Obsessive compulsive disorder - OCD treatment and therapy from NOCD
OCD subtypes
Somatic OCD

Somatic OCD: Intrusive Thoughts, Diagnosis and Therapy Options

4 min read
Patrick McGrath, PhD
Reviewed by Dr. 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.

Occasionally, many of us may have moments where we’re painfully aware of how loud we’re breathing or how often we’re blinking. It’s not uncommon to be aware or take notice of your natural bodily functions. However, when these thoughts are constantly occupying your mind or becoming hard to avoid, it can be a sign of something known as somatic obsessive-compulsive disorder (somatic OCD). 

Somatic OCD is a less common OCD subtype that causes hyperawareness around normal bodily functions such as breathing, swallowing or blinking, which often causes a compulsive need for distractions. It can also cause frustrations or fears over not being able to adequately distract oneself, and it’s a vicious cycle that can be hard to manage on your own. The good news is that there are effective treatment options for somatic OCD, and they’re now more accessible than ever. 

Intrusive thoughts and somatic OCD

Somatic OCD cycles are often triggered by an intrusive thought that creates increased awareness around a particular bodily function to the point of obsession. For example, someone with somatic OCD might be eating at a restaurant and suddenly become very aware of their own chewing. Once this happens, the sounds or action of chewing might start to bother them. They might have an intrusive thought such as, “What if I don’t chew my food enough to swallow it properly?” or, “What if I forget how to chew altogether?” From there, they might act on a compulsion to try to distract themselves, such as tearing up their napkin or focusing intensely on the music in the restaurant. They may also stop eating altogether to avoid having to deal with the feelings that surround their hyperawareness. 

Other intrusive thoughts someone with somatic OCD might experience include:

  • Fears around not swallowing properly
  • Concerns over the regularity of your own heartbeat 
  • Hyperfocus on blinking at the proper pace or the proper amount 
  • Obsessions over the idea that you may suddenly stop breathing

Like many forms of OCD, somatic OCD varies widely from person to person. Some people may experience hyperawareness that has them focusing on inhaling and exhaling for minutes, or even hours, at a time, disrupting their normal thought processes and the ability to go about their typical day. Others may experience fearful, intrusive thoughts around suddenly not being able to complete their normal bodily functions properly, for example: “What if I stopped breathing all of a sudden?” 

If you suspect you or someone you love may be dealing with somatic OCD, know that you’re not alone. The first step toward working on OCD management is realizing that it may be impacting your life.

Diagnosis and therapy for somatic OCD 

When it comes to diagnosing and treating OCD, the best thing you can do is find a licensed therapist with specialized experience in OCD and OCD treatment forms. The right therapist will be able to identify and diagnose your somatic OCD and work with you to find the right plan of action. The most effective form of treatment for OCD and its subtypes is a specific type of cognitive behavioral therapy (CBT) called exposure and response prevention therapy (ERP therapy). 

ERP therapy is the gold standard of therapy for OCD — it has been proven to help those with OCD understand how to manage their symptoms and refrain from giving in to time consuming and debilitating compulsions. By exposing those with OCD to potential triggers in a safe and controlled environment, they can work on not responding to such triggers. Ultimately, the goal of ERP therapy is to help those with OCD live a life free from compulsions. When you’re looking for a therapist to help you diagnose and treat somatic OCD, look specifically for therapists with experience or certifications in OCD, CBT and ERP therapy. 

One of the most affordable and accessible ways to access an ERP certified therapist is online therapy through services like NOCD. NOCD has a nationwide network of specially trained therapists ready to help treat OCD and its various subtypes. NOCD therapy is clinically proven to reduce OCD symptoms in over 90% of members. You’re able to see your therapist via one-on-one video sessions or calls from the comfort of your own home. You can schedule a free call with the NOCD clinical team any time to get started. You can also join our Somatic OCD community and get 24/7 access to personalized self-management tools built by people who have been through OCD and successfully recovered.

Take it one step at a time 

As with any newly realized health condition, finding out you may be dealing with OCD can be challenging, but you’re never alone in your journey. NOCD has a wealth of informative blogs and learning materials to help you better understand OCD and its subtypes, and our team is available anytime to answer your questions and get you set up on the path to a life free from OCD compulsions.

NOCD Therapists specialize in treating Somatic OCD

View all therapists
Taylor Newendorp

Taylor Newendorp

Network Clinical Training Director

I started as a therapist over 14 years ago, working in different mental health environments. Many people with OCD that weren't being treated for it crossed my path and weren't getting better. I decided that I wanted to help people with OCD, so I became an OCD therapist, and eventually, a clinical supervisor. I treated people using Exposure and Response Prevention (ERP) and saw people get better day in and day out. I continue to use ERP because nothing is more effective in treating OCD.

Gary Vandalfsen

Gary Vandalfsen

Licensed Therapist, Psychologist

I’ve been practicing as a licensed therapist for over twenty five years. My main area of focus is OCD with specialized training in Exposure and Response Prevention therapy. I use ERP to treat people with all types of OCD themes, including aggressive, taboo, and a range of other unique types.

Madina Alam

Madina Alam

Director of Therapist Engagement

When I started treating OCD, I quickly realized how much this type of work means to me because I had to learn how to be okay with discomfort and uncertainty myself. I’ve been practicing as a licensed therapist since 2016. My graduate work is in mental health counseling, and I use Exposure and Response Prevention (ERP) therapy because it’s the gold standard of OCD treatment.

Want to work with one of our therapists?
Schedule a free call to learn more.