Distorted Physical Sensations in OCD

I have previously written about OCD and mental imagery, where I discussed how those with obsessive-compulsive disorder (and those of us without) sometimes see, hear, or feel things without the presence of corresponding external stimuli. In particular, those with OCD often find their intrusive thoughts are accompanied by sensory experiences that attach some type of physical sensation to the distorted thinking of OCD. 

A recent study published on November 20, 2017, in the journal Clinical Psychology and Psychotherapy delves into the link between the strength of compulsions associated with OCD and the physical sensations that come with them. For example, the study authors noted that participants who struggle with contamination obsessions might feel “uncomfortable sensations in the skin, muscles or others body parts, like an itch or a burning sensation that drives the patient to do the compulsion until feeling…relief.”

For the purpose of this study, researchers asked people with OCD to answer questionnaires designed to measure the strength of these sensory obsessions. The results indicated that people who had more difficulty controlling their compulsions also tended to have stronger sensory elements related to their obsessions, compared with those who had less difficulty controlling compulsions. This seemed especially true for those whose obsessions focused on cleanliness and personal contamination. How interesting! This study suggests that the intensity of these sensations might play a significant role in how those with OCD manage their symptoms.

Other interesting findings from the study include the fact that the strong sensory components to obsessions appeared more often in people with all-around vivid imaginations, and that a large group of those with OCD experienced their intrusive thoughts as auditory — whispered, spoken or shouted voices.

Below are the key findings of the study, as summarized by the authors: 

• Obsessive thoughts are often accompanied by perceptual experiences, such as feeling dirt on one’s skin or seeing blood before one’s inner eye.
• Sensory experiences have been associated with decreased insight in obsessive-compulsive disorder.
• We found that 75% of obsessive-compulsive disorder patients have such sensory experiences.
• The severity of perceptual obsessions predicted low control over compulsions.
• Clinicians should not confuse sensory experiences with hallucinations and psychosis, respectively.

I especially appreciate this last bullet point as I’ve written about OCD and psychosis and the confusion it might cause, not only for those with the disorder but for clinicians as well.

What I find most exciting about this study is its potential to be helpful in the treatment of obsessive-compulsive disorder. If strong sensations make OCD symptoms more difficult to beat, perhaps we could focus on how to reduce or redirect these sensations as part of the person’s therapy.

Once again, I am incredibly thankful for all the dedicated scientists who continue to work hard to unlock the mysteries of OCD!

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