What is sensorimotor OCD, and do I have it?

image of brain with words 'understanding sensorimotor OCD and MoodSmith logo

If you have been overly focused on what you considered taken for granted bodily functions, such as breathing, you might have come across the term Sensorimotor OCD.

Sensorimotor Obsessive-Compulsive Disorder (OCD) is a subtype of OCD where the person is intensely focused on automatic bodily processes, such as breathing or blinking, and according to the OCD&Anxiety Centre, it can also include the internal sound of thinking.

This heightened awareness can lead to significant distress. It can disrupt daily life, making even simple tasks seem overwhelming.

But how do you know if you have sensorimotor OCD? What are the signs to look out for? And if you do have it, what can you do about it?

Today I want to shed some light on sensorimotor OCD, its symptoms, how it’s diagnosed, and what treatment options available to you.

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Understanding Sensorimotor OCD

Sensorimotor OCD is a subtype of Obsessive-Compulsive Disorder. It’s characterized by an excessive focus on involuntary bodily processes. These processes are typically automatic and go unnoticed in daily life.

However if you have sensorimotor OCD, these processes become the centre of your attention. You become hyperaware of their breathing, blinking, swallowing, or heartbeat. Which causes you a significant amount of distress and anxiety. If you have ever suffered from panic disorder, you probably have an idea what it is like to focus on your breathing, and by doing so, it ‘messes it up.’

The prevalence of sensorimotor OCD within the broader spectrum of OCD subtypes is not well-documented. This is partly due to the challenges in diagnosing this subtype. Its compulsions are less visible, often leading to misdiagnosis or underdiagnosis.

The Nature of Sensorimotor Obsessions

Like all forms of OCD, people’s obsession vary from person to person, and Sensorimotor is not different. Some individuals may obsess over their breathing, constantly aware of each inhale and exhale. Others may fixate on their blinking, unable to divert their attention from each blink.

These obsessions can be incredibly distressing. They can interfere with daily activities and lead to significant impairment in functioning. The individual may develop compulsive behaviours to manage their anxiety, such as deliberately altering their breathing pattern or blinking rhythm.

The role of anxiety and stress in exacerbating sensorimotor OCD symptoms cannot be overstated. Increased stress levels can intensify the obsessions, leading to a vicious cycle of anxiety and obsession.

Differentiating Normal Awareness from Sensorimotor OCD

How do you know whether your obsessing is normal, or OCD? I mentioned earlier that people with panic disorder, indeed this was my experience when I had panic attacks, that I was hyper aware of my breathing, but yet I did not have sensorimotor OCD, I had panic disorder.

It’s important to differentiate between normal body awareness and the obsessive focus seen in sensorimotor OCD. Everyone experiences moments of heightened body awareness. For instance, you may become aware of your breathing during a yoga class or notice your heartbeat after a strenuous workout.

However, in sensorimotor OCD, this awareness is constant and intrusive. It’s not a fleeting moment of attention but a persistent focus that causes distress. This is what sets sensorimotor OCD apart from normal body awareness.

Symptoms and Diagnosis of Sensorimotor OCD

The symptoms of sensorimotor OCD can be quite distressing. The individual is constantly aware of certain bodily sensations. This awareness is not a choice but an intrusive thought that they cannot shake off.

Compulsive behaviours may also be present. These are attempts to manage the anxiety caused by the obsessions. For instance, an individual obsessed with their breathing may deliberately alter their breathing pattern to alleviate their distress.

The impact of sensorimotor OCD on quality of life can be significant. It can affect relationships, work performance, and overall well-being. The constant focus on bodily sensations can be mentally exhausting, leaving little room for anything else.

Recognizing the Signs: Do I Have Sensorimotor OCD?

If you are constantly aware of certain bodily sensations, you might wonder if you need to meet with a therapist to see what is going on. However, you really only need to go for an assessment if this hyper-awareness is interfering with your quality of life.

For example, if your focus on these sensations is persistent and intrusive, it may be worth seeking professional help. If these obsessions are causing significant distress or impairment in your daily life, it’s a sign that you may need support.

The Diagnostic Process

Diagnosing sensorimotor OCD can be challenging. This subtype of OCD is less recognized and understood than others. Its compulsions are less visible, often leading to misdiagnosis or underdiagnosis.

A thorough assessment by a mental health professional is crucial. They will differentiate sensorimotor OCD from other conditions with similar symptoms. This process may involve detailed interviews, questionnaires, and possibly psychological testing.

The importance of a correct diagnosis cannot be overstated. It’s the first step towards getting the right treatment and support. If you suspect you have sensorimotor OCD, don’t hesitate to seek help.

Treatment Options for Sensorimotor OCD

There are several treatment options available for sensorimotor OCD. The choice of treatment depends on the individual’s specific symptoms and needs. Remembering that what works for one person may not work for another is important.

Cognitive-behavioural therapy (CBT) and exposure and response prevention (ERP) are commonly used. These therapies help individuals confront their obsessions and reduce their compulsive behaviours. They are considered the gold standard in OCD treatment.

