Fears of suffocation fall under the OCD subtype of Harm OCD. This theme is characterized by persistent fears that one could do something that causes harm to themselves or others via suffocation.
What is the fear of suffocation?
Harm OCD with a focus on the fear of suffocation involves fears about causing suffocation in oneself or others. One may fear that they will purposefully suffocate someone or themselves, or accidentally cause suffocation, find themselves unable to breathe, or run out of air. People with this theme of OCD often feel an especially high sense of responsibility for others and their well-being—for example, new parents who are afraid of leaving their child near objects that could cause them to suffocate.
Someone who is experiencing a fear of suffocation often has unwanted, intrusive thoughts, images, or urges that cause them significant distress and anxiety, called obsessions. In an effort to rid themselves of these uncomfortable feelings, people with OCD often will perform rituals or compulsions. Compulsions are actions, either mental or physical, that serve to neutralize uncertainty or worry or prevent a feared outcome.
People with Harm OCD with a focus on fear of suffocation may frequently research online various cases involving suffocation. They may research safety precautions to take in regard to suffocation risks. They may also go to great lengths to remove any perceived risk of suffocation in their lives, engaging in compulsions like never using plastic bags, only wearing shirts with a wide collar, always driving with the windows down, or avoiding swimming.
Common obsessions
- What if I accidentally suffocate myself?
- What if I accidentally suffocate someone else?
- What if I purposefully suffocate myself or someone else some day?
- What if I leave something out and my child suffocates on it?
- Images of suffocating oneself or others
- What if I suffocate on bedding or clothing in my sleep?
- What if I get trapped and run out of air?
- What if I get trapped underwater?
- What if my carbon monoxide alarm is faulty?
- What if I suffocate due to an allergic reaction?
- What if I suffocate due to a respiratory illness?
Common triggers
People with a fear of suffocation in Harm OCD may be triggered by situations involving any perceived risk of suffocation. They may avoid using any item that could potentially be a suffocation hazard, or avoid situations that feel hazardous, like driving with the windows up. They may go to great lengths not to be alone with someone else or by themselves, fearing they may act on unwanted thoughts, images, or urges, or find themselves unable to breathe without others to help. Triggers may also include watching shows about people who have died by suffocation, hearing about it in the news, or people discussing it. People with OCD tend to avoid situations in which they feel intrusive thoughts are triggered or may be triggered.
For example, consider these possible scenarios in which someone with a fear of suffocation in Harm OCD could be triggered:
- Eleanor was supposed to watch her infant cousin for the night. At the last moment, she backs out. She is afraid that she will not be able to watch the infant safely enough, fearing the baby will suffocate in bedding or clothing due to her negligence.
- A news story airs on TV about SIDS and how this may be linked to suffocation. Jenny, a new mom herself, becomes obsessed with intrusive thoughts about this.
- Bryan is watching a movie where someone uses a plastic bag to suffocate another person. Now Bryan refuses to go near plastic bags.
- Gavin feels like he must drive with his windows down at all times, worrying that he will run out of air and crash or pass out if he leaves them up.
How can I tell if it’s suffocation fears in Harm OCD, and not just cautiousness and safety?
This is an excellent question. To know if you may be suffering from OCD, you need to learn to recognize the OCD cycle.
The OCD cycle is composed of: 1) intrusive thoughts, feelings, images, or urges; 2) anxiety or distress that comes as a result; 3) compulsions performed to relieve the distress and anxiety brought on by the intrusive thoughts, images or urges. Understanding this cycle can help you distinguish OCD from other conditions. Something to keep in mind is that if you are feeling an intense urgency to feel safe or comfortable immediately, that is a red flag that OCD may be at work.
Intrusive thoughts and irrational fears can and do occur in everyone. Most people who do not have OCD are able to brush these thoughts off rather easily and live without their worries dominating their values and choices. However, people with OCD struggle to do this. This is where OCD holds its power—making worries, fears, and doubt feel insurmountable.
Common compulsions
When people with Harm OCD with a focus on suffocation fears experience intrusive thoughts, images, feelings, or urges that cause distress, they may engage in compulsions, or behaviors or mental acts done in an attempt to alleviate the distress and discomfort caused by intrusive thoughts or to prevent a feared outcome. Compulsions may provide temporary relief, but do nothing to keep obsessions from returning again and again. Performing compulsions often inadvertently strengthens obsessions and fears, reinforcing the idea that obsessions posed an actual threat or danger.
Here are some examples of common compulsions for people with fears of suffocation in Harm OCD:
- Avoiding potential safety hazards that could cause suffocation
- Avoiding being home alone
- Avoiding going places alone
- Self-reassurance
- Seeking reassurance from others
- Confessing thoughts to others
- Avoiding using excessive bedding or sheets
- Avoiding closed spaces
- Avoiding water
- Avoiding any form of pressure on one’s neck
How to overcome fear of suffocation
Suffocation fears related to Harm OCD can be debilitating, but it is highly treatable. By doing exposure and response prevention (ERP) therapy with an OCD specialist, you can find freedom from the OCD cycle.
ERP is the gold standard treatment for OCD and many other anxiety disorders. It is backed by decades of clinical research proving its effectiveness and shows promising results within 12-25 sessions on average. With ERP, you will be able to teach your brain that you are able to tolerate uncertainty and discomfort, even about your strongest fears.
In ERP, you’re gradually and safely exposed to the thoughts and situations that are likely to trigger intrusive thoughts and anxiety about suffocation. With your therapist’s guidance and support, you will learn how to resist the urge to respond to these feelings and situations with compulsions. By doing this over time, you will learn that you are able to tolerate anxiety, experience decreased anxiety and distress in response to OCD triggers, and feel more confident in your ability to sit with uncertainty and discomfort about suffocation.
Examples of possible exposures done to treat Harm OCD with a focus on fears of suffocation include:
- Touching plastic bags, holding them, or using them
- Being alone with someone else while having access to plastic bags
- Watching news stories on suffocation
- Reading warning labels about suffocation
- Writing a script about a worst-case scenario involving suffocation
- Creating a loop tape about your worst fear coming true and listen to it repeatedly
If you’re struggling with OCD, you can schedule a free 15-minute call today with the NOCD care team to learn how a licensed therapist can help. At NOCD, all therapists specialize in OCD and receive ERP-specific training. ERP is most effective when the therapist conducting the treatment has experience with OCD and training in ERP.
We look forward to working with you.