Pure O & Obsessive Compulsive Disorder

PUBLISHED May 28th, 2021 & UPDATED ON Nov 17th, 2022

Obsessive-Compulsive Disorder (OCD) is suuuper complex and has a lot of different aspects to it! But when someone says they’re “soooo OCD” just because they like to colour-coordinate their closet, it makes it a lot harder for people who actually have OCD to figure out what’s going on with them! We’re going to dive into one specific kind that tends to go unnoticed just because it doesn’t have obvious, physical compulsions. This is your guide to Pure O and how it shows up!

What Is Pure O?

Pure O (a.k.a. Pure Obsessions) is a nickname for the mental aspect of OCD that’s characterized by unwanted (and oftentimes distressing) intrusive thoughts that don’t respond to logic! It’s not as well-known as other forms of OCD only because it doesn’t show up as excessive hand-washing, counting, or rearranging. Kinda exclusionary, don’t you think? Well, that’s why we’re here to help you recognize it more easily!

“The person has obsessions — unwanted intrusive thoughts — and then performs mental compulsions,” explains therapist and Anxious Like You podcast guest Alegra Kastens, who struggles with Pure O herself. “Mental compulsions are really common and they often get missed by therapists.”

Here are a few ways these thoughts can show up:

Harm (thoughts of hurting someone you love or driving your car off a bridge)
Pedophilic (sexual thoughts about an inappropriate person, like a child)
Scrupulosity (a fixation on religion or beliefs surrounding your morals)
Disgusting (just plain absurd thoughts…like drinking from a dirty puddle with a straw)

Let’s dive a little deeper.

Symptoms of Pure O

Often, Pure O is labelled as “less severe” than other forms of OCD just because it’s not as obvious, but it’s defs not! It’s suuuper uncomfy for those going through it because they are the one experiencing these awful thoughts, even though they “seem fine” on the outside. It invalidates their symptoms…when it’s actually such a common experience! Now, symptoms of Pure O are divided into these two groups.

1. Mental Rituals

These rituals include constantly going over memories to make sure nothing bad happened, repeating a word over and over in your head, and mentally doing or undoing actions!

“A big one is mental checking,” says Alegra. “So, let’s say someone has a sexual obsession about a family member. It’s like, ‘let me check my groinal area, if I feel aroused.’ Or mentally reviewing the past, ‘when I was in my baby’s room, did I stab her? Did I do this?’ and constantly going over it in your mind.”

2. Reassurance-Seeking

This may cause you to ask other people for assurance over and over and over! You may even keep reassuring yourself if no one else is around. This can include researching things online and avoiding any situations that can trigger more worries.

“A lot of ruminating…‘why am I having these thoughts? What do they mean about me?’…trying to solve them,” adds Alegra. “Mental self-reassurance. Thought neutralization (trying to replace a bad thought with a good thought in your mind). The list goes on.”

Pure O OCD Treatment

Fighting Pure O can be an uphill battle! It’s tough to recognize what’s happening at first, which may keep you from seeking mental health support. But once you get that diagnosis, a therapist will be able to set you up with a plan for psychotherapy and, possibly, medication. These two main things will help you overcome intrusive thoughts.

1. Resisting Compulsions

This is definitely easier said than done. But, compulsions are never the answer! It may feel like a relief to follow through on mental checks or seek reassurance at that moment, but it just keeps perpetuating the OCD cycle. Alegra recommends sitting with that feeling and not doing anything about it because when you act on compulsions you are just telling your brain that “the false alarms are actually real alarms.” It’s a total waste of time and energy, so kick ‘em to the curb!

2. Exposure and Response Prevention (ERP)

This route of treatment is effective for OCD because it makes you challenge your thoughts without taking any action! A mental health professional will guide you through exposure to your intrusive thought and control your response. For example, if your fear is stabbing someone you love, they will have you hold a knife to their back! It helps you realize that you don’t actually want to hurt someone, and you’ll be able to use that knowledge going forward!

For more info on Pure O, listen to “OCD & All The Ways It Shows Up with Alegra Kastens” on the Anxious Like You podcast!