Somatic OCD involves preoccupation with repetitive, intrusive thoughts and/or physical sensations out of the individual’s control. It is normal to have some involuntary physical sensations. People without OCD can accept this and move past these thoughts and/or sensations. Somatic OCD develops when an individual becomes consumed with obsessing over these thoughts and/or sensations, begins to feel anxiety, distress, doubt, confusion, or another difficult emotion because of these obsessions, and may develop some compulsive behaviours (physical or mental) to find short-term relief from these difficult emotions. Unfortunately, the obsessive doubts (e.g., “Why am I having this sensation”, or “What does this sensation mean?”) cannot be argued or reasoned with and it is exhausting and endless to attempt to do so.
What are the OCD symptoms?
Obsessions: The obsessions in somatic OCD revolve around physical sensations. This can involve hyper fixation on certain physical sensations and a fear about the meaning of these sensations, where the individual often worried that something is wrong. Some examples of the intrusive thoughts associated with suicidal OCD include: “If I don’t blink enough, I could go blind. I need to monitor my blinking.”, “I can’t stop noticing my heart rate. Did my heart always beat this fast? I should count it.”, and “What if I forget how to chew my food? Will I ever be able to do this without thinking about it again?”. The thoughts can take an infinite number of forms and are only limited by the brains capacity to imagine.
Compulsions: To manage the anxiety and distress associated with the uncertainty of these physical sensations, people with OCD seek to reduce the amount of anxiety and distress caused by these thoughts by behaving in repetitive ways that provide short-term relief. They may find themselves attempting to make the sensations go away by distracting themselves, avoiding certain situations, repetitively checking for the presence of the physical sensation (e.g., if they are blinking enough), mentally reviewing their past thoughts, counting the frequency of the physical sensation (e.g., their breath), researching, seeking reassurance and/or reassuring themselves.
Why does it occur?
Somatic OCD can occur when the thoughts clash with an individual’s morals or values (e.g., that it’s important to be on top of their health). This clash can cause anxiety and distress, and the individual may attempt to suppress the thoughts, causing a rebound effect where the thoughts come back more often and more intensely. Individuals with somatic OCD may try to find relief from the anxiety and distress by performing certain compulsions. They may find themselves stuck in a cycle of obsessing, feeling anxious or distressed, and engaging in a compulsion to relieve the anxiety or distress for the short period until the obsession returns.