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 unit is part of a guide. To see all units in the guide, click here.
In this unit, we’re going to build on what we talked about earlier. There’s various beliefs people have associated with consciousness of bodily functions which cause their anxiety. As mentioned in the previous unit, it’s these beliefs that are the problem, not the consciousness of bodily processes.
Note often these might be beliefs which are in the subconscious; you might not even believe them on a rational level, but they still cause you fear. It’s like someone who knows there’s nothing to be afraid of when public speaking, but stills feels a lot of anxiety all the same.
Regardless, the first step to removing our SOCD is to challenge these faulty beliefs. The idea is to break down the entire set of beliefs and see where they don’t make sense, and replace it with something more accurate.
Challenging a belief can be thought of in terms of a trigger, automatic belief and a challenge.1 The trigger is the situation in which we end up feeling anxious, the automatic beliefs are the ‘faulty’ beliefs we hold which ultimately cause the anxiety, and the challenge is about how that automatic belief might not really be true. When we internalise the ‘challenge’ as to why this automatic belief might be wrong, anxiety is reduced.
Challenging SOCD beliefs
Let’s take the example of being conscious of blinking. The trigger in this case is simply awareness of your own blinking (it could be situation specific as well, e.g. when you are reading, but more on that later). The automatic beliefs can vary a lot, but often are something like ‘while I have this consciousness, I can’t do anything normally or enjoy things since I have to worry about this.‘ Worse still there’s often the belief that ‘this might follow me for the rest of my life, so I’ll NEVER have a normal happy life’, which is even more anxiety inducing. You might feel horrible right now, and every time you are triggered you think that this feeling will be there for the rest of your life. Naturally, the thought of living an anxiety ridden life forever is about as bad as it can get.
Let’s try challenge this. Why can’t you live a normal life with this consciousness? Maybe because it makes you anxious; but why are you anxious at all? Usually, it’s because people think they can’t perform their normal functions while they have this consciousness. But in reality, so long as you’re not spending time trying to consciously control them, if you just get on with your life, you’ll find you CAN pretty much operate as normal. You can drive a car, take a test, watch a movie, talk with people, and so on. It really doesn’t affect you much (if it all) if you don’t give it conscious attention. Even if there was some effect, like sometimes it being a tiny bit awkward when you recognise your blinking, it really isn’t a big deal; it doesn’t have a big impact. So there’s no reason to be anxious; if you didn’t have the anxiety associated with it, there’d be no reason why you can’t live a more or less normal life.
In table form:
As you can see above, often these beliefs are in sets and related to each other. There’s many many variations of such faulty beliefs, and it’ll be specific to your situation. In the end though, you end up with severe anxiety, usually worrying about how you’ll escape this for the rest of your life. Generally there’s some kind of feared consequence.
Some common SOCD themes include:
- Health related e.g. ‘If I don’t do my breathing correctly, I’m going to not get enough oxygen and pass out’ or ‘what if I choke on my saliva’. These focus on consequences to do with health
- Social anxiety related beliefs: e.g. ‘what if people notice my weird blinking and judge me’.
- Not being function or do something normally e.g. ‘what if I never live a normal life again, or what if I can’t take my exams?’ (as above)
- Not being able to enjoy life e.g ‘what if I can’t ever enjoy reading a book again because I keep noticing my blinking?’
There’s many more out there. You can see in most of these cases there’s some feared outcome. I’m not going to challenge all of these now, but I’ll do one more on health anxiety since it’s a common one. The trigger for example is being conscious of your breathing. The automatic belief is usually something like ‘if I don’t breathe correctly, I’m going to pass out and/or die’ . The challenge to this is that your body automatically regulates your breathing; no more how hard you try to hold your breath, your body will force you to breathe if it needs to. It doesn’t matter that you are conscious of it or control it. No matter what, your body will sort itself out, and this is true of everything. As long as you’re not anxious about it, there’s nothing to worry about it. We can also look at the ‘evidence’ thus far; in breathing ‘incorrectly’, has anything bad actually happened? Probably not, which suggests there’s nothing to worry about.
A key belief to be challenged: that it will last forever
From my experience, one of the common anxiety-inducing beliefs is that this condition will last for the rest of your life. As above, this can be broken down easily. Once you’ve removed any anxiety associated with consciousness of a sensation and you realise your feared outcomes won’t occur, there’s no reason why the rest of your life won’t be great. It wouldn’t matter that the consciousness is there for the rest of your life (not that it will be), because there’s no anxiety and it doesn’t really have an effect on anything. I’m emphasising this because for most people, knowing that while you may not have it sorted out right now, believing that soon enough you’ll be anxiety free and living a normal life is hugely relieving.
