Sensorimotor Breathing Obsession..need help/advice

[Guest ocme]

Hello to everyone, I am new here although I have been reading these boards for the past few months now. I joined so that I could post a question for which I desperately need some feedback on. I could really use some advice regarding the best way to treat a sensorimotor obsession with breathing. It is impacting my life at this point.

It started about a month ago while doing a breathing awareness exercise as part of a mindfulness meditation program (which I was doing to help reduce anxiety). The idea was to focus on your breathing without letting your mind wander (which was supposed to be difficult). Well it was until I thought to myself "what if I can't stop being aware of my breathing". From that point on I got stuck with what I discovered through online research is called a sensorimotor obsession with breathing. Before this instance I did not know that I had OCD.

There doesn't seem to be much information about this specific OCD condition. I have read the Dr. Steve Seay and Dr. David Keuler articles on this issue which focus on ERP as the treatment method. I have also purchased a book called Overcoming Obsessive Thoughts by Dr's. Purdon and Clark (focusing on Pure-O OCD specifically). I am currently reading the OCD Workbook and hope it might help me. I also read about and ordered Dr. Jeffery Schwartz's book Brain Lock and understand the 4-step method he teaches.

I have just started seeing a psychologist who believes I should apply ERP therapy with the use of written and recorded exposure based on my worst fears about this breathing obsession. I guess something like recording "I will never stop thinking about my breathing" or "from now on I will always have to consciously control my breathing" and then listening to this on a loop for like an hour everyday until I get sick of it and become habituated to these thoughts without having any anxiety response. This is the Exposure component I assume but I don't understand what the Response Prevention part should be. Is the coping strategy a mental one that tells me to avoid thinking about the breathing obsession and I have to prevent myself from doing this?

The thing is that sometimes I am able to get over this breathing obsession completely and can go on without thinking about it for days (this is especially the case when I get distracted). I realize there is nothing to be anxious about and that I have always breathed normally without any issues all of my life. There is no difference between me before this issue and me right now aside from my thought process. I thought I had this licked...

I went from being aware of my breathing throughout the day to only being aware at night when going to sleep (sleep became a trigger) to being over it and just recently BACK AGAIN to being distracted both day and night (after having thought I was over this). I don't understand how my mind is doing this to me even after I have been able to decouple the anxiety from my breathing awareness successfully in the recent past to the point where I thought I was perfectly fine!

Is anyone out there dealing with this breathing obsession currently with a professional? I feel like there is not a lot of research on this specific problem and that most treatment methods focus more on traditional OCD symptoms which feature obsessions and compulsions. Agian I don't really even understand what the compulsion part of this breathing obsession is although I assume it must be something mental.

The therapist I went to before my current psychologist said that OCD requires medication to handle and that I should definitely get evaluated by a psychiatrist. This particular therapist admitted to have been suffering from OCD and was on meds which made all the difference. Although this was a bias towards medications/ssri's given their experience which my current psychologist calls transference (applying your situation to someone else).

Now I am beginning to wonder if an SSRI would be the solution to getting rid of this breathing obsession once and for all (in conjunction with CBT). Has anyone here who deals with this breathing awareness (or any other sensorimotor obsession) had any noticeable results with medications? Any advice at this point would be greatly appreciated (I am sorry for the length of this post).

[Guest Gasspanicc]

prob the easiest ocd. let it be and ull find yurfself forgettin. dont fight it worst u can do lol

[Guest ocme]

I appreciate this advice. I understand the concept and yes, sometimes I just accept it and if distracted enough over time I forget about it. Yet other times I try to just accept it and I still find myself overly focused on it (this is worse when I have too much free time).

When you say don't fight it, what exactly do you mean? Like don't ruminate about it/worry about it? In other words don't make a big deal about it?

Have you dealt with this sensoimotor obsession before?

Edited October 10, 2013 by ocme

[SuperInfinity]

prob the easiest ocd. let it be and ull find yurfself forgettin. dont fight it worst u can do lol

Hang on a second, you can't tell others about what difficulty a certain type of OCD is for them. I've been under the impression that this is the WORST form of OCD and I've never experienced another type of OCD really badly... it all depends on the individual. Maybe you can say that for most people this OCD isn't that bad, but we're all different. For me this can sometimes be an absolute nightmare.

OP, I really don't know. It's really just bizarre. I had it mildly when young, then I forgot about it for years. About five years ago I got it extremely badly, and it seemed to go away gradually over a few months, and I could even consciously talk about it and it wouldn't be there. Then around the middle of last month it was suddenly back again with a vengeance.

I don't know what to say, but I think anxiety and stress has a lot to do with it. It's important to note that this isn't just about some ever-increasing psychological feedback loop "don't panic => panic", it's far more complex than that. It's really about stress hormones and anxiety. There are times when I'd be thinking about how unfortunate I was to have the problem with the usual stress going through me..... and even while I was thinking that I had not actually been thinking about my breathing or swallowing at all for the past ten minutes. So it's a pretty WEIRD thing.

