Hyperawareness and Sensorimotor OCD

Hyperawareness and Sensorimotor OCD are subtypes of Obsessive Compulsive Disorder that focuses on sights, sounds, and physical sensations.

Hyperawareness OCD and Sensorimotor Obsessive Compulsive Disorder Treatment

“I wonder how I’ll start this article. How did I start all my other articles? It’s supposed to be about Sensorimotor and Hyperawarness OCD, but where do I start? I’m kinda congested today, so breathing makes a scratching, scraping noise, which is distracting and annoying. I wonder if other people think about that. Is that normal? Alright, I need to get back to work, but the echo-y internal sound of breathing in my ears won’t go away. Is it always there? How do I get it to stop? If it doesn’t stop, I’ll be too distracted to write my article. Darn. Now that I’ve been thinking about my thoughts and writing them down I can’t stop thinking about my thoughts. Stop thinking. STOP THINKING.”

A side effect of having a human brain is that we can think about anything! We can think about things have haven’t happened yet, or things that could never happen. If we wanted to, we can put all of our attention on a bodily sensation or function and think about what that feels and sounds like. We can even think about our own thinking.

While this may be a fun feature of our brain’s ability for many, it is experienced as an impairment and burden to some. In fact, people can experience these thoughts as constant, intrusive, and nagging obsessions that drain their energy and can leave them feeling hopeless that they will ever go away.

What is Hyperawareness and Sensorimotor OCD?

Hyperawareness and Sensorimotor OCD are two subtypes of Obsessive Compulsive Disorder (OCD) that pertain to an undesired and excessive amount of mental and emotional energy toward thoughts, sounds, physical sensations, bodily functions, visual anomalies, or energy level. This overattention to thoughts and sensory experiences falls in line with the OCD experience. Sufferers find that they are unable to shake off these thoughts despite a great deal of effort and they believe that if they cannot get rid of these thoughts that they will have a catastrophic impact on their future, their functioning, and ultimate happiness.

Hyperawareness Obsessive Compulsive Disorder

Hyperawareness OCD often refers to the excessive attention paid to external stimuli. Someone who experiences Hyperawareness OCD feels as if whatever their brain has fixated on is significantly louder, brighter, closer, persistent, occurring in greater frequency, and more distracting to them than to the average person. While not wanting to pay attention to these things, their brain has latched onto these very specific stimuli with a Kung-Fu grip that feels impossible to release.

Common objects of focus in Hyperawareness OCD can include highway noise, TVs in other apartments, people talking, screeching breaks, other’s keyboard typing, florescent lights, broken TV pixels, oscillating fans, etc.

Some obsessions within Hyperawareness OCD have even earned their own name. For example, Misophonia is the excessive awareness of sounds. This differs from Phobophobia, which is a fear of a particular sound. With Misophonia, people become too focused on a specific yet benign sound that has no objective offensive character or quality. Despite this, the sound somehow makes someone feel, well, miserable. For example, sitting too close to someone eating carrots, or another crunchy food, can feel physically grading, like there is no end to the sound, and seem like a concentration black hole sucking in all thought other than the CRUNCH CRUNCH sound. (This may also be from my personal experience)

In addition to external stimuli, Hyperawareness also refers to being overly aware of one’s thought process. The internal monologue of our thoughts is how we think, make decisions, and evaluate between choices. Someone suffering with Hyperawareness OCD will feel completely distracted by the internal thinking, thinking about the thinking, and the assumption that they shouldn’t be thinking about their thinking.

Sensorimotor Obsessive Compulsive Disorder

Sensorimotor OCD can be considered a more specific subtype of Hyperawareness OCD. Many people will simply categorize the Sensorimotor symptoms as Hyperawareness, and they wouldn’t be wrong. In fact, other writers may not even make a distinction between Sensorimotor and Hyperawareness. Think of Sensorimotor as the hyperawareness of bodily sensations and/ or functions.

Common Sensorimotor OCD symptom include excessive attention of one’s:

  • Breathing (sensations, depth, quality, fullness)
  • Blinking (frequency, intensity, sound, feeling)
  • Eye floaters
  • Heart beat (sound, consistency, situational context, sensation)
  • Feeling of clothing on skin (weight, texture, fit, tags, seams)
  • Joints popping or creaking
  • Posture
  • Position of arms and legs
  • Swallowing (amount, frequency, quality, pattern)

What Makes Hyperawareness and Sensorimotor OCD So Bad?

You probably wouldn’t notice someone doing Sensorimotor and Hyperawarness OCD compulsions as most of them are covert and internal behaviors, such as sensation checking, mental comparison, and rumination.

All OCD subtypes have their own feared outcomes that present the sufferer with possible consequences if they don’t avoid, check, get reassurance, or neutralize the fear. These “feared stories” are often in the form of an “If ___, then ____”, or “What if…” frame. Hyperawarness and Sensorimotor OCD generally focuses on the fear that the awareness of the thought or sensation will never go away, resulting in a lifetime of distraction, inability to be present for work or relationships, diminished quality of work and other endeavors, and an eventual life without happiness. All of this is feared unless they can get their obsessions to go away for good.

Compulsions for Hyperawareness OCD and Sensorimotor OCD

Compulsions are an attempt to regain the confidence that everything will be ok, that the attention to these thoughts and sensations won’t ruin their life, and that these thoughts will eventually go away permanently. Unfortunately, while compulsions may provide a temporary sense of relief, the ultimately solidify one’s attention on these obsessions, and eventually make the problem worse.

Since the subjects of the obsession are decidedly neutral (breathing, blinking, swallowing, etc.), the main compulsive effort is simply to get rid of the thought and overattention. The hope is that if the sufferer can get rid of the thought, even for a minute, that they can get back to their life. Some attempt to drown out distracting sounds with music. Others try to use meditation and mindfulness as a way of controlling their thoughts. Some become workaholics to constantly occupy their mind with occupational tasks. Others try to suppress their thoughts by effortfully shoving their thoughts out of their mind. Some suffers will change their whole wardrobe to avoid specific sensations. Some sufferers will see a long line of doctors to figure out if there is actually anything wrong with their bodily functioning.

These attempts, while hopeful, inevitably feed the obsession and make it worse. Instead of treating the thought and sensation as neutral and harmless, sufferers reinforce the feared association by treating the thought as something worthy of fear. Furthermore, attempts to suppress the thought by forcefully pushing the thought out of mind makes it more present in our attention.

Treatment for Sensorimotor OCD and Hyperawareness OCD

The OCD Cycle. External and interanl triggers cause an obsession. OCD Obsessions are often "what if" or "if, then" questions that cause anxiety, which is often that "Oh No" feeling. To get rid of the anxiety, rituals, avoidances, reassurances, or checking compulsions are done. This provides relief and confidence, but is often short lived and the obsession returns. Thus, completing the OCD cycle by starting from the top again.

Sensorimotor OCD and Hyperawareness OCD can be treated using the combined approaches of Cognitive Behavioral Therapy (CBT), Exposure and Response Prevention (ERP), and mindfulness based approaches, such as Acceptance and Commitment Therapy (ACT).

CBT is often used as the overall framework of therapy as it helps someone reconsider the interpretation of their thoughts, leading them to a more rational understanding. Through cognitive restructuring, therapist and client work together to use reason to develop a grounded understanding of their thoughts that typically undermine the OCD’s anxious-based feared story. Using logic will not, however, reduce the level of discomfort with the feared story. Instead, it helps to build the client’s rational confidence as treatment progresses into mindfulness and ERP exercises.

Treating this subtype differs from other OCD manifestations. Typically, OCD subtypes are treated through exposure to the triggering item, situation, or action. Through continued exposure to these stimuli, the experienced anxiety slowly reduces through a processed called “habituation.” In Hyperawareness and Sensorimotor OCD, our focus is not on the specific sensations or thoughts themselves. Instead, the focus will be on the feared outcome of the sensations and thoughts. In other words, Exposure and Response Prevention exercises will focus on tolerating the fear that the awareness of sensation will in fact ruin one’s life. For example, accepting that the inability to avoid noticing eye floaters may have a negative impact on one’s career and personal life.  The reality of these feared stories is of course illogical, without evidence, and often absurd. Nevertheless, it is the anxiety associated with the stories that must be inoculated.

Finally, Acceptance and Commitment Therapy (ACT) is used to help clients develop a more tolerant and accommodating perspective of their thought and physical sensations. Instead of viewing one’s thoughts and feelings as antithetical to happiness, success, and connection, ACT helps by providing some space between the thought and the client. This process helps the client see that the thought and sensation are just that, thoughts and sensations; not the enemy. When the awareness of triggering sounds, sights, or sensations are accepted as simply the result of the brain and nervous system perceiving the world, then they can be disconnected from their feared story (i.e. if I keep focusing on my breathing then I’ll never be focused on my life and will never feel happy again, etc.). Finally, the client then works to take this previously feared thought with them into their life and attempts to pursue their values and goals despite the periodic presence of the thought.

