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Sensorimotor OCD Body-Focused Obsessions & Compulsions (Swallowing, Breathing)

Body-Focused & Sensorimotor Obsessions (sometimes called somatic obsessions)

Body-focused, or sensorimotor, obsessions involve hyperawareness of automatic bodily activities (e.g., breathing or swallowing). Individuals with this type of OCD get “stuck” analyzing how often and how “completely” these processes have occurred.

This post is the first in a series of posts discussing body-focused obsessions and compulsions (i.e., sensorimotor obsessions and compulsions) in obsessive-compulsive disorder (OCD). This series was inspired by an original article written by Dr. David Keuler for Beyond OCD. You can access Dr. Keuler’s excellent article here.

Body-Focused Obsessions and Compulsions in OCD (sometimes called Sensorimotor, Somatosensory, or Somatic Obsessions/Compulsions)

As I have mentioned previously, one particularly distressing symptom of obsessive-compulsive disorder (OCD) can be hyperawareness of particular bodily sensations. Body-focused obsessions (also called sensorimotor obsessions (Keuler, 2011) or somatosensory obsessions) often feel intolerable and typically involve getting your attention “stuck” on thinking about or analyzing particular autonomic processes. Thoughts may become fixated on one’s breathing rate, heart rate, swallowing, blinking, eye “floaters”, or flickering of the visual field (Keuler, 2011). Sufferers frequently label the problem as conscious breathing/conscious swallowing/conscious blinking, obsessive breathing/obsessive swallowing/obsessive blinking, or compulsive breathing/compulsive swallowing/compulsive blinking. Although for most individuals these processes occur automatically below conscious awareness, individuals with this form of OCD find themselves acutely and frustratingly aware of their own bodily sensations.

People with these obsessive-compulsive symptoms attend to how often and how “completely” these processes have occurred. For example, individuals with respiration/breathing-related symptoms often try to consciously control their breathing rates, as well as how “fully” each breath is inhaled and exhaled. Obsessions and compulsions involving breathing, swallowing, and blinking are quite common in this form of OCD. However, other individuals may over-attend to fullness and other sensations in the bladder, stomach, or digestive system. Still others find their attention gets overly focused on the urge to burp or belch. Another different, distressing symptom involves analyzing the amount and frequency of eye contact with other people (Keuler, 2011). Doubt and uncertainty about how often and how intensely to make eye contact can lead to avoidance of other people, which may disrupt performance in work, school, and social settings. Additional examples of body-focused obsessions and compulsions include paying excess attention to how your tongue moves when eating or speaking, the timing of your speech, the amount of saliva in your mouth, the sound you hear when swallowing or chewing, how your teeth feel when your mouth is closed, or how your skin feels as it brushes against your clothing.

Although compulsions associated with these symptoms often involve consciously controlling these processes, mental rituals occur as well. These include repeating certain words or phrases in one’s head, counting, intentionally thinking “positive thoughts” to counteract “negative thoughts”, or engaging in “figuring out” rituals. In this way, sensorimotor OCD is similar to Pure-O OCD. Because these types of symptoms differ from “classic” OCD symptoms, diagnosis is often delayed because many individuals (and their therapists) do not understand that these symptoms reflect underlying OCD.

Understandably, individuals suffering from body-focused, sensorimotor OCD become desperate to redirect attention away from these processes (Keuler, 2011). However, attempts to forcefully distract or redirect attention are often ineffective. Most individuals find that the more they try to actively push their awareness onto something else, the more their awareness becomes locked on their symptoms. This can result in extreme anxiety, distress, and panic. Life may come to feel upsetting, intolerable, and out-of-control.

Subsequent posts will discuss core fears related to body-focused obsessions and compulsions, as well as treatment strategies for reducing these symptoms. As is the case for other types of OCD, evidence-based treatments consist of exposure and response prevention (ERP).

 

Continue reading Part 2.

 

Questions? Comments? Experiences with body-focused obsessions like hypervigilance for swallowing or breathing? Share below.




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44 Comments

  1. Hello,
    I’ve been having symptoms of sensorimotor ocd. I become self concious about my blinking. Even though I know my anxiety is irrational, its hard to shake it off. It gets worse in public places, at home I seem to feel a bit better. I read your articles, but I still don’t quite understand how to apply any coping techniques or mechanisms. Any suggestions or advice you can give?

    • Hi Chris,

      For sensorimotor symptoms, it’s best to work with a therapist who can provide you with information about your symptoms and guide you through the process of treatment. Check out the IOCDF website for possible therapists in your area.

