Sensorimotor OCD, a subtype of obsessive-compulsive disorder, is a condition that can feel isolating and overwhelming. It focuses on automatic bodily sensations or functions—things most people don’t think twice about, such as breathing, blinking, or swallowing. For those with Sensorimotor OCD, these sensations become the centre of intrusive thoughts and compulsive behaviours, making it hard to focus on daily life.
I aim to provide a comprehensive understanding of sensorimotor OCD, how it differs from other OCD subtypes, and the evidence-based treatments available to help individuals regain control of their lives.
What is sensorimotor OCD?
Sensorimotor OCD, also referred to as somatically focused OCD, occurs when individuals become hyper-aware of automatic bodily sensations or processes. These sensations, typically unnoticed by most, become the focus of obsessive thoughts and compulsive behaviours.
Common examples include:
- Breathing: Hyper-awareness of the act of breathing, which can feel overwhelming and inescapable.
- Blinking: Fixation on the frequency or sensation of blinking.
- Swallowing or salivation: Obsessing over the mechanics of swallowing or the amount of saliva in the mouth.
- Heart rate: Constant monitoring of one’s pulse or heartbeat.
- Other sensations: Awareness of joint creaking, muscle movements, or specific body parts (e.g., the tongue, feet, hands).
Unlike other OCD subtypes, such as contamination OCD, where the fear is external (e.g., germs), Sensorimotor OCD focuses internally on sensations that are always present. This internal focus can create a sense of being “trapped” in one’s body, with this feeling, leading to heightened anxiety and compulsive attempts to control, suppress or avoid these sensations.
Sensorimotor OCD vs. Hyperawareness OCD
There is a difference between Sensorimotor OCD and Hyperawareness OCD. While both involve heightened attention, the distinction lies in the focus:
- Sensorimotor OCD centres on bodily sensations or processes, such as breathing or swallowing.
- Hyperawareness OCD involves excessive attention to external stimuli (e.g., sounds, lights) or internal processes, such as one’s thought patterns or consciousness itself.
Despite these differences, both subtypes share a common cycle of obsession, anxiety, and compulsive behaviours aimed at reducing distress.
The difference between awareness and attention
A key concept in understanding Sensorimotor OCD is distinguishing awareness from attention:
- Awareness is the natural process of noticing something, such as you’re breathing or blinking.
- Attention is the mental energy we choose to focus on something.
For individuals with Sensorimotor OCD, the problem isn’t awareness itself, but the compulsive attention given to these sensations, like checking. This excessive focus amplifies the sensations, creating a feedback loop of distress. Treatment focuses on breaking this loop by learning to allow awareness without directing attention to it.
Common obsessions and compulsions in sensorimotor OCD
Obsessions
- Fear that the sensation will never go away.
- Belief that one will lose control or go “crazy” because of the fixation.
- Catastrophic thoughts, such as “I’ll never feel normal again” or “This will ruin my life.”
Compulsions
- Monitoring or checking the sensation.
- Overthinking or ruminating about the sensation.
- Attempting to suppress or distract from the sensation.
- Seeking reassurance from others or researching the sensation online.
These behaviours may provide temporary relief but ultimately reinforce the obsession, perpetuating the cycle of OCD.
I have created a questionnaire which you can find here to check if you meet, the criteria for this theme of OCD.
What causes sensorimotor OCD?
Like other OCD subtypes, Sensorimotor OCD arises from a combination of genetic, environmental, and psychological factors. Key contributors include:
- Genetic predisposition: A family history of OCD or anxiety disorders.
- Personality traits: Perfectionism, high sensitivity, or a tendency toward rumination.
- Environmental triggers: Stressful life events or trauma.
- Critical incidents: Many individuals can pinpoint a specific moment when they became hyper-aware of the sensation, such as reading about a medical condition or experiencing a panic attack.
Understanding these underlying factors can be an important part of therapy, helping individuals make sense of their experiences and identify areas for healing.
How is sensorimotor OCD treated?
Cognitive Behavioural Therapy (CBT)
CBT is the gold standard for OCD treatment. For Sensorimotor OCD, therapy focuses on:
- Exposure and Response Prevention (ERP):
ERP involves intentionally exposing oneself to the feared sensation (e.g., focusing on breathing or blinking) without engaging in compulsive behaviours. This teaches the brain that the sensation is not dangerous and reduces the anxiety associated with it. - Challenging Core Beliefs:
Therapy helps individuals identify and challenge catastrophic beliefs, such as “I’ll never escape this” or “I’ll lose control.” - Behavioural Experiments:
These exercises help individuals practice allowing sensations to exist in their awareness while redirecting attention to meaningful activities. For example, someone obsessed with swallowing might focus on a value-driven activity, such as spending time with loved ones, while allowing the sensation to remain in the background.
Value driven therapy
This emphasises mindfulness and acceptance, teaching individuals to observe bodily sensations without judgment or the need to change them. This approach helps individuals shift from a stance of resistance to one of acceptance, reducing the power of the obsession.
Compassion-Focused Therapy (CFT)
CFT addresses the shame and self-criticism often associated with OCD. It helps individuals develop an understanding and proactive relationship with themselves, which can be crucial for recovery.
Eye Movement Desensitization and Reprocessing (EMDR)
For individuals whose OCD is linked to a specific traumatic event, EMDR can help process and reframe the memory, reducing its emotional impact and breaking the cycle of obsessive focus.
Behavioural experiments: shifting attention
One of the most effective strategies for Sensorimotor OCD is practicing attention-shifting exercises. Here’s an example:
- Identify the obsession: “I’m fixated on my breathing, and it feels unbearable.”
- Challenge the catastrophic belief: “What if I could notice my breathing but still live a meaningful life?”
- Experiment: Set a timer for 5 minutes. During this time, allow yourself to notice your breathing without trying to control or avoid it. Simultaneously, engage in a meaningful activity, such as reading, drawing, or talking to a friend.
- Reflect: What did you notice? Did the sensation become less distressing as you focused on something meaningful?
These exercises help retrain the brain to see the sensation as non-threatening and reduce the compulsion to fixate on it.
Why recovery is possible?
One of the most challenging aspects of Sensorimotor OCD is the belief that recovery is impossible. Thoughts like, “I’ll never regain control,” or, “This is so unfair,” can feel overwhelming. But with the right treatment, individuals can learn to live fulfilling, value-driven lives, even with occasional awareness of bodily sensations.
Recovery does not mean eliminating awareness of these sensations—it means breaking the cycle of compulsive attention and finding freedom in choosing where to focus your mental energy.
Contact
If you’re struggling with Sensorimotor OCD, the first step toward recovery is scheduling a psychological assessment. This includes psychometric testing to fully understand your experience and create a tailored treatment plan. You can email me here: info@homebasedtalkingtherapy.com.