I think us OCD sufferers are sensitive and tend to panic vastly more than non-OCD people. We feel like everything is falling apart when it's not. So a soothing voice as in a therapist or just try to reassure yourself and have confidence in yourself more. You're worth it.

I understand the horrible irony of breathing exercises that are meant to relax you making you this way. I always try to stay far, far away from those sorts of exercises... though on the flipside some people would advocate exposure therapy. If we think in basic terms.... concentrating on your breathing means you're interested in your breathing right? Your breathing is important, but maybe you need to be more interested in OTHER things and eventually you'll forget about your breathing or swallowing. Trying to dismiss breathing or swallowing altogether probably is not the way to go as we need these functions. Filling your conscious brain with other stuff rather than saying the motor stuff is "wrong" seems the best way to go about it. And it's a known fact that this OCD stuff can morph from one thing to another easily... so it's not the target of the OCD that's important, it's the relieving anxiety that causes it in the first place.

There was one experiment done on mice where they put them through a lot of hugely stressful situations and the mice predictably got extremely anxious. However then they took away all such stimulus and guess what? The mice didn't suddenly lose all their anxiety, the vast majority of it stayed, and they seemed to start seeing things that weren't there and continuing to panic even when there was no danger. So it might be that your brain almost "wants" to panic and is finding something to panic over. The mice didn't go from being in an extremely anxious state to suddenly being all relaxed and calm, they were still very anxious for a long time afterwards. Eventually by being in a calm, serene setting, they finally did go back to normal again.

Edited October 10, 2013 by SuperInfinity

[Guest ocme]

Superinfinity,

Your reply is very insightful and I sincerely thank you for it.

I identified immediately with what you said about consciously worrying about the breathing obsession only to realize you weren't thinking about your breathing while doing so. It's truly insane sometimes and this is what make it maddening! The subtitles are very hard to wrap your head around yet the anxiety and level of distraction it can create can be enormous.

I am still trying to figure out what the compulsion component of this obsession is in order to properly perform the ERP therapy. The obsession is obviously the conscious hyper awareness of my breathing and that I will never be able to stop noticing it but I can't identify any coping strategy that I'm using to subdue this fear (ie. mental compulsion) which is a necessary component for ERP therapy to work.

I also completely agree with you that it's not necessarily the topic of the OCD that matters but learning to extinguish the anxiety that it creates.

Regarding the mouse experiment that is very interesting and I can relate to that. I have been highly stressed for the last 4 months and I think this is what triggered my OCD in this past month. Like you mention, my brain was looking for something to focus its anxiety on and this breathing obsession fit the bill (as it is so ridiculous that to actually become panicky over such a thing really causes alarm).

[gingerbreadgirl]

hey there,I don't really have any advice,I just wanted to offer my support. I can imagine this is horrible, I had a similar kind of thing when I was a kid when I couldn't stop thinking about swallowing, and I also had a period of time when I couldn't stop thinking about blinking, and it was horrid. I hope you are able to get a handle on it soon x

[Guest arctic_vixen80]

I've had all 3. Breathing, swallowing and blinking. I still struggle with the swallowing one. It's horrible and I dunno what the compulsive bit is either. The one that came first for me was the breathing but over the years I've become less bothered about it and it doesn't bother me so much any more whether I'm aware of it or not. I dunno how you need to feel about yours to make it go but it's hard to do that with something that scares you. I been told that I need to accept it and should deliberately think about it as well. I really wanna find away to deal with the swallowing one.

[Guest ocme]

This feedback and support really helps.

Arctic_vixen80 I hear you about the swallowing obsession. I almost felt I was developing that one when I started reading about sensorimotor obsessions but it passed and for some reason I just got stuck on the breathing one. It is true thought that once a new obsession develops, the anxiety it created tends to override the older obsession and then your total focus is on the new one. The mechanism again is just fear. Your attention will automatically move to the item you currently fear the most therefore the subject of the obsession is basically meaningless. It's just how you interpret it and usually this includes a healthy dose of fear and anxiety. We both need to figure out how to remove the anxiety component from these obsessions to help kill the hyper-focus on them.

I still need to figure out what the compulsion part of this breathing obsession is. I am working on writing up a 3-5 minute first person script describing my worst scenario fears related to this obsession. Then I will read it aloud and record myself. The idea being to play this recording back to myself on a loop for about an hour a day for a week in order to reduce my level of anxiety with this issue. This is what the OCD Workbook describes for purely obsessional symptoms.

[Guest arctic_vixen80]

That's ok Yasminhuskie you didn't say anything that upset me. Your experience sounds pretty scary.