Don’t aim for complete certainty
When challenging your faulty beliefs, you often can’t say things for certain. Perhaps you can’t say for SURE that you can do things normally while being consciousness of some sensation, but that’s okay; you can say it makes sense that it shouldn’t cause me any major problems. Then you go out and live life, and the proof will you be in doing things properly. My point is that don’t get caught up trying to prove beliefs for sure. One of the issues people with OCD have is they often want complete certainty, which unfortunately isn’t possible a lot of the time. Sometimes you just have to say ‘I don’t know for sure, but this seems like it should be the case’.
Exercise 1: Challenge your beliefs – Using the table provided above, challenge your own beliefs you’ve built up surrounding consciousness of bodily processes. Being able to break down your own beliefs is such an important skill in dealing with anxiety. It can be difficult when you’ve had them for a long time. And there’s usually multiple faulty beliefs, working in a chain. Break it all down, and question each one. If you do this properly, you should be able to come to the conclusion that there isn’t a whole lot to be feared by having the consciousness of a sensation in of itself. However it doesn’t mean much (or any) of your anxiety will be gone; this is just the first step.. Feel free to post these or any questions in the comments section below.
Continue to 1.3 Developing A New Attitude
I’m back again. This seriously is the best guide. No joke, reading this I already feel significantly better and we haven’t even gotten to other exercises! Do you have a way to send a tip along?
Thanks for the kind words Andrew! That warms my heart.
I’m not taking tips at the moment; I’d rather just people’s thoughts on whether it’s helpful or how things could be improved 🙂
Hello—this guide has been extremely helpful, are you available for a 1v1 chat?
Hey there! I’m just reading through your site and it’s great so far! I’ve been experiencing sensorimotor ocd when it comes to swallowing and salivating. Although I do have to ask you because I struggle with this.. when you say to stop associating the sensation with anxiety, what if the anxiety is still there no matter how hard you try to not be anxious? Doesn’t that just keep you ruminating on trying to make yourself not feel anxious wondering why you’re anxious when you’re not supposed to be anxious?
What I mean by wanting to separate anxiety from the sensation is for you not to feel any anxiety when you have awareness of that sensation. It’s not something that happens quickly or easily, it takes time for your body to realise there’s no threat and that there’s no reason for fear to be associated with the sensation. You can’t really do anything to get to that state other than the exposures which I discuss in the guide, but it still takes a lot of repetition.
You can’t think your way to that. Nor should you worry about you feeling anxious at the moment; the anxiety will only go away with time if you do the right things, hopefully.
You think of it as an irrational phobia; like someone who’s afraid of cats but knows there’s nothing to be afraid of. He can’t get rid of the fear just by telling himself he shouldn’t be scared…he has to have repeated exposures with the cat and hopefully then it diminishes over time.
I have the blinking OCD and one of my beliefs is a fear of going too long without blinking? Am I blinking naturally or am I manually blinking? Sometimes I feel like I am and the eyes feel tired and dry
Hi Mick. Please see the rest of the pages; that’s a classic fear for people with SOCD. Ultimately you learn to let go and stop controlling things, and deal with whatever comes. Stop investigating and stop trying to make it natural or to any specific pattern, just let it go. The anxiety will hopefully go away over time, as will any weird physical feelings like feeling dry or something. Even if these latter physical feelings do happen occasionally, they ultimately have little impact on your life and there’s perhaps not much that can be done about it, so you learn to just live with whatever comes…and it’s all okay.
Thanks for replying
Letting go is hard but I understand, at the moment I’ve got this background anxiety humming away like it feels like something catastrophic will happen if I let go or distract from the awareness, it’s a real mind puzzle, it could be some historic anxiety that’s blue printed into my subconscious mind.
If that makes sense?
Did you experience something similar?
It’s hard to compare exact feelings, but I had just this ongoing feeling of pain and dread which just stays there. Although this was well after I had ‘let go’, so you might be experiencing the feeling while you are still trying to stay ‘in control’…ultimately you have to I guess…
OK, the letting go bit is going to be very hard
Did you have the blinking ocd?
Yep I had that, and a few others!
Hi, i have socd since february, looking in Internet was thé worst Idea i had because develop me 8 obsessions.
Its harder if Thérè is more than one obsession?
Yes often researching and looking it up makes things worse! But sometimes it has to get better before it gets worse.
I don’t think its harder when theres more than one. Often it switches from one to another.
Hallo! Thanks a lot for the blog! My problem is that I have greatly reduced the anxiety, even had a couple of months where the consciousness of my eyes (not my blinking, only the sensation of my eyes haha) was gone, but now I had a major relapse and I’m telling myself “You have been stuck for over 1,5 years now, there is no way you are gonna get better” and that makes me lose hope to ever recover 🙁 any tips on that?
