Those that struggle with panic attacks and panic disorder often find that they become hypersensitive to their body’s sensations. They notice every small pain, every tingle, every time their breathing doesn’t feel like it is as full as it should be.
Once they feel something is “not quite right” it triggers a rush of anxiety, which ultimately can trigger a panic attack. This creates a cycle, where a person’s “self-monitoring” (unconscious monitoring of their own body) leads to a situation where any sensation that feels even a little bit different can trigger recurring and severe panic attacks.
What makes this situation interesting is that there is also a form of obsessive compulsive disorder (OCD) that can cause similar self-monitoring…
All About Sensorimotor OCD
“Sensorimotor OCD” is a subtype of obsessive compulsive disorder where a person becomes incredibly aware of their own bodily functions. Their “obsession” (recurring thought) is that they need to pay attention to or perform a bodily function or it will not happen. For example, they are checking to make sure that they breathe, and then making themselves breathe as a result.
What makes sensorimotor OCD unique is that it changes how the brain and body function. It causes many of those processes to move from the unconscious to the conscious. When you’re thinking about breathing, you have to breathe manually.
It’s not just breathing, either. It is also moving your legs/walking, blinking – any process that your body does on its own without your control.
The issue here is that your body’s automatic process is much more efficient and effective than anything you can do manually. It knows exactly how much air it needs, and how to move each muscle. So, when you think about breathing (for example), you often breathe incorrectly, causing hyperventilation.
When you hyperventilate, you have panic attacks.
Panic Attacks and Sensorimotor OCD
Panic attacks and sensorimotor OCD are two distinctive types of anxiety. But the overlap becomes clear when we look at how both conditions rely on the same mechanism: hyper-awareness of bodily sensations.
- In panic disorder, that awareness is typically fear-based and reactive.
- In sensorimotor OCD, it is obsession-based and compulsive.
Yet in both cases, the result is the same — an overactivation of self-monitoring that keeps the person trapped in a cycle of anxiety and physical discomfort.
When someone experiences a panic attack, it is not just fear that drives the process. It is the interpretation of what the body is doing. A person may feel their heart rate increase slightly — a normal, healthy response to a thought or movement — but interpret it as the first sign of cardiac distress. The brain sends a signal of danger, and the body follows with more adrenaline, more heart rate increase, more chest tightness, and more panic. It becomes a feedback loop that feels uncontrollable.
In sensorimotor OCD, a similar loop exists, but instead of fear of immediate danger, the focus is on control and awareness. The person may think, “What if I stop breathing?” or “What if I blink incorrectly?” The thought itself generates discomfort, and to relieve it, the person consciously focuses on that action — manually breathing or intentionally blinking. This conscious effort momentarily reduces anxiety but reinforces the belief that their awareness and control are necessary. Over time, this constant focus strengthens the connection between attention and anxiety, making it harder to return these functions to automatic control.
The Shared Role of Interoception
At the center of both conditions is a process called interoception — the brain’s ability to sense and interpret signals from within the body. Interoception is essential for survival. It tells us when we are hungry, tired, or in pain. But when anxiety or obsessive thinking is present, this system becomes hypersensitive. A small variation in breathing depth or a mild muscle twitch may trigger the same alarm response that a dangerous physical threat would.
This hyperawareness leads to what psychologists often call catastrophic misinterpretation — the belief that a benign bodily change means something serious or life-threatening. For example, if a person with panic disorder feels lightheaded, they might think they are about to faint. If a person with sensorimotor OCD feels their breathing become uneven, they might believe they are losing control of it. These interpretations cause distress, which intensifies the body’s sensations, completing the cycle of anxiety and physical reaction.
When Anxiety Becomes Self-Sustaining
One of the most difficult aspects of both panic attacks and sensorimotor OCD is how self-sustaining they can be. The more a person monitors, the more sensations they detect. The more sensations they detect, the more their anxiety rises. In panic disorder, this often leads to avoidance behaviors — avoiding exercise, caffeine, or stressful situations that might raise the heart rate or trigger sensations associated with panic. In sensorimotor OCD, it leads to compulsive checking or repeated self-focus, which further strengthens the pattern.
The nervous system becomes conditioned to respond to internal cues rather than external ones. Over time, the brain learns to associate certain sensations — a tight chest, a skipped breath, a heartbeat — with immediate danger. These associations can form even in the absence of any real medical risk.
Why the Cycle Is So Hard to Break
The challenge in both conditions lies in the fact that the sensations themselves are real. The tightness, shortness of breath, or racing heart are not imagined. They are genuine physiological responses to anxiety or hyperattention. However, because these sensations feel so threatening, the individual tries to fight them or regain control, which paradoxically makes them worse.
In panic disorder, attempts to calm down by controlling breathing or slowing the heart rate often lead to even more awareness of the sensations. In sensorimotor OCD, trying not to think about blinking or breathing leads to an even stronger focus on those actions. The act of monitoring keeps the body and mind locked in a loop of attention and fear that can persist for hours or even days.
The body is capable of functioning without conscious input, but anxiety and intrusive thoughts interfere with this system, turning natural sensations into perceived threats.
Treatment and Relearning How to Trust the Body
The treatment for panic attacks and sensorimotor OCD starts with one main idea: your body already knows what to do. The problem isn’t that your body is malfunctioning — it’s that your mind has stopped trusting it. Therapy helps you learn to step back, allow your body to function naturally again, and reduce the fear attached to normal sensations.
There are several approaches that can help:
- Cognitive Behavioral Therapy (CBT) – CBT helps you recognize the thought patterns that drive the cycle of anxiety. For example, when you think “I can’t breathe right” or “I might lose control,” CBT helps you test those thoughts against reality and learn to respond to them differently. Over time, this reduces the power they have to trigger panic.
- Exposure and Response Prevention (ERP) – Commonly used for OCD, ERP involves slowly and safely allowing yourself to experience uncomfortable sensations or thoughts without reacting to them. If you have sensorimotor OCD, this might mean noticing your breathing without trying to control it. The more you practice, the more your brain learns that these sensations are not dangerous.
- Interoceptive Exposure – A form of exposure therapy used for panic disorder, this involves purposely bringing on mild physical sensations that resemble those felt during panic attacks — such as breathing quickly or spinning in a chair. Doing this in a safe environment helps teach your brain that these sensations are not harmful and do not need to be feared.
- Mindfulness and Acceptance Techniques – These techniques train you to observe sensations without reacting to them. Instead of trying to make sensations stop, you learn to notice them, accept them, and move forward with your day. Over time, this teaches your body that it doesn’t need to stay on high alert.
When practiced consistently, these approaches teach the brain a new pattern: sensations are allowed to exist without interpretation. Breathing feels uneven sometimes. Hearts beat faster sometimes. Muscles twitch, throats tighten, and lungs expand at different depths. These are normal human experiences.
The Goal of Treatment
The ultimate goal of treatment is to restore automatic trust in the body. You learn that you do not need to watch your breathing, track your heart rate, or measure your sensations. The body’s systems are built to self-regulate. When you stop trying to control them, they return to doing exactly what they are meant to do — quietly, efficiently, and without your attention.
As the fear fades, the sensations fade too. The body calms down, the brain stops checking, and the loop of panic and awareness begins to break. What once felt like a fight for control becomes a process of letting go, allowing the body and mind to return to their natural rhythm.
If you feel like panic attacks, OCD, or any other issue is controlling your life, please reach out to Long Island Counseling, today.