Note: All parts of the guide have been updated as of Sep 2022 after much discussion from those suffering from SOCD and my own experience. In particular I have considerably adjusted the ERP approach, as I now believe that is better to simply avoid doing any explicit rituals, rather than trying to literally do nothing, which seems to have been causing some issues for people.
There was a time in my life where I was utterly miserable, completely consumed by anxiety and dread. Each day was a struggle, yet no one else could see or even knew what I was facing. I felt like I was in a bubble, suffering alone silently, while others went about their lives seemingly without any troubles.
The problem was that I just couldn’t stop thinking about bodily processes like breathing, blinking and swallowing. I didn’t want to be conscious of them. I wanted them to happen automatically so I could get on with my life. But the more I tried to avoid thinking about them, the more they followed me and the more anxious I got, until every waking moment I was thinking about them. It wasn’t just anxiety though, it was dread and a constant pain I felt deep inside. I remember I kept thinking “Am I going to be haunted by this for the rest of my life?”. There was only thing I wanted, and that was somehow to be free of this affliction.
I can now say that I am. My darkest period was many years ago now, way back in 2012. It took several months initially, and it wasn’t always smooth, but I eventually got back to living a normal life.
What is sensorimotor OCD?
I didn’t know it then, but what I was suffering from something known as sensorimotor OCD (SOCD for short). Essentially you become aware or conscious in some way of some bodily sensation; it could be breathing, blinking, swallowing, or a whole host of other things. But you don’t want to have this consciousness of it. Perhaps you think it means you can’t enjoy life, do things normally, or maybe you’re worried about health effects from not doing them properly. Whatever the reason, you want it gone.
The problem is, each time you think about the thought, the awareness is there. You try to stop thinking about the thought; but that doesn’t work; all that you can think about IS the thought, and so the awareness is constantly there; exactly what you don’t want. And you feel terrible anxiety and pain every moment you remember it. You might try other rituals (mental or physical) such as trying to ‘do it properly’ or distracting yourself, but these don’t really help either. It’s easy to get negative and think that this will ruin the rest of your life, and this makes you feel even worse.
It may not seem like it, but this is actually a form of Obsessive Compulsive Disorder (OCD). Although quite different from classical forms of OCD like hand-washing, the fundamental principles are the same. There’s some faulty beliefs involved and anxiety, and you feel like doing behaviours/compulsions to mitigate it. However, these only make the anxiety worse.
But what makes SOCD worse than your usual kinds of OCD is that you can’t escape from it. There’s no respite. You can’t run away from your thoughts. And the more you’re worried about, the more you remember it, and it can make every waking moment a living hell. Unfortunately, often suicidal thoughts aren’t far away. There’s also often a constant gnawing feeling of pain, dread and discomfort, which is not the case for other forms of OCD or anxiety.
Note: Throughout this guide, when I use the word ‘obsession‘ or ‘sensation‘, I’m referring to becoming obsessively aware or conscious of some bodily sensation that you can’t stop thinking about, such as breathing, blinking, swallowing, eye floaters, your nose (there’s a never ending list of these!).
A Step by Step Guide to Overcoming Sensorimotor OCD
Having been through this and been blessed to be on the other side, I want to help people overcome this rare, difficult to diagnose, yet very debilitating condition. I’ve written a step by step guide based on principles used by psychologists as well as my own experience. I’m also here to help with any questions or issues you might be facing personally.
My guide is structured as follows (see all units listed here):
Module 1 – Getting Your Mind Straight (CBT): This is all about understanding what’s going on in your mind with sensorimotor OCD. We’ll explore the right way to think about SOCD, consider problematic beliefs causing your anxiety and how these can be challenged, and then finally how to develop the right attitude to overcome this. This is the foundation to change, and can be completed relatively quickly.
Module 2 – Exposure and Response Therapy (ERP): This is where we actually start taking action and begin facing the OCD head on. Essentially we ‘expose’ ourselves to what we’ve been afraid of, and eventually our brains will habituate to the sensation and anxiety will diminish. We’ll first look at what your existing triggers and compulsions are, then the different kinds of exposures you can do, and finally discuss your mindset and putting this into practice. This can be quite difficult, but this is where with consistent effort, the anxiety will really begin to decrease. This stage usually will take a month or two, after which the anxiety should be significantly reduced.
