The Unseen Battle: A Journey into Somatic OCD

By: Suzanne Feinstein, PhD

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Obsessive-Compulsive Disorder (OCD) is a mental health condition that affects millions of people worldwide. It is characterized by recurring, unwanted thoughts (obsessions) and repetitive behaviors (compulsions). One specific form of OCD that is less known but equally debilitating is Somatic Obsessive-Compulsive Disorder (Somatic OCD).

What is Somatic OCD?

In the vast landscape of the human mind, there exists a peculiar battlefield, one that is often unseen and unspoken. This is the realm of Somatic Obsessive-Compulsive Disorder (OCD), a form of OCD that turns the body’s automatic processes into conscious burdens.

Somatic OCD is a subtype of OCD where individuals have persistent, unwanted thoughts and compulsive behaviors related to sensations in their body which they are unable to control. These obsessions often revolve around normal, automatic bodily processes such as breathing, blinking, or heartbeat. For instance, a person suffering from somatic OCD might develop an obsession with the rhythm or depth of their breathing, or the frequency of their blinking or heartbeat. These intrusive thoughts can dominate their cognitive processes, leading to heightened fears about their physical or mental health.

The Impact of Somatic OCD

Imagine a day when the simple act of breathing becomes a conscious effort. Each inhale and exhale, usually unnoticed, now demands your attention. This is the reality for those grappling with Somatic OCD. It’s as if an invisible intruder has invaded their mind, turning the unconscious act of breathing into a task that requires constant monitoring.

The impact of somatic OCD on an individual’s life can be profound. The constant monitoring and fixation on bodily sensations can lead to significant distress, anxiety, and impairment in daily functioning. It can interfere with work, school, and personal relationships, causing a person to withdraw from activities they once enjoyed.

Moreover, the fear and anxiety associated with these obsessions can lead to compulsive behaviors as a way to alleviate the distress. These compulsions, however, only provide temporary relief and often reinforce the obsessions, creating a vicious cycle that is hard to break.

Examples of Somatic OCD include:

  • Fixating on the movement of your wrist and fingers when you type
  • Focusing on how your eyes move when you read 
  • Noticing and keeping track of your head movements
  • Observing how you walk or run
  • Focusing on the amount of time you chew
  • Focusing on how you are breathing
  • Measuring and monitoring your heartbeat
  • Intensively focusing on how you are blinking
  • Focusing on how you are swallowing
  • Constantly researching symptoms or seeking reassurance that you are physically well

The Silent Struggle

Living with Somatic OCD can feel like being trapped in your own body. It’s a silent struggle that others can’t see. On the outside, everything seems normal, but on the inside, it’s a constant battle to try and return to a state of unawareness.

The more one tries to ignore these sensations, the louder they become. It’s like being in an echo chamber where the echoes are your own thoughts about your bodily functions. The fear is not just about the awareness itself, but also the worry that this heightened awareness will never end. It’s a cycle that feeds on itself – the more you think about it, the worse it gets.

Leading causes of Somatic OCD:

The exact origins of Somatic OCD are not entirely clear, but several factors are thought to contribute:

Neurological Underpinnings: It’s believed to involve a dysregulation in the brain areas that are tasked with sensory information filtering. This inability to control excess sensory information can cause abnormal fixations on bodily sensations. 

Genetic factors: Somatic OCD may run in families, indicating a potential genetic component. 

Environmental Factors: People with Somatic OCD often have a history of trauma or abuse. 

It is important to note that these are potential contributing factors and not definitive causes. The exact cause of Somatic OCD is likely a complex interplay of various genetic, neurological, and environmental factors.

Treatment Options

Somatic OCD is a challenging and often misunderstood condition. However, with increased awareness and understanding, individuals suffering from this disorder can seek the help they need and lead fulfilling lives. If you or someone you know is struggling with somatic OCD, remember that help is available, and recovery is possible.

Cognitive Behavioral Therapy (CBT), particularly Exposure and Response Prevention (ERP), has shown to be effective in treating Somatic OCD. It involves gradually exposing oneself to the fear of the bodily sensation and resisting the compulsion to perform any rituals to reduce the anxiety.

Medication, such as selective serotonin reuptake inhibitors (SSRIs), can also be beneficial in managing the symptoms of somatic OCD. A combination of medication and therapy is often the most effective treatment approach.


The road to recovery may not be easy, but it is possible. It requires patience, courage, and the willingness to face one’s fears. But remember, you are not alone in this journey. Reach out to mental health professionals, join support groups, and connect with others who are going through the same struggle. Together, we can shed light on Somatic OCD and help those affected to reclaim their lives.

Advanced Behavioral Health, LLP helps people tackle their Somatic OCD using scientifically–proven CBT techniques. Call 646-345-3010 or email Dr. Suzanne Feinstein at for a free 15 minute consultation to see if you qualify for treatment.

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