  2. I have this with breathing and it is the worst thing ever. Thanks for this, i will try and treat it.

    • Sensorimotor symptoms can be very distressing. Good luck!

      • I am at my end, I have sensory motor ocds and it is ruining my life!

  3. Well, at least I know that what I’ve suffered for so long is treatable, and is classified as a sensorimotor obsession (I didn´t know it had a specific name). I’ve been suffering from this type of OCD for many years. And even though I´ve been diagnosed with OCD (a fairly common disorder), I felt very alone since most of the books, and material out there are focused on cleaning issues.

    I was very impressed when I got into this site, since I fit into the description of most of what is said in it. I’ve suffered from blinking obsession, breathing obsession, being pending on my bladder, but the most stressful and painful obsession that I’ve ever had is the swallowing obsession. I’ve been able to overcome most of my previous obsessions, but the swallowing obsession seems to be the hardest one, since no one has been able to tell me the real nature of it (what’s the obsession and what’s the compulsion). Here I’ll go a little bit into detail (see if doctors and patients have heard something similar):

    Swallowing saliva has become a voluntary and conscious process. My mouth feels up with saliva, my tongue gets very tense, and I’m forced to swallow manually. If didn’t swallow manually, my mouth would fill up with saliva at the point of drooling. Naturally I know there’s something wrong here, since I’ve always lived my life without being concerned, focused or committed to swallow manually every 5 to 10 minutes. There have been days that I go through it but as it have been wisely said: like tip toeing, and being afraid of getting the symptoms back.
    I just want to live a fulfilling life with no fear, and be able to enjoy the goods moments, without being forced to swallow manually constantly so I don´t get my tongue stiff and my mouth filled with saliva. I’ve visited many doctors, taken Prozac, Rivotril, but no one has ever been able to tell me the real nature of my symptoms; what´s my compulsion, and what´s my obsession. Also, no doctor has been able to explain the swallowing process so I can be sure if I´m swallowing and excess of saliva produced by anxiety or is just that I have a dysfunctional swallowing mechanism. Well, sorry for this long post, but since it seems my problem is not that uncommon as I initially thought, I wanted to participate. Any comments, suggestions, ideas, will be greatly appreciated. I live in South Miami.

    • Hi Ernesto,

      With these types of symptoms, it’s always important to consult with medical specialists to make sure there’s not a medical cause for your symptoms. It sounds like you might have already done that based on your description, but if you haven’t, that’s a step you can’t afford to skip.

      If these symptoms reflect OCD, it is important to target them in the right way…which will be based on understanding the obsession/compulsion distinction. The obsession typically consists of having your attention locked on your symptom. You can clarify this further by asking yourself, “What am I really anxious about?” For some people, it’s a fear of choking. For others, it’s a fear of other people noticing your swallowing and thinking you’re weird. For others (probably you fall into this category), it’s a fear that life will be ruined because you’re having to pay attention to your swallowing.

      In this last case, rituals may consist of trying to not notice the symptom, trying to figure out what you need to do to eliminate the symptom, or trying to wish the symptom away. These are the same types of mental rituals used by people with other types of unwanted thoughts.

      Unfortunately, these efforts thwart your ability to learn to become less bothered by the symptom (which is the only realistic goal at this juncture).

      I noticed that you didn’t mention working with a therapist yet–find a therapist to help you tackle this.

      Good luck in your recovery.

  4. Thank you for this fascinating article. I’ve wondered for a long time why I get so obsessed with my breathing, it makes me dizzy sometimes.
    Can I ask you about this other odd thing I sometimes do. I want to breathe in rhythm with things around me ie same amount of breathing time for trees on either side of the road, I want it to be even in my head or I hold my breath. Sorry sounds so weird and hard to explain. And not in conjunction with breathing but I like to not step on cracks on paving stones, and wanting to step on the same number of paving stones per foot…
    These things don’t rule my life (I am an ordinarily functioning mother of young children!) and don’t make me “anxious” per se, but I am aware of them…I don’t know if this is OCD?
    Many thanks again for this helpful article.

  5. I’m thirteen, and sensirometer OCD is controlling my life. I am starting middle school soon, and I just know it will get worse. Sometimes I have conscious breathing, as well as overawareness of what my arms are doing and I can’t make eye contact. Also when I’m around someone I’m not comfortable around, I’m over conscious of what my mouth is doing, so I don’t talk much. It also makes me uncomfortable walking in public it just developed during sixth grade. Help!

  6. I have the breathing ocd. I panicked at the dentist the other day thinking my breathing was off track and something bad was going to happen. . But what I’m wondering, you say in this article there’s no reason to fear that I control and manually breath. Why is that? How is it if our bodies were made to breath automatic that it is ok if we manually control our breathing all day?

