Saturday, March 31, 2012

Sensorimotor Obsessions: Hyperawareness of Body Sensations

princess pea final 001

I have felt an affinity to the Princess who can feel the pea under all the mattresses in her bed. When I read David J. Keuler's article, When Automatic Bodily Processes Become Conscious: How to Disengage from "Sensorimotor Obsessions", I recognized myself. Here is Keuler's list of examples of Sensorimotor Obsessions:

  • breathing [whether breathing is shallow or deep, or the focus is on some other sensation of breathing]
  • blinking [how often one blinks or the physical requirement to blink]
  • swallowing/salivation [how frequently one swallows, the amount of salivation produced, or the sensation of swallowing itself]
  • movement of the mouth and/or tongue during speech
  • pulse/heartbeat [awareness of pulse or heartbeat, particularly at night while trying to fall asleep]
  • eye contact [unlike social anxiety-based concerns, this form involves awareness of the eye contact itself or which eye one is looking at when staring into the eyes of another person]
  • visual distractions [e.g. paying attention to “floaters”, the particulate matter that is drifting within the eye that is most visible when staring at a blank wall or awareness of subtle movements of the eyes, such as saccadic eye movements]
  • awareness of specific body parts [e.g. perception of the side of one’s nose while trying to read or, as in the cases of a young boy and older man, a hyper-awareness of particular body parts such as their feet or fingers respectively]
My health anxiety is linked in part to assuming what I am aware of is dangerous. Floaters in my field of vision were particularly hard to deal with because I was afraid it was serious, and then when the doctor said it wasn't, I was worried I'd be aware of the bits of gray squiggles forever, and haunted by them, and I obsessed about obsessing. Bladder sensations took up a lot of my mental space from an early age.

Keuler proposes treatment consisting of:
  • Helping the sufferer understand that awareness of automatic body processes is not dangerous
  • Exposure to the sensation and prevention of responses such as distraction.
  • Body Scan and Mindfulness, and learning to observe sensations without judgement(Jon Kabat-Zinn has detailed instructions for doing a body scan. I did them everyday for many years, and it helped expand my focus.)
He suggests post-it notes with reminds of the sensation in strategic locations, practicing inviting the sensation in rather than fleeing from it, which ultimately leads to less sensitivity to the sensations and/or greater tolerance of them. Before you panic at the thought of purposely evoking sensations you'd rather banish forever, remember that in actuality you can't perfectly set up the world to never remind you of your breathing, your tongue or your bladder.

I know that bliss when a sensation recedes and the agony of something reminding me of it, but it's the jolt of encountering the feeling reinforces the anxiety, making me wish I could ratchet down my life even more so that I never get surprised. It was liberating to discover that I could purposely face the sensation, and not have to tiptoe around my life.


Apt cartoon by xkcd, about tongue awareness.

23 comments:

  1. Thank you so much for writing this and providing the links for more info.

    I deal with this, especially with my breath and, at various times, my bladder. I wasn't even sure if it was OCD.

    I am reading a Kabat-Zinn book on mindfulness. It has been so helpful to me. I will check out the instructions for the body scan.

    Thanks again for making me more aware!

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    1. Glad I could help in awareness! The body scan is good at helping me experience my body as a whole rather than the one place I am obsessing about.

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  2. Wow! I get that sometimes. I had the bladder sensitivity thru university. It's gotten less as the years go buy and i've figured out that my focusing on it is making it a big deal and as i let go, so will this focus. I get the eye floater thing quite frequently because i read a lot and reading for long periods of time seems to bring them up. Then i'm reading around the floaters, trying to ignore them until they go away.

    I think i also got this a bit when i started taking this medicine. Every thing that i noticed 'could' be a side affect. I would think that's kind of normal to do that.

    Thanks for this interesting topic!

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  3. I had this weird thing with my eye about a year and a half ago. I could see strange shadows. I went to the eye doctor and he said it was nothing. It really bugged me for a while. Somehow, it just sort of went away and I stopped noticing it. Luckily I don't struggle with this stuff too, too much, but when I do, ugh. I really feel bad for those who have a real problem with sensorimotor obsessions because you just can't get away from it.