I've had it too where as soon as one obsession is gone and new one takes it's place but I have had it where I've been scared about all 3 at once but it's impossible to think of them all at the same time. Yeah I would love to know how to get over the fear part of this.

Let us know if the loop thing works for you.

[Guest ocme]

Is anyone taking medication for this kind of sensorimotor obsession? If so, is it helping at all?

[Guest arctic_vixen80]

I've taken a few medications for it. I think Sertraline, clomipramine and now I take Fluoxetine and Rsiperidone. I think it's helped ease my anxiety and helped with some aspects of the sensory motor OCD but I'm still struggling with my current problem. Different meds work for different people. I heard Mindfulness is meant to be helpful sensory motor OCD but it does involve being aware of breathing sometimes.

[Guest Gasspanicc]

try focusing ur attn on ur feet the sensation of ur feet. the point is to have ur awareness focused on something other then the obsession.

[Guest ocme]

Arctic_vixen80,

Mindfulness is actually the reason this obsession started for me. If it hadn't been for the breathing awareness exercise I did I would never have developed this obsessional breathing thing in the first place. I keep wishing I could go back in time and undue the past!

Regarding your meds, how long have you been on them? I here with OCD people need to try each medication for at least 3 months before they know if they're working or not. I also heard that the dosages have to be much higher (for ssri's in relation to how much is used for other disorders) meaning the risk for side effects can be greater. Have you experienced any sever side effects?

Clomipramine (Anafranil) is an older tricyclic antidepressant which I have heard is the quite powerful for OCD but with stronger potential for side effects. So this one did not work well for you?

[Guest ocme]

try focusing ur attn on ur feet the sensation of ur feet. the point is to have ur awareness focused on something other then the obsession.

Yes I have tried this kind of thing (especially when trying to fall asleep) and sometimes I can pull it off.

[Guest Gasspanicc]

dont force it just let gooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooooo

[Kitty Kay]

Have you seen this article, Ocme? http://www.steveseay.com/treatment-body-focused-obsessions-ocd/

[Guest ocme]

Yes, that article plus the other one by Dr. Keuler are the only ones I can find online that discuss this obsession.

As with all obsessions they recommend ERP therapy which is fine except I don't know what the ritual prevention part of this obsession is. As it is purely mental I can expose myself to the mental fear part of it but there doesn't seem to be a compulsion aspect to it that needs to be prevented.

[gingerbreadgirl]

I wonder if the compulsion part is something quite subtle. Like I know I used to fight against the thinking about blinking/swallowing, and tried to suppress the thoughts, and that in itself fuelled the obsession because it just made me worry more. So I guess the compulsion would be fighting the thoughts, so in order to resist it you'd say to yourself 'yes, ok, maybe I will never be able to stop thinking about breathing, whatever' and just accept it without engaging with it or fighting it, if that makes sense?

[Guest arctic_vixen80]

I was on a low dose of Clomipramine for about 4 years I think. I think I should have taken a higher dose because I was still struggling with OCD. My psychiatrist put me on a higher dose. The only side effect I had from them was very low sex drive but it didn't completely get rid of my swallowing. I was still scared of it. So she took me of clamipramine and put me on fluoxetine which I've not had any side effects from as far as I know and she also added Risperidone which I'm getting some really weird dreams I dunno if it's causing that. She's trying different meds so that she can build a case to refer me to a specialist place in London.

I must admit at the mindfulness course I was a bit wary of doing breathing exercises but it turned out to be ok but when the breathing fear first started I avoided lots of breathing exercise things.

I've done a bit of research about sensory motor OCD and can't find much on it either apart from what you found. I do feel it needs more research.

[Guest ocme]

I wonder if the compulsion part is something quite subtle. Like I know I used to fight against the thinking about blinking/swallowing, and tried to suppress the thoughts, and that in itself fuelled the obsession because it just made me worry more. So I guess the compulsion would be fighting the thoughts, so in order to resist it you'd say to yourself 'yes, ok, maybe I will never be able to stop thinking about breathing, whatever' and just accept it without engaging with it or fighting it, if that makes sense?

This is VERY helpful gingerbreadgirl! Thank you for the idea because I think it may be the very compulsion I've been trying to identify. It's quite subtle and almost seems like common sense. It is therefore very easy to overlook but I think you hit the nail on the head with this one!

Edited October 11, 2013 by ocme

[SuperInfinity]

But how can you accept that for the rest of your entire life, you may be sitting/standing/running/climbing/kissing, thinking about when you're going to swallow, blink, breathe next? How could anyone accept such a thing?

[Guest ocme]

That's how exposure response prevention works. Accepting the fact allows your to decouple the anxiety response from it. Once the anxiety is removed the brain gets tired of the obsession and the symptoms slowly dissipate. They may never be gone completely but the situation becomes more manageable at the very least.