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

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

6 min read
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.

“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? 

Occasionally, we have all become acutely aware of bodily sensations that run in the background. While breathing normally happens without thinking about what your body is doing, it can be very easy to tune into your breathing patterns and suddenly become fixated on each and every breath you take. 

Heightened awareness of bodily functions, such as blinking or breathing, isn’t uncommon among the general population—and it’s especially common when someone is experiencing anxiety or panic. However, if this awareness 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 OCD 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 learning more about Somatic OCD from experienced specialists, you can learn how to get better.

Do these symptoms sound familiar? Learn how you can overcome them.

As an OCD specialist, I know how overwhelming somatic OCD symptoms can be—especially when it feels like there’s no escape from them. You’re not on your own, and you can talk to a specialist like me who has experience treating somatic OCD.

Learn more

How does OCD work?  

Obsessive-compulsive disorder (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 most people shrug them off and move on. People with OCD, on the other hand, attribute meaning to that thought and develop an obsession with it. 

For someone with OCD, the obsessions can center on or be triggered by many things. Typically, these obsessions are broken down into different OCD subtypes. A few of these subtypes include:

Let’s say that random thought is about hurting a child. People with OCD might ask: “What does this thought appearing in my head say about me?”

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

In an attempt to reduce these uncomfortable, anxious feelings, people with OCD will engage in compulsions. These can include things like physical behaviors in order to feel relief or avoidance of anything that will trigger their obsessions—such as excessive hand washing in the case of contamination OCD

People with OCD enact these compulsions to reduce their discomfort, and they can be temporarily effective. But compulsions’ effectiveness in reducing anxiety means people will turn to them whenever they obsess over a thought. 

No matter the subtype, almost everyone with OCD will feel the need to complete compulsions to deal with the discomfort their obsessions create. Often, someone with OCD feels certain that something terrible will happen if they don’t engage in their compulsions, further perpetuating the cycle. 

What is somatic OCD?

To dive further into why you may feel like you can’t stop focusing on your breathing, let’s look at somatic OCD. Somatic OCD is a subtype of OCD with obsessions around being extremely conscious of the sensations happening in your body. 

 If you think you may have somatic OCD, you might find yourself unable to stop noticing or thinking about “normal” everyday functions like swallowing, blinking, breathing, etc. Since these functions typically occur without thought, having obsessive thoughts about them can be extremely overwhelming and frustrating. 

Think back to the questions at the beginning of this article: How often have you caught yourself asking them (or some variation)? When you begin questioning the normalcy of your breathing or fixating on some aspect of your breathing, it can feel impossible that you will ever stop noticing it. However, somatic OCD is a highly treatable disorder; you can learn to manage your symptoms.

Access therapy that’s designed for OCD

I’ve personally used ERP to help many people who struggled with somatic OCD regain their lives. I encourage you to learn about accessing ERP therapy with NOCD.

Learn about ERP with NOCD

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 therapy 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 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 myself—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 (lack of oxygen)

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. 

Where to go for somatic OCD treatment

The most important part about starting your journey to recovery from Somatic OCD is to find qualified professionals who truly understand OCD treatment and who have received specialized training.

NOCD has a nationwide network of therapists who all specialize in OCD and have received intensive training to treat it with ERP therapy, working with clinical leaders who developed some of the world’s leading OCD treatment programs. In fact, many of them have lived with and recovered from OCD themselves, and they know from firsthand experience just how important the first step of your recovery journey can be.

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Dr. Keara Valentine

Dr. Keara Valentine specializes in cognitive behavioral therapy and other evidence-based treatments for anxiety disorders, obsessive-compulsive disorder (OCD), social anxiety, panic, and depression. She is also a Clinical Assistant Professor within the Department of Psychiatry and Behavioral Sciences at Stanford University, providing psychotherapy in the mood, anxiety, and OCD clinics and participating in research on novel OCD and Hoarding Disorder treatments.

Patrick McGrath, PhD

Dr. McGrath is a Licensed Clinical Psychologist and the Chief Clinical Officer at NOCD. He is a member of the Scientific and Clinical Advisory Boards of the International OCD Foundation, a Fellow of the Association for Cognitive and Behavioral Therapies, and the author of "The OCD Answer Book" and "Don't Try Harder, Try Different."

ERP Therapy
Obsessive compulsive disorder (OCD)
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NOCD Therapists specialize in treating Somatic OCD

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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.

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.

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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