What is sensorimotor OCD or hyperawareness OCD?
by Katherine Pica LCSW
What is sensorimotor OCD or hyperawareness OCD?
Hyperawareness or Sensorimotor OCD is where a significant amount of attention is spent thinking about body functions or sensations. Often these sessions are unconscious but with this type of OCD the brain gets stuck focusing on them. If you are struggling with this form of OCD it can feel impossible to pull your attention away from them. According to the International OCD Foundation “Sensorimotor obsessions as defined here involve either a focus on automatic bodily processes or discrete physical sensations.” Basically with Sensorimotor OCD you end up focusing on on typically unconscious body sensations. If you are struggling with this form of OCD it can feel impossible to pull your attention away from them.Why is it called Sensorimotor or hyperawareness OCD?
There have been many names for this: Sensory focused obsessions, Hyperawareness OCD , obsessing about obsessing, neutral obsessions, somatic OCD, sensorimotor OCD and so on. For ease we will call it sensorimotor OCD in this article. With Sensorimotor OCD the brain often gets stuck on body sensations and has a very hard time pulling attention away. Focusing on body sensations can also cause distress. For some individuals they worry that they are not breathing fast enough, that their heart rate is too slow. Some are worried about swallowing too little too much, not deep enough ect. These concerns are just at the tip of the iceberg. What all these different body focuses have in common is the repetitive thoughts that come with this type of OCD? Do you want these thoughts to go away? Do you want desperately to stop thinking about body sensations. There are many common OCD thoughts that go along with sensorimotor OCD. OCD therapy helps treat these thoughts. 
What are common obsessions with Sensorimotor or Hyperawareness OCD?
Breathing
Tongue’s position in mouth
Tinnitus
Posture of body
Blinking
Swallowing
Hearing too loud hyperacusis
Floater in eyes
Heart rate / pulse
Sitting position
Bladder
Misophonia- sound sensitivity ( Sensitivity to breathing or chewing of others)
Is Sensorimotor OCD or hyperawareness OCD really a form of OCD?
Yes, this really is a form of OCD. We often think of OCD how we would see it portrayed in the media. For example obsessions with germs or needing things in order or counting compulsions. However Sensorimotor OCD turns it’s obsessions to one's body functions. The compulsions turn to trying to do anything to get rid of the thoughts and excessive attention to one's body function.
Some will try to distract themselves with TV or music. Others will keep themselves very busy so they have no extra downtime to do any thinking. Many will try to do anything not to think about the obsession. While it may seem like it temporarily helps it actually ends up contributing to OCD and making the OCD process stronger.
Also, have you ever tried to stop thinking about something? Try that right now! Do not think about the ending of this: Mary had a little_____. Little bow peep lost her ______. It's impossible to try not to think about something! When we try hard not to let the thoughts come, normally they come back even stronger.
What are common sensorimotor OCD thoughts?
There are common thoughts when it comes to Sensorimotor OCD. As an OCD therapist who has worked with many different clients with Sensorimotor OCD there are many common themes that we see. Some examples are below:
Will I think about this forever?
As long as I am having these symptoms then my life is ruined!
Life would be so much better if I did not have these struggles?
I will go crazy if I always have to think about this!
I want these thoughts to go away!
What are the obsessions and compulsions when it comes to sensorimotor OCD?
For those who struggle with Sensorimotor OCD it can be very difficult because the focus is mostly on one's body functions. But there are thoughts that go along with it that cause a lot of distress. Mostly the thoughts are that things will always be like this. I will notice this forever. My life will be so horrible if this does not go away. These thoughts are considered obsessions.
Compulsions in sensorimotor OCD often involve over focusing on the body sensations or trying so hard to do anything to not think about it. Also compulsion can be checkin to see if you are thinking or focusing on a body sensation.
Compulsions are OCD’s way of trying to regain control. Instead of saying I am going to learn to let these thoughts be here, there can be a frantic effort to get rid of the thoughts. “If I just do this then the thing I fear will not happen.” or if I just keep myself distracted then I will not have to think about it.
Unfortunately this will take away anxiety very briefly and what will happen is that anxiety or distress will come right back again. Doing the compulsions may initially cause distress to go away but they end up reinforcing and growing OCD. Working with an OCD therapist is very important to get help for OCD.
What does hyperawareness and sensorimotor OCD therapy look like?
Exposure and response prevention (ERP) has been shown to be the most effective form of therapy for OCD. ERP is an evidenced based therapy and is considered the “gold standard” for treatment of OCD. It is important to make sure your therapist has ERP training in order to get the right type of treatment. Mindfulness skills or Acceptance and Commitment Therapy (ACT) can also be helpful when used in conjunction with ERP. ERP is a very specific type of Cognitive Behavioral Therapy (CBT) that helps us learn to accept the obsessions and then work to reduce the compulsions.
ERP therapy can be challenging, however continuing to suffer from OCD is far more challenging. There is so much hope for the OCD sufferer. I have worked successfully with numerous individuals who have suffered with sensorimotor OCD and have helped them overcome the grip Sensorimotor OCD has had on their lives. OCD therapy can help!
How to find an OCD therapist in San Diego?
If you, or someone you know, is struggling with sensorimotor OCD or any of the symptoms listed above, I would encourage you to get help from an OCD therapist. Living with OCD is very difficult but with effective treatment you can get on the path to recovery. The first and most crucial step is to reach out to get the process started.
At Resilience Counseling we serve clients in San Diego and all over the state of California. If you feel like you want to take the first step to get help with your OCD, please contact us so we can set up a free 15 minute consultation today!
OCD therapy and other areas of focus in the San Diego based office
References
David J. Keuler, PhD, (2011), “When Automatic Bodily Processes Become Conscious: How to Disengage from “Sensorimotor Obsessions”” International OCD Foundation. https://iocdf.org/expert-opinions/when-automatic-bodily-processes-become-conscious-how-to-disengage-from-sensorimotor-obsessions/
