OCD and Intrusive Bodily Sensations: How Your Brain Creates Problems That Weren't There

Do you ever find yourself fixated on uncomfortable bodily sensations that no one else seems to notice? You're not alone. For millions of people with OCD, intrusive sensations can become a daily battle that drains energy and creates immense distress.

The Attention Experiment: How Your Brain Creates Sensations

Take a moment and try to notice an itch somewhere on your body. Don't stop looking until you find one...

Found it? Don't scratch it. That itch was likely there all along, unnoticed until I directed your attention to it.

This is exactly how OCD mental checking works. It's like a spotlight that illuminates whatever it touches – thoughts, feelings, sensations – making them impossible to ignore.

Many people with OCD report distressing awareness of bodily sensations – groinal responses, breathing irregularities, heart palpitations, and more. But are these sensations really problems, or is something else happening?

What Is Mental Checking in OCD?

Mental checking is a hidden OCD compulsion that happens entirely in your mind. While no one can see it happening, it silently drains your energy. You might look perfectly normal in a conversation while your mind is frantically checking whether you're experiencing a "wrong" or "inappropriate" sensation.

Here's the trap: Your brain convinces you that checking provides relief, but it actually intensifies the problem. It's like scratching poison ivy – it feels good for a moment, then makes the itch ten times worse.

The big paradox is this: You create the very problem you're trying to solve. Each time you check a sensation, you first have to bring that sensation into your awareness. It's like repeatedly opening your refrigerator to make sure the milk is still there, but somehow adding more milk each time you check.

Studies show something fascinating: repeated checking – whether physical or mental – actually destroys your confidence in what you know. The very act meant to increase certainty dramatically reduces it instead.

How Your Brain's Attention System Creates Sensations

Your brain's attention system works like a magic trick. Let me demonstrate:

Focus on your left foot right now. Really focus on it. Can you notice anything? Pressure, an itch, electricity? That sensation probably wasn't there before I mentioned it.

That's selective attention – and it's exactly what happens during OCD mental checking.

When you direct attention to any part of your body or mind, your brain amplifies those signals. Normal bodily processes like breathing or swallowing can suddenly feel "wrong" or uncomfortable when you focus on them.

The same happens with thoughts. When OCD demands that you check if you're having a "bad thought," the very act of checking brings that thought to mind.

Think about being absorbed in a great movie. You're not aware of how your clothes feel against your skin. But if someone whispers "is your shirt tag itchy?" suddenly you can't focus on anything else.

Your attention works like a spotlight in a dark theater – whatever it illuminates becomes your reality. In OCD, this spotlight gets stuck in hyper-focus mode, constantly scanning for the thoughts and feelings you fear most.

The more you check for a sensation, the better your brain gets at finding it. Each check makes the next more likely to find something – even if that "something" is created by the very act of looking.

Breaking the OCD Sensation Cycle with Non-Engagement Responses (NERs)

So how do we break this cycle? With techniques called Non-Engagement Responses or NERs – your OCD circuit breaker.

NERs work like a remote control that instantly pauses the mental ping-pong match your OCD has trapped you in. Instead of trying to answer OCD's questions or get rid of uncomfortable sensations, NERs let you step out of the game entirely.

Here are four types of NERs you can start using today:

1. Affirm Your Anxiety

When your brain says "Your breathing doesn't feel right - check it!" simply respond: "Yep, my breathing feels strange and that's making me anxious." This acknowledges the feeling without starting the checking cycle.

2. Affirm Uncertainty

When your mind says "You're feeling something down there. You're probably attracted to that person" respond with "Yep, I might be feeling something. I guess I'll never really know for sure if it means something." This removes the fuel that powers the sensation-checking engine.

3. Affirm Possibility

When OCD whispers "What if this heart flutter means something serious?" simply respond: "Maybe my heart rhythm will feel weird forever. Maybe it'll get even weirder!" You can even amplify it: "Maybe I'll be hyper-aware of every heartbeat for the rest of my life!" This transforms threatening sensations into something so over-the-top they lose their power.