Medication, particularly selective serotonin reuptake inhibitors (SSRIs), may also be beneficial. These drugs can help reduce the intensity of obsessions and compulsions.

Cognitive-Behavioural Therapy (CBT) and Exposure Response Prevention (ERP)

CBT is a type of psychotherapy that helps individuals change their thought patterns. In the context of sensorimotor OCD, CBT can help individuals understand and change their obsessive focus on bodily sensations.

ERP, a specific type of CBT, involves gradual exposure to the feared sensation. The individual is then encouraged to resist the urge to perform their usual compulsive behaviours. Over time, this can help reduce the anxiety associated with the sensation.

Both CBT and ERP require commitment and effort from the individual. However, with consistent practice, they can lead to significant improvements in symptoms and quality of life.

Medication and Alternative Therapies

Medication, specifically SSRIs, can be an effective part of sensorimotor OCD treatment. These drugs increase the level of serotonin, a neurotransmitter, in the brain. This can help reduce the intensity of obsessions and compulsions.

Alternative therapies, such as mindfulness and meditation, can also be beneficial. They can help individuals manage their anxiety and reduce their focus on bodily sensations. Some individuals may also find relief with complementary treatments like acupuncture or yoga.

It’s important to remember that treatment should be personalized. What works for one person may not work for another. Therefore, it’s crucial to work with a healthcare provider to find the most effective treatment plan.


Case Study

Introduction

all names and identifying details have been changed and anonymised.

This case study details Sarah, a 32-year-old woman diagnosed with sensorimotor OCD.

Background

When I first met Sarah, she had experienced symptoms of sensorimotor OCD since her late twenties. She became intensely aware of her breathing patterns and constantly monitored each breath. This hyperawareness led to significant anxiety, interfering with her daily activities and overall quality of life. Despite understanding that her focus on breathing was irrational, she felt powerless to stop it.

Initial Assessment

Sarah’s initial assessment involved a detailed clinical interview

  1. Symptom Profile: Sarah reported persistent intrusive thoughts about her breathing, leading to compulsive monitoring and attempts to control her breathing patterns.
  2. Impact on Life: Her preoccupation with breathing resulted in severe distress, affecting her work performance and social interactions.
  3. Family History: A history of anxiety disorders in her family suggested a genetic predisposition.

Based on these findings, Sarah was diagnosed with sensorimotor OCD.

Treatment Plan

I developed a comprehensive treatment plan for Sarah, focusing on cognitive-behavioural therapy (CBT), emphasising Exposure and Response Prevention (ERP).

Cognitive-Behavioral Therapy (CBT)

  1. Exposure and Response Prevention (ERP):
    • Exposure: Sarah was gradually exposed to situations that triggered her hyperawareness of breathing. For instance, she practised deep breathing exercises and focused on her breath during therapy sessions.
    • Response Prevention: Sarah was encouraged to resist the urge to control her breathing, allowing herself to experience the anxiety without performing her compulsive behaviours.
  2. Cognitive Restructuring:
    • Sarah worked with me to identify and challenge maladaptive thoughts related to her breathing. She learned to reframe these thoughts, understanding that her body would regulate her breathing without conscious effort.

Medication

  1. Selective Serotonin Reuptake Inhibitors (SSRIs):
    • Sarah was prescribed an SSRI to help reduce her overall anxiety and OCD symptoms. The medication helped to stabilize her mood and provided a foundation for the effectiveness of CBT.
    • As I am a psychologist, we do not prescribe medication; this was prescribed and monitored by her psychiatrist.

Treatment Process

  1. Initial Phase:
    • The first few weeks focused on building a therapeutic alliance and educating Sarah about sensorimotor OCD and its treatment.
    • Sarah started on a low dose of SSRIs, which was gradually increased based on her response and tolerance.
  2. Middle Phase:
    • Intensive ERP sessions were conducted twice a week. Sarah practiced exposure exercises both in and outside of therapy.
    • Cognitive restructuring sessions helped Sarah to challenge and change her obsessive thoughts about breathing.
  3. Maintenance Phase:
    • As Sarah’s symptoms began to decrease, the frequency of therapy sessions was reduced.
    • Ongoing support and booster sessions were scheduled to prevent relapse and reinforce coping strategies.

Outcome

After six months of treatment, Sarah experienced significant improvement in her symptoms. Key outcomes included:

  1. Reduction in Hyperawareness: Sarah’s preoccupation with her breathing decreased substantially. She was able to engage in daily activities without constant monitoring of her breath.
  2. Improved Functioning: Sarah reported improved performance at work and better social interactions. Her overall quality of life improved significantly.
  3. Decreased Anxiety: The combination of CBT and SSRIs led to a marked reduction in her anxiety levels.

Conclusion

We have all heard the quote that knowledge is power and I always find this applicable when a person first can put a label on all those symptoms they have been experiencing. If you are able to put a label of sensorimotor OCD on your experience, working with a good therapist, who specialises in OCD can help give you your life back.

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