If you would like to learn more about Hyperawareness OCD and Sensorimotor OCD, or would like to schedule an assessment, please message me here.

FearCast Podcast episodes relevant to Hyperawareness and Sensorimotor OCD:

Episode 18- Sensorimotor and Hyperawareness

The California OCD and Anxiety Treatment Center offers specialized therapy for Hyperawareness OCD Sensoritmotor OCD in its Fullerton offices. In addition to serving North Orange County, Los Angeles, and the Inland Empire, CalOCD offers online therapy, group therapy, and Intensive Out-Patient treatment.

138 thoughts on “Hyperawareness and Sensorimotor OCD”

  • Hi would you consider treating me – I’m from the UK and can’t find a therapist here with experience in this type of OCD!

    Thanks in advance

  • I suffer from sensorimotor blinking OCD, I ‘m french and there are very few therapists who understand Sensorimotor OCD, and even fewer who know how to treat it. Can I send you a message ? All the best, Caroline

    • Hi Caroline,
      Unfortunately, you are right. Very few therapists know about Sensorimotor OCD, nor have any idea how to effectively treat it. I’m happy that people like you have been able to find this article and have it help in any way.

      If you have specific questions, you can message me through the contact form at CalOCD.com (https://calocd.com/contact/contact/).

  • I have found this article fascinating. For the past 3 years I have been experiencing sensorimotor OCD with eye floaters. I have seen a couple of different therapists for this over the padt couple of years but they really didn’t have any experience or knowledge around this particular form of OCD. I am currently really struggling and would love to hear from you. I live in the UK.

    • Eye floaters are a great example of a sensorimotor/ hyperawareness obsession. I’ve worked with a few people with this obsession, and they are a huge bother, but ultimately tolerable.

      I’d be happy to talk about how CalOCD services and how I can help. Feel free to send me a message through the contact link, or feel free to call me at +1 (714) 423-3779.

      • Hi Kevin. Thank you for your response. Have your previous clients been able to overcome their eye floaters obsession? My feelings toward them are that I’m the only person in the World who has them like this. It’s unbearable.

        • As I mentioned, you are not the only person in the world, and you are able to ultimately carry on a meaningful life whether or not your attention is fixated on them. The word “overcome” can mean different things for people seeking treatment, and unfortunately I cannot give you reassurance or certainty that you will be completely free of your awareness of them. In fact, the higher the desperation you have that they leave for good, the higher the chances they will remain in your awareness. Instead, you’ll have to learn to live a value-driven life alongside them in order for you to eventually “overcome” them, as previous clients have. I hope this answers your questions.

          If you would like to talk more about eye-floaters and treatment, please feel free to contact me via phone or email. Thanks so much.

        • Hayley, No you are not the only person in the world with this type of obession. I have it also. Some days i can look past them and other days i cannot. My counsellor has helped but todays like with restrictions with covid doesnt help.

  • Hi! How could we treat Sensorimotor OCD at home? I have it almost everyday with my breathing, and I can’t top thinking about it. Please help

    • Hi Shannon, Thanks for the message. While individual counseling is going to help you by specifically targeting and processing struggles contributing to and resulting from the obsession, it may not be possible for a number of reasons. Many self-help books exist that can help you develop your own treatment program and include many of the same tools that a therapist would use. Of course, not having that individual attention to process and collaborate with will be a drawback, however self-help books can be very effective. “The Mindfulness Workbook for OCD” by Hirshfield and Corboy, and “The OCD Workbook” by Hyman, are two great resources to start with. Give these a try if you aren’t able to connect with a therapist who specializes in OCD and anxiety treatment. I hope these help, and best of luck!

      • I’m thanuja from india, Bangalore karnataka state
        I’m suffering from hyper awareness of breathing blinking swallowing .how to overcome from this i can’t tolerate these feels like dye. 6 years it’s torturing me I wasn’t knowing that it’s ocd I got to know recently I can’t even express how I’m feeling right now I thought of commuting suicide it’s really horrible I have to inhale exhale constantly even single minute it’s not leave me free ?

        • Hi Thanuja,

          I’m glad you found the article, and I hope it gave you some hope.

          First, if you are considering suicide or harming yourself in any way, please go to the nearest emergency room, or contact your countries local suicide prevention hotline. While OCD can feel overwhelming and make you believe there is no hope of recovery, OCD is a treatable disorder!

          The goal of breathing obsessions isn’t to eventually figure out how to breath correctly, but to accept that there is no such thing as a “right” or “wrong” breath, and actively monitoring your breathing all day only makes it worse. If you aren’t already connected with a therapist, I’d encourage you to seek someone out who can help you through this time. The IOCDF is a great resource for those seeking help internationally.

  • Hi there
    I’m from the UK and I have suffered from swallowing, (a bit of) blinking and the breathing ocd ever since I was 13 (I’m 20 now) there have been a few years since i have had any of them! but the swallowing one was triggered a few weeks ago and now it has swapped over to the breathing one. I’m absolutely desperate for help-it is debilitating! Would you be able to do sessions with someone in the UK? most doctors and therapists just don’t understand it over here ?
    Please help me :,(

    • Hi Seren,

      Thanks for reaching out. Unfortunately, many therapists do not have experience working with, much less heard of, Sensorimotor/ Somatic OCD, so the treatment options are limited. Further, even if they have heard of this OCD subtype, many therapists outside the United States do not use CBT and ERP as part of their treatment.

      I am able to work with people in the UK, as well as most other countries outside the United States. If you would like to discuss treatment options, please feel free to message me through the contact page, and I’ll do my best to see what we can do.

      Thank you for reading the article.

        • Hi Giuseppe,

          Thanks for the message. On occasion, I will consult with other therapists about their clients with OCD and OCD spectrum disorders. If they are interested in consulting with me, please have them contact me and we can work out a time to speak.

          Often, clients who find my various articles or podcasts helpful will share the article and episode with their therapist as a conversation starter. This might be an easier plan than having us consult directly.

      • Hi my name is Patryk I’ve had this stupid Bresthing blinking and swallowing OCD since I was 7. It’s not as bad as it used to be because when I was younger I kept on mouth breathing and thinking about my breathing all day long. I hate it so much especially if I’m around people or close to people. PLease I am begging you to help me. I fe like I will have this for the rest of my life. Please help. Is it possible to cure this completely?

        • Hi Patryk,

          “Curing” OCD is a tricky conversation. If you mean completely get rid of the thought about your breathing, or stopping your attention on your breathing forever. Then no, probably not. But if you mean come to a ceasefire on the awareness of your breathing and begin living your life with the knowledge that you will sometimes get distracted by your breathing, just like you get distracted by a bunch of other things but dont care, then yes, you can recover.

          You will breath. You NEED to breath. The trick is remembering that it’s not your brief and periodic awareness on your breathing that’s the problem, it’s the unwillingness to say you will have your breathing AND your conversation with your friends. Not either/ or. It is easier said than done, but it’s doable. Feel free to reach out with any questions, or potentially chat about treatment options.

  • I’m so glad there are therapists out there that recognise and treat sensorimotor OCD. I have had recurrent hyper awareness of blinking since I was a child which, after many years of intense episodes and relapses, I have finally started to find some ways to work with. I used to think I was alone in all this but have been part of a Facebook group for the last year that has introduced me to many others who are suffering. Whilst I’ve had some treatment and am mostly in a good place right now, I am always saddened that there isn’t more support and awareness out there for sufferers of this all consuming and hugely distressing condition which is much more significant and widespread than a lot of us realise. So many therapists and OCD centres have not come across this before and find it difficult to fully understand and treat. Please keep doing what you are doing and helping people like us, it means so much to know we are understood and not alone.

    • Hi Vicky,

      Thank you for all the kind words. I’m so happy that my article was encouraging to you and that you found it helpful. There is so much good information out there these days, between blogs, articles, YouTube, podcasts, Facebook groups, and even Instagram! Remember, you aren’t alone, and there are people who understand!

  • Hello, I was just wondering what are some of the best exercises and/or ways to treat sensorimotor OCD by myself? I have it with my tongue and my fingers.

    • Hi Nick,

      The best exercise you can do is to resist the urge to stop the awareness. The more attention to pay to the sensation, the more of a problem it will become! Instead, allow it to be there and let it be part of your life.

      Of course, treatment can be more complicated than this, and it is, but at its core OCD treatment is about resisting compulsive actions and tolerating unwanted discomfort.