4. Affirm Difficulty

When OCD makes you notice how your clothes touch your skin, simply acknowledge: "Yeah, it would really suck to feel this clothing sensation intensely all day long." It's surprisingly disarming because OCD expects you to panic and try to "fix" the sensation, not calmly acknowledge it.

Important: Use NERs as final statements, not conversation starters. Say your response once and redirect your attention elsewhere.

ERP Therapy for Intrusive Bodily Sensations: A Step-by-Step Guide

Let's dive deeper into using Exposure and Response Prevention (ERP) specifically for those intrusive sensations. ERP is considered the gold-standard treatment for OCD, with research showing 70-80% of patients experiencing significant improvement.

Step 1: Map Your Sensation Triggers

Take a moment to identify which bodily sensations trigger your checking cycle:

• Is it awareness of your breathing that suddenly feels "not right"?
• Maybe it's swallowing that suddenly feels manual instead of automatic?
• Perhaps it's a perceived asymmetry in how your clothes touch your skin?
• Or a feeling that your eyes aren't blinking "correctly"?
• Are you focusing on what you're feeling in your groin?

Action Step: Write down 2-3 specific sensations that trigger your checking. Rate each on a scale of 1-10 for how much distress they cause.

Step 2: Create Your ERP Hierarchy

ERP works best when you start with moderately challenging exposures (around 4-6 on your distress scale) before tackling the most difficult ones.

Action Step: Arrange your sensation triggers from least to most distressing. For example:

• Level 1: Noticing regular breathing (distress 4/10)
• Level 2: Noticing swallowing sensation (distress 6/10)
• Level 3: Feeling groinal responses (distress 8/10)

Step 3: Design Intentional Exposures

Unlike accidental exposures that happen throughout your day, intentional exposures give you control and predictability.

Action Step: For each sensation, create a 10-minute exercise where you deliberately focus on and amplify the sensation. For example:

• Breathing exposure: Set a timer for 10 minutes. Sit quietly and intentionally focus on your breathing. Notice each inhale and exhale. Try different patterns of breathing. The key is to stay with the sensation without checking if it "feels right."
• Swallowing exposure: Take small sips of water while focusing entirely on the swallowing sensation. Notice every aspect without trying to swallow "correctly."
• Groinal responses: Feel it. Notice it. Let it be. Maybe adjust your pants, risking noticing more, move around quickly as to cause even more.

Step 4: Implement Response Prevention

This is where NERs (Non-Engagement Responses) become crucial. We're not just doing the action, we're responding as if we don't care. Just noticing a sensation, letting it be. "I hope I feel this forever." "Yep, feeling that one."

Step 5: Practice Mindful Acceptance

Rather than trying to escape the sensation, practice observing it with curiosity.

Action Step: During your exposure, narrate your experience out loud or in your head:

• "I notice tingling in my fingers"
• "I observe tightness in my throat"
• "I'm aware of my heartbeat speeding up"

Describe without judging whether the sensation is "good," "bad," "right," or "wrong."

Step 6: Integrate ERP Into Daily Life

Once you've practiced in controlled settings, it's time to apply these skills in real-world situations.

Changing Your Relationship with Uncertainty

The path forward isn't about eliminating uncertainty – it's about changing your relationship with it.

Remember: The checking is the problem, not the sensation itself. Your relationship with uncertainty is what needs to change, not the uncertainty itself.

If you feel a sensation, love it, be with it, take value away from it. With consistent practice of ERP and NERs, many people experience significant reduction in their OCD symptoms within 8-12 weeks.

Getting Professional Help for Sensorimotor OCD

While self-help techniques can be powerful, working with an OCD specialist can significantly accelerate your progress. Look for therapists who specialize in ERP for OCD, particularly those with experience treating sensorimotor obsessions.

For more comprehensive guidance, consider structured programs specifically designed for OCD management. These often include detailed worksheets, video demonstrations, and step-by-step guidance for creating your own exposures.

Remember that recovery is possible. Thousands of people have transformed their relationship with intrusive bodily sensations using these evidence-based approaches. With commitment and the right tools, you can too.