Somatic OCD

What is Somatic OCD?

Somatic OCD, also known as illness anxiety disorder or illness phobia, is a condition in which the person experiences obsessive worry or fear of having or contracting an illness. This type of OCD may manifest itself in ways such as checking for wounds in the body and worrying about symptoms that are severe but not actually present. People with somatic OCD may have physical symptoms of a medical condition that they cannot readily explain.


They may spend a significant amount of time researching their medical condition or visiting the doctor with complaints of anxiety and physical symptoms. Unfortunately, this type of OCD often goes undiagnosed because people who are suffering from illness phobia believe that their concerns are justified by actual symptoms.

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Symptoms of Somatic OCD

Somatic OCD is a type of obsessive-compulsive disorder (OCD) that involves recurring worries or fears about your physical health. Common symptoms of somatic OCD include:

  • Frequent and intrusive thoughts or images related to physical illness, the risk of getting a serious illness, or concerns over past illnesses or other medical conditions.
  • Obsessive worries that you have an illness, even when there is no clear evidence of illness. These thoughts or images may be accompanied by urges to check on your symptoms or body functions.
  • Constantly checking or examining yourself for signs of illness, such as feeling excessively anxious about bodily sensations like aches and pains.
  • Compulsive behaviors that are related to your health or medical condition, such as excessive exercise or frequent trips to the doctor.
  • Avoiding situations where you might have symptoms of a serious illness or be exposed to germs and other potential sources of contamination.
  • Other obsessive-compulsive symptoms, such as excessive hand-washing or avoidance of numbers or words that have a specific meaning related to illness.

Obsessions of Somatic OCD

  • Fear of specific harm or illness. For people with somatic obsessions, this often takes the form of an intense fear that their body or a particular part of their body is somehow damaged or diseased. This could include fears about having cancer, HIV/AIDS, tumors, or even simply being infected with a common cold virus.
  • Obsessions about body waste or fluids. This can include obsessions about passing gas, urination, bowel movements, sexual fluids such as semen or vaginal discharge, and other bodily emissions.
  • Fear of specific sensory information. A person with somatic OCD may be afraid of certain types of touch, feeling pain from a specific body part, or experiencing a specific kind of smell associated with the body.
  • Fear of perceived defects in the body’s structure or appearance. For example, a person may be obsessed with the size or shape of their nose, eyes, mouth, or other parts of their body and feel intense anxiety about having a flaw that is embarrassing or shameful.
  • Obsessions about specific sounds or noises. This could include a fear of ears popping, certain types of voices, whistling, clicking noises, and other kinds of sounds that are connected to the body in some way.

Compulsions of Somatic OCD

  • Obsessive checking of one’s body for symptoms of illness, such as lumps or rashes. This often includes a drive to repeatedly touch or tap certain areas of the body in an effort to “release” any discomfort or anxiety that might be felt at that spot.
  • Relentless hand washing, showering, or other forms of grooming to “undo” the perceived contamination or to avoid illness.
  • Repeatedly asking others for assurances that one is healthy or clean, and obsessively questioning them if they fail to respond with the desired answer.
  • Ritualized eating behaviors, such as excessive chewing or avoiding certain textures of food, to avoid potential contamination.
  • The compulsive need for symmetry or exactness in one’s belongings or surroundings as a way of reducing anxiety related to the perceived illness or threat of contamination. This may include arranging items in even numbers, lining up objects with extreme precision, and taking excessive measures to ensure that all surfaces are wiped perfectly clean.
  • Engaging in compulsive exercising as a way of reducing anxiety and releasing negative thoughts, or to counteract “impure” urges such as sexual fantasies.
  • Ritualized touching and tapping of inanimate objects like doorknobs, steering wheels, or light switches as a way of “cleaning away” any perceived contamination or threat.
  • Avoiding places, people, or situations that trigger feelings of anxiety about illness and the need for constant reassurance. This may include social isolation and decision-making paralysis when faced with a new situation.