      • Hi Kevin,
        I am wondering if you have encountered sensorimotor OCD in the form of hyperawarness of motion / balance?

        • Hi Rhianon,
          Thank you for the question! I have absolutely worked with people who have obsessions about balance and the importance of their body movements. In my experience, the obsession can center around a “just right” feeling, or inspecting the quality of the movements. This over-attention is very time consuming and can impact many areas of someone’s life.

          If this does not describe your obsession, fear not. Sensorimotor/ Hyperawareness OCD (well, OCD and anxiety in general) is only limited by our imagination and awareness. So, we can obsess about anything! Just because you don’t read many people discussing the same details of your own obsession doesn’t mean you are alone, and it absolutely doesn’t mean you are hopeless!

          If you have further questions about treatment or getting a handle on your obsessions, feel free to contact me and we’ll see how CalOCD can help. Thanks again for your comment.

  • Hi Kevin,

    Thank you for the article. I related to much of it.

    I was wondering if I could get some advice in relation to my own anxiety, which I believe is likely a hyperawareness/sensorimotor OCD issue. I’ve brought it up with a couple of different therapists, but they did not seem familiar with the issue. I sometimes worry about being distracted by the things mentioned in the article, such as sounds, and bodily processes, but my big one is my own shadow.

    Any time I become aware of it, for example if I am writing, and noticed the shadow of my hand on the paper, I become anxious about it distracting me, and making me mess up my work. I feel torn between two modes of action. Do I look to consciously expose myself to more and more situations where I will notice it, or do I leave it, as exposure will only make it worse? It seems like for me it’s the fear of doing the wrong thing that makes me more anxious, and so I almost end up doing neither consistently.

    Any advice would be greatly appreciated! Thanks

    • Hi Maximilian,

      Thanks for reading the article.

      While there are plenty of things you can do to help with this obsession, the common thread between all of them will be to devalue the importance you place on your shadow. You will notice it from time to time, as we all do, however your job will be to spend as little time questioning, evaluating, or criticizing yourself for the awareness. Exposures can certainly be helpful, but accepting this attention and calmly shifting back to your intended focus will be an important step.

      Thanks again for the question!

      • Hi Kevin,

        That makes sense. Thank you very much for your reply. I greatly appreciate you providing some clarity as it can be hard to find it when your stuck in these little worries!

    • I’m controlling every breath I take what if my mind forgets how to breathe by itself, is it bad to control your breathing most of the day? I always feel out of breath. Fuck.

  • Hi Kevin,

    I began experiencing hyper awareness of my own thinking back in May. Being inquisitive, I listened to your Podcast where you mention that once you become aware of blinking you cannot unsee it. Curiosity killed the cat and as soon as I heard that I became fixated on blinking. Since then my life has been turned upside down. I am hoping you didn’t mean that forever and henceforth my attention will be fixated on my blinking. I have read other things that suggest sensorimotor awareness can fade. Apologies for the reassurance seeking, but the thought of never ever experiencing a moment when I’m not fixated on blinking seems too much. Any hope you can offer would be much appreciated.

    • Hi Matt,

      The comment of “you cannot unsee it” is a turn of phrase that simply speaks to the way Sensorimotor and Hyperawareness obsessions are experienced. Many describe it as an “all of a sudden I noticed…” or “I never thought about it before, but…” in relation to the onset of this obsession.

      Yes, people can see marked improvement with these obsessions. CBT, ERP, and mindfulness all work together to help someone suffering from these symptoms to build acceptance of these sensations/ awarenessness as normal functions or phenomenon while working to give them less attention.

    • Hello, My adult daughter has been suffering for over 2 years with severe OCD. It started with obsessing over a tooth that was given her problems. It then evolved into obsessing over her tongue. Now she is obsessing over her fear of pain which is causing her to have severe anxiety which in turn is causing severe pain in her arms. She is very discouraged but is not getting the help that she needs as we live in a rural area & most mental health services dont know alot about OCD. She tells me that there is no help for her. I have encouraged her to seek online therapy with someone that is knowledgeable in OCD. Is there anything else that you could recommend and can you give her some words of encouragement? Thank you, Cindy

      • Hi Cindy, I’m sorry to hear that your daughter is experiencing this. A huge advantage to people seeking therapy these days is the prevalence of online treatment/ teletherapy. Through teletherapy, anyone with internet access can meet with a licensed professional. If you have specific questions about teletherapy, please feel free to message me or call me and I’ll be happy to discuss various options.

  • Hello! I’m hyperaware of objects in my vision, which means if I shift my vision from Object A to B, some part of my vision keeps focussing on A. This happens while watching a video as well. Obects in videos for me work similarly as objects in real life. I tend to become hyperaware of the blurr background as well.
    Also, I have hyperawareness of sounds like fan and vehicles.
    Others are -What if I’m not able to concentrate while reading, writing, watch etc. and become hyperaware while doing them and pull myself out of the immersive experience? And then I eventually get pulled out. This is also coupled with above mentioned vision hyperawareness. My vision tends to fixate on objects nearby when I’m reading or writing.

    I have been dealing with this for years and my hope is dying.
    Can you suggest me something?

    • Thanks for the comment. I appreciate the fact that you are acknowledging that people can experience both hyperawarness and sensorimotor obsessions, and be aware of a few at once. This is important as some believe they are worse off by having more than one, but ultimately the obsession is the same no matter how many objects or stimuli are part of the obsession.

      As with all obsessions in this subtype, recovery happens when you are able to accept the awareness and resist fighting it out of your awareness or experience. Make space for the sounds and sights are normal things and evidence that your sensory system is working. Treating your awareness as a simple, albeit annoying, reminder of your sensory system rather than the awareness that will ruin your life will help your acceptance and eventual recovery.

      Thank you again for the comment!

  • Hi!
    I think a have a hyperawareness about my tongue. The first time I got it, I became aware of the positioning of my tongue and I can’t seem to figure out how to rest it properly. Whenever I try to relax it, my tongue moves on its own. I also felt some tingling/numbing sensation on my tongue . I don’t really have the urge to be aware or move my tongue, it just does it on its own. I have been feeling theses symptoms for weeks but I think it has gotten a bit better since then. I think my biggest concern right now is whether or not this thing is gonna go away.

    It has been bothering my productivity lately and sleep lately and the sensation on my tongue is the first thing that I notice every time I wake up. I would like to talk about this with my parents so that they can arrange an appointment to a doctor. I’m just afraid that when I start talking about my condition with my parents, they too will become hyperaware of their tongue and I don’t want that to happen. I really need some advice here.

    Thank you!

    • Hi Patrick,

      Thanks for the comment, and I highly encourage you to talk about this with your parents especially if it makes it more likely that you’ll be able to get some help for it. There is help out there, and the treatment methods outlined in the article do help you get a better handle on your obsession.

      Your other concern about sharing this fear with others is also something I have come across. Some people worry that by sharing their obsessions with someone, they will inadvertently give this obsession to others. While some people may become aware of a new obsession, or even briefly take on the fear when hearing about a new obsession, it is so exceedingly rare that I am tempted to say it essentially doesn’t happen. Therefore, I urge you to take this risk and not let it get in your way of seeking help.

      To help with this, consider the job of the OCD/ Anxiety therapist. I hear obsessions from hundreds of people, maybe thousands in the course of my career all day, every day. If your “contagious obsession” worry was valid, OCD and Anxiety therapists would experience an abnormally high rate of obsessional thinking and fluctuating obsessions with every new client, however this is not happening. Take the risk and tell them. If you would like to set up a consultation with me, or discuss treatment options further, feel free to contact me at (714) 423-3779, or by email here.

      Thanks for the comment.

  • Hey. I’ve had sensorimotor ocd on and off for four years, it has gone for up to a year in between all this and it always relapses, I don’t know what I can do about the relapses, I’ve completely beaten the swallowing ocd which hasn’t come back and the breathing ocd, however I have a blinking ocd and after a week of ERP I feel so much better the blinking doesn’t annoy me as much. What are some other good strategies I can do for this.

    • It sounds like whatever you are doing is helping! The other aspect you should consider is accepting you have OCD that will return every now and again. Expecting the OCD to return and pester you from time to time can help you take a calm, welcoming, and empathetic perspective with your anxiety. Knowing it will return lets you recognize the tell-tale signs of it and practice mindfully disengaging from your typical compulsive patterns and overattending.

    • Hii how did u treated ur swalow awareness so it went ? Mine js better but atill get stuck sometimes! I need to hear from pol who overcame what did they do?