    • Have you contacted your medical doctor to rule out medical causes for your symptoms? If you’re concerned about your breathing, share your concerns with your medical doctor and see what they say.

  7. Thankyou for this website. I have had sensorimotor ocd for 15 years now and have only just recognised that I have this. I always thought I had the normal ocd. I haven’t really discussed this with anyone as all the books tend to only describe the washing/cleaning/checking ocd which I certainly do not have. I have had the breathing/swallowing/blinking and floaters obsession. I am looking for a therapist but I live in london/united kingdom. Is there anyone you could recommend?

  8. To all of those who have this condition: I have found a way that might help relieve your symptoms.

    I have this condition since the age of 13. Sometimes if leaves me alone for years, sometimes it gives me hell. If you also suffer from this, you probably know that the worst part is when you get REALLY focused on the thought. You would do anything to make your mind forget, but it just gets worse.

    What I found out is your mind can only focus on a limited number of thoughts at a time. There’s like 3-4 “slots” in your brain, if you keep all of them occupied, there just won’t be any remaining slots for your “OCD thoughts”.

    A way to achieve this “state” is drumming. This might sound weird, but what you should realize is this: playing the drums involves parallel attentions to your left hand, right hand and – if you are right handed – right foot. I advise that you actually try to find a drum kit and ask someone to show you how to play the drums. You will understand automatically. It would probably work with other types of musical instruments, but the good thing about drums is that you can play them without owning a drum kit – just imagine you have one 🙂 Buy an air drum kit 🙂

    Hitting the drums randomly does not work, but playing a specific rhythm of a song does, as it requires full attention to parallel tasks. It keeps all the “slots” in your mind occupied, and your obsessive thought goes away in about a minute. It does not cure you, and it is not a substitute for proper medical help from a professional, but just the feeling that you can make the thought go away with this technique can be a great help. You can say “I can make this go away any time”, which is a huge help to getting “cured”.

    Spread the method! 🙂

    • You’re absoulutely right! Video games help the same way.

  9. I have this problem too..it started in in freshman year of highschool..just randomlly out of the blue i became aware of my breathing. And im still conciously aware of it now as i type this it scares the living hell out of me and bothers me so mutch i cant sleep. i dont want to tell anyone because im afraid they will think im crazy but idk what to doo??? i dont want to be conciouslly aware of my breathing its like i control my breathing is there some sort of treatment for this??

  10. i really need your help 🙁 extremly, feeling hopeless because of this i have the need to swallow every second , can you please help me my telephone number is 347-367-0340 my name is rafaela i really need some advice in how i can overcome this

