Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Why can’t I stop focusing on my breathing? Understanding Somatic OCD

By Dr. Keara Valentine

Mar 01, 20246 minute read

Reviewed byPatrick McGrath, PhD

why can't i stop focusing on my breathing

“Why am I breathing so much?” 

“Do I always breathe like this?”

“Can anyone else hear my breathing?”

“What if I’m not breathing enough?”

“What if I forget to breathe?”

Have you ever found yourself asking these questions? 

Being in tune with your body can be a very positive thing. So a heightened awareness of bodily functions, such as blinking or breathing, is normal—and it’s especially common if you’re experiencing anxiety or panic. However, if what you’re feeling starts to feel intrusive and long-lasting, or if you find yourself urgently trying to ease the anxiety you feel, you may be experiencing a subtype of obsessive-compulsive disorder called somatic OCD—also known as sensorimotor OCD.

I know—it’s not what most people imagine when they think of OCD. But that’s only because the condition is so misunderstood, sometimes even by mental health professionals. As a specialist in OCD treatment, I can assure you: If you’re experiencing these symptoms, you’re not alone. And by working with someone trained to help you get a handle on your Somatic OCD, you can get better.

What is OCD, exactly?  

OCD is a commonly diagnosed mental health disorder. Its key feature is a cycle of intrusive, unwanted thoughts (obsessions) and urgent, often repetitive behaviors (compulsions) done to try to stop the thoughts, feel better, or prevent feared outcomes from occurring. 

The cycle begins with an intrusive thought. Virtually everyone experiences intrusive thoughts, but can shrug them off and move on. If you have OCD, on the other hand, these thoughts can take up a significant part of your day. You may attribute meaning to your thoughts, and develop an obsession with them that interferes with your daily life. 

Obsessions can be triggered by many things, including subtypes of OCD like Checking OCD, Counting OCD, Relationship OCD, and Harm OCD.

Let’s say that random thought is about not breathing enough. You might wonder: “What is this thought telling me?”

The most likely answer to this question is nothing. You are not your thoughts. They arrive and leave like trains in a station. But if you have OCD, distinguishing the thought from you becomes challenging—even impossible—and can create extreme anxiety. 

As a result, you’ll engage in compulsions in an attempt to reduce your uncomfortable feelings. These can include things like physical behaviors—such as excessive hand washing in the case of contamination OCD—or avoiding anything that will trigger your obsessions. The catch is that while acting on compulsions offers relief, it’s only temporary. And the cycle of obsessions and compulsions will just repeat. You might feel certain that something terrible will happen if you don’t engage in your compulsions, further perpetuating the cycle. 

How is somatic OCD different from other types of OCD?

Somatic OCD is a subtype of OCD with obsessions around the sensations happening in your body. You might find yourself unable to stop noticing or thinking about “normal” everyday functions like breathing, swallowing, or blinking. Since these functions typically happen automatically, obsessions tied to like these thoughts can be extremely overwhelming and frustrating. 

Think back to the questions at the beginning of this article. When you begin worrying about the normalcy of your breathing or fixating on some aspect of it, you might wonder if you’ll ever be able to stop noticing each inhale and exhale.

Treating somatic OCD

The good news is that somatic OCD is very responsive to a particular type of treatment called Exposure and Response Prevention therapy (ERP). 

ERP is considered the gold standard of treatment for any subtype of OCD, including somatic OCD, and it’s supported by decades of clinical research. If you begin ERP therapy, you can expect to work with your therapist to find out what triggers your cycle of obsessions and compulsions.  

From there, you and your therapist will work to expose you to these triggers—starting small and working your way up to more challenging ones—to allow you to experience the obsessions about your breathing and face your fears in a safe and controlled environment. The goal is to help you experience the trigger and, over time, feel less urgency to complete your compulsions. 

Working with a specialist like me—or one of the therapists at NOCD—you’ll engage in exposure exercises in order to resist the urge to seek short-term relief through compulsions. Here are some examples:

  • Walking or running on a treadmill to elevate your heart rate, then resisting the urge to check your pulse as you catch your breath.
  • Drawing your attention to your breathing rate, then sitting with the worry that you might never stop counting your breaths, rather than intentionally distracting yourself.
  • Saying “I might not be getting enough oxygen to my lungs,” and not going online to research symptoms of hypoxia.

Most of the time something amazing happens as a result of this therapy: You won’t be riddled with distress from intrusive thoughts, images, or urges. Your need to engage in compulsions goes away. And the things that matter the most to you won’t feel like they’re at risk of slipping away. In essence, you’ll get to live a life that’s free from the grip of OCD.

Working with an OCD specialist to address the thoughts and situations that cause you distress is more accessible than ever thanks to virtual ERP therapy. In fact, peer reviewed research shows live teletherapy sessions of ERP can be more effective, delivering results in less time than traditional outpatient ERP therapy, often in as little as 12 weeks. 

Want to begin your ERP therapist search? We encourage you to browse the NOCD Therapist Directory. Every NOCD therapist is not only specialized in ERP but trained to deliver treatment online. Choose your therapist and we do the rest, including helping with scheduling and payment. Of course, if NOCD Therapists aren’t the right fit, you can also explore the International OCD Foundation Therapist Directory.

If you’re experiencing somatic OCD symptoms focused on breathing, it can be difficult to see a way out of your struggle—after all, you’re always breathing! But I want to emphasize that I have extensive experience treating this type of OCD, and the right form of treatment from an experienced professional can truly make an impact on your life, even if it’s difficult to imagine right now.

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