"Pure O" OCD: Symptoms, Causes, And Treatment
Obsessive-compulsive disorder (OCD) is a condition typically depicted in popular media as one of behaviors rather than thought. Pure obsessional OCD is a form of OCD that involves obsessive thoughts without physical compulsions. While this type of OCD may be viewed as a less severe form, pure O OCD can be distressing and disruptive to daily life and is a valid form of OCD.
What is OCD?
Obsessive-compulsive disorder (OCD )is a mental health condition classified by intrusive and obsessive thoughts and ritualistic behaviors that are often used to relieve these thoughts.
Causes of OCD
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Experiencing OCD without compulsions
Pure O OCD (also known as purely obsessional OCD or primarily obsessional OCD) is thought by some experts to be considered a misnomer. While a person with this disorder does not exhibit visible physical compulsions, they often do experience mental compulsions or mental rituals in response to their intrusive thoughts. These hidden mental rituals of pure O OCD exist to “fix” the scary, wrong, or disturbing cycle of thoughts.
Symptoms of pure O OCD
Pure O OCD can be difficult to diagnose because it is not a clinical diagnosis in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Instead, it falls under the general diagnosis of OCD. In addition, clients may be reluctant to share their pure O OCD symptoms, as these intrusive thoughts and mental compulsions are often embarrassing. Having a patient mental health practitioner and open-ended questioning may help encourage clients to discuss the symptoms of this disorder, which may include but aren’t limited to the following:
- Repetitive and distressing thoughts, images, or impulses
- Continual and often exhausting attempts to neutralize these patterns of obsessive thought
- Continually seeking reassurance from others
- Mentally repeating specific words
- Mentally re-doing certain actions
- Avoiding stressful situations or people
Because the symptoms of OCD are occurring in the individual’s mind, it can be challenging for others to know they’re happening. Friends and family members may perceive constant requests for reassurance as “neediness” and may not recognize them as symptoms of OCD
Common pure O OCD obsessions and compulsions
The intrusive and obsessive thoughts of an individual experiencing OCD can vary but typically fall into one of several common categories, including the following:
- Doubt about a romantic partner or relationship
- Disturbing or inappropriate sexual acts
- Aggressive or violent ideas
- Fear of something bad happening to a loved one
- Sacrilegious thoughts
- Tracking or worrying over somatic actions (breathing, swallowing, blinking)
- Doing something embarrassing
In response to these repetitive and disruptive thoughts, an individual may try to find the answer behind them or “fix” them through the following mental compulsive behaviors:
- Reassuring themselves about their motives and thoughts
- Mentally reviewing memories, experiences, and ideas
- Trying to neutralize thoughts through rationalization
- Seeking reassurance from others
- Avoiding situations that incite obsessive thoughts
- Performing superstitious rituals (mentally)
- Continually questioning their own motives
How pure O OCD impacts mental health
OCD can be emotionally, mentally, and physically exhausting. Large amounts of energy are spent on obsessing over thoughts and in the rituals intended to fix those thoughts. Pure O OCD can be especially difficult to diagnose as symptoms can be more challenging to identify by oneself or by loved ones since it plays out in your head.
Treatment options for OCD
When it comes to treatment, pure O OCD symptoms may be managed by a combination of psychotherapy, medication, and healthy lifestyle habits.
Medications for OCD
Common medications prescribed for obsessive-compulsive disorder include selective serotonin reuptake inhibitors (SSRIs) and certain tricyclic antidepressants.
The BetterHelp platform is not intended to provide information on which medication or medical treatment may be suitable for you or your pure O OCD. The content provides generalized information that is not specific to one individual. Do not take any action without consulting a qualified medical professional.
Common OCD therapies
Research indicates that specific psychotherapy approaches can be highly effective in treating Pure O OCD, including cognitive-behavioral therapy (CBT), exposure and response prevention (ERP), and mindfulness-based cognitive behavioral therapy (MB-CBT).
Self-care practices
Specific strategies that promote mental and physical health may be recommended to help manage symptoms of Pure O, including but not limited to the following:
- Getting regular physical activity
- Practicing relaxation exercises such as meditation, progressive muscle relaxation, and deep breathing
- Maintaining strong social connections
- Seeking community through OCD support groups
Therapy for OCD
Talk therapy is one of the primary treatments for pure O and related disorders like anxiety. Some individuals choose not to take medication, and even when prescribed medication, therapy is recommended to address the obsessive thoughts and compulsions experienced with this disorder. Cognitive-behavioral therapy is the most common and effective form of therapy for pure O OCD.