  11. im 23 year old male and up front im sorry for my language i wasnt born here .. My severe ocd started over 8 months ago .. i had it for long years i just never new what it was , i knew there was soemthing wrong but i was afraid to tell anybody just like Randy cuz ppl will think im crazy ….. so wen i was like 8 i saw some embarrasing stuff twice in that year ,and than i couldnt get over what i saw i was shocked and thats what trigerred it …….i repeatly thought those thoughts an after a while they actuallly went away idont remeber how … dan when i was like 17 i was obssesed about my height and woried and worried times a millinos n measuring my self a nonstop ….than i realized its in my head u cant grow an inch in a week , i mean come on …. but i had to hear it from ppl and self talk from me …… so i didnt have ocd the whole time it went away and came back after some schock or a very stressful event has accoured ….ohh yea n somewhere in highscool i had the same thing as u randy but not as severe ,still bothered me and i didnt know what was wrong with me ,,,…that was nothing comparing to what i started having 8 months ago .. i drove to tx ,,,im a driver from chicago to tx ,,i was driving and i noticed a diference in my eyes that right one loooked a litle weird like there was something so i pulled over n im like ok hmm …i started closing n openig righ n left eye … and suddenly i was like maybe ill fix it ,,,so i was like maybe its my inside of my eye ,,so i did something with my brain and i leterally got my eye blurried like for a second or less n after the first time i did that i strted doing it left n right n again over n over again …. than i developed the urge with was like i have to doit ,,,but wait its messing up my eyes ,,,, hmm yea now i know that ,,,and i kept doing it for a whole month i came back from tx n i started having very scary days …..afraid i would go blind or i would mess up my eyes ,,so basicly it was eyes …..my parents told me to go to the doc but i was ofcourse” smarter” that a non ocd person an i waited like 3 weeks an i didnt do anyhting just sat home and went to my gf ………..biggest mistake ever ,,, so dan i went to a psychiotrist WHEN i was so scared and couldnt stop looking at windows not throught m but at them lliterally clear glass . and mirrors and all that stuff corners theres so much problems i developed its sick ….when i got back home cpl days later i started having flashes in my eyes along with fear an a sensation that scared the living hell outta me …. first thought ill mass up my eyes n ill go blind or my eyes will go crossed n so many other ideas ,,like turning off my eyes ..omg that was a nightmare … dan wen i went to the doc he says its ocd telling my eyes not to work properly and those other ideas ……. but the guy had problems himself and i knew that without asking him i saw him tapping fingers and acting stressed out very much he couldnt concentrate like he wasnt paying attention to me just his problems ,,,so im like great i paid 150 to hear from a doc who has a prob himself,…..after i left i went to other room n talked paid 50 box for n hour ..n nothing ,,she justed asked me ,, an ssaid its anxiety but nothing was mentioned about ocd ,,, when i left i came out cryiing cuz i was hopless i mean if she didnt help me who could all she syas what anxiety is n all that stuff ,,,,but no steps or anything about how to help me ………..so i went online n started reading ….i was like cool this is easy …POSITIVE SELF TALK…. is the key so i started talking to myself n making myslef like everything i didnt n that whatever is happening it will go away ,,,but after like 30 minutes it came tback the fear ,the fear of meesing my eyes up the fear of having it forever the fear of reapeating it to myslft untill it goes away …..the only thing could came outa it was the flashes n sensations in my eyes ,,,,,, i was like hmm ,,online it said ,,think about it dont be afraid of it an accept ur thoughts ,,,,so i did ….i was like but idont even know what this is but im like well nobody can tell me so ill just try n calm down (BY SELF TALK ITS IN MY HEAD N ITS OK ITS A DISORDER ) guess what it did help as soon as it went away i was like happy n full of life ..than when it came back im like f–k off n it helped im like hmm thats something dan i had guilt that i was a smartass when it went away but a lost person when i had it …so after weeks i started thinking more n more ..reading online n line …….n i was like what guilt who m i guilting it ??myself are you ok man ??? n im like its just me ,,,nobody else…dan i went online again to get more steps n articles …so i read that ocd has 3rd person behavior …ok if u think about it it does …but its not like anybody is sitting in ur head ,,n thats when i started thinking n pannicking an made up me n ocd ,,,,,so i was like ok lets start ,so i was tlaking to myself n stuff n than i had problems telling myself who is talking me or ocd …..n alll that crap started happenig being scared n loosing me n it was ocd not me inside me ,,,,,,omg it was awfulll after a week i was like what am i doing playing a stupid litle made up game in my head … n than i started realising there is no ocd tlaking ,,its me n not knowing how to deal with the condition (the imaginary other perosn ocd in my head ))))) ,,,how did i realized it ??? self talk ,,,, u dont have to take seriously this ocd thing like omg omg omg ,,,,,,,,,,,,,, 8 months later i still am having problems wiht ocd ,,just no fear no repeating thoughts or anyhthing like that ,,, ,,,,,,,, months ago i strted looking at blank space like u know the chair has bars n i would look at the space beteween the bars not through the bars just that space like there was film or glass …hmm dont ask me why ,,,,,i strted realizing well im doing it n im hurting my eyes cuz i can feel m pinching but i though it wasnt normal so i kept doing it till they didnt pinch ,,,,but as u know its not like i just let it go ,i asked my gf n parents look at the space between the bars n shes like ok ??? im like can u see it or can u just look though it …she says i can but my eyes hurt ,,,,im like great im trying to make my eeys not hurt by doing it all the time ,,n she did it once n it hurt her eyes like a pinch ……so i realized i wont doit but that stupid urge came n i did it ….dan i read more n more n more ……..it was a long time after i read this artice that should of been read in begingin ,,,if u get the urge tell urslef its a false messege from the ocd condition ,,so im like its false ignore it ,,,,it has the right to be there but i dont act on it ..,,,,,,,,,,,hey guess what ,,it helped…,….i dont wanto type everything because it owuld take my hours n hours ……but i have not heard of a worse ocd than mine ……..my ocd caused my eyes to have alot of eye floaters and worries …im typing this now n i see eyefloaters which i never had 8 months ago ………….
    tips that will help u ……what i had
    scared of fear im like ok ?? i was really scared but im scared of fear ?? im talking about recent stuff how i overcame it ……its fear its normal so fear came to my head n im like yea its fear how can i be scared of fear ,,,,so i started telling myslef its fear its normal ..dont push it away dont be scared its just fear something normal .. it went away after two days and i havnt been scared of it ……..i had fear an ocd ,now i have less ocd n no fear at all …… im not fully healed but im not stiitng n feeiling scared of nothing …so randy u can still b aware of ur breating but think about ur fear and its only fear n act like hmm just fear noting else its normal ,,,,i can guarente u it will bother u less ……the worst part was fear not doing the rituals just the fear ……. ocd is very dumb its like loosing common sense ,,,,,so if its common sense issue ,,hey maybe this is just dumb and i should think aobut it ,,,,but in a POSITIVE THINKING WAY dont think about it n tell ursself ur scared or that it will never go away ..think positvie about each of ur thoughts n riutals ….i had read articles like ways to overvome ocd … n one said sopposably from a very trainer helper ……if u feel contamineted that worst treatment is to put ur hands in somtheint dirty like mud or toilet …..n sit with those dirty hands for hours …..im like that person is n idiot (the one who wrote it )
    i see that comeing but make ur hands dirty for a minute n keep telling urself its ok nothing is happening to me its just a anxiety disorder ,,n dan wash them …. n reapeat it untilll that fear is gone …its guarenteed it will help ………..but facing the fear or phobia what ever you have without positive self talk will only make u more scared ……………..how do u learn new stuff ???by looking hearing reading talking and reapeatingto urself that information ………same thing with us ocd ppl ,,,,,,,, i know i will cure my ocd forever thats a fact i been living without it for days ….but i didnt know how to respond to it when it came back …….just go into the thoughts n unarm them ,,,n i can guarente u ur ocd will get better ,,,,,,,n wehn u do get those thoughts dont b like omg they came back its ok they can ,,,,but those thought will b normal ……………ocd is all about feelings ……….anxiety and fear ……….. i started realizing that the feelings n that urge make u do the rituals …………. dont wait for axiety to go away just think about what causing in apositvie way nd it will bohter u less than pull out n think about something totally diferent ,, and anxiety will go away on by its self ,,dont u dare to push it away cuz u will make it worse ,,,,,its ,,,,,,when it come back think aobut it in a positive way ….. i started thinking once about a fear n it was like me going full force into the thought n telling my self like 30 positive things about tha thought ,,,,,surprisangly it went away .. …………………….but that was recently after i learned how to respnd to thoughts n realize fear n axiety is normal… but
    in big loads its starts to be a problem ………..so make sure u dont push it away or wait for it to go wayay cuz it wont help trust me ,,just do something u like to do ,,,,,, theres alot ,,the easiest way for me is lstenign to a song i like very loud ,,, ,,,,works great ,,,,but thats just easiest to me …i never for a day gave up after i went to the doc i was fighing and making myself think about other stuff ,,,but i never knew about the how to respond to it when it comes to u ,,,, baby its gold ………..how do u respond to it ??/? self talk ….
    i know if i went to the doctor ealrier n saw the site how to respond to it ,,i owuld be cured by now im sure ,,,,,,its just a matter of time b4 i get better n i know it ,,,,,i wish i could help ppl in person ,,,,,,but i cant really cuz idk any around me ,,,so i hope this aticle will help all of you ,,,,,,,,
    dont do the ritauals its a false meesege ur receiving ,,,,,,,,,,

