For those living with somatic OCD, a subtype of obsessive-compulsive disorder (OCD), it’s not uncommon to become hyper-focused on everyday bodily functions. One example is tongue position—where your tongue rests in your mouth when you’re not speaking or eating. You may worry that improper tongue posture is impacting your breathing or tooth alignment. You may feel the need to constantly monitor or adjust it.
This kind of fixation can be exhausting, taking up mental energy and making it harder to focus on the things that matter most. In this article, we’ll discuss how to navigate any health concerns you may have about proper tongue posture, why it can become a source of obsessive focus for individuals with somatic OCD, and how to manage these thoughts so you can feel more at ease in your everyday life.
Understanding somatic OCD
In order to discuss the connection between obsessive-compulsive disorder (OCD) and concerns about tongue posture, we first need to understand OCD. OCD is a mental health condition where intrusive thoughts, feelings, urges, sensations and images become obsessions, leading to repetitive actions or mental rituals (known as compulsions). These compulsions are performed in an attempt to ease the anxiety brought on by intrusive thoughts, but typically only serve to further a distressing cycle.
For people with somatic OCD (also known as sensorimotor OCD), obsessions can center on bodily functions, such as breathing, swallowing, or tongue positioning, causing an exhausting hyperfixation on elements of daily life that should feel automatic. While most people rarely think about how they’re blinking or where their tongue is resting, those with somatic OCD may question whether their body is working “correctly” or “efficiently.” This intense focus can lead to compulsive behaviors—such as repeatedly adjusting your tongue, or monitoring your breath to try to ensure that everything feels “right.”
“With somatic OCD, there’s almost a lack of…belief in automatic processes,” says Dr. Patrick McGrath, Chief Clinical Officer at NOCD. “It’s like saying, ‘body, I know you’ve been doing this since I was born, but I’m not sure you know how to do it the right way.’” This mistrust in the body’s natural rhythms can leave you feeling trapped in anxiety and compulsions, making it hard to focus on anything else.
With somatic OCD, there’s almost a lack of…belief in automatic processes. It’s like saying, ‘body, I know you’ve been doing this since I was born, but I’m not sure you know how to do it the right way.’
Dr. Patrick McGrath
Common somatic OCD obsessions
People with somatic OCD often become preoccupied with specific bodily functions. These obsessions can vary, but may include:
- Breathing: Worrying about breathing too fast, or too slow, and trying to control each breath.
- Swallowing: Monitoring swallowing to ensure it’s done “correctly.”
- Heart rate: Obsessing over whether your heartbeat feels “normal.”
- Tongue position: Fixating on whether your tongue is resting in the “right” spot and adjusting it frequently.
- Blinking: Feeling the need to blink a certain number of times, or fearing that improper blinking will damage your eyes.
If these concerns resonate with you, know that there are strategies and resources available to help you regain control—allowing you to refocus on what matters.
Understanding tongue posture concerns
While hyperfixating on your tongue’s posture typically isn’t healthy, it is possible to have legitimate concerns about tongue positioning. Understanding the difference between a medical issue and an obsessive focus is key to addressing the problem effectively.
If you’re concerned about your tongue posture and think it is impacting your physical wellbeing, a visit to a dentist or orthodontist can be helpful to rule out structural or functional issues. It’s important, however, to approach this with balance—seeking reassurance from multiple professionals or over-researching your concerns may indicate that OCD is driving your behavior.
Hyperfixation vs. medical concern
Some people experience both legitimate dental health concerns related to tongue posture and somatic OCD at the same time. If you’ve been diagnosed with somatic OCD and are concerned you may have an oral health issue as well, consider the following:
- Seek clarity: It’s reasonable to visit a dentist or orthodontist to confirm whether your tongue posture is affecting your oral health. Once you have received a professional opinion, however, trust that expertise and avoid repeatedly seeking second or third opinions—which can feed OCD-driven reassurance-seeking.
- Prioritize mental health: Even if a dentist identifies a minor issue with tongue posture, addressing any OCD-driven hyperfixations you may be dealing with will be important. Focusing too heavily on “fixing” posture without addressing the OCD cycle can make the obsession worse, and prove detrimental to your mental health.
- Balance improvement and management: If improving your tongue posture is recommended by a dentist or other health provider, work on gradual adjustments while resisting the urge to turn the process into a compulsion. Mental health professionals, particularly those trained in exposure and response prevention (ERP) therapy, can help you develop strategies to manage intrusive thoughts while maintaining your focus on any other legitimate health needs you may have.
It’s important to know when to reach out for help. A dentist can address structural concerns, such as jaw alignment or tongue placement affecting breathing or oral health, while a trained therapist can help with intrusive thoughts and compulsive behaviors. If you have OCD, make sure you address the mental aspect of the condition, rather than only seeking reassurance through dentists.
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ERP: the proven treatment for OCD
Somatic OCD, like other forms of OCD, responds very well to exposure and response prevention (ERP) therapy. ERP works by helping individuals gradually face their fears and resist the urge to engage in compulsions. ERP helps you learn to sit with distressing thoughts or sensations, while practicing tolerance and acceptance.
Despite some common misconceptions, Dr. McGrath affirms that ERP is as effective for somatic OCD as it is for other subtypes. He highlights that the goal of ERP is to “gain back the confidence that you already know what to do and how to do it,” by challenging the doubts and insecurities that OCD introduces into everyday bodily processes.
How ERP Addresses Tongue Position Fixations
For someone fixated on tongue position, ERP might involve deliberately placing the tongue in positions that feel “wrong” or “uncomfortable” and sitting with the resulting discomfort, without trying to correct it.
If you’re worried that this type of practice will create long-term issues, rest assured that these ERP exercises are temporary, and meant to help you break the cycle of obsessive thoughts; they aren’t meant to create lasting habits. It’s natural to feel some anxiety while engaging in these exercises—especially since your intrusive thoughts likely center around your tongue’s positioning—but it’s important to remember that your body is more capable than OCD might make it seem. Your mouth knows how to return to a natural, healthy state.
ERP also involves identifying and eliminating any safety behaviors or rituals. For instance, if you find yourself performing specific routines before bed to ensure your tongue is in the “right” position, ERP would focus on gradually reducing and eventually eliminating these actions. Over time, this practice reduces OCD’s influence and helps you feel more at ease with natural bodily processes.
Bottom line
If you’ve been fixated on proper tongue position, know that your body is naturally equipped to manage these processes on its own. While tongue position can play a role in dental health or breathing, it’s important to differentiate between genuine oral health concerns and obsessive fixations. Trusting your body’s ability to function and keep your tongue in the right position without constant oversight is a key part of finding peace.
If worries about tongue position—or any other bodily function—are taking over your thoughts, know that you’re not alone. Many people with somatic OCD face similar challenges, and there is help available. Working with a specialized therapist trained in ERP can provide the support you need to break free from obsessive thought patterns. With time, and the right strategies, you can regain trust in your body’s ability to care for itself, and focus on what truly matters in your life.
Key takeaways:
- Somatic OCD can cause individuals to fixate on automatic bodily functions, such as tongue position, leading to intrusive thoughts and compulsive behaviors.
- While understanding proper tongue posture is helpful, fixating on it can disrupt daily life and may indicate an obsession related to somatic OCD.
- Exposure and response prevention (ERP) therapy is a highly effective evidence-based treatment for somatic OCD—helping individuals face intrusive thoughts and reduce compulsions.
- Specialized therapists are available to support you through the challenges of somatic OCD, providing effective tools and strategies to help you find relief.
- Trusting your body’s natural ability to manage its functions is a key step to overcoming somatic OCD, and regaining peace of mind.