  • I honestly can’t describe the feeling of what it is like to come across this article and find an explanation for something I have been living with for about 10 years. So many of the other reader’s comments here totally resonate with me…like those who feel they must be the only person in the world who is suffering from their particular OCD symptoms.
    I have issues with the feeling of clothing on skin, and the position of my arms. I have interpreted all this as pain and spent a decade or so visiting surgeons and specialists to work out what is wrong. (I’ll try not to think about the money I have spent on doctors and treatments…)
    On top of this, I spend most of my day thinking about the problem, diagnosing and constantly re-diagnosing it (this self diagnosis changes multiple times each day), and thinking about the fact that I’m over thinking it! It’s exhausting!
    Thank you so much for the very informative website. It has given me some hope.
    I am from Australia and will contact you directly about getting help.

    • Thanks so much for reading the article, and I’m glad that it has resonated with you and validated your experience. It can be lonely experiencing OCD and anxiety, but as you can see there are many people who are experiencing similar things. The best part is, there is hope through treatment! I look forward to speaking when you have a chance.

  • Hello,
    I have had the sensation/feeling/thought of a bloating stomach for more than 20 years. This has occurred after diner. It fluctuates in frequency and intensity. It becomes more stick when I feel tired, stressed, or sleep poorly.
    When my son started OCD symptoms 2 years ago, my problem got worse. This happened every night, affected my daily activities, and reduced my life quality.
    I can not rid of the idea that there is a lot of gas in my stomach. That feeling keeps me from laying down to sleep at night. I have to sit up during the night to drink water to burp gas out. Then I got entangled.
    I can’t sleep. When I lay down, I feel my stomach bloating. I try to resist sitting up to burp but I can’t. My bloating sensation stays for hours that keeps me from falling asleep. Even when I don’t feel anything, I keep checking then it comes.
    I feel anxious and worried about:
    What if my symptoms never go away, and I have to live the rest of my life like this?
    What if life is never satisfying again?
    My physical health is fine. I had an endoscopy done 2 years ago with a normal result. I practiced medicine as an internist in Vietnam for 15 years before coming to the US 10 years ago
    I read sensorimotor ocd in different sites but rarely found anyone with similar symptoms. I really need your advice.

    • Thanks so much for your comment and questions.

      To address your questions, and ultimately the focus of treatment for sensorimotor/ hyperawareness OCD, you will have to take the perspective that the symptoms may never go away and life will not be satisfying again. This sounds bleak, but at it’s core it is just as unanswerable as “When will this sensation go away?” We don’t know if or when, but we don’t need to in order to continue making the best possible life we can. In the course of doing so, we shift the focus from “when will this symptom go away” to “whether or not it goes away or is here, what do I want to do with my day?”

      Acceptance is an important step in recovery from Sensorimotor/ Hyperawareness OCD, and it is a major focus in treatment. If you would like to speak more about treatment and treatment options, please feel free to contact me. Until then, thank you for the comment.

      • Ive been overthinking my breathing for about 2 months now and it causes a lot of overwhelming anxiety and discomfort, it usually happens when times are quiet like in class , and i Aldo have difficulty drinking because i get a lot of panic when i swallow it sometimes

        • These are all common obsessions within this subtype. The aim of treatment is to help you reduce your overthinking and acknowledge the presence of a sensation, thought, or feeling while allowing your attention to shift away from it.

  • Hello,
    I recently developed an obsession with my swallowing. After doing research online about this, I learned that this is a form of OCD and that there are many other “themes” that people could obsess over. I was in a state of high anxiety at this time and I instantly began to fear the possibility of developing new obsessions. For example, in other articles about OCD, I read that people can obsess over their heartbeat, benign sensations, objects in their peripheral view, body positioning, blinking, breathing, unwanted images, eye floaters, and even the presence of thinking taking place which had my mind convincing me that I was beginning to develop those obsessions. It then grew to a realization that I could essentially obsess over anything in my mind or anything around me! I started freaking out because I realized that I was not in control of these thoughts and awarenesses in my mind. Even though the idea of developing a new obsession actually does not scare me too much anymore, I still experience varying levels of anxiety during the day whenever I remember these obsessions or think about OCD in general which is pretty much 24/7. How do I deal with this fear of the anxiety itself? I feel very restless most of the time as if my brain is constantly trying to remind me and come up with new obsessions/potential fears all day. I’ve been letting these thoughts just pass by without responding which has greatly helped in lowering my anxiety, but I constantly feel a sense of discomfort and fear a lot of the time. I wish I could simply forget about everything I researched about OCD but that is not possible. My fear is that I’m forever going to be stuck in this anxious state and I’m never going to be at peace again. This has made me very depressed and it’s been hard for me to ignore these thoughts and the anxiety attached. I also can’t function and perform well in my college classes as a used to. Please help!

    • Thanks for the comment, and I’m sorry to hear about your struggle.

      Obsessing about obsessing is another subtype of OCD that can impact anyone struggling with OCD. In short, it is an obsessive pattern about the quality, quantity, content, impact, and future of obsessions. It is OCD about OCD, and for some it includes a general fear of fear and compulsions to understand, control, or eliminate the presence of fear.

      Ultimately, you will have to accept that we are all afraid sometimes, but that we can learn to effectively deal with anxiety and uncertainty, even if its the uncertainty about what we’re going to feel uncertain about next!

      Mindfulness and acceptance using ACT can be really helpful to treating this. I commonly use these tools to help someone accept that they do not need to know the future to live in the present. There is help for this!

  • Hello… I am baibhabi…. I am having this problem of obsessed swallowing since 2 months…. Can’t concentrate on my studies and other things… I am slipping into depression slowly… Please can you help me? Tell me some ways or methods please I can’t find any help…

    • Cognitive Behavioral Therapy, Exposure and Response Prevention, and Mindfulness are going to be the most effective and helpful methods of overcoming these obsessions. I would be happy to learn more about your symptoms and to see how I can help. Feel free to reach out if you want to discuss treatment options.

      • Hi- thank you for sharing this. I’ve contracted covid a couple of weeks ago and went through some traumatic experiences. Afterwards it feels like my ocd has been triggered all over again. It began with some religious related thoughts than now I can’t look away from eye floaters its like they are everywhere all over my field off vision small sand like dots, long stains (floating flys), flashy spots and they are so distracting that I can’t actually focus on anything else. They scare me, it feels like I am the only person who feels this way in the World and that they’ll drive me crazy and the series of thoughts keep going on. I sometimes also hear a whislt that doesn’t stop.
        Back in 2012 I had a similar episode and CBC helped a lot but it wasn’t related to senses. Does that fall under hyperawareness and sensorimotor OCD? I ve been having those obsessions for almost 10 days and they are so painful. I had a severe ocd episode in 2012 but wasn’t related to senses, rather religious thoughts and ili was able to overcome it via CBC… do you recommend same approach? Also how can I reach out to you if I want to schedule a meeting with you.

    • Hi please can you help me? All started with change in mouth. My tongue cant stop to rub it until its sore and bleeds. I feel like there is hole in my mouth. I chipped lower front tooth and it all started. I had it polished. Since then i had to file all crooked edges because my tongue feels them. Its been 7 months 24/7 im losing my mind ..

  • Hi! I just wanted to let you know your article helped me feel understood in a way I never thought would happen. I struggle with sensory issues of the positions of my body. Specially my hips. For example of I’m laying in bed I feel like my leg is not as stretched out as I want. But then I move and it’s too much. I can never find the perfect spot. Or if I drive I keep moving myself back and back into the seat cuz it’s not at the right position. I also struggle with symmetry. If I move two parts of my body, it feels like I moved one harder than the other and I keep doing it over and over. I feel like I’m always adjusting. I just kinda wanted your opinion or to see if you had anything to say. Thank you for this!

    • Thanks so much for the comment.

      Based on your comment, not feeling “right,” whether intentionally seeking out the feeling or allowing the feeling to linger when it is naturally there, will be crucial for your recovery. Also, consider why it is so important to feel symmetrical or have the “right” feeling? Ultimately your task will be to see if you can allow yourself to not feel right for extended periods of time and practice being OK with not feeling OK.

  • Hi I have a breathing OCD, I’ve had it since 2016. I was never really able to get a therapist, I live in the Philippines and we don’t really have a lot of specialists here. I was able to reduce my anxiety of it for the past years because I got busy with school, my friends and my boyfriend. For a while I would only notice the breathing or sometimes occasionally blinking and then “I would tell myself it’s okay I’ll forget about it later” and I do, This would happen everyday. But recently, I started to think about it more and more and I can’t stop now. It’s like I’m back to square 1 and I really don’t know what to do. I can’t distract myself with friends or school like I used to because currently we are still in quarantine. Can you please give me some advice how I can reduce my anxiety again on my own?