  12. yea one more thing with my steps ,,,,which i wish i did em in my first month or earlier b4 i got in the deepest point of my ocd ,,,, i been able to go anywhere from cpl hours away with out ocd to cpl days without it completely,,,,,,so i really think its something that can be cured but it just needs work ,,,,and lota time ,,,and the problem iis when wen it comes i forget to work smart insead i work hard but my last weeks have been the most helpfull ,,,,,,, the problems with this is if a person isnt experineced with it u get urself into deeper ocd pattern ,,,,,but dan aagain how can u know how to treat it respond to it if u dont know or u just do ur rituals n are a prisoner of ur ocd like i was in first month ,,,

  13. I’ve just read this article and most of the comments… and it’s been a few days since I’ve found out that what has been bothering me for two years seems to have a name and is not something as uncommon as I thought it was. Actually, I read something last summer, in 2012, about sensorimotor OCD… but I didn’t want to accept that this could be it. So after a lot of frustration, I’ve come to accept it. And is not that bad, it really isn’t. Because you see that you are not alone in this. Right now, I actually feel better than I have in a long time. There were times when my ignorance and poor self-esteem really believed that I am the only person in the world thinking about this. And many times it left me feeling hopeless, frustrated and weird. On the other hand I was afraid to search for more information, not wanting to find stuff to make me more confused than I already was. But, being a psychology student, it is hard not to go deeper into this kind of stuff.
    For the past two years the only thing bothering me was swallowing/tongue/teeth awareness. And it has been bothering me a lot, believe me. I’ve also had a lot of pain because of wisdom teeth, which made everything worse. For all those of you in your 20’s, pay attention to wisdom teeth! They can cause a lot of distress.
    In these past two years I’ve come to understand what was going on and I want to share my experience with whoever is reading is. Personally, I know it is sensorimotor OCD, but I also somehow wanted to get stuck with these uncomfortable states, because I didn’t know this awareness had a name, I couldn’t understand how this whole process of flow is going on inside of every one of us, how everybody else seems to flow so well without caring about all this. It was a sort of curiosity too. Back then I didn’t even have any idea about Freud’s theories on conscious, subconscious, and unconscious and how everything works. So, I wanted to understand how it works, but my anxiety kept me for a long while not searching for more. I wanted to understand how it works to prevent these annoying states from bothering me in the future. Whenever there was a big event coming up in my life I used to feel a lot more anxiety than usual related to this awareness, because I was afraid of failing to enjoy that event in my life at its fullest.
    Truth is, this whole awareness thing, on any part of the body, is annoying to anyone who pays attention to it. Many OCD things can be annoying to anyone, if you give them just the thought. But the trick is, to let the thought go! Control is an illusion and ignorance is bliss. Your mind needs to learn acceptance and peace. Accept anything. Even the thought that becomes so annoying. Accept the fact that there are annoying thoughts, laugh at them and look them straight in the fear. Once you accept it, you realize just how small and harmless your fears are, compared to who you really are. It is a sort of paradox.
    And one other thing that I find extremely important is Self-Esteem. You must Believe. Believe in yourself and do things that make you feel accomplished, that make you feel good about yourself. When you feel good about yourself, you get to feel power and that goes above your anxiety. Build your self-esteem on things only related to you! Don’t put your dreams into someone else’s hands, don’t let your worth be dragged by anybody else but you. Is society that often make us feel so vulnerable and then we start all this war with ourselves because we feel weak and powerless.
    I believe it is important to understand all this that I find to be in the core of sensorimotor OCD… I think low self-esteem and anxiety play a huge role and these are the things that have to be worked on first of all. And mindfulness. Learn to let things go.
    I really recommend meditation. And as a great reading: The Power of Now by Eckhart Tolle.

    • I can relate completely to what your saying and had the same problem with the wisdom teeth as well !

      • Well written, how are you doing now?
        I’m pretty much over the worst part and start to get way better every day. I can relate to what you’re saying. WIth the Book I think the most important thing to understand is that we are not our thoughts, they don’t define me, how I am and what my values and actions are. Not 1%, I am still completely free to do whatever I want to do. That being said, if we give the thought power by f.e. by having fear of being embarrassed publicly by swallowing loud or whatever sensorimotor thing you wanna insert here, the thought becomes way more powerful and controls us more and more. So bluntly going into public and swallowing very loud (ERP) will confront ourself with the feared outcome and only then we can see how our believes about this being rationally dangerous/embarrassing will disappear and moreover our irrational fear will disappear because the body sees that there is no danger in the thing.
        What’s your thoughts on this?

  14. I have obssesion on my teeth and eyes.
    I have to wash my teeth tree times a day
    and i do it brush hard so my gums are sore on some spots and it little hurts while I clean them but I sill have to do it and imy eyes produce little more mucus than iusual and i have to clean th up all the time and chexk.them out …and when am I m public i.think about my eyes ase well. I also feel anxious right now and werid…. I jave other ocd simptpms as well. Hekp me.

  15. I’ve had this problem and it’s a pain in the rear. I’ve had it mostly with blinking and swallowing. The blinking issue has gone away and hasn’t really affected me as much but I’ve had the hardest time overcoming swallowing. I think the reason it affects me so much is because other people can hear it if you’re in a quiet area and close by them. This makes me more aware of it when around others. There’s really no solution to it.

  16. Ive recently come across the sensorimotor ocd, awarness of blinking. It came out of nowhere, although I was using erp for another obsession issue I was having and had no clue sensorimotor ocd existed. At first anxiety was through the roof and that I was loosing my mind. I have now used erp for blinking issue and anxiety is not as bad. Its can really be frustrating especially when trying to watch something on tv or whatever. There are times where it feels like thats all I think about. Havent used medication at this time, but am thinking about it. Sometimes the mentel rituals used to bring down the anxiety come fast and hard to stop. Only two people know of this my wife and therapist. When I first searched online for this issue I was a little relieved that I was not alone. My main issue now is my mind is trying to find another obsession to replace the blinking and I will not have it. Some days I wish I could just forget, but I know thats not possible