I think my post here is relevant https://sensorimotorocd.net/3-1-life-beyond-sensorimotor-ocd/
Relapse I’d say is part of the journey almost. True recovery is when you remember it after months and you are still okay I’d say, and don’t fall into any kind of panic about it.
Trust that if you are doing the correct processes, then we can always hope for complete recovery. If perhaps we haven’t been them, then it’s an opportunity to learn what those are. Remember that complete recovery is possible, you can take hope in the success of others. I like many others had a big reoccurrence of it years later, and I think it takes those kinda experiences to really recover fully in the long term. See it as an opportunity to really get over it this time for the long run.
Thank you so much for this blog. I have suffered with swallowing OCD for literally 30 years on and off. Most recently I have had it for 5 years. I function normally but the dread and anxiety are always there. My question is do you have tips for how to approach the actual need to swallow? I have tried it ALL to reduce the anxiety, refusing to manually swallow until my body just did it ( definitely does not work as we often have to manually swallow), waiting as long as possible to swallow, and swallowing as soon as I feel the urge. Nothing really helps more than a few minutes. It is so frustrating because I understand fully that it is all based on my fear of it. I know that. Any advice on how to approach it would be so appreciated and helpful.
Great question. My advice to you is to have NO strategy. The problem is having ANY strategy as well as thinking about how to deal with it. It can be hard to have no strategy when you feel the dread or anxiety, but you must.
So it doesn’t matter IF you swallow consciously or if you don’t, or if it keeps changing. Don’t be trying to do anything in particular. Don’t consciously draw attention to it unnecessarily. Don’t have anything you do each time. Just relax and let it all be.
Try to only allow yourself to strategise about it once a day maximum, and that can be the time you can strategise or change strategy, review how things have gone etc. But other than that, just carry on.
Let me know how that goes.
Thank you for devoting your time and expertise to this problem that affects so many people.
I am very hopeful reading what you have written and I am doing as you say.
It is very important to meet someone who has had these problems and who has been able to put them behind them. Since I started reading your blog I have noticed a lot of improvement.
Excuse my way of writing, I am writing to you from Spain and I have used the translator.
Thanks for the kind comment Serg, it is much appreciated. Wishing you all the best.
I just wanted to say it helps so much just to realize that I’m not the only one who’s struggled with this! I’ve had a sensorimotor obsession around breathing, eye movements while reading, and sometimes the way clothing feels on my skin for a few years now. I’ve had more “traditional” kinds of OCD in the past that I’ve gotten over (obsessive hand washing and teeth brushing), but when I developed this I really felt scared, because unlike those other things your body and the sensations that accompany it are always with you.
I’m trying to find an OCD specialist who is aware of somatic/sensorimotor ocd in my area currently. In the meantime, hopefully this guide will help.
I can’t even express how much this means to me. You are helping me and so many others out more than you could possibly image. Thank you so much for writing this!
Thanks for sharing your appreciation Angelina, it means a lot. Hoping you can find a specialist, and either way I hope the guide continues to be of use.
Olá, você tem me ajudado muito. Sou brasileiro, você me deu muitas esperanças.
Fico feliz em ouvir isso. Tudo de bom meu amigo!
Hello, my case is a little special.
I think I developed an obsession about breathing more than a month ago after a panik attack during one week.
I was so frustrated about my breathing that I have “choose” to focus on my blinking instead. It was simply consisted in making forced blinks even if I don’t need to. I was feared of not able to do it automatically.
The same day, I was able to convict myself that I was cured from this after be able to distract myself during 2 hours without dry eyes or pain (“so I can blink automatically !”). The same time my breathing obsession had came back…
But quickly after, I filmed myself with my phone doing something because I wondered “just in case, do I blink when I think about it ?”.
That was my biggest mistake… I saw this video of 7 minutes and pointed out only 3 forced blinks, 0 automatic one. That was like a “traumatism”, I was panicked.
So now, I fear I’m not blinking at all when I’m think about it.
The first days were horrible. I had dried eyes, especially after sleeping (like if you have put toothpaste on my eyes).
Now, I have a little anxiety and try to not force my blinks. My eyes are a little dried and heavy, but the fear is always here.
It’s like an unbreakable vicious circle.
Indeed, my OCD consists in wondering if I blink or not, but if I think about it I don’t blink because I have proved this to myself through theses videos.
You see, it’s not completely a false belief like “I will stuck like this forever”, because there is some rational parts through theses videos I’ve made (and I still make sometimes).
My complusions consist in seeing in the mirror if my eyes are not red, googling, reassurance, ruminations, force to blink, monitoring others blinking, etc. I think the core fear is linked to health anxiety, the pattern is like that :
“Do you blink ?” ==> If you think about it like now, I’m sure you don’t blink ==> But if you don’t blink, your eyes will be dried and you will have eye’s diseases.