    • There are a bunch of great books out there that can help you if you aren’t able to meet with a therapist in person.

      The Mindfulness Workbook For OCD, by Hershfeld and Corboy
      The OCD Workbook, By Hyman
      Freedom From Obsessive Compulsive Disorder, by Greyson

      All of these books would be a great start to understanding how OCD works and how you can overcome it.

  • Hello,
    A couple years ago I began to swallow constantly. Since that time I have been to several doctors, general, ENT and gastroenterologist to try to find a medical reason. No one has been able to give me a reason. Found your article and am wondering if this is my issue. How would I know that my issue is OCD or not a still undetermined physical reason?

    • Great question. Ruling out general medical issues is a great first step. Since nothing has been found, it is a good idea to do an assessment with a therapist trained in these issues to help you determine if OCD is playing a role in your distress.

      Also remember that OCD is tricky and relies on making you doubt so that it can survive! No matter what a therapist or doctor says, anxiety/ OCD may still respond with, “well, it could still be something else, so I’d better see another doctor/ therapist/ specialist.” Accepting the doubt and the possibility we have missed something is an important part of recovery.

      Thanks for the question.

  • Due to a lot of stress I have an OCD failure again. It is a kind of consciousness that you are on and that you think, it is not necessarily a specific thought, it is a frozen mode. is also difficult to explain to the psychologist, because he keeps asking what my obsessions are, that makes it so frustrating. it’s just that I stay on and kind of think about that.

    • Sensorimotor and Hyperawareness obsessions can be hard to explain to therapists who do not know about it, but presenting articles like this one to them can help them understand.

      Additionally, OCD can be triggered and re-triggered by life’s stress and is not a failure on your part. Extending compassion to yourself and your obsessions will help you make headway in overcoming them.

  • Hi Kevin,
    Many thanks for this wonderful site and information. Do you believe medication can be helpful in conjunction with psychotherapy for sensorimotor ocd? If yes, which medications could help?

    • Hi Rao,

      Research shows that medication can be a very helpful component of OCD treatment, and produce the best and most long-lasting effects when used along side behavioral treatment (CBT, ERP, etc).

      For which medications that are best for you, I will encourage you to speak with your doctor or qualified psychiatrist to get the most accurate information for you and your situation.

  • Hi I have just read your article and gained some reassurance so thank you. My issue is that I keep focusing on a sensation behind my nose, I do this so much that I can even make it pulse! It is now driving me mad and I am working on trying to accept it as normal. Any suggestions would be appreciated.



    • Thanks for the comment Katie, and I’m glad the article helped.

      The goal of treatment for Somatic obsessions is to spend less time focused on the feeling or sensation. This also means spending less time questioning it, wondering whether it’s still there, thinking about the long term impact this sensation/ awareness will have on your life, etc. Instead, taking the personal and mental perspective of, “yup, there’s that feeling again. Now, what was I just up to…?” You’ll notice the feeling, but treating it like you would treat any other tickle, stitch, or flinch in your body that you already feel and don’t care about is the way to go.

      Thanks again for the comment.

      • Hi Kevin,

        Thanks for your advice. When you say spend less time focused on the feeling, does this mean acknowledging it but not spending time thinking about when it will go away, etc? I am currently having trouble diverting my attention from it, but I am practicing allowing myself to experience it without having additional thoughts about how to deal with it. If that makes sense.

        I just want to know if I’m doing it right

  • Hi
    I tend to focus on sounds of silence in my ears, I ma very scared of ever getting tinnitus, its just one of my fears in life not sure why but it is….there are times that I can tell you I would go in my closet where its quite or my car and make sure I don’t hear anything. I will also plug my ears with my fingers and listen to make sure I hear nothing….most times I move on and I don’t think of it again. Actually the other day I remember I walked in my closet and heard the sound of silence (like the ocean sound with a seashell) but I was able to say I don’t give a fu#k and nothing bothered me…then one day I am just sitting at my desk at work quite place and the thoughts started and I think I hear something in my left ear…now all I do again is say its never gonna go away and I will think of this forever and is there something there? is this my anxiety? and the ultimate question is IS THIS OCD? if it is I feel positive that I can get to the part in my life where I say who cares and it goes away just like it did the other day when I was in my closet just getting something…how am I able to say that and not care but then two weeks later I am where I am today, and its not a good place I’m stressing over it and its all that I think of? Please send me a note back and tell me this is OCD and I will get back to where I was a week ago!! thanks

    • Hi Chris,

      Yes, this is likely your OCD as it sounds very consistent with others’ experience, however if you are concerned you may consider meeting with a therapist to evaluate the issue.

      With these types of obsessions, the effort to make sure you stop noticing the sound ensures that you will hear the sound more. One of the biggest difficulties with treatment is helping someone get to the point where they are accepting that they will hear a sound, or not, and that either way hearing a sound, or not, is part of life and doesn’t deserve further investigation or evaluation. Whether it is tinnitus or OCD, there is an unnecessary amount of effort given to it, so your job will be to limit or eliminate the attention given to it.

      I hope this helps!

      • OMG. I have this very exact fear- of getting tinnitus and not being able to deal with it.

        I have been suffering from Hyper-awareness OCD for quite sometime now but have been managing it successfully by reading ACT books etc and reading this site.

        Unfortunately, however I began to have intermittent episodes of pulsatile tinnitus (when you hear your pulse in your ear) for 1.5 months now and this has sent me in a spiral for the past 2 weeks- to the point where I am now borderline in crisis. My situation is a little different because I have experienced for real the fear I had- the tinnitus!

        I am now trying to use my ACT to prevent the panic and anxiety in response to the intermittent noise in my ear. But it seems to be not working…

        All I think about is whether the tinnitus is permanent, will it increase in intensity and frequency etc. Will it become unbearable to the point where I can no longer deal with it. Will I become suicidal like all the horror stories I read on online tinnitus forums…I keep scanning to see if the tinnitus is there every morning. I focus and focus until I find an extremely low frequency noise…I then try and hone in on it to see if it is real noise from an appliance in my house or whether its in my head. 80% of the time I can identify an objective external source for the noise. But when I cannot identify an external source I panic and spiral into a vicious cycle of intrusive thoughts. They all boil down to the fear [emphasis added] that there will come a point that the tinnitus will be constant and permanent and I wont be able to deal with the noise and that I may become suicidal….

        It is now consuming the majority of my time- and I am googling frantically about tinnitus on a daily basis. I have seen several ENT’s but they are unable to find any physiological reason for the tinnitus and the pain- As I am unable to “pop my ears” they suspect Eustachian Tube Dysfunction.

        My question is- do I really have tinnitus or is my hyperaweareness OCD playing up.

        • Hi Bourke,

          Both things can be true; you can have tinnitus and Hyperawareness OCD at the same time. Often, OCD heightens the perceived threat and long term impact of any Tinnitus symptoms, resulting in further overattention, rumination, and compulsive efforts to eliminate the “threat.” To overcome it, you’ll have to give up on getting rid of it. This means giving up on the thoughts and actions you do in the attempt at eliminating the awareness or the presence of the sound. Make space for it. Allow it be in your awareness at times without fighting or judging it. It’s easier said than done, but its possible to bring about a radical change in perspective when you’re ready to stop fighting against it.

  • hi kevin, i don’t even have physical anxiety anymore with this disorder. how is it possible that the hyperawareness is still on?

    • Hi Michael,

      I’m not exactly sure what you mean, but sometimes the obsession can begin with the presence a real physical sensation, but if/ when the sensations subsides, the pattern of rumination and physical checking persists. This continued checking/ evaluation is part of the problem that needs to be addressed. That said, to get more information, you should reach out to a therapist to discuss the continued issues to see how they can help.

  • I have been bothered by hyperawareness of my own thoughts for months now, I am now in a phase where I am not afraid of it, how can this be explained? unfortunately it is still there.

    • Hi Bakkie,

      This happens. Not being afraid of it does not make it better or worse, just different. It sounds like now you are simply noticing a sensation. If this is the case, let the sensation be there because it’s a natural human experience to sometimes notice thoughts, feelings, mental images, sensations, or urges. Notice it, resist judging it, and allow yourself to move on to other thoughts.

  • Hey, Hope you are doing well. I am struggling with breathing obsession (somatic ocd, where i have to constantly think about my breathing the way i inhale or exhale which causing severe anxiety and sometimes irregular breathing, if i dont notice it i think i would choke out, i need help, its rare to get therapist who understand this, i will be grateful if you can refer me to someone who understand me and treat me better. Thank You.

    • A great place to start in finding a therapist is by visiting http://www.IOCDF.org. They have a database of therapists that you can search with your zipcode to find people near you.

