thoughts and triggers while resisting the urge to perform compulsions in response.
You won’t jump into the most difficult triggers right away. Instead, you’ll start with less distressing situations and work your way up. This structured, step-by-step approach helps you build tolerance to the discomfort without feeling overwhelmed, and gradually teaches your brain that the anxiety caused by the intrusive thoughts isn’t as dangerous as it feels.
In the case of sensorimotor/somatic OCD, examples of exposures include:
- Intentionally blinking, breathing, or swallowing “wrong”
- Going to dinner with friends, where it will be difficult to engage in compulsions surrounding your chewing
- Write down “I might be blinking too much” or “my breathing might not be ‘complete’” and read it back to yourself
- Read a case study about someone who couldn’t perform an autonomic process/function correctly
- Engage in activities where bodily sensations are heightened. For example, exercising or participating in a yoga class, where you might become hyper-aware of your breathing, heart rate, or body position
Dr. McGrath says that the goal of these exposures is for people to learn that they can handle the distress that’s brought on by their obsessions. “Eventually,” he says, “the process will go back to being automatic.” It might sound overwhelming, but that’s kind of the point—through facing your triggers, they will become less and less overwhelming over time. It’s important to know that you will not be forced into anything you’re not ready for. Remember, you and your therapist will work together to come up with a plan for your exposures.
Bottom line
Sensorimotor or somatic OCD are interchangeable terms used to describe a subtype of OCD that can make you feel overwhelmed, confused, or even fearful about your body’s automatic functions. That’s why it’s important to find a trained therapist who specializes in ERP and can guide you through treatment. They can help you navigate the overwhelming thoughts and compulsions associated with sensorimotor/somatic OCD and provide structured support through ERP.
Key Takeaways
- Sensorimotor and somatic OCD both refer to a subtype of OCD that centers around heightened awareness of bodily sensations such as breathing, swallowing, blinking, tongue position, eye contact, chewing, itching, and heartbeat, among others.
- People with sensorimotor/somatic OCD have obsessions about their bodily sensations or functions and perform compulsions in response.
- Sensorimotor/somatic OCD can be treated with exposure and response prevention (ERP), a specialized form of cognitive behavioral therapy (CBT).