Module 3 – Moving Beyond Sensorimotor OCD: This is where we look beyond to a life free of body-focused obsessions. Generally, people find it can return, months or even years later. Sometimes, some anxiety lingers as well. This is about dealing with these kinds of things so you can be anxiety free in the long run. We want 100% recovery, not 80% or that it comes back again and again.
I wish you all the best in your recovery. A normal life, completely free of this, is possible for you 🙂 . I’d love to hear your stories in the comments, and feel free to leave a comment or ask a question!
I’ve read a bit of your article and I’ve noticed this for months now, it started when I was feeling pretty anxious and then out of the blue I was just conscious of my blinking! The first few weeks I noticed it were quite hard and I did start feeling down because of it but I wouldn’t let it stop me from seeing people and going about my daily life, I found this article before which told me to just think about my blinking but that didn’t really help with me and luckily I started seeing a therapist in January to do with my anxiety and depression after being on a 9 month waiting list and he said it’s best to accept it and then focus on other things and to try not to be anxious when I am conscious of it.
After speaking to him I felt relieved and it did go away for a couple of months but came back in March, I have been trying to do the same thing but i am still aware of it however this time round I see the blinking in a more relaxed way, I can get anxious sometimes though still, usually if I’m in a busy place or even just on my own at home but the anxiety’s not as bad as before and speaking to my therapist has helped a lot as well, I find this article really interesting from what I’ve read so far too but I’ve got a bit more to read yet, sorry for the essay by the way haha, I thought I’d just share my experience!
Thanks for sharing your story! What you described sounds quite familiar (blinking was one of my major obsessions). It’s good you’re seeing a therapist and have someone to talk about it with.
The only thing I’d say is don’t worry if awareness of blinking ‘comes back’. When you learn to accept it and it ceases to cause you any anxiety, it won’t matter whether the awareness is there or not. The main thing is for you to have no anxiety and be able to just live your life normally.
All the best and I’m happy to answer any questions if you have any 🙂
Hi there – great article! I’m hooked on blinking at the moment and starting ERP. One of the main things my mind is telling me is that my mind will never ‘unlock’ the thought of blinking. I’ve gone most of the day today without any anxiety (it was mostly this morning). Hoping to make some progress soon
Great job on starting ERP.
Regarding that thought, the key to overcoming sensorimotor style obsessions is to actually be comfortable with the obsession. So yeah, perhaps you DO remember the awareness or thought of blinking for the rest of your life. But as long as you have no anxiety, and it doesn’t affect your day to day life, then it doesn’t matter. So its about reframing your goal here. https://sensorimotorocd.net/1-1-the-goal/ really gets into this.
It’s impossible to guarantee a thought not appearing, but we can affect whether we anxious about it and whether it affects our lives.
This makes so much sense, thank you Aadil!
Hi I suffer from the OCD swallowing. You mention that I should resist the urge to swallow, however I find that actually tends to make it worse then if I were to just swallow whenever feels “natural”. To be clear, I’m not so much obsessed with swallowing, but more the saliva just keeps building up in my mouth at times which forces me to swallow it.
OK, thank you
Thanks again for the advice. Is there anywhere that supports this approach of letting the saliva sit and not swallowing it consciously / the swallowing being the compulsion? Because I find that when I use that approach I’m often debating when to swallow the saliva which makes it worse. And I’ve seen many other resources say to just swallow whenever and not care – why would this be the wrong approach?
OK thank you again for all the help, it’s really appreciated. Yea I’d say whenever I feel the saliva build I often try not to pay attention to it and just let myself swallow whenever I get the urge / it feels natural – usually it’s every ~30 seconds but could be more / less frequent depending on how engaged or distracted I am in another activity. If I’m engaged in another activity usually it happens without me thinking about it – but it’s when I have nothing on my mind that things get tricky and I find my body doesn’t swallow the saliva as “subconsciously”. But it sounds like we are saying basically the same thing?
For me the thing is the swallowing saliva is not pleasant, if anything it’s kind of painful. So (I think) my compulsions are reaching for food or water which feel good to swallow. But I hear you on your point here.
