Sensorimotor or Somatic OCD
Sensorimotor OCD or Somatic OCD is a sub-type of OCD that is characterized by obsessions and compulsions around one’s somatic experiences. Somatic experience are the physical sensations you can’t control. Examples might include experiences like breathing, swallowing or blinking. Obsessions can involve either a focus on automatic bodily processes or physical sensations. Engaging in the compulsion can reduce the anxiety and provide the short term relief within this sub-type. Engaging in the compulsions looks to provide that short term relief but then reinforces the OCD cycle, keeping you stuck.
Examples of Somatic OCD Obsessions: Obsessive thoughts, images, urges, and doubts.
Blinking-Did I blink too much or how many times should I blink?
Breathing- Obsessing over the sensation of breathing. Will my breathing stop? Is my breathing normal or did it change?
Swallowing/Salivation- Obsessions about the amount of frequency of swallowing. What if I forget to swallow?
Movement of the mouth and/or tongue during speech.
Pulse/Heartbeat- Obsessing over heart rate and my heart beating. What if my heart stops?
Eye contact- Obsessions about am I making proper eye contact and the physical feeling of my eye making contact.
Awareness of Specific Body Parts- Hyper awareness about your body parts. Noticing how the bottom of your feet feel each time you walk.
Somatic OCD Obsessive Thoughts:
I can’t stop noticing my breath.
How often am I blinking?
Am I chewing the right way?
How do I know when to swallow?
I can’t stop paying attention to my heart beating.
My breath doesn’t feel deep enough. I’m not breathing correctly.
How will I ever live a normal life if I can’t stop thinking about my breathing?
What if I never stop being fixated on my breath?
Somatic OCD Compulsions:
Distractions: Distract yourself in an attempt to make the intrusive thoughts go away.
Excessive research: A person may spend hours online researching their condition.
Mental review: Thinking back to a time when they felt free from these obsessive thoughts.
Reassurance Seeking: Asking a loved one or family member for reassurance to get relief or for insight. Self reassurance can look like a person trying to convince themselves that the issue will go away or that it is not a big deal.
Avoidance: Another form of distraction. Avoiding certain triggers or situations that might trigger their obsessions.
Somatic OCD Example:
Vanessa is 47 years old and has worked in an airport for 12 years. Vanessa constantly hears from friends and co workers how bad their job stresses them out. How they need to be on high blood pressure medications and how much the stress is impacting their body negatively. Vanessa gradually had more obsessions focusing on her heart rate and heart beating. A recent trigger happened when a cousin of hers had died from a heart attack randomly. Vanessa began to worry when her heart started beating faster that it was a medical issue and if her heart would stop beating and she would die at work. Vanessa would obsess every time she had to walk long distances throughout the airport, trying to focus and listen on her heart beat and breathing.
Vanessa began to wear a watch that tracks her heart rate and pulse. Vanessa would check her pulse and heart rate, monitoring her watch often. She would ask her co workers for reassurance and would be constantly setting up doctors appointments to go over scenarios. Vanessa ruminated throughout the day engaging in physical and mental compulsions. We see in this example fears and obsessions that Vanessa’s heart will suddenly stop and that she must be hyper-vigilant of her heart to ensure that it doesn’t stop. These obsessions and compulsions take up a great deal of time in her day and negatively impact her functioning. Vanessa is exhibiting many characteristics of the Somatic OCD sub-type.
Treatment for Somatic OCD:
Treatment for this sub-type of OCD, like all forms of OCD is the gold standard of treatment, exposure and response prevention (ERP). Exposure and Response Prevention (ERP) looks at the idea that triggering situations and thoughts are at the core of OCD. Ongoing exposure to these triggers without engagement in rituals can reduce the severity felt. As a licensed mental health therapist trained in ERP, I will assist you through the exposures and how to implement effective response prevention measures. If you feel that OCD has had a negative impact on your life, you might consider counseling and ERP to learn how to handle it more effectively. Please feel free to reach out for a free consultation, where we can discuss the impacts of OCD and benefits of counseling/ERP.
