Pure Obsessional OCD: 'Pure O'
Pure Obsessional OCD or Pure O is a sub-type of OCD that is characterized as intrusive, unwanted thoughts that come to your mind against your will. Obsessions and fears that can feel uncontrollable. Pure O, unlike other sub-types of OCD such as contamination OCD; might not have observable compulsions. We might see someone with contamination OCD showering or hand washing often. With Pure O, it is not as clear when a compulsion is happening. The idea of Pure O is to help us understand the symptoms of OCD that are not visible compulsions. Pure O obsessions can involve a number of themes. Common ones seen can include ones health, their relationship, germs, or religion.
Compulsions are rituals/behaviors that offer relief from the obsessions. Engaging in the compulsion can reduce the anxiety and provide short term relief. A person is more likely to seek that short term relief with the compulsion, and look to reinforce the OCD cycle that keeps them stuck. With Pure O, we know that we will not see the visible compulsions but that does not mean they are not there. Below we will look at some of the common compulsions that characterize Pure O OCD.
Common Pure O Obsessions: Repeated intrusive images, thoughts, and impulses that create a great deal of distress.
Health.
Relationships.
Religion.
Sexual orientation.
Harm.
A person might make repeated attempts to ignore, suppress, or neutralize the obsessive thoughts.
Common Pure O Compulsions: Repetitive actions, either behavioral or mental- done as a way to get relief from the obsessions.
Mentally repeating certain words.
Mentally reviewing- memories.
Rumination
Mentally un-doing or re-doing certain actions- neutralizing behaviors.
Seeking reassurance.
Avoiding certain triggers.
Looking for self-assurance.
Researching online.
Pure O OCD Example:
Alan is 55 years old and works in marketing. Alan faces a great deal of anxiety and worry each day coming into work. Alan has fears and worries about saying something offensive. Alan worries that he will accidentally say something racists or sexist to his boss or co workers. Alan tries to reassure himself as best as he can. Reminding himself that he is not a racist or sexist, and that he hates having these thoughts. Alan has dealt with this fear for years after an incident at work happened three years ago where a co worker made a racist comment that was emailed to their boss. Ever since that person was fired, Alan has worried about what if that happened to him. Alan engages in a number of mental compulsions. Alan ruminates over this fear for over an hour each day. Alan will avoid being near his co workers and will resist talking if he has to be near them. Alan looks to give himself self-reassurance. With this case, we are not seeing physical compulsions present. Compulsions are internal that only Alan can see and feel. As we know more about Pure O OCD, we can see that Alan is still engaging in a number of mental compulsions. These compulsions are keeping Alan stuck in the OCD cycle, leading to further and further distress.
Treatment for Pure O OCD:
Treatment for this sub-type of OCD, like all forms of OCD is the gold standard of treatment, exposure and response prevention (ERP). Exposure and Response Prevention (ERP) looks at the idea that triggering situations and thoughts are at the core of OCD. Ongoing exposure to these triggers without engagement in rituals can reduce the severity felt. As a licensed mental health therapist trained in ERP, I will assist you through the exposures and how to implement effective response prevention measures. If you feel that OCD has had a negative impact on your life, you might consider counseling and ERP to learn how to handle it more effectively. Please feel free to reach out for a free consultation, where we can discuss the impacts of OCD and benefits of counseling/ERP.