I can’t just tell to my self, “ok I don’t care, I will have eye’s diseases and ?”, I’m so scary about my health, but worrying about it is counterproductive, I know it.
I have a little proved to myself that I probably blink when this is like in “background”. But the OCD come back saying “your eyes seems not dry because you don’t really think about your blinking, but now your attention is on this”, so my eyes get dried, feel heavier etc.
Plus… I have no urge to blink, so I don’t know when to blink. I don’t “notice” my blinking like the majority, it seems I simply can’t, I just stare. My eyes’ movements seem weird too, it’s like I prevent myself from blinking without wanted to do it !
Now I’m very uncomfortable when I’m staring something or a screen, I need to move my eyes or my head and force a blink.
Sorry for this long comment and my English, but I’ve not seen a situation like mine, the majority of the case consists of “just” (for me obviously, I know how it can be terrible for those who suffer) be conscious of their blinks.
I regret seeing on the internet for my old breathing obsession and thinking that “blinking” was less worse than “breathing”, after all, breathing seems not so harmful (I mean physically) than blinking…
I’m so hopeless, but I try doing my best to live my life, but that’s not easy…
I’m sorry to hear about you are going through. But actually what you have described doesn’t not so different to what many SOCD suffers go through. The fears are often grounded in something else, whether health, social or otherwise. In your case it is about health.
You have done well to identify your compulsions. I also think you have thought through your thought process well. I think the faulty belief is that if your blinking isn’t done consciously or done enough or the right way, you will have problems. I would question that. I would say based on others experiences with SOCD, once the anxiety goes, all these problems tend to disappear. Even how often to blink etc, the feeling of pain etc, just focus on doing the right things and things should work out. You can’t say for sure, but you should have hope and faith that things will work out.
For you I think it will be a lot of doing exposures and stopping your compulsions, along with stopping any avoidance behaviour. Make the goal for yourself to be able to live life while it is there, without any anxiety.
The same way you work through breathing is the way you would work through blinking. Ultimately there isn’t really a difference between the two in the way you deal with it. Often the SOCD will jump around from sensation to sensation.
All the best
Thank you for your reply. I was getting better and I just a little “refall” into it with some compulsions (mirror, videos, checking others blinks…).
I think the main problem that fuel this belief is theses videos I made showing me I don’t blink if I don’t do it manually.
Plus I don’t feel I need to do it, maybe I don’t need to, but that’s strange. I just stare without any tickling so any need to blink. It’s like my brain forces me to play an eternal “staring contest”.
My eyes gets often dry and are painful, it’s not really like tickling (as many kids, I’ve already made some staring contest, I know what is tickling), it’s more a constant dry feeling.
So I’m blocked in a spiral because of theses videos (which provoke the real begining of my obsession for blinking by the way). I don’t know how to make progress because theses videos seems to show me reality, isn’t it ?
Just don’t caring at all about blinking (as I did for my entire life) may be a way, but that’s not easy, because I’m getting physical effects (dry, red, painful and tired eyes, maybe some sinusite idk if it’s linked, and I’m just generally tired but that’s quite normal I guess).
I know you are not a therapist but have you any tips or ideas for ERP concerning my specific problem based on your experience or other’s experience ?
Some are quite simple like to stop making video about it (seriously, who take time to make videos to see if he blinks correctly ?), to stop compulsively check my eyes in the mirror.
But some others are more complex to determine. Should I blink or not, especially I don’t feel the need to do it ? The majority (maybe you too ?) seems to know when to blink so you’re “aware” of it, but that’s not my case.
Should I expose myself to my old videos maybe (it’s give me a lot of anxiety when I see that I don’t blink at all on them) ? Should I try to stare intentionally ? I’m a little bit lost.
You see, I have not really a fear of blinking but rather a fear of staring.
Not sure if you had a full comment Bishesh, but it doesn’t seem to have come through…
I have been suffering from peripheral vision ocd. It got stuck to my thought and now I cant concentrate on things which are infront of me whether people or objects ,my hyper extended peripheral vision gets attracted to things which are in its range and I cant make eye contact neither can focus on my central vision always distracted . what should I do to overcome this ..
Hmm. I would check if there is any medical issues there if you physically are unable to make eye contact.
it sounds like it is a case where you have begin to notice what it’s in your peripheral vision thought, and once you have, you are noticing it all the time, even when just looking at something ‘centrally’. This is totally normal, others have a similar OCD where they begin to notice their nose or something else which they normally don’t notice. Like other types of SOCD, it is about getting used to life and doing things, where that awareness is there or not. You should find you can do all the things you do normally in life without this causing an issue, esp once the anxiety has dropped.