What Are Somatic Sensations in Visual Tourettic OCD
Somatic sensations and somatic behaviours are two important but distinct concepts in psychology. Although the terms sound similar, they describe different aspects of how we experience and respond to our bodies.
Somatic sensations are the physical feelings we notice in our bodies — such as touch, pain, temperature, tension, or awareness of particular body parts. These sensations are processed by the nervous system and can be strongly influenced by emotions, thoughts, and surroundings.
A simple everyday example is the itchy feeling that arises when an insect crawls on the skin. Nerve endings send signals to the brain, creating the sensation of irritation.
What Are Somatic Behaviours
Somatic behaviours are the actions we take in response to those sensations. Scratching the itch is a clear example. In everyday life, these responses are usually automatic and helpful. In certain forms of OCD, however, the relationship between sensation and behaviour can become more intense, distressing, and difficult to control.
The Role of Somatic Sensations in Involuntary Gazing
In visual Tourettic OCD (also known as staring OCD or ocular Tourettic OCD), people often experience a distinct somatic sensation just before or during an involuntary gaze. This may feel like:
- A sudden “pull” or magnetic sensation in the eyes
- Ocular tension or pressure behind the eyes
- A racing heart
- A general sense of discomfort or rising urge
These physical feelings can be followed by intense distress, including doubts about morality or character — especially when the gaze is drawn toward private areas of other people. This distress frequently leads to compulsive efforts such as avoiding situations, covering the eyes, mentally replaying the moment, or seeking reassurance that no offence has occurred.
Example: Tim is sitting in a meeting when he suddenly notices a tight, pulling sensation around his eyes. Within a second, his gaze has shifted toward a colleague’s chest area. Immediately afterwards, he is flooded with shame and the thought, “What if she noticed and thinks I’m a pervert?” The somatic sensation, the automatic glance, and the obsessional doubt have become tightly linked.
Heightened Bodily Awareness in OCD
Research on interoception (the sensing of internal bodily states) has shown that many people with OCD experience heightened awareness of bodily sensations. One study found that individuals with OCD reported greater noticing of body sensations than people without the condition, along with a more maladaptive pattern of responding — greater worry about unpleasant feelings and lower trust in the body (Eng, Collins & Stern, 2020). These differences were independent of medication status and other diagnoses.
Such findings help us understand how intensified bodily awareness may contribute to the development or maintenance of compulsive behaviours, including those seen in sensorimotor and visual forms of OCD.
Sensorimotor OCD and Sensory Phenomena
Sensorimotor OCD involves an intense, often unwanted focus on automatic bodily processes such as breathing, blinking, swallowing, or the positioning of body parts. People may become preoccupied with the feeling that they are not performing these functions “correctly,” or they may monitor their own (or sometimes other people’s) physical rhythms in ways that interfere with daily life.
A large study of more than a thousand people with OCD found that around 65% reported sensory phenomena — uncomfortable bodily sensations, “just right” feelings, or urges — that preceded their repetitive behaviours (Ferrão et al., 2012). These sensory experiences were linked to greater symptom severity and were more common when tics were also present.
This research supports the idea that difficulty filtering or regulating sensory information can play a meaningful role in OCD, which may include presentations that involve involuntary gazing.
Vision as an Active Process
We often think of seeing as a passive experience — something that simply happens as light enters the eyes. In reality, vision is an active, continuous process in which the eyes, brain, and body work together. Our visual system constantly gathers information, interprets it, and helps guide movement and attention.
When something unusual or emotionally relevant appears (e.g., a bright light or a speeding car), our eyes are often drawn towards it automatically. This rapid, stimulus-driven response is known as exogenous attention. Feelings and past experiences can influence these automatic eye movements. In OCD, this process can become amplified.
Heightened Exogenous Attention and Involuntary Staring
Some people with OCD appear to experience heightened exogenous attention, an increased tendency for salient or emotionally charged visual stimuli (e.g., body parts) to capture their gaze. This may contribute to more frequent or more intense involuntary glances towards body parts or other features that stand out.
Once the gaze is drawn, the person may struggle to look away, which fuels distress and leads to avoidance, mental checking, or other compulsive efforts to regain a sense of control.
Clinical note: The idea that involuntary staring sometimes functions in a tic-like way, providing temporary relief from underlying tension or sensory discomfort, is a clinically useful hypothesis. Just as some people with OCD use repetitive handwashing to ease tactile discomfort, involuntary gazing may, for some individuals, serve a similar regulatory function. Importantly, the staring itself is typically unwanted. The distress and subsequent compulsions arise from the meaning the person attaches to the experience, for example, worrying it means perversion or cheating.
Practical Strategies for Managing Somatic Sensations
If you experience pre-gaze tension or ocular pull, the following strategies can be helpful:
- Label the sensation early: “This is a physical build-up in my eyes, not a moral problem.”
- Use a competing response: Take a moment to lift your eyebrows slowly, pausing for a few seconds to break the intense gaze. It’s a simple yet effective way to refresh your perspective!
- Practice interoceptive awareness: Notice the sensation without fighting it or analysing it. Allow it to peak and pass.
- Re-anchor in the present: Ask yourself what your senses are actually registering right now, rather than following the imagined story.
- Reduce secondary anxiety: The less meaning and panic you attach to the sensation, the less intense it often becomes over time.
Below is a straightforward explanation of re-anchoring in the present. It explains the senses and the imaginary story connected to them, highlighting their significance in the narrative.
It refers to the direct, present-moment sensory information your body is receiving — without interpretation, prediction, or storytelling.
It means asking:
- What do my eyes actually see right now?
- What do I hear?
- What physical sensations are present in my body at this exact moment?
- What is objectively happening in the immediate environment?
In Visual Tourettic OCD, this might sound like: “My eyes just moved automatically for a second. I can see the person continuing their conversation. No one is looking at me strangely. My body is sitting in this chair. That is all that is actually happening.”
It is the opposite of going into the mind’s narrative. It is grounded, concrete, and based on current sensory evidence.
The Mind’s narrative
The mind’s narrative is an imagined story that OCD creates after the automatic glance. It is not based on what is happening right now. Instead, it is built from remote possibilities, past memories, fears, and mental shortcuts (when your brain quickly grabs a memory, news story, or past event and uses it as “proof” for an OCD doubt, even though it doesn’t actually apply to the present moment).
A typical imagined story in V-TOCD might go like this:
“That glance lasted longer than I think. She must have noticed. She’s probably thinking I’m a pervert or that I was staring on purpose. This proves there’s something wrong with me. People will judge me. I’ve done something immoral, and I need to figure out exactly what happened and whether she was offended…”
This story feels real and urgent, but the mind constructs it. It mixes imagination with reality and treats possibility as probability.
The Difference in Practise
- Senses (present reality): “My eyes shifted automatically. Nothing else is currently happening.”
- Imagined story: “This means I’m a bad person / she noticed / I’ve caused harm / I’m immoral.”
By deliberately returning your attention to what your senses show right now, you weaken the imagined story and reduce the secondary anxiety that fuels the cycle.
Further Exploration
My book, Through the Eyes of OCD: Understanding Tourettic Tics and Involuntary Gazing, explores these themes in greater depth. It examines the possible contribution of heightened exogenous attention, the connections between somatic sensations, sensory processing, visual perception, and behavioural responses, and reviews a range of treatment approaches. The book is available on Amazon.
Thank you for reading.
Raising awareness of this frequently misunderstood presentation of OCD can make a real difference. Sharing accurate information helps reduce shame and encourages people to seek the support they deserve.
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