    • Hi joe can you please tell me exactly how you used erp for blinking? Im desperate for help after seeing several professionals without a clue how to address this

  17. Hi Steve, I have also have sensormotor OCD and for me it is a little different. Basically, for periods of time I cannot bear the sensation of my clothes on my skin and this sends me into spiralling states of panic and rumination to a degree that I am sometimes forced to escape through the use of drink and drugs. The strange thing is that this condition often lies dormant for months, especially if I am busy, but then it will come back unexpectedly in full force. I also suffer from menieres disease and the stress of the OCD exasperates my symptoms of vertigo and ear fullness. What can I do? In the past I have just rode it out until I have found something distracting enough to take my mind of it. I also live in South-East Asia and so there are no specialists here that would be able to help me. We do have alot of monastries though, as it is a Budhist country. I have tried meditation before but this has not really worked and I would love to know how to incorporate exposure response prevention effectively into my life. Thanks so much!

  18. I’m wondering if I have OCD with breathing. My breathing issue day and night 24/72 came out of nowhere 11 weeks ago (January 25, 2014). This was 2 1/2 weeks after gallbladder removal. I have gone through a bunch of testing with my pulmonologist including echocardiogram and everything shows clear. Both pulmonologist and my doctor are baffled. I think they are suspecting anxiety but neither one has come out and said it. I am going to see a therapist in 3 1/2 weeks. I have never suffered anxiety in my life and I’m a 55 year old woman. Here’s hoping this can be resolved and I don’t have to rely on any kinds of meds. I hate this feeling that I’m suffocating.

  19. Hi Dr. Seay, thanks for your article which has helped greatly. I have been anxious about the swallowing sensation and with time realized it was a natural body function and try to fight it anymore. My issue is that although the anxiety has subsided I still notice and ‘feel’ the sensation. Is it possible for my subconscious to take over once again or have I broken this conscious/subconscious barrier?

  20. Hi Dr. Seay
    I always breathe through my nose.and i try to breathe slowly and deep but..
    I became obsessed with my breathing for 10 years.
    With each breath, burning sensation in my throat and sometimes cough.
    When I do not think about my breathing everything is ok.
    would you please help me?

    • I have been feeling like you for about 9 months it started when I thought I hadn’t taken a full breath and it’s just got worse.
      I seem to breath through my nose iv given myself a cough as an attempt to take a breath so I have now become obsessed with my chest!

  21. About three years ago I noticed I couldnt close my mouth properly without strain and became very self conscious about it. I had actually just got clean from drugs for the first time when it occured, so I think that might have triggered it. Well eventually I got sober for good and found out that I actually had a upper jaw that grew to far down and gave me a gummy smile and lip incompetence. So still be obsessed with my mouth being closed and my tongue in my mouth, I had jaw surgery six months ago thinking it would solve everything. Problem is, im still consciously always thinking of my mouth and it is driving me crazy. It has put my life on hold at this point. Im waiting to get my braces off in a month too see if that helps, because I know my lips always get stuck on my braces, so that could be a contributing factor. If that doesnt help, its back to the psychiatrist.

  22. Dear Dr. Seay.My name is Bernardo and I am from Mexico I just found your website and I am amazed by all your knowledge about OCD. I do have OCD , specifically Somatic verifier type and I am taking Luvox (fluvoxamine)and pregabalin. I constantly feel a muscular tension in the back of my neck which produces me anxiety (annoying and stressing sensation. and also i perceive visual non normal phenomena which is part of the symptomatology. I have been felt better ultimately but has been a long and hard way and i don’t know if I am doing things correctly.It would be incredible and a great help to know your opinion about my situation. Thanks a lot and peace and love

  23. If only I’d read this article when I was younger! So about a year ago I started worrying that I was going to swallow consciously, making a loud noise whenever I swallowed. I haven’t been able to swallow quietly/without restricting my throat since, and I’m worried because I can’t even remember what it feels like to swallow normally, and I don’t even know how anymore. Plus after reading this article I began to worry that I would start blinking/breathing badly also, and thought, “What if that also becomes an ‘unchangeable’ habit?” I mentioned it to my therapist, but she just said to do ERP on it, namely asking myself, “What is the urge?” and delay/change it — which, frankly, hasn’t helped much. Does anyone have any tips? Thank you so much!

    • Part of what you’re describing seems to be related to the crossover between hyperawareness OCD and social anxiety. If the worry about swallowing relates to the idea that swallowing loudly would be noticed by others, part of addressing it effectively would involve ERPs built explicitly around loud swallowing.

