Understanding Somatic OCD: 5 Coping Strategies to Overcome Your Body-Focused Obsessions

Somatic OCD

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When you hear the term “obsessive-compulsive disorder,” you may associate it with excessive cleaning, washing hands, or organizing. There is a lesser-known type of OCD that centers around body-focused obsessions – Somatic OCD.

Somatic OCD, also known as Sensorimotor OCD, involves being preoccupied with physical sensations and symptoms, often fueled by fear and the desire for reassurance. 

It is estimated that 5-7% of adults have symptoms related to body-focused obsessions. This can be an incredibly distressing experience, as your mind is constantly occupied with worrisome thoughts and fears.

In this article, let’s discuss the signs of somatic OCD, potential causes and core fears, symptom management options, and practical ways to cope with your symptoms.

Signs of Somatic OCD

Somatic OCD often begins with a heightened awareness of bodily sensations, which then turns into obsessions and compulsions. It is no surprise that if you suffer from this disorder, you are experiencing a lot of fear. 

Whether you are feeling sensations you aren’t used to and are convinced the cause is a significant health concern, or you had a traumatic experience and now worry that more may follow, your thoughts and body sensations are led by fear. You are stuck in a flight response, which can increase sensation in the body parts you closely monitor.

Common signs of Somatic OCD include:

  • Constantly checking heart rate, breathing rate, or other bodily functions
  • Fear of having a severe illness or disease
  • Excessive worry about physical symptoms, even after being reassured by medical professionals
  • Spending excessive time researching and seeking information about health conditions

This type of OCD is particular to you and your experiences. What you fixate on or fear the most can be anything in the body. 

Common somatic fixations can include:

  • Breathing
  • Blinking
  • Swallowing/salivation
  • Movement of the mouth and tongue during speech
  • Pulse/heartbeat
  • Eye contact
  • Visual distractions or floaters in the eyes
  • Awareness of specific body parts
  • Bladder or bowel pressure
  • Skin tingling or itching
  • Joints popping or creaking
  • Sensitivity to the internal sound or mechanisms of thinking

It’s important to note that while these behaviors may seem like normal concerns, they become more critical to address when they interfere with daily life and cause significant distress.

Causes of Somatic Fears

As with other types of OCD, the exact cause of somatic OCD is not fully understood. It is believed to be a combination of genetic, environmental, and biological factors.

Some research suggests that if you have experienced trauma or illness, you may be more susceptible to developing somatic OCD. Additionally, certain personality traits, such as high levels of anxiety, may also play a role.

OCD or Real Medical Concern: How do you know the difference?

Life can be unpredictable, and you may require medical attention at some point. If you are experiencing discomfort that you want to bring to the attention of your doctor or counselor, please do so. Gaining control over your somatic OCD does not mean ignoring all body sensations and never seeking medical attention. 

The key to understanding how somatic OCD affects you is to analyze your thoughts. Ask yourself these questions:

  1. When you feel a physical sensation, do you automatically catastrophize and assume the worst possible cause? 
  2. Do you dismiss simple and ordinary causes for your symptoms?
  3. When a doctor has thoroughly examined your symptoms, explained possible causes, and done proper testing, and still nothing is found, can you accept that you are diagnostically healthy? 
  4. Do you feel a sense of relief when receiving reassurance, then quickly become worried again?

If you answered yes to these questions, OCD likely drives your somatic fears.

Understanding how quickly your mind goes from 0 to 100 on the fear scale is pivotal in understanding the effect of your somatic thought patterns. At first, it may seem impossible to recognize the difference between somatic OCD symptoms and a genuine medical concern. Over time, you can learn to be more pragmatic about how you assess your body and when you feel something abnormal.

Note: When you want a test redone or decide to see another doctor, you can be made to feel like you are obsessing over your symptoms. Know that seeking a second opinion for the right reasons can be a regular part of medical care. Wanting a second opinion does not necessarily mean you are experiencing somatic OCD. 

Remember, the questions above are meant to observe your thoughts when you experience symptoms and reveal the motivation for your actions to achieve symptom relief. 

These questions are not meant to replace medical intervention. If you have persistent symptoms, it is ok to be seen by a doctor. It is common to feel guilt, shame, and possibly worry that others might think you are making up your symptoms. These feelings are normal and should be discussed with your doctor and therapist. 

Symptom Management Options for Somatic OCD

The good news is that somatic OCD is highly treatable. The first step in managing this type of OCD is to seek help from a mental health professional who specializes in treating anxiety disorders. From there, your counselor will create a plan to address your symptoms based on what affects you the most. 

Here are the most common and effective symptom management options for this disorder:

Cognitive-behavioral therapy (CBT) 

CBT is considered the gold standard technique for managing OCD, including somatic symptoms. This therapy helps you recognize and challenge your obsessive thoughts, as well as develop healthier coping mechanisms for what is causing your symptoms.

