OCD is a mental health condition, so most people are aware of the mental symptoms that people with OCD face, as well as the mental anguish it can cause. Less often recognized are the many types of physical sensations that OCD can bring about, making people feel especially helpless and confused. Sometimes, physical sensations caused by OCD can even cause people to seek medical help from a doctor, only to be told that there is nothing medically wrong.
One of my earliest memories was being unable to stop thinking about the action of yawning. I remember it vividly: it was all I could think about. You may have heard people refer to yawning as “contagious”—often when you yawn, others around you will yawn in response. As you can probably imagine, my compulsive focus on my own yawning would lead me to yawn, leading to a pattern that would continue for hours. I remember asking friends and my brother if they ever had similar experiences, only to be given strange looks.
Monitoring feelings can make them more noticeable
OCD bringing compulsive hyperawareness to physical sensations can occur in any number of OCD themes. People might compulsively bring their attention to their breathing, heart rate, swallowing, blinking, or other typically automatic or subconscious bodily processes. Just as intrusive thoughts become more distressing when you pay attention or engage with them, the same can be said for these physical symptoms.
For instance, the more you notice your heart rate, the more likely you will be to “feel” your heart beating more often, this can lead you to conclude that something must be wrong: Is it beating too hard? Too fast? Too slow? Why am I feeling this? What does it mean? What if I can never stop fixating on my heartbeat? Many people who suffer from this form of OCD can become hyper-focused on the idea that they may never feel better again.
Another common example of this phenomenon is found in people with sexual intrusive thoughts who feel sensations in their groin, often referred to as a “groinal response.” They may then try and figure out the exact “cause” of these experiences and may attribute meaning to them. For instance, someone experiencing POCD (pedophilia-themed intrusive thoughts) may fear that they are in fact a pedophile and a danger to children.
This couldn’t be further from the truth, as people suffering from OCD go to great lengths to avoid any possibility of encounters with the things they fear. Unfortunately, by compulsively monitoring and fixating on any sensations in their groin, people can actually cause a groinal response, reinforcing their worst fears—it’s truly a vicious cycle.
How do you treat physical responses in OCD?
In order to treat OCD that involves involuntary physical sensations, it is important to learn how to sit with the discomfort that the feelings bring. You must gradually learn that you will recognize certain bodily functions more readily than someone who doesn’t have OCD. These things will seem louder to you. That’s okay—the goal isn’t to not notice them. Instead, the goal is to develop an acceptance of these feelings, remembering that the more you try not to think about something you feel, the more likely you are to experience it.
The best course of treatment for somatic and sensorimotor symptoms in OCD is exposure and response prevention (ERP) therapy. ERP is the gold standard for OCD treatment and has been found effective for 80% of people with OCD. The majority of patients experience results within 12-25 sessions.
As part of ERP therapy, you will track your obsessions and compulsions and make a list of how distressing each thought is. You then progress through exposure exercises, at every step resisting the urge to engage in compulsions like body checking, counting, or monitoring. When you continually reach out for quick relief by doing compulsions, it only strengthens your need to engage in them in the future. On the other hand, when you prevent yourself from engaging in your compulsions, you teach yourself a new way to respond, allowing yourself to accept discomfort and feel less anxiety over time.
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For people whose OCD symptoms include physical sensations, exercises known as interoceptive exposures are often used. In interoceptive exposures, physical sensations like an elevated heart rate or heavy breathing are triggered, providing the opportunity for someone to learn how to accept these feelings without resorting to compulsions to feel better.
At NOCD, all of our therapists specialize in OCD and receive ERP-specific training and ongoing guidance from our clinical leadership team. Many of them have dealt with OCD themselves and understand how crucial ERP therapy is. NOCD offers live face-to-face video therapy sessions with OCD therapists, in addition to ongoing support on the NOCD app, so that you’re fully supported during the course of your treatment.