      Regarding your obsession, you are holding a false belief that you HAVE TO think about your breathing or you will “choke out.” What happens when you sleep? What happens in those moments before you realize you weren’t thinking about breathing? Answer: you were breathing just fine. OCD wants you to think that you have to monitor your breathing or else face some terrible consequence. To recover from this, you must be willing to turn your attention away from your breathing and actively not monitor it. It can be frightening, but it can be done.

  • Hi I am hyperaware of my own thoughts and thought processes and I have no idea how to get over this. I can’t think about anything else because I’m literally scared of the thinking and never being able to stop thinking about my thinking. I’m also scared of never being able to have thoughts flow again. Is this possible to recover from??

    • Hi Natalie,

      Yes, you can recover from this, but perhaps not in the way you hope. Recovery from this obsession is not in the elimination of meta-cognition (thinking about your thinking), but is in acceptance that you have this feature to your thinking and that you will periodically become aware of your thinking and sometimes also be distracted by it. This happens, and is a normal side effect of having a human brain. There are some exercises and techniques that can be helpful in this, and working with a therapist can help you implement and practice them. If you have any further questions, please let me know and I’ll be happy to help.

  • Hello Kevin, I seem to be suffering from a rare and terrible variation of Hyperawareness OCD. When I was a child I first experienced anxiety related to forever noticing my breathing and swallowing. Later however, it evolved into being hyperaware of me thinking about a children’s horror show that I didnt like, and being terrified I would spend literally the rest of my life thinking about this kid’s horror show. I feared waking up the next morning and still thinking about it. This kind of ‘consciousness’ came and went, sometimes it stayed for a week before completely forgetting I ever had it. Around age 20, I linked this fear of forever thinking about a thought with terrible thoughts about my self, which fueled all my obsessions to this day. My life is completely ruined now at 26, because whatever bad thought I can think of, I fear it will stay forever and as a result it kinda does. My frustration is that I cant find a single story on the internet that is same as mine. They either have obsessions about fearful thoughts or they have sensorimotor obsessions. Mine are linked together in a terrible, life wrecking storm of anxiety. What do I do? Am I the only person on the planet that experiences this particular form of ocd? I feel cursed.

    • Hi Karl,

      Thank you for the comment, and I’m sorry to hear about your struggle. Unfortunately, OCD does not always fit into a neat little box, and an individual’s manifestation can seem obscure. However, it is important to remember that it is all just OCD.

      The problem ultimately is not in the obsession, but the compulsion. The amount of effort you spend in trying to get rid of the thought only ensures the thought remains present and active in your attention. Letting go of the control over the thought will allow the thought to eventually leave (as it always does anyhow), and accepting the periodic distraction and remembrance as a fleeting mental experience will help normalize the feature of remembering and de-escalate the significance of it.

      I’m happy to talk more about it with you and discuss what treatment could look like. Until then, I hope all is well.

  • Hi. I have a obsession with the positioning of my tongue and swallowing as well. I have tried to accept them and move on, but the moment I think they are gone, they come back again and stay for a long time. I just don’t know how to rest my tongue in the right way. Is there a solution?

    • Hi Raju,
      Your question is absolutely reflective of your obsession. There is no “right way” to rest your tongue in your mouth. Continually monitoring your tongue and ruminating about the quality of its position will only maintain and strengthen the obsession. Instead, you have to place your tongue wherever it is and accept the possibility that you have it in there wrong, then allow yourself to move on and get engrossed with other thoughts and issues.

  • I’d be really interested to hear you thoughts on the relative importance of the ‘exposure’ part of erp in regards to sensorimotor ocd. From personal experience, exposure is always present with a breathing obsession. Furthermore, some literature I’ve read points to the fact that exposure, via mindfulness and directed attention, can lead to rumination and ‘working out’. Rumination is seen as a compulsion. There is a distinction in this literature between ‘directed attention’ (bad) vs general awareness (ok). I know mindfulness is considered beneficial in almost everything I’ve read – but is there not a danger of becoming too mindful and introspective that leads to rumination?

    • Hi Peter,

      Great question and observation. As a general rule, anything that we do in therapy can become a compulsion if/ when the client begins to use it as a reassurance tool. You’re right that exposure to the sensation/ stimulus (breathing, blinking, the tip of your nose, etc) is unhelpful and draws unnecessary attention to it, but exposure to the feared outcome or consequences of the awareness can be beneficial. Mindfulness, if it’s being used as a way to draw attention to one’s internal experiences, is helpful for a number of people and other OCD subtypes, but is less helpful (read “unhelpful”) with Sensorimotor/ Hyperawareness. Mindful and simple acknowledgement of the sensations is fine only when coupled with a casual redirection away from the sensation toward other things. In other words, when the sensation/ stimulus is treated as if it is neutral and unimportant. A lot of the work with this subtype is focused on a redirection outward, disengagement with the internal experiences, and discontinuation of the analysis/ compulsive rumination.

  • Hi I have been dealing with hyper awareness breathing, blinking and heart beat and I dont know what to do anymore its interfering with my life I cant even get a good night sleep anymore I really need help.

    • Hi Jose,

      I’m sorry to hear about the obsession’s impact on your sleep. Many people suffering with this OCD subtype struggle with sleep for a number of reasons. The purpose of treatment is to practice stopping the compulsive and obligatory over-attention on the sensations, resist analysis of their quality or presence, and acceptance of uncertainty when you don’t figure out the meaning or solution of the sensation or attention. Treatment is out there and can be very helpful. If you want to speak more about treatment, please feel free to contact me at (714) 423-3779, or message me through the contact page.

  • Hello there. Similar to comments below, i’m having trouble finding therapy which fully understands the nature of sensorimotor OCD. I live in the UK and was wondering if you do provide therapy? Thank you for your help.

  • Hi Kevin, I am from The Netherlands. Since I have had a panic attack in November 2020 after a very stressful period, I hardly can’t stop thinking about the word ‘ breathing’. Now and then I also concentrate on my breathing. It has quite an influence on my daily life. Since December 2020 I use medication (Paroxetine 40 mg) and in a few weeks I start with a psychologist specialized in cognitive behavioral therapy. Do you have experience with this type Somatic Obessesions and is mentioned therapy often succesful? Regards Dennis

    • Hi Dennis,

      I do have experience working with this type of obsession. Breathing is a very common focus of Hyperawareness and Sensorimotor OCD. Treatment can take time, but I have had success with people who practice disengaging from the attention on breathing and the fear that they will ruin their life through over attention on breathing. It’s a slow process, but its about a radical shift in the way you view your breathing that makes the difference.

  • I enjoyed your article, I suffer with this junk and this has been informative. One thing I would like clarification on… you have pointed out mindfulness to be a compulsion, then turn around and recommend mindfulness as part of the solution. I have read of many specialists in this field that say mindfulness is a good way to control this, including yourelf… I think. can yo please clarify.

    • Of course Joe,

      Being mindfully present is a great way to help disengage from the fantasy and feared thoughts of obsessional thinking. And while with some subtypes I, and others, will encourage people to turn their focus toward their feelings while taking a tolerant position of them, doing this with Sensorimotor/ Hyperawareness can simply be more of the same compulsive hyperawareness and monitoring. Instead, cautiously being mindful present (meaning, nonjudgementally acknowledging all that is happening in our present moment) with our experience without getting overly stuck in any sensation, thought, feeling, or urge while redirecting attention toward meaningful activities is one way to use mindfulness effectively for OCD.

      I hope this clarification helps. Thanks for the question!

  • Hi, my name is Norees, I’m really glad I came across this article, I have been struggling with a breathing obsession as well as vision obsessions for the last year. I have ups and downs but it gets to the point where my obsessions routinely trigger panic attacks, especially when I think my breathing is wrong or my vision is off or I think I’m dizzy. Would you have any suggestions to help me cope with this? I have been struggling with a lack of hope due to the many relapses I’ve had over the last year

    • Hi Norees, The best thing you can do is to give the feelings as little attention as possible. I know that can seem hard, but treating the feelings as a temporary and benign feeling will help lower the importance you give it, and therefore reduce the amount of attention it takes. In other words, treat it like it’s not a problem and go on with your day as if it were nothing. I hope this helps.

  • I’m not sure what I have but it could be hyperawareness OCD to sound, I never had an issue until a week ago, where I was feeling anxious and I was sleep deprived. However I have been noticing that I started to become fixated to quite a few things such as sounds from mainly everything such as car traffic outside my house to clocks and mainly any repetitive sound. It’s making me quite anxious and I’ve been researching a lot I heard it’s called misophonia. However I was dealing with intrusive thoughts last month and somatic OCD a few days ago where I naturally just got better but it seems for this hyperawareness OCD I have found that the more I hyper focus the harder it is for me to habituate to the sounds and they are quite intrusive. Also my personal research that I have found said that’s incurable and it’s making me quite anxious in helping me find the solutions to the issue. I hope your team can get back to me soon to discuss this and what I can do to combat this issue.

