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.
This is first unit of the guide. To see all units in the guide, click here.
This is the first unit in Module 1: Getting Your Mind Straight. This module is all about getting the right mindset which is the foundation for change. In psychology terms we’re going to be doing psycho-education or cognitive therapy, the first part of the Cognitive Behaviour Therapy (CBT) process. Completing this section won’t solve the problem by itself, but it’s a huge first step.
What’s your problem?
What is the problem you are facing right now? What is it, exactly? You might think that the problem is being conscious of some bodily process, but I would say that isn’t the real problem. The real problem is the anxiety and pain you’ve associated with that consciousness. Each time you become conscious of a bodily process, certain beliefs in the subconscious are remembered, and that makes you anxious. And that anxiety is unbearable.
Take consciousness of breathing for example. When you think about it, there’s nothing inherently that makes you anxious when you are conscious of it. I’m conscious of my breathing right now for example, and I’m fine (this was something which once gave me A LOT of anxiety). And this is true of most of the population; they might consciously control their breathing for a while (say while doing meditation), and it causes them no issue at all. What’s really making you anxious are the beliefs (and stories) you’ve created around this consciousness. If you believe (even on a sub-conscious level) that ‘my quality of life will reduced while I’m conscious of breathing’ or some other negative belief, then every time you are conscious of breathing, you remember this anxiety inducing thought, and you end up being anxious!
Again, my point here is that the problem is not consciousness of bodily processes in of itself. That doesn’t cause anything, and isn’t associated with anxiety. It’s our beliefs surrounding it that are the problem. The process for most people is:
(1) Consciousness of bodily process -> (2) Negative beliefs (often subconscious) -> (3) Crippling anxiety and pain
So people think that consciousness of bodily processes is the problem and try to remove it, but this doesn’t work long term. This is because it’s pointless try to distract yourself or forget about something you’re scared of. These don’t work because of the way our brains work. The more you are scared of something, the more your brain will remind you of it, and hence ironically it’ll be at the forefront of your mind. From an evolutionary perspective, if there’s a threat that you should be worried about, your brain make sure you’re away of it. For example say you saw a highly venomous spider in your bathroom; there’s no way you’ll just forget about it. Every time you walk in, you’ll be on high alert until you’re sure the spider is no longer there. Similarly the more scared we are of a particular thought or sensation, the more our brains will remind us of it.
The goal is to have no anxiety
That takes us to the goal of this program. The goal is NOT to be not conscious of our bodily processes, but rather to eliminate any anxiety associated with them. Your goal should be that you can have that consciousness right there with you, but feel no anxiety. In other words, you are completely comfortable with it being there and have no desire for it to go away. We want to decouple being conscious of the sensation with any negative beliefs and anxiety.
I often think of it as imagine there was some guy running around following all day saying “be conscious of your blinking!” or “make sure you don’t have too much saliva!”, or whatever it is. The goal would be to have no trouble with this guy; he could go on keep saying that and it wouldn’t trouble you at all. It can be very empowering to just make this shift from running away to wanting to face the sensation head on.
The way you measure success will change too. It’s not about how long you’ve gone without forgetting the sensation; that’s irrelevant. The only metric is how much anxiety/pain you feel over the long term. The less anxiety you feel (though there’ll be ups and downs), the better you’re doing.
Funnily enough, once the anxiety goes, you will forget about being conscious of your bodily processes. That’s what happened to me; once no longer had anxiety associated with being conscious, I went long periods without ever remembering about it at all. But remember, that isn’t the goal. The goal is to eliminate anxiety associated with bodily processes, not avoid consciousness of them. Once the anxiety is gone, you’re all good.
Think about how you’ve been trying to deal with this. Have you been trying to run away from being conscious of the sensation? How have you been measuring success?
I just wanted to say, reading this is so comforting. It’s even more comforting knowing someone else has forged a path toward living with this terrible form of OCD. Terrible, yet treatable. Thank you! I can’t wait to keep reading more.
I think I just felt a bit of hope by finding this website ;_; <3
Hey! Great text! You write in your text that consciousness of a bodily process isn’t the problem because everyone has this but instead it’s the anxiety we create around the process. You explicitly use “bodily process” but most of my Sensorimotor OCD doesn’t come from any natural body process such as blinking and swallowing etc. But instead from sensations of for example my lips or gum, which i presume not many get naturally. So I’m just wondering whether it’s the same for both?
Hi Johannes. Sorry for the late reply. it is the same; there is actually a whole set of similar OCDs known as hyperawareness OCD, where one gets fixated one something which isn’t necessarily related to the body. e.g someone might notice their heartbeat, or the sound of the fridge or something like that.
Aadil of Sydney, your blog has truly been a lifesaver for me! There isn’t much information on Somatic OCD on the internet, and to my knowledge, it hasn’t been the subject of any studies, but you have realised the most thorough analysis of it by far. I am currently struggling with the blinking and swallowing variants of this, but I started to feel so much better after you somehow shared here, on this website, my exact thoughts and beliefs. You really felt and thought the exact same things, many years ago, in the opposite corner of the Earth! Psychology is of great interest to me, and I would like Somatic OCD to one day be the topic of academic research in the field. Perhaps we could have a chat and exchange ideas someday? With best regards, Patrick of Romania.
Thanks for the kind words Patrick! I’m humbled to think this is being read all around the world! You can reach me on my email on the support page. I do hope there is more academic research done in this area as I think it’d help so many people!