I actually got over this swallowing issue before and it wasn’t an issue for a few years – I started a super busy job and I think my brain basically just didn’t have enough space to think about the OCD. Whenever it arose I would just tell myself don’t fight it, let it be and within minutes it was gone. But then out of nowhere a month or so ago it returned but using the same approach as always it persisted that day and has basically been 24/7 since then, probably because I started doing a bunch of googling and I turned it into a bigger problem than it is. At the core this definitely is mental, but I do wonder if there could be anything physical that’s making this harder to deal with too (I’m seeing an ENT soon to confirm).
Hello, thank you for putting this together. Have you really overcome this issue? My ocd is focused on saliva and social interactions. Would you say that the acceptance is more important than the erp?
Hi, I have swallow OCD. I swallow every second and it feels horrible. I don’t know how to stop it. I tried to swallow after 5 minutes (I put a timer) but I can’t resist.
I feel saliva in my mouth and I swallow.
Do you know any tips to not doing it?
I need help, I feel so frustrated
Hi i have swallowing ocd but now only 10% almost gone.. 1st remove fear if u have fears.. see theres nothing scary in ur sensation its ur mind making up problems and staying focused on it!! Key tip is acceptance and not judging what ur feeling .. if u have awareness accept it to be there .. let that second or moment pass without judging or getting anxious like oh no i started noticing again !! Keep silent!! Dont try to do certain things to swalow in controlling ways!! When u do it consiously u get stuck for more minutes hrs focusing!! If u have addiction or urge to swallow each time u feel it!! Try reducing try to keep saliva in ur mouth more and let it wait!! Its all training ur mind!! And dont be afraid if u dnt control it it happens automatically!! When talking also dnt be afraid read books and train ur focus to nt focus on the mouth! Let sensations awareness be there and try to mindfully focus on smtn else ! Base tip is to remove anxiety and irational beliefs that it will be stuck!! As thoughts dnt try to fight them resist them ! Let it come and pass like clouds ! Engagement wt sensation n thoughts makes it worse! Show ur mind fake it that u dont care! Remove the fear response ! So ur brain learns theres no danger! And slowly by time during months of practice u change! Bt repetition is important! Deciding ur atitude and moving working through it! U can also put reminders and swalow conciously during the day! To see n train ur mind its boring! Bt when u get sensation and try to swalow in controling ways that keeps u stuck! And offcourse change beliefs/attitudes/ avoidances !! Whatever u do u have to show ur mind no fear! No rejection! No fighting to stop! Checking if its there! Needs time and practice !
U can also chew gum and train ur mind to focus on somethings else.. and Erp is to expose urself to salivating response prevention is to remove fear !! Anxiety!! Get used to being uncomfortable!!
And remind urself that the sensation is always there ! And everyone notices from time to time!! Its us making a problem !! Just swalow if u need to and move on!! When u feel it and start thinking abt it all day!! That thinking process should stop! Put a reminder on ur phone every 10 mints! And see wheres ur focus! On thoughts / sensation! Excercise ur brain muscle to be flexible in shifting focus! On anything possible! Present moment! Nature! Books! Tv! With people! With the sounds near u! Exercise to focus on smtn else ! By time u have great benefits!
Great advice Arpie. Glad to see you’re doing better!
Hi, I have a breathing obsession. It is seriously affecting my life. Whenever I feel anxious, I try to breathe calmly (Is this an obsession?) Also, have you taken pills for recovery?
If it’s giving you a lot of anxiety and mental anguish, and the anxiety is centred around not wanting to be aware of breathing, then it sounds like sensorimotor OCD.
There’s nothing wrong with trying to breathe calmly necessarily…it just depends. If you are trying to run away from awareness of breathing and so are trying to control it, it could be a problem. But simply taking some time to do conscious breathing is often good for anxiety in most situations.
Nope, I personally did not take any pills.
Hi Mars, has it got better? I am also going through this. I cannot breathe properly when i think of it.
I feel even worse than people with typical SOCD. Since I have awareness of my fingers or the fingers touching or something like that. It came originally from me needing to touch certain places or else “somebody close to me would die”. But then, later on, it just morphed into feeling this unpleasant sensation in or around my fingers instead. Sometimes it’s lips and tongue too. Is that too somatic OCD even if it’s not a bodily process? This whole question may be one giant compulsion lol, but all I see is people with breathing OCD or blinking one.