    • Yes, OCD and anxiety disorders are chronic disorders, however they can be helped through the right treatment. It’s also helpful to remember that you are unlikely to habituate to the sound itself, but you must work on tolerating the possibility that you’ll be distracted by these sounds from time to time, and that the periodic awareness may never go away. This is the focus of treatment for these issues, not habituation to the stimulus (sound in this case).

  • Hi kevin, i reached out to you a few weeks ago, and youre not taking clients from the uk atm, which is okay, i have an awareness of my thinking. Is this something you have worked with clients to be more accepting of? My current therapist uses acceptance only and feels acceptance and not reacting emotionally will desensitize. Im accepting and letting my mind do whatever it needs to and letting the awareness be there without judging the thoughts i notice.

    • Hi Anisha,

      The work you are doing with your therapist can be helpful, but be sure to not get stuck in focusing too much on your thoughts. Some people believe they have to be constantly aware of their thoughts and practice acceptance with every one as a means of overcoming them. This method is incorrect as it just means that you are spending ALL your time thinking about your thoughts in the hopes that they go away. It’s completely backwards. Instead, you should be paying less attention to your thoughts and gently allowing the thoughts to leave without having to handle and manage each one. So, what you are doing can be a good step, but the next would be to begin spending less time even searching for thoughts and more time engaging with your external world.

  • Hi I have hyperawareness OCD when I notice the quietness I hear when I’m alone. This started when I began noticing a ticking clock which never bothered me and then one day it started to annoy me. I ve had this clock in my house 35 years and noises never really bothered me until this happen. I tried to put up with the clock by going about my day and left the room when it really got bad but then My obsession started focusing on the sound of being quiet. Now I’m also focusing on sounds I hear in my head which seem to get louder and louder when I feel anxious about this obsession. There’s nothing wrong with my hearing it’s just me focusing on it especially when I watch TV. Or if I’m not really thinking of anything. The ticking clock now doesn’t bother me but the hearing obsessions do now and quietness other times. Its at the point now where if I’m in a quiet room trying to do anything the focus on my hearing gets louder and louder and distracts to the point I can’t even concentrate on what I’m doing. The only time it gets better if I’m distracted by something I’m thinking about or talking to someone. I’ve been to two different OCD therapist s and they told me to sit with the clock ,quietness and the sound of my own hearing without doing any compulsions which I tried for a many months. At first when I sat with all this the aniexty would eventually come down but the sensation always there and I’m trying hard to accept this but haven been able to find anyone to help me do this. I’m at the point where I don’t know if these therapists are teaching me the ERP correctly or I’m just not doing it right. Im now obsessing and worrying about the therapy I was getting for this because it’s not working. I’m trying to stay positive but It’s making me depressed because I’m dealing with this problem for 2 years now and haven’t found anyone to help me.

    • Hi JR,

      The thing that may be happening in therapy that is incorrect is the therapists hopes to desensitize you to the sound of clocks or other distracting sounds. This should not be the focus of therapy as you may not be able to habituate to the sound. You notice it! What’s more important is addressing the feared story associated with the clocks. In other words, whats so bad about being distracted? THAT is what needs addressing. In many of my cases, addressing the fear about being in a perpetual state of distraction and being unable to focus is the fear that needs addressing, not the distraction itself. Perhaps this is something to bring up with your current therapist and see if they are willing to shift their treatment. Best of luck!

  • Hi ,

    I am having swallowing obsession. I feel like I have saliva in my mouth all the time and I will get choked. It becomes really difficult for me to sleep in the night. I went to Ent and he said there is nothing wrong with my throat and salivary glands but I am still having this obsession. It is making my life hell. I had obsession with bowel and bladder in the past and with the help of antidepressants I was able to overcome it. I have seen my psychiatrist and he has prescribed me few medicines but still this obsession is not going away. Could you please help me with it. I am really struggling. I have a 7 year old boy and I am not able to provide good care to him. Please help me.

    • Hi Ankita,

      I’m sorry to hear about how this obsession is impacting you. I would be more than happy to talk with you about whether I can help, however whether I am able to help will depend on your location and our mutual available times. Feel free to reach out to me at (714) 423-3779, or through the contact page to set up a discussion/ consultation about CalOCD’s services.

      Whether you and I are able to work together, I highly encourage you to take this issue seriously for the sake of your son. You now have someone relying on you, and you cannot care well for someone else if you are not taking care of yourself. Taking care of your own mental health and addressing this obsession in an effective way is one way that you are able to take care of him. So, please contact me or reach out to a local OCD therapist to start working on this.

      Thank you for the comment, and best of luck with your recovery.

  • Hi Kevin. I am so glad I came across this article as I have been so focused on figuring out what’s “wrong”. I suffer with things touching my neck, such as earphone wires or clothing. It’s the worst at night when I’m trying to sleep. I also have a weird one, which I hope is linked. This obsession is the worst and makes me feel scared of the future and very alone as I have never heard a similar experience from anyone else. I became fixated with my sister’s body in a way that I couldn’t touch or sometimes even look at it. This has been a problem since I was a kid, and unfortunately followed me into adulthood. My sister and I get on very well and I have managed to reduce the obsession just by having this good relationship with her, however it’s still there and I sometimes get a similar feeling with my partner, such as when he sleeps next to me and his feet touch my leg (for example). I’m fearful this will feeling will expand. I’m terrified of having children in the future and feeling that way towards their bodies too.

    • HI Clara,

      Thanks for the comment. Obsessions can take many forms, and even if it is not a common obsession it can still be treated like the others. It sounds like you get hyper sensitive and attend to your sensations a lot, and especially so at night. However, you will get distracted! So far, you have evidence that your sense of touch works. Great! The main question will be how do you respond to the sensations and what are you doing about it. Your job, ultimately in treatment, will be to accept that you are going to get distracted by physical sensations, and that you might be hypersensitive at night, but that it’s not the end of the world, and that you can still carry on a productive, meaningful life.

      Treatment can be helpful, so reaching out to a therapist for this may be a good place to start.

  • Thanks Dr Kevin for this article and bringing attention to what is still a poorly understood and treated issue.

    I’ve someone who recovered from sensorimotor OCD several years ago. As theres still a lack of information on how to treat it as well as a lack of access to a suitable therapist for many, I’ve written a brief guide on overcoming sensorimotor OCD at https://sensorimotorocd.net/. It’s based primarily on CBT and ERP, and my own experience. I hope it is useful to people who are struggling with this.

  • Hi I have this problem with my swallowing it’s really put me in a bad spot and now I’m starting to get suicidal thoughts plz I need help I would pay or do anything plz get back to me thank you

    • Hi Rafael,

      If you are having suicidal thoughts for any reason, do not hesitate to get in touch with a local therapist or mental health professional. You can call 911, or whatever your local emergency phone number, or go to the nearest emergency room to get immediate help if you are feeling like you are a danger to yourself or to someone else.

      The swallowing obsession is workable and you can find recovery and a happy, functional life after the obsession, and suicide is a permanent solution to a temporary problem.

  • Hi I really like your article. But I really need help. Not for me but for my brother. We believe he has sensorimotor ocd. His thoughts or sensations won’t leave him alone and I feel so helpless. He has been in and out of hospitals and they been misdiagnosing him. Like they diagnosed him with schizophrenia but we know he doesn’t have that as our other brother has that. He needs help and we only have medical. And we can’t find any place that can hep with his hyperawareness or sensorimotor ocd. And he needs to be properly diagnosed and treated. And he lost his job and is in over debt with everyone. Please he really needs help but he only has medical. Please. Do you know anything that could help us? This is really overwhelming for me. As I have other stresses is in own life. And we’re about the same age. Mid twenties.

    • Hi Dora,

      You can find a good article or two on Sensorimotor/ Hyperawareness OCD and give them to your brother’s treatment providers and ask that they consider this as part of his diagnosis, or provide reasons why it is not this diagnosis.

      I’d be more than happy to talk on the phone about your brother and what treatment options are out there and how your family can move forward finding help for him. Please feel free to call me at (714) 423-3779, or email me at Kevin@calocd.com

  • So about a year ago I became very hyper aware f my breathing to the point where I couldn’t think about anything else. That same day, it was like all my hyper awareness from my breathing switched to my brain and I became overly aware of my thoughts and thought processes about anything. I never become aware of breathing anymore because all of it is now in my head. I feel like I am overly aware of my reactions to good or bad events. It feels like I forgot how to react to certain things. My passion for things in life has diminished and I can’t think about the things I love like the way I used to. Does this sound familiar to you? Thanks.

