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How can I do ERP for body-focused sensory OCD?

I received an inquiry on my website with this exact question and, though I responded to the person who asked the question, I thought that this would be a good topic to discuss here and on my YouTube channel. This is an issue that plagues many, but there are few resources for dealing with this independently. Let's start by talking about what this is, and then focus on what you can do about it. Body-focused sensory OCD, otherwise called Hyperfocusness OCD, happens when a person fixates on a part of their body and finds it difficult to place their focus on other more meaningful things. Examples include people who hyper focus on their blinking, their breathing, the position of their arms (just to name a few examples I've seen!) or any other bodily sensation.

When it comes to treating this presentation of OCD, the initial question is the same as they are with any OCD: "What are you really afraid of?" For some, they fear that there is something wrong with their body and they are checking to make sure that they are okay physically. Other fear that they will only focus on this and will never be able to focus on anything again. Still others fear that there is something wrong with their, brain and they will never be normal again.

The important thing in treating OCD is understanding that core fear and targeting that, not necessarily the secondary thought that the OCD gives. For instance, if I have a patient who hyper focuses on their blinking and has a core fear that they will never be able to focus on anything else ever again, they are likely noticing their focus on their blinking and fighting it by trying to think of something else. The problem here is that OCD loves a fight and will gladly fight you as long as it can! Instead of fighting it, we can instead dare it to come true and test it out.

For instance, we can all try a game/exercise right now. For the next 5 minutes (or however long you last) try to only focus on your blinking. No thinking about anything else. If you have any stray thoughts, you lose. If you think about dinner, you lose. If you think about another body sensation you still lose! Go ahead, give it a try.

How long did you last? Most people can only push this exercise for a few minutes before some stray thought comes in, even if that stray thought is "this isn't working! I'm still focused on my blinking!" In a way here you have called the OCD out, it told you that you would never focus on anything else again and you dared it to come true. Generally it does not come true, and there is some fear and freedom in that and you can move on. Then, when the OCD attacks again, and it will, you can dare it to come true in whatever way would bother it the most.

Of course, these are general suggestions and you would be best served to reach out to at therapist near you or directly to me for specific guidance. OCD can be tricky and it takes a knowledgeable coach to get you through the twists and turns!

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