I would consider that a kind of sensorimotor OCD, since it’s to do with the body. But even if it’s not to do with the body, if it’s about being ‘aware’ of something it falls under hyperawareness OCD, and the principles are pretty much the same.
Hi, since one month i became concious about my breathing. Now i cannot remove my focus from it. I am unable to breathe properly whenever i think of it. Please help me. It has become very frustrating. I feel like crying everytime.
That’s what this guide is for! Breathing is one of the most common ones. Please read through and I hope it can be of benefit.
I have all of them, but the swallowing triggers me the most. I try to stop thinking about swallowing, but every second I remember it and I end up swallowing again. My throat hurts now and I don’t know what to do I can’t find peace will this end or something
If you do the right things, God-willing you can get better. Many others have improved. The key is, dont try to ‘stop thinking’ about swallowing. Rather let it be, and get comfortable with the awareness.
Hello. I have gone through therapy three times and I still have it. It is better but still here. I also have extreme anxiety seeing were I am in my life. I loved my life. This pandemic messed me up. What am I doing wrong? I still work from home like I always have. Should I be going out every day? Would that help me get back on track? I got a puppy to fill my life with something else other than work and obsessing. I don’t have children and I had to give the puppy away because she needed more love and attention than I could muster to give her as I am truly depressed about this. Where do I go no? I am so tired.
Hey Rosa! I’ve replied to your email. I’m probably not the best person to answer some of the questions you’ve raised here, as I’m only really comfortable answering questions about OCD. Hang on and all the best; remember that recovery is possible and has happened for others! Praying for you
I have become intensely aware of my breathing lately and now, I try not to think about it or focus on something when I’m reminded of it, but often I can’t help but begin to panic as I’m afraid that I’m breathing too much and not enough, and I make myself dizzy trying to breathe normally. thanks for sharing. i do have ocd and i guess this is just yet another presentation. definitely makes it less scary to know it really is in my head in a way and that others relate
Get used to it being there (so no need to try to stop thinking about it), and get used to not breathing ‘normally’ (i.e., no need to try to breathe any certain way). That’s when you will have nothing to fear.
I have swallowing OCD. Probably made worse by now having been diagnosed with it and doing tons of research. I have experience panic and anxiety for the past 7 years, but now for the last month this bout of OCD has popped up. At first I was hopeless and useless. I honestly can say that I wanted to die. I could not sleep, for my swallowing would wake me up.
I just wanted to know if anyone also starts to feel a “lump” sensation when they hold off from swallowing for a long time or even 30 seconds. The saliva, yes, does bother me. However, even when I am not salivating much and am not thinking about that aspect of it I get this sensation in my mouth and throat like I NEED to swallow. It’s like when you get anxious and you need to gulp. It’s certainly worse or can be when I’m around others and it’s quiet. My partner, who has suffered from OCD in the past, I notice swallows when I do which makes me insane with anxiety. I just want to know that I am not alone I suppose. If anyone has any advice or information on this I would be forever grateful.
Hello, I am from Kazakhstan. (I’ll say right away I’m writing through a translator). I have been suffering from sensorimotor OCD for over 5 years. At first I got stuck on swallowing, then after a certain time on blinking, breathing, etc. Correction, it all started after a panic attack at the age of 15. Then, over time, the number of things I obsessed over increased. I began to get hung up on how I write, eat, talk, walk and much more. Over time, the tension grew, and he began to lose weight. Now I don’t understand how I’m talking, how this process happens. It’s terribly hard for me, I have to think over every word and understand the essence of every word. Does this apply to sensorimotor OCD as well? I have practically no money left, in Kazakhstan and Russia there are no experienced specialists who know how to treat this disease. All the time I fell for charlatans and only lost money and time. Over time, my condition has only worsened. please answer me. Can I chat with you about this?
Hi, I’m dealing with the breathing issue. It keeps me up when trying to sleep because I feel like my breathing will stop if I don’t control it. Even though I know it won’t. Any tips?
I think I have breathing OCD .
I focused on my breathing whenever i am ideal and the thought goes away when i am occupied with some work.