    • Hi Will,

      Scrutinizing your reactions and feelings can definitely be a symptom of OCD. Often, the obsession can be whether you are feeling the way that you “should” in any given moment, if you feel better, worse, or different than you did before an event, or whether you will never feel the way you did in the past. Ultimately the excessive evaluation needs to be eliminated and acceptance of however you feel at any given moment needs to take precedence. Acceptance and Commitment Therapy with Exposure and Response Prevention can be helpful you accomplish this goal.

  • Hi would you consider treating me – I’m from the Canada and can’t find a therapist here with experience in this type of OCD!

    Thanks in advance


    • Hi Ankita,

      You may consider contacting the IOCDF to see if they have a therapist who has experience with this subtype. unfortunately I am not taking any new clients internationally at this time.

  • I have had problems with hyperawareness since 2005, leading to compulsions to ward off the noticing. As a result of a tingling sensation in my head since about 2011, I have been doing even more compulsions, usually physical, to prevent myself from noticing various things. It has severely impacted my life and my independence. The most frequent problems are noticing sounds in general, noticing s’s, most commonly in songs, and noticing my thought processes while eating foods I particularly look forward to. I also have had a reduced attraction to individuals, which causes me to feel pressure to have a normal response, and more recently I have been noticing the right rim of the right lens of my glasses. The most problematic compulsions are usually minor but irritating, like putting my foot down before I hear a sound or something will happen to someone or a variety of other bad thing will occur. Mini-compulsions can happen virtually every minute depending on the situation. The usual feared end result of this is noticing people starting to talk rather than just listening to what they are saying. It has especially affected my sleep, where I frequently have tingling sensations in my head that I fear I won’t be able to neutralize. It has been really bad lately as I started predominantly noticing sounds starting to occur. This had already gone on for two whole weeks before other problems that are and are not OCD-related started to arise. This has prolonged the length of the noticing, which has now gone on for nearly 3 weeks. It’s a really scary situation that is taking a serious psychological toll on me.

    • Hi Gaius,
      Thanks for sharing your experience. It can feel so catastrophic when it seems like noticing only leads to more noticing! However, the noticing only becomes a problem when we treat it like its a problem. Noticing all the things you mentioned are ultimately just neutral, normal things that you see, feel, or experience. But, if you are getting agitated, effortlessly trying to stop noticing, or ruminating about how disastrous the noticing is, you will only reinforce it as a “problem” and as a “threat.” When you devalue those sensations and start treating them as if they are useless nonsense, you will slowly pay less attention to them.
      Again, thanks for sharing!

  • Hi i am going through breathing ocd. I cannot breathe properly when i think of it. It is badly affecting my life. Please help me.

    • Hi Jeenet,

      Oddly, the most important thing you can do to stop the obsessions about your breathing is to stop caring whether you have the obsession and awareness about breathing. When the thought comes in, instead of fighting against it or effortfully trying to fix your breathing or your attention try acknowledging that you breath “improperly” sometimes, that now is one of those times, and that you can still live your life and breath “improperly.” In reality, there is no way to breath “improperly,” but when you label it as a problem that needs fixing you already categorize it as “bad” and worthy of your attention in order to “fix.” So, paradoxically, when you let the thought/ “improper” breathing be part of your day, you eventually learn that it is not dangerous or worth your attention.

  • Hi, have you ever worked with anyone who one day developed a hyperawareness to their own existence itself. Like became hyperaware of their own consciousness almost, and the fact they were a human and then started to develop chronic anxiety around this? This is what happened to me and it’s causing all kinds of scary intrusive thoughts. I’m scared I’ll never go back to living life without this hyperawareness. The anxiety it’s causing is debilitating.

    • Hi Leanne,

      This obsession straddles the world of Hyperawareness OCD and Existential OCD. I have worked with people who have this element as part of their other obsessions and is treated the same way using Cognitive Behavioral Therapy and Exposure and Response Prevention. One of the first things to look at is the feared story associated with this obsession for you. I’d be interested in what is so bad that you have this awareness and what are you worried about being true or true about you going forward because you have this fear. This will help direct where we go with Exposure treatment.

      Of course, a reframe that can help reduce the weight of this obsession can be to view this as a neutral awareness about you and your experience. This is an awareness that perhaps others do not get to have. However, you currently view this as a detriment. So, some of the work to be done in challenging this fear is to look at why you view this as a detriment. This is easier said than done, and not the silver bullet of treatment, but a place to start. Getting started in treatment with a therapist who understands these OCD subtypes will be very helpful in getting you to a more comfortable and functional relationship with these thoughts.

  • Hi Kevin,

    Are you able to treat people internationally at this point in time? I am really at a breaking point and cannot find a therapist that is experienced with my specific form of hyperawareness OCD.

    Thank you

  • Hi Kevin,
    Thanks for the article and I’m starting think my OCD has morphed from the
    Pure O type, to sensorimotor. Is that even possible? I’m currently not experiencing the Pure O symptoms but I am experiencing a constant weird sensation in my lower back which causes me to regularly focus on that area. .It’s especially sensitive when lying down or when seated in a chair. The best way to describe the phenomenon is a hypersensitivity of my back/skin making contact with my bed, chair, etc. . Thanks for your insight and service to the OCD community.

    • Hi Jay,

      Thanks for reading the article. First, yes, OCD can absolutely flip between different subtypes, such as from Pure O to Sensorimotor, or it can sometimes switch to a combination of subtypes. A common pairing is SO-OCD and Relationship OCD, and Scrupulosity and Existential OCD.

      Regarding the hyperattention to your lower back; if the sensation starts to cause pain, numbness, or prolonged discomfort, you can have that checked out by a medical doctor to see if there is any genuine medical issue going on. Ruling out any real medical/ physical issue can be part of a thorough assessment. That said, if it follows the same pattern of the sensation being simply a sensation, annoyance, or hypersensitivity, then perhaps you can continue treating it as a focus of your OCD.

      If you have further questions, please feel free to reach out!

  • Hi Kevin,

    After reading your article, my problem with Hyperawareness of thoughts felt a little less obscure and unheard of. It gave me hope that there’s at least a possibility this could be resolved. Thank you for that.

    As I’ve mentioned I am hyper aware of my own thoughts and obsessed with my thought processes. I wait for the arrival of the next thought anxiously all the while wondering how it used to happen in the background without my knowledge which is now suddenly at the forefront. Even when I’m talking to people I start to think, do I visualize what they say (for eg: if they say tree, do I visualize a tree) or do I let my mind wander, if so how do I let my mind wander? It’s like I’ve forgotten how to think. I fear I will get lost in this type of thinking and will be unable to focus on my present or enjoy any sort of life experience.

    When my thought processes momentarily return to auto(unconscious), I’m back to my usual way of thinking, blissfully unaware of it all. It’s only when I become aware of my thinking that I start to experience issues with it.

    Does this sound like hyperawareness OCD of thoughts or is this something else? If so, is it possible to recover from this?

    Would you consider treating someone from India via teletherapy? I’ve already tried the iocdf website and there is no one available in my area who treats this type of OCD.

    Thank you in advance.

    • Thanks for checking out the article and offering your kind words. This does sound consistent with hyperawareness obsessions, especially the components of being overly concerned about stopping your awareness on your internal voice (meta cognition).

      Unfortunately we cannot provide treatment in India at the moment. You could consider contacting the IOCDF to see if they know a therapist who can work with you.

  • This is a great article. I first experienced intense fear and anxiety was when I first tried marijuana 20 years ago. I experienced the paranoia that a lot of people experience when smoking. I hated the sensation of my mind slowing down, and being conscious of it. To this day, I become very anxious when I come across the smell of it. A few months after that, I had a terrifying panic attack in my dorm room, alone with my own reeling thoughts and fixating on the sounds around me- I became convinced that I was losing my mind. Today, I haven’t experienced panic but the anxiety is very much with me still, mostly in the form of fear that I’ll lose my mind. I’ve become fixated again on sounds, fearing that I’ll never stop hearing a particular sound that (I think?) I’m hearing. I’ve become hyperaware of different things over the years, mostly of my own thoughts. I appreciate that you’ve discussed this so thoroughly.

    • Hi Jason,

      Thanks for reading the article, and I hope it was helpful for you. We can become fixated on anything! Sounds, sounds, physical sensations, or even thoughts. Accepting their presence in your moment is key to calling off the anxiety cavalry. The attention will pass eventually. It always does.

Leave a Reply

Your email address will not be published. Required fields are marked *