Online treatment for OCD
For some individuals, scheduling in-person therapy appointments may be difficult or impossible. There may not be a licensed therapist available in their area who specializes in pure O OCD, or they may find it emotionally taxing to meet with a therapist in person. Online therapy offers a convenient and effective solution to these challenges.
Research has demonstrated that online therapy can be as effective as in-person therapy. With an online platform like BetterHelp, you can complete an online questionnaire to be matched with a licensed professional who meets your personal needs.
Takeaway
Is pure O OCD anxiety?
Pure O OCD is not just anxiety; it is a separate mental illness from anxiety disorders. Although this condition causes rumination and racing thoughts that might incite anxiety, similar to many anxiety disorders, it also involves compulsions, making it a form of OCD. However, the compulsions in this type of OCD are purely mental instead of outward compulsions, so they might not consistently be recognized as compulsions.
For example, a person may repeat a phrase in their head several times out of fear of a harmful outcome or unwanted thoughts. These hidden compulsions could also involve mental acts like repeating words silently in their head, using mental reviewing, replaying events, or shouting in their head to avoid highly distressing images or thoughts. In more outward OCD subtypes, compulsions are often physical, such as hand-washing, repetitive actions, organizing items in an order, or reassurance seeking.
How rare is pure O OCD?
Pure O OCD is considered a rarer subtype of the condition compared to other forms. However, it isn’t the only rare subtype. Another rare subtype of OCD is harm OCD, also called HOCD. Harm OCD can involve significant fears of harming oneself or others or believing that one has accidentally already done so without knowing. Many forms of OCD are treatable, and effective treatment approaches typically include exposure and response therapy (ERP therapy), cognitive-behavioral therapy (CBT), and dialectical behavior therapy (DBT). The best treatment can depend on the client.
Does pure O OCD go away?
According to clinical psychology studies, pure O OCD is treatable and manageable. Exposure therapy is often recommended for significant distress caused by this condition, allowing people to regain somatic function by exposing them to feared thoughts and compulsions. Although difficult, exposure therapy has high success rates.
What is the cause of pure OCD?
OCD is considered a condition that develops from a mixture of genetic and environmental factors. Some people develop OCD because they have a family history of mental health challenges. Others may develop OCD due to experiencing a traumatic event.
Why does pure O OCD feel real?
Pure O OCD can seem real because OCD is a condition that causes strong beliefs that bad events will occur if one does not give in to compulsions. Purely mental compulsions can seem like a prison, keeping you stuck in your head and causing you to believe that you can’t escape. However, this belief is untrue. OCD is treatable and manageable, and it is possible to find a way out of your thoughts.
Is pure O OCD psychosis?
Some people wonder if pure O OCD is a form of psychosis because it can involve repeated distressing images and thoughts, as well as delusions in some cases. However, this condition is separate from psychosis and, on its own, doesn’t cause hallucinations, delirium, or severe delusions. Many people with this condition know their thoughts are irrational but struggle to stop them.
How do you stop pure O thoughts?
Stopping intrusive thoughts may be difficult if you’re pushing back against them. In exposure therapy, clients are trained to embrace their intrusive thoughts, talk openly about them, and interview them instead of pulling away. Resistance often worsens these thoughts, whereas acceptance and exposure can make them disappear, as they no longer control your mood.
What is the rarest type of OCD?
There is no one consensus on the rarest type of OCD, but subtypes like harm OCD, pure O OCD, and pedophilia OCD are considered somewhat rare. Still, anyone can experience these types of OCD, and millions of people struggle with symptoms worldwide.
How do you stop ruminating with pure O?
Exposure therapy techniques or cognitive restructuring may help you stop ruminating. Forcing yourself to distract yourself and move on from a situation may also be helpful, especially if you get fixated on it and go into a mental loop. If you’re unsure how to start, consider talking to a therapist.
What is the best therapy for pure O OCD?
The best therapy for pure O OCD is often considered to be exposure and response prevention, a form of CBT. Exposure therapy exposes people to the thoughts they are afraid of, encouraging them to open up with the therapist and examine the thoughts in detail.
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