Especially during night when i try to sleep with no distractions like Mobile / books , i focus on my breathing . Its challenging for me to be ideal as i fear i will focus on my breath again.
Any tips to fight this ?
That’s very common. The guide should hopefully help. You need to get used to be okay with having the awareness of breathing and being okay with it, while being idle. So you can practice by setting some time each day to be aware of breath and do nothing else, til you get more and more used to it.
Quick question…..So I’ve been practicing acceptance for about a month now and the anxiety has definitely gone down, but I’m noticing that even in moments with very little anxiety, my brain is still reminding me of my sensations over and over again and that’s what has been scaring me because it feels like its never going to go away. Did this happen to you at all when you started getting better?
Yeah that happens in my experience. You can keep thinking about it with less anxiety, or sometimes a bit of anxiety pops up here and there. Again, it’s about acceptance of all of it in my opinion; like accepting those sensations might keep being there. Of course when you really accept it, after a while your brain will not remind you of it probably, but you can’t force it. You just kind of focus on getting on with your life I think.
I appreciate your work, thank you! For me, the obsession is the feeling I’m breathing ‘wrong’ and the anxiety manifests as a lot of tension in my shoulders. I feel the general literature online can be confusing
The main problem with it involves the mindfulness approach and purposefully drawing attention to the issue. I think it is well meaning, but there is a difference between awareness and attention (as dr Greenberg exlains).
We should allow and invite awareness, but should not actively hold the issue in our attention (which just perpetuates the problem).
I’d be very interested in hearing your opinion on this and how you thread the needle between attention and awareness.
All the best
Great point. I’m planning on revising this guide and I think this is a key point which I haven’t made clear enough. I think I would advise caution with mindfulness insofar as it can be a reason to focus on the sensation, whereas as you say, you just want to be inviting awareness but not doing anything to keep it there.
Ultimately in the end, I think what you want is to have an attitude of acceptance and inviting the awareness, but then not doing anything about it at all. Even strategising about what to do is something which draws unnecessary attention to it. That said, I feel initially mindfulness can be useful.
I have somatic ocd and many people advised me to learn the skill of letting go of control . and they say controlling the breath is compulsive behavior. but I can’t stop doing it. they advised me to give up. but how? is it possible. i know i will never find the right breathing pattern when i am suffering from ocd. so how to welcome it without interfering
I’m stuck on how to experience it. for example I see my nose when I talk. yeahhh it’s okay. but I don’t know when I talk my teeth touch or not. I don’t know the words that make my teeth touch. So how should I experience it? how it will be. I will try to talk without control (this is super hard). Or it would be: “Oh, I’m paying attention to how the mouth works. I don’t know what it usually looks like. I’m not going to find the answer. And so I’ll try to talk teeth touching (just whatever I choose) for a while I thought hmm I’m controlling my teeth so they don’t touch so now I’m going tove on to let them touch .it’s exciting !!!! “I find method 2 very good, but people say proactive control is compulsive behavior. they said I should not control but let the brain work on its own. what should I do
I think something like method 2 makes more sense to me. Not trying to get to some ‘answer’. But I think it’d be like it doesn’t matter whether the teeth touch or not, or how it feels, just go on talking. No need to test and try out different methods or consciously observe them I think.
My name is Noah and for the longest time I thought I just had Anxiety induced swallowing but after reading this I can say I have sensorimotor OCD. I’ve had this problem for about 8 years now and it’s challenging just living regular life but I’ve gotten by. I live alone and work in a loud factory I limit my time with my family whom I love very much and usually decline to hang out with any work friends or other friends. While I don’t mind swallowing or thinking about it I cannot swallow in front of other people and that’s something I thought I would never over come, until reading this. I’m very interested in anyone else who has this problem and would like to normalize it by being around one another or if you’d just like to talk online.
My email email@example.com
Discord Blue Banquet#0802
That sounds really challenging, and I’m sorry to hear about your difficulties.
There is a social component here for you, perhaps tied to social anxiety which complicates things. If you check out Dr Seay’s articles on the resources page he touches on these kind of fears more than I do, which may help. I hope you can get back to being able to spend time with your family and friends, it is DEFINITELY possible for you.