Exposure and Response Prevention Therapy

ERP exposure and response prevention therapy is a specific type of CBT that focuses on gradually exposing you to your fears and helping you resist performing compulsions. This can be an effective way to manage somatic OCD, as it enables you to confront your fear of bodily sensations head-on.

Medication

Medication may be recommended by your counselor to help manage symptoms of anxiety and OCD. Antidepressants or other medications can be used to ease stress, calm the nervous system down, and allow you to operate with a more even feeling.

Reducing Stress

Stress, anxiety, and depression can all magnify the sensations you have in your body. Also, once a fear has been triggered, it’s easy for the fear to spiral into ruminating thoughts that cause more symptoms. When you have experienced deep fears for an extended period, your body consistently operates out of a heightened state. You may even feel that reducing stress is impossible because you have suffered for so long or that you don’t remember what it’s like to feel at peace. This is a familiar feeling when you experience this type of OCD.

Reducing stress and being in a more calm state takes time and requires different approaches to achieve it. To lessen your stress load, consider habits or activities you enjoy. This could include self-care activities, hobbies you haven’t participated in for a long while, or even connecting with people who can make you laugh for a while. All these things take you out of the cyclical fear spiral of thoughts and into the world around you. 

Coping with Somatic OCD

Living with somatic OCD can be challenging. The following strategies can help reduce stress and potentially improve or lessen your symptoms.

Strategies to manage Somatic OCD symptoms include:

  • Practicing relaxation techniques such as deep breathing or meditation: This aligns with reducing stress and helps lower your body’s heightened state of awareness.
  • Distracting yourself with activities you enjoy: When you immerse yourself in activities that make you happy, it’s a welcome distraction from constantly monitoring your body. These activities help you know it is possible to enjoy an afternoon without checking your heart rate.
  • Setting limits on checking behaviors: It is tough to go from constantly checking your body for concerns to never paying attention to how you feel. This would be an unrealistic goal that would surely result in stress and more body checking. Try reducing the amount of checks on one body part for one day. See how that feels, and keep reducing in small increments over time. Celebrate small successes along the way.
  • Challenging negative thoughts: Seeking reassurance from trusted sources instead of constantly Googling symptoms or letting your mind spin into a negative thinking pattern is key when reducing your somatic symptoms. Become aware of these thoughts while they occur and devise a word or phrase to use mid-thought to stop the thought before it finishes. This can help you recognize these patterns quickly and more effectively control the cycle of fear before it begins.
  • Building a support network of family, friends, and mental health professionals: Connecting with people you love and care about your mental health is essential to feeling safe and relaxed. Try having dinner with friends, a game night with family, or joining a support group of people who have a similar experience as you do. OCD can make you feel isolated and alone. Connecting with others can draw you out of isolation and help add fun and enjoyment to your life.

Bonus Tip: Another helpful strategy to lessen your symptoms is to identify the checking behaviors you currently engage in and see if harmless habits reinforce your “checks.”

For example, you may have a smartwatch that tracks your heart rate. Even if you are checking the time, you may be exposed to your heart rate on your watch face. This encourages extra monitoring, even when you aren’t engaging in a fear-based symptom “check.”

One way to alleviate this unintentional “check” is to change your watch face to one that does not display your heart rate automatically. Watch faces are available for download that require an additional touch to see your heart rate and those that do not show your heart rate at all. This simple change can lessen your heart rate obsession over time. 

For more information on watch face options, look on the company website that makes your smartwatch to see which options are available for your watch model.

Conclusion

Somatic OCD is a disorder that focuses on body sensations and bodily functions based on fears that something is medically wrong with you. Because of the severity of the fears, body checking is a common impulse when faced with unfamiliar sensations. Often, body checking does not accomplish reassurance and instead creates a fear cycle about the body and the sensations you feel.

Somatic OCD can significantly impact daily life and cause immense distress. Using an appropriate combination of CBT, ERP, reducing stress, and medication if your counselor believes it to be beneficial, you can learn to manage your symptoms and live with less fear and more peace. 

Also, you can regain confidence in your body and its signals once you process and work through your fears.

If you or someone you know is struggling with somatic OCD, don’t hesitate to seek help. Take a step towards managing somatic OCD and regaining control of your life. Call us at (833)-274-heal or schedule an appointment with an OCD counselor today to begin your mental health journey. 

More on This Topic:

The Self-Assessed OCD Test: 12 Questions To Identify Your Symptoms And Understand Your Next Steps

Therapies For OCD: Discover The 10 Best Standard And Alternative Options

The 4 Different Types Of OCD: What You Need To Know

Sara Makin MSEd, LPC, NCC

Sara Makin MSEd, LPC, NCC

All articles are written in conjunction with the Makin Wellness research team. The content on this page is not a replacement for professional diagnosis, treatment, or informed advice. It is important to consult with a qualified mental health professional before making any decisions or taking action. Please refer to our terms of use for further details.

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