OCD subtypes
Somatic OCD

What Are Somatic OCD Exposures? Explanation and Examples

3 min read
Keara Valentine
By Keara Valentine
All types of OCD include obsessions and compulsions. Obsessions are unwanted and intrusive thoughts, feelings, urges and doubts, while compulsions are repetitive physical or mental actions performed in an attempt to relieve distress and anxiety

Have you ever become suddenly aware of how loud you’re breathing or how often you’re blinking? From time to time, we all experience a hyperawareness of our bodily sensations that typically run on autopilot. Since we aren’t usually tuned into these sensations, it might feel overwhelming to all of a sudden be acutely aware of them. 

If awareness of these normal sensations becomes overwhelming to the point that you feel you need a distraction from thinking about them or you worry you may never be able to not think of them, it’s possible that you have a subtype of OCD called somatic OCD.

Similar to other OCD subtypes, somatic OCD is often triggered by intrusive thoughts that lead to a hyperfixation of bodily functions, such as chewing, blinking or breathing. The thoughts can vary from person to person, with some people experiencing fear that they’ll never stop noticing these sensations and others fearing that they may suddenly stop breathing or will forget how to swallow.

Learning you have somatic OCD can be scary, but the first step to managing your symptoms is understanding how they may be affecting your life. Relief from your symptoms is possible — somatic OCD can be effectively treated.

How is somatic OCD treated?

Somatic OCD can be treated as effectively as almost all subtypes of OCD through a form of cognitive behavioral therapy (CBT) called exposure and response prevention (ERP) therapy. ERP therapy is the gold-standard treatment option for OCD and is known for leading patients to a life free of compulsions.

In ERP therapy, a therapist works with the patient to intentionally trigger their OCD cycle to allow the patient to experience their symptoms in a safe and controlled environment. If you begin ERP therapy, you can expect your therapist to work through exposures with you where you’ll be challenged to let your intrusive thoughts come up while resisting the urge to enact your compulsions. As you become more used to your intrusive thoughts, you’ll begin to feel less and less inclined to engage in compulsions.

What are somatic OCD exposures?

In many other subtypes of OCD, exposures may look like directly approaching the trigger. However, somatic OCD exposures will often look much different. You might think that exposure for somatic OCD would be to focus even more on the physical sensations that are scary. However, this is often not helpful because you are already doing that. Instead, the goal is to learn to stop directing attention to the sensation and to stop ruminating.

For some people with somatic OCD, they may begin to notice their bodily sensations because they’re scanning to make sure they’re not missing a medical issue. In a case like this, your therapist will engage you in exposures that challenge that belief in order to help you resist feeling the need to body scan.

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Other exposures for somatic OCD may include doing anything you avoid because it makes you more aware of your bodily sensations, such as exercising.

What is response prevention?

In addition to your exposure sessions, it’s critical to practice response prevention. In this case, this means becoming aware of when you fall into an obsessive awareness of your bodily sensations. Rather than trying to fight off this mental process, allow it to simply exist. The more you try to fight off your obsessive thoughts, the more they’ll spiral and lead to intense rumination and the need to enact your compulsions. Somatic OCD treatment largely comes down to defining the line between awareness and attention and working to give your OCD cycles less attention.
If you’re ready to begin managing your somatic OCD symptoms, you can schedule a free call with the NOCD clinical team. All NOCD therapists specialize in OCD and receive ERP-specific training to offer you effective treatment options.

Keara Valentine

Keara E. Valentine, Psy.D., is a postdoctoral fellow at Stanford University School of Medicine in the OCD and Related Disorders Track, where she specializes in the assessment and treatment of OCD and related disorders. Dr. Valentine utilizes behavioral-based therapies including Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) with children, adolescents, and adults experiencing anxiety-related disorders.

NOCD Therapists specialize in treating Somatic OCD

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Adriana Delgado

Adriana Delgado

Licensed Therapist, LMHC

My journey as a therapist has brought me in front of more and more cases of OCD, which has led to specialization in OCD treatment. My experience working at intensive in-home services for children & families, and intensive outpatient programs, has prepared me for even the biggest challenges. During sessions, I use Exposure and Response Prevention (ERP) therapy because it’s one of the most effective treatments for OCD, and works for any OCD subtype.

Alyse Eldred

Alyse Eldred

Licensed Therapist, LMFT

I’ve been a licensed therapist since 2017, and as an OCD specialist, I only use Exposure and Response Prevention (ERP) therapy. Research shows that ERP is the most effective OCD treatment available. I truly enjoy helping people understand themselves through ERP and I’m grateful to be part of a process that helps people gain control of their lives.

Andrew Moeller

Andrew Moeller

Licensed Therapy, LMHC

I've been a licensed counselor since 2013, having run my private practice with a steady influx of OCD cases for several years. Out of all the approaches to OCD treatment that I've used, I find Exposure and Response Prevention (ERP) therapy to be the most effective. ERP goes beyond other methods and tackles the problem head-on. By using ERP in our sessions, you can look forward to better days ahead.

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