      • Ah, thank you so much! I talked again with my therapist more in depth and we talked about acceptance to counter the OCD, which I think is the best way to do it. Also, I think that not minding/giving meaning to the thought is really helpful.

  24. oh man, like I really don’t understand how if when the obsession about breathing comes on, what am I supposed to do? I can’t just not play with my breath, once you become aware of your breath and it feels like you are suffocating to death, what do you do? you take in breaths of air. I was working with a therpist trying to ert my way out of this but honestly he has no idea. its like where does the obsession end where does the compulsion begin/ i just feel like forcing myself to become aware of my breath is useless when there is no way to stop the compulsion to “control” my breath. Thank god for zoloft. thank god for xanax. but I have been dealing with this stupid problen for 8 years and I feel like no one really understands what to do to make it go away. yes i understand that gradually exposing myself to my breathing is a start but then what? becasue as soon as I’m aware of it i start controlling my breathing, how can I not, its what we do? I just don
    t get iot. i just let another therpist go becasue he literally told me, I don
    t know what to tell you. thanks for at least having a website about this.

    • The obsession is the persistent breathing awareness; the compulsion is typically the attempt to control the breath, or — alternatively — the attempt to not notice the awareness of your breath. This is why focused awareness can help — it helps you practice nonjudgmental awareness. In your case, treatment might also incorporate nonjudgmental awareness of situations in which you feel you are controlling your breath. As a side note, control is tends to be more nuanced and less binary. Looking at it as an all-or-nothing phenomenon may be less helpful.

  25. I felt this breathing ocd when I was a teen. At that time I couldn’t able to find the actual reason or even the name for it. It made me to panic a lot and my anxiety level was off the charts. After few days, it disappeared completely. It never returned for almost 7 years untill recently. After a stressful event, I begin to notice generalized anxiety like symptoms along with breathing ocd for 7 weeks. I also had insomnia during this time. I am currently taking antidepressant after consulting a psychiatrist. Also I took one session with a psychotherapist. She said that I am the one who is incharge of my thoughts and should control them whenever they arise. I don’t understand whatever she said. But I have used several cbt workbooks and online materials to control my sleep dread. Since I couldn’t able to find any therapist specialised in dealing with breathing ocd, I want to follow your ideas. I think the obsession of mine will be more likely that I will die if I don’t control my breath. The compulsion part is conscious breathing. What will work in this case? Does holding breath for a while work because it may teach my conscious brain that breathing can occur involuntarily.

  26. Hi steve i got this hyperawareness obsession for about 7 or 6 months im on meds right now and i worked with a therapist and psychiatrist. The sessions with the therapist really dont work it out because she dont know a thint about this and with the psychiatrist was another history he really help me out but because of money issues i had to drop it out like 3 months ago. Im really hopeless if i look back nothing has changed too much with my problem its seem like im gonna be like this forever and not gonna be able to enjoy or progress in life. my obsession is related with swalowing its a convo with the awareness of itself and exesive salivation líke i cant stop swallowing and if i force myself to not swallow my mouth fill up. Dr steve what can i do to recover from this problem idk what more to do. If you read thanks a lot. Your article and the people who post about his succes here hel me in though times

    • Rafeal same problem here.I stoped going to college because of this issue. It all started when I took a college class and I noticed my saliva and swallowing and ever since then it hasn’t stopped. It’s like my brain don’t want to let it go. I try to avoid quiet places because when you swallow too much saliva constantly it makes your stomach make noises. I have to watch my talking because I don’t want to spit on people. It is the worst. I’m very depressed because of it. I want my old life back. It’s a 24/7 thing. I need help!!!

  27. 3 weeks ago i had unwanted intruisive thoughts and i had a lot of fear and stress during first two days.THen after googling and watching treatment videos my stress level came significantly low.I had days where i dint even feel like i had any problem.And then one day suddenly another thought poped in and i became anxious again.BUt Again i started feeling better after some days.Even when the thoughts came i could easily disengage from those thoughts as i started saying to myself that everyone has unwanted thoughts and i shouldnt take this as a problem.THat really helped .But again 2 days before suddenly i started obsessing about swallowing my saliva.Now i dont have much stress because before whenever i had stress before i used to feel like my stomach is tightening and uncomfortable but now nothing that sort happens.BUt still i have been swallowing my saliva quite often because of the thoughts.NOW my question is if i have sensorimotor ocd or not and will it fade if i dont take any stress#

  28. I have a obsession with my eyes I’ll look at things but I’ll stare at them all the details on the object its ruining my life especially in public I domt know where to stare I cant play video games I’ll pay attention to the detail of the game when I tey to play idk what to do I’m taking luvox now

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