Pure OCD, or Purely Obsessional OCD, is a specific type of Obsessive-Compulsive Disorder. It is marked by intrusive and unwanted thoughts, known as obsessions, without the overt compulsions usually seen in OCD, like repetitive handwashing or checking behaviours.
Despite its designation, people with Pure OCD often perform mental rituals or subtle behaviours to alleviate their anxiety, which may not be evident to those around them.
My thoughts about Pure O OCD
In my experience, about a third of people with OCD have the type known as Pure O or Pure OCD.
This seems to develop in individuals who have rich imaginations, are a little more extroverted, have creative talents and may have had ADHD (or ADD) as a child but, for some reason, had their natural playfulness and spontaneous characters suppressed by parents or school to try and fit in and be good.
This is my favourite group of people to work with, as they just need to be taught how to be their true selves and find ways to release their inner creativity and unique personalities.
Key Features of Pure OCD
Intrusive Obsessions:
- Persistent, distressing thoughts, images, or urges that are often taboo or contrary to the individual’s values.
- Common themes include:
- Harm obsessions: Fear of hurting oneself or others.
- Sexual obsessions: Unwanted thoughts about inappropriate or taboo sexual acts.
- Religious or moral obsessions: Fear of sinning, blasphemy, or failing to uphold moral standards (“scrupulosity”).
- Existential obsessions: Persistent questions about reality, existence, or life’s purpose.
- Relationship obsessions: Doubts about the genuineness or health of personal relationships.
Mental Compulsions:
- Unlike traditional OCD, compulsions are mental or covert behaviours, including:
- Reassuring oneself mentally (e.g., “I’d never do that”).
- Replaying scenarios or analysing situations repeatedly.
- Mentally “undoing” perceived harm or “neutralising” bad thoughts.
- Seeking certainty by reviewing memories or situations.
- Unlike traditional OCD, compulsions are mental or covert behaviours, including:
Emotional Distress:
- High levels of anxiety, guilt, and shame related to the content of intrusive thoughts.
- Fear that having certain thoughts equates to acting on them (thought-action fusion).
Avoidance:
- Avoiding people, places, or activities that could trigger distressing thoughts.
Insight:
- Most individuals with Pure OCD recognise their thoughts as irrational or excessive, but the distress remains overwhelming.
Other names for this disorder are:
Pure OCD, while commonly referred to by that name, is also known by other terms that highlight its focus on obsessions or the absence of overt physical compulsions. Here are some alternative names or descriptions:
- Purely Obsessional OCD
- Primarily Obsessional OCD
- Obsessive Rumination Disorder
- Mental OCD
- Intrusive Thought OCD
- Covert OCD
- Rumination-Based OCD
- Thought-Based OCD
- Subclinical Compulsion OCD
- Hidden Compulsions OCD
Clarifications:
- These names emphasise the internal nature of compulsions (mental rituals or thought patterns) and the dominance of obsessions.
- The term “Pure OCD” is somewhat misleading since most individuals with this condition do engage in compulsions, even if they are not outwardly visible.