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  4. I love your blog and the way you write about OCD. I've come to believe that I probably have some low-grade version (ruminating about what's wrong with me is something I do!)

    I obsess about all kinds of things and have some rigid thinking habits and behaviours. But I've never had the classic OCD symptoms (hand washing, fear of germs) and was quite slack about things like schoolwork and appearance when I was growing up - go figure!

    I also focus on bodily sensations and perceptions, sometimes in the context of social anxiety, sometimes not. (I'm looking at my floaters as I write.) For me there seems a point where my low-grade OCD meets my social anxiety; perhaps I have both kinds of bodily awareness sometimes.

    I'm beginning to understand a lot about my mental terrain that I wish I'd understood when younger. Your blog's helped me have more compassion for myself (and everyone with OCD issues).

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    1. I'm thrilled that my blog helped with your self-compassion! That was one of the hardest things for me, to have compassion for myself.

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  5. Thanks for writing, you have inspired me.

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  6. I have this. I never knew it was related to ocd. Wow. Thank you for this great post!

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  7. I'm glad this post made useful connections for so many people! OCD has so many manifestations and I still get those aha moments of "oh, that's my OCD too!"

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  8. Hi,
    I have recently started to get the sensorimotor obsession. Strange focus on my eyes and whether or not I need to blink. I found Dr Kuelers article and want to try the ERP methods. As someone who has tried the methods have they had a positive impact or helped you to overcome them?
    Thanks
    James

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    1. James, yes, ERP has helped, especially imaginal exposure and mindfulness. Letting the sensations be there, without judging them, until I get used to them, combined with listening to recordings I've made on my ipod about my feared consequences. Jonathan Grayson's Freedom From OCD has some ideas for making imaginal exposure tapes.

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    2. Wow, I have always used exactly the same metaphor for my obsessions and hyper-awareness, and have often described it as being like the princess and the pea...Yes, that pea is enough to turn you black and blue

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  9. Hi, again as above. Fantastic blog - it is like reading about my own life. Mine is only focused around a breathing obsession, but still sounds exactly the same. Quick question, I have had long periods of not obsessing (up to months at a time) and then it jolts back in often with a few weeks of terrible. Do you experience the same ? Also, I am not very keen to see a therapist. I feel pretty self aware and feel like I have a good understanding without talking to a specialist.

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    1. Hi Jason,
      It seems to be a common experience to have OCD wax and wane. I had plenty of self awareness, but I needed someone to help me put into action what I knew intellectually but which hijacked my nervous system, and made the anxiety feel so formidable. Exposure Therapy made a big difference.

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  10. I love the princess and the pea paradigm. It's just so...accurate! Plus, thinking of myself in that way is so much better than "paranoid", "obsessive", etc. Thanks for sharing.

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  11. are there any drugs that can work along with therapy?

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  12. really good article, have had this theme of ocd for over a year, keeps coming back!
    good article

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  13. Anon - Yes, drugs can help with therapy. Check out my story at the top of the page, Medication for OCD.

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  14. http://sm-ocdtalk.board.net

    Hi I'm Nick,
    I have created a new messageboard for those with sensorimotor ocd being that I am one myself. I hope to form a community help eachother through support and information. I have currently started therapy and plan to share the tools I earn from this and hope other will feel free to share, comment, or ask questions. Thank you, and God bless. Nick.

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    1. Hi Nick, I recently checked and couldn't connect with your sm-ocdtalk board. If you have a corrected address, let me know.

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  15. Hello, I've recently learned I've got Ocd .... I shallow breath, compolsivly hold my breath and obsess about my bladder.... thanks for your blog these help to read when I feel isolated

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  16. Welcome Shalie. I am glad my blog can be of help. Isolation makes the OCD all the more intense, and I hope that you find a therapist or OCD support group. The International OCD Foundation has info on these.

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  17. Hi, great post and I can identify with much as I have suffered with this myself for some 20 years.

    I’ve just set up a Yahoo group for people who have Sensorimotor OCD and want a safe place to find support and understanding from fellow sufferers. Please come along and say hello. Best wishes.

    https://uk.groups.yahoo.